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Despite vaccine progress, experts warn 'dark winter' still awaits for US


FILE - In this Dec. 2, 2020, file photo, a customer walks past a sign indicating that a COVID-19 vaccine is not yet available at Walgreens in Long Beach, Calif. (AP Photo/Ashley Landis, File)
FILE - In this Dec. 2, 2020, file photo, a customer walks past a sign indicating that a COVID-19 vaccine is not yet available at Walgreens in Long Beach, Calif. (AP Photo/Ashley Landis, File)
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Federal officials and infectious disease experts have renewed warnings of a “dark winter” as coronavirus cases surge across the United States, but efforts to stave off a public health disaster have encountered political resistance and the challenges the country faces could get worse as the pandemic spreads.

"The reality is December and January and February are going to be rough times," Robert Redfield, director of the Centers for Disease Control and Prevention, said at a U.S. Chamber of Commerce event. "I actually believe they're going to be the most difficult time in the public health history of this nation."

Redfield predicted total U.S. deaths from the virus might hit 450,000 by February if current trends continue. He stressed the importance of mask-wearing and social distancing to limit the spread of the outbreak, and he lamented to politicization of the issue that has led many Americans to defy restrictions.

“It’s not a fait accompli,” Redfield said. “We’re not defenseless. The truth is that mitigation works. But it’s not going to work if half of us do what we need to do. Probably not even if three-quarters do.”

Wednesday marked the highest single-day death toll of the pandemic in the U.S. with at least 2,800 deaths reported. Hospitalizations also hit a record high and new infections topped 200,000 for the first time.

With no signs that a situation that has been gradually worsening for months is likely to improve, some infectious disease experts expect daily deaths to reach 4,000 within weeks. One model recently projected total coronavirus cases could double by the end of January.

An analysis by USA Today found 45 states and two-thirds of counties reported more new coronavirus cases in a week in November than at any previous point in the pandemic. The first surge of cases in the spring was dampened by stay-at-home orders and the onset of warmer summer weather, but containing the virus in the fall has proven far more difficult.

“[Americans] will be facing a dark winter, sadly, due to the high incidence currently, which is likely to continue to spread without interventions to reaffirm the hygienic public health requests—face masks, physical distancing, hand hygiene—in a consistent and unified manner throughout the country,” said Dr. Panagis Galiatsatos, an infectious disease expert at Johns Hopkins University School of Medicine.

That basic guidance—masks, distancing, and hand washing—is still the best defense against the virus, experts say. Even when the numbers of cases and deaths have grown so large that people become numb to them, strict adherence to those protocols can slow the spread and save lives.

“I think what we need to do is really become much more attentive to staying in, staying home when we can, not going out, and not interacting with groups of people without a mask or in close proximity,” said Dr. Lisa Lee, an epidemiologist and bioethicist at Virginia Tech and a former CDC official.

However, that might be asking more than Americans are willing to give at this point. Millions traveled last week for the Thanksgiving holiday despite dire warnings from federal and state public health officials. That could lead to a wave of new infections across the country, and Christmas poses a similar risk in just a few weeks.

“Even if only a small percentage of those travelers were asymptomatically infected, this could translate into hundreds of thousands of additional infections moving from one community to another," Cindy Friedman, chief of the CDC’s travel branch, told reporters on a briefing call Wednesday.

The dimming short-term prognosis comes amid rising optimism about the long-term prospects for containing the virus. The Food and Drug Administration could grant emergency use authorization for Pfizer’s coronavirus vaccine as early as next week, and Moderna’s vaccine will be considered soon after that, with other candidates now in late-stage trials.

Moncef Slaoui, the head of the Trump administration’s vaccine program, predicted Wednesday that up to 100 million Americans could be immunized by the end of February, accounting for most of the nation’s high-risk population. Officials are hopeful herd immunity could be reached by mid-summer, but many complications might still arise.

“The light is at the end of the tunnel. We see it...,” Assistant Health Secretary Adm. Brett Giroir told Sinclair Thursday. “But we can have a very difficult couple of months until the vaccines get out there in more wider distribution.”

Even if the end appears to be in sight, getting there could still be a painful and deadly trek. According to Lee, the nation is in the worst place it has been since the pandemic began, and the steep increase in infections in recent weeks will be difficult to reverse.

“It is a mathematical certainty that the more people who are infected, the more people are likely to become infected,” Lee said.

State and local officials in many areas have responded to the uptick in cases with urgency, rolling back reopening plans and imposing new restrictions. Some governors who opposed mask mandates in the past are now embracing them, but others remain reluctant.

In Los Angeles, Mayor Eric Garcetti warned Wednesday the city could run out of hospital beds by Christmas and called upon residents to “cancel everything.” The city issued a stiff “safer at home” order that banned most nonessential activities, but there were numerous exemptions.

"The public health condition of our city is as dire as it was in March in the earliest days of this pandemic," Garcetti said.

Though most Americans continue to support social distancing and mask use, vocal resistance to public health restrictions has grown as the issue became more politicized. It could be much more difficult to get pandemic-weary communities to comply with new limits on economic and social activity now than it was in the spring.

“Many people are just tired of that and are starting to engage in behaviors that are high risk for getting COVID,” Lee said.

According to Peter Loge, a former senior adviser to the commissioner of the Food and Drug Administration under the Obama administration, the public has received conflicting, confusing, and sometimes inaccurate information from politicians and pundits for months. In the absence of clear and consistent guidance from leadership, some people will inevitably do whatever they want.

“After eight months, people are exhausted, many have run out of savings, they are missing family and friends, and are just done,” said Loge, director of the Project on Ethics in Political Communication at George Washington University. “When people feel like they can no longer do something, they often stop doing it.”

As officials struggle to balance economic needs and public health concerns, some residents have dismissed restrictions as contradictory and arbitrary. In New York City, schools were shuttered last month while restaurants remained open for indoor dining. In Los Angeles, parents grew frustrated that playgrounds were closed and shopping malls were open.

In Staten Island Wednesday night, hundreds of maskless demonstrators gathered outside Mac’s Public House to protest the arrest of the bar’s owner for flouting the city’s 10 p.m. curfew for alcohol sales. Owner Danny Presti and several local Republican politicians addressed the crowd, denouncing government overreach and the economic damage wrought by restrictions.

“We take back Staten Island tonight,” Presti said, according to The Staten Island Advance. “We take all the states back. This is how we take our country back.”

Some public officials have handed those who want to dismiss restrictions ammunition by violating their own guidance to attend dinner parties, travel, or visit family members. The apparent hypocrisy has fueled anger and skepticism about government mandates disrupting daily life in the name of public health.

"These Democrats do not follow their own edicts,” White House Press Secretary Kayleigh McEnany said at a briefing Wednesday. “They act in a way that their own citizens are barred from acting."

Some leaders like California Gov. Gavin Newsom have promptly apologized for their transgressions, but others have defended their actions as not explicitly violating the rules that were in place at the time. Even if dining out or traveling was technically allowed, Loge said it could be a costly mistake for officials not to practice what they preach.

“Telling voters to stay at home, and to stay alone, while you eat out with friends is hypocritical, undermines public confidence in our leaders when we need that confidence most, and threatens public health,” he said. “Telling people to ‘do as I say, not as I do’ is questionable parenting and terrible leadership.”

An impending change in leadership at the White House might have an effect on the nation’s trajectory. President Trump, who often downplayed the threat of the virus during his reelection campaign and predicted concerns about it would disappear after Election Day, has said little about the latest surge in cases and has not signaled any change in strategy.

Projected President-elect Joe Biden has vowed to counter the virus aggressively once he takes office in January. Biden is expected to announce his nominee to head the Department of Health and Human Services next week, as well as a White House adviser to coordinate the federal coronavirus response.

“Christmas is going to be a lot harder,” Biden said during a virtual roundtable with workers and business owners Wednesday. “I don’t want to scare anybody here, but understand the facts. We’re likely to lose another 250,000 people dead between now and January.”

Dr. Anthony Fauci, the federal government’s top infectious disease expert, told CBS News he was set to have his first substantive conversation with Biden’s transition team Thursday. He had not yet spoken to Biden directly, but he expected to continue his role in the nation’s coronavirus response in the next administration.

“President-elect Biden has made it clear that he will make the best decision he can based on the science and other information,” Loge said. “Policy will be driven by data; the messaging will follow. Policy should drive politics, not the other way around.”

Biden’s proposed plan includes more coronavirus testing, lower costs for treatment, working with businesses to produce more protective equipment, and providing more relief to those impacted by the pandemic. He also wants governors to impose mask mandates nationwide, but some have already said they would refuse.

As troubling as the coronavirus numbers are now, experts expect they will be much worse by the time Biden takes office. Herd immunity through immunization would still be months away at best, and a clear message of caution from the White House might not be enough to overcome the social and political forces that have driven the nation to this point.

“I really wish I had an easy or hopeful answer,” Lee said, “but what we’re seeing right now is enormously challenging and I’m very worried for our country.”

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