Not just vaccine distribution but the outbreak itself. It is bad.

First published in January 2021.

Yesterday, we had more than 4,000 deaths from COVID-19 in the United States. The highest single day ever.

But the story is worse when you look at cases and hospitalizations.

And thus, we feel the urgency to act.

Let’s talk data (via @COVID19Tracking)

7-day moving averages from yesterday:

  • Daily deaths: 2,761highest ever
  • Daily new hospitalizations: 4,284highest ever
  • Daily new cases: 224Khighest ever
  • % positive: 16.6%highest since Apr 21

You know what is not the highest ever? Testing!

So, this is a problem for lots of reasons. Obviously, having more Americans dying is horrible, but yesterday’s deaths represent infections from mid-December. Before the holiday surge. And back then, cases were lower. And the percentage of tests positive was lower.

Remember, the percentage of positive cases is another way of asking – how many infections are you missing? And at 16.6% positive, we are missing a vast majority of infections. And of course, there is the new variant that we aren’t tracking closely.

So, what do the numbers mean? With case fatality rate around 1.7%, yesterday’s 4,000 deaths will soon become the new daily norm.

And let’s talk testing because it remains a problem. We did as much testing yesterday as we did on November 20. So since November 20, cases are up 35%, deaths have doubled, but testing is the same.

With the new variant starting to take off, it is easy to see us hit 500,000 deaths before February ends.

It is catastrophic. But not baked in. Not inevitable.

We can substantially slow deaths in February. How? By getting high risk people vaccinated in January.

Remember that over 90% of deaths are in people over 55. Which is why we have to prioritize getting vaccines out quickly, especially to older people. And why Joe Biden’s team announcement to not hold back doses is so smart.

The bottom line is this: We are in for a VERY rough few months!

A horrible January largely baked in because of failures in December. But what we do in upcoming weeks will shape February. We have to remain careful, wear masks, and push on testing. But it is critical to get as many vaccinated in the next few weeks as possible.

It will save a lot of lives.🔷

Dr Ashish K. Jha, Physician, health policy researcher. Dean of the School of Public Health, Professor of Health Services, Policy and Practice, Brown University, Rhode Island.

[This piece was first published as a Twitter thread and turned into the above article on 8 January 2021 with the purpose of reaching a larger audience. It has been minorly edited and corrected, and published with the author’s consent. | The author of the tweets writes in a personal capacity.]

(Cover: Shutterstock.)