• Jamie Saito

COVID-19 Update: Cases Soar Nationwide and Hawaii’s Plan to Decrease Contact Tracing

National Cases Increase Rapidly

The United States broke another COVID-19 record on Wednesday, December 2nd after recording over 200,000 new cases in one day. The CDC warned that, at this rate, the U.S. death toll will likely rise to 450,000 people by February.


Throughout the month of November, the number of new infections soared with the U.S. recording more than 100,000 new cases per day. During Thanksgiving week, the TSA screened around 9.5 million passengers. As the height of the holiday season approaches, the CDC urges Americans not to travel this year to reduce the number of infections after the winter holidays.


“Travel volume was high over Thanksgiving,” said Cindy Friedman, Chief of the CDC’s travel branch,

“Even if only a small percentage of those travelers were asymptomatically infected, this can translate to hundreds of thousands of additional infections moving from one community to another.”


For those that do plan to travel, travelers should begin planning for their COVID-19 testing. Throughout Thanksgiving weekend, “long waits and delayed results greeted people seeking tests before they traveled or gathered.”


“There was literally a mad rush for tests,” said Jon Weinstein, Director of the COVID-19 Testing Task Force in Maryland, “Even people who had appointments in some places still had to wait just because of the sheer volume.”


With an anticipated surge of post-Thanksgiving cases and pre-Christmas travelers, the demand for testing will likely increase. Travelers should start researching possible testing locations and begin making appointments if they are available. The CDC suggests that people be tested one to three days prior to travel and three to five days after traveling.


The agency has also decreased their suggested quarantining time to ten days without any symptoms, citing new research and data. However, people should still watch for symptoms for up to 14 days post-exposure.


ICU Levels Reach Max Capacity


The San Francisco Bay Area, Southern California, and San Joaquin Valley will return to a stay-at-home-order on Sunday, December 6th. According to the Los Angeles Times, “Bars, wineries and personal-care services must close; restaurants must halt all dining; and gatherings of people from different households will be prohibited.”


For the rest of California, a stay-at-home-order will be reinstated if a region’s ICU capacity falls below 15%. The Southern California region and San Joaquin Valley have fallen below this mark, with 12.5% and 8.6% ICU capacity, respectively.


While ICU capacity in the Bay Area has not fallen below 15% yet, California Governor Gavin Newsom announced that the area will be returning to a stay-at-home-order because the region is “on track to hit critically low hospital capacity levels, triggering new restrictions.”


Beyond California, doctors and nurses are increasingly worried about ICU capacity. On December 2nd, the U.S. recorded 100,000 new hospitalizations.


“We’re drowning at the hospital,” Micah Luderer, an internal medicine resident at Barnes Jewish Hospital in Missouri said. “People are dying every day from covid-19, and we’re not doing everything in our power to stop the virus.”


As the Los Angeles Times puts it, “Mortality rates can dramatically increase when ICUs are stretched beyond capacity, and officials have warned that there are limits on the number of doctors, nurses and other healthcare providers who are well-trained in providing intensive care. Quality of care can fall substantially if hospitals are forced to transfer critically ill patients to parts of the hospital that are not designed for such use.”


Vaccine Approval on the Horizon


Pfizer, Moderna, and AstraZeneca have announced high success rates with their new vaccines, but the FDA has not yet officially approved any for use. The Washington Post predicts that approval may occur by mid-to-late December.


If and when a vaccine is approved, the CDC plans to prioritize high-risk groups, which includes around 200 million people. Dr. Anthony Fauci predicts that “the so-called general population, who do not have underlying conditions or other designations that would make them priority” will have access to vaccination in around late spring and early summer of 2021.


However, distribution of these vaccines may also provide another barrier. The Pfizer vaccine must be kept at minus-70 degrees Celsius, possibly posing a challenge for areas without access to specialized freezers. While the Moderna vaccine needs to be stored at minus-20 degrees Celsius, it can be kept for up to a month at refrigerator-level temperatures. Both use new messenger-RNA technology that has never before been approved for use by the FDA. The AstraZeneca vaccine can be stored at refrigeration temperatures for up to six months, which may be easier to distribute throughout the nation, especially in rural areas.


Hawaii


The Federal CARES Act, which provides funding for Hawaii’s contact tracing, is set to expire by the end of December. Senator Brian Schatz questioned the state’s preparedness to continue the program at the same capacity. Following reports in August that the Department of Health did not have an adequate contact tracing system, the state has increased the program to 429 people. Governor David Ige told Hawaii Public Radio that the state “has a plan in place to continue contact tracing and deploy vaccines if federal funds are not renewed.”


However, according to HPR, if federal funds are not increased, the Department of Health is planning to decrease its contact tracing program.


“I do anticipate a reduction, we also want to make sure the plan is able to scale if we do have a surge in cases and have additional investigation needs,” said Sarah Kemble, the state’s acting epidemiologist.


The National Guard has also played a large role in increasing the state’s contact tracing efforts, but without renewed approval by President Donald Trump, they will be departing at the end of the year, which may change the way the program functions.


With cases rapidly increasing on the mainland, all four county mayors have advocated for increased travel restrictions. As of Wednesday, December 2nd, Hawaii County Mayor Harry Kim has required a second COVID-19 test for all new travelers.



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