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The US has reached its highest daily number of Covid-19 cases since the pandemic began, recording more than 81,400 new infections on Friday.
The surge in numbers put the US on the brink of what could be its worst stretch of the pandemic to date, with some hospitals in the West and Midwest already overwhelmed, and the death toll beginning to rise.
The current swell is considerably more widespread than the waves of last summer and spring. The unprecedented geographic spread of the current increase makes it more dangerous, and experts warn that it could lead to severe shortages of medical personnel and supplies. Hospitals already report on the shortage of basic medicines needed to treat Covid-19.
And it’s not just about scaling up evidence to identify more cases. Covid-19 hospitalizations increased in 38 states over the past week and are increasing so rapidly that many facilities in the West and Midwest are already overwhelmed. The number of deaths nationwide has exceeded 1,000 in recent days.
The last time the country hit a new daily record for coronavirus cases, 76,533 on July 17, just four states accounted for more than 40,000 of those cases: Arizona, California, Florida and Texas.
On Thursday, the daily number of cases reached 73,686. But this time, 14 states represent the same lion’s share of cases. And 22 states have broken their records for maximum cases in a single day in the past two weeks.
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More than 170 counties in 36 states were designated as fast-growing hotspots, according to an internal federal report prepared Thursday for Department of Health and Human Services officials and obtained by The Washington Post.
“A key way to overcome previous waves was to relocate healthcare workers. That’s just not possible when the virus is on the rise everywhere,” said Boston University epidemiologist Eleanor J. Murray.
Equally alarming, Murray said, is that no one knows how high this wave will grow before it reaches its peak.
“We are starting this wave much higher than any of the previous waves,” he said. “And it will just keep going up until people and officials decide to do something about it.”
Jae C. Hong / AP
Romelia Navarro, right, is comforted by a nurse as she cries while sitting next to the bed of her dying husband, Antonio, in the Covid-19 unit at St Jude Medical Center in Fullerton, California.
More than 8.3 million Americans so far have been infected with the coronavirus, and at least 222,000 have died, according to a database maintained by The Washington Post.
The high number of cases in recent days has stoked concerns that the country has not even made it to the holiday season and cold weather, which experts have long warned will cause cases to skyrocket even more.
More interactions could mean more streaming during Halloween, Christmas, and New Years celebrations. The cold, dry air of winter will also help the virus stay stable longer, even as it leads people to shelter indoors together.
On Thursday, Chicago Mayor Lori Lightfoot announced new restrictions on businesses. Hours later, the White House’s coronavirus response coordinator, Deborah Birx, warned that closing public spaces might not be enough.
“It won’t be as simple as closing public spaces,” Birx said, noting the increase in gatherings in people’s homes.
“What has happened in the last three or four weeks is that people have moved their social gatherings indoors.”
J. Scott Applewhite / AP
In September, activists from the Covid Memorial Project marked the deaths of 200,000 lives lost in the United States to the virus.
In some areas of Wisconsin, 90 percent of hospital intensive care unit beds are full, said the office of Democratic Gov. Tony Evers. The first patient was admitted Wednesday to a makeshift field hospital built on a state fairgrounds.
Hospitals from Missouri to Idaho are beginning to reach capacity. On Thursday, the United States had more than 40,000 current hospitalizations for COVID-19, the first time that level has been reached since August.
In the past three weeks, 34 states saw sizable increases in hospitalizations, and the number has more than doubled in Connecticut, Montana, New Mexico and Wyoming.
In Utah, leaders are trying to open a field hospital in an exhibition center. State epidemiologist Angela Dunn warned that the health care system is maxed out, hospital staff are exhausted, and Utahns are freaking out.
“You know, I just don’t know what to do anymore,” Dunn said at a news conference Thursday, asking residents to be more cautious.
“I’m not really trying to scare anyone. I’m just trying to inform you of what’s going on.”
Experts said the problem many hospitals are facing this winter will not be finding enough beds. It will ensure that hospitals have sufficient specialized staff.
“Creating beds is relatively easy, but what do you do when you get past the nurses, doctors and ICU teams?” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
Mark Lennihan / AP
In this May 28, 2020 photo, a woman walks past a fence in front of Brooklyn’s Green-Wood Cemetery adorned with tributes to the victims of Covid-19 in New York.
In recent months, healthcare workers have been able to reduce death rates, the proportion of patients who die once infected. Much of that progress is due to the hard-earned experience of ICU staff – new approaches and insights into how to combat the virus, such as when to use ventilators, the adoption of treatments such as steroids, and patients with pronation, which help with breathing by shifting them into your abdomens.
But the hard-won battle to reduce death rates could be in jeopardy as hospitals are overwhelmed and staff stretches, Osterholm said. And as the pandemic has crept into rural areas of the Midwest, the minimum staffing in smaller hospitals is being reduced even further as doctors and nurses fall ill.
A report this week from the Osterholm center showed shortages in 29 of the 40 basic but critical drugs often used for Covid-19 patients. That includes antibiotics, sedatives like propofol that are used to calm patients during intubation, and heart medications like norepinephrine. And because of the widespread nature of infections, hospitals find it more difficult to stock up on those drugs elsewhere.
America’s growing fatigue with the pandemic will likely make it even more difficult to contain a winter wave, specialists fear.
Even when hundreds of people die each day, “there is this false sense of calm right now,” said Tom Inglesby, director of the Johns Hopkins Center for Health Safety.
“We have the president saying, ‘We are just around the corner.’ We have state leaders who openly defy public health guidelines. “
Inglesby pointed to the plans and metrics that many states submitted last spring for reopening. “That has been completely ignored in many places,” he said.
In North Dakota, one of the hardest hit states, Republican Gov. Doug Burgum instructed people to wear masks and avoid gatherings.
“It is not a job for the government,” Burgum recently declared.
Jabin Botsford / The Washington Post
President Donald Trump and Democratic presidential candidate Joe Biden participate in the final presidential debate on the Belmont University campus on October 22, in Nashville.
In the last presidential debate on Thursday night, President Donald Trump claimed that the virus was “disappearing” and “we are learning to live with it.” The Democratic rival, former Vice President Joe Biden, responded: “We are learning to die from it.”
Experts say leaders and residents need quick action to stop the spread of the virus.
“It has been framed as a false choice between total shutdowns and doing nothing, but that’s not the case,” said Inglesby, who urged people to wear masks and avoid large gatherings.
Politicians must also stop minimizing the risk posed by the virus and start discussing tough decisions and trade-offs that lie ahead openly with the public, Murray said. Is it worth it, for example, to keep bars open if it means having to close schools?
“Sometimes I worry about being too pessimistic,” he said.
“We are not making predictions and saying that this dark winter is somehow inevitable. We are trying to warn people that it will be if we don’t do something about it.”
“But it does not have to be like that”.
