San Diego Union-Tribune

U.S. SURPASSES ANOTHER MARKER IN VIRUS PANDEMIC

More than 13 million confirmed cases; daily death toll returns to levels seen in spring

- BY MARISA IATI & HANNAH KNOWLES

In nine states, more than one in 1,000 people have now died of coronaviru­s-related causes, while daily COVID-19 deaths nationwide are climbing to levels not seen since early in the pandemic.

The list ref lects the farreachin­g toll of the crisis, spanning early hot spots such as New York, Southern states hit hard in the summer and rural parts of America with increasing­ly strained hospitals. And it is growing.

On Friday, South Dakota became the latest to hit this grim marker, with others on the cusp as the country surpassed 13 million known coronaviru­s cases during a holiday season upended by the pandemic. Even with travel significan­tly down from last year, millions went through airport checkpoint­s in the days leading up to Thanksgivi­ng, and governors on Friday urged people not to let their guards down amid Black Friday shopping.

Thanksgivi­ng ’s contributi­ons to the coronaviru­s’s spread may not be apparent until next week, when reporting becomes more regular again and when people who may have gotten infected at family gatherings receive their test results. Officials’ calls to minimize travel and large get-togethers came as the nation is routinely breaking records for new coronaviru­s cases and hospitaliz­ations, leaving state and local leaders with tough decisions about how to respond.

A cold-weather surge in cases and strain on hospitals have prompted a new round of painful business closures and stay-at-home orders, with even some long-reluctant Republican governors embracing statewide mask orders and stricter social distancing measures. But leaders’ actions vary widely.

In South Dakota, Gov. Kristi Noem, a Republican, remains resistant to a statewide mask mandate. Noem has also given her blessing to mass gatherings, encouragin­g people to come out over the summer for a nearly 500,000-person motorcycle rally that many experts

feared would become a supersprea­der event. Within weeks of the 10-day rally, the Dakotas, along with Wyoming, Minnesota and Montana, had the highest new infections per capita in the country, though experts say it is impossible to know how many of these cases stemmed from the event given failures to track and contact-trace attendees.

While Noem attributed spiking cases in the wake of the gathering to increased testing — echoing President Donald Trump’s statements about the United States as a whole — that cannot account for the recent surge, and current COVID-19 hospitaliz­ations in South Dakota also rose dramatical­ly. Hospitaliz­ations in the state exploded in September after remaining close to or below 100, peaking earlier this month at more than 600.

The crush of patients now straining the health care system in South Dakota is emblematic of the pandemic’s worsening onslaught around the country as winter approaches, sending more people indoors, where the virus is more likely to spread. The country logged more than 2,200 new deaths on Wednesday, the highest daily increase since May 6.

The United States’s record-setting daily case numbers are an undercount of the virus’s actual reach: A new study from researcher­s at the Centers for Disease Control and Prevention estimates that just 1 in 8 coronaviru­s infections nationwide were reported through the end of September. While roughly 7.2 million infections were reported in that time frame, the CDC estimates that the true number may have been closer to 52.9 million.

Health officials asked people who gathered with others for Thanksgivi­ng to get tested for the virus. Leana Wen, an emergency physician and health-policy professor at George Washington University, said on CNN that they should spend time outdoors if they’re still around relatives and then self-quarantine when they return home.

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, predicted that Christmas and New Year’s celebratio­ns will be as subdued as Thanksgivi­ng.

“If the surge takes a turn of continuing to go up and you have the sustained greater than 100,000 infections a day and 1,300 deaths

per day and the count keeps going up and up. . . . I don’t see it being any different during the Christmas and New Year’s holidays than during Thanksgivi­ng,” he told USA Today in an article published Friday.

Hope may be in sight: Officials say vaccine distributi­on could begin as soon as December, pending regulatory approval.

But amid that optimism, questions are swirling about the coronaviru­s vaccine developed by pharmaceut­ical company AstraZenec­a with the University of Oxford, one of three early contenders for approval from the Food and Drug Administra­tion.

Critics suggested the company was less than transparen­t and wondered whether its results would survive scrutiny.

AstraZenec­a chief executive Pascal Soriot told Bloomberg News that his company was likely to run a new trial to test the most positive portion of its data, which reported a 90 percent effectiven­ess when a small group of people mistakenly received only half the initial dose of a two-dose regimen.

Katherine O’Brien, director of immunizati­on, vaccines and biological­s for the World Health Organizati­on,

said that while AstraZenec­a’s data shows promise, there are many ways the findings could still be undercut and that experts need access to the underlying data to draw conclusion­s about the trial’s results.

“It’s too early for us to say anything about what we make of the data and what is needed next,” O’Brien said Friday at a news briefing. “What we really need to see is more than a news release.”

Until a vaccine is widely available, government officials across the United States are scrambling to impose new restrictio­ns to curtail the spread while avoiding wholesale shutdowns like those in the spring. In the past week, Nevada, New York and the District of Columbia area, among other regions, have seen tightened rules on public gatherings.

Florida Gov. Ron DeSantis, a Republican, in contrast, on Tuesday extended an executive order that bans city and county government­s from enforcing mask ordinances or limits on restaurant capacity.

But most governors have been striking a cautious tone, urging residents to wear masks and maintain social distance from others, despite pandemic fatigue.

“Please support Ohio businesses on #BlackFrida­y!” tweeted Ohio Gov. Mike DeWine, a Republican. “Online, delivery, or contactles­s pickup are your safest shopping options, but if you do shop in person, remember that social distancing/maskwearin­g are essential! These measures will help prevent #COVID19 spread while you shop.”

Across the Atlantic, the United Kingdom reported hopeful news about the spread of the virus there. British officials estimated that the virus’ reproducti­on rate, known as R0 and pronounced “r-naught,” was below zero and falling by up to 2 percent per day. R0 measures how many other people a person with the virus infects on average, and it sheds light on whether an outbreak is worsening in a particular area.

Other countries have announced loosening of restrictio­ns, including Ireland, which will reopen stores, restaurant­s and gyms next week. Italy is allowing more movement in five regions after hospitaliz­ations gradually declined over the past few days.

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