As 2020 draws to a close, most will remember the year as one defined by sacrifice and loss.
In the 347 days since the first reported case in the United States, the new coronavirus officially called SARS-CoV-2 flourished and became one of the textbook disasters of modern history. Over casualties, the country mourns the equivalent of the September 11 death toll each day, and is expected to do so for months. In all, 1 in 1,000 Americans has died, with a heavier burden on the elderly and people of color.
Among developed nations, the US stands out after a year marked by virus denial, conspiracy, masked politicization and disregard for the rules, even at the highest levels of government. Shares hit record highs as millions lost jobs. Even as vaccines are quickly shipped by truck and plane to the most vulnerable, America’s hospitals are getting busier by the day.
“I’ve never seen anything like this, more than 2,000 people dying on a daily basis,” said Catherine Kennedy, a 40-year-old RN who works at Kaiser Permanente Roseville Medical Center in California. “It has taken its price.”
Covid toll
In less than a year, the coronavirus became a historically deadly catastrophe in the United States.
On Wednesday, the US reported 225,671 new cases, raising the moving average to 178,740 and setting the year to close with more than 19 million cumulative cases, or roughly one in every 20 Americans.
Data for the holiday season is hurt by a slowdown in testing and reporting, but more broadly, the numbers likely underestimate the number of cases. In one study, fewer than 10% of patients had been diagnosed with antibodies published in The Lancet in September.
The death toll, officially over 340,000, is similarly underestimated. Some 299,028 excess deaths occurred from late January to early October in the US, which are more than the expected total as calculated by statistical models. Two-thirds of them are likely attributable to covid-19, although they are not counted in the official number, according to the US Centers for Disease Control and Prevention.
New York City lost its first resident to COVID on March 14, 2020; its total toll is more than 25,000. Mayor Bill de Blasio said Thursday that March 14, 2021 will be a day of remembrance.
“2020 is going to go down in history as one of our saddest and most difficult years, possibly the most difficult year in the history of New York City,” he said.
The virus spread across the United States as contaminated water, showing up first in the Pacific Northwest, then the Northeast, South and West before a Midwest deluge that brought rural hospitals to their breaking points. Since November, nearly every state has broken single-day case records.
New York City on Wednesday reported a seven-day average positivity rate close to 8%, the highest in more than seven months. California posted a daily record for deaths on Tuesday, and Governor Gavin Newsom said the highly transmissible new British variant had been detected in a patient in Southern California.
The relentless pace of infection, more than 100,000 a day since early November, has weighed on the country’s health workforce.
Short-term fixes
Kennedy Hospital, northeast of Sacramento, is experiencing a surge. The capacity is 166 beds, but there are 244 in use, thanks to a hodgepodge of short-term fixes: cramming multiple patients into private rooms and turning underused parts of the building into covid intensive care units.
Like many in her role, Kennedy is reusing the rare N95 masks and volunteers for shifts outside of her normal work in the neonatal ICU. You are concerned about the impact on the new cohort of nurses and have seen colleagues take stress leave or early retirement.
“We are the richest nation in the world and there is absolutely no reason why that should be,” said Kennedy, who is also president of her state’s nursing association. “The current administration failed the people.”
Although treatments have improved and some states have reported that patients generally stay in hospitals for shorter periods, recent waves shifted needs from urban centers to more rural areas, where resources are scarce. Covid-19 has killed a higher proportion of Americans in rural areas than anywhere else, according to the CDC.
In doing so, the virus exposed the ways in which the world’s most expensive healthcare industry has struggled to care for victims. The United States spends 17% of its GDP on health care, the most of any major economy, twice the average of the Organization for Economic Cooperation and Development nations, and a total of 42% of global spending, according to the Organization. World Health. A recent study estimated that the impact of the pandemic will reduce life expectancy at birth in the United States by more than a year.
“I didn’t expect the United States to do it as shamefully as it has,” said Stephen Bezruchka, an associate professor at the University of Washington School of Public Health, who said the country’s high level of inequality and state and federal policies Disconnected have been the main drivers of their failures. “To be honest, I was amazed.”
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