An advisory panel of experts for the Centers for Disease Control and Prevention on Tuesday recommended that healthcare workers should be first-in-line to receive a coronavirus vaccine.
In a 13-1 vote, the Advisory Committee on Immunization Practices said vaccine allocation should prioritize the country's 21 million frontline healthcare workers and 3 million residents in long-term care facilities, it is unclear whether hospitals will require their workers to inoculate once it becomes available.
Rush University Medical Center in Chicago has no plans to make a coronavirus vaccine mandatory for staff in the next year, according to Dr. John Segreti, a hospital epidemiologist and medical director of infection control and prevention at Rush. He said the provider's decision stems from supply and delivery uncertainties, as well as questions about potential adverse reactions from the vaccines.
"I think the healthcare industry will strongly encourage their (healthcare personnel) to get vaccinated I doubt many will mandate it this year," he said.
Like other employers, hospitals have the right to mandate vaccinations as a condition of employment. Employees can opt to exempt themselves from such requirements for medical reasons or religious beliefs, which would then require employers to provide them with "reasonable", alternative work accommodations.
The number of providers who have flu vaccination requirements has steadily increased in recent years in an effort to reduce rates of infections and illnesses acquired within healthcare settings. A 2018 JAMA Network Open study that surveyed more than 500 hospitals on their policies regarding mandatory influenza vaccination requirements found that the share of providers who require staff to get a flu shot had increased from 44% in 2013 to nearly 70% in 2017.
Experts say mandatory vaccination policies have been a major factor in driving up flu vaccination coverage among healthcare staff. Flu vaccination coverage among healthcare personnel was more than 80% during the 2019-2020 flu season, according to the CDC, compared to 64% during the 2010-2011 season. Personnel who were required to get a flu shot had a rate of 94%, while employees who were not required to a get a shot had a coverage rate of 70%.
Segreti said Rush requires its employees, volunteers and students to receive the flu vaccine each year. But he said say they are taking a wait-and-see approach with coronavirus vaccines.
"If the vaccine proves safe and effective, we may mandate it in the future," Segreti said.
UNC Health in Chapel Hill, North Carolina is taking a similar approach to Rush,saying it plans to recommend all its employees get vaccinated if the remaining trials are positive. But the health system doesn't plan to make vaccinations mandatory.
"While we do not yet have answers to many key questions surrounding a potential vaccine and its rollout plan or timeline, we are grateful to have a team of regional and national experts to review vaccine data and to guide our decisions and planning efforts," according to UNC Health's statement. "Our goal is to then provide as much data and information as possible to both our co-workers, patients and the community related to the vaccine."
But Dr. Steven Corwin, CEO of New York-Presbyterian Hospital, said in a recent interview with Modern Healthcare that the organization was inclined to mandate staff get vaccinated but stressed the decision would come down to how much supply is available versus the demand to get vaccinated.
"I would be inclined to mandate it because we don't want our healthcare workers to get sick, and we don't want our healthcare workers to infect each other, which can happen, or infect patients, which can happen," Corwin said. "I think that's critically important to do."
Federal officials have estimated the most promising coronavirus vaccine candidates one from Pfizer and BioNTech and another developed by Moderna could gain emergency use authorization by the U.S. Food and Drug Administration and start to be distributed in a few weeks.
Yet the speed at which the vaccines were developed is playing a part in the public's mixed view over its safety and efficacy.
A recent Gallup Panel survey conducted between Oct. 19 and Nov. 1 found 58% of Americans reported they were willing to get vaccinated against the coronavirus, an increase from 50% who said they were willing back in September. Among those who said they would not get vaccinated, 37% reported the development timeline of the vaccine was their top reason for concern, while 26% said they wanted to wait to confirm the vaccine was safe.
Corwin acknowledged there remained concerns over the safety of a new coronavirus vaccine in certain populations, such as among pregnant women. He said any vaccination mandate the health system instituted would exclude those individuals, along with others with qualified exemptions.
"But short of that, I think it would be unfair to the public to (not have the workforce get vaccinated) to be honest with you," Corwin said.
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A COVID-19 nasal swab test kit sits on a table Thursday, Aug. 13, 2020, during a clinic held by the St. Clair County Health Department at Yale High School.(Photo: Brian Wells/Times Herald)
The state of Michigan reported this week three schools in St. Clair County were experiencing COVID-19 outbreaks. Local health officials said the outbreaks happened before the closure of school buildings in recent weeks, and their reporting on the state's website was delayed.
"These cases should not be taken out of context," St. Clair County Health Department Public Health Officer Dr. Annette Mercatante said in a written statement."The trends of the school outbreak postings is that outbreaks are slowing down with switching to all virtual, which is what we would expect. Outbreaks in other congregate settings that continue to be in person continue to increase. It can be safely assumed that if you are still going out to work, play or socialize you will have exposure to COVID-19 and eventually will get infected. This is resulting in greater hospitalizations and other stressors on our healthcare systems and will result in further deaths."
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Port Huron High School and Capac Elementary School were reported to have outbreaks only among staff, with Landmark Academy having an outbreak among both staff and students. Port Huron High School had two cases reported in the outbreak, Capac Elementary School had three cases and Landmark Academy had four cases.
An outbreak is defined as an educational institution having two or more COVID-19 cases who could have shred exposure on school grounds and are from different households. Students and staff believed to have been exposed to COVID-19 outside of school grounds and are not believed to have spread the virus in the school are not included in the state's outbreak reporting.
Information is reported by local health departments to the state, Michigan Department of Health and Human Services spokeswoman Lyn Sutfin said. Schools only report cases for individuals who were at school during their infections period.
Capac Community Schools returned to in-person classes for pre-kindergarten through sixth grade students, according to a post on the district's Facebook page.
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More than half of the 27 deaths announced Tuesday were people from rural counties, such as Barnes, Renville and Mountrail counties. All victims were between the ages of 50 and 100.
Per capita, North Dakota's rural areas are also reporting the highest number of active COVID-19 cases. Griggs County, about 100 miles southwest of Grand Forks, leads the state with 288 active cases per 10,000 people. In contrast, Cass County, which encompasses Fargo and West Fargo, has 64 active cases per 10,000 people.
The North Dakota Department of Health reported a high number of COVID-19 deaths Tuesday because of a reporting lag from over the weekend, as is normal for the number of tests and deaths reported on Tuesdays, the state said.
North Dakota's pandemic death toll is now at 954 residents, and November was the state's deadliest month by far with 388 reported so far. November's death count will likely increase as death investigations conclude.
The 954 total deaths means one in every 800 North Dakotans has died from the virus in a state with a population of 762,000, according to 2019's census estimate.
This new milestone comes exactly two weeks after the state marked one in every 1,000 North Dakotans had died from the virus.
At least 554 of the state's deaths have come in nursing homes and other long-term care facilities. There are more than 500 infected nursing home residents and 544 infected staff in the state.
The Department of Health says COVID-19 test results are delayed by approximately four days, as labs nationwide are experiencing a backlog in tests. This delay is concerning because residents may be spreading the disease without knowing that they have it.
In wake of this delay, the Department of Health recommends North Dakotans quarantine until they receive their test result, and residents with symptoms should isolate regardless of their test result.
For about two weeks, active COVID-19 cases have been decreasing in North Dakota. There are now 5,686 residents known to be infected with the virus.
As of Monday, South Dakota has now eclipsed North Dakota in the most COVID-19 cases per capita and deaths per capita over the last week, according to the Centers for Disease Control and Prevention.
Hospitalizations decreased Tuesday and there are now 319 residents hospitalized due to the illness.
The state's hospitals are under severe staffing crunches, and available hospital beds are scarce. About 14% of staffed beds were available statewide as of Tuesday.
With only 3,347 tests reported, the 409 new cases announced Tuesday included the following:
About 13.4% of the 3,059 residents tested as part of the latest batch received a positive result, and an average of 12.4% of those tested in the last two weeks got a positive result. Like active cases, the state's positivity rate has decreased in the last two weeks.
Readers can reach reporter Michelle Griffith, a Report for America corps member, at mgriffith@forumcomm.com.
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Editor's note: The opinions expressed by the author do not necessarily reflect the opinions of the AAMC or its members.
Medical school prepares us students for our future roles as clinicians. We learn about the underlying mechanisms of disease, how to perform physical exams, and how to convey bad news. Were also taught about epidemiology, ethics, and interprofessional teamwork.
While these skills are essential to helping us be good doctors to the patients in front of us, the COVID-19 pandemic has highlighted an additional responsibility: We must be trusted voices in our communities and advocates for policies that support public health.
Its because of my belief that research is essential for informing good health policy that I was eager to accept a position writing reports on the United States response to COVID-19 for the World Health Organization (WHO).
As European countries like Italy and Spain experienced widespread community transmission and their health care infrastructure was overwhelmed by high COVID-19 caseloads, WHO Regional Director for Europe Hans Kluge, MD, solicited help in collecting data on the health system and public health responses of different countries.
During my time as an undergraduate, I had worked as a research assistant for Andrew Barnes, PhD, an associate professor at Virginia Commonwealth University (VCU) School of Medicine, studying Medicaid expansion and its impact on substance use disorder treatment. I continued to seek out opportunities to blend my interests in medicine, policy, and business during a gap year working at the Centers for Medicare & Medicaid Services and the Duke-Margolis Center for Health Policy. I soon returned to VCU for medical school, where I joined Dr. Barnes in evaluating the impact of Virginias Medicaid expansion.
When Dr. Barnes received the WHOs call for volunteers to track the United States response to the pandemic, he recognized that it would be a great opportunity for me given my health policy interests.
I joined a team of two others Lynn Unruh, PhD, a registered nurse and health economist, and Andriy Koval, PhD, an assistant professor and data scientist both at the University of Central Florida.
Together, we have collected data and published reports every four to six weeks for the COVID-19 Health System Response Monitor (HSRM), which tracks 53 country responses in six categories: preventing transmission, ensuring sufficient physical infrastructure and workforce capacity, providing health services effectively, paying for services, governance, and measures in other sectors, such as border controls.
My teams HSRM reports show that inaction and the lack of a scientifically-informed, unified response have contributed to the sustained spread of COVID-19 in the United States.
The COVID-19 HSRM serves a dual purpose: It acts as a database for policymakers and health systems leadership to inform their decisions in the present and it will be a learning tool in the future to look back and identify best practices.
Eight months have passed since President Donald Trump declared COVID-19 a national emergency, and the outlook remains bleak. The United States continues to lead the world in the number of COVID-19 cases and deaths.The week of Thanksgiving, we recorded an average of nearly 162,007 new cases per day and hospitalizations and deaths were climbing across the country. All of this is quite surprising given earlier reports that rated the United States as one of the most well-prepared countries for a pandemic.
My teams HSRM reports show that inaction and the lack of a scientifically-informed, unified response have contributed to the sustained spread of COVID-19 in the United States. Governmental leadership has largely devolved to state and local governments, with states responsible for instituting public health measures like mask mandates and even creating test purchasing compacts.
Further complicating the situation are the inconsistent messaging, misinformation, and politicization of masking and other public health measures.
Testing and contact tracing issues persist, including test supply shortages and reporting delays. Personal protective equipment shortages and lack of bed capacity have also plagued the nation, particularly in hot spot areas.
Millions of Americans continue to lose their employer-based health insurance, including 5.4 million who lost coverage between February and May. There has been a grave exacerbation of existing disparities, including fewer testing sites in communities of color and a growing digital divide among schoolchildren from different racial and socioeconomic backgrounds.
As a nation, COVID-19 may be the wake-up call weve sorely needed to invest in our public health infrastructure.
There are a few silver linings, nonetheless. There are 319 potential treatments and 213 vaccine candidates in development globally, highlighting the strength of our research and development networks. Were learning more about how to care for COVID-19 patients, and therapies like dexamethasone may improve survival for the seriously ill. Vaccine development is making headway, with manufacturers already having sought regulatory clearance for two vaccines that have proven to be more than 90% effective.
And as a nation, COVID-19 may be the wake-up call weve sorely needed to invest in our public health infrastructure.
Despite our countrys inadequate response, its been a blessing to work on the COVID-19 HSRM. Im humbled to have a chance to inform policymakers and the public and to contribute to the global efforts to contain COVID-19.
The experience has further reinforced what I learned in my health policy research on the local, state, and national levels: Our issues extend beyond a broken health care system.
Growing evidence demonstrates that 80% of health outcomes are attributable to social determinants of health and COVID-19s devastating impact on communities of color has drawn increasing attention to these factors. Physicians serve as the first line of defense, identifying and addressing the needs of patients and connecting them with community resources.
Over the past few months during a preceptorship at a rural family medicine clinic, Ive witnessed the importance of social determinants of health and policies firsthand through the patients Ive seen: the bricklayer who continues to delay necessary medical care due to job insecurity and financial instability; the woman who suffers from depression due to an unstable housing situation and struggles to make doctor visits due to a lack of transportation; the mother without health insurance desperately searching for low-cost options to replace a long-expired EpiPen for her college-bound daughter; and the soon-to-be father recovering from opioid use disorder but burdened by social stigma and limited employment prospects.
The COVID-19 crisis has similarly illustrated that the best health policies are often not health care policies. Economic policies like paid sick leave have ensured that people can comply with public health measures like staying home from work and self-isolating when potentially infected. Likewise, bans on evictions can allow families to avoid choosing between health and housing. Increased education funding has supported more equitable access to resources like high-speed internet and lessened potential generational impacts on health.
COVID-19 has turned our world upside down and with it, our health care system. But in uncertainty lies opportunity. We need physicians who can share their clinical experiences and advocate for the needs of our most vulnerable. Medical students, by engaging in health policy research, can help shape the future of our health care system and drive meaningful reform that facilitates whole-person care and better outcomes for our patients.
Mathew Alexander is a second-year medical student at Virginia Commonwealth University School of Medicine. He conducts research related to global health policy on the COVID-19 pandemic for the World Health Organization and European Observatory.
Avid snowboarder Jenny Leveilledoesn't plan to rely on ski resorts' indoor facilities this season. This decision, she believes, will giveher a possible advantage when it comes to coronavirus and swirling concerns over indoor exposure.
Leveille, who'll be heading to the mountains out West after Thanksgiving in Michigan, plans to return to her van -- which includes a bathroom -- when she needs a break for fuel or relief.
Ski season is underway, and changes are afoot.In Europe, Germany, hard hit by Covid-19, is aiming for a coordinated European Union approach to keeping ski resorts shut inAlpine countriesfor the holiday season in order tolimit the spread of coronavirus. However, reaching an agreement with neighboring Austria is proving challenging, German Chancellor Angela Merkel indicated last Thursday.
Meanwhile, some slopes have opened in Switzerland, which is not an EU member. The "future for the upcoming winter season looks bright," Mayor of Zermatt Romy Biner-Hauser told CNN on Thursday.
With its wide-open spaces, stashes of powder and even covering up to brave the elements, skiing might seem like the perfect pandemic sport -- if the proper precautions are taken.
A face mask, a standard part of the skier's uniform, is a requirement this year. Resorts are implementing mask mandates except while guests areactively eating and drinking. Ski destinations are also limiting indoor capacity, adding outdoor capacity, adding hand-sanitizing stations on chair lift lines and reconfiguring how chair lifts are filled.
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Another three Mainers have died as health officials on Monday reported 250 new coronavirus cases across the state.
Mondays report brings the total number of coronavirus cases in Maine to 11,757. Of those, 10,487 have been confirmed positive, while 1,270 were classified as probable cases, the Maine CDC reported.
The agency revised Sundays cumulative total to 11,507, down from 11,508, meaning there was a net increase of 249 over the previous days report, state data show. As the Maine CDC continues to investigate previously reported cases, some are determined to have not been the coronavirus, or coronavirus cases not involving Mainers. Those are removed from the states cumulative total. The Bangor Daily News reports on the number of new cases reported to the Maine CDC in the previous 24 hours, rather than the increase of daily cumulative cases.
New cases were reported in Androscoggin (64), Aroostook (1), Cumberland (57), Franklin (3), Hancock (5), Kennebec (29), Knox (3), Lincoln (1), Oxford (9), Penobscot (10), Sagadahoc (4), Somerset (6), Waldo (1) and York (54) counties, state data show. Information about where three additional cases were reported wasnt immediately available.
Only two counties Piscataquis and Washington reported no new cases.
The seven-day average for new coronavirus cases is 174.1, up from 165.1 a day ago, down from 207.3 a week ago and up from 73.6 a month ago.
Two women in their 80s from Penobscot County and a woman in her 80s from Somerset County have succumbed to the virus, bringing the statewide death toll to 194. Nearly all deaths have been in Mainers over age 60.
Mondays report marked the sixth time in the past 10 days when new coronavirus cases surpassed 200. That comes as Maine has seen coronavirus cases surge to unprecedented levels over the past month, hitting highs not seen in the earliest weeks of the pandemic.
Health officials have warned Mainers that forceful and widespread community transmission is being seen throughout the state. Every county is seeing high community transmission, which the Maine CDC defines as a case rate of 16 or more cases per 10,000 people.
There are two criteria for establishing community transmission: at least 10 confirmed cases and that at least 25 percent of those are not connected to either known cases or travel.
There are now 121 known cases of coronavirus among more than 30,000 University of Maine System students, faculty and staff, according to UMS spokesperson Dan Demeritt.
There are 110 cases at the University of Maine six new cases involve non-residential students; Two cases at University of Maine at Augusta; Four cases at University of Maine Farmington; One case at University of Maine at Presque Isle one new case involving a non-residential student; and four cases at University of Southern Maine one new case involving a non-residential student.
The only schools in the UMS with no active cases of coronavirus are University of Maine at Fort Kent, University of Maine at Machias, University of Maine Law School.
So far, 699 Mainers have been hospitalized at some point with COVID-19, the illness caused by the new coronavirus. Of those, 139 people are currently hospitalized, with 48 in critical care and 22 on ventilators.
Meanwhile, 146 more people have recovered from the coronavirus, bringing total recoveries to 9,098. That means there are 2,465 active confirmed and probable cases in the state, which is up from 2,365 on Sunday.
A majority of the cases 7,012 have been in Mainers under age 50, while more cases have been reported in women than men, according to the Maine CDC.
As of Monday, there have been 847,706 negative test results out of 908,538 overall. Nearly 1.7 percent of all tests have come back positive, Maine CDC data show.
The coronavirus has hit hardest in Cumberland County, where 3,824 cases have been reported and where the bulk of virus deaths 71 have been concentrated. Other cases have been reported in Androscoggin (1,560), Aroostook (138), Franklin (215), Hancock (248), Kennebec (796), Knox (205), Lincoln (156), Oxford (340), Penobscot (866), Piscataquis (42), Sagadahoc (153), Somerset (451), Waldo (229), Washington (191) and York (2,338) counties. Information about where an additional five cases were reported wasnt immediately available.
As of Monday morning, the coronavirus had sickened 13,393,166 people in all 50 states, the District of Columbia, Puerto Rico, Guam, the Northern Mariana Islands and the U.S. Virgin Islands, as well as caused 266,932 deaths, according to the Johns Hopkins University of Medicine.
CHICAGO Coronavirus killed at least 165 people over the weekend, the state reported.
Among the most recent victims were 108 people in Cook County, including a woman in her 30s and a man in his 40s. At least 12,193 people have died from COVID-19 in Illinois, and another 689 deaths are considered to be probably related to coronavirus.
The state also reported 15,051 confirmed cases since Friday. That brings the total number of confirmed cases in Illinois up to 720,114.
To prevent more deaths and to slow down the virus and hopefully avert a full stay at home order the entire state is under Tier 3 restrictions. The rules close museums, casinos and theaters; cut capacity at stores; stop indoor sports and put stricter rules in place at gyms and salons, among other things.
RELATED:Chicago-Area Health Care Workers Completely Burned Out As Hospitalizations Soar With No End In Sight
Chicago is under a stay at home advisory. People are being asked to stay home as much as possible, leaving only for essential things like grocery shopping; to work from home if possible; to stop gathering with anyone outside their household; and to stop traveling.
People should also wear masks and wash their hands regularly, officials have said.
The surge in new cases in Chicago and across Illinois can only partially be explained by increased testing; in reality, there are more cases because coronavirus is spreading so much, officials have said. Theres evidence of that in the way positivity rates and COVID-19 deaths and hospitalizations have rapidly risen in recent weeks.
Illinois seven-day positivity rate was at 10.1 percent Sunday with 62,740 tests reported. It was at 10.1 percent Friday. The figure represents total confirmed cases divided by total tests.
Illinois seven-day test positivity, which measures how many tests were positive out of total tests, was at 12.1 percent Sunday. It was at 12.2 percent Friday.
As of Saturday night, 5,858 people were hospitalized with coronavirus in Illinois, including 1,185 people in the ICU and 723 people using ventilators.
In Chicago, 41 deaths and 2,398 confirmed cases were reported since Friday. There have been at least 3,413 deaths from COVID-19 in Chicago and 160,802 confirmed cases, according to state data.
An average of 1,803 confirmed cases are being reported per day, a 15 percent decrease from the prior week. The citys seven-day positivity rate is at 11.7 percent, down from 13.8 percent the week before.
The city is seeing an average of 15 deaths per day, unchanged from the average number of people per day who were dying a week prior.
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The US continued to report more than 100,000 new coronavirus cases a day over the holiday weekend, as experts warned that widespread Thanksgiving travel could fuel a surge in coming weeks.
In New York, Governor Andrew Cuomo warned of a problem in the hospitals a serious situation, and appealed for retired physicians to return to the frontlines.
The number of new cases reported in the US topped 200,000 for the first time on Friday, according to Johns Hopkins University. Since January, when the first US infections were reported, more than 13m cases have been recorded and more than 265,000 people have died.
There was some good news on Monday, as Moderna said it would apply for US authorisation to use its coronavirus vaccine. The company announced final results from its trial, which it said confirmed 94% efficacy.
Modernas data will be weighed by the Food and Drug Administration (FDA) on 17 December. The company said it expected to have doses for 10 million people ready for the US by the end of December. Pfizer and BioNTech submitted an application for emergency use on 20 November.
The news came as the number of hospitalisations in the US reached a record high. According to the Covid Tracking Project, 93,238 patients were in hospital on Sunday, a steady climb from 47,531 at the start of November, straining workers and resources as winter approaches.
Hospital capacity is the top concern, Cuomo told reporters on Monday, after ordering all elective surgeries to cease in one county and urging hospitals statewide to ready plans to increase capacity by 50% or set up field hospitals.
In Rhode Island, hospitals reached Covid-19 capacity on Monday, the same day a two-week pause meant to control the rise in new cases took effect. A state alert to phones read: Hospitals at capacity due to Covid. Help the front line by staying home as much as possible for the next two weeks.
Under restrictions announced earlier in November by the Democratic governor, Gina Raimondo, some businesses will be required to shut down for two weeks while others are restricted.
Recreational businesses including bowling alleys, theaters and casinos, as well as indoor sporting facilities and gyms, must close. Bars and bar areas in restaurants are also required to close, while restaurants are limited to 33% indoor capacity. Residents are also asked to close their social circles to only people in their own household.
This will not be easy but I am pleading with you to take it seriously, Raimondo said. Choosing to gather with those outside your household will have ripple effects that will increase the strain on our hospitals and put lives at risk.
Raimondo did not rule out another shutdown.
In New Jersey, Governor Phil Murphy said he was re-tightening the limit on outdoor gatherings to 25 people, effective 7 December, with exceptions for funerals, memorials, weddings, religious and political activities such as protests. Murphy also said all indoor youth and adult sports will be put on hold from 5 December to 2 January, also with exemptions.
As you start to make your holiday plans, please recognise that the gathering limits are back to what they were in May and June when we all came together and crushed the curve as much as any state in the nation, the Democrat wrote on Twitter, looking ahead to Christmas. Keep gatherings as small as possible.
In South Dakota, a Republican-run state which has seen surging case numbers, the Rapid City council was set to consider a mask mandate. One ordinance would require face coverings in certain situations but would have no penalties for violators. It also includes exemptions, including young children, law enforcement and religious services.
The Republican governor, Kristi Noem, opposes mask mandates or other interventions. Cities across the state have passed their own mask requirements. State health officials on Sunday reported 700 new cases with 544 hospitalised.
Counties across California have enacted stricter restrictions after the state broke a record with more than 7,700 hospitalisations. With 59% of all hospital beds in use within the states healthcare system, total hospitalisations have increased by 89%, said Gavin Newsom, Californias governor, who is in quarantine after three of his children came in contact with a California highway patrol officer who tested positive for coronavirus. Public health officials project that without any intervention, hospitalisations could increase to 78% by Christmas Eve.
The state is averaging 14,657 cases a day. During the peak of the pandemic in July, California reported a seven-day average of just 9,881 cases a day.
Los Angeles county, the most populous in the US, has asked its 10 million residents to stay home as much as possible. San Francisco and San Mateo counties moved to the most restrictive tier in the states pandemic blueprint, forcing most indoor activities to close and putting residents under curfew from Monday.
Despite dire warnings from authorities including the Centers for Disease Control and Prevention (CDC), millions traveled over the weekend, as Thanksgiving drew to a close. Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said that could cause a spike in cases and warned that the level of infection in the US would not all of a sudden turn around.
What we expect, unfortunately, as we go for the next couple of weeks into December, is that we might see a surge superimposed on the surge we are already in, Fauci told NBC on Sunday.
Fauci said it was not too late for people to help curb the virus by wearing masks, staying distant from others and avoiding large groups.
Between 800,000 and more than a million travelers made their way through US airport checkpoints each day in the past week, according to the Transportation Security Administration, as airports recorded their highest travel numbers since the pandemic began.
Wednesday was the busiest such day since mid-March, with 1,070,967 clearing airport security, the Washington Post reported. In the early days of the pandemic, daily totals fell below 100,000.
The impact of mass travel and Thanksgiving gatherings could mean a flood of new cases just before Christmas.
When you look at people who are hospitalised today, they were infected two weeks ago, maybe more, Dr Jonathan Reiner, a professor of medicine at George Washington University, told CNN. And then it takes usually another week for folks to succumb to the illness.
Vivian Ho contributed reporting
That's the top percentage for any issue, and it follows months of polling from Gallup showing that Americans think the coronavirus is the most important problem facing the country. What's the point: President Donald Trump claimed that the media would stop noticing the coronavirus once the election was over. That simply hasn't been the case. While we have made strides on the development of a vaccine, the coronavirus situation is growing worse, as cases surge and the total death toll rises to more than 260,000 Americans.
The ongoing pandemic means that Biden will have a tough job ahead of him as he begins his presidency in less than two months. Biden's difficult task isn't just about the coronavirus cases, but about everything that is connected to it, including the economy and the mental health of Americans.
All of these statistics are terrible, and they may get considerably worse.
Furthermore, Biden will have to help ensure that Americans actually take the vaccine. While I have argued that the numbers are encouraging on that front, there's still work that needs to be done for people to trust the vaccine.
Indeed, the economy remains a top problem for Americans. In the Monmouth poll, nearly as many Americans said the economy was either first or second biggest issue facing Biden at 36% as said the coronavirus was the first or second most important issue at 42%.
No other issue when combining first and second gets above 20% for the biggest issue facing Biden.
Now, almost everybody agrees that a coronavirus pandemic relief package must be passed by Congress and signed into law by Biden to help the economy. Yet it's not as easy as it might seem.
No doubt the financial troubles and worries have played a role in the mental health of Americans.
Likewise, the emotional well-being of Americans has slid. In every week since March, more Americans have indicated that their emotional well-being has gotten than have said it has gotten better.
The potentially good news is that implementing plans to fight the coronavirus pandemic will help with all of these issues. And with a new administration and a vaccine coming to the forefront, there is a light at the end of the tunnel. It'll take a lot of hard work to get there, though.
People wait in line at a TSA security checkpoint at Orlando International Airport the day before Thanksgiving. Paul Hennessy/NurPhoto via Getty Images hide caption
People wait in line at a TSA security checkpoint at Orlando International Airport the day before Thanksgiving.
Millions of Americans traveled for Thanksgiving despite pleas not to do so from the Centers for Disease Control and Prevention. Dr. Deborah Birx of the White House Coronavirus Task Force says if you're one of them, assume you're infected, get tested and do not go near your friends or family members without a mask on.
Because COVID-19 is a largely invisible threat, our brains struggle to comprehend it as dangerous. Dr. Gaurav Suri, a neuroscientist at San Francisco State University, explains how habits can help make the risks of the virus less abstract.
Emergency room doctor Leane Wen discusses why it's tempting to make unsafe tradeoffs in day-to-day activities and how to better "budget" our risks.
In participating regions, you'll also hear a local news segment that will help you make sense of what's going on in your community.
Email us at considerthis@npr.org.
This episode was produced by Brianna Scott, Art Silverman and Lee Hale. It was edited by Connor Donevan with help from Christopher Intagliata and Wynne Davis. Our executive producer is Cara Tallo.
