The Herman Cain Award subreddit is just overflowing with publicly declared anti-vaxxers dying, like by the hour it seems. It's just shocking how many people are kicking the bucket right now.
On my way home from a family gettogether where I heard of deaths and severe illness in distant relatives, I started thinking about what form the transition to endemicity of the virus could take. I live in Jacksonville and things are really bad here in the unvaccinated population. That probably colors my thoughts more negative than the issue deserves. In any case, here is what I wrote down when I got home. I think there is a possibility that the unvaccinated are going to be absolutely screwed as vaccination rates are going up:
I am slowly becoming more and more supicious that Delta is more virulent than previous variants.
Generally, transmissible pathogens do not do well in terms of becoming endemic if their virulence is excessive, but this is not always true, particularly with zoonotic diseases. But now we have a large population of vaccinated people in whom the virus can circulate with minimal mortality.
Maybe this has removed the brake on virulence similar to what is seen in zoonotic diseases like Ebola.
In other words, the vaccinated are to the unvaccinated what bats are to humans in areas where Ebola is endemic. Combine this with the close contact of this population with the susceptible, unvaccinated population and one comes up with the, not at all desirable, situation that ever more lethal variants could freely circulate exterminating over time the unvaccinated adult population. (immunity conveyed via infection in adults doe not appear to be protective in the long run, whereas children are probably more likely to develop robust immunity from infection)
I now can imagine the entering of the endemic stage to be accompanied by a massive die-off of the unlucky unvaccinated population.
What I am saying here is not more than basic evolutionary biology: The apparent decrease over time in virulence of a successful endemic pathogen is not necessarily mediated by a change of the pathogen but also by a major mortality event in the host population selecting for resistant varieties and resulting in an apparent decrease in virulence.
The depopulation of the Americas by infectious diseases after contact with Europeans comes to mind, but there are many other examples, particularly in plant diseases (Dutch elm disease and others).
Well, food for thought, nothing more.