The Centers for Disease Control and Prevention has finally acknowledged that aerosol transmission happens and that ventilation is important. The initial bungled messaging and science around masks was unfortunate, but things have turned around; the CDC has even publicized how masks can help protect the wearer from infection, as well as lower the chances of onward transmission. The importance of clusters and super-spreading is more widely appreciated, maybe partly because of the highly publicized White House cluster, which is still simmering.
We have reasons to celebrate, but—and you knew there was a but—a devastating surge is now under way. And worse, we are entering this dreadful period without the kind of leadership or preparation we need, and with baseline numbers that will make it difficult to avoid a dramatic rise in hospitalizations, deaths, and potential long-term effects on survivors.
Almost every day, America is breaking new records in confirmed cases: They are up 40 percent from just one week ago. These cases are not confined to a region or a state; the whole nation is in the midst of a terrible surge. So, too, is much of Europe, where country after country is experiencing record numbers of cases.
This is not a “casedemic”—the false notion that we just have better testing and detection, without any real change in the underlying risk for illness and death. It’s true that we missed a lot of cases in the spring because we didn’t have enough tests, and that we are catching more of them now. But it’s not just confirmed cases that are on the rise. The United States is also experiencing a steep increase in hospitalizations, as well as about 1,500 reported deaths a day; those are the highest numbers since mid-May, and they are still rising sharply. Trevor Bedford, a scientist at the Fred Hutchinson Cancer Research Center, in Seattle, calculates that more than 2,000 deaths a day may already be baked in for early December, meaning that even if we stopped every new infection from now on, we’d still see that many people die per day in just a few weeks among those already infected.
Read: ‘No one is listening to us’
The Pfizer-BioNTech vaccine—or Moderna’s vaccine—may be available in the United States to health-care workers and other high-priority people as early as the end of this year. But it won’t be distributed widely until well into 2021, even in the best-case scenario—and the Pfizer vaccine needs two doses, about 21 days apart. Those promising monoclonal antibodies, too, are in very short supply. The president was one of fewer than 10 people to receive the treatment outside of a clinical trial. Even if the drug works as well as we hope, the 300,000 doses that Eli Lilly has agreed to deliver will not be enough when they finally arrive, probably toward the end of this year, when we have 150,000 positive cases a day, and still rising. Dexamethasone availability is excellent, but deaths are climbing despite its widespread use, because it helps address only one of this disease’s complications.