In the first week of 2021, the United States reported more cases of COVID-19 than at any other point in the pandemic so far, and the second-highest number of deaths. Holiday data-reporting slowdowns from Christmas and New Year’s are likely still affecting most metrics—most notably reported tests, which are still well below pre-holiday levels. Hospitalizations, our most stable metric through the holidays, continue to march upward.
Even as the holidays disrupted the reporting of case and death data, the numbers we saw from nursing homes and other long-term-care facilities were grim. By our most recent long-term-care-data compilation, on New Year’s Eve, U.S. states had reported more than 1 million COVID-19 cases in LTC facilities. Although long-term-care residents and staff account for only 5 percent of the nation’s COVID-19 cases, they made up 38 percent of the nation’s COVID-19 deaths on the last day of 2020. U.S. states reported 5,963 COVID-19 deaths among LTC residents and staff in the final week of December—the deadliest month in long-term-care facilities since we began tracking the data in May.
There are now more than 132,000 people hospitalized with COVID-19 in the United States—more than were hospitalized at the peak of the spring and summer surges combined. These record hospitalization levels are not evenly distributed: As hospitalizations in the Midwest and Mountain West have continued to fall, they have risen in California and across the entire South.
With case numbers still wobbly after the recent holidays, hospitalizations are our best indicator of the movement of the pandemic, and they suggest a major resurgence of the virus in the South. Every single southern state has seen hospitalizations rise significantly since the middle of last month, and 13 states in the South set new records for COVID-19 hospitalizations in the past seven days.
In Alabama, December’s case spikes have translated into a higher per capita hospitalization rate than any U.S. state saw during the summer surge. Alabama now has the third-highest per capita hospitalizations in the country, trailing only Arizona and Nevada. Staffing shortages in Alabama hospitals, coupled with very low availability of ICU beds, have public-health officials in the state bracing for a coming crisis, as holiday exposures send more COVID-19 patients to the hospital. In Tennessee, one of the first southern states to see a major case spike in the current surge, hospitalizations are still rising, and one in every 1,000 Tennesseans has died due to COVID-19 since the beginning of the pandemic. The Tennessee Tribune has chronicled ongoing failures to reduce test turnaround times in the state, with one-third of labs still taking longer than two days to provide test results.