Why this COVID surge is different from all the rest

That gap between infections and deaths is, to an extent, part of the plan. As they organized their vaccine-distribution tiers last fall, states made a risky bet.

Following guidance from the U.S. Centers for Disease Control and Prevention, they gambled they could hold off on vaccinating younger workers who, broadly speaking, tend to weather COVID, in order to put more jabs in the arms of those at highest risk of hospitalization and death. That is: seniors and people with serious comorbidities.

“The tradeoff is between SARS-CoV-2 spread and reduced hospitalizations and deaths,” Lawrence Gostin, a Georgetown University global-health expert, told The Daily Beast. “Speeding up vaccination of the young would probably reduce spread a little more, but vaccinating the vulnerable has a powerful impact on the death rate.”

Even as numbers veer in a disturbing direction, that gamble is showing signs of paying off.