The United States, facing surging cases of Covid-19 across the country, is in for a dark winter.
With no national plan in sight to rein in the pandemic, growing levels of fatigue and the holidays approaching — traditionally spent indoors with extended family and friends — the stage is set for a dangerous and deadly winter, experts say.
"There isn't much we can do to prevent what we think is going to be about 2,200 deaths a day by Jan. 1," said Dr. Vin Gupta, a pulmonologist and an affiliate assistant professor at UW Medicine in Seattle.
The nation continues to log record-high daily cases of Covid-19. On Thursday, NBC News reported 120,048 new cases, surpassing the previous record high from the day before. And the number of daily deaths reported topped 1,000 several days last week.
"This is a very scary moment," said Dr. Kelly Henning, an epidemiologist who heads the Bloomberg Philanthropies Public Health program. "People are feeling some fatigue. But the virus is not. It's continuing to circulate."
Forty-three states are reporting rising cases, including Colorado, where Gov. Jared Polis said Friday on the "TODAY" show that Covid-19-related hospitalizations in the state were the "highest they've ever been."
Dr. Ken Lyn-Kew, a critical care pulmonologist at National Jewish Health, a hospital in Denver, said the increasing Covid-19 admissions were coming at a time when many doctors, nurses and other hospital staff are exhausted.
"There is a lot of sadness and fatigue," Lyn-Kew said. "There's burnout from dealing with this for months."
The rising cases are "certainly a reflection of the number of connections that people are having, and contacts that people are having indoors driving the spread of disease," said Dr. Tom Frieden, a former director of the Centers for Disease Control and Prevention and the president of Resolve to Save Lives, a global public health initiative.
It's why public health officials worry about Thanksgiving and other winter holidays that are sure to bring together people — especially those desperate to connect with loved ones who they have not seen for months. Yet, family gatherings can be especially risky, with research showing the virus can spread through entire households with ease.
"When you get that close-knit but extended family together, or you get that multigenerational family in one home, it tends to spread it through everybody," Lyn-Kew said. "We need to sacrifice a little now to get back to what we used to be able to do in the future. If we don't, a lot of our loved ones aren't going to be there when we get back together again."
Also troubling is that the U.S. is entering flu season, which could potentially lead to what experts have called a "twindemic" — surging cases of both Covid-19 and the flu, which could overwhelm hospitals.
While it remains to be seen whether the country is in for a severe flu season, public health experts are urging people get a flu shot if they haven't already. Though flu vaccines are not perfect, they can help drive down an onslaught of cases and reduce the severity of the disease, freeing up hospital space.
Prospects for a widely available Covid-19 vaccine by the end of the year, however, are growing dim. A vaccine may receive emergency use authorization in the coming weeks, but would only be available in limited quantities, and priority would go to first responders and health care workers before the general population.
"We're hoping that some of the biological interventions [like vaccines and therapeutics] we're making are going to make a difference, but we're still going to need behavior changes," said Dr. Myron Cohen, director of the University of North Carolina Institute for Global Health and Infectious Diseases.
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Henning said now is the time to "double down on public health measures," such as physical distancing and ongoing hand-washing.
"We hear these things over and over again, but we have to really internalize them now. And really use all those tools, as we go into this these winter months," she said.
Stay-at-home orders and mask mandates have been proven to help slow the spread of Covid-19. The CDC reported Friday that in Delaware, such mitigation efforts, combined with contact tracing, led to an 82 percent reduction in cases and an 88 percent reduction in hospitalizations in late spring.
Despite widespread pushback on face coverings in many states, Cohen predicted Americans will come to embrace them.
"There will be an evolution of behavior change," Cohen said. "I cannot believe a species that can put somebody on the moon can't figure out how to wear a mask."