During the Civil War, 504 people were dying every day. On 224 of the past 257 days, the country’s seven-day average of coronavirus deaths has exceeded that mark. As of this writing, the current seven-day average of coronavirus deaths is more than twice that number. That’s because the country is in the midst of its third surge in new coronavirus cases.
Over the past week, one out of every 355 Americans has contracted the virus. The average number of new cases has increased 40 percent over that same period. Since the beginning of July there’s been a consistent relationship between new cases and deaths, with the daily death toll representing about 1.8 percent of the number of cases two weeks prior. That suggests that the number of deaths nationally will continue to surge in parallel with the number of new cases.
At the federal level, though, there’s no sense of urgency or panic. President Trump interrupted his stream of false assertions about winning the presidential election to celebrate the announcement that a coronavirus vaccine candidate had been successful, but he has done nothing obvious to guide the public response to the accelerating crisis. And it is accelerating: On Oct. 29, the number of new cases was increasing 18 percent week-over-week. Two weeks later, that rate had more than doubled.
By now, it's hard to dispute that the primary cause for federal inaction is that Trump has decided to simply let the virus spread. We've seen hints of this for months, the most obvious of which was Trump's decision to pluck a neuroradiologist named Scott Atlas off Fox News and install him in the White House coronavirus task force. There, Atlas has pushed back against government epidemiologists to advance a strategy centered on slowing the spread of the virus by letting far more people contract it — and then, hopefully, become immune to it.
From within the White House, The Post reported last month, Atlas has “advocated allowing infections to spread naturally among most of the population while protecting the most vulnerable and those in nursing homes until the United States reaches herd immunity, which experts say would cause excess deaths, according to three current and former senior administration officials."
Atlas was incensed at this characterization. Not the reporting on his tactical approach, mind you, but on claims that he has embraced a “herd immunity” strategy. Speaking to an online news outlet the following day, Atlas called assertions that he supported the idea a “repeated distortion, lie, or whatever you want to call it.” He then outlined his actual approach — which mirrored The Post’s reporting and is functionally equivalent to herd immunity.
“It’s a three-pronged strategy,” he said. “Number one: aggressive protection of high risk individuals and the vulnerable (typically the elderly and those with co-morbidities). Number two: allocate resources so that we prevent hospital overcrowding, so that people can be treated for this virus and get the other serious medical care that is needed. Number three: open schools, society and businesses because keeping them closed is enormously harmful."
This is the approach that Trump has publicly described for months: protect those at risk and let everyone else do their thing. The broad problem, repeatedly demonstrated, is that things can’t get back to normal if people are constantly getting sick. But the specific and most dangerous problem is that the only one of Atlas’s three prongs that is being implemented effectively is the third, the one centered on allowing the virus to spread. The government’s not doing the first two well, if it’s even trying to do them at all.
The most vulnerable population in the United States is those who live in facilities focused on caring for the elderly. When the virus seeped into nursing homes in the spring, the effect was devastating. Despite the assurance that there would be “aggressive protection” of this group, cases and deaths continue — and appear to be accelerating.
Last month, we reported that there had been a fairly steady number of new cases and new deaths in long-term care facilities since the beginning of the second surge in new cases this summer. Earlier this week, Politico reported that the number of new cases in those facilities was surging, with states implementing systems aimed at curtailing new infections.
As of Oct. 9, there were 537,446 cases in long-term care facilities and 84,136 deaths, according to data from the Kaiser Family Foundation. As of Nov. 6, those figures are 616,646 cases and 91,578 deaths, increases of 15 percent and 9 percent respectively. That figure would account for about a third of the deaths nationally over the same period.
One approach the administration has embraced is the deployment of rapid coronavirus testing capacity nationally. It has repeatedly announced that millions of tests would be sent to states to better track new infections, particularly in places such as long-term care facilities. In the week of Nov. 9, the government distributed just under 2.6 million tests nationally, about two for every resident of a long-term care facility as of last year. Most states, though, are trying to monitor a variety of at-risk populations from the same pool of tests.
Atlas also assured the country that the federal government would ensure that hospitals aren't being overwhelmed. On that measure, too, the government is failing.
There are more people hospitalized with the virus now than at any previous point in the pandemic — about 1 out of every 8 people who have ever been hospitalized for covid-19, the disease caused by the virus — according to data from the COVID Tracking Project. This surge is straining hospitals and spurring new stay-at-home orders in places such as El Paso and Chicago. Iowa has run out of staffed hospital beds.
There are also nearly 13,000 people currently in intensive care, according to the COVID Tracking Project. The government’s estimate as of Wednesday is that about 71 percent of ICU beds nationally are filled. In 10 states, more than 80 percent of ICU beds were filled, including 93 percent of beds in North Dakota.
The Atlantic’s Ed Yong, writing about the emotional toll the current surge is taking on health-care workers, explained how resource-intensive ICU stays are.
“An ICU nurse can typically care for two people at a time, but a single COVID-19 patient can consume their full attention,” he reported. “Those patients remain in the ICU for three times the length of the usual stay."
In North Dakota, the shortage of staff spurred the state to allow coronavirus-positive nurses to remain on duty if they were able to do so, a policy to which nurses have objected.
Where is the federal government in this? If the plan, however dubious, was to allow the virus to spread while offsetting the worst effects, when can we expect that offsetting to take place? The situation now is akin to a fire chief assuring people that the best approach to fires breaking out in an apartment complex is to let the fires burn themselves out while he provides them with fire extinguishers. And then not providing the fire extinguishers. And then spending most of his time tweeting about how he won the vote for best fire chief.
It’s a grim, grim moment, which is poised to get worse over the short term. Even if the number of deaths is kept down during the winter — a big if — there are long-term health risks posed by even nonfatal infections. ICUs choked with coronavirus patients also mean ICUs unable to handle other serious illnesses or injuries. What’s more, the idea that allowing the virus to spread to build immunity depends on an unproven assumption that reinfections can’t occur over a relatively short period of time.
The most remarkable part of all of this is that a vaccine does appear to be close. It’s a moment, then, when we might soon achieve herd immunity the safe way, by inoculating people against the virus without their becoming sick. It’s a moment in which the president and his team could ask for a bit more patience and constraint with light glimmering at the end of the tunnel. Instead, we’re being told to keep our foot on the accelerator and try to live our lives as normal, as though that’s really possible anyway.
It’s a fierce competition, but this may define Trump’s legacy. He will be remembered as the president who faced a deadly crisis and decided to look away.