The pandemic's final surge will be brutal

Worse yet, the country could lose what progress it has made on the case-fatality rate since the spring and see it increase, which would mean that people could die who, under other circumstances, might not have. Improvements in the outcomes of COVID-19 cases came in part from doctors and nurses learning how better to identify and treat the disease’s most serious symptoms, which can vary widely from patient to patient. Health-care workers cannot provide that level of care when hospitals are overwhelmed by the most serious COVID-19 cases.

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As Robinson Meyer and Alexis Madrigal have reported, hospitals have now hit a breaking point at which they no longer have the capacity to treat COVID-19 patients that, not long ago, might have been hospitalized. One indication, observed by Ashish Jha, the dean of the Brown University School of Public Health, is that in recent weeks, about 3.5 percent of cases translated into hospitalizations a week later. But that number has started falling. The University of Nebraska Medical Center—which started preparing for such a scenario in 2003, making it perhaps the nation’s best-prepared hospital—was nearing its breaking point at the end of November, Ed Yong found.

The last three weeks of the year will tell us the magnitude of the situation. Thanksgiving caused a data lag, and the seven-day average of deaths could likely increase in the next few days, in part because medical examiners will finish catching up on their work. At the same time, we may start seeing the effect of Thanksgiving travel and gatherings on case counts, the surge many have been fearing. By Christmas and into the New Year, we’ll have a sense of how new cases from Thanksgiving will translate into deaths.

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