More people traveled through U.S. airports on Sunday than any other day during this pandemic, setting the stage for waves of new infections across the country.
More than 1.28 million people passed through security checkpoints, the Transportation Security Administration said.
At the same time, more Americans were hospitalized last week than any other week in the pandemic, according to the COVID Tracking Project.
Six states set new records Sunday for the majority of hospitalized COVID-19 patients: Alabama, California, Georgia, Mississippi, North Carolina and South Carolina.
Doctors say massive vacation trips will bring more patients, a big problem because many hospitals are already over capacity.
“It’s really frustrating, because if you look at the data for the last 10 days, they actually started to show some signs of light,” said Dr. Jonathan Reiner, a professor of medicine at George Washington University.
“Places like the Midwest, with a drop in the number of cases. Even in the Northeast. America’s positivity rate fell from about 12 percent to about 10 percent.
“Those are really tangible signs of a slowdown in the crisis. And now there will almost certainly be another peak.”
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And unlike the previous holidays, the Christmas-New Years combo runs for an entire week.
“We know that after every major holiday, there was an increase in the number of cases,” said emergency medicine doctor Dr. Leana Wen.
“We saw this after Memorial Day, after July 4, after Labor Day. And those holidays were relatively short compared to Christmas and New Years.”
On top of that, the weather is much colder now, which means more indoor gatherings and a higher risk of airborne spread.
COVID-19 patients occupy more and more ICU beds
ICUs are often associated with heart attacks and car accidents, but a growing number of ICU beds are now occupied by COVID-19 patients.
Last week, about 40 percent of all ICU patients in the US had COVID-19, according to an analysis of CNN data released Monday by the US Department of Health and Human Services.
That’s a 16 percent increase at the end of September; 22 percent at the end of October; and 35 percent at the end of November.
And more hospitalizations inevitably lead to more deaths.
More than 63,000 Americans have already died so far this month, the most in any month since the pandemic began, according to Johns Hopkins University.
In just 11 months, more than 333,000 people have died from COVID-19. That means more than 1 in 1,000 Americans has died from the coronavirus, and the rate is accelerating.
A California hospital may soon have to ration the limited number of ICU beds and treatment equipment, which means some people will receive treatment and others will not, said Dr. Kimberly Shriner, an infectious disease specialist.
At this rate, Huntington Memorial Hospital in Pasadena is preparing for “definitive triage,” he said.
And with most Americans unable to get vaccinated until well into next year, the United States faces a “surge” after vacation travel, said Dr. Anthony Fauci, director of the National Institutes of Health.
“As we move into the next few weeks,” he said, “things could get worse.”
The new travel requirements go into effect Monday
As more countries detect the highly contagious strain of coronavirus first detected in the UK, the US Centers for Disease Control and Prevention announced new testing requirements for travelers arriving from the UK.
The new rules go into effect on Monday. Passengers must have had a negative antigen or PCR test within 72 hours of boarding a flight from the UK to the US, along with documentation of their lab results.
The airlines must confirm the test before the flight.
So far, dozens of countries have banned travelers from the UK.
All viruses mutate over time, and the new coronavirus has mutated before. But scientists advising the UK government estimated that this strain could be up to 70 percent more effective at spreading than others.
The companies behind the first two vaccines to gain emergency clearance in the US, Pfizer / BioNTech and Moderna, are testing their vaccines to confirm whether they are effective against the new strain.
Implementation of the vaccine is slower than expected
About 2 million doses of the COVID-19 vaccine have been administered in the US, according to the CDC. A total of more than 9.5 million doses have been distributed.
Those numbers now include the Pfizer / BioNTech and Moderna COVID-19 vaccines. And while there are delays in submitting data, federal officials had previously said they were working to distribute 20 million doses by the end of the year.
When asked about the apparent slowness of vaccine implementation, Dr. Fauci said that large, comprehensive vaccine programs with a new vaccine start slowly before gaining momentum.
“I’m pretty sure that as we gain more and more momentum, transitioning from December to January and then February to March, I think we’ll catch up with the projection,” he said.
Dr. Esther Choo, a professor of emergency medicine at Oregon Health and Science University, said vaccine delivery is “just a very complicated thing.”
“At every step, there is complexity and there is the possibility of delay, whether it be individual state planning, assignment, training, vaccine supply, storage … there are so many factors at this stage,” said Dr. Choo.
“We need to be prepared for the fact that it will be a slow rollout in many places and that it will not change our behaviors or necessarily the trajectory of the pandemic in this country any time soon,” said Dr. Choo.
With vaccines likely not being widely available until the summer, experts have urged Americans not to lower their guard. That means keeping wearing masks, washing your hands frequently, and social distancing.
Why herd immunity is a moving target
For the United States to achieve herd immunity through vaccination, 70 to 85 percent of the population would need to be vaccinated, Dr. Fauci said.
“The range is going to be between 70 and 85 percent,” he said Sunday.
He said the reason he initially said 70 to 75 percent and then raised the high level to 85 percent “was really based on pure measles calculations and extrapolations.”
“We have to realize that we have to be humble and realize what we don’t know,” he said. “These are pure estimates and the calculations I did, 70 to 75 percent, is a range.”
The measles vaccine is 98 percent effective, Dr. Fauci said. When less than 90 percent of the population is vaccinated against measles, a breakthrough against herd immunity begins and people begin to become infected.
“So I did a calculation that COVID-19, SARS-CoV-2, is not as communicable as measles,” said Dr. Fauci.
“Measles is the most communicable infection you can imagine. So I imagine you would need something a little less than 90 percent, that’s where I got to 85.”