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COVID-19 infections spike again as restrictions are reimposed

Even as hopes grow about the distribution of vaccines in the coming months, COVID-19's impact continues to ripple across the U.S. with enormous consequences. Twenty-six states set records for COVID-related hospitalizations during Thanksgiving week. William Brangham spoke with Dr. Céline Gounder, an epidemiologist and infectious disease specialist at Bellevue Hospital, to learn more.

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  • Judy Woodruff:

    Even as hopes grow about the distribution of vaccines in the coming months, COVID-19's impact continues to ripple across the U.S. with enormous consequences, more than 138,000 new cases reported over the past day, and over 800 deaths.

    Hospitalizations remain very high, more than 90,000 in all. And 26 states set records for COVID-related hospitalizations during Thanksgiving week.

    William Brangham has a conversation about the latest.

  • William Brangham:

    Judy, over the weekend, public health officials warned that, with large holiday gatherings, infections could grow significantly between now and Christmastime.

    The surge in cases and hospitalizations and deaths come as new questions emerge about the three new vaccines that are on the horizon.

    Dr. Celine Gounder is an epidemiologist and infectious disease specialist at Bellevue Hospital and the New York University Grossman School of Medicine. She's also a member of president-elect Biden's COVID advisory team.

    Dr. Gounder, very good to have you on the "NewsHour."

    Cases are accelerating across the country over this past month. Can you just give us a snapshot, as you see it, of how things are going right now?

  • Celine Gounder:

    Well, the nation was already experiencing a surge in cases, essentially our third wave of cases, before the Thanksgiving holiday.

    And the problem with the Thanksgiving or really any other such holiday is you're bringing together people and families, friends from all over the country. You're bringing together people of different generations.

    And what we were seeing in the weeks coming up to this was much of the transmission was being propagated by younger people, so teens, 20s, 30-somethings, and now those folks were being brought into contact with older people, who are at much higher risk for severe disease.

    And while we often see this kind of spread rippling out from the younger people to the older people, Thanksgiving really put that on fast-forward. And so we're very concerned about seeing a much, much bigger surge on top of what we already were facing in the weeks ahead.

  • William Brangham:

    And do you think of that as an equivalent or greater risk than the sort of ongoing things that we know of as high-risk behaviors, crowding into bars and gyms and stores and other in-person indoor gatherings?

  • Celine Gounder:

    Well, we know the small indoor gatherings with family and friends are very high-risk.

    The way I think about coronavirus is, it's a virus that hitches a ride on our love and our trust for other people. And it's precisely the people we're closest to that we are least likely to take measures to protect ourselves. We're least likely to mask around them. We're least likely to avoid contact with these people.

    And so we're at — we're at much higher risk of infecting them unbeknownst to us or them accidentally infecting us.

  • William Brangham:

    We are also, as I mentioned, seeing a rise in the death toll.

    And although we have made incredible strides in caring for people who develop really serious COVID-19 infections, why are we seeing that death toll also rise? Is it just because there are so many cases out there?

  • Celine Gounder:

    Yes, this is exactly the conversation we were having earlier this year about flattening the curve.

    The challenge is that, when health systems are overrun, when doctors and nurses are so short-staffed, having to each care for so many patients, it's very difficult to deliver the same level of care, to monitor patients as closely. And it's precisely in those situations that the case fatality rate, the risk of dying shoots up.

    And so we're already seeing hospitals overrun right now. We're heading into a holiday season, when we are usually operating on skeleton crews, so that doctors and nurses can themselves spend some time with family and friends over the holidays. And it's against that backdrop that we are now in danger of having an even bigger spike.

  • William Brangham:

    Obviously, the one bit of bright news we have been seeing is this news about the vaccines.

    I mean, I — you think about 2020, at the beginning of this year, we identified this novel virus, and now, at the end of the same year, we have got three possible candidate vaccines to target that virus. I mean, that is unadulterated good news.

    The question, of course, with limited amount of doses available initially, how those get rolled out, who gets them. From your perspective, how should we prioritize? Who gets those first precious shots?

  • Celine Gounder:

    Right.

    Well, the idea here is to prioritize for impact, to really protect those at highest risk. So, obviously, doctors and nurses, especially those caring for patients with coronavirus, are going to be at extremely high risk, particularly given that, in some parts of the country, we're still facing shortages of personal protective equipment, so your masks and your facials and your gowns and your gloves and so on.

    So, first- line health care providers are certainly among those first in line, other first responders, like EMTs, probably law enforcement, firefighters, those kinds of folks, and then beyond that, people who are at extremely high risk of severe complications. So, that would include the elderly, people living in nursing homes, as well as communities of color that have been hit disproportionately hard during this pandemic, where we have seen some of the highest rates of cases, as well as deaths.

  • William Brangham:

    All right, Dr. Celine Gounder, thank you very, very much for being here.

  • Celine Gounder:

    My pleasure.

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