Monday, December 27, 2021

Coronavirus: Record-breaking cases

Omicron is pushing caseloads in part of the country to levels higher than last winter's peak.
Coronavirus Briefing

December 27, 2021

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Daily reported coronavirus cases in the United States, seven-day average.The New York Times

Record-breaking case numbers

Americans are returning from the holiday weekend to bleak news: Omicron is pushing caseloads in part of the country to levels higher than last winter's pandemic peak. Public health experts are warning that this is still likely the early stages of a fast-moving surge.

Delaware, Hawaii, Massachusetts, New Jersey, New York and Puerto Rico are among the areas that have reported more coronavirus cases in the past week than in any other seven-day period of the pandemic.

The New York Times

Yesterday, even as holiday interruptions to data reporting began to affect daily case totals, the seven-day national average of new daily cases neared 215,000, a 83 percent jump over the past 14 days. Deaths also increased by 3 percent during that time, to a seven-day average of 1,328. The national record for average daily cases is 251,232, set in January during a post-holiday surge.

Hospitalizations are up, too. About 72,000 Americans are hospitalized with Covid-19, 7 percent higher than the previous two weeks but still well below previous peaks.

The New York Times

Since Dec. 5, there has also been a nearly fivefold increase in Covid hospital admissions among children in New York City, where the new variant is spreading rapidly. About half were under 5 and not eligible for vaccination.

Public health experts warned that the most severe disruptions could still be ahead.

Past surges of the coronavirus have been regional, allowing states to reallocate resources like monoclonal antibodies, while this wave has threatened to overtake the whole country at once, said Michael Osterholm, a professor and director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

"With this one, all 50 states are in the soup at the same time. It's like every state is being hit by a viral hurricane," he said.

Dr. Osterholm predicts that in the next three to five weeks, a substantial share of health care workers will get infected and be unable to work, straining an overburdened system. "We're already stretched so thin," he said.

Airlines also struggled to return to normal after a chaotic weekend of cancellations as Omicron hit flight crews. At least 2,600 more flights were canceled today, including about 1,000 U.S. flights, and the problem threatened to extend into the holiday week.

Dr. Anthony Fauci raised the possibility of a vaccination requirement for air travel.

"When you make vaccination a requirement, that's another incentive to get more people vaccinated," Dr. Fauci said on MSNBC. "If you want to do that with domestic flights, I think that's something that seriously should be considered."

The holidays are clouding data on the Omicron surge, but, where the data is available, the signs are not positive.

Most states in the Northeast have been relatively reliable in their reporting after the Christmas holiday, and case counts there are setting records. New York, New Jersey, Rhode Island are seeing case highs. Massachusetts, New Hampshire, Vermont and Maine have not yet reported data since Christmas, but cases there are already reaching highs and are expected climb even further.

Testing and holiday parties

Rapid tests may be difficult to find in the U.S., but they are an extra tool to keep us safe — especially as we think about gathering for New Year's Eve. Here's a guide to using them.

The most important thing to know about rapid tests is that they are most effective when you are most contagious. So the best time to use one is immediately before a gathering.

As Dr. Emily Landon, an infectious disease specialist at the University of Chicago, describes it, rapid tests have something like an "expiration date." After around 12 hours, you shouldn't trust a negative test, because if you're infected you may have moved into a different stage of the illness. So even if you're testing regularly, you should take a rapid test shortly before meeting up.

"The way to do it is when you get together for your gathering, have everyone do the test before they take off their mask, or right before they come to the gathering," Dr. Landon said. If your holiday season involves staying with different friends or family, you may want a more robust approach — testing every day.

Then, there's the after party. Gathering with people outside your household increases the chance of transmission, even though that chance can be mitigated with rapid testing.

It's reasonable to continue using rapid tests after a party if you remain anxious, Landon said, but it gets expensive and is not strictly necessary. (If you're worried that you have been exposed to Covid, our colleague Tara Parker-Pope suggests that you test at least twice over a three- to four-day period. She also has a good rundown on the tests that are available.)

If you feel symptomatic after a gathering, you should get tested, and rapid testing is not enough. That's where P.C.R. testing comes in. They're more sensitive than rapid antigen tests but are generally not as accessible, and results often take a day or more to come in.

"Certainly if anybody develops symptoms after that gathering, you want them to get tested immediately, because if there is a vulnerable individual they could go and get monoclonal antibodies — or eventually, get access to things like Paxlovid — and take them in order to prevent infection," Landon said.

What else we're following

What you're doing

The new normal in Maine where my entire state is currently in the red: On Christmas morning 2021, two negative coronavirus home tests sit on the kitchen table, having just been texted to my parents. My daughter and I have received the OK to come for Christmas. All of my family had to, right down to my 10-year-old niece.

— Sarah Anne Lunt, Scarborough

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