US faces uneasy crossroads on COVID-19 before holidays

The U.S. recovery from the crushing delta wave of the coronavirus is beginning to stall out, with case counts stuck around 70,000 per day for two weeks after a precipitous decline from the peak of the Sun Belt surge in September.

A drop in hospitalizations, a key metric as people begin to “live with” the virus and vaccinated persons fend off breakthrough infections, also appears to be slowing around the 45,000 mark.

The Mountain West is seeing some of the biggest surges, with states like Montana and Wyoming accounting for some of the highest rates of hospitalization per population.

“We are definitely in a crisis in terms of people getting the care they need,” Dr. Angela Dunn, executive director at the Salt Lake County Health Department in Utah, told National Public Radio. “When a patient needs an ICU bed, it takes us two to three hours because they’re all full. Usually, it takes 10 minutes.”

While vaccination rates in those places tend to be lower than the national average, some highly vaccinated places like New Mexico, Colorado and parts of the Northeast have seen surges, muddying the picture.

“It’s inevitable that there’s going to be an acceleration in cases as it gets colder and people move indoors and the virus transmits more efficiently,” said Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. “The issue is: Are enough high-risk people immune to severe disease by being vaccinated or having prior infection in a given region to keep hospitals from being stressed? There are pockets, even in highly vaccinated states, with gaps in immunity, which is likely what is going on in Colorado.”

The slowdown in progress puts the nation at an uneasy crossroads as winter sets in and Americans try to enjoy the Thanksgiving and Christmas holidays after a bruising 20 months.

President Biden, who pledged to corral the virus, is fighting the pandemic on two fronts, using a mix of pleas and mandates to lift vaccination rates among holdouts and deploying a booster program to shore up waning immunity in people came forward months ago.

With 58% of the U.S. population vaccinated, scientists generally believe the winter spike will be rough at times but not as bad as the horrific spike last year when the vaccine campaign was in its infancy.

Dr. Panagis Galiatsatos, an assistant professor at Johns Hopkins School of Medicine in Baltimore, said the majority of cases he’s encountered are in vaccinated persons who come to his doctor’s office and are “doing well.”

“Very few in the ICU. It’s the vaccine status that has been the game-changer in ICU decline,” Dr. Galiatsatos said.

While the U.S. sees uneven results, Europe is heading into crisis mode.

The World Health Organization said COVID-19 deaths in Europe rose 10% during the first week of November. The continent accounted for over half of global deaths during the same period.

The problem is particularly acute in Eastern European countries like Russia, Ukraine and Romania, where vaccine skepticism is high.

Germany is seeing some of its highest caseloads of the pandemic â€" it has a 67% vaccination rate but uptake varies by region â€" and the Netherlands is reimposing mask mandates.

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