The next few months will be covid’s “worst-case scenario” in the US, says the expert

(CNN) – Across the United States, preparations are underway to rapidly distribute covid-19 vaccines once authorized, but experts say that before that promise of relief, the next few months are likely to be difficult.

What comes next is arguably the “worst case scenario in the country in terms of overwhelmed hospitals, in terms of the number of deaths,” according to emergency medicine doctor Leana Wen.

“There are so many viruses in our communities right now,” he said.

His words echoed a grim prognosis from Centers for Disease Control and Prevention (CDC) director Dr. Robert Redfield, who warned Wednesday that the next three months will be “the most difficult in the history of public health. nation.

It is a sad reality that is already reflected in the numbers. Over the past two days, more than 200,000 new cases have been registered every day. And as the number of infections increased, the United States has added a million cases to its total count every six days for the past three weeks.

Hospitalizations also hit six figures for the first time this week, with more than 100,600 covid-19 patients nationwide. second the COVID monitoring project.

And for the second consecutive day, Thursday, the United States reported more than 2,800 deaths from covid-19, breaking a grim record the country had set a day earlier.

Health systems under stress

Top health officials have long warned that the rise in cases would be followed by an increase in the number of hospitalizations that could cripple health systems across the country. Hospitals and experts in the United States sound the alarm.

Marvin O’Quinn, president and chief operating officer of CommonSpirit Health, which operates hospitals in 21 states, told CNN they are seeing an increase in patients across all hospitals.

“We now have around 2,100 positive cases in our hospitals. That’s a nearly 70 percent increase since November 11, “O’Quinn said.” We’re seeing 70 to 100 new cases every day. “

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In Pennsylvania, just under 5,000 people are hospitalized with COVID-19 and two parts of the state are nearing a staff shortage, Health Secretary Dr. Rachel Levine said Thursday.

“It is very important to remember that we must all be aware, that we all have a role to play in what is happening in hospitals right now,” Levine said. “You may not need hospital care right now; You may not have a loved one in the hospital right now. But what is happening in our hospitals has a direct impact on you. It has a direct impact on the mitigation measures to be taken to contain the spread of the virus.

“The people who run our health care system trust you to do the right thing,” he continued.

In Ohio, Governor Mike DeWine warned that hospitals were not only in crisis, but that “the crisis is getting worse and worse.”

Dr. Andy Thomas of Ohio State University Wexner Medical Center told reporters that a third of ICU patients across the state were positive for COVID-19. In some rural hospitals, patients with Covid-19 represented up to 60 percent of the ICU population, Thomas added.

“It’s not sustainable for those hospitals to run,” Thomas said. “The most difficult area for hospitals to increase their capacity, or their number of beds, is in the intensive care unit.”

And hospitals across the country have yet to see the impacts that Thanksgiving meetings and travel could bring, and another wave is expected to begin to take shape in the coming weeks.

Michael Osterholm, a member of President-elect Joe Biden’s Covid-19 transition advisory council, said measures are urgently needed to help slow the spread and prevent hospitals from being “overrun”.

“I’d rather do it now and try to avoid future cases rather than wait to try to put it in place when the house is so on fire we’ve actually crossed our cliff of cases and the hospitals are practically literally overrun,” she said. “This is what we have to face.”

Strict new measures

In California, hospitals are treating about 2,066 COVID-19 patients in intensive care units, according to data from the state health department. This is the highest number since the start of the pandemic.

The sad figure comes when Governor Gavin Newsom announced a strict regional order to stay home. The order will go into effect 48 hours after the hospital’s intensive care unit capacity drops below 15 percent in one of five regions the state is divided into: Northern California, Bay Area, Greater Sacramento, San Joaquin Valley and Southern California.

Projections show that four of these five regions will reach that threshold in the next few days, with only the Bay Area expected to remain open until mid-late December, Newsom said.

“We are at a turning point in our fight against the virus and we need to take decisive action now to prevent the California hospital system from being overwhelmed in the coming weeks,” he said.

Delaware Governor John Carney announced a stay-at-home recommendation Thursday, in which he tells residents to avoid indoor encounters with anyone outside their home from December 14 to January 11, he said. the governor’s office.

“A vaccine is on the way, but make no mistake, we are facing the toughest months of this crisis,” the governor said in a statement. “I know we’re all tired of covid-19, but he’s not tired of us. We are begging the people of Delaware to do the right thing. “

Meanwhile, the lockdown on the Navajo Nation that expires at the end of this weekend will now be extended for another three weeks.

“Our health experts now say the current surge or surge is far more serious and troublesome than the wave we saw in April and May,” President Jonathan Nez said in a written statement Thursday.

Under the lockdown, Navajo citizens are required to stay home at all times, except for essential activities, emergencies, and outdoor exercise.

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Governors expect the first doses of vaccines to arrive soon

Meanwhile, state and local leaders have begun providing updates on when they expect the first batches of vaccines to arrive. No vaccines have received clearance for emergency use from the Food and Drug Administration (FDA).

New York City Mayor Bill de Blasio said Thursday that the city should receive the first round of covid-19 vaccines in about 12 days. Initial doses will come from Pfizer and about a week later, the city will receive Moderna’s vaccines, de Blasio said.

The priority will be to give vaccinations to health workers and high-risk workers and nursing home residents, the mayor said.

“Over time, there will be enough vaccines for everyone,” de Blasio said, but for now the city is working “on faster and more efficient distribution.”

In New Hampshire, the governor announced that the state plans to receive the first doses of Pfizer vaccine in the third week of December, adding that the Moderna vaccine will arrive the following week.

Massachusetts Governor Charlie Baker said he expected about 300,000 doses of the COVID-19 vaccine by the end of the month. Healthcare workers, residents and staff at long-term care facilities “will absolutely top the list” for the first few doses, Baker said, as the state prepares to officially publish its treatment plan. distribution on Friday.

Redfield, director of the CDC, accepted the covid-19 vaccine recommendations that were voted on this week by the agency’s advisory committee on immunization practices.

Advisors voted 13-1 on Tuesday to recommend that health care workers and residents of long-term care facilities be first in line for any FDA-approved vaccine. But top federal health officials say CDC leadership is just that: driving.

States can use these recommendations, as well as advice from other experts, to develop the best allocation plans for their residents, based on their circumstances, Health and Human Services Secretary Alex Azar said Thursday.

What challenges await us?

Top health officials are continually working to determine how distributing a vaccine to different communities would work best once the green light is given.

“There is a huge gap between a loading dock and a person’s arm,” said Rick Bright, a member of Biden’s Covid-19 Transition Advisory Committee. “We are looking very closely at the complicated path between manufacturing the vaccine and delivering and administering that vaccine.”

“We understand that there is still a lot of work to be done at the local, state and tribal and territorial levels to make sure there is an infrastructure in place to deliver those vaccines, to make sure there are people on site and that they are trained to be able to administer them. vaccines, “he said.

In addition, he said, work is still ongoing to ensure that there are messengers in every community who are informing residents “in all the languages ​​necessary to make sure that people can understand the value of that vaccine and trust that vaccine and stay. in line with take that vaccine.

The biggest challenge remains to be addressed, according to Dr Marcella Núñez-Smith, co-chair of the advisory board.

“In some of our most affected communities, we know there is some degree of hesitation and caution about vaccines,” he told NBC News.

“What we need to do is find out what questions people have,” he said. “At the same time, we must recognize that trust between the Americans and the federal government has declined and it will take work to rebuild and restore that trust.”

Andrea Diaz, Taylor Romine, Andy Rose, Cheri Mossburg, Rebekah Riess, Ganesh Setty, Shelby Lin Erdman, Sahar Akbarzai, Jon Passantino and Evan Simko-Bednarski contributed to this report.