The Health 202: When will 2021 feel normal again? Here’s what eight experts predict.

We won't be back to normal from coronavirus pandemic until Fall 2021 -  Business Insider

Around half a million Americans are now getting a coronavirus vaccine shot every day. But that pace must accelerate considerably if the United States has any hope of quashing the virus in 2021.

Public health experts differ on how quickly that might happen  and when things might start to feel “normal” again around the country.

To inaugurate our first Health 202 of the new year, we asked eight experts for their predictions.

After all, we all want to know when we can go to concerts and ballgames again. Or even just go to the office. (Let’s start small.)

We asked two questions. The first has to do with when the United States will reach “herd immunity” — the point at which enough people are immune to a virus, either by recovering from it or getting vaccinated against it. Herd immunity generally kicks in when about 70 percent of people are immune, although experts differ on the precise threshold.

To reach herd immunity with the coronavirus, approximately 230 million Americans would need the vaccine. As of yesterday, just 4 million had gotten the first of two shots. Daily immunizations have increased considerably over the past few days, with about 500,000 people getting the shot each day, but experts say that number needs to at least double and ideally quadruple.

We also asked these experts when they personally expect their lives to return to normal.

Here are their responses, edited lightly for clarity and brevity.

When will enough Americans be vaccinated for the U.S. to reach herd immunity, based on how things look right now?

Carlos del Rio, professor of medicine and global health at Emory University

“At the current pace it will take a really long time. … I think if we can get our act together and start vaccinating 1 million people a day like President-elect Biden is promising, then we can get to 260 million people getting at least one dose … more or less or by late August or early September. If we really scale up and get to 3 million per day, then we can get to 260 million people in [less than] 100 days or three months. Can we do it? Yes! But it will require coordination, leadership and funding. So, as you see, my answer is: It depends.”

Eric Topol, director and founder of Scripps Research Translational Institute:

I think by July, if we get 2 to 3 million people vaccinated per day, and even sooner, if we have a rapid neutralization antibody assay to be able to defer those who have had a prior infection and mounted a durable immune response. Yes, that is optimistic, but it can be done.”

Jay Bhattacharya, professor of medicine at Stanford University:

“There is a lot of disagreement in the scientific literature about the herd immunity threshold, which is certain to vary from place to place. I don’t think anyone responsible would confidently say what it is, and would never put forward a single number for the U.S. as a whole. Rather, the key question is how rapidly we inoculate people who have a high risk of mortality conditional on infection — most older folks and some late middle-aged folks with severe chronic conditions. Prioritizing them for vaccination will yield the greatest benefit in reducing covid-19-related mortality, regardless of when herd immunity is hit.”

Jesse Goodman, professor of medicine and infectious diseases at Georgetown University:

“I am not sure that in the near future we will reach a level of population immunity where the virus will be virtually shut down, as we are accustomed to with measles. Through immunity due to vaccination, combined, unfortunately, with infections in the unvaccinated, we should reach a state where the risk of exposure is reduced due to a mostly immune population. While cases will still occur, our health system will no longer be stressed and large outbreaks should be less common.

“I am hopeful we can get to such a situation in the last quarter of this year, provided vaccine production, access and acceptance go well and no mutant viruses arise that gain the ability to escape current vaccines.”

Kimberly Powers, associate professor of epidemiology at the University of North Carolina at Chapel Hill:

“That question is difficult to answer, as there is considerable uncertainty around the level of immunity we would need in the population to achieve herd immunity, along with the speed with which we can expect widespread vaccine uptake to occur.”

Leana Wen, public health professor at George Washington University and former Baltimore health commissioner:

“Right now, vaccine distribution is progressing at an unacceptably slow speed, and at this current rate, it will take years to reach herd immunity — if ever. If we are able to pick up speed by many times in January, there is still a chance we could substantially slow down the infection and perhaps approach herd immunity in 2021.”

Marc Lipsitch, professor of epidemiology at Harvard University:

“I think you mean ‘will enough Americans be vaccinated to reach the herd immunity threshold?’ My answer is possibly not because we don’t know if the vaccines protect enough against transmission for the threshold to be achievable, and because the new variant may increase that threshold substantially.”

Michael Osterholm, chairman of the Center for Infectious Disease Research and Policy at the University of Minnesota:

“There are three factors that will independently determine when enough Americans will either be protected from covid-19 via vaccination or development of antibody following actual infection.

First, when will there be sufficient vaccine produced and distributed so everyone can receive their two doses? This includes vaccinating those who may have immune protection from actual infection but are vaccinated anyway to increase durable protection. Second, will enough people agree to be vaccinated? And finally, what is the durability of vaccine-induced protection over time? 

“Each of these factors will play a role in achieving local, regional or national herd immunity protection. I feel confident we can achieve the first factor of sufficient vaccine by the late summer or early fall. But ultimately, the second two factors, how many will be vaccinated and how durable is immune protection will determine the answer to this question. I hope, when considering all three factors, it will be late summer or early fall, but we all realize hope is not a strategy.”

When do you expect your own daily life to feel similar to pre-pandemic times?

Carlos del Rio:

I am hoping to be ‘close to normal’ by December 2021 more or less. However, as a physician seeing patients, I will probably continue to wearing a face mask and goggles for much longer.”

Eric Topol:

“In 2022.”

Jay Bhattacharya: 

“Given the changes that the previous year has had on my professional and personal life, I do not expect my daily life to ever feel similar to pre-pandemic times. More broadly though and given the disappointingly slow roll out of the vaccine to the vulnerable in many states, I anticipate that American society will start to feel more like normal by April 2021.”

Jesse Goodman:

“Hopefully late this yearlife should begin to feel similar to pre-pandemic times. However, it is likely that both great vigilance and some social distancing will still be needed, particularly if the population is not nearly all vaccinated. In addition, we may well require periodic immunization against the current and, possibly, other emerging coronavirus variants.”

Kimberly Powers: 

“I expect daily life to feel more normal by sometime this summer, but I think it will be 2022 before some mitigation measures can be fully relaxed.  And I expect that our society will feel ongoing consequences of this pandemic — physical, mental, emotional, and economic — for years to come.”

Leana Wen: 

“I don’t know. I was much more optimistic a few weeks ago. But given the lag in vaccine rollout thus far and how under-resourced our public health systems are, I am concerned things for much of 2021 will feel more like 2020 than 2019.”

Marc Lipsitch:

I think that sometime in the second half of the year there will be enough vaccination in the U.S. and some other countries that we will begin to treat covid-19 more like seasonal flu, which is deadly to large numbers of people but does not overwhelm health care and does not cause us to curtail normal social contact. This is because with enough vaccine in those at high risk of death and hospitalization, transmission may continue (at a reduced level thanks to some immunity in the population from prior infection and vaccine) but the outcomes will be less severe.”

Michael Osterholm:

“I’m not sure it ever will. We will not go back to a pre-covid-19 normal. We will instead exist in world with a new normal. And even that will in part be determined by the availability of adequate vaccine supply to cover everyone in high, middle and low income countries. I look forward to the day when my office hours are as they were pre-covid-19.”

Fauci says he didn’t expect such a high US death toll from COVID-19

https://thehill.com/homenews/sunday-talk-shows/532405-fauci-says-he-didnt-expect-such-a-high-us-death-toll-from-covid-19

Fauci says he didn't expect such a high US death toll from COVID-19

Anthony Fauci, the nation’s top infectious diseases expert, said Sunday he did not expect the death toll from the coronavirus to be so high in the U.S.

“There is no running away from the numbers,” Fauci told guest host Martha Raddatz on ABC’s “This Week.”

“It’s something that we absolutely have got to grasp and get our arms around and turn that, turn that inflection down by very intensive adherence to the public health measures uniformly throughout the country with no exceptions,” he added.

Statistics held by John Hopkins University show that 350,215 deaths have been recorded in the United States so far, a number that has been quickly growing over the last two months.

“I did not” expect the death toll to reach the recent milestone of 350,000 in the U.S., Fauci said.

“But, you know, that’s what happens when you’re in a situation where you have surges related to so many factors inconsistent adhering to the public health measures, the winter months coming in right now with the cold allowing people or essentially forcing people to do most of their things indoors as opposed to outdoors.”

Raddatz asked Fauci how effective he thought proposals by President-elect Joe Biden would be, such as a 100-day mask mandate and a target of 100 million vaccinations.

“The goal of vaccinating 100 million people in the first 100 days is a realistic goal. We can do 1 million people per day,” Fauci said. “You know we’ve done massive vaccination programs, Martha, in our history. There’s no reason why we can’t do it right now.”

US hits 350,000 COVID-19 deaths amid fear of surge after holiday gatherings

https://thehill.com/homenews/532396-us-hits-350000-covid-19-deaths-amid-fear-of-surge-after-holiday-gatherings

As U.S. inches closer to 350,000 Covid-19 deaths, one model proj -  WRCBtv.com | Chattanooga News, Weather & Sports

More than 350,000 people have died of the coronavirus in the U.S., with another surge of cases and deaths expected in the coming weeks as a result of smaller holiday gatherings.

The country reached the grim milestone early Sunday morning, according to data compiled by Johns Hopkins University. More than 20 million people have been infected since the pandemic began nearly one year ago, according to the tally.

Public health experts attributed a nationwide spike in cases, hospitalizations and deaths in early December to a large number of Americans traveling over the Thanksgiving holiday, and pleaded with citizens to stay home for Christmas and New Year’s celebrations. 

Multiple states have reported a record number of cases, including North Carolina and Arizona, according to the Associated Press. New York hit 1 millions cases total as of Saturday, becoming the fourth state to do so along with Texas, Florida and California.

Last month, federal officials approved two vaccines by Pfizer and Moderna for emergency use. The first round of doses have been administered to doctors, nurses and other front line healthcare workers as well as nursing home residents.

The elderly and other patients deemed “high risk” are the next group of Americans slated to receive vaccines with public health officials estimating younger and healthy citizens can expect to be eligible for vaccination toward the middle to end of spring. 

The Centers of Disease Control and Prevention last week reported more than 2 million people in America have been vaccinated, far short of the 20 million figure the federal government initially said it hoped to top by this time. That number has since grown to 4.2 million as of Sunday. 

“We would have liked to have seen it run smoothly and have 20 million doses into people today by the end of the 2020, which was the projection,” said Dr. Anthony Fauci, the nation’s leading infectious disease doctor. “Obviously, it didn’t happen, and that’s disappointing.”

Fauci said a targeted approach in assisting local governments in vaccine rollout programs is the best way for the federal government to make up for lost time. 

“There really has to be a lot more effort in the sense of resources for the locals, namely, the states, the cities, the counties, the places where the vaccine is actually going into the arms of individuals,” Fauci said. 

California reports first case of new coronavirus variant

https://www.axios.com/california-covid-coronavirus-variant-1081cbb4-5d2c-42f2-8785-b35e567296c9.html

California reported its first case of a new variant of the coronavirus that may be more transmissible, AP reports.

The big picture: California is the second state to document a confirmed case of the variant — which originated in the United Kingdom — after Colorado reported the first case in the United States on Tuesday.

  • California Gov. Gavin Newsom announced the infection during an online conversation with Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, according to AP.
  • The governor said the case was located in Southern California, but he did not provide any other details about the person who was infected.
  • “I don’t think Californians should think that this is odd. It’s to be expected,” Fauci said Wednesday, per AP.

Of note: There is thus far no evidence that the new variant is more deadly — only that it appears more transmissible. There is also no evidence that COVID-19 vaccines will be less effective against the new variant.

  • A non-peer reviewed study by the Centre for Mathematical Modelling of Infectious Diseases at the London School of Hygiene and Tropical Medicine found that the variant is 56% more transmissible than other strains.
  • The British government previously warned that a new variant could be up to 70% more transmissible.

Go deeper: What you need to know about the coronavirus mutation

Operation Warp Speed at a crawl

Boise's Leading Local News: Weather, Traffic, Sports and more | Boise,  Idaho | KTVB.com | ktvb.com

The Centers for Disease Control and Prevention reported on Monday that 2.1 million doses of coronavirus vaccines have been administered in two weeks. While this might sound like an impressive number, it should set off alarms.

Let’s start with the math. Anthony S. Fauci, the government’s top infectious-disease doctor, estimates that 80 to 85 percent of Americans need to be vaccinated to reach herd immunity. Both the Pfizer and Moderna vaccines require two doses. Eighty percent of the American population is around 264 million people, so we need to administer 528 million doses to achieve herd immunity.

At the current rate, it would take the United States approximately 10 years to reach that level of inoculation. That’s right — 10 years. Contrast that with the Trump administration’s rosy projections: Earlier this month, Health and Human Services Secretary Alex Azar predicted that every American will be able to get the vaccine by the second quarter of 2021 (which would be the end of June). The speed needed to do that is 3.5 million vaccinations a day.

There’s reason to believe the administration won’t be able to ramp up vaccination rates anywhere close to those levels. Yes, as vaccine production increases, more will be available to the states. And Brett Giroir, assistant secretary for health at HHS, argued on Sunday that the 2.1 million administered vaccines figure was an underestimate due to delayed reporting. So let’s be generous and say the administration actually administered 4 million doses over the first two weeks.

But even that would still fall far short of the 3.5 million vaccinations needed per day. In fact, it falls far short of what the administration had promised to accomplish by the end of 2020 — enough doses for 20 million people. And remember, the first group of vaccinations was supposed to be the easiest: It’s hospitals and nursing homes inoculating their own workers and residents. If we can’t get this right, it doesn’t bode well for the rest of the country.

Here’s what concerns me most: Instead of identifying barriers to meeting the goal, officials are backtracking on their promises. When states learned they would receive fewer doses than they had been told, the administration said its end-of-year goal was not for vaccinations but vaccine distribution. It also halved the number of doses that would be available to people, from 40 million to 20 million. (Perhaps they hoped no one would notice that their initial pledge was to vaccinate 20 million people, which is 40 million doses, or that President Trump had at one point vowed to have 100 million doses by the end of the year.) And there’s more fancy wordplay that’s cause for concern: Instead of vaccine distribution, the administration promises “allocation” in December. Actual delivery for millions of doses wouldn’t take place until January, to say nothing of the logistics of vaccine administration.

The vaccine rollout is giving me flashbacks to the administration’s testing debacle. Think back to all the times Trump pledged that “everyone who wants a test can get one.” Every time this was fact-checked, it came up false. Instead of admitting that there wasn’t enough testing, administration officials followed a playbook to confuse and obfuscate: They first attempted to play up the number of tests done. Just like 2 million vaccines in two weeks, 1 million tests a week looked good on paper — until they were compared to the 30 million a day that some experts say are needed. The administration then tried to justify why more tests weren’t needed. Remember Trump saying that “tests create cases” or the CDC issuing nonsensical testing guidance?

When that didn’t work, Trump officials deflected blame to the states. Never mind that there should have been a national strategy or that states didn’t have the resources to ramp up testing on their own. It was easier to find excuses than to admit that they were falling short and do the hard work to remedy it.

Instead of muddying the waters, the federal government needs to take three urgent steps. First, set up a real-time public dashboard to track vaccine distribution. The public needs to know exactly how many doses are being delivered, distributed and administered. Transparency will help hold the right officials accountable, as well as target additional resources where they are most needed.

Second, publicize the plan for how vaccination will scale up so dramatically. States have submitted their individual plans to the CDC, but we need to see a national strategy that sets ambitious but realistic goals.

Third, acknowledge the challenges and end the defensiveness. The public will understand if initial goals need to be revised, but there must be willingness to learn from missteps and immediately course-correct.

I remain optimistic that vaccines will one day end this horrific pandemic that has taken far too many lives. To get there, we must approach the next several months with urgency, transparency and humility.

First case of highly infectious coronavirus variant detected in Colorado

Colorado officials on Tuesday reported the first known case in the United States of a person infected with the coronavirus variant that has been circulating rapidly across much of the United Kingdom and has led to a lockdown of much of southern England.

Scientists have said the variant is more transmissible but does not make people sicker.

The Colorado case involves a man in his 20s, who is in isolation in Elbert County, about 50 miles southeast of Denver, and has no travel history, according to a tweet from the office of Gov. Jared Polis (D).

“The individual has no close contacts identified so far but public health officials are working to identify other potential cases and contacts through thorough contact tracing interviews,” the statement said.

A federal scientist familiar with the investigation said the man’s lack of known travel — in contrast with most confirmed cases outside the United Kingdom — indicates this is probably not an isolated case. “We can expect that it will be detected elsewhere,” said the official, who spoke on the condition of anonymity to discuss the broader context of the announcement.

The Centers for Disease Control and Prevention confirmed as much in a statement Tuesday afternoon, saying additional cases with the new variant will be detected in the United States in coming days. The variant’s apparent increase in contagiousness “could lead to more cases and place greater demand on already strained health care resources,” the agency said in a statement.

Researchers have detected the more transmissible variant in at least 17 countries outside the United Kingdom, including as far away as Australia and South Korea, as of Tuesday afternoon. Officials in Canada had previously said they had identified two cases.

Although the U.K. variant appears more contagious, it is not leading to higher rates of hospitalizations or deaths, according to a report from Public Health England, a government agency. Nor is there any sign that people who were infected months ago with the coronavirus are more likely to be reinfected if exposed to the variant, according to the report. All available evidence indicates that vaccines, and immunity built up in the population, should be protective against this variant.

The Colorado case occurred in a county of about 27,000, which is currently classified, along with much of the state, in the “red” level for the virus, denoting serious but not extreme risk.

Two weeks ago, several hundred people gathered at a community church in the county seat of Kiowa to consider whether to pursue legal actions against Polis and other state officials for imposing coronavirus-related restrictions, according to the Elbert County News. County commissioners and the county sheriff have declined to enforce restrictions emanating from Denver.

“I was expecting to see it in ski country first because those areas are where people from across Colorado, the U.S. and internationally, gather,” said Elizabeth Carlton, an assistant professor of environmental and occupational health at the Colorado School of Public Health. The absence of any apparent travel history associated with the infected person, she said, suggests he “can’t be the only case in Colorado.”

Polis, in his statement, called on Coloradans to do everything they could to prevent transmission by wearing masks, standing six feet apart when gathering with others, and interacting only with members of their immediate households.

The arrival of the new variant “doesn’t fundamentally change the nature of the threat,” said Justin Lessler, an epidemiologist at Johns Hopkins Bloomberg School of Public Health. “It’s no more deadly than the virus was before, and it doesn’t look like it infects people who are immune.”

Lessler echoed others, saying he would be “astounded” if this was the only chain of transmission of the new variant in the United States. “We know that the virus spreads easily and quickly between countries,” he said, and the fact that the infected person had no travel history indicates “this strain has gotten here sometime in the past, and there are chains of transmission ongoing.”

The variant has a higher attack rate, according to the U.K. report, which bolsters the hypothesis that the variant has out-competed other versions of the coronavirus and is now the dominant variant across much of the United Kingdom. Among people known to have been exposed to someone already infected with the variant, 15.1 percent became infected. People exposed to someone infected with the non-variant version had a 9.8 percent infection rate.

That difference suggests the variant is more transmissible, though Public Health England said more investigation is needed to bolster the hypothesis.

The working theory among many scientists is that the increased transmissibility of the variant, known as B.1.1.7, is driven by mutations that have altered the spike protein on the surface of the virus. The variant has 17 mutations — eight of which alter the spike protein.

Precisely how those changes are leading to more infections is unknown. The virus may be binding more easily to receptor cells in the human body, or replicating more easily and driving higher viral loads, enhancing viral shedding by someone who is infected. Another possibility is that people are shedding the virus for a longer period, increasing the chances of passing it along.

“Preliminary evidence suggests that the new variant does not cause more severe disease or increased mortality,” Susan Hopkins, a senior medical adviser to Public Health England, said in a statement released Tuesday.

The newly published data echo the findings in a separate study published last week, based on modeling and hospitalization data — and not yet peer-reviewed — that estimated that the variant is 56 percent more transmissible but does not appear to alter the lethality of the virus.

“The good news is that B.1.1.7 does not seem to cause much more severe disease, and there’s no evidence that it is managing to evade the immune system, which means vaccines are expected to protect against it,” William Hanage, an epidemiologists at the Harvard T.H. Chan School of Public Health, said Tuesday after reviewing the new report. “The bad news is that B.1.1.7 does appear to be much more transmissible.”

Officials in the United States have been signaling since last week that the new variant was probably already present in this country.

“I’m not surprised,” Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, said Tuesday. “I think we have to keep an eye on it, and we have to take it seriously. We obviously take any kind of mutation that might have a functional significance seriously. But I don’t think we know enough about it to make any definitive statements, except to follow it carefully and study it carefully.”

Research findings on coronavirus variants have been ambiguous at times, and scientists say they are still trying to extract reliable signals from noisy data. There have been several false alarms sounded about virus mutations in the past. A major challenge is discerning whether a virus variant is spreading rapidly because it has a competitive advantage based on genetic and structural differences, or because it is simply lucky, having arrived early to a location or leveraged a few superspreader events to gain dominance.

But with the United Kingdom seeing a severe winter surge of infections, public officials are taking no chances and have effectively locked down southern England, including London. Other countries have banned travelers from the United Kingdom.

The United States, despite having the world’s highest number of documented infections, has a weak track record in publishing genomic sequences, the process that enables researchers to track changes in the virus. Most sequences have been published by academic or private research institutions. By comparison, the United Kingdom has a national health system with a robust surveillance system.

“The U.K. made the decision in the spring to do this. The U.S. has sequencing equipment and infrastructure. As with many things in this pandemic, it was not executed the way it should have been,” said Neville Sanjana, a geneticist at New York University.

All viruses mutate randomly, and over time some of those mutations appear to confer some kind of advantage to the virus as it adapts to the human species. The novel coronavirus, SARS-CoV-2, mutates at a slow rate, and scientists do not think the genetic changes seen in the variant so far are sufficient to allow it to elude the vaccines now being administered to millions of people in many countries. But the coronavirus is a moving target and these mutations require surveillance.

Many scientists call the arrival of more transmissible mutations a wake-up call. “The lack of virus sequencing and case tracking in the USA is a scandal,” said Jeremy Luban, a virologist at the University of Massachusetts Medical School.

Francois Balloux, who directs the Genetics Institute at University College London, on Twitter predicted that within two weeks, enough data will accumulate to determine whether this new variant is indeed more transmissible. Previously, Balloux and his colleagues combed through genome sequences, looking for evidence that common variants had increased transmissibility.

“We don’t see much,” he said, referring to a report published in the journal Nature in November that found no signs of mutations that helped the virus to spread more easily. However, he said he “wouldn’t underestimate the evolutionary potential of SARS-CoV-2.”

Biden to address nation on pandemic as Fauci says coronavirus surge ‘has just gotten out of control’

Fauci: U.S. may see “surge upon surge” of coronavirus in weeks ahead – The  Denver Post

President-elect Joe Biden plans to deliver an address on the coronavirus pandemic as the nation experiences what his chief medical adviser on the issue, Anthony S. Fauci, described Tuesday as a surge in cases “that has just gotten out of control in many respects.”

Biden’s remarks, planned Tuesday afternoon in Wilmington, Del., are expected to be his most extensive comments to date since early this month, when he laid out a plan for his first 100 days in office that included imploring all Americans to wear masks.

Fauci, appearing on CNN on Tuesday morning, lamented what he expects to be a post-holiday increase in cases and the strong possibility than January’s caseload will exceed even that of December. “You just have to assume it’s going to get worse,” Fauci said.

Fauci also acknowledged that the rollout of vaccines was not reaching as many Americans as quickly as the 20 million that Trump administration had pledged by the end of the month.

“We certainly are not at the numbers that we wanted to be at the end of December,” said Fauci, director of the National Institute of Allergy and Infectious Diseases. “We are below where we want to be.”

But Fauci, who accepted Biden’s invitation to play an expanded role in his administration, expressed hope that by “showing leadership from the top,” Biden could make an impact — comments that appeared to be implicit criticism of President Trump, who has said little publicly about the crisis since Election Day.

“What he’s saying is that let’s take at least 100 days and everybody, every single person put aside this nonsense of making masks be a political statement or not,” Fauci said of Biden. “We know what works. We know social distancing works. We know avoiding congregant settings works. For goodness sakes, let’s all do it, and you will see that curve will come down.”

Separately Tuesday, Vice President-elect Kamala D. Harris plans to get vaccinated in Washington. Biden received his first shot last week.

In remarks earlier this month, Biden also pledged to distribute 100 million vaccine shots in his first 100 days in office and said he wanted to open as many schools safely during the period as possible. He has also promised to sign an executive order requiring masks to be worn on federal property.

On Monday, Celine Gounder, a member of Biden’s covid-19 advisory board, said during a television appearance that Biden is also considering invoking the Defense Production Act to increase production of coronavirus vaccines,

Appearing on CNBC’s “Squawk Box,” Grounder said Biden could invoke the wartime-production law “to make sure the personal protective equipment, the test capacity and the raw materials for the vaccines are produced in adequate supply.”

During his CNN appearance, Fauci said that getting children back to school safely should remain an imperative, despite rising caseloads.

“You can’t have one size fits all, but the bottom line, what I call default position, should be that wherever we are, try as best as we can to get the children back to school and to keep them in school and to have a plan to try and keep them as safe as possible,” he said.

About 200,000 new coronavirus cases have been reported daily in recent weeks, with a record high of 252,431 on Dec. 17.

The nation’s overall caseload surpassed 19 million Sunday, even as the holidays were expected to cause a lag in reporting. Hospitalizations have exceeded 100,000 since the start of December and hit a peak of 119,000 on Dec. 23. Deaths are averaging more than 2,000 a day, with the most ever reported — 3,406 fatalities — on Dec. 17.

1 of every 17 people in the U.S. has been infected, and 1 in 1,000 has died. Yet the worst may lie ahead.

1 of every 17 people in the U.S. has been infected, and 1 in 1,000 has died.  Yet the worst may lie ahead. - The New York Times

With bubble-enclosed Santas and Zoom-enhanced family gatherings, much of the United States played it safe over Christmas while the coronavirus rampaged across the country.

But a significant number of Americans traveled, and uncounted gatherings took place, as they will over the New Year holiday.

And that, according to the nation’s top infectious disease expert, Anthony S. Fauci, could mean new spikes in cases, on top of the existing surge.

“We very well might see a post-seasonal — in the sense of Christmas, New Year’s — surge,” Dr. Fauci said on CNN’s “State of the Union.”

“We’re really at a very critical point,” he said. “If you put more pressure on the system by what might be a post-seasonal surge because of the traveling and the likely congregating of people for, you know, the good warm purposes of being together for the holidays, it’s very tough for people to not do that.”

On “Fox News Sunday,” Adm. Brett P. Giroir, the administration’s testing coordinator, noted that Thanksgiving travel did not lead to an increase of cases in all places, which suggested that many people heeded recommendations to wear masks and limit the size of gatherings.

“It really depends on what the travelers do when they get where they’re going,” Admiral Giroir said. “We know the actual physical act of traveling in airplanes, for example, can be quite safe because of the air purification systems. What we really worry about is the mingling of different bubbles once you get to your destination.”

Still, U.S. case numbers are about as high as they have ever been. Total infections surpassed 19 million on Saturday, meaning that at least 1 in 17 people have contracted the virus over the course of the pandemic. And the virus has killed more than 332,000 people — one in every thousand in the country.

Two of the year’s worst days for deaths have been during the past week. A number of states set death records on Dec. 22 or Dec. 23, including Alabama, Wisconsin, Arizona and West Virginia, according to The Times’s data.

And hospitalizations are hovering at a pandemic height of about 120,000, according to the Covid Tracking Project.

Against that backdrop, millions of people in the United States have been traveling, though many fewer than usual.

About 3.8 million people passed through Transportation Safety Administration travel checkpoints between Dec. 23 and Dec. 26, compared with 9.5 million on those days last year. Only a quarter of the number who flew on the day after Christmas last year did so on Friday, and Christmas Eve travel was down by one-third from 2019.

And AAA’s forecast that more than 81 million Americans would travel by car for the holiday period, from Dec. 23 to Jan. 3, which would be about one-third fewer than last year.

For now, the U.S. is no longer seeing overall explosive growth, although California’s worsening outbreak has canceled out progress in other parts of the country. The state has added more than 300,000 cases in the seven-day period ending Dec. 22. And six Southern states have seen sustained case increases in the last week: Tennessee, Alabama, Georgia, South Carolina, Florida and Texas.

Holiday reporting anomalies may obscure any post-Christmas spike until the second week of January. Testing was expected to decrease around Christmas and New Year’s, and many states said they would not report data on certain days.

On Christmas Day, numbers for new infections, 91,922, and deaths, 1,129, were significantly lower than the seven-day averages. But on Saturday, new infections jumped past 225,800 new cases and deaths rose past 1,640, an expected increase over Friday as some states reported numbers for two days post-Christmas.

The deadliest year in U.S. history didn’t have to be so deadly

If you decided to read the names of every American who is known to have died of covid-19, the disease caused by the novel coronavirus, at a rate of one per second starting at 5 p.m. Tuesday, you would not finish until a bit after 10 a.m. Saturday. Except, of course, that’s only including the deaths known as of writing; by then, we can expect 8,000 more deaths, pushing the recitation past noon.

Preliminary federal figures indicate that more than 3.2 million Americans will die over the course of 2020, the highest figure on record. It’s just a bit shy of 1 percent of the total population as of July 1, and about 1 in 10 of those deaths will be a result of covid-19.

That’s the primary context in which any discussion about how the pandemic has affected the United States should occur. Secondarily, we should consider how the number of new coronavirus infections correlates to that figure. At the moment, nearly two people are dying of covid-19 each minute, a function of a massive surge in the number of new infections that began in mid-September.

The surge and the deaths are inextricable. For months, the number of new deaths on any given day has been about 1.8 percent of new cases several weeks prior. Allowing the virus to spread wildly means allowing more Americans to die.

In an opinion piece for the Wall Street Journal, one of the architects of the decision to let the virus spread, former White House adviser Scott Atlas, blames the scale of the pandemic on the media. It’s the “politicization” of the virus, he argues, that has led to the dire outcomes we see, and that’s largely due to “media distortion.”

It’s hard to overstate both how dishonest Atlas’s argument is and how ironic it is that he should point the blame elsewhere. He makes false assertions about where states have been successful and suggests that mitigation efforts that weren’t 100 percent effective shouldn’t be used. He boasts that the effort to combat the spread of the virus was left to states — which is precisely the criticism aimed at President Trump’s administration. When Trump (and Atlas) undercut efforts to slow the spread of the virus, Trump supporters — including state leaders — picked up on that approach, contributing to the current spread.

Trump and Atlas shared the view that allowing the virus to spread was beneficial, as doing so increased population immunity. That another result would be surging deaths was met with a shrug or silence.

At the end of March, Trump offered one of his only forceful endorsements of slowing the spread of the virus. Having been presented with research indicating that as many as 2.2 million Americans would die of the virus if no effort was taken to limit its spread, he endorsed stay-at-home measures aimed at preventing new infections. His team suggested that implementing such mitigation efforts would keep the death toll under 240,000, with the added benefit of preventing hospitals from being overwhelmed.

This was one of Atlas’s arguments, too: Let the virus spread but backstop hospitals to prevent them from being flooded. The government accomplished the first goal, at least.

So we’ve raced past the 240,000-death mark, passing 300,000 deaths this month.

It’s important to remember, too, how often Trump himself promised this wasn’t going to be the country’s future. As the virus was spreading without detection — in part thanks to the Centers for Disease Control and Prevention’s failure to develop a working test — Trump repeatedly downplayed how bad things would get. There were thousands of deaths around the world, he noted in early March, but less than a dozen in the United States. He compared the coronavirus to the seasonal flu and to the H1N1 pandemic in 2009, an event that had the politically useful characteristic of having occurred while Trump’s eventual opponent in the presidential election was vice president.

Over and over, Trump predicted a high-water mark for coronavirus deaths. Over and over, the country surged past his predictions. As the election approached, he began simply comparing the death toll to that 2.2-million-death figure he’d first introduced in March.

The United States will not reach 2.2 million coronavirus deaths over the course of the pandemic. We probably won’t reach 500,000, assuming that the national vaccination effort — the far-safer way to spread immunity — progresses without significant problems.

Right now, though, thousands of people are dying every day and tens of thousands more are on an inevitable path to the same result. More robust efforts to prevent new infections could have reduced these numbers, as robust efforts did elsewhere (contrary to Atlas’s theories). A consistent, forceful message from a president whose base is devoutly supportive of him would unquestionably have reshaped the virus’s spread. Had Trump embraced the expertise of government virologists, instead of a radiologist he saw on Fox News, it would have perhaps pushed the curve depicting the number of deaths each day back down instead of driving it higher.

This was the deadliest year in American history. Perhaps it would inevitably have been, given the size of the population (particularly the elderly population) and the emergence of covid-19. But it unquestionably didn’t have to be as deadly as it was.

Kaiser Permanente CEO: ‘We’re at or near capacity everywhere’

Kaiser Permanente's health system reaches carbon-neutral status |  FierceHealthcare

Hospital executives in California are sounding alarms on their inpatient capacity as COVID-19 hospitalizations surge in the state, according to ABC News.

As of Dec. 23, California is among the eight states where the virus is spreading quickest. On Dec. 22, the state saw one of its biggest jumps in one-day COVID-19 hospitalizations, with an additional 653 patients admitted to hospitals

Officials from Oakland-based Kaiser Permanente, San Francisco-based Dignity Health and Sacramento-based Sutter Health said during a Dec. 22 news conference that they are facing capacity issues. In some cases, COVID-19 patients are being treated in hallways, gift shops and conference rooms.

Greg Adams, the chairman and CEO of Kaiser Permanente, said during the conference, “We simply will not be able to keep up if the COVID surge continues to increase. We’re at or near capacity everywhere.”

Many hospital officials said Thanksgiving gatherings contributed to the surge. The executives urged Californians to not gather for Christmas and New Year’s.