Urgency grows as COVID surges
While some states rampup fight, Trump seen as withdrawn
School system sin Detroit, Indianapolis, Philadelphia and suburban Minneapolis are giving up on in-person classes. Some governors are reimposing restrictions on bars and restaurants or getting more serious about masks. And President Donald Trump has publicly disengaged fromthe battle against COVID-19 at a moment when the coronavirus is tearing across the United States at an alarming pace.
Meanwhile, with a COVID-19 vaccine drawing closer, public health officials across the country are gearing up for the biggest vaccination effort in U.S. history — a monumental undertaking that must distribute hundreds of millions of doses, prioritize who’s first in line and ensure that people who get the initial shot return for the necessary second one.
The virus is blamed for more than 242,000 deaths and over 10.5 million confirmed infections in the U.S., with the country facing what health experts say will be a dark winter because of disregard for mask-wearing and oth-
er precautions, the onset of cold weather and crowded holiday gatherings.
“It should frighten all of us,” Dr. David Peterman, CEO of Idaho’s Primary Health Medical Group, said of the virus numbers. “It’s easy to look at TV, and say, ‘I’m not in the intensive care unit, my grandmother’s not in the intensive care unit.’ But if I say to you your doctor cannot treat your child with an ear infection because I cannot answer your phone call, or your doctor is on quarantine, or our clinics are full with people with coronavirus?”
Deaths per day in the U.S. have soared more than 40 percent over the past two weeks, from an average of about 790 to more than 1,100 as of Wednesday, the highest level in three months.
That is stillwell belowthe peak of about 2,200 deaths per day in late April, in what may reflect the availability of better treatments and the increased share of cases among young people, who are more likely than older ones to survive a bout with COVID-19.
But newly confirmed cases per day in the U.S. have rocketed more than 70 percent over the past twoweeks, reaching an average of about127,000— the highest on record. And the number of people hospitalized with the virus hit a high of more than 65,000.
Amid the staggering numbers, some state leaders maintained a hands-off approach, pushing “personal responsibility” rather than government-imposed restrictions such as mandatory mask-wearing.
Public health experts worry that Trump’s refusal to take aggressive action on the pandemic or to coordinate with Presidentelect Joe Biden’s team during the final two months of his presidency will only worsen the effects of the virus and hinder the nation’s ability to swiftly distribute a vaccine next year.
Trump has yet to weigh in on the recent spike in virus cases, and aides say he has been more focused on tracking the rollout of a vaccine, which won’t be widely available for months. He has fumed that Pfizer intentionally withheld an announcement about progress on its vaccine trial until after Election Day, according to a White House official who was not authorized to publicly comment and spoke on condition of anonymity. Pfizer said it did not purposely withhold trial results.
Although the president has consistently played down the pandemic, public health experts expressed worry about Trump’s silence on the troubling spike in cases, as well as his refusal to begin coordination on virus issues with Biden’s transition team.
“It’s a big problem,” said Dr. Abraar Karan, a global health specialist at Brigham and Women’s Hospital and Harvard Medical School. “The transition is not going to happen until January, and we are in a complete crisis right now. We already know where this is headed. … It’s not good enough to say we’re going to wait until the next president to address this.”
White House officials declined to comment Thursday on when Trump last engaged with members of the coronavirus task force.
“The president is regularly briefed about the coronavirus,” said White House spokesperson Sarah Matthews. “The relevant information is brought to him on the big decisions, and then he moves forward in the way that’s best for our country.”
Meanwhile, state and local officials around the country are scrambling in the midst of mounting caseloads.
Reflecting what has largely been a divide between red and blue states, Republican Gov. Kevin Stitt of Oklahoma has refused to impose a mask man date, citing concerns about enforcement and a “one-size-fits-all” approach. Instead, he held a news conference this week with doctors who implored residents to wear masks.
In North Dakota, nurses opposed GOP Gov. Doug Burgum’s move to allow health care workers who test positive to remain on the job, saying scientifically proven measures such as a mask mandate should be tried first. Burgum has declined to do that.
In other states, officials have tightened restrictions, though not as much as when the virus first hit in the spring.
Chicago Mayor Lori Lightfoot called on residents to cancel Thanksgiving gatherings, limit all social gatherings to 10 people, and stay home except for essentials, like work or getting groceries, starting on Monday.
In New York, Gov. Andrew Cuomo has issued an order starting Friday for bars, restaurants and gyms to be closed by 10 p.m., and has set a cap of 10 people for private gatherings. In Illinois, public health officials asked employers to allow their personnel to work from home when possible and urged residents to stay at home as much as possible and skip nonessential travel.
Lawrence Gostin, a public health expert at Georgetown University’s law school, said that even the good news that Pfizer’s vaccine showed 90 percent efficacy in early trial results could be diminished if Trump doesn’t begin coordination efforts with Biden’s team on how to roll out the vaccine.
“I fear the next three months ahead could be the worst we’ve faced during the pandemic,” Gostin said.
The vaccination push could begin as early as next month, when federal officials say the first vaccine may be authorized for emergency use and immediately deployed to high-risk groups, such as health care workers.
“The cavalry is coming,” Dr. Anthony Fauci said Thursday on ABC’s “Good Morning America.” He said he hopes shots will be available to all Americans in April, May and June.
State and local officials are planning for the likelihood that the first shipments will not be enough to cover everyone in high-priority groups.
In Philadelphia, the health department is counting how many health care workers and others would be among the first in line. In Louisiana, officials are planning a remote exercise this week to play out different scenarios exploring how the process might unfold.
“If you get 10,000 doses, what are you going to do, versus 100,000 doses?” said Dr. Frank Welch, director of Louisiana’s immunization program.
For the vaccination effort to get off the ground, state officials have been readying systems to track supplies and who has been vaccinated. That information will be fed into a national network and will be critical in giving federal health officials an up-to-date picture of vaccinations around the country.
Providers such as pharmacies and doctors’ offices will also need to be able to look up records, so people do not have to return to the same place for their second shot. More than one vaccine could also become available, and doses cannot be mixed and matched.
“We not only have to bring people back for a second dose, but need to make sure that we have very good records of which vaccine they received the first time,” said Dr. Jinlene Chan of Maryland’s health department.
To help people find doses in their area, the Centers for Disease Control and Prevention wants to put information on a vaccine finder website, which will be updated each day with the latest inventory.
So far, states have received far less money than they say they need for vaccine distribution, and it’s unclear if anymore federal help is coming. Public health groups estimate that an additional $8.4 billion is needed to pay for staff, data systems and outreach and supply costs.