Fast and Furious: COVID Surges to Unprecedented Levels in U.S.

Infection preventionists and other healthcare professionals battling coronavirus disease 2019 (COVID-19) fight a foe that’s paving a trail of illness, hospitalizations, and death not seen before during this pandemic. Grim records keep getting broken and trends indicate that the COVID-19 scourge only promises to get worse. The United States recorded 3157 COVID-19 deaths yesterday, the highest number in a single day and more than 20% higher than the previous record of 2603 deaths set back on April 15, according to Johns Hopkins University. The number of new cases of COVID-19 confirmed yesterday was 180,083, the fifth highest single-day increase.

Meanwhile, according to the COVID Tracking Project, more than 100,000 people have been hospitalized for COVID-19, another new record. That’s an 11% increase in hospitalizations in a week; a 26% jump in the past two weeks.

This may be the “surge superimposed on a surge” that Anthony Fauci, MD, director of the CDC’s National Institute of Allergy and Infectious Diseases, warned about when healthcare experts cautioned the public about traveling and getting together over the Thanksgiving holiday. Travel was indeed less than it had been in previous years, but still way too high in the midst of a pandemic, according to many healthcare experts. When asked in a recent Q&A with Infection Control Today® whether the lessening of travel over Thanksgiving was enough to slow down the pandemic, Kevin Kavanagh, MD, a member ICT®’s Editorial Advisory Board and the founder of the patient advocacy organization Health Watch USA, responded: “Absolutely not. I think it’s very problematic with what I’ve seen. I’m very scared we’re going to have another surge.”

As with the first wave, some states are getting hit harder than others. In Nevada, 29% of all hospital beds are occupied by COVID patients, according to the US Department of Health and Human Services. Seventy-seven percent of that state’s inpatient beds and 80% of the beds in hospital intensive care units are in use. In New Mexico, 27% of hospital beds are occupied by COVID patients. Colorado and Arizona are also being feeling the strain, with 20% of their hospital beds being occupied by patients with SARS-CoV-2. Meanwhile, in 32 other states, at least 10% of all hospital beds are being occupied by COVID patients.

The shifting of more and more healthcare resources and space to COVID victims, means less healthcare resources and space will be available for non-COVID patients. In addition, as one hospital in New Jersey found, the relaxing of infection prevention protocols in order to stave off COVID presents an opportunity for other deadly pathogens. That 850-bed urban hospital found itself not only having to deal with COVID, but also with carbapenem-resistant Acinetobacter baumannii (CRAB), a pathogen that has a 55% morality rate.

Infection preventionists and other healthcare workers strive to keep up. “The hard part is we all are exhausted from this,” says Rebecca Leach, RN, BSN, MPH, CIC, an infection prevention coordinator and a member of ICT®’s Editorial Advisory Board. Leach says that she works at least 10 hours a day but thinks about the pandemic every waking moment.

“Everybody is tired of having to change their way of life for this. And I can understand the impatience with the public. My biggest impatience is with leadership in government. Some states are doing more to be proactive and some states are not. And that’s where my biggest concern is…. As we saw before in the summer, when states really locked down or mandated masking and that kind of thing, we saw the decrease. If we did that again, I think it would work.”

Rebecca Leach, RN, BSN, MPH, CIC

Reports that COVID vaccines developed by by Pfizer/BioNTech and Moderna could be approved soon by the US Food and Drug Administration (FDA) and distribution for those vaccines will start as early as December 15 and December 22 respectively, offer some hope that help may be on the way. In addition, an advisory panel for the US Centers for Disease Control and Prevention (CDC) recommends that exhausted infection preventionists and other healthcare professionals should be first in line to get the vaccines, along with residents and employees at long-term care facilities. Meanwhile, though infection preventionists must deal with what’s going on now.

“I’m trying to be very hopeful about a vaccine, but I’m also realistic,” says Leach. “We know that there are not going to be enough doses until probably well into next year to really cover a lot of people. They say in the next few weeks we may start seeing a vaccine here in Arizona, which is exciting news. But it’s going to be limited to however many doses we get…. And the whole process of how it’s going to be distributed is a little bit up in the air. Do they have the people to give the vaccine and track it and how is that going to work? I’m hopeful, but it’s not the end by any means especially in the next few months.”