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The US Is About To Hit Its Pivotal Pandemic Moment

The US has the highest COVID death toll in the world. Hospitals and morgues are packed across the nation. But three promising vaccine trials offer a glimmer of long-term hope.

Posted on November 23, 2020, at 6:24 p.m. ET

Mario Tama / Getty Images

An inmate prepares to load bodies into a refrigerated temporary morgue trailer in a parking lot of the El Paso County Medical Examiner's office on Nov. 16.

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The US is currently in perhaps the most consequential moment of the coronavirus pandemic, a dreaded time of rapidly increasing cases — overwhelming hospitals and morgues nationwide — that is intersecting with newfound hope that several vaccines could roll out across the country in the next year.

What’s especially scary about this much-dreaded third wave, with record-breaking numbers of people being diagnosed and hospitalized with COVID-19, is that it will likely get much worse, as temperatures dip and holiday travel increases over the next few weeks.

Even with a vaccine within tantalizing reach and advances in treatments that mean fewer people diagnosed with COVID-19 are dying as a result, the current numbers reflect a grim reality in America:

  • The US now has the highest coronavirus death toll in the world, with more than 257,000 deaths.
  • On average, more than 1,300 people are dying of COVID every day — the highest level since May.
  • There are over 11.8 million confirmed infections in the country after a record high of nearly 200,000 cases reported on a single day on Nov. 20.
  • Nationwide hospitalizations have hit record highs for 13 straight days, with more than 83,000 people hospitalized as of Sunday.
  • Hospitals in at least 25 states are reporting dangerous shortages of doctors, nurses, and other staff.

News reports and anecdotes illustrating the human toll of the virus are staggering. El Paso County in Texas had to request additional volunteers to help with transporting bodies in morgues overflowing with COVID-19 victims — the grim task became so overwhelming that the National Guard was called in to help. There are long lines for food in Dallas and Los Angeles and for COVID-19 tests in New York and Massachusetts. And hospitals across the country are running out of space and, more critically, staff. Wisconsin officials said hospitals in the state were close to a “tipping point” where they will “stop being able to save everyone who gets severely ill.” In Minnesota, intensive care units were at 97% capacity, with one doctor saying, “There’s no beds anywhere.”

Overworked healthcare workers are pleading with people to follow basic guidelines and not to travel during the holidays. Rural hospitals are struggling with scarcity of staff, funds, and protective equipment. And Americans continue to mourn the loss of their loved ones while struggling to cope with the devastating socio-economic hardships of the pandemic: Millions of unemployed people will lose benefits, and a wave of evictions will deepen the homelessness crisis as coronavirus relief programs and orders expire at the end of the year. Meanwhile, the government cannot agree on a relief bill.

In a last-minute warning, the CDC advised Americans against traveling for Thanksgiving, and public health professionals urged people to restrict their indoor celebrations to household residents. But despite experts’ dire warnings, the TSA screened more than 3 million people between Friday and Sunday, the highest three-day total since mid-March.

Kena Betancur / Getty Images

Travelers at Newark International Airport on Nov. 21.

The government is barely helping. People across the country are traveling in droves to see their loved ones after months of “COVID fatigue,” brought on by confusing and ever-changing local and state regulations. Elected officials would rather stoke culture wars over the pandemic than release quality information. There is weak guidance from the federal government.

President Donald Trump, for his part, has spent the past two weeks refusing to accept his defeat in the election, tweeting lies about voter fraud, and golfing. When he did tweet about COVID, it was either to deflect blame from his administration’s gross mishandling of the pandemic or to claim credit for positive vaccine data.

Where COVID-19 hot spots were once contained in big cities like New York or across the Midwest region, now any number of cities and states can be considered hot spots depending on the metrics, the New York Times reported. At least 51 states and territories saw a more than 25% increase in COVID cases in the last two weeks compared to the previous two weeks, according to an NBC News analysis. The highest-risk states currently include North and South Dakota, Wyoming, New Mexico, and Minnesota, according to NPR.

The alarming surge in cases has forced governors and mayors across many states to impose lockdowns and tighten restrictions in recent weeks. California enforced a nighttime curfew requiring residents to stay at home from 10 p.m. to 5 a.m. for all nonessential activities until Dec. 21. In-person dining is forbidden for at least three weeks in LA County starting Nov. 25. In a controversial move, New York City closed its public schools again — after a confusing announcement — and the state is likely heading for additional restrictions on restaurants, gyms, and businesses. At least 25 states have tightened restrictions in November, including mask mandates, curfews, and restrictions on social gatherings, according to a USA Today analysis.

Even as the country grapples with what experts fear will be a long, dark, third wave of COVID-19, there is promise on the horizon in the form of three vaccines. On Monday, Oxford University announced preliminary results showing that its coronavirus vaccine is 70% effective, according to early data from clinical trials. Earlier this month, Pfizer and Moderna announced that trials for their vaccines indicated that they are more than 90% effective. Last week, Pfizer became the first drug company to submit its vaccine for emergency authorization by the FDA.

The White House vaccine chief told CNN Sunday that if the agency approves the vaccine, healthcare workers in the US could be vaccinated as early as Dec. 11 or 12. The FDA requires a vaccine to be at least 50% effective before authorizing its use.

Even as he acknowledged the vaccine trial results as “extraordinarily impressive,” the nation’s top infectious disease expert, Dr. Anthony Fauci, has urged Americans to “double down” on public health measures, including mask wearing, social distancing, and avoiding congregating, as the country awaits the shots.

President-elect Joe Biden’s coronavirus team will have to oversee an unprecedented campaign to vaccinate millions while managing logistical barriers to get the vaccine across the country and then convince people to get their shots amid growing mistrust. All three vaccines require two shots several weeks apart, and Pfizer’s vaccine needs to be stored in ultra-cold temperatures that may make it hard for rural hospitals to store and use the vaccine.

“Now, I’ve used that metaphor that ‘the cavalry is on the way,’” Fauci said at a White House press briefing earlier this month. “If you’re fighting a battle and the cavalry is on the way, you don’t stop shooting; you keep going until the cavalry gets here, and then you might even want to continue fighting.”


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