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America at a 'crossroads': Will the coronavirus epidemic get better—or much worse?


The recent decline in new U.S. coronavirus cases and hospitalizations is easing an immense strain on hospitals, but experts say Americans still need to take urgent steps to prevent another surge in the epidemic.

When will the Covid-19 epidemic end? Here are the good, bad, and ugly scenarios.

Where America's coronavirus epidemic stands

Recent data indicates that America's coronavirus epidemic has improved since last month's peak in reported cases, hospitalizations, and deaths, though the reported rates of each of those metrics remain high.

According to data compiled by the New York Times, U.S. officials on Thursday reported about 77,804 new cases of the novel coronavirus. As of Friday morning, officials had reported about 28.4 million cases since the United States' epidemic began.

According to the Times, the United States' average daily number of newly reported coronavirus cases over the past week was 69,450—down by 32% when compared with the average from two weeks ago.

However, the Times' data showed that, as of Friday morning, the rates of newly reported coronavirus cases were "staying high" in Colorado, Iowa, Nebraska, New Hampshire, South Dakota, Vermont, and Wyoming, which have each reported a daily average of at least 15 newly reported cases per 100,000 people over the past week. And the rate of newly reported coronavirus cases was "going up" in the U.S. Virgin Islands, which has had comparatively lower case rates, as of Friday morning, the Times reports.

According to the data, rates of newly reported coronavirus cases were "staying low" or declining from previously higher rates in Washington, D.C., Puerto Rico, and the remaining U.S. states.

Meanwhile, U.S. hospitalizations for Covid-19 have reached their lowest level since November 2020. According to data from The Atlantic's COVID Tracking Project, there were 52,669 Americans with Covid-19 hospitalized for treatment on Thursday, including 10,846 who were receiving care in an ICU and 3,567 who were on a ventilator.

According to data from the Times, U.S. officials reported about 2,465 new deaths linked to the coronavirus on Thursday. As of Friday morning, officials had reported about 508,107 U.S. deaths linked to the virus since the country's epidemic began.

Declines ease strain on hospitals, frontline workers

Frontline health care workers say the recent decreases in new coronavirus cases and hospitalizations have given them some respite from the strain of the country's overwhelming surge in Covid-19 patients over the past few months.

Joe Kowalczyk, a respiratory therapist at Mercy Hospital St. Louis, said when St. Louis hospitals were inundated with Covid-19 patients, respiratory therapists arriving for their shifts would look at their assignments and cry. But recently, the number of Covid-19 patients at Mercy Hospital St. Louis has dropped. During one of Kowalczyk's recent shifts, there were about 20 Covid-19 patients, down from up to 100 during the recent surge.

"It is so weird to look back on it," Kowalczyk said. "Everyone was hitting their wit's end definitely toward the end just because we had been doing it for so long at the end of year."

According to the Associated Press, Missouri data shows the number of Covid-19 hospitalizations in the state had hovered at nearly 3,000 per day from late November 2020 into January of this year, but they've recently have dropped by about 60%, falling to 1,202 Covid-19 hospitalizations as of Monday.

Similarly, Covid-19 hospitalizations in Wisconsin have decreased from 2,277 patients on Nov. 17, 2020, to 355 patients on Wednesday, according to the Wisconsin Hospital Association. And the Covid-19 patients hospitalized for care in Wisconsin are not as sick as those hospitalized earlier in the epidemic, with the number of Covid-19 patients in ICUs dropping by 81% since Nov. 16., the AP reports.

As a result, Wisconsin health officials on Feb. 15 removed all staff from a field hospital erected last October at the state fairgrounds in suburban Milwaukee.

But health officials note that Covid-19 hospitalizations in many parts of the country are at about the levels seen during earlier peaks in the epidemic. Further, declines in newly reported coronavirus cases and hospitalizations appear to be leveling off, Ali Mokdad, a professor of health metrics sciences at the University of Washington in Seattle, told the AP.

"In the past week, we're seeing the slowdown of the decline," Mokdad said.

Further, there are some reasons to be concerned that cases and hospitalizations may climb once again, Mokdad said.

Some experts believe the United States could see a "fourth surge" of coronavirus cases in late March or April, driven by emerging, more transmissible variants and by the easing of restrictions intended to curb the virus's spread.

"We're at that crossroads, where it could go well or it could go badly," Anthony Fauci, director of the National Institute for Allergies and Infectious Diseases and chief medical adviser for the White House's Covid-19 response, told the Times.

How to prevent another coronavirus surge 

According to experts, many factors will determine whether the United States sees another surge, including how well Covid-19 vaccines can prevent the virus's spread; whether new coronavirus variants are less susceptible to Covid-19 vaccines; how quickly Americans are vaccinated; whether states relax coronavirus-related restrictions; and whether people continue following public health measures aimed at slowing the virus's spread, even if state and local mandates are lifted.

Lindsay Wiley, an expert in public health law and ethics at American University, said individual choices are particularly important. Americans will have to continue practicing physical distancing, wear face masks, and take other precautions to keep the virus from spreading, experts say.

Along the same lines, state officials should maintain restrictions aimed at preventing the virus from spreading further, according to experts.

"Everybody is tired, and everybody wants things to open up again," Ashleigh Tuite, an infectious disease modeler at the University of Toronto, said. But "[b]ending to political pressure right now, when things are really headed in the right direction, is going to end up costing us in the long term" (Hollingsworth/Richmond, Associated Press, 2/25; Mandavilli, New York Times, 2/25; Holcombe, CNN, 2/26; New York Times, 2/26; "COVID Tracking Project," The Atlantic, accessed 2/26).


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