'There's no way to sugarcoat it': COVID-19 cases are surging; one American dies every 107 seconds

John Bacon

The U.S. set a record this week for new coronavirus cases over a seven-day period with more than 500,000 infections. An American is testing positive every 1.2 seconds.

Daily deaths are also climbing – one of us is dying every 107 seconds, according to Johns Hopkins data.

And daily hospitalizations have been rising steadily for more than a month, from 28,608 on Sept. 20 to more than 44,000 on Tuesday.

"There's no way to sugarcoat it: We are facing an urgent crisis, and there is an imminent risk to you, your family members, your friends, your neighbors and the people you care about," said Wisconsin Gov. Tony Evers, whose state is seeing one of the nation's worst outbreaks.

As winter approaches, America is facing a crucial fork in the road, said Melissa Nolan, an infectious disease expert and professor at the University of South Carolina.

"We might see a larger surge due to the pandemic fatigue Americans are experiencing," Nolan told USA TODAY. "Americans are tired of adhering to public health guidelines and getting tested."

She repeated the familiar plea of public health experts: Masks. Social distancing. Hand washing. Risk mitigation strategies until a vaccine is developed. 

While the White House’s science policy office ranked “ending the Covid-19 pandemic” among President Donald Trump's top achievements, the world isn't buying in. Stock markets around the globe fell sharply Wednesday amid investor fears that global lockdowns are once again on the horizon.

"We're well behind this virus," Dr. Mike Ryan, executive director of the World Health Organization's emergencies program, said this week. "We will have to get ahead of this virus, and that may require sacrifice for many, many people in terms of their personal lives."

Some suggest a national lockdown might allow a “reset” for states more severely affected to reduce their spiraling numbers, but that is unlikely to happen given the political climate, most experts agree.

"A national mandate from the federal government for universal masking is more likely to achieve the greatest impact to reduce deaths in the next several months," said Robert Glatter, an emergency physician at Lenox Hill Hospital in New York City.

That's not very likely either, however. 

Meanwhile, states like Wisconsin suffer. State officials there are urging residents to stay home and avoid social gatherings – despite a series of legal challenges that have frustrated efforts by Evers to order restrictions.

"It's a nightmare scenario, frankly, that this could get quite a bit worse in the next several weeks or months before it gets better," said Ryan Westergaard, chief medical officer for the Wisconsin Department of Health Services.

Experts say at least one vaccine candidate could win FDA approval by year's end. But that could just be the beginning of questions related to vaccinating a nation of more than 300 million people. And a world of more than 7 billion people.

Grissel Franco, clinical coordinator, Cristian Franco, lead medical assistant and Brenda Vargas, medical assistant with Vo Medical Group in Calexico perform testing with patients wanting to know if they are COVID-19 positive on April 7, 2020.

Nolan warns that until it becomes clear what type of vaccine clears FDA guidelines for mass distribution, it won't be clear what problems  the nation faces in getting it to the public. For example, some vaccines require refrigeration – and, because this is how the world works in 2020, it turns out we are nearing a national shortage of clinical laboratory refrigerators.

We still don't know how well any vaccines actually will work. And even if they do work, Americans must be convinced it is safe and effective before they line up to get the shot.

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Once the vaccine is available, "uptake issues" must be overcome, said Ogbonnaya Omenka, an associate professor and public health specialist at Butler University. Will the vaccine be mandatory or optional? And if mandatory, how will it be enforced "in view of the clash between individual liberty and public health?"

Also, there are questions of prioritization: figuring out who should get the vaccine first because there won't be enough to go around for some time. Young, healthy people would seem to be last in line, but what effect will that have on in-classroom learning for students?

There is also evidence that vaccine hesitancy may be higher in minority communities, the communities that have been hit the hardest by the pandemic, said Dr. Anuj Mehta, a pulmonary and critical care physician at National Jewish Health in Denver.

"Convincing people that a vaccine is a safe and effective will be a critical part of widespread dissemination," Mehta said.

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Trump, who recovered from COVID-19 earlier this month, continues to downplay the latest wave of infections

"We're rounding the turn," the president said at recent campaign stop. "We're doing great. Our numbers are incredible."

Trump points to daily death totals, which, while rising, have not reached numbers seen in April, when thousands of Americans died each day. Glatter said deaths have not reached those numbers during this surge because of increased testing, more judicious use of intubation and noninvasive forms of ventilation, and use of steroids and the medication remdesivir when indicated. 

The world is also struggling.

South African President Cyril Ramaphosa said Wednesday that he has gone into quarantine. India is second only to the U.S. in reported infections, nearing the 8 million mark.

In Europe, several nations are weighing tougher restrictions. European Union officials on Wednesday urged the bloc’s 27 nations to introduce common rules to test for the disease and track its spread to help prevent further damage to their virus-battered economies.

“We are seeing a large number of cases, we are seeing widespread disease" in Europe, Ryan said. "We are seeing very, very high positivity rates and an increasing lack of capacity to do any effective form of contact tracing."

He said stay-at-home orders may be needed in some countries to take the "heat out of this phase of the pandemic."

When will it all end? There are so many variables, it's not easy to say. Glatter said it will take three years. 

Nolan went out on a limb: "Next spring," she said.

Contributing: Mike Stucka, USA TODAY; Sophie Carson, Milwaukee Journal Sentinel

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