Covid-19 Live Updates: Grim Day in U.S. as Covid-19 Deaths and Hospitalizations Set Records

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‘It’s terrible, because it was avoidable’: U.S. virus deaths have passed the spring peak.

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‘It’s terrible, because it was avoidable’: U.S. virus deaths have passed the spring peak.
Workers at a Brooklyn hospital retrieving a body from a refrigerated trailer in April.
Workers at a Brooklyn hospital retrieving a body from a refrigerated trailer in April.Credit…Victor J. Blue for The New York Times

The United States on Wednesday recorded its single-worst daily death toll since the pandemic began, and on a day when Covid-19 hospitalizations also hit an all-time high, the pace of loss showed no signs of slowing any time soon.

Not since spring, during the pandemic’s first peak, were so many deaths reported. The high point then was 2,752 deaths on April 15. On Wednesday it was at least 2,760.

Hospitalizations from the virus topped 100,000 — more than double the number at the beginning of November. That is a clear indicator of what the days ahead may look like, experts say.

“If you tell me the hospitalizations are up this week, I’ll tell you that several weeks down the road, the deaths will be up,” said Dr. Jeremy Faust, an emergency medicine physician at Brigham and Women’s Hospital in Boston.

For all the similarities to the spring pandemic peak, there are some profound differences.

In April, the virus and the deaths were concentrated in New York and New England. Today, the pandemic’s toll is being felt across the country.

Still more sobering: The April peak represented the worst moment of spring. It was followed by a decline in deaths as lockdowns were imposed and many Americans altered their behavior.

And as staggering as it is, the death toll reported Wednesday appears likely only to worsen, experts say, as the delayed effects of Thanksgiving travel are felt. And many Americans are now weighing how to celebrate Christmas and New Year’s.

“This is a much worse situation,” said Dr. Ashish Jha, dean of Brown University’s School of Public Health. “Summer is not going to bail us out. Things are not shut down.”

Still, interpreting daily death tolls can be tricky.

The figure represents what health authorities report on any given day, not when people actually die. So while the total appeared to dip in the days after Thanksgiving, for example, that most likely meant those doing the tallying had time off, not that fewer people were dying.

The April 15 peak included deaths announced that day, as well as probable deaths in New York City which were later reported to have occurred that day.

There are other differences from the spring, some more hopeful.

Though coronavirus cases have exploded recently, with new infections topping one million a week, a far smaller proportion of people who get the virus these days are dying from it. National data from the Centers for Disease Control and Prevention shows that the share of cases resulting in death dropped from 6.7 percent in April to 1.9 percent in September.

But over all, deaths in the United States are still climbing.

“It’s terrible, because it was avoidable,” said Dr. Leora Horwitz, an associate professor of population health and medicine at the N.Y.U. Grossman School of Medicine. “We are a world outlier in this regard.”

The bright spot, Dr. Horwitz said, is that health care workers have gotten much better at treating the virus, and that has cut the death rate.

“There is good news in that these numbers are far fewer than they would have been in March or April,” she said.

Dr. Faust said that the pool of people sick with Covid-19 has shifted since the spring, with fewer patients from nursing homes. That has meant a smaller proportion die.

“The concentration of cases is moving into a younger and healthier population, and it takes more of those cases to add up to the eye-popping number that we saw in April,” he said. “But it is happening.”

— Sabrina Tavernise
As deaths rise, U.S. hospitals struggle to keep record numbers of patients alive.

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The number of Covid-19 patients in American hospitals has surpassed 100,000 for the first time, nearly double the number from spring during the coronavirus’s deadly first wave, according to the Covid Tracking Project.

The Tracking Project on Wednesday put the number of patients at 100,226.

The relentless rise in hospitalizations follows a rapid climb in new cases, which now number more than one million every week. And deaths, a so-called lagging indicator that tends to spike after a rise in hospitalizations, have also been rising fast. They have now passed 270,000 in the U.S.

The numbers paint a sobering picture of what the next few weeks may look like, experts said. Hospitals in some places are nearing capacity, and if states are unable to curb the surge of new cases, those systems could soon become overwhelmed, as New York was in the spring.

“Any thinking person has to be worried,” said Philip Landrigan, the director of a global public health program at Boston College. “That we have so many hospitalizations speaks to the fact that we have done a very poor job of controlling this pandemic. It is spreading very rapidly, and in many places, it is basically spreading out of control.”

Still, the situation today is different from the spring.

Hospitalizations are climbing steadily, but they are not keeping pace with the soaring number of cases. The share of people infected with the coronavirus who are admitted to hospitals has actually been shrinking, a twist in the data for which experts offer different theories.

One explanation is testing. Many more people today are getting tested than at the start of the pandemic and that is turning up many more mild cases. And many of those who do contract the virus become far less sick, said Dr. Caitlin Rivers, an epidemiologist at Johns Hopkins University, meaning they are less likely to need hospitalization.

But Dr. Rivers does not believe that the share of people who are sick enough to need hospitalization has changed that much. It is just that now they are spread across the United States, unlike the spring, when they were concentrated in New York and New England.

“Now we can see more of the iceberg,” she said. “This spring, you got a test because you were in the hospital and you were already sick. Now you can get tested even if you don’t have symptoms. We are adding to the denominator, but many of those people were never really destined for the numerator.”

But others said the shift was more than just increased testing.

Dr. Michael Osterholm, an infectious diseases expert at the University of Minnesota, who is on President-elect Joseph Biden’s advisory panel for the pandemic, said that he had seen a downturn in hospitalizations over the past few weeks, but that he suspected it reflected an attempt by hospitals to manage rising caseloads.

“Patients that would have been hospitalized last month today are being sent home and watched closely,” Dr. Osterholm said. “Many of our health care systems are literally on the edge. They are in a sense triaging, keeping only the most severely ill patients.”

Complicating the situation for hospitals is the fact that with cases now exploding in nearly all parts of the country, health care workers cannot be brought from other states to help, he said.

The next two weeks will be critical, Dr. Osterholm said.

“If we get this Thanksgiving surge, we will have hospitals hit their case cliff,” he said. “Then you can’t have more hospitalizations because there won’t be enough health care professionals to care for them.”

Hospital administrators said their staffs were already stretched.

Marvin O’Quinn, president and chief operating officer of CommonSpirit Health, which runs hospitals in 21 states, said his system had been drawing from its own outpatient facilities as well as outside companies to meet the growing need for hospital workers.

“There just aren’t enough nurses or doctors,” said Mr. O’Quinn. “This has escalated around the last two or three weeks.”

He said his hospital system is now treating 2,056 Covid-19 patients, the highest number to date and about 65 percent more than a month ago. About 100 new cases a day are being admitted. He said hospitals in Omaha, Los Angeles and Phoenix had seen substantial increases in caseloads.

“I’m concerned,” he said, adding that he believed the hospitals were as prepared as they could be.

“We took the summer to get ready. We knew the fall was coming.”

— Sabrina Tavernise the New York Times