And now we wait.
Thanksgiving is over, and public health officials’ persistent warnings that large celebrations and travel could douse accelerant on out-of-control Covid-19 spread have passed. But whether their warnings were heeded — and what kind of impact Americans’ decisions might have had — won’t be clear for a few weeks.
It will take a few days for those who got infected to start feeling sick, to get tested, and to get their results back. It will be two weeks or so before people who get sick enough to need hospital care show up in emergency departments. And it could be another two weeks after that before the seriously ill die, and a bit longer before those deaths are recorded in official tallies. It’s why experts describe metrics such as hospitalizations and deaths as lagging indicators — the results of transmission that occurred weeks prior.
What’s more, spread could compound in the interim. If people contract the coronavirus at Thanksgiving, within a few days they could be passing it to their colleagues, their teammates, and others — all before they show symptoms, and even if they never show symptoms.
“Probably what this means is three or four weeks after Thanksgiving, we will see more people die than otherwise would have,” said Michael Mina, an epidemiologist at Harvard’s T.H. Chan School of Public Health. “We’ll see more people get infected over Thanksgiving. And unfortunately, it will probably be a lot of older people who are gathering together with their families.”
The pre-holiday messages from public health officials were direct, and sometimes desperate. Please don’t travel, the Centers for Disease Control and Prevention warned. Don’t gather with people outside your households, and if you do, keep it to a small number, governors and mayors pleaded.
“The best gift we can give each other, the most gratitude that we can express to one another, is to keep one another safe this Thanksgiving,” Wayne Frederick, the president of Howard University and a surgeon, said he told his patients. “And the only way to do that is to stay apart from one another.”
Many people got on board. A STAT-Harris Poll showed most people were less likely this year to travel out of state to visit family and friends or take a flight for Thanksgiving, findings backed up by a range of other surveys showing most people planned to wait until next year for their traditional turkey feasts.
But some people definitely gathered together. Data from the Transportation Security Administration showed that more than 1 million air travelers were screened the Friday, Sunday, and Wednesday before Thanksgiving — a threshold rarely hit since March, though it’s still less than half of the number of travelers screened around Thanksgiving last year.
Public health authorities have blamed past holiday weekends for spiking cases in some areas, but gatherings of family and friends are just one log on the fire that is the U.S. epidemic. New cases have cropped up among college students socializing, kids playing after-school sports, and people taking exercise classes. They’ve been fueled at indoor restaurants, religious services, prisons, nursing homes, and other sites. Transmission is so high in many places it’s often hard to track down where people got infected.
As cases have increased, some states and local communities have taken an increasingly hard line against those activities, shuttering indoor dining again or prohibiting after-school activities. But many others have resisted because of concerns about the social and economic impact of taking such measures, particularly without additional federal aid for those who would be affected.
In the U.S., the pandemic has reached a point of dissonance. Over the past several weeks, there have been waves of remarkably heartening news on the vaccine front, with multiple candidates showing efficacy levels that surpassed top public health officials’ expectations. If all goes to plan, vaccines will start reaching some people by the end of the year, with the rest of the population eligible to get in line over the coming months. A culling of Covid-19 is within sight.
At the same time, cases and hospitalizations nationwide are reaching record levels, according to STAT’s Covid-19 Tracker. The country reported more than 2,000 deaths on two days last week for the first time since the spring. Health experts are trying to motivate people to hang on a few months more, to take the steps that can help blunt transmission — and to urge public officials to implement new plans to force cases down.
“There is such a moment and a need for us to rally and do this smartly and save lives over this winter, because if we hold out, it can make a tremendous difference,” Amber D’Souza, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, said at a briefing before the holiday. “This really is the moment to pull things in, because the way that infectious diseases work, it is exponential. We will see cases continue to double every few weeks until we get this under control.”
“I cannot be in four rooms at once, I cannot be at the bedside of four patients at once,” Consuelo Vargas, an emergency room nurse in Chicago, said on a press call arranged by National Nurses United, the largest organization of registered nurses in the country, ahead of the holiday. “We are being forced to choose who we are going to pay attention to first, and where do you want to be on that list? Your goal should be to not get on that list. Social distance, wear a mask, avoid large crowds.”
Another nurse, Juan Anchondo of El Paso, Texas, noted that his city has received national attention for its Covid-19 outbreak, which has forced the city to bring in refrigerated trucks to hold bodies. He said other communities could find themselves in similar straits, particularly with the December holidays on the horizon.
“This all started after Labor Day, just a steady spike of Covid infections,” Anchondo said. “I’m afraid because the holidays are coming up — Thanksgiving, Christmas — I’m afraid it’s going to be worse here, and everywhere else in the states. It’s a scary time out there right now.”