It was nearly the same number of people who died in the 9/11 attacks (2,977). And it was far more than the estimated 1,800 Americans who died over a matter of days when Hurricane Katrina struck the Gulf Coast in 2005. During World War II, from the Pearl Harbor attacks in December 1941 to Japan’s surrender, about 300 US soldiers died every day on average (and about 407,000 were dead in total by August 1945).
Unfortunately, the coronavirus pandemic has more in common with a slow-motion tragedy, like a war, than an acute event like 9/11. More than 2,600 deaths were reported on December 1, the day before the US set its new record for daily deaths; the previous high had been 2,752 on April 15. With the number of daily new cases and hospitalizations still rising across the country, public health experts expect new terrible death records will be set over the coming winter.
Coronavirus pandemic metrics are slippery things, however. America was so bad at testing during the first few months of the virus’s spread that there were likely quite a few cases and deaths that were caused by Covid-19 but were not counted as such. Even today, the US positive test rate is so high that experts say the statistics aren’t coming close to capturing every case or death.
According to the Johns Hopkins University tracker, the official number of total deaths attributed to Covid-19 in the US is 274,121. But total excess deaths — the number of deaths above what would be expected in a normal year — has reached 345,000, according to the Times. Most, though not all, of those deaths are likely uncounted Covid-19 fatalities.
At a certain point, this is all academic. What’s undeniable is that America is entering a period of mass death unlike anything we’ve seen so far in the pandemic. Cases and hospitalizations have been rising steadily, and deaths always follow. Improvements in treatment have lowered the fatality rate, but a higher number of hospitalized patients will inevitably mean more deaths. And it is older, low-income, and minority Americans who are dying at disproportionate rates from the coronavirus.
The US also set a new single-day record for current hospitalizations on December 2, topping 100,000 for the first time, according to the Covid Tracking Project. Hospitals all across the nation are under tremendous strain.
The US is going to lose a lot more people before the Covid-19 pandemic ends
As hospital beds fill up and staff is stretched thin, the likelihood of losing people who otherwise might have survived under normal circumstances increases.
Ashish Jha, dean of the Brown University School of Public Health, explained the risks in a recent Twitter thread. He started by pointing out that the percentage of new Covid-19 cases who end up in the hospital is actually shrinking. That would suggest people who would have been hospitalized earlier in the year are now being turned away from the emergency room or asked to stay at home because they’re not yet in critical condition.
Some of this is good public health practice — you want to keep beds open for the sickest patients — but it also creates a situation where somebody who’s at the margins could be denied entry to the hospital and their condition might deteriorate more quickly at home.
Everything — COVID and non-COVID is affected— Ashish K. Jha, MD, MPH (@ashishkjha) December 1, 2020
So borderline admission for heart failure? Person now goes home
Pt with infected leg where you’d prefer IV antibiotics in hospital? They go home with oral antibiotics
This is what is happening in hospitals across America right now
Full hospitals could also be left without enough room or staff for patients with other serious conditions, and some of those people could die without access to the medical care they need. They may not die of Covid-19, but they would still be victims of the pandemic.
On Twitter, Kari Jerge, a surgeon in Kansas City, Kansas, described recent dilemmas doctors are facing: a non-Covid patient who died because he needed an emergency kidney replacement with a dialysis machine but there were no nurses available to run the machine, and having to turn down a transfer of another patient in critical condition because there were no ICU beds left.
This is likely only going to get worse over the holiday season. Many states and cities still refuse to take the mitigation measures necessary to control the virus, even though none of them meet the benchmarks for safely staying open. Vox’s German Lopez painted the grim picture in his most recent update on how each state is faring in containing the coronavirus:
Across these benchmarks, zero states fare well on all three metrics, suggesting no state has its outbreak under control right now. In fact, no state meets even two of three benchmarks — only Washington, DC, does. (Washington state is excluded due to recent problems with its testing reports.)
One caveat: Because of Thanksgiving, states are likely underreporting Covid-19 tests and cases. So as bad as things may already seem, they’re likely even worse than reported.
America’s outbreaks, reaching from California to Florida, are the result of the public and the country’s leaders never taking the virus seriously enough and, to the extent they did, letting their guard down prematurely. States, with the support of President Donald Trump, moved to reopen — often before they saw sizable drops in daily new Covid-19 cases, and at times so quickly they didn’t have time to see if each phase of their reopening was leading to too many more cases.
The public embraced the reopenings, going out and often not adhering to recommended precautions like physical distancing and wearing a mask.
Even as cases began to fall later in the summer, America’s overall caseload remained very high. And yet many states moved to reopen once again, with much of the public embracing the looser restrictions and subsequently going out.
It’s this mix of government withdrawal and public complacency that experts have cited in explaining why states continue to struggle with getting the coronavirus under control.
There is still time to soften the blow, with states and cities implementing more social distancing restrictions and requiring better mask adherence. But barring a sudden change in public behavior and public policy, America’s outbreak is not going to get better anytime soon.
At this point, we appear to be waiting for the vaccine to be widely distributed to bring the virus under control — something that may not happen for another six months or longer. Prioritizing the most vulnerable populations for vaccination should help reduce the death toll, but there is no avoiding the fact that tens of thousands of Americans are likely to die over the next few months.
CDC Director Robert Redfield said on Wednesday that the US Covid-19 death toll could reach 450,000 by March 1 without better social distancing and mask-wearing. That would mean about 175,000 more deaths between now and then.
In that scenario, the number of Americans who died of Covid-19 would surpass the number of American soldiers who died in all of World War II — and across a much shorter time frame (about one year versus four). In terms of mass-death events in America’s history, the coronavirus pandemic would rank behind only the Civil War and the 1918 flu pandemic.
As other parts of the developed world celebrate the complete eradication of the virus, America is still reaching the worst kind of milestones. And there are more to come.