The Thanksgiving surge in coronavirus deaths is here. It's 'horrifically awful,' a hospital chaplain said.
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- More than 47,000 people in the US have died from COVID-19 since Thanksgiving.
- The virus has become the country's leading cause of death.
- It's just the beginning of the effects of Thanksgiving travel and gatherings, one epidemiologist said. The rate of death probably won't slow anytime soon.
- At some hospitals, staff can't keep up, and they say patients are falling through the cracks.
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In August, Stacey Singer DeLoye was finally allowed to visit her mother, Marilyn, at her Minnesota nursing home - as long as they were outdoors, masked, and distant.
"She was totally cheerful," Stacey told Business Insider. "I was astonished at how happy she was in that place, and I was impressed with how well they did at keeping the pandemic out."
But a few weeks ago, everything changed.
The Monday after Thanksgiving, a social worker at the nursing home called Singer DeLoye in tears. The worker told her that Marilyn, at age 80, had tested positive for COVID-19.
"They thought Mom was going to rally, but she wasn't rallying," Singer DeLoye said. "She seemed to be very, very tired and she was declining."
On December 6, the nursing home called again: It was time to say goodbye. Marilyn was unconscious. Stacey's brother Scott grabbed an iPad, donned a mask, and went into their mom's room in the COVID-19 ward. He video-called Stacey and all of Marilyn's grandchildren.
"When she'd breathe in and breathe out, it sounded just like crackling cellophane," Stacey said. "We all told her we loved her. We all remembered a story about something she did that was really special to us."
An hour later, Marilyn died.
She's one of more than 47,000 people in the US who have died from COVID-19 since Thanksgiving.
On Wednesday, the US reported a record of 3,448 deaths. In total, more than 312,000 have died in the country since the beginning of the pandemic (though that's almost certainly an undercount).
This week alone, two school teachers in Texas who'd been married 30 years died together, holding hands. A convent in Wisconsin lost eight nuns. COVID-19 claimed a Chicago paramedic - the fire department's third coronavirus death. An elder of the Standing Rock Sioux tribe died of the virus, just a month after his wife.
This unprecedented and tragic surge in fatalities is, in part, a product of pandemic fatigue, cold weather that has led people indoors, and the patchwork nature state policies on masks and closures - many of which are quite lax. But these recent record-breaking days of death, in particular, are the result of infections contracted around Thanksgiving.
Despite CDC warnings to the contrary, an NPR analysis of mobile phone data found that 13% of Americans ventured more than 31 miles from home on Thanksgiving Day. That's not a huge drop from last year, when it was 17%.
But it's common knowledge that the most Thanksgiving travel comes in the days before and after the holiday. The Transportation Security Administration screened 9.5 million airline passengers during the 10-day Thanksgiving travel period. That's less than half of what the TSA reported in 2019, but it still included some of the busiest days since the pandemic began.
Cases generally take about two weeks to appear in official tallies, since the virus incubates in the body for an average of five days, then people usually wait a few days to get tested after symptoms appear. Then there's the multiday wait for results, and the subsequent process of reporting them to health agencies.
Deaths, in turn, generally follow one to three weeks after a rise in cases.
Like clockwork, that is what we're seeing now.
"Every floor I walked in today, everybody's completely full," Amy Carlozo, the chaplain at Swedish Covenant Hospital in Chicago, told Business Insider.
"This is so horrifically awful," she added.
Nursing homes and hospitals are overwhelmed
Singer DeLoye suspects that staffing issues over Thanksgiving week created an opening for the virus to get into her mom's facility. That week, Minnesota Public Radio reported that the state's nursing homes were experiencing severe staffing shortages. This forced officials to call in the National Guard and email thousands of state employees in search of temporary staff.
With new people coming into a facility and understaffed workers spread thin, it can be difficult to spot new cases before patients infect others.
Courtesy of Stacey Singer DeLoye
Scott Singer told his sister that there were 16 other patients on their mom's COVID-19 floor - one of two such wards in the nursing home.
Marilyn Singer's end-of-life isolation did not match the way she'd lived. She'd moved from place to place for most of her years - California, Portugal, Belgium, Illinois, Wisconsin, Florida. She went to business school (the first woman in her program, she always said), appeared as an extra in a few movies, and worked as an accountant. She'd given Stacey and Scott many of her own original oil paintings, which decorate the walls of their homes. She had four grandchildren.
Courtesy of Stacey Singer DeLoye
Zoom goodbyes like the one those grandchildren had with Marilyn have become a daily occurrence for Carlozo. Cook County, where Chicago is located, has the third-highest death toll in the US at more than 7,500, according to Johns Hopkins.
Due to a shortage of N95 masks, Carlozo doesn't go into COVID-19 patients' rooms unless absolutely necessary.
"It's almost like doing your job with your hands tied behind your back," she said.
Instead, she stands outside and calls into the video meetings with family members.
Amy Carlozo
"I just want to do one more thing, and I wish I could do that one more thing for every patient I've dealt with," Carlozo said. "The volume is just so large at times I feel like I can't do enough."
She also frequently calls relatives after a patient has died, to listen to their grief and walk them through the process of finding a funeral home. Sometimes it's the first time Carlozo is meeting them.
"That's kind of how fast some of this is going. We haven't developed a relationship with them before their loved one has passed," she said.
Horror in the hospital
Experts are not surprised that exactly three weeks after Thanksgiving, the number of COVID-19 deaths each day has hit a new record. The virus became the leading cause of death in the US this month, according to an analysis published Thursday in the Journal of the American Medical Association.
"I don't think we've seen the full brunt of what happened during Thanksgiving yet. I think we're beginning to, but it's probably going to continue for some time," Amesh Adalja, an infectious-disease expert at the Johns Hopkins University Center for Health Security, told Business Insider.
That's because the chain of cases from the holiday are still spreading. Yet hospitalizations were already at all-time high of more than 114,000 as of Thursday. Nearly 22,000 of those people were in the ICU, and more than 7,800 were on ventilators, according to the COVID Tracking Project. In Southern California, intensive-care units have no beds left.
"There's been times when we've had multiple patients having cardiac arrest at the same time, and we've had to really triage to figure out which patient to resuscitate first," Dr. Hari Reddy, the intensivist medical director at St. Bernardine Medical Center in San Bernardino, told The Los Angeles Times. "If there's multiple emergencies, I try to gauge which patient I can make the most difference in."
More than 180 hospitals in California have applied for waivers to bypass mandatory staff-patient ratios, the LA Times reported.
"If you have a heart attack, if you get into a car accident, if you fall off a ladder or have a stroke, we may not have a bed for you," Dr. Brad Spellberg, chief medical officer at Los Angeles County-USC Medical Center, said in a briefing on Friday.
It could get much worse
The upcoming December holidays could spread the virus even more than Thanksgiving, according to Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.
"This cannot be business as usual this Christmas because we're already in a very difficult situation, and we're going to make it worse, if we don't do something about it," he told The Washington Post.
The Institute for Health Metrics and Evaluation projects that COVID-19 could kill about 148,000 more people in the US by February 1.
"It's gotten to the point where it's just sort of numbers whizzing by and charts showing, you know, this horrible curve," Singer DeLoye said. "The human toll is missing."
Adalja said he doesn't expect this surge to let up before the holidays accelerate it.
"There's a lot of transmission going on, and there are just so many vulnerable people getting hit with infections, that I think it's just going to be a continual surge that we face until we get to a point where enough people are vaccinated," he said. The earliest that could be, he added, is January.
Carlozo said she had planned to take time off around Christmas but has now decided against it.
"I don't want to not be there for my nurses and my patients and my staff," she said.
She's trying not to think about the further death her hospital might see in the weeks ahead.
"I can't live in the would've, could've, should've," she said. "I just can't watch the news anymore. I can't hear it. I can't hear the deniers. I went through my period of anger back in, you know, October and November, and I'm done. I'm done. I just need to take care of what's in front of me."
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