Fears growing US may see 1M COVID-19 deaths
Cases spike from delta variant as omicron spreads
Less than three months ago, the U.S. reached 700,000 COVID-19 deaths, and public health experts mused over whether the toll would reach a once-unthinkable 1 million.
Now the nation is within days of reaching 800,000 coronavirus deaths as 1,200 Americans die from the coronavirus every day, the delta variant drives an infections spike and the ominous omicron variant races around the world.
“There is no question that we will reach 1 million deaths sooner rather than later,” Robert Glatter, an emergency medicine physician at Lenox Hill Hospital in New York City, told USA TODAY in an interview. “At the current trajectory we may reach it much sooner than expected, with cases, hospitalizations and deaths significantly increasing in the past two months.”
Such a death toll may be inevitable, but “we can still do a lot within our means to prevent that from happening,” said Ogbonnaya Omenka, an assistant professor at the Butler University College of Pharmacy and Health Sciences.
Glatter and Omenka emphasized a recurring theme: Vaccination is the key to curbing the trajectory. But other mitigations will be required.
Experts cringe at what winter could bring. The flu is already spreading through some communities. The coronavirus causes about 100,000 new COVID-19 cases a day in the U.S. The delta surge hasn’t peaked, and here comes omicron.
Masking indoors and at large outdoor events, vaccinations and booster shots and testing if sick or exposed may be the only hope for avoiding the looming triple threat of the flu, the variants – and the holidays.
“The potential for a catastrophic surge of deaths looms large this winter,” Glatter said. “The outlook ... looks bleak at best.”
Tighter U.S. travel restrictions kicked in this month. New York City Mayor Bill de Blasio unveiled a vaccine mandate requiring 184,000 businesses to have all of their workers vaccinated starting
Dec. 27.
“Even before omicron, we were worried about the cold-weather months and the holiday gatherings,” de Blasio said. “Before we heard the word ‘omicron,’ we saw the troubling trendlines.”
A more dangerous omicron?
Omicron, the latest “variant of concern” as described by the World Health Organization, is drawing a lot of attention. There are signs that vaccinated people have some protection. Pfizer announced that lab tests indicate a third dose of its vaccine provides neutralizing antibodies against omicron similar to the level observed after two doses against the original coronavirus and other variants.
Glatter said Americans need to receive all three doses to prevent transmission, breakthrough infections, severe disease and hospitalizations.
“The variant is circulating in vaccinated persons and could adapt in the future to ‘outsmart’ the vaccine’s antigen cocktail,” said Melissa Nolan, an assistant professor of epidemiology and biostatistics at the University of South Carolina Arnold School of Public Health. That could make the “omicron variant in February 2022 more infectious in vaccinated persons than today.”
Atul Nakhasi, a primary care physician at Martin Luther King Jr. Outpatient Center in South Los Angeles, said the goal in the fight against COVID-19 is the same as every fight in health science: to alleviate human suffering.
Historical advances have been made toward detecting early cancers, decreasing preventable heart attacks and treating HIV to the point where people can live a normal and full life. COVID-19 is the latest in a long line of similar targets that medical science must vanquish or neutralize, Nakhasi said.
“That is the remarkable feat of science, and I have no doubt science will and can do the same now for the pandemic,” Nakhasi told USA TODAY. “Our goal is to turn deadly COVID into the COVID cold. I think we can do it.”
Until recently, the only available treatment was monoclonal antibodies, which must be delivered through a shot or infusion. Health care providers may soon get another treatment option – a federal advisory committee recommended that the Food and Drug Administration authorize the first antiviral oral pills to treat COVID-19, called molnupiravir from Merck and Ridgeback Biotherapeutics.
“Just as with the flu, vaccines prevent sickness, hospitalization, death and transmission,” Nakhasi said. “Yet we also have Tamiflu for treatment, too. Similarly, it is great news to have effective pill treatments potentially soon available.”
No ‘golden bullet’
More and better treatment options for unvaccinated, high-risk people are being developed every day, Nolan said.
Collectively, these give promise to lower overall mortality risk – and lower the risk of more dangerous variants. When an unvaccinated, immunosuppressed person is infected with SARSCOV-2, the virus mutates more quickly.
Treatments such as the Merck pill not only lower the chance of death but also lower the chance of variants, Nolan said.
The nation must proceed with “cautious optimism,” regardless of the experimental results, until treatments prove successful against the disease, Omenka said. The clinical approach alone – vaccines and medications – won’t be enough to combat an infectious disease, he said.
A hybrid approach of clinical and of public health practices such as hand washing and face covering remains the most viable method, he said.
“It’s understandable, the eagerness to identify a sort of ‘golden bullet’ for the disease,” Omenka said. “However, the drugs are aimed at mitigating the severity of the disease, not preventing or curing it.”
Nolan said clinicians and public health officials look beyond the numbers and are devastated by every death. Hoping to avoid the 1 million milestone, they are “saddened” to see low vaccination rates among some groups and in some areas – rates helping to drive the toll ever higher, she said.
“We hope to gain these groups’ trust for future vaccination interventions,” she said.
A study by researchers from Carnegie Mellon University and the University of Pittsburgh found that vaccine hesitancy decreased among U.S. adults by onethird from January to May. The largest decrease in hesitancy during the period, by education group, was in those with a high school education or less.