New President Joe Biden takes office as the US death toll from Covid-19 has exceeded the number of American troops killed in World War II.
Here's where things stand and what we might be able to expect in the coming weeks and months.
(ROBERTO SCHMIDT AFP/File / MANILA BULLETIN)
By the numbers
Almost a year after the first recorded death from the coronavirus in the US, a further 406,000 people have died, according to a tracker maintained by Johns Hopkins University.
But the seven-day average of new cases began dropping after peaking on January 12, according to data maintained by the Covid Tracking Project, and deaths are tracking a similar trajectory.
An ensemble forecast by the Centers for Disease Control and Prevention, which takes an average of 37 models, projects that by February 13 there will be a total of between 465,000 to 508,000 Covid-19 deaths.
Variants threat
Models, of course, are only as good as the assumptions that feed them, and there are a number of variables that could alter the picture.
First -- the virus itself, and the rise of variants.
A CDC projection last week estimated that the highly-transmissible B.1.1.7, which is currently not thought to be widespread, could become the dominant strain in the US by March, supercharging the infection rate.
Additional variants that appear to be more transmissible have been reported from South Africa and from Brazil -- so far they don't appear to be in the United States, but the country has an underpowered "genomic surveillance" system to keep track.
Of particular concern is the E484K mutation from South Africa, which has raised concerns over vaccine effectiveness.
Trevor Bedford, an infectious diseases scientist at the Fred Hutch research center, tweeted Wednesday: "We need to investigate the manufacturing timeline and regulatory steps required to update the 'strain' used in the vaccine," and suggested an "update" may be needed by fall.
The Biden plan
On the other hand, viruses need available hosts to infect, and strong public health policies would bend the curve down.
Biden has made confronting the pandemic a top priority, and his team has unveiled a detailed national strategy that would bring to bear the power of the federal government to ramp up the rate of vaccinations and testing.
The administration is also seeking a $1.9 trillion Covid relief and economic stimulus package from Congress, including $20 billion for vaccines and $50 billion to scale up testing -- essential to getting children back to school and workers back to work.
As of Wednesday, 35.9 million doses of Pfizer and Moderna shots have been distributed to states, while 16.5 million have reached arms as either the first or second injection -- a rate of 46 percent.
Biden's administration is seeking to vaccinate 100 million people in his first 100 days of office, that is by April 20.
Officials say they will invoke emergency legislation called the Defense Production Act to boost supply -- and set up thousands of federal vaccine sites as well as mobile clinics to clear up the distribution bottlenecks.
The supply side should also improve when other vaccines receive emergency authorization.
It's hoped that the one-dose Johnson & Johnson shot will be a gamechanger, and it could be greenlit in as little as a few weeks. The AstraZeneca-Oxford vaccine would likely follow.
#ScienceIsBack
The administration has also won early praise from epidemiologists for once more centering an evidence-based approach, and rescinding an order to withdraw from the World Health Organization.
"The first full day of the Biden administration, and there is a national plan laying out a comprehensive approach to addressing #covid19, from testing to vaccines, from securing PPE supply to protecting workers. If only we had this months ago," tweeted George Washington University public health professor Leana Wen.
New CDC director Rochelle Walensky said Wednesday she was ordering a review of all existing guidance related to Covid-19, interpreted as a reference to the censoring of government scientists by Trump officials.