U.S. public health officials are again warning of a harsh winter with a stressed health system and climbing death rates as hospitals continue to stretch their capacities among record COVID-19 cases and hospitalizations.
"The blip from Thanksgiving isn't even here yet, so we're getting those staggering numbers of new cases and hospitalizations before we even feel the full brunt of the Thanksgiving holiday," top pandemic response official Anthony Fauci warned Monday during the Milken Institute Future of Health summit.
What's even more concerning are the multiple upcoming holiday events in December, Fauci said. "You go through Christmas and Hanukkah, you go through the week between Christmas and New Year's, and then you have another celebration on New Year's that extends that vulnerable period by two or three times," he said.
New York on Monday ordered hospitals in the state to expand their bed capacity by 25% and issued a call for retired doctors and nurses to return to service if they are able.
The New York implementation, called Surge and Flex, also tells hospitals to balance patient loads within their systems and directs private hospitals to shift patients among themselves as necessary.
"None of this has been done before," New York Gov. Andrew Cuomo said during a press briefing. "It was highly disruptive for the hospital management system, but we started it in the spring, it went fine enough, and we now have had more experience in it."
Other states have been monitoring hospitalizations, which again totaled more than 100,000 on Monday, to varying degrees. California uses ICU capacity metrics to determine when and where it will be implement stay-at-home orders, but other areas of the country have more lax public restrictions.
Fauci called the actions in California prudent. "They said if we keep going up at the rate we're going, very soon our hospital system, our public health system is going to be stretched to the maximum," he said. "So now's the time to call a timeout, shut down not indefinitely, but just enough to add some flexibility to the hospital system. Otherwise, they could be in significant trouble."
Meanwhile, HHS on Monday released a large dataset with facility-level COVID-19 information that had previously only been available at the state level. The data gathering from the federal government during the pandemic has been controversial, but outside agencies reported they believe the data dump is reliable.
Some of the data comes from TeleTracking, a third party that received a $10 million bid in April to implement a new HHS program that replaced a well-established platform from the Centers for Disease Control and Prevention. At the time, public health officials blasted the change.
HHS officials said in a blog post Monday the new data are paramount to the pandemic response but also "tremendously complex" and part of a constantly changing effort. "Today’s unprecedented pandemic demands near-real-time data sharing across government, across diverse sectors, and with the public," they wrote. "HHS is aggressively responding to this call-to-action by responsibly unlocking information wherever our societal benefits of data access outweigh the potential risks."
Coronavirus vaccine news has provided a bright spot. U.K. officials reported Tuesday the first people there received an injection of the vaccine the country recently approved from Pfizer and BioNTech.
In the U.S., the FDA is meeting this week to consider the Pfizer vaccine, which could receive an emergency use authorization and be sent to hospitals and long-term care facilities by the middle of this month.
Health officials, however, remain concerned the U.S. population will be hesitant to get the vaccine produced in record time. Online disinformation will be a major hurdle, former CDC head Tom Frieden said Monday at America's Health Insurance Plans Consumer Experience and Digital Health Forum.
"These are complicated issues and again the fundamental tool that we have is transparency and communication," he said at the insurance lobby conference.
Continual, daily briefings from public health experts could help, "so that we can walk the path of discovery as they walk the path of discovery," Frieden added.
Healthcare workers will be among the first to receive approved vaccines and hospitals are currently outlining their plans for prioritizing staff and staggering shots.
Clarification: The competitive status of the bid TeleTracking won has been disputed. A database that tracks government spending now lists multiple offers received.
Hailey Mensik contributed reporting.