Here is what we know about the state of COVID-19 as we approach the winter holiday season.
On Thanksgiving Eve, more than 1 million passengers cleared airport security, the highest single-day volume since the coronavirus reshaped American life in March. While airplanes are not likely settings for super-spreader events, everything before and after people step on a plane is somewhat risky. This includes parents shouting at their misbehaving kids in security lines; individuals munching on Auntie Anne’s pretzels, masks dangling from their chins, in departure-terminal crowds; and, most importantly, extended families swapping sweet-potato pie and invisible pathogens over the dinner table in poorly ventilated homes. A holiday surge on top of the calamitous autumn surge could be coming soon.
What we don’t know about the new stage of coronavirus cases—and what we will not know for several days or even weeks—is just as important to spell out.
On a typical weekend, every part of the U.S. testing apparatus takes a break. Some doctor’s offices close, so fewer people get tests. Some testing sites close, so fewer tests are assayed. And some health departments close, so fewer test results are reported. That’s why, on Sundays and Mondays, news organizations typically report a small drop in positive cases.
On a special holiday weekend like Thanksgiving, the testing break is especially disruptive, writes Erin Kissane, a founder of the COVID Tracking Project at The Atlantic. Many test sites, labs, and health departments took off Thanksgiving and the long weekend. As they work through the backlog of tests in the next few days, we’ll likely see a misleading decline in cases early in the week followed by a huge surge.
But that’s not all: We’re also likely to see a historic increase in testing from all these people returning from their Thanksgiving vacation. On Sunday, the White House coronavirus-task-force coordinator, Deborah Birx, told CBS that everybody who traveled should “assume that you were exposed and you became infected.” That would mean tens of millions of people trying to get tested in the next week or so, leading to a backlog on top of the backlog.
In sum, the next few weeks are going to be a statistical blur at the very moment when families are looking for clarity regarding the winter holidays. As COVID-19 hospitalizations reach an all-time high, we are facing a normal weekend testing delay, exacerbated by a major holiday, complicated by the already rising COVID-19 caseload, and further burdened by the imminent wave of tests that will be demanded by people coming back from their Thanksgiving trip. For that reason, state and local governments, businesses, and families might have to fly blind for a while in the fog of pandemic.
The safe assumption is that cases, hospitalizations, and deaths will all reach new highs before Christmas. The virus is simply everywhere. While the spring wave slammed into the Northeast and the summer surge swept over the South, the latest surge, while concentrated in the Midwest, is truly national. Almost every state has seen an increase in cases since September, and nearly 40 states saw COVID-19 hospitalizations reach record highs in the past three weeks. Right when Americans should have separated themselves from new exposures, millions of them shuffled and reshuffled themselves into new combinations of people. This epidemiological experiment seems destined to produce more deaths, more grieving, more illness, and more exhausted health-care workers, who were already on a “catastrophic path” before 9 million people filed through TSA checkpoints in the past week.
There is some cause for optimism. Most obvious are the promising vaccines from Pfizer/BioNTech and Moderna, which are not only the fastest vaccines ever developed but also pioneers in mRNA manipulation that mark a new frontier in science. Second, the fall surge has been so dramatic that it’s pushed many state governments to adopt mitigation policies that should bear fruit for households that aren’t traveling. For example, on November 14, North Dakota’s governor finally issued a statewide mask mandate. Positive COVID-19 cases in the state peaked four days later and have since declined by 30 percent. (The decline might also have something to do with households taking additional precautions that aren’t mandated by the state.) Finally, the viral spread in some states has been so calamitous that it may have narrowed the path for worse outbreaks in the future. Former FDA Commissioner Scott Gottlieb has estimated that in North and South Dakota, one-third to one-half of the population might have already contracted the virus. It’s a matter of straightforward epidemiological math that a population with 50 percent antibody protection is less likely to experience a mass outbreak than a population with no antibody protection.
But as I write, I’m reminded that optimism in a pandemic is a monkey’s paw, a gift that also curses. For the past nine months, the United States has engaged in a danse macabre between hasty fear and sunny carelessness. With the spring surge, many places locked down their population to get control of the outbreak. When the data improved, many declared victory, threw out their mask ordinances, unlocked the bars, and held a viral bacchanalia. Then the virus resurged. While several countries, such as Japan, found a way to adapt, universalize masks, reduce crowding, and enforce public quietude, the U.S. has toggled between hysterical overreaction (closing schools for young children, against the best international evidence) and an olly-olly-oxen-free approach to virus mitigation (also against the best international evidence).
A vaccine is waiting on the other side of this pandemic winter. But before the temperature rises, and before the vials are distributed, Americans will have to find ways to remain safe inside, at home.