U.S. avoided worst surge scenario.

As bad as it has been, officials feared holidays would bring even more cases, deaths

The United States appears to have avoided the worst-case coronavirus scenarios that officials feared would overwhelm hospitals in the aftermath of Christmas and New Year’s gatherings. But experts caution that the threat from the virus has not diminished and could intensify with the emergence of new variants.

Even as hospitalizations begin to stabilize, they do so from record heights. The country’s hospitals averaged more than 130,000 COVID-19 patients a day over seven days this month, far exceeding summer and spring surges. The death toll from cases contracted before and after the holidays will stretch into February. Authorities reported nearly 4,500 deaths Wednesday, a new single-day record.

Cases skyrocketed at the start of 2021, approaching a seven-day daily average of 250,000 around Jan. 10 before declining. But the toll on the health care system was softer than expected.

Hospitals had braced for enormous spikes in patients that could have forced rationing care, exhausted already limited beds and sparked a nationwide shortage of health care workers. But officials across the country said those dire predictions — a wave of severe Christmas cases weeks after a rapid increase from Thanksgiving — did not materialize in most places.

“The surge on top of a surge that could have happened didn’t really happen,” said Erin Bromage, a biology professor at the University of Massachusetts at Dartmouth. “We dodged a bullet, and we’ve done better than we could have, but we are still in a pretty terrible spot.”

Anthony Fauci, the nation’s top infectious-disease expert, said at a White House briefing Thursday that cases appeared to be plateauing, but he warned it could be a temporary slowdown.

Hospital leaders and experts are still on edge. Variants of the coronavirus, including the B.1.1.7 strain that originated in Great Britain and is believed to be 50 to 70% more contagious, could result in further case spikes in cold weather months when people are more likely to be indoors. And the availability of the vaccine, while offering lifesaving protection to millions, could also lead to a false sense of complacency, particularly as it can be difficult to obtain.

“It’s like a pot of boiling water, so the temperature may have been turned down some, but it’s still dangerously hot,” said Carmela Coyle, chief executive of the California Hospital Association. “Plateauing is not a good thing.”

Infections soared in the aftermath of Thanksgiving, leading some to fear an even greater surge after back-toback Christmas and New Year’s celebrations where people would gather with family and friends and then travel back home, potentially spreading the virus with each step.

“We dodged a bullet, and we’ve done better than we could have, but we are still in a pretty terrible spot.” ERIN BROMAGE BIOLOGY PROFESSOR, UMASS AT DARTMOUTH