The numbers are worrying. Public health experts have sounded the alarm for months that, even with the great promise of vaccines on the horizon, there are still dark days ahead, with the worst of the potentially pandemic yet to come.
What do these projections mean? We spoke with CNN medical analyst Dr. Leana Wen, an emergency physician and visiting professor at the Milken Institute School of Public Health at George Washington University, to learn how people can understand the numbers and what can be done to change the trajectory of the pandemic.
CNN: The CDC is predicting more than 90,000 deaths in three weeks. Can these numbers be right?
Dr. Leana Wen: Sadly yes. We average between 3,000 and 4,000 deaths every day due to Covid-19. To reach that terrible number of 90,000 deaths in three weeks, there are about 4,300 deaths per day. With the increase in infections and hospitalizations, it is almost certain that we will also see a steady increase in the daily mortality rate.
This is so tragic, and I hope we don’t become insensitive to those numbers. Each person is someone’s grandfather, father, mother, spouse, son or friend.
CNN: Is there anything we can do about this terrible trend?
Wen: There is not much we can do about the death trajectory that we will see in the next three weeks. This is because of the delay time: it usually takes a week or more between the time someone is exposed and when they show symptoms, then another week or more to get sick enough to be hospitalized, then days to weeks before someone succumbed to the disease.
The people we can see dying in the next two or three weeks are those who have already been exposed to the coronavirus, possibly during the December holiday. The best that can be done is for these individuals to seek immediate medical attention and receive the best care possible to treat their disease, but it is too late to prevent them from becoming infected.
This is not the case for all people who have not yet been infected. There is a big difference between modeling a weather forecast and modeling an infectious disease. You may be able to predict a hurricane’s trajectory and then get out of that trajectory, but you can’t change where the hurricane is going. This is different with a pandemic. The future is not predetermined. Our individual and collective actions are now what determine how far the virus spreads.
We’ve been talking about basic public health measures for months, and they’re still our best protection against this contagious respiratory disease. Keep physical distance – because this virus requires close contact. Being outdoors is better than indoors – because the outside air disperses virus particles. Wear a mask – this can prevent the transmission and acquisition of the coronavirus. Avoid crowded meetings – and know that more than half of the transmission (according to the CDC) is from people who have no symptoms and who may be infected, but do not know it. Wash your hands thoroughly frequently.
These measures are additive. The more you do, the more consistently, the better you are protected. Our individual actions protect us and those around us. They also protect the community, reducing the spread of coronavirus and helping to reduce the pressure on our overburdened hospitals and public health systems. Collectively, our actions help to change the path of the disease and are fundamental to stop this growing increase.
CNN: Why do you think the numbers keep going up? Are people tired of following these precautions?
Wen: That is certainly part of it. Pandemic fatigue is very real. We need to recognize that. Yes, there are some people who do not believe that the coronavirus is real and may be breaking the guidelines for masking and social detachment. However, I think many people have tried very hard to follow precautions, but are finding it increasingly difficult not to see their loved ones. They may be letting their guard down and there can be tragic consequences.
Another reason is that people may be misunderstanding what the arrival of vaccines means. Supply is limited and vaccine delivery has been much slower than we would like. Many people will not have access to vaccines for months. Even those who received the vaccine can still spread the virus to others.
Don’t get me wrong – vaccines will change the game when enough people can be vaccinated. It is incredible that we have safe and highly effective vaccines. But they are not the ones that will take us out of this very dangerous wave. What will get us out of there are these public health measures.
I wish there was an easier way out. I think everyone would like that, and I know everyone is tired and would like this pandemic to end. But we need to remain vigilant and keep our guard.
CNN: US President-elect Joe Biden said he will ask for 100 days of wearing a mask. Will that make a difference?
Wen: Yes. An influential model from the University of Washington shows that wearing a mask can save 30,000 lives by March. This is really remarkable. President-elect Biden spoke of the masks as a patriotic duty, a way of showing respect for one another. We must wear masks whenever we are outside and cannot stay 6 feet away from others, and whenever we are inside the house with people who are not our family.
Not having meetings, inside the house, with anyone we don’t live with will also make a big difference. In many parts of the country, what is driving the latest wave is these internal meetings – think about dinner parties and game nights. It is in these intimate environments that people are letting their guard down and becoming infected.
I understand why people want to get together with their relatives and friends. The weather is cold and it is difficult to see each other outdoors. However, our loved ones are just as likely to be asymptomatic carriers of Covid-19 as strangers. We need to be extremely careful and make only outdoor or virtual visits with those who are not in our immediate home.
CNN: With many new coronavirus infections, does this affect the way people should think about shopping for groceries or other basic activities?
Wen: When there are high rates of coronavirus in the community, this increases the risk of all of our activities. Activities that were previously low risk are high risk. That’s because there are so many people around us who are carriers of the coronavirus, and the chance of finding someone – and getting infected by it – becomes increasingly greater.
I’m seeing more patients who have no idea where they got the coronavirus. There is a family history: they were very careful with the quarantine and were not exposed to risks. Perhaps everything they are doing will work in environments that require masks and distance, or perhaps only the exposures they have are through grocery shopping and correct tasks.
There is so much coronavirus around us that the same activities that were quite safe a few months ago are just more risky now. This means that we need to be even more vigilant. If you were to go shopping once a week, consider reducing it to once every two weeks. If you are particularly vulnerable to serious illnesses, consider delivering your purchases. Be even more attentive if you need a subway or bus to get to work. Obviously, always wear a mask (at least a three-layer surgical mask). Again, make sure you don’t meet indoors with people, even your close friends.
CNN: Is there hope coming in the spring? Will warmer weather help?
Wen: It is difficult to know for sure. The coronavirus spreads more in the cold. The warmer climate also means that people will be able to see themselves more outdoors, and this can alleviate some of the loneliness that people are feeling while being safe. As we enter the spring, more people will be able to be vaccinated as well, and this will also be protective.
That means we have to take it a little longer. There is hope on the horizon, but we have some difficult weeks and months ahead. We can overcome this, with optimism and caution.