Winter needn’t be as ‘dark’ as some predict

Perhaps you’ve heard winter is coming. Or as Joe Biden warned last week about a third virus wave, “We’re about to go into a dark winter, a dark winter.” He’s playing up the worst case as the election nears, so some context is in order.

Virus cases are increasing, but this is inevitable as cooler weather arrives and Americans go indoors. Cases have also been climbing across Europe, in some countries more than in the U.S. But the good news is that America is better prepared to handle another virus surge, and progress toward a vaccine continues.

The seven-day U.S. rolling case average has nearly doubled from the recent low in mid-September. Cases are more geographically dispersed than in the spring and summer, rising even in states with strict restrictions and mask mandates. This includes New York and its neighbors whose governors were hailed for supposedly controlling the virus. The increase has been most acute in upper Midwest states that weren’t hit as hard earlier. Some of the increase is due to more testing, which is detecting more asymptomatic cases.

Most concerning are hospitalizations, which are up by about 40% since mid-September though are still 30% or so below spring and summer peaks. Most hospitals have ample capacity to treat virus patients while continuing elective procedures, which were stopped during the spring. COVID patients occupy 13% of hospital beds in Wisconsin, 15% in South Dakota and 15% in North Dakota.

Some hospitals report being swamped, but resources can be deployed to areas that need the extra beds. In El Paso, where COVID patients make up 40% of hospital beds, Texas Gov. Greg Abbott has announced an alternate care site and the feds are sending critical-care personnel.

Wisconsin has set up a field hospital in the Milwaukee suburbs to treat patients who aren’t severely ill but may still need medical support. As of Monday that hospital was treating four patients. Hospitalizing patients with moderate illness can prevent complications that cause long-term damage and can turn deadly.

Governors seem to have learned from mistakes during earlier waves, including New York Gov. Andrew Cuomo’s failure to use field hospitals set up by the feds in New York City. Mr. Abbott was slow to deploy resources to the lower Rio Grande this summer but has responded more swiftly in El Paso.

Death rates have also fallen tremendously as treatments have improved. This includes therapeutics like Gilead’s antiviral remdesivir and Regeneron’s antibody cocktail, but also medical protocols such as prone positioning, low-flow oxygenation in lieu of invasive ventilation, and anticoagulants to treat blood clots.

A new study by the NYU Langone hospital system reports its mortality rate declined by 70% from March to August after accounting for age, health risks, admission vital signs and other factors. The Houston Methodist hospital system reported its mortality during the early summer surge was about 3.5% versus 12.1% in the spring.

Deaths have also trended lower because the public is doing a better job of shielding the elderly and those at highrisk. The Centers for Disease Control and Prevention reported last week the share of deaths in nursing homes declined by 45% between May and August. Individuals over age 85 are 630 times more likely to die than those between 18 and 29, says the CDC.

This is why the epidemiologists who wrote the Great Barrington Declaration, which has been signed by tens of thousands of doctors and scientists, advise a focus on protecting the elderly. They also warn that government lockdowns lead to worsening heart-disease outcomes, fewer cancer screenings and more mental illness.

Nearly a third of the socalled excess deaths in the U.S. this year have been attributed to causes other than COVID, including cardiovascular disease and uncontrolled diabetes. COVID has accounted for less than 10% of deaths among those over 65 this year, and a much smaller share among younger people.

Treating non-COVID health ailments can reduce virus deaths. Masks can also help at the margins, and wearing them to protect others indoors and in crowds is public-spirited and important until a vaccine is widely available, which may be as early as this spring.

Meanwhile, vaccines continue to progress, and four in the U.S. have entered Phase 3 trials, meaning they have already shown evidence of generating antibodies in vaccinated patients. Mr. Biden says most Americans won’t be able to get vaccinated until the middle of next year, but Anthony Fauci of the National Institutes of Health this month suggested April.