Temperatures are dropping, nights are growing longer, the holidays are nearing, and the science is clear: The pandemic is far from over. A long, dark winter awaits.
The number of new coronavirus cases in the United States each day has ballooned from less than 40,000 in early September to more than 100,000 in early November. The U.S. now confirms more cases in a single day than China has reported since the pandemic began.
“We may be turning a corner, but not in a good way,” said Julie Swann, an expert in healthcare systems at North Carolina State University.
But while a winter surge of COVID-19 is now unavoidable, experts caution that the number of infections and deaths it will bring is not yet written in stone — and its magnitude depends on what we do next. Hundreds of thousands of lives may hang in the balance.
“Saying a surge is inevitable may sound like fatalism,” said William Hanage, an epidemiologist at Harvard’s T.H. Chan School of Public Health. “But just because some surge of some size is inevitable, it doesn’t mean the size is inevitable.”
If the United States continues to relax social distancing restrictions and mask-wearing requirements, as many as 500,000 more Americans could die of COVID-19 between now and the end of February, according to scientists at the Institute for Health Metrics and Evaluation at the University of Washington. That’s on top of the roughly 240,000 COVID-19 deaths the country has absorbed already.
Even if we take substantial collective action, the number of deaths due to the coronavirus could top 100,000 between now and Feb. 28, the IHME researchers said.
“We are past the point of being able to get the virus under control,” said Christopher Murray, director of the institute and leader of the modeling work. “There is too much of it out there.”
Scientists have warned for months that the virus that causes COVID-19 could be seasonal, spreading more easily in the cold winter months like influenza and the viruses that cause the common cold.
Experience has shown that SARS-CoV-2 is capable of spreading even when temperatures soar. This summer, outbreaks occurred at an overnight camp in Georgia, a hockey rink in Florida and prisons in California. But experts said there are myriad reasons why the coronavirus would spread even more rapidly in the winter.
Some are due to the biology of the virus itself. Studies have shown that SARS-CoV-2 has more stamina in cold conditions than in warm ones. Cold weather also affects human behavior. When the temperature falls, it becomes less comfortable to spend time outdoors, where the risk of infection is significantly lower than it is inside.
“The virus loves indoor, poorly ventilated spaces,” Hanage said. “Good ventilators could be helpful, but it is not as good as outside.”
Epidemiologists are also deeply concerned about the coming holiday season, and the ensuing family gatherings at which people from different households are likely to be indoors and unmasked for hours at a time.
“Mask use indoors is extremely important, especially if you are having a multi-generational family meal,” Hanage said. “But of course, people have to remove their masks to eat.”
The sort-of-silver lining is that over the past eight months, physicians have become much better at treating patients who are hospitalized with COVID-19. That means more people will survive. Nonetheless, a COVID-19 patient who survives a hospital stay is still taking up a bed that won’t be available to a patient fighting cancer or trying to recover from a stroke — or waging their own battle against the coronavirus.
“If this was an actual war that was killing 200,000 people, we would be building bombers, we’d be building missiles,” he said.
A missile won’t stop the coronavirus, but the widespread use of epidemiological tools might: Rapid tests that can be administered at home would be a game-changer. So would robust contact-tracing and a concerted effort to resist virus fatigue and remain socially distanced from those who are not in your household.
Simply getting people to wear masks every time they leave their homes would reduce infection rates by 25%, experts say.