Global Health: A ‘very deadly December’ with tens of thousands of coronavirus death to come

A possible scenario sees 415,090 Covid-19 deaths by January, the Institute for Health Metrics and Evaluation (IHME) at the University of Washington says in its latest forecast. The worst-case scenario is 600,000 deaths by January 1.

An influential model is predicting a catastrophic winter with a significant rise in coronavirus deaths.

“When we look ahead into the winter with seasonality kicking in, people becoming clearly less vigilant, you know mask use is down, mobility is up in the nation, you put all those together and we look like we’re going to have a very deadly December ahead of us in terms of toll of coronavirus,” IHME director Dr. Christopher Murray told CNN’s Anderson Cooper.
The IHME model is essentially predicting the number of deaths will double in the next four months. As of Friday, nearly 6.4 million infections have been recorded in the US and more than 192,000 Americans have died, according to data from Johns Hopkins University.
Despite the dire prediction, President Donald Trump says the US has done “really well” in fighting the virus, according to a Thursday video on the White House official Facebook page.
“I really do believe we’re rounding the corner and the vaccines are right there, but not even discussing vaccines and not discussing therapeutics, we’re rounding the corner,” Trump said.
Speaking with MSNBC’s Andrea Mitchell on Friday, Dr. Anthony Fauci said he does not agree with the President’s statements.
“We’re plateauing at around 40,000 cases a day, and the deaths of around 1,000,” said Fauci, the director of the National Institute of Allergy and Infectious Diseases.
He said test positivity is increasing in some regions of the country and people are spending more time indoors because of cooler weather.
“That’s not good for a respiratory-borne virus,” he said. “You don’t want to start off already with a baseline that’s so high.”
Fauci’s disagreement with that comment is another example of a top scientist and a member of the White House coronavirus task force publicly disputing the President’s claims about the virus.
“We’re in a very politically-charged atmosphere now and whenever you’re trying to get people all together singing from the same tune and doing the same things as a society, unified against this common enemy — this virus — it’s very difficult to do that when you have such a charged atmosphere that we have right now,” Fauci told CNN’s Wolf Blitzer Friday. “And that really is truly unfortunate.”
Fauci warned that the country needs to get the levels down lower “so that when you go into a more precarious situation, like the fall and the winter, you won’t have a situation where you really are at a disadvantage right from the very beginning.”

US may not return to normal until 2021, Fauci says

The US might not return to pre-coronavirus life until the end of next year, Fauci said, but he is cautiously optimistic the US will have a vaccine by the end of this year.
“But it’s not going to be turning a switch off and turning the switch on. It’s going to be gradual and I think it’s going to take several months before we get to the point where we can really feel something that approximates how it was normally before Covid-19,” he said.
Blitzer to Fauci: Who should we trust, you or President Trump?
Blitzer to Fauci: Who should we trust, you or President Trump? 
There’s also the issue of how many doses of the vaccine will be available and how long it takes to distribute the vaccine.
“It’s going to take several months to get the country safe and vaccinated,” Fauci said.
Nearly 30 US states are reporting downward trends in Covid-19 cases, but the pandemic will likely worsen again, Fauci said.
“We need to hunker down and get through this fall and winter because it’s not going to be easy,” Fauci said.
Experts — including the US Centers for Disease Control and Prevention director — have warned the months ahead will be challenging. The US continues to see about 36,000 new cases each day — which is better than August but still too high, Fauci said.
“I keep looking at that curve and I get more depressed and more depressed about the fact that we never really get down to the baseline that I’d like,” he said.
As the weather gets colder, Americans will move indoors more, where the virus spreads more easily.
The coming flu season will complicate diagnoses. The strains on the healthcare system will make for one of the “most difficult times that we experienced in American public health,” CDC Director Dr. Robert Redfield has said.

Where we stand now

The actual number of infections could be far greater. Many may have had Covid-19 without knowing, as the CDC projects about 40% of people who are infected don’t show any symptoms.
Others could have been sick but never got tested. A new study says the US greatly undercounted Covid-19 cases at the start of the pandemic — missing 90% of them — mostly due to a lack in testing.
Across the US, 28 states are reporting downward trends — including Florida and California — compared to the previous week, and 14 are steady.
Experts worry a surge could come weeks after Labor Day celebrations, like cases soared after the Fourth of July.
An ensemble forecast from the CDC now projects that between 205,000 and 217,000 people in the US will die by October 3.
Medical experts also worry about the upcoming flu season. Fauci told CNN Friday the CDC recommended people getting their flu vaccines by October 31.
“What we’re hoping for — and I hope this happens — is that a combination of people getting vaccinated against the flu and the fact that the very public health measures that they implement to avoid coronavirus will actually help them avoid influenza,” Fauci said.
Fauci also recommended people “hunker down” for the fall and winter, but he says that does not mean shutting down the country again.
“We don’t need to shut down, we can do this if we pull together and abide by relatively simple and understandable public health measures,” Fauci said, adding that the measures include social distancing, wearing masks and avoiding crowds.

Non-symptomatic children can transmit virus, data show

Even children with mild or no symptoms can transmit Covid-19, according to contact tracing data from three Utah child care facilities released Friday.
Researchers said 12 children got Covid-19 in a child care location and transmitted it to at least 12 people outside, including household members.
They analyzed contact tracing data from 184 people with links to three child care centers in Salt Lake County from this April to July.
They found at least two children who had no symptoms not only had caught the virus but passed it to other people, including one mother who was hospitalized. One 8-month-old child spread the virus to both parents.
The researchers say that two of the facility outbreaks began with staff members who had household contacts with the virus.
Overall, children accounted for 13 of the 31 confirmed Covid-19 case linked to the facility, and all of the children had mild or no symptoms.

Infected college students shouldn’t be sent home

Colleges across the country have made face masks a requirement hoping to keep Covid-19 cases down. But just weeks into the first semester, campuses from all 50 states have reported infections.
The University of Texas at Austin announced this week three confirmed clusters on campus which collectively account for about 100 cases. San Diego State University confirmed almost 400 infections among students, after announcing a halt on in-person instruction.
And more than 1,300 Arizona State University students have tested positive since August 1.
Colleges and universities should try to isolate infected students instead of sending them home, Fauci has said.
“You send them back to their community, you will in essence be reseeding with individuals who are capable of transmitting infection, many communities throughout the country,” he said earlier this week.
“So it’s much, much better to have the capability to put them in a place where they could comfortably recover.”
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