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US braces for ‘fifth wave’ of Covid on eve of Thanksgiving

Twenty months into a pandemic that has claimed almost 770,000 American lives and nearly a year after Covid-19 vaccinations became available, US health experts warn a fifth wave of infections risks overwhelming health systems in the worst-affected states.

Fears of another surge in infections come on the cusp of the Thanksgiving holiday, when tens of millions of Americans will travel to reconnect with their families, some of them for the first time since the start of the pandemic.

But what was expected to be a celebration has become fraught with danger in some Midwestern states, where vaccination rates are low and Covid-19 cases are rising rapidly after a summer lull.

Even some northeastern states where vaccination rates are above 70 per cent, such as Maine and Vermont, are experiencing an uptick in case numbers, a trend that probably reflects breakthrough infections caused by waning immunity to Covid jabs, according to epidemiologists.

For now, at least, hospitalisation rates in these states are not rising as rapidly as in the Midwest, suggesting vaccines remain a vital tool to prevent serious illness.

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“We are preparing for the absolute worst,” said Andrew Jameson, an infectious disease doctor at Mercy Health Saint Mary’s hospital in Michigan, a state where daily Covid-19 case numbers have almost doubled since the start of November.

Jameson added: “We are exhausted. It’s hard. The biggest burden is being borne by the nurses, frankly. We’ve lost so many critical care nurses who have just left the bedside completely.”

Over in Minnesota, state authorities this week called up 400 members of the National Guard to support nurses in long-term care facilities experiencing chronic staff shortages.

Nationally, cases have increased by nearly 30 per cent since the beginning of the month to a high of 28 cases per 100,000 people, below the January 2021 peak of about 75 cases per 100,000 people.

But the jump in infections is alarming health experts, who warn that a nation that has plentiful access to jabs is dangerously exposed, due to low vaccination rates, politicisation of mask wearing and social distancing, and rising public complacency.

“We are in the early stages of what will be a substantial fifth wave,” said Eric Topol, director of the Scripps Research Translational Institute. He added that the US was in a “worse position than all countries in western Europe”, some of which are battling third waves.

Just under 60 per cent of Americans are fully vaccinated, compared to 69 per cent in the UK, 79 per cent in Spain and 86 per cent in Portugal. The US is in a similar position to many eastern European countries such as Hungary and Poland, where Covid vaccination hesitancy is high and a deadly wave of the virus risks causing chaos in hospitals, according to Topol.

In the US, political affiliation has become correlated with vaccine hesitancy, and unvaccinated adults are now three times as likely to lean Republican than Democratic, according to a recent poll from KKF. The Republican party has also stepped up its opposition to the Biden administration’s vaccine and mask mandates, despite the recent jump in cases.

At Mercy Health hospital in Grand Rapids, Michigan, just over a fifth of the 350 beds are taken up with Covid-19 patients, a dramatic turnround from the summer, when virtually none were admitted to the hospital.

Jameson attributed the deteriorating situation to the rapid spread of the highly infectious Delta variant, people taking fewer precautions because they were “burnt out” by months of social distancing, and large pockets of unvaccinated people in some parts of the state.

“The patients who are in the ICU and are sickest are almost exclusively unvaccinated but we are seeing older [vaccinated] patients, typically 70- to 80-year-olds, hospitalised. These are people who may not have had such a good immune response,” from their initial vaccination round, said Jameson.

The Biden administration’s attempt to roll out a speedy booster campaign has been hampered by squabbling among government scientists. So far, just 18 per cent of the fully-vaccinated population has had a booster shot, most of them aged over 50, according to government data.

Bivariate state maps showing how the vaccination rates compare to new case/hospitilisation rates in each state between August and November of 2021. Colors and data are binned in quantiles depending on the range of the data. In the summer, the relationship between vaccinations and cases/hospitalisations was consistently inverse across states, whereas waning immunity and lagging vaccination rates in different states has broken that relationship, particularly for cases, as breakthrough cases have increased significantly over the past few months.

The uptick in Covid cases prior to Thanksgiving has meant tough decisions for many families planning a holiday reunion.

Natalie Chaudhuri, a 21-year-old student at Georgetown University in Washington, said she had decided not to return to her home state of Texas, where both her parents are healthcare workers. Instead she will meet her siblings in New York City.

Chaudhuri said that she and her siblings had all received a booster shot ahead of the holiday and would be tested before and after travelling.

“I’ve been more worried, especially since we saw a big spike after Halloween on campus,” added Chaudhuri. “But, we’re a majority vaccinated campus, so that has helped me feel better about it.”

For many public health experts, boosting vaccination rates remains the key to ensuring hospitals do not become overcrowded and the rate of deaths does not jump.

“Just because we’re facing a fifth wave, doesn’t mean it has to be a deadly one,” said David Dowdy, associate professor of epidemiology at Johns Hopkins University School of Medicine in Baltimore.

Dowdy said the difference between last winter’s deadly wave of Covid-19 and the upcoming surge was the far greater levels of immunity, mainly due to the vaccine.

He added: “That immunity may not always be enough to stop someone from getting sick, but in most cases, it will keep them alive and out of the hospital.”

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