U.S. surpasses 12 million COVID-19 cases as Thanksgiving nears
Infectious disease expert Dr. Amesh Adalja on how to celebrate the holiday safely
From a health standpoint, we’re in the middle of the Fight of the Century. COVID won the first couple of rounds and is now surging in much of the country. There are six new cases every second and one death every minute. We hit new records daily, and it’s going to get worse before it gets better.
Vaccines are on the way, but it will be months before lots of people get vaccinated. For now, we have to make do with the 1-2 punch of weapons already in our arsenal.
We can beat the virus.
The first punch – closures of parts of our society – is a blunt instrument that slows disease spread but must be better timed and aimed.
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The second – getting infectious people isolated quickly to reduce spread – hasn’t landed to have impact in most of the country.
When businesses opened in much of the country at the beginning of summer as cases were increasing it was like leaning into a left hook. We got hit hard, especially by surges after the Memorial Day and July Fourth holidays.
The current rise in cases started after Labor Day, again driven by gatherings. With colder weather, people are moving to more activities indoors, where the virus spread more easily. Now we’re looking ahead to Thanksgiving and Christmas, with cases likely to spike even more if people don’t change their approach to traditional holiday gatherings.
In the face of rapidly increasing case numbers, many states are reimposing closures and other restrictions. We need to do this to get cases back down, but can do it in a more targeted way that focuses on activities and locations that are highest risk.
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If everyone follows the 3 W’s – wearing masks, watching their distance from others, and washing hands frequently (or using hand sanitizer) – many things will be reasonably low risk. If we target and time closures well and take these safety measures, we won’t have to close everything.
Retail shopping can be safer with masks, paid sick leave so workers don’t come in while ill, good ventilation, and capacity controls, but malls teeming with large crowds are risky. Getting your hair cut is safe if masks are worn and the shop isn’t packed with people waiting. Getting takeout or delivery food is fine, but eating inside restaurants or going out to bars is high risk. In-person school is possible, especially for K-8 students as long as we make schools safer and avoid social get-togethers such as after-school events and teacher break room gatherings.
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Our second punch – boxing the virus in – has flailed and missed badly. I wrote in April about what we needed to do to avoid resurgence of Covid; other countries have succeeded.
To avoid having to close yet again while vaccine is on the way, we will need strategic testing to find infected people, rapid isolation of all who are infected to prevent further spread, contact tracing to warn those exposed and test them, and quarantine of contacts until they are not potentially infectious so that we can end webs of disease transmission.
With the current surge in cases, we’re back to long waits for testing and for results. Isolation and quarantine work but require financial and social support to be successful; these supports were largely absent.
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Contact tracing never was very effective in most places. With the high and rapidly increasing number of cases we’re now seeing just about everywhere, it becomes nearly impossible to find everybody who may be exposed. We need to up our game so that, in the coming months while vaccination is being rolled out, we can stop the spread of cases and clusters by boxing the virus in so we can save lives and continue economic recovery.
This 1-2 punch – strategic closures targeted to where the risk is highest followed by knocking the virus down and keeping it down – is what we have to work with now. Until there’s a safe, effective, widely available vaccine, we have to make it work so we can keep people and our economy healthy.