The rise of ubiquitous self-testing and the paucity of accurate, timely data from the CDC on COVID numbers has left us feeling our way in the dark in terms of the current state of the pandemic. Clearly there’s a new surge underway, driven by the BA.5 variant. What we can report from our experiences on the road over the past few weeks is that the wave is significant.
We’re hearing from our health system members that inpatient COVID volumes and COVID-related ED visits are significantly up again—often double or more what they were just two months ago, although still well below levels of past surges. Length of stay for COVID inpatients is shorter, with fewer ICU visits than during the Delta surge—about the same intensity, proportionally, as during Omicron.
But COVID-related staffing shortages are once again having a real impact on hospitals’ ability to deliver care—clinical and non-clinical staff callouts are at high levels again, as during Omicron.
One piece of good news: masking is back in vogue among many health system executive teams, likely in response to a number of “superspreader” events: gatherings of hospital staff over the past few weeks that resulted in clusters of cases. One system described an all-hands session for anesthesiologists that resulted in more than a dozen cases across the next week—forcing the hospital to cancel procedures.
We’re worried that this BA.5 surge is just getting started, and with booster uptake stagnating and masking all but nonexistent in the general population, the late summer and early autumn situation could be significantly worse.
Wednesday’s storming of the U.S. Capitol did not just overshadow one of the deadliest days of the coronavirus pandemic — it could have contributed to the crisis as a textbook potential superspreader, health experts warn.
Thousands of Trump supporters dismissive of the virus’s threat packed together with few face coverings — shouting, jostling and forcing their way indoors to halt certification of the election results, many converging from out of town at the president’s urging. Police rushed members of Congress to crowded quarters where legislators say some of their colleagues refused to wear masks as well.
“This was in so many ways an extraordinarily dangerous event yesterday, not only from the security aspects but from the public health aspects, and there will be a fair amount of disease that comes from it,” said Eric Toner, senior scholar at the John Hopkins Center for Health Security.
Experts said that resulting infections will be near-impossible to track, with massive crowds fanning out around the country and few rioters detained and identified. They also wondered if even a significant number of cases would register in a nation overwhelmed by the coronavirus. As Americans shared their shock and anger at the Capitol breach Thursday, the United States reported more than 132,000 people hospitalized with the virus, and more than 4,000 deaths from covid-19, the disease caused by the coronavirus — making it the highest single-day tally yet.
“It is a very real possibility that this will lead to a major outbreak but one that we may or may not be able to recognize,” Toner said. “All the cases to likely derive from this event will likely be lost in the huge number of cases we have in the country right now.”
Trump devotees who flocked to the capital this week said they were unconcerned by the virus, belittling common precautions known to slow its spread and echoing the president’s dismissive attitude toward rising case counts. Trump had encouraged them to gather in defiance of his election loss: “Big protest in D.C. on January 6th,” he tweeted last month. “Be there, will be wild!”
Mike Hebert, 73, drove two days from Kansas to participate. Marching toward the Capitol on Wednesday with an American flag, he said he did not feel the need to wear a face covering.
“I am as scared of the virus as I am of a butterfly,” said Hebert, adding that he is a veteran who was shot twice in Vietnam.
Sisters Courtney and Haley Stone left New York at 11 p.m. to make it to the Capitol by morning so they could quietly counterprotest, draped in Biden gear. “Do you want a mask? I have one,” Haley, 22, asked a Trump supporter, only to be rebuffed.
“Oh, you believe in the mask hoax?” the woman replied.
Health experts predicted Wednesday’s events will contribute to an ongoing case surge in the greater Washington region. The average number of daily new infections in Virginia, Maryland and the District of Columbia reached a record high Thursday, and current covid-19 hospitalizations in the District have risen 19 percent in the past week.
They also noted differences with other large gatherings such as Black Lives Matter protests. Fewer people wore masks during the Capitol protests and riot, they said, and crowds were indoors.
“If you wanted to organize an event to maximize the spread of covid it would be difficult to find one better than the one we witnessed yesterday,” said Jonathan Fielding, a professor at the schools of Public Health and Medicine at UCLA.
“You have the drivers of spreading at a time when we are bearing the heaviest burden of this terrible virus and terrible pandemic,” he said.
Calling in to CBS News Wednesday, Rep. Susan Wild (D-Pa.) described her evacuation to a “crowded” undisclosed location with 300 to 400 other people.
“It’s what I would call a covid superspreader event,” she said. “About half the people in the room are not wearing masks, even though they’ve been offered surgical masks. They’ve refused to wear them.”
She did not identify the lawmakers forgoing face coverings beyond saying they were Republicans, including some freshmen. The Committee on House Administration says it is a “critical necessity” to mask up while indoors at the Capitol, and D.C. has a strict mask mandate.
“It’s certainly exactly the kind of situation that we’ve been told by the medical doctors not to be in,” Wild said.
“We weren’t even allowed to get together with our families for Thanksgiving and Christmas,” she said, “and now we’re in a room with people who are flaunting the rules.”
At least one member of Congress has tested positive since the mob spurred an hours-long lockdown. Newly elected Rep. Jacob LaTurner (R-Kan.) tested positive for the coronavirus late Wednesday evening, according to a statement posted on his Twitter account. It said he is not experiencing symptoms.
“LaTurner is following the advice of the House physician and CDC guidelines and, therefore, does not plan to return to the House floor for votes until he is cleared to do so,” the statement said.
Luke Letlow, a 41-year-old congressman-elect from Louisiana, died of covid-19 last month.
Any infections among members of Congress and their staff will be far easier to contact-trace than those among rioters, said Angela Rasmussen, an affiliate at the Center for Global Health Science and Security at Georgetown University.
“It certainly would have been easier if they were detained by Capitol police and identified, but testing suspects may be something to consider as law enforcement begins to identify them,” Rasmussen said in an email.
She noted that some may try to evade identification and criminal charges, and said she is deeply concerned for the households and communities they might expose.
“I think really rigorous contact tracing of people who are not identified as being present on Capitol grounds will not be possible,” she said.
People who refuse a vaccine for COVID-19 could find normal life curtailed as restaurants, bars, cinemas and sports venues could block entry to those who don’t have proof they are inoculated, Britain’s new vaccine minister said on Monday.
Several major COVID-19 vaccines have been announced in recent weeks, raising hopes that the world could soon return to some semblance of normality after the coronavirus killed 1.46 million people and wiped out a chunk of the global economy.
The British minister responsible for the vaccine rollout, Nadhim Zahawi, said getting vaccinated should be voluntary but that Google, Facebook and Twitter should do more to fact-check opposing views of vaccines.
Asked by the BBC if there would be an immunity passport, Zahawi said a person’s COVID-19 vaccine status might be included in a phone app that would inform local doctors of a person’s status.
“But also I think you’d probably find that restaurants and bars and cinemas and other venues, sports venues, will probably also use that system as they’ve done with the app,” Zahawi told the BBC.
“The sort of pressure will come both ways: from service providers – who will say ‘look, demonstrate to us that you have been vaccinated’ – but also we will make the technology as easy and accessible as possible.”
Health authorities in many countries have become increasingly concerned in recent years by the growth of anti-vaccine groups, which are especially active on social media.
Asked if it would become virtually impossible to do anything without the vaccine, Zahawi said: “I think people have to make a decision but I think you’ll probably find many service providers will want to engage in this in the way they did with the app.”
Zahawi declined to give any specific date on a vaccine rollout as none have yet been approved for public use.
The message, he said, should be that a vaccine is good for the community and the country.
Like a lot of people, I have really gotten into listening to podcasts over the last year. They’re such an immersive way to learn about the world, and I like how the format lets you dive as deep on a topic as you want. So, I was inspired to start one of my own—but I knew I couldn’t do it on my own.
I couldn’t ask for a better partner on this project than Rashida Jones. A mutual friend suggested that the two of us might have a lot to talk about, and it turned out he was right. I already knew she was a talented actor, but I was impressed by her thoughtful perspective on the world. So, we decided to start a podcast that lets us think through some of today’s most pressing problems together. In our first episode, Rashida and I explore a big question that is top of mind for many people: what will the world look like after COVID-19?
I know it’s hard to imagine right now while new cases are surging around the world, but there will come a time when the COVID-19 pandemic is behind us. I think it’s safe to assume that society will be changed forever, given how disruptive the virus has been to virtually every part of our lives.
Unfortunately, we still have a long way to go before life truly gets back to “normal.” Rashida and I were joined by Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, to discuss what to expect in the months to come. I’ve had the opportunity to work with Dr. Fauci on a number of global health issues over the years, including the quest for an HIV vaccine and cure. He’s such a quiet and unassuming guy normally, so it’s been wild to watch him become a huge celebrity.
Dr. Fauci and I are both optimistic that a vaccine will bring an end to the pandemic at some point in the near future. But what the world looks like after that is a lot less clear. I suspect that some of the digitization trends we’ve seen—especially in the areas of online learning, telemedicine, and remote work—will become a regular part of our lives. I hope this episode leaves you hopeful about the future and curious about what comes next.
Governors across the country are grappling with an alarming surge of coronavirus cases and hospitalizations, so far putting forward a fractured response.
Despite the escalating public health crisis, many governors have taken only modest actions; most states still allow major sources of spread such as bars and indoor restaurants to remain open.
President Trump on Friday touted progress on a vaccine but did not announce any major new steps aimed at slowing the spread of the virus in the short term, and he is leaving most of those decisions to states.
Experts are urging governors to impose stronger measures such as closing bars and gyms, prohibiting indoor dining, mandating masks, and advising people to limit in-person gatherings.
“There are many very troubling warning signs in outbreaks across the U.S.,” said Anita Cicero, deputy director of the Johns Hopkins Center for Health Security. “I do feel that more immediate action is required.”
While most state actions have been relatively minor, stricter rules are starting to pop up, particularly from states with Democratic officials, underscoring the red versus blue divide on public health measures reminiscent of earlier this year.
New Mexico Gov. Michelle Lujan Grisham (D) on Friday instructed residents to stay home except for essential business, and Chicago Mayor Lori Lightfoot (D) issued a similar advisory. More such orders could be coming as the situation worsens.
Experts for the most part are not calling for a return to full-scale lockdowns, saying much has been learned since the spring about how the virus spreads, and there is little reason to stop low-risk activities such as curbside pickup from a store.
But significant sources of spread such as bars, indoor restaurants and gyms should be closed in hard-hit areas, they said.
Many states have not taken those steps, despite the ever-mounting case counts.
The country is now recording an unprecedented 150,000 new cases every day, with hospitalizations at record levels of more than 60,000 and deaths at around 1,000 per day and starting to rise. Hospitals in some areas are reaching capacity and becoming overwhelmed.
These trends show no signs of slowing as temperatures get colder and more activity moves indoors.
Just 13 states have closed their bars, according to a tracker from the Kaiser Family Foundation.
But there’s bipartisan pressure for states to do more.
A Washington Post op-ed on Wednesday — authored by Richard Danzig, Navy secretary under former President Clinton; James Lawler, an infectious disease doctor at the University of Nebraska; and Tom Bossert, a former homeland security adviser to President Trump —called on states to take three specific actions: limit indoor gatherings to no more than 10 people, close indoor restaurants and bars, and require masks in public.
The authors said those steps should be taken in any region where there are more than 20 new cases per 100,000 people per day. Forty states are already above that threshold, according to the COVID Exit Strategy tracking site.
Still, governors in some of the hardest-hit states have resisted actions such as statewide mask mandates and bar closures.
Iowa Gov. Kim Reynolds (R) has long opposed a statewide mask mandate, but amid the worsening outbreak, she issued an order last week requiring masks at businesses such as barbershops and at large gatherings.
At the same time, she emphasized that she did not want to close businesses.
“You can still eat in a restaurant, you can still go to a movie and work out at a gym, and in many states you can’t do that,” she said at a press conference on Tuesday. “Iowa is open for business, and we intend to keep it that way.”
Mississippi Gov. Tate Reeves (R) struck a similar note in an address on Thursday.
“We’re trying to open things up but to do it in a safe, responsible way,” he said. “We’re not going to shut down businesses. We’re not going to have long term mandates with no end in sight.”
On Capitol Hill, congressional leaders have been deadlocked over a new round of economic aid, which could provide relief for businesses such as bars and restaurants and allow them to temporarily close to slow the spread of the virus without taking a major financial hit.
“There needs to be a policy lever to help support and maintain those small businesses,” said Preeti Malani, chief health officer and professor of medicine at the University of Michigan.
In New York City, bars and restaurants are still open, with a new 10 p.m. curfew. But the prospect of schools closing has sparked criticism about the city’s priorities.
“If NYC closes schools and continues to allow indoor dining our priorities are totally backwards,” tweeted New York City Council member Mark Levine.
Malani said schools have been a “good-news situation” and have not been a significant source of transmission.
“If the balance is between keeping the bars open and keeping the schools open, that’s an easy decision in my mind,” she said.
Celine Gounder, a coronavirus adviser to President-elect Joe Biden, made a similar point on Friday.
“Some of those higher-risk places are, for example, restaurants, bars and gyms, whereas schools are not zero risk, but they’re much much lower risk, and they’re an essential service really,” she told CNBC. “So I think we need to close only those things that really are contributing to the spread and really try to let as much as possible remain open, like schools, if they’re not contributing to spread.”
Anthony Fauci, the government’s top infectious disease expert, said at an event hosted by the think tank Chatham House on Thursday that the news that Pfizer’s vaccine candidate was more than 90 percent effective in an interim analysis provides something of a light at the end of the tunnel.
That promising news, he said, should encourage people to take some tough steps for a few months until the vaccine is widely available.
“Ever since it became clear a few days ago that we have a really quite effective vaccine getting ready to deploy, [the message] is rather than ‘Hey. Don’t worry. You’re OK,’ it’s ‘Don’t stop shooting. The cavalry is coming. But don’t put your weapons down. You better keep fighting because they’re not here yet,'” Fauci said.
The U.K. could see up to 50,000 coronavirus cases per day by mid-October if current growth continues, top scientific advisers warned in a televised address from Downing Street on Monday.
The big picture: The U.K. has upgraded its coronavirus alert level from three to four as infections appear to be “high or rising exponentially.” Meanwhile, recent European Center for Disease Prevention and Control (ECDC) data shows that over half of all European Union countries are seeing an increase in COVID-19 cases.
What they’re saying: “At the moment, we think that the epidemic is doubling roughly every seven days” in the U.K., chief scientific adviser Patrick Vallance said.
England’s chief medical officer Chris Whitty stressed that unemployment and poverty are risks of taking strong action against the virus — like enforcing stay-at-home orders — but that more deaths will occur if aggressive action is not taken.
Where it stands: ECDC data shows that Spain, France, the Czech Republic, Croatia and Romania have recorded more than 120 confirmed COVID-19 cases per 100,000 inhabitants in the last 14 days, according to AP.
In Madrid, the rate of infection is nearly three times higher than the national average, at 683 cases per 100,000 inhabitants, per AP. Spain, one of the first epicenters of the virus in Europe, is faring the worst of countries tracked by the ECDC.
France has seen 31,285 deaths since the start of the pandemic, one of the highest death tolls in Europe. This weekend, France reported a record 13,000 new infections in 24 hours.
The Czech Republic reported 3,000 new cases on Thursday, almost as many as the country saw in all of March.
Croatia has recorded over 14,000 new COVID-19 cases per day since Sept. 16, while Romania is seeing over 11,000 new infections per day, according to Johns Hopkins data.
What to watch: Analysts expect the British government to announce short-term restrictions after Prime Minister Boris Johnson met with ministers over the weekend, AP reports.
German Chancellor Angela Merkel is planning second-wave prevention with her “Coronavirus Cabinet.” These plans include walk-in “fever clinics” to separate coronavirus patients from others.
Police in Madrid are limiting travel in working-class neighborhoods that have seen high transmission rates, while parks are closed and restaurants and shops must limit their occupancy at 50%.
Czech Republic’s Health Minister Adam Vojtech resigned Monday because of rising cases.
There are 20 new testing centers set to open in Paris and surrounding suburbs this week.
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HENRY KOTULA 