With coronavirus cases spiking in most states, including Maryland, public health officials are imploring people to wear their masks and skip big Thanksgiving gatherings.
Nationwide, more than 100,000 new cases have been reported daily for more than a week. Maryland is faring better than most, but has confirmed more than 1,000 cases a day since Nov. 4 and more than 2,000 Saturday.
“It looks terrible. What we’re seeing is cases rising really rapidly, and so are hospitalizations and deaths,” said Dr. Nilesh Kalyanaraman, Anne Arundel County health officer.
“Are we doing better than many other states? Yes,” he said. “Are we doing well? No.”
Widely respected models by the University of Washington are predicting deaths from the pandemic at levels once unimaginable. The models show almost 440,000 deaths nationally by March, up from more than 240,000 now.
They predict more than 8,200 deaths in Maryland, double the current number.
“The sad truth is the next several months will likely be by far the most difficult we have faced,” Republican Gov. Larry Hogan said Thursday.
Public health officials long projected a fall wave would be bigger than the initial spring wave because coronaviruses tend to thrive in colder weather like the flu.
A big reason is indoor gatherings, Kalyanaraman said. Contact tracing data shows family events have been a major contributor to spread in Maryland and beyond. Further, states including Maryland loosened restrictions in the summer on businesses, allowing more people to gather in public. Two weeks ago, people lined up in the hundreds to vote, either early or on Election Day.
Meanwhile, fatigue with pandemic-related restrictions and rules has led to some lapses in mask wearing, social distancing and hand washing.
To understand the recent acceleration of cases, look at the number of cases weeks ago, said Dr. Clifford Mitchell, director of the environmental health bureau at the Maryland Department of Health. Cases already were in the hundreds when this wave began, compared with dozens in the spring.
Even if most people are taking steps to control spread, too many are still passing the virus, he said.
“If each one of those people infects two people, cases rise exponentially,” Mitchell said. “At some point it becomes very difficult to slow that process down. … That’s why we’ve been very consistent in our messages. This is everyone’s responsibility."
Mitchell said the state is working with emergency planners and hospitals to keep tabs on resources, including hospital beds and staffing. Other states already have reported they are at capacity, including in parts of North Dakota, Texas and Wisconsin.
For comparison, Wisconsin, which has about the same size population as Maryland, added 7,777 new cases Friday with more than 2,000 people hospitalized.
Maryland reported 2,321 new cases Saturday, a record. The state still has available hospital beds, even as more than 900 people are hospitalized currently with COVID-19, the illness caused by the coronavirus. That’s well more than three times the number from a mid-September low. But it remains below the 1,700 beds in use in late April, when Mitchell said some hospitals were full.
Hogan asked hospitals to prepare again for a surge, which means thousands more beds and extra staff at the ready. That includes special ICU units that hospitals can wedge in corners of their facilities. Extra hospital beds also remain available in the Baltimore Convention Center and a formerly shuttered hospital in Laurel.
Officials also asked hospitals to consider halting some non-emergency procedures again, specifically those requiring use of intensive care beds.
“Hospitals are being cautious and balancing management of resources with medically necessary care,” said Bob Atlas, president and CEO of the Maryland Hospital Association.
“With this said, patients should not delay care [for any serious health problems] and should consult their physicians for guidance on changes to their medical conditions,” Atlas said.
As the virus surges nationally, Maryland may fare better because mask wearing is estimated at about 75%. That’s not as high as states such as Massachusetts, where it’s 81%, but higher than states where cases are rising the fastest, including South Dakota, where it’s 51%. The national average is estimated at 68%.
Dr. Ali Mokdad, senior faculty for the University of Washington institute, said everyone should get on board — or back on board — with masking, distancing and hand washing.
Families should protect one another and postpone Thanksgiving gatherings or they could make matters worse. There have been upticks in cases nationwide following every other holiday this year, led by Memorial Day.
“It happened after Memorial Day and also Mother’s Day and Fourth of July,” Mokdad said. “That was different because the activities were all outdoors. Now most activities are indoors."
States and cities are re-tightening restrictions, including Chicago which imposed a new stay-at-home order. Others are considering actions, such as in New York City where schools may close again.
Hogan stepped up restrictions in the past week after he said Maryland “entered the danger zone” with cases. That included limiting restaurants to half capacity and indoor gatherings to no more than 25 people.
In his news conference Thursday, Hogan said he wanted to keep as much of the economy open as possible. But he wouldn’t rule out more restrictions in the coming weeks and months “to save lives” and keep hospitals from being overrun.
Baltimore City and several counties already have gone further than state restrictions, with some limiting restaurants and shops to 25% capacity and limiting indoor gatherings to no more than 10 people.
Kalyanaraman said officials should see whether the renewed restrictions have an effect in a week or two and then decide if more steps are needed. He’d prefer if there were consistent statewide or even national mandates, but said public health officials are at least trying to make their messages clear.
Dr. Letitia Dzirasa, Baltimore health commissioner, said people need to remember to take precautions, particularly around extended family. She lamented that practical and effective measures such as mask wearing have become associated with “leftism.”
“There is nothing political about wearing a mask, yet the dramatic spike of cases in many Republican-majority states may be associated with this belief,” Dzirasa said. “We are hopeful that Baltimore City residents will continue to heed the advice of public health professionals."
Public health experts at Johns Hopkins University echoed the messages during a recent news conference about holiday safety.
About 50 million people plan to travel for Thanksgiving, down from 55 million the year before, according to estimates from the auto service provider AAA. But this year, most will go by car.
That may help people avoid germy and cramped airports, but the gatherings themselves remain concerning, the Hopkins experts said.
They suggested “high risk” family members such as returning college students should quarantine for two weeks and monitor for symptoms before seeing vulnerable seniors. Open windows and turn on a fan while gathering indoors, even if it’s chilly, said Keri Althoff, associate professor in the Johns Hopkins University department of epidemiology.
“It really is more safe to be outdoors,” she said, advising people to use space heaters or wear warm coats. “That still doesn’t mean we should forget about masks.”
Better yet, she said, postpone the visit and stay home with immediate family.