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170,000 additional deaths in the United States? What expert project for the pandemic winter: shots




More than 700 Americans die from COVID-19 every day. If the number of cases continues to rise during the winter, that number could almost triple, according to forecasts. Mark Felix / AFP via Getty Images .

rock legend Mark Felix / AFP via Getty Images

More than 700 Americans die from COVID-19 every day. If the number of cases continues to rise during the winter, that number could almost triple, according to forecasts.

Mark Felix / AFP via Getty Images

Coronavirus cases are increasing rapidly in many states as the United States enters the winter months. And forecasters predict a meteoric rise in infections and deaths if current trends continue.

This is exactly the kind of scenario that public health experts have long warned could be in store for the country, if it didn’t aggressively reduce infections over the summer.

“We were really hoping to eliminate the cases in anticipation of a bad winter,” says Tara Smith, professor of epidemiology at Kent State University. “We basically did the opposite.”

After hitting an all-time high in July, cases dropped significantly, but the United States has never reached a level where the public health system could truly contain the outbreak.

Today, infections are on the rise again.

The United States is averaging more than 52,000 new cases per day (the highest since mid-August), due to outbreaks within the country, particularly in the Midwest, Great Plains and West .

The return of students to campus, resistance to mandates on social distancing and the wearing of masks are contributing to this increase, as well as more and more people spending time in restaurants and other indoor environments, Smith says.

Harvard TH Chan School of Public Health professor Dr. Michael Mina likens the situation to a growing wildfire with small sparks all over the United States that will only gain strength as the weather cools.

“We’re likely to see massive explosions of cases and epidemics that might make it seem like what we’ve seen so far hasn’t been that much,” Mina says.

Nearly 400,000 dead in February?

According to a forecast from one of the country’s leading coronavirus modeling groups, more than 170,000 people could die from COVID-19 by February 1, bringing the total number of deaths from the pandemic to nearly 390,000.

“Unfortunately, in the United States, this is still the first wave of the epidemic,” says Ali Mokdad, professor of health measurement sciences at the Institute for Health Metrics and Evaluation at the University of Washington, who developed the model.

The model foresees three different scenarios to reflect the potential impact of policies and people’s behavior on the results. The worst assumes that social distancing warrants continue to be canceled and projects nearly 483,000 cumulative deaths by February 1. The rosiest scenario assumes that communities re-impose these mandates when deaths reach a certain level per capita and almost everyone wears masks. In this case, the cumulative deaths could still reach nearly 315,000.

Currently, the United States averages over 700 deaths per day. IHME predicts it could reach over 2,000 a day by mid-January, rivaling the most fatal days of spring.

So far, Mokdad says the data clearly shows that the United States is stuck in a reactive cycle: When cases increase in their community, people change their behavior dramatically, they stay at home more and wear masks, even in places where it is not necessary.

Once the situation improves, people revert to their previous behavior.

“We’re like a roller coaster all over the United States,” says Mokdad. “We reduce the cases, then we let our guard down. But it’s a deadly virus that you can’t give it a chance to circulate.”

And cold weather could play a role. In the southern hemisphere, countries have seen an increase in cases in recent cold months, even with a lot of social distancing and many people wearing masks, says Mokdad, who says “there is a factor of seasonality. “with COVID-19 which mimics pneumonia.

High levels of circulating viruses

Even places that have already returned from devastating epidemics remain vulnerable to a resurgence over the winter, says Lauren Ancel Meyers, a professor at the University of Texas at Austin who heads the University’s COVID-19 Modeling Consortium from Texas.

Outbreaks can be triggered when people congregate in bars, like this one in Sturgis, SD, during the Sturgis Motorcycle Rally in August. Michael Ciaglo / Getty Images .

rocker legend Michael Ciaglo / Getty Images

Meyers notes that even in Texas, a state where a summer surge has helped bring the cumulative death toll to more than 17,000, the virus is much more widespread than it was in the spring. This is true in many parts of the country.

“Even though things seem a little flat from a point of view of where the trends are heading, the level at which we are stable is still a considerable number of viruses circulating in our communities,” she says, although the hope is that these communities can be more responsive now to take precautions if cases increase.

His group’s model currently predicts a total of 234,684 deaths by Nov. 9, but looks no further.

“We understand so much how this virus is spread,” Meyers says. “What we don’t know is what the behaviors will be and what decisions people will make in the months to come.”

This projection is similar to what researchers at the University of Massachusetts, Amherst predict in the COVID-19 ForecastHub, an “ensemble model” merging about 30 different COVID models.

It predicts around 234,633 total deaths by November 7.

“There are some kind of opposing forces acting on what we might see,” says Professor Nicholas Reich at Amherst at the University of Massachusetts, whose lab manages the overall model.

“On the one hand, we know people will be spending more time indoors and this has the potential to increase transmission,” he says. “On the other hand, people are generally more careful.”

But Reich says there are just too many uncertainties to predict beyond a month: “In my mind, that’s kind of the limit of reliable predictability,” he says.

The choice

While the US epidemic can be described as having different “waves” one in spring, another in summer, public health experts say this does not fully capture how the pandemic has spread unevenly. in the country all year round.

“A better way to think about this is a wave that has entered a pool and in that pool it is dragging,” says Dr. Roger Shapiro, professor at Harvard TH Chan School of Public Health. “Wherever it hasn’t been yet, it will go, and the place where it once was may return.”

Estimates vary, but the vast majority of the U.S. population has not been infected, which means most communities are still at risk of major epidemics, he says.

Strict mask compliance and fewer indoor gatherings could help avoid the worst COVID-19 winter scenarios. But it is not certain that community leaders have the political will to impose such restrictions.

Mina says he predicts states will continue to open up as the transmissibility of the virus increases and more people spend time indoors, creating “a perfect storm.”

“Will it be that we close completely again?” Mina asks. “Or do we pick a lot of infections? If so, we still haven’t done a very good job of figuring out how to keep vulnerable people safe.”

But COVID-19 modeler Nicholas Reich notes that the terrible predictions are only our best guess. He says winter could be very different if Americans take the precautions seriously.

“The optimism we can get from that is that human behavior can change that,” he says. “We can bend and flatten the curve.”

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