Covid Epi Weekly: Death Won’t Take a Holiday this Holiday Season
Tom Frieden
President and CEO of Resolve to Save Lives. Former CDC director and NYC Health Commissioner. Focused on saving lives.
We have a divided government and a divided country, just when we most need unity to stop the pandemic. Covid is skyrocketing across the country, but some areas are being hit much harder than others. Correcting for how much testing is done, there’s a 100-fold difference between South Dakota and Vermont and 10-fold difference between the Northeast and Upper Midwest.
How bad is the increase we’re seeing? Bad. Cases are doubling, tripling, or more in many communities and states. Much of the US is in the exponential increase phase, and every day of delay costs lives. The basic 1-2 punch concept still applies. 1) Knock the virus down, minimizing societal harm, and 2) Keep it down.
First, let’s take a look at the numbers. They’re bad almost everywhere. According to the CDC, national percent positivity increased (from 7.2 to 8.2%), and increased among all age groups in all regions. Horrifying. This is a national tsunami. Hospitalizations are up 14% and deaths up 8%. Deaths follow hospitalizations by a week or two. These numbers will continue to rise.
Many thanks to Covid Exit Strategy for their great work tracking the situation in each state. I hope the site, and others, like it, will be put out of business by a competent federal response that gets us all on the same page and demonstrates that our only enemy is a virus. The more we work together, the more we can control Covid.
The increases in hospitalizations required the Covid Exit Strategy team to add a new color. The Upper Midwest is in the exponential increase phase. Here’s the key point: the per capita hospitalization rates for Covid range from 500 per million to <50/million. That’s a 10-fold difference. Policy matters! Covid can be controlled.
It’s been frustrating to see a continued focus on the wrong numbers. Detected cases are only about one fifth of total infections. A weighted ranking of test-intensity and incidence helps. As I mentioned at the beginning of this post, there’s a 100-fold difference between South Dakota and Vermont.
We’re waking up to the fact that we need to shut down. We can do this sensibly, keeping schools, childcare, universities, shopping, barber shops, and other places open—but ONLY with rigorous safety measures and modifications. We will need to reduce travel and risky indoor gatherings. Ireland’s approach is a great example.
Like oh-so-much-too-much in our society, Covid hurts the most vulnerable most. Rates of infection are vastly higher in Native American, Latinx, and Black communities. The virus doesn’t stay in any group—we’re all connected. The more safe we all are, the more safe we all will be.
Sooner or later, we’ll have to knock down the spread of the virus with strategic closures. But we need to vastly up our game in preventing household spread.
A stunning study found a very high attack rate among children in families with Covid: 77%!
Other studies have found lower rates, but the bottom line is not finding people who are infected fast and helping Covid patients relocate during maximum infectivity extends explosive spread by weeks or months. We must reduce the time from infectivity to isolation, offer paid sick leave for all, and make isolation more effective. Knocking down spread is the first punch, boxing the virus in when new infections emerge is the second punch.
We must discover more, such as how to avoid leaving infectious people at home, how to best use the tens of millions of antigen tests being sent out, and how to scale production of N95 (including safely reusable) and surgical masks.
Pandemic fatigue is understandable. We all feel it. The WHO Euro released a helpful report showing how we can help address it:
- Understand and empathize
- Engage communities to find solutions
- Reduce restrictions but protect lives
- Be transparent, consistent, predictable, and fair.
The virus isn’t giving up, and neither can we. Success is possible. It takes rigor, discipline, patience, and working together. This CDC article shows the positive impact of targeted closures and widespread use of masks.
The sooner we shut, the softer and shorter we can shut. We can minimize disruption to holiday shopping, jobs, education AND reduce major drivers of spread. To have happier holidays, we need to stay much safer for the next six weeks.
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Community Outreach Pharmacist, Pharmacy Owner
4 年I have several family members who refuse to believe the COVID information posted. They think it is fake! The most common reason I keep hearing is that they believe the stats are messed with to look like a death is caused by COVID when it’s due to some other reason. The only way I was able to make them consider that something is different from previous years was to mention the OVERALL death rate comparison by years. They started to understand why society needs a lockdown. I took COVID out of my argument and just informed them how the overall death rates for any cause had drastically risen in 2020. There must be SOMETHING different about 2020. I just thought this way of explaining the situation to people that want to politicize the pandemic could help other health professionals. When people don’t want to hear or believe the COVID reality, just show them the information as total deaths due to any cause.
Guided by data, lead with connection
4 年Thank you! Your first sentence says it all. While there were many echoing the concept of unity during the early months of the pandemic, this sentiment has been weakened due to various reasons (i.e., pandemic fatigue, political polarization). Public health initiatives aim to protect the individual, by targeting inventions at a community or population level. The success of these initiatives, including mask mandates and vaccinations, are largely dependent on community-built trust and unity. And at this point, there is a lack of trust in the current administration’s ability to protect the American people. This distrust is fueled by inconsistent messaging, disagreeing with experts, and an unwillingness to acknowledge the severity of the virus. Our focus now needs to be directed toward re-building trust in science.?
Helping Medical Device Companies go 'from Concept to Clearance'
4 年Tom, these are all the states that are closing doors and turning on the heat. In the dead of summer, all the southern states that closed their doors and ran the air conditioning were seeing the same meteoric rise. I am glad that the hospital and mortality rates have subsided,
Thoughtful analysis for sure and it’s fairly easy to track this data so America as a nation must decide how much covid is acceptable on a daily basis. Thoughtful analysis such as covid cases per 100k or net covid hospitalizations per million helps standardize for differences in availability of testing now vs at the start of the pandemic. This data is a useful measure to show which states are clearly underperforming in their covid response. This can help frame current and future policy at the federal, state and local levels. It’s never to late for the US to attain a future pandemic response similar to that of the experience of Taiwan or S. Korea. Taiwan for example recently announced domestically transmitted covid cases were zero for over 200 days which is remarkable. So how many cases is too many for America? Some of us may want new covid cases to approach the zero bound while others seem to embrace the spread of covid in their communities. Regardless of the sporadic approaches policy makers adopt it’s clear that we need to figure out a more viable approach to dealing with the pandemic so K-8 children can be in schools full time and so we don’t continue to make excuses as to why we can’t make that happen.