First signs of Thanksgiving COVID-19 wave emerge

The first signs of a post-Thanksgiving surge in coronavirus cases are beginning to show up in data released by states across the country in a troubling prelude of what may become the deadliest month of the pandemic so far.

Those hints of an uptick in case counts come as the country faces an already substantial wave of infections that began in the Upper Midwest and spread to every corner of the map as summer turned to fall and the weather cooled.

The United States has averaged nearly 200,000 new confirmed cases a day over the last week, according to The Covid Tracking Project, run by a group of independent researchers. More than 2,200 people a day have died on an average during that period. The number of patients being treated in hospitals has crested 102,000, the highest levels of the pandemic.

The country still lacks a national testing strategy that public health experts say is essential to bringing the pandemic under control. President Trump’s remarks about the virus have become few and far between, even as he continues to hold in-person events where attendees are mostly maskless. The White House held a vaccine summit on Tuesday, though representatives from the two companies that have produced the earliest vaccines were not present.

There are some hopeful signs that the third wave is ebbing in parts of the Midwest. The number of newly confirmed cases has declined for two straight weeks in 10 states, including hard-hit Wisconsin, Iowa, Michigan and New Mexico.

But new data shows other states experiencing substantial increases. In Alabama, where authorities reported about 14,000 new cases a week through middle and late November, case counts jumped to more than 22,000 in the first week of December. Georgia’s case counts rose in early December by about 50 percent from its November figures. Florida cases spiked to 65,000 last week, a substantial increase over its averages last month.

“At this point, we could be just picking up the beginning of the Thanksgiving surge, but surely in the following week we’re going to see it,” said Michael Osterholm, director of the Center for Infectious Disease Research and Prevention at the University of Minnesota. “We’re slingshotting this surge of cases into the holiday season in a way that is truly dangerous.”

Cases have risen over the last week in 38 states and the District of Columbia. In the summer wave, the virus was spreading fastest in Arizona, where at its peak 380 residents per 100,000 were becoming infected every week; now, 35 states have per capita infection rates higher than that.

Several states have already opened field hospitals to handle the new surge. In California, Los Angeles County and the Bay Area are reimposing harsh lockdowns to try to contain the spread. In Wyoming, Gov. Mark Gordon (R) issued his first statewide mask mandate.

In another troubling sign, the percentage of patients diagnosed with COVID-19 who are admitted to hospitals is declining. That suggests that some medical facilities, concerned about space and staff levels, are sending home some people who might have been admitted earlier in the year, compromising their ability to monitor a very sick person and intervene immediately if necessary.

There is hope that highly effective vaccines created by Pfizer and the German pharmaceutical firm BioNTech and by Moderna will win approval from federal regulators in the coming days, but distribution challenges mean it will still be months until the bulk of Americans get access to either.

Until then, epidemiologists and public health experts say they remain concerned that the number of cases will continue to spike, especially if Americans treat the winter holiday season as casually as they did Thanksgiving, when millions got on planes or drove to be with friends and family outside their immediate households.

“The United States is going to kind of muddle through this until there’s a vaccine,” said Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. “It’s becoming increasingly unlikely that we will gain control of this until we have a vaccine.”

In that dangerous interregnum between vaccine approval and widespread deployment, millions of Americans are at risk of infection and thousands will die. Projections from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington School of Medicine estimate another 265,000 people will die in the United States by April 1.

“Mass scale-up of vaccination in 2021 means we have a path back to normal life, but there are still a few rough months ahead,” IHME Director Christopher Murray said in a statement.

And those estimates cover only deaths from COVID-19. Health experts are just as worried about deaths tangentially related to the pandemic. If hospitals are overrun by coronavirus patients, those who need immediate care for other health crises — heart attacks, strokes or injuries — may find that care is not as available as it might be under normal circumstances.

“We’re now worrying about hospital capacity in December,” Adalja said. “It’s not just the direct deaths.”

There is already evidence that the number of drug overdoses has increased during the pandemic. The number of cancer screenings has declined markedly, raising concerns that early-stage cancers will go undetected until they become far more deadly.

The pandemic fatigue that has settled on a nation exhausted by months of lockdowns, social distancing and economic pain is a vexing problem for public health officials who need Americans to hang on now that an end is in sight. Some say the messages politicians and public health officials send need to be tougher than it has been.

“I wish every person could spend 30 minutes in the corner of an ICU. They would have a very different sense of reality,” Osterholm said. “When people start dying in emergency rooms because they can’t get a bed, maybe that’s when Americans will get a different sense of reality.”