STEVE INSKEEP, HOST:
One week ago today, the United States reached a terrible number, 10 million COVID cases since the start of the pandemic. This morning, we reach 11 million - 1 million new cases in one week, which shows how quickly the situation is deteriorating. Hospitalizations are reaching a record high. And that helps explain why public health officials are urging people to rethink their holiday plans. NPR's Allison Aubrey is on the line, as she is just about every Monday. Hey there, Allison.
ALLISON AUBREY, BYLINE: Good morning, Steve.
INSKEEP: You know, I was looking at the NPR chart of the states that we published the other day, the yellow, orange or red, depending on how bad it is. And just a shocking amount of the map was red, I mean, most of it seemed to be.
AUBREY: Yeah. You know, it's hard to point to hot spots because the virus is circulating so widely all over the country. Since early November, Steve, there's been an 80% increase in new cases. And we have not yet reached the peak. I mean, just look at the positivity rates. I just checked the CDC's latest numbers. They're rising nationwide. We have a double digit, 11%, positivity rate. Some counties in Iowa, the upper Midwest have two times that rate. And there are 70,000 people hospitalized with COVID-19 right now.
INSKEEP: And I guess we should mention, these things happen in a sequence. They're kind of lagging indicators. If we have a ridiculous increase in positivity now, that means a ridiculous increase in hospitalization in a few weeks and an increase in deaths a few weeks after that.
AUBREY: That's right. And right now, we're averaging about a thousand deaths a day. That's 42 people every hour, Steve, dying of COVID-19. And that number has been rising. You know, when you hear about exponential growth of the virus, that means every infected person is spreading it to at least one more person. So two cases become four, then 16, then 32 very quickly. That's what has happened. It spirals out of control. I spoke to Marc Boom. He's a doctor. He's the CEO of Houston Methodist. He says, right now, there are about 150 people every day being admitted to Texas Medical Center hospitals. And he said if the current trend continues, it is just not sustainable.
MARC BOOM: So two weeks from now, that's 300. And then two weeks after that, that's 600. And two weeks after that, that's 1,200 if that trend continues. And that's what we cannot allow to happen. And it just - it - things get so much worse so quickly. We've got to be vigilant. And we've just got to persevere.
AUBREY: He says it's just absolutely crucial that everyone take precautions to slow the spread.
INSKEEP: You know, I'm remembering in the spring when people talked about flattening the curve - meaning, if you traced the infections on a chart, there was this big curve heading upward. We needed to bend it back down again. But when I look at the chart now, it's - there's no curve. It's vertical.
AUBREY: Yeah. Yeah.
INSKEEP: It's going straight up. What do we do?
AUBREY: You know, take, for example, what they've done in England. They've basically gone back to a nationwide lockdown. They've kept schools open. But restaurants, pubs, lots of non-essential businesses have been closed. Here in the U.S., Steve, it's a hodgepodge. I mean, Chicago has a stay-at-home advisory. There are new rules for gatherings in Michigan. North Dakota just issued a mask mandate. I spoke to one of President-elect Biden's coronavirus advisers, Loyce Pace. She told me, at their very first meeting last week, the focus was to lay the groundwork for a much more unified approach. And what we're likely to see here, Steve, is a set of evidence-based guidelines on when to issue restrictions and when to loosen them.
LOYCE PACE: You know, these things are a dial, not a light switch. And so I think that that will be a part of our discussion is really understanding better when and where to turn up that dial based on data.
AUBREY: She says this is just crucial going forward.
INSKEEP: I just want to observe, Allison, I've now heard two different Biden advisers state a consistent message, that phrase about the restrictions being a dial, not a light switch. You have an idea of an incoming team that has an idea about how they want to talk to the country. But, of course, there's also an outgoing administration. The main message from that administration over the weekend - Dr. Anthony Fauci said that President Trump hasn't met the coronavirus task force in months. The president is busy making false claims about the election. So what is the safest approach for the holidays for people?
AUBREY: You know, I think there's a new element of pandemic fatigue here, Steve. Most people get it. This is not the year for big parties, for big gatherings. But many people are expanding their social bubbles ever so slightly, getting together with one or two more friends, allowing one more play date. It's this incremental expansion of our social bubbles, combined with more time indoors that some experts say is leading to more spread of the virus in households. I spoke to Dr. David Rubin about what this means for the holiday. He's the director of PolicyLab at Children's Hospital of Philadelphia.
DAVID RUBIN: The safest thing to do is to keep your bubble extremely small and not to gather with extended relatives. But if other families are like mine, and I'm in the middle of this - I'm still sort of debating with my own siblings.
AUBREY: So you hear it right there. It's tough for him. He says if you are planning to host a gathering, you can ask every person who will join you to quarantine beginning today, beginning right now. Every day they limit their interactions with others, it will decrease the likelihood they're coming to your house infected.
INSKEEP: I'm hearing stories of people asking their relatives to get tested before the gathering.
AUBREY: Yeah. You know, a test cannot hurt. But Rubin says it's only so helpful.
RUBIN: The drive-by test on Tuesday before Thanksgiving is not going to protect the family at the Thanksgiving table because it only tells you about your exposure six or seven days ago, particularly if you've not been quarantining.
AUBREY: You know, in the interim, you may have been exposed. That's why if you want to protect the people you're gathering with, everyone's got to take precautions.
INSKEEP: Can I ask about additional findings about what happens to people who do test positive and who do have the worst symptoms? There's some research about people diagnosed with mental health disorders, including anxiety and depression and insomnia. What's going on?
AUBREY: That's right. A very large news study based on the medical records of more than 60,000 people diagnosed with COVID here in the U.S. found 1-5 were also diagnosed with conditions including anxiety, depression, insomnia, as you say, within the first three months following the infection. I spoke to Adam Kaplin about this. He's a psychiatrist at Johns Hopkins. They now have a clinic for COVID patients who have survived hospitalization and need follow-up care. He says he is not surprised by these findings.
ADAM KAPLIN: We know that when you get COVID-19, it has this effect on the entire body, including the fact it does affect the brain. And so just any inflammation of the body will register to the brain. That inflammation affects people's moods. And, in fact, this is one of the awful, longer-term consequence of the infection for many people.
AUBREY: And complicating this, Steve, is the fact that isolation is a risk factor for anxiety and depression. And what are we all being asked to do to slow the spread? - limit contact with others. So it's tough.
INSKEEP: NPR's Allison Aubrey is here to tell us the truth, no matter how grim. Allison, thanks so much.
AUBREY: Thank you, Steve.
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