MINNEAPOLIS — The decline in COVID-19 cases across the United States over the past several weeks has offered some relief to overwhelmed hospitals, but administrators prepare for yet another potential surge as cold weather moves people indoors.
Health experts say the fourth wave of the pandemic is peaking in the US overall, particularly in the Deep South, where hospitals were confined weeks ago. But many northern states are still grappling with rising cases, and what lies ahead for the winter is far less clear.
Unknowns include how the flu season might put pressure on hospital workers already suffocated and whether those who have refused vaccinations will change their minds.
An estimated 70 million eligible Americans remain illiterate, providing kindling for the highly contagious Delta variant.
“If you aren’t vaccinated or have protection against natural infections, this virus will find you,” warned Mike Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy.
Nationwide, the number of people now in hospital with COVID-19 has fallen to nearly 75,000, up from more than 93,000 in early September. New cases are declining on average by about 112,000 per day, a drop of about one-third over the past 2 1/2 weeks.
Deaths also appear to be declining, averaging about 1,900 per day versus more than 2,000 a week ago, though the US closed on Friday on a heart-wrenching milestone of 700,000 dead in total since the pandemic began.
The easing of the summer boom has been attributed to more mask wear and more people getting vaccinated. The reduction in the number of cases could also be due to the virus burning through susceptible people and running out of fuel in some places.
In another promising development, Merck said on Friday that its experimental pill for people sick with COVID-19 has cut hospitalizations and deaths in half. If it receives authorization from regulators, it would be the first pill to treat COVID-19 – and a vital, easy-to-use new weapon in the arsenal against the pandemic.
Now all treatments authorized against the coronavirus in the US require an IV or injection.
The government’s top infectious disease expert Dr. Anthony Fauci warned Friday that some may see encouraging trends as a reason to go without vaccination.
“It’s good news that we are starting to see curves”, he said. “This is not an excuse to shy away from the issue of needing vaccinations.”
Our Lady of the Lakes Regional Medical Center in Baton Rouge, Louisiana, saw the onset of COVID-19 hospitalizations in mid-July, and by the first week of August, the place was beyond capacity. It discontinued elective surgery and brought in military doctors and nurses to help care for patients.
With cases now subsiding, the military is due to leave in late October.
Still, the hospital’s chief medical officer, Dr. Catherine O’Neill, said the hospitalization rate is not decreasing as rapidly as cases in the community because the delta variant is affecting more young people who are otherwise healthy. are and have been in the intensive care unit on ventilators for a long time.
“It creates a lot of ICU patients who don’t go anywhere,” she said. And many patients are not going home at all. Over the past few weeks, the hospital saw as many as five COVID-19 deaths for several days, including a day when 10 deaths were reported.
“We lost another father in his 40s just a few days ago,” O’Neill said. “It continues to happen. And that is the tragedy of COVID.”
As far as the outbreak goes from here, “I have to tell you, my crystal ball has broken several times over the past two years,” she said. But she said the hospital would have to be prepared for another surge in late November, even as flu season progresses.
Systems Medical Director for Hospital Quality at Ochsner Health in Louisiana, Dr. Sandra Camarli said that this fourth surge of the epidemic has been difficult. “It’s frustrating for people to die from vaccine-preventable diseases,” she said.
At the peak of this most recent wave, Ochsner hospitals had 1,074 COVID-19 patients as of 9 August. By Thursday, it had come down to 208.
There is a shortage in other hospitals as well. The University of Mississippi Medical Center admitted 146 patients to the hospital in mid-August. On Friday, it had come down to 39. Lexington Medical Center in West Columbia, South Carolina, had more than 190 in early September, but just 49 on Friday.
But Camarli doesn’t expect this decline to continue. “I fully expect more hospitalizations because of COVID,” she said.
Like many other health professionals, Natalie Dean, a professor of biostatistics at Emory University, is taking a cautious approach about winter.
It is unclear whether the coronavirus will take on the seasonal pattern of the flu, with peaks projected in winter, as people gather indoors for the holidays. Only because of the size and diversity of the country, there will be places where outbreaks will increase further, she said.
Furthermore, the uncertainties of human behavior complicate the picture. People react to exposure by taking precautions, which slow down viral transmission. Then, feeling safe, people mingle more freely, triggering a new wave of infection.
“Infectious disease models are different from weather models,” Dean said. “A storm doesn’t change its course because of what the model said.”
An influential model from the University of Washington, projects that new cases will spike again this fall, but that vaccine protection and infection-induced immunity will prevent the virus from killing as many people as last winter.
Still, the model predicts that about 90,000 more Americans will die by January 1, for a total of 788,000 deaths by that date. The model calculates that about half of those deaths could have been avoided if nearly everyone wore masks in public.
“Mask wearing is already going in the wrong direction,” said Ali Moqdad, a professor of health metrics science at the university. “We need to make sure we’re ready for the winter because our hospitals are exhausted.”
Johnson reported from Washington state. Associated Press writer Zeke Miller told Washington, DC. contributed from
Subscribe to the bi-weekly newsletter to have health news sent straight to your inbox.