It’s 2021, and everyone is happy about that. However, COVID-19 cases are still exploding, vaccine distribution is still stumbling, and hospitals are overwhelmed. Because, unfortunately, just flipping the calendar page failed to make the virus go away.
Despite some dents in the curve caused by reduced testing and reporting over the holidays, daily new cases of COVID-19 remain at near-record levels. The reason they’re not even higher is easily seen by looking at two of the largest hot spots in the nation: Houston and Los Angeles. In the last three weeks, the rate of positive tests in both those cities has gone from less than 5% to over 20%, reflecting just how inadequate the testing program is to handle the soaring case load. With the poor reporting through the holiday period, it’s likely to be at least two weeks before we know where the nation is at the moment, and perhaps another week before the results of all the holiday travel/get-togethers are factored in.
‘Which means that Joe Biden is likely to be putting his hand on a Bible just as the nation is facing, not just another crunch, but one that puts an unprecedented strain on the healthcare system.
Over ten months into the pandemic, the states with the highest number of deaths per population are … New Jersey, New York, and Massachusetts. Yes, North Dakota and South Dakota have been working very hard to dislodge these states at the top of the list, and considering that those states have actually skipped out on reporting for several days, they may have even moved up a notch, but what’s amazing is just how long the Northeast stares have held thus extremely dubious “honor.”
Despite a surge across the South in the summer, and a largely Midwestern surge in the fall, despite case counts that put the original Northeast surge in the rear view, those states still took the biggest hit from the novel coronavirus. And the reason isn’t hard to see. Right now, the case fatality rate for COVID-19 in the U.S. stands at just over 1.7%. But at the end of May, that case fatality rate stood at 5.5%.
Part of that difference came because a year of wrangling with the SARS-CoV-2 virus has given doctors and nurses insight into the best ways to treat patients. Anti inflammatory steroids help with patients needing breathing assistance. Monoclonal antibodies, though still in low supply, are very effective for patients in early stages. Even intubating patients on their sides rather than their backs has made a difference.
But the biggest difference in care is simply… care. The reason those death rates were so high in the early days is because the healthcare system was completely unprepared and overwhelmed. And here’s something that hasn’t changed: The fatality rate for untreated COVID-19 remains around 10%.
Which means that stories like Los Angeles hospitals having to treat patients in gift shops, or Texas setting hospitalization records five days in a row are a huge red flag. Case fatality rate has been declining slowly since that first surge of cases, but it doesn’t have to stay that way. A genuinely overwhelmed system at this point could quickly generate a peak in deaths that would reverse that trend. And while doctors have learned, they’re also incredibly exhausted. Not just exhausted, actually, because over 2,000 healthcare workers in the U.S. have died from COVID-19.
It’s not enough to say that this is a critical point, because every moment of this pandemic has been critical. Every moment is a moment when good actions can make things better, and continued inaction will make things worse. And every moment is also frustrating because the changes we make today aren’t visible for weeks.
The coronavirus didn’t magically go away in the spring. It didn’t magically go away just because the endless year finally ended. It won’t go away just because Joe Biden moves into the White House. It will only go away when there is adequate testing, efficient contact tracing, effective social distancing, widespread use of masks, and effective distribution of vaccines.