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It’s a worrying sign for the US ahead of vacation travel time: Coronavirus infections are on the rise in more than half of all states. Experts warn that this could be the beginning of an extended winter wave.
The spike is a reversal of the trend after cases continued to decline from mid-September through late October. The country now has an average of more than 83,000 cases per day – an increase of about 14% from a week ago and 12% more than two weeks ago.
“I hate to say it, but I suspect we are at the beginning of a new winter wave,” says Dr. George Rutherford, epidemiologist at the University of California at San Francisco.
Growing outbreaks in the Midwest and Northeast are most responsible for the rise in national numbers, and this comes after many weeks of high case numbers and stress for states in the mountain west where some hospitals are dealing with patient crises.
“There are still large parts of the country that are underimmunized, and even in states that are relatively well vaccinated like Colorado, New Mexico, Minnesota, and Vermont, we see persistent transmission,” says Rutherford.
The surge in cases has not yet been translated into a nationwide surge in new hospital admissions, which tend to follow a surge in infections by several weeks. However, the dire situation in some parts of the West and the Upper Midwest paints a worrying picture for other states where cases are now increasing.
“It’s a marathon here,” says Dr. Kencee Graves of the University of Utah Hospital in Salt Lake City, Utah, who describes her state like much of Mountain West as stuck on a “plateau of a wave” where hospitals not only have an intensive care unit full of COVID-19 patients, but also many other types of dependent patients.
Despite the worrying trends, experts modeling the course of the pandemic believe that an increase will not result in the same number of deaths and serious illnesses as last year.
“The vast majority of the population has some form of immunity,” says Nicholas Reich, a biostatist at UMass Amherst who runs a COVID-19 prediction model. “It feels really different at this moment – there are fewer people to infect.”
How bad could it get?
The increase in cases is not unexpected, given the patchwork quilt of COVID-19 immunity in the US, where approximately 60% of the population is fully vaccinated.
Americans are moving around as they were before the pandemic, wearing of masks is low compared to last year, people are spending more time indoors due to the cooler weather, and protection from infections, both vaccinations and infections, is decreasing, says Ali Mokdad. Professor of Health Metrics Sciences at the Institute of Health Metrics and Evaluation at the University of Washington.
“When you put all of this together – and what you see in Europe, where many countries with higher vaccination rates than the United States are seeing increases – it will of course happen, “he says.
And unlike last year, the US is grappling with a much more contagious version of the virus that “makes it really hard to break chains of transmission,” not to mention “human nature that wants us to go back in time.” . pandemic life, “says Reich of UMass, Amherst.
How bad the situation gets depends on the complex dynamics surrounding immunity. Southern states suffered a brutal wave this summer that may have built enough immunity to infection to save them from another major resurgence this winter. Areas that hadn’t risen as much, particularly states in the northern half of the country, are now struggling to see increases, but many also benefit from higher vaccination coverage.
“The real question is how big is it going to get, and is it really going to be significant? And I have a feeling that in New England it is going to hit a wall of vaccinated people,” says Dr. Ashish Jha, Dean of the School of Public Health at Brown University.
“I think the Midwest and Great Plains – which have lower vaccination rates but haven’t seen a large delta surge – may very well see some infections in the coming weeks and months.”
Even with a small increase, hospitals could still suffer
Even if hospitals are seeing fewer COVID-19 patients overall, it is already clear that many are less prepared for the demands of the pandemic compared to the previous year.
“Every hospital I’ve spoken to in the last month has a serious staff shortage, especially nurses,” says Dr. Bruce Siegel, President of America’s Essential Hospitals, which represents hundreds of public hospitals in the United States
At the University of Utah Hospital, Dr. Graves reported that their ICU was closed because it could no longer be occupied, and over the past month, patients have waited an average of three to five hours for an ICU bed. “Our resources and stamina are far less today than they were a year ago,” she says.
Hospitals in the southwest are also struggling with overcrowded intensive care units.
New Mexico has higher vaccination rates than many nearby states, but the state was forced to enact its crisis standards for the care plan weeks ago. Some hospitals have activated these plans, but none have moved into the most extreme scenario of deciding who will be treated and who will not, says Troy Clark, president of the New Mexico Hospital Association.
As of the spring, there was a “huge influx of patients we don’t normally see” with other urgent medical needs, says Clark. That kept the hospitals very busy until the winter – with no scope to accommodate the growing number of COVID-19 patients.
It’s a similar situation in many states, including Arizona, where hospital admissions for COVID-19 are now as high as they have been since February. “We just don’t have that extra capacity for a COVID spike,” said Ann-Marie Alameddin, president of the Arizona Hospital and Healthcare Association.
The upper Midwest now has some of the highest falls per capita in the country. Minnesota hospital leaders are asking people to be careful not to require medical care in the event of a COVID or non-COVID emergency. “This has never been more serious,” said Kelly Chandler of Itasca County Public Health, which includes the city of Grand Rapids, in a recent public statement. “We are at the 2020 crisis level, but without the same COVID precautions.”
When we go on vacation, the risk of COVID increases as more people travel and meet indoors. But “we also have some things that help, like more vaccines and kids getting vaccinated,” says Ashish Jha of Brown. “So we’re in a stalemate. I don’t expect us to have a terrible climb, but I can well imagine parts of the country seeing modest climbs when people get together and the weather stays cold.”
MediaFrolic’s Rob Stein contributed to this report.