US enters brutal stretch of pandemic, even with approaching vaccines

The United States is entering an even more brutal stretch of the pandemic, with deaths now exceeding 3,000 people every day, but there is a light at the end of the tunnel from a vaccine. 

The promise of a vaccine sets up a diverging reality, where in the short term the pandemic is getting even worse, but there is reassurance that it will not last forever. Public health experts are therefore urging the public to double down on precautions to get through the toughest phase for a few months until the vaccine is widely available. 

Centers for Disease Control and Prevention (CDC) Director Robert Redfield issued a stark warning about the coming weeks on Thursday. “We are in the timeframe now that probably for the next 60 to 90 days we’re going to have more deaths per day than we had at 9/11 or we had at Pearl Harbor,” Redfield said during an event hosted by the Council on Foreign Relations. 

The U.S. is at record-breaking levels of more than 200,000 new cases every day and more than 100,000 people in the hospital. And the situation is only getting worse, especially as the surge from Thanksgiving gatherings starts to show up. 

Despite this worsening crisis, President Trump has been largely silent on the spread of the coronavirus, except to tout progress on a vaccine. He has not consistently urged the public to take precautions in the short term or announced major new steps to slow the spread until a vaccine is widely available. 

Governors have also had a fractured response, with some announcing new measures even as others largely resist restrictions amid the surge. Only 15 states have closed bars, for example, one of the main sources of spread of the virus, according to a tracker from the Kaiser Family Foundation. Congress has been deadlocked for months on additional economic aid, which could help these businesses financially while they close for public health reasons. 

Experts are urging the public to step up precautions like wearing a mask and avoiding indoor gatherings, even in private homes if people from multiple households are mixing together. The CDC is encouraging people not to travel for the holidays this month as well, given that travel is likely to lead to a further spike.

“This is going to be, I think, a brutal time for us,” Redfield said. “As I said I think it will be the most challenging time in the history of our nation from a public health perspective. And I want the public to really understand that despite what I said, that’s not written in stone if people really would embrace the strategies that we’ve asked.”

He added people should “not to let their guard down, just because they’re around family members who come to celebrate a holiday.”

The first people are likely to start getting vaccinated within days, starting with health care workers and people in nursing homes. Officials project 20 million people will be vaccinated in December. But the majority of the public will not have access to the vaccine for several months, likely sometime in the spring. 

“The fact is vaccines are not going to have a public health impact for at least several months,” Anthony Fauci, the government’s top infectious diseases expert, said Friday on a webcast hosted by the Journal of the American Medical Association. While some individuals will be protected starting this month, vaccinations will not be widespread enough to significantly slow the spread of the virus for several months. 

A rising problem is that as the pandemic gets even worse, hospital capacity is being stretched to the breaking point, threatening the quality of care that patients are able to receive. 

“We are short of ICU beds,” said Janis Orlowski, chief health care officer for the Association of American Medical Colleges, which represents academic medical centers around the country. 

“I think that we really have to see what we can do to dampen the travel and to really drive home the point that we can’t have a repeat of Thanksgiving,” she added. 

Some states have moved to significantly tighten restrictions amid the surge. Pennsylvania Gov. Tom Wolf (D) on Thursday issued a three-week “pause” that includes banning indoor dining and restricting indoor gatherings to no more than 10 people. 

But the U.S. response remains divided and many states have not taken such steps.

Ashish Jha, dean of the Brown University School of Public Health, pointed to the partial lockdowns that the UK, France and Germany imposed at the end of October as having turned around their trajectories, in contrast to the U.S., where new cases are still rising.

“At one point, both UK & France had more cases (per capita) than we did,” he tweeted. “But the three big European nations put in policies to bring the virus under control. And it’s working. And we haven’t. And it shows.”

Hospital capacity is an increasing concern as it is unclear how much worse the pandemic will get. 

“We are seeing an unfolding disaster,” said Yonatan Grad, an infectious disease expert at the Harvard T.H. Chan School of Public Health. “We’re seeing incredibly high rates of transmission. We’re seeing increasing hospitalization, we’re seeing increasing ICU bed occupancy and in many places are running up against the limits of the resources they have available to care for people.” 

“I think it’s challenging in the extreme right now and it’s going to get worse,” he added.