COVID cases are falling, but the U.S. is on the brink of 700,000 dead

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Nursing coordinator Beth Springer looks into a patient’s room in a COVID-19 ward at the Willis-Knighton Medical Center in Shreveport, La., in August. Despite a decline in COVID-19 cases in the United States over the last several weeks the country’s total deaths are close to 700,000.

Gerald Herbert/AP

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Registered nurse Noleen Nobleza inoculates Julio Quinones with a COVID-19 vaccine in Orange, Calif.

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Dr. Anthony Fauci, the government’s top infectious disease specialist, warned on Friday that some may see the encouraging trends as a reason to remain unvaccinated.

«It’s good news we’re starting to see the curves» coming down, he said. «That is not an excuse to walk away from the issue of needing to get vaccinated.»

Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana, began seeing a surge of COVID-19 hospitalizations in mid-July, and by the first week of August, the place was beyond capacity. It stopped elective surgeries and brought in military doctors and nurses to help care for patients.

With cases now down, the military team is scheduled to leave at the end of October.

Still, the hospital’s chief medical officer, Dr. Catherine O’Neal, said the rate of hospitalizations isn’t decreasing as quickly as cases in the community because the delta variant is affecting more young people who are otherwise healthy and are living much longer in the intensive care unit on ventilators.

«It creates a lot of ICU patients that don’t move anywhere,» she said. And many of the patients aren’t going home at all. In the last few weeks, the hospital saw several days with more than five COVID-19 deaths daily, including one day when there were 10 deaths.

«We lost another dad in his 40s just a few days ago,» O’Neal said. «It’s continuing to happen. And that’s what the tragedy of COVID is.»

As for where the outbreak goes from here, «I have to tell you, my crystal ball has broken multiple times in the last two years,» she said. But she added that the hospital has to be prepared for another surge at the end of November, as flu season also ramps up.

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Dr. Sandra Kemmerly, system medical director for hospital quality at Ochsner Health in Louisiana, said this fourth surge of the pandemic has been harder. «It’s just frustrating for people to die of vaccine-preventable illnesses,» she said.

At the peak of this most recent wave, Ochsner hospitals had 1,074 COVID-19 patients on Aug. 9. That had dropped to 208 as of Thursday.

Other hospitals are seeing decreases as well. The University of Mississippi Medical Center had 146 hospitalized COVID-19 patients at its mid-August peak. That was down to 39 on Friday. Lexington Medical Center in West Columbia, South Carolina, had more than 190 in early September but just 49 on Friday.

But Kemmerly doesn’t expect the decrease to last. «I fully expect to see more hospitalizations due to COVID,» she said.

Like many other health professionals, Natalie Dean, a professor of biostatistics at Emory University, is taking a cautious view about the winter.

It is unclear if the coronavirus will take on the seasonal pattern of the flu, with predictable peaks in the winter as people gather indoors for the holidays. Simply because of the nation’s size and diversity, there will be places that have outbreaks and surges, she said.

What’s more, the uncertainties of human behavior complicate the picture. People react to risk by taking precautions, which slows viral transmission. Then, feeling safer, people mingle more freely, sparking a new wave of contagion.

«Infectious disease models are different from weather models,» Dean said. «A hurricane doesn’t change its course because of what the model said.»

One influential model, from the University of Washington, projects new cases will bump up again this fall, but vaccine protection and infection-induced immunity will prevent the virus from taking as many lives as it did last winter.

Still, the model predicts about 90,000 more Americans will die by Jan. 1 for an overall death toll of 788,000 by that date. The model calculates that about half of those deaths could be averted if almost everyone wore masks in public.

«Mask wearing is already heading in the wrong direction,» said Ali Mokdad, a professor of health metrics sciences at the university. «We need to make sure we are ready for winter because our hospitals are exhausted.»

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