The nationwide surge in coronavirus cases is forcing many school districts to pull back from in-person instruction, Axios’ Marisa Fernandez reports.
Why it matters:Remote learning is a burden on parents, teachers and students. But the wave of new infections, and its strain on some hospitals’ capacity, makes all forms of reopening harder to justify.
Where it stands:Over 60% of U.S. public school students will be attending schools with in-person options, up 20% from Labor Day, Education Dive reports. But some of those districts are pulling back.
Spikes in COVID-19 cases are forcing two Salt Lake County high schools to close their doors and switch to online-only instruction — in a district where half the high schools were already closed, the Salt Lake Tribune reports.
Both Boston and Chicago’s public school districts shut down in-person learning as health officials investigate outbreaks in nearby suburbs.
Nineteen Minnesota counties are on the verge of closing their K-12 schools for the foreseeable future because of rising coronavirus cases, the Pioneer Press reports.
The other side: Early evidence suggests that in-person school reopenings have been safe — and fears that they’d become hotspots haven’t come to pass.
Some experts say local governments trying to contain their outbreaks should close bars and restaurants first, shutting down schools only as a last resort.
That’s the approach Germany took this week. The government will allow schools and day cares to remain open while paying bars and restaurants to shut down, in an effort to curb the rise in cases.
The bottom line:School districts are in a tough spot as they try to juggle the safety of their staff, frustrated parents and the needs of their students.
At least 1,004 new coronavirus deaths and 90,728 new cases were reported in the United States on Oct. 29. Over the past week, there have been an average of 77,865 cases per day, an increase of 42 percent from the average two weeks earlier.
As of Friday afternoon, more than 9,078,400 people in the United States have been infected with the coronavirus and at least 229,200 have died, according to a New York Times database.
Case numbers in the United States have reached alarming new records in recent days as outbreaks continue to grow across the country. Though rural counties and small metro areas continue to see some of the worst growth, infections are also rising rapidly around major cities like Chicago and Milwaukee.
The national trajectory is worsening rapidly. Wisconsin has opened a field hospital. North Dakota, which not long ago had relatively few cases, has grown so overwhelmed that it has now ended most contact tracing. Cases have reached record levels recently in more than 20 states, including Illinois, Tennessee, New Mexico, Nebraska and Utah.
Nearly half a million people in the United States have contracted the novel coronavirus in the last seven days, according to a Reuters tally, as cases and hospitalizations set fresh records in hot spots in the Midwest.
More than 5,600 people died from the virus nationwide in the last week, with hospitalizations shooting up 13%, a Reuters analysis showed.
Illinois, which has emerged as a hot spot in recent weeks, reported over 31,000 new cases in the last seven days, more new infections than any other state except Texas.
To try and contain the surge, Illinois Governor J.B. Pritzker imposed fresh rounds of restrictions in six of 11 regions.
Indoor dining in bars and restaurants will be suspended by Wednesday and gatherings will be limited to 25 people under a state formula that triggers ‘mitigation’ when the positivity rate tops 8% for at least two days in a row. The affected areas include some Chicago suburbs.
Other states have walked back reopening plans to curb the spread of the virus as cooler weather sets in across most of the nation.
Idaho Governor Brad Little on Monday announced indoor gatherings of more than 50 people would be prohibited, and outdoor gatherings are to be capped at 25% capacity.
Health experts believe the virus is surging because of private social gatherings, colder temperatures driving people inside, and fatigue with COVID-19 precautions.
Beyond the Midwest, the Texas city of El Paso is also facing a surge in cases that is overwhelming local hospitals, with officials setting up an alternate care facility to help relieve medical centers.
“We are seeing all sorts of patients. The narrative historically has been the above-65, those with multiple co-morbidities. But we’re seeing 20-year-olds. We’re seeing 30-year-olds, 40-year-olds,” Dr. Ogechika Alozie, an infectious disease specialist in El Paso, told Reuters. “There’s that exhaustion, but again, we buckle up and we take care of the patients.”
U.S. President Donald Trump, facing a tough re-election battle on Nov. 3, lashed out again at reports that the coronavirus is surging, and reiterated his false claim that the country is “rounding the turn” in its battle with the virus that has killed more than 225,800 people.
Pennsylvania, a hotly contested ‘battleground’ state in next week’s election, on Tuesday reported a fresh record in new coronavirus cases, according to the state’s health department.
The number of people hospitalized with the coronavirus has climbed significantly from a month ago, straining cities that have fewer resources to weather the surges.
The patient who died on Tuesday morning at Aurora St. Luke’s Medical Center was rolled out of her room under a white sheet. One nurse, fighting back tears, stood silently in the hall as the outline of the body passed by — one more death in an eight-month-old pandemic that has no end in sight.
“Those moments, they hit the soul,” said Jodie Gord, a nurse manager who oversees a team of about 120 people at the hospital in Milwaukee.
Aurora St. Luke’s is far from alone in coming under strain. Hospitals around the United States are reeling from the rampaging spread of the coronavirus, many of them in parts of the country that initially had been spared the worst.
Approaching the eve of the election, President Trump has downplayed the steep rise in cases, attributing much of it to increased testing. But the number of people hospitalized for the virus tells a different story, climbing an estimated 46 percent from a month ago and raising fears about the capacity of regional health care systems to respond to overwhelming demand.
The exploding case numbers point to a volatile new phase in the pandemic, coming after earlier waves hit large cities such as New York, then Sun Belt states like Florida and Arizona. While some of those places have begun to bring the virus under control, the surge of hospitalizations is crippling some cities with fewer resources.
In El Paso, where the number of people hospitalized with Covid-19 has more than tripled over the past three weeks, doctors at University Medical Center have started airlifting some patients to hospitals as far away as San Antonio while treating others in a field hospital in a nearby parking lot. Across the border in Mexico, the mayor of Ciudad Juárez, himself hospitalized after testing positive for the virus for the second time, is urging a temporary ban on U.S. citizens crossing into his city.
“We have never seen this in El Paso,” said Dr. Joel Hendryx, chief medical officer at University Medical Center, one of the largest hospitals along the border. Citing the need for field hospitals, Dr. Hendryx drew a sharp contrast to the city’s earlier surge in July, when mitigation measures drove case numbers down.
Dr. Hendryx’s hospital had 195 inpatient coronavirus cases as of Tuesday compared with about 30 a month ago. In addition to the parking lot tents, officials in El Paso are converting the downtown convention center into a 50-bed hospital. Hundreds of health workers from other parts of Texas are deploying to El Paso, including an ambulance strike team with paramedics from the Houston area.
The situation is also becoming critical in states such as Idaho, Missouri, New Mexico and Utah, with frontline workers exhausted and hospitals struggling to find replacements for those testing positive each day.
At St. Luke’s Magic Valley Medical Center in Twin Falls, Idaho, where more than one-third of patients have Covid-19, administrators are sending children to a hospital in Boise, two hours away. The influx of patients from rural areas with little health infrastructure is similarly straining hospitals in Wisconsin, where cases have increased 53 percent from two weeks ago.
Across the country, case numbers have risen to fearsome new levels in recent days, with the seven-day average for new cases exceeding 70,000 for the first time in the pandemic. Twenty-six states are at or near record numbers for new infections. More than 500,000 cases have been announced in the past week. And exactly zero states are seeing sustained declines in case numbers.
On a per capita basis, smaller cities and rural counties in the Upper Midwest and Mountain West are struggling most acutely. North Dakota, South Dakota, Wisconsin and Montana lead the country in new infections per capita. Of the 12 metro areas with the highest rates of new cases over the past two weeks, 10 are in North Dakota or Wisconsin.
But the dismal trend lines are not confined to those regions. North Carolina, New Mexico, Pennsylvania, Rhode Island and West Virginia have recently set seven-day records for new cases. And more big cities are starting to spiral, with alarming trends emerging in Chicago, Milwaukee and Newark.
And while the escalating case numbers had not been accompanied by a steep rise in deaths, that trend is starting to change. About 800 deaths are now being recorded across the country each day, far fewer than in the spring but up slightly from earlier this month.
Cities and towns nationwide are rushing to impose new restrictions. In Idaho, Gov. Brad Little backtracked on reopening but stopped short of a statewide mask mandate. Mr. Little limited indoor gatherings to 50 people, required masks at long-term care facilities and placed new restrictions on how bars and restaurants could serve their customers.
In Newark, all nonessential businesses will have to close at 8 p.m. beginning on Tuesday. Mayor Lori Lightfoot of Chicago imposed a curfew under which nonessential businesses must shut down from 10 p.m. to 6 a.m., and bars without a food license are no longer allowed to serve customers indoors.
In Fargo, N.D., Mayor Tim Mahoney used his emergency powers to pass the first mask mandate in the state. The mayors of Nixa and Ozark in Missouri imposed mask mandates after appeals by nearby hospitals overwhelmed by coronavirus hospitalizations.
On one of the I.C.U. floors at Aurora St. Luke’s in Milwaukee, the mood was somber on Tuesday morning as doctors and nurses made their rounds. Twenty of the 24 beds were filled, and many of the patients were on ventilators.
But the staff put on a brave face. They gave thumbs-up to patients from the hallways, walked into rooms to greet others and assisted one woman as she ate her breakfast.
Before noon, an older woman was transferred to the I.C.U. from the Covid-19 floor. Within 30 minutes of her arrival, loud beeping sent staff members running to her room, frantically grabbing personal protection gear.
The patient’s oxygen levels had plummeted to dangerously low levels, and she was going into cardiac arrest. A nurse practitioner called the patient’s family, making it clear there was a possibility she would not make it.
A staff member performed compressions on the woman in hopes of keeping her alive. After several minutes, her condition stabilized — for the moment.
She was the second patient who needed such care in just three hours. When the nurses and doctors stepped away for a breath, the woman lay on the bed, now intubated, eyes glazed over and her face pale. It was hard to see any clear signs of breathing.
Some staff members patted each other on the back. Others took deep breaths. A health care worker walked out of the patient’s room, holding a small plastic bag in her hand. Inside was jewelry to give to the family, said Ms. Gord, the nurse manager, in case the woman died.
Staff members still seemed in shock over the death of the other patient from that morning. She had become dear to the I.C.U. team, said Ms. Gord, who stood quietly and with obvious emotion as the stretcher slipped past. “Bless her soul,” she murmured. “Sweet little lady.”
Staff members said they were fighting constant exhaustion. “What’s going to happen when we cannot take care of these patients?” said Dr. Pedro Salinas, a critical care specialist, who worries about how much longer the staff can endure. “They are emotionally and mentally exhausted.”
The prospect of ending up in an overcrowded hospital ward is making some who are sick with the virus hesitant to check in. At the hospital in El Paso, staff members said some Covid-19 patients were arriving in the emergency room so debilitated that they required intubation almost immediately.
Sandra Garcia, 31, an El Paso resident who tested positive for the coronavirus last week, said she had been grappling with fatigue, shortness of breath and a loss of taste and smell, but had refrained from seeking care in the city’s crowded hospitals.
In the meantime, she is caring for a 13-year-old who also has Covid-19 and 5-year-old twins, who are all studying online from home. Ms. Garcia said she questioned why Dee Margo, El Paso’s mayor, had failed to order a shutdown of the city to curb the spike in cases.
“He’s just trying to get re-elected and it’s disgusting,” Ms. Garcia said.
Last week, Mr. Margo announced new restrictions such as closing parks to league and tournament play, but he said an order for a full city shutdown would need to come from the governor of Texas.
Dr. German Hernandez, a nephrologist who has been caring for patients at several hospitals in El Paso, said the situation was so acute that patients on oxygen were being kept in rooms in the trauma area of University Medical Center. He said that could be devastating in the event of a disaster such as the August 2019 mass shooting at a Walmart in the city that left 23 people dead.
“God forbid we have another Aug. 3 shooting because we can’t handle it right now,” Dr. Hernandez said. “We have no buffer.”
The fall Covid-19 surge keeps growing, with 29 states setting new records this month for the most new daily cases since the pandemic began, according to data from Johns Hopkins University.
And it’s not just due to more testing. The average number of daily new cases this past week is up 21% compared to the previous week, according to JHU. But testing has increased only 6.63% over the same time frame, according to the Covid Tracking Project. “We’re rising quickly. If we just go back about six, seven weeks ago to Labor Day, we were at about 35,000 cases a day,” said Dr. Ashish Jha, dean of Brown University School of Public Health.”
At least 73,240 new US cases and 985 deaths were reported Tuesday, according to JHU. “I would not be surprised if we end up getting to 100,000” new cases a day, Jha said. The surge is hitting all regions of the country. As of Wednesday, 40 states were trending in the wrong direction, with at least 10% more new cases this past week compared to the previous week, according to JHU. Missouri is the only state with at least 10% fewer cases, and the remaining nine states are relatively steady.
Without changes, ‘half a million people will be dead’
This month, 11 states reported their highest single day of new deaths since the pandemic began.
And because a vaccine probably won’t be available to most Americans until the middle of next year, personal responsibility will be key to saving American lives.“If we continue our current behavior, by the time we start to go down the other side of the curve, a half a million people will be dead,”said CNN medical analyst Dr. Jonathan Reiner, a professor of medicine at George Washington University.Under the current conditions, the daily US death toll is projected to reach 2,000 by January 1, according to the University of Washington’s Institute for Health Metrics and Evaluation.In the past nine months, more than 8.7million people in the US have been infected with coronavirus, and more than 226,000 have died.
Imminent threats to hospital capacity
Even after setting up a field hospital at the state fairgrounds, Wisconsin is facing a dire predicament with hospital capacity. “There is no way to sugarcoat it. We are facing an urgent crisis, and there is an imminent risk to you and your family,” Gov. Tony Evers said.
In Ohio, admissions to intensive care units have doubled since the beginning of this month, Gov. Mike DeWine said. Colorado is also worried about hospital capacity as the number of daily new cases skyrocketed this month. “If these trends continue, it would exceed May hospitalization numbers,” Gov. Jared Polis said. “And the modeling suggests that if we don’t change what we’re doing, it’ll exceed all of the existing hospital capacity by the end of the year. This thing moves quick, and we need to change the way we live.”The city and county of Denver has reduced the maximum allowed occupancy of restaurants, retailers and some other businesses from 50% to 25%, according to a statement Tuesday.”Why we’re doing this is to send a clarion call to everyone that we have a responsibility to once again put our hands on this boulder and begin to push it back up the hill,” Denver Mayor Michael Hancock said.
HENRY KOTULA 