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As Covid-19 Hospitalizations, Infections and Deaths Soar, Leaders Warn of Perilous Winter


The coronavirus pandemic in the U.S. continued down a dark road this week, one likely to grow darker in weeks to come.


More than 100,000 patients with Covid-19 filled hospital beds across the nation, a record that dwarfs peaks in hospitalizations months ago. Confirmed cases hit a new daily high Thursday of 217,664, and coronavirus deaths rose to a record 2,879, according to data from Johns Hopkins University, after the long Thanksgiving weekend disrupted reporting.


State and local leaders instituted new, stricter mitigation measures to thwart the spread, while reopening field hospitals. Public health leaders warned of a perilous winter, with the looming impacts of holiday travel and gatherings expected to exacerbate the situation in the weeks ahead.

The strong language echoed dire predictions made in the spring as deaths mounted in early hotspots. Only this time, the virus is already widespread and the U.S. is contending with pandemic fatigue, compounded by a desire to be with family during the holiday season after months of isolation.

“I don’t see it getting better. I only see it getting worse,” said Patricia Kissinger, an infectious disease epidemiologist from Tulane University School of Public Health and Tropical Medicine. “It’s just not a good scenario.”


The Covid-19 death toll could reach nearly 450,000 by February, Centers for Disease Control and Prevention Director Robert Redfield said this week. Speaking in an interview hosted by the U.S. Chamber of Commerce Foundation, he said December, January and February are lining up as very tough months for a pandemic-weary nation.


“I actually believe they’re going to be the most difficult time in the public health history of this nation, largely because of the stress that it’s going to put on our health-care system,” Dr. Redfield said.

Many epidemiologists say it is too soon to see the full impact of increased travel and gatherings for Thanksgiving, as the incubation period for the virus can last up to 14 days, and there can be lags in state case reporting.


Increased travel for the holiday season began two weeks ago as college students returned home and Americans spread across the country despite warnings from the CDC. Millions of people passed through airports, according to data from Transportation Security Administration, with a pandemic record of 1.17 million air travelers this past Sunday.


“It’s scary to kind of anticipate it, but at the same time, I’d rather have a more positive belief in the population’s ability to self-guide and mitigate,” said Thomas Miller, chief medical officer at University of Utah Health. “And if not that, that’s even more of a message coming up on Christmas.”


Gatherings on holidays like Labor Day and Halloween led to increased case counts this year. Thanksgiving and the holidays shortly thereafter arrive at a precarious time, as cases, hospitalizations and deaths hit new highs across the country. The added impact of a possible post-holiday surge makes containment all the more challenging. The higher the virus’s prevalence in a community, epidemiologists say, the greater the chance of transmitting it.


“The fact is, any gathering of people for any reason, particularly without masking and social distancing, is a dangerous event,” Maine Gov. Janet Mills said Friday, while extending a requirement for venues like bars and restaurants to close by 9 p.m. "If we are not able to get this virus under control, other steps may be necessary."


Anthony Fauci, the federal government’s top infectious disease expert, warned Friday that a peak after Thanksgiving may not follow for two to three weeks after the holiday. “That’s the concerning thing, because the numbers in and of themselves are alarming,” Dr. Fauci told NBC’s Today Show.

The Thanksgiving holiday caused a temporary slowdown in data reporting by states. Seven-day averages for both new Covid-19 cases and deaths sank starting on Thanksgiving, interrupting what had been a steady upward climb as worsening outbreaks spread throughout the country. But those averages were climbing again this week, according to a Wall Street Journal analysis of data collected by Johns Hopkins University.


There may be some catch-up effect as states report a backlog of data, but it isn’t possible to tell how large this holiday backlog is, according to the Covid Tracking Project, which saw a holiday data-reporting lag in its own figures. The Covid Tracking Project said Thursday it wasn’t yet seeing an increase in cases due to Thanksgiving weekend exposure, and that it remained too soon given the pace of disease progression and how long it takes for states to report new cases.

Hospitalization data aren’t lagging in the same way and remain at record levels. The number of people currently hospitalized topped 100,000 for the second day in a row Thursday, according to the Covid Tracking Project.


The surging cases and hospitalizations point to grim weeks ahead, even as hopes rise for effective vaccines to mitigate the virus threat. The CDC’s most recent projections, a combined view from about three dozen groups that produce modeling forecasts, shows total Covid-19 deaths could reach between 303,000 to 329,000 by the day after Christmas, meaning a possible 52,000 additional deaths.


“We are very concerned,” said Dr. Miller, chief medical officer at the University of Utah Health. “At the current case rate, it’s tough.”


In hard-hit parts of the country, where intensive-care units have been overwhelmed, hospitals have been forced to move patients to other health-care systems and limit elective surgeries to make more room. Staffing shortages have prompted administrators to search for more nurses, and rural hospitals are struggling as large systems they typically depend on for additional needs are overrun themselves.

In Nebraska, coronavirus-related hospitalizations have shown early signs of slowing slightly over the last week. But health-care professionals are keeping a close eye on case counts after Thanksgiving, anticipating the impact in hospitals in the weeks to come.


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SHARE Dec 4, 2020 at 4:30 pm ET As Covid-19 Hospitalizations, Infections and Deaths Soar, Leaders Warn of Perilous Winter By Jennifer Calfas and Jon Kamp Family members gathered Thursday at the funeral of Humberto Rosales, a 49-year-old El Paso, Texas, man who died from Covid-19 complications.PAUL RATJE/AGENCE FRANCE-PRESSE/GETTY IMAGES The coronavirus pandemic in the U.S. continued down a dark road this week, one likely to grow darker in weeks to come. More than 100,000 patients with Covid-19 filled hospital beds across the nation, a record that dwarfs peaks in hospitalizations months ago. Confirmed cases hit a new daily high Thursday of 217,664, and coronavirus deaths rose to a record 2,879, according to data from Johns Hopkins University, after the long Thanksgiving weekend disrupted reporting. State and local leaders instituted new, stricter mitigation measures to thwart the spread, while reopening field hospitals. Public health leaders warned of a perilous winter, with the looming impacts of holiday travel and gatherings expected to exacerbate the situation in the weeks ahead. The strong language echoed dire predictions made in the spring as deaths mounted in early hotspots. Only this time, the virus is already widespread and the U.S. is contending with pandemic fatigue, compounded by a desire to be with family during the holiday season after months of isolation. “I don’t see it getting better. I only see it getting worse,” said Patricia Kissinger, an infectious disease epidemiologist from Tulane University School of Public Health and Tropical Medicine. “It’s just not a good scenario.” The Covid-19 death toll could reach nearly 450,000 by February, Centers for Disease Control and Prevention Director Robert Redfield said this week. Speaking in an interview hosted by the U.S. Chamber of Commerce Foundation, he said December, January and February are lining up as very tough months for a pandemic-weary nation. “I actually believe they’re going to be the most difficult time in the public health history of this nation, largely because of the stress that it’s going to put on our health-care system,” Dr. Redfield said. Many epidemiologists say it is too soon to see the full impact of increased travel and gatherings for Thanksgiving, as the incubation period for the virus can last up to 14 days, and there can be lags in state case reporting. Increased travel for the holiday season began two weeks ago as college students returned home and Americans spread across the country despite warnings from the CDC. Millions of people passed through airports, according to data from Transportation Security Administration, with a pandemic record of 1.17 million air travelers this past Sunday. “It’s scary to kind of anticipate it, but at the same time, I’d rather have a more positive belief in the population’s ability to self-guide and mitigate,” said Thomas Miller, chief medical officer at University of Utah Health. “And if not that, that’s even more of a message coming up on Christmas.” Gatherings on holidays like Labor Day and Halloween led to increased case counts this year. Thanksgiving and the holidays shortly thereafter arrive at a precarious time, as cases, hospitalizations and deaths hit new highs across the country. The added impact of a possible post-holiday surge makes containment all the more challenging. The higher the virus’s prevalence in a community, epidemiologists say, the greater the chance of transmitting it. “The fact is, any gathering of people for any reason, particularly without masking and social distancing, is a dangerous event,” Maine Gov. Janet Mills said Friday, while extending a requirement for venues like bars and restaurants to close by 9 p.m. "If we are not able to get this virus under control, other steps may be necessary." Anthony Fauci, the federal government’s top infectious disease expert, warned Friday that a peak after Thanksgiving may not follow for two to three weeks after the holiday. “That’s the concerning thing, because the numbers in and of themselves are alarming,” Dr. Fauci told NBC’s Today Show. The Thanksgiving holiday caused a temporary slowdown in data reporting by states. Seven-day averages for both new Covid-19 cases and deaths sank starting on Thanksgiving, interrupting what had been a steady upward climb as worsening outbreaks spread throughout the country. But those averages were climbing again this week, according to a Wall Street Journal analysis of data collected by Johns Hopkins University. There may be some catch-up effect as states report a backlog of data, but it isn’t possible to tell how large this holiday backlog is, according to the Covid Tracking Project, which saw a holiday data-reporting lag in its own figures. The Covid Tracking Project said Thursday it wasn’t yet seeing an increase in cases due to Thanksgiving weekend exposure, and that it remained too soon given the pace of disease progression and how long it takes for states to report new cases. Hospitalization data aren’t lagging in the same way and remain at record levels. The number of people currently hospitalized topped 100,000 for the second day in a row Thursday, according to the Covid Tracking Project. The surging cases and hospitalizations point to grim weeks ahead, even as hopes rise for effective vaccines to mitigate the virus threat. The CDC’s most recent projections, a combined view from about three dozen groups that produce modeling forecasts, shows total Covid-19 deaths could reach between 303,000 to 329,000 by the day after Christmas, meaning a possible 52,000 additional deaths. “We are very concerned,” said Dr. Miller, chief medical officer at the University of Utah Health. “At the current case rate, it’s tough.”

In hard-hit parts of the country, where intensive-care units have been overwhelmed, hospitals have been forced to move patients to other health-care systems and limit elective surgeries to make more room. Staffing shortages have prompted administrators to search for more nurses, and rural hospitals are struggling as large systems they typically depend on for additional needs are overrun themselves. In Nebraska, coronavirus-related hospitalizations have shown early signs of slowing slightly over the last week. But health-care professionals are keeping a close eye on case counts after Thanksgiving, anticipating the impact in hospitals in the weeks to come.

“I’m hoping that we don’t see an associated spike in hospitalizations and subsequent deaths, but we’re really preparing for that possibility,” said Jasmine Marcelin, an infectious-disease physician and assistant professor at the University of Nebraska Medical Center.

Over the course of the pandemic, improved treatments have helped more patients recover from the virus and reduced lengths of stay. But crowded ICU rooms and limited staffing threatens that progress.

These metrics are helping inform new restrictions from elected officials. In California, Gov. Gavin Newsom said Thursday regional stay-at-home orders would close nonessential businesses if ICU availability dropped below 15%. The Democratic governor said he expected the measures to take effect in parts of the state in the next week. Projections he made earlier this week showed ICU capacity statewide overrun by Christmas Eve.

On Friday, health leaders in five Bay Area counties and the city of Berkeley instituted new restrictions under the state’s regional plan before meeting that threshold, saying a more aggressive action was needed sooner rather than later.

“We cannot wait until after we have driven off the cliff to pull the emergency break,” said Santa Clara County Health Officer Sara Cody.

On Friday, health leaders in five Bay Area counties and the city of Berkeley instituted new restrictions under the state’s regional plan before meeting that threshold, saying a more aggressive action was needed sooner rather than later.

“We cannot wait until after we have driven off the cliff to pull the emergency break,” said Santa Clara County Health Officer Sara Cody.

In New Jersey, Gov. Phil Murphy this week urged residents to stay in the state, while New Mexico and Oregon unveiled new tiered systems to mark restrictions for different counties. Current mortality projections are “not a fait accompli,” the CDC’s Dr. Redfield said. Virus-mitigation steps like limiting crowds, wearing masks and a CDC push for states to begin diagnosing asymptomatic infections through surveillance can help.

With encouraging news about vaccines in recent weeks, doctors, public-health leaders and elected officials have urged Americans to remain vigilant. On Friday, the CDC emphasized the universal role of face masks, increased testing and physical distancing, saying “a multipronged approach to implementing all evidence-based public health strategies at both the individual and community levels is essential.”

Vaccines likely won't be available to the general public for months and, without an adherence to mask-wearing, physical distancing and other ways to slow the spread of the coronavirus, this record-setting surge will continue, they say.

“We cannot let our guards down,” Dr. Marcelin said. “And we cannot become complacent.” “I want people to think about the vaccines as the icing on the cake,” she added.



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