With coronavirus cases spiking nationwide, all signs point to a harrowing autumn



In multiple states, hospital leaders warned that the current spike is straining resources and sidelining the very staffers needed to face growing numbers of sick people. From Maryland to Iowa, local officials have pleaded for tighter restrictions that might help slow the virus’s accelerating spread.

As a worrisome summer gives way to a harrowing fall, the nation’s surge of coronavirus cases shows no signs of easing. With little help and scant guidance from a Washington stuck in political limbo, some states and localities rushed to put in place new restrictions aimed at slowing the virus’s spread. Still, almost every metric appeared headed in an ominous direction.

On Tuesday, the country hit another one-day record, logging more than 135,000 new coronavirus cases, along with 1,403 additional deaths. At least five states, including Missouri and Wisconsin, set single-day highs for fatalities. At least five more, including Illinois and Pennsylvania, set single-day highs for new cases. Almost nowhere in the country are caseloads actually subsiding.

“We’re now seeing widespread community transmission,” said Maryland Gov. Larry Hogan (R). “More people are getting infected with the virus, more people are being hospitalized and going into intensive care, and more people are dying.”

He announced plans to return the state to restrictions that haven’t been in place for months, including a 50 percent capacity limit on restaurants and a new health advisory urging a 25-person cap on indoor gatherings. Hogan also issued an updated travel advisory, asking residents to avoid nonessential travel to 35 states with high infection rates.

Nearly 62,000 infected Americans currently lie in hospital beds — a number the nation has not experienced since April. More than a dozen states have hit new highs for hospitalizations this month, with many setting records again on Tuesday, according to figures compiled by The Washington Post.

“I’m not sure it disappoints me as much as it scares the hell out of me,” said Michael T. Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy. “This is like one huge coronavirus forest fire, and I don’t think it’s going to spare much human wood out there unless we change our behavior.”

More likely, he said, the grim present will grow only darker as the fall wears on. Despite positive news this week, no vaccine will arrive in time to quickly alter the current trajectory. In many places, bars, gyms and restaurants remain open. Weddings and funerals continue. People fighting pandemic fatigue or who are dismissive of the risks are gathering with friends and family, and doing so more often indoors as cold weather arrives.

Osterholm believes the United States will soon see new confirmed cases climb above 200,000 a day — a figure that would have seemed unfathomable when daily infections peaked at roughly 30,000 new cases a day last spring.

“I don’t see anything changing this right now. The behaviors are not changing,” he said. “The deaths will go up precipitously over the course of the next month. It’s going to happen.”

As the numbers climbed, governors and state health departments appealed to their residents to wear masks and maintain social distancing — echoing President-elect Joe Biden’s message to Americans that masks are not partisan.

“Today’s data is alarming,” Ohio’s Republican governor, Mike DeWine, tweeted Tuesday, as he reported another 6,508 cases, 386 hospitalizations and 23 deaths. “Everyone must take this pandemic seriously.”

In a growing number of states, officials expressed concern about keeping hospitals open for anyone who might need them.

North Dakota Gov. Doug Burgum (R) on Monday announced a plan to allow health-care workers with asymptomatic cases of the coronavirus to continue working in covid-19 wards of hospitals while in full protective gear. The change is meant to ease some of the burden on hospitals facing staffing shortages as doctors and nurses become infected or quarantine because of contact with an infected person, Burgum told reporters.

Asymptomatic employees awaiting test results can also continue working, which the governor said should free dozens of staff members at a time in each hospital. North Dakota has further tried to reduce the strain on hospitals by contracting with nurses from out of state and implementing surge plans. Still, Burgum said, the state’s hospitals “are under enormous pressure.”

In Ohio this week, hospital executives said routine care and non-emergency procedures could be delayed if the number of available staff members falls further or infections grow exponentially.

In Oklahoma, health officials are confronting similar dilemmas.

“Every day, we’re scrambling to try to get every single patient to a bed that has a nurse and a doctor, and respiratory therapist, and all of the things that they need to care for them,” said Julie Watson, chief medical officer of Integris Health, which operates 18 hospitals across Oklahoma. “So it’s exhausting, to be honest with you. It’s exhausting, because there’s just no break.”

Watson said the system has hired hundreds of additional nurses on a contract basis, but resources are still stretched.

“The part that is most frustrating for us as physicians is it does not have to be this way,” she said. “We shouldn’t have to choose between surgeries that patients need and caring for patients who get covid because they’re not wearing their mask, or, God forbid, someone who was around someone who wasn’t. That, to me, is unjust.”

That same worry persisted in Minnesota, where Amy W. Williams, chair of the Department of Medicine at the Mayo Clinic, said the number of covid-19 patients in the hospital rose sharply in the past two weeks as the virus spread rapidly in the Upper Midwest.

Williams said her top concern was maintaining adequate staff because Mayo personnel were becoming exposed or infected in the community along with other people, forcing them to quarantine and miss work.

The startling surge has compelled new efforts in some parts of the country to slow the rampant virus.

Minnesota Gov. Tim Walz (D) announced Tuesday that by week’s end, bars and restaurants must stop serving at 10 p.m. In addition, he put in place new caps on weddings, funerals and other social gatherings.

Iowans also will soon be subject to stricter coronavirus rules, as the state faces a daily case count that has nearly doubled since the first day of the month.

Gov. Kim Reynolds (R) said Tuesday at a news conference that masks will be required at indoor gatherings of more than 25 people and outdoor gatherings of over 100 people. Groups that congregate at restaurants, bars or other gatherings will be limited to eight people, unless they are all from the same household.

Each participant in a youth or high school sporting event will be allowed only two spectators, and masks will be required for staff members and customers at personal-services businesses such as hair salons.

The new restrictions are notable for Reynolds, who has resisted implementing a statewide mask mandate since the spring. She stressed Tuesday that Iowa’s restrictions still are less severe than those of many other states.

“Iowa is open for business, and we intend to keep it that way,” she said.

Earlier in the week, Utah’s outgoing governor, Republican Gary R. Herbert, declared a state of emergency aimed at easing hospital overcrowding and quelling the spike in infections. The move includes a statewide mask mandate and a household-only requirement on social gatherings for two weeks.

“We cannot afford to debate this issue any longer,” Herbert said in a video posted to Twitter. “Individual freedom is certainly important, and it is our rule of law that protects that freedom.”

Even as the pandemic continued to rage, glimmers of hope emerged.

The disclosure Monday that Pfizer’s experimental coronavirus vaccine is more than 90 percent effective in ongoing trials sharply increased prospects that federal regulators will authorize the vaccine on an emergency basis as early as mid-December, and that the first shots could be administered before the end of the year or early 2021. The news bodes well for other vaccines currently in the pipeline, scientists said, even as they warned of the difficulty in distributing any drug to hundreds of millions of people.

Regulators this week also granted emergency authorization to the first covid-19 treatment to protect people with mild illness from developing severe disease.

The drug, a laboratory-brewed antibody that imitates the immune system’s attack on the virus, is made by Eli Lilly & Co. Health experts have championed the class of medicine as a powerful tool to change the course of the pandemic and work as a bridge to a vaccine. It is in the same family of medication as an experimental treatment President Trump received when he was stricken with covid-19, the illness caused by the novel coronavirus.

But the initial scarcity of the drug and the logistical complexities of administering it could mute its immediate impact on the pandemic and raise questions about whether it will find its way to the patients in greatest need.

Brittney Martin, Lenny Bernstein, Laurie McGinley and Carolyn Y. Johnson contributed to this report.



First Published at www.washingtonpost.com on 2020-11-11 07:15:04

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