As millions wait for a life-saving shot, the number of U.S. deaths from covid-19 continues to rise at a terrifying rate. On Tuesday, the last full day of Donald Trump’s presidency, the death toll hit 400,000 – an unthinkable number. More than 100,000 Americans have died in the pandemic in the past five weeks.
In the US, someone now dies from Covid every 26 seconds. According to the University of Washington’s Institute for Health Metrics and Evaluation, the disease claims more American lives each week than any other disease from heart disease and cancer.
“It didn’t have to be that way, and it shouldn’t be,” said Kristin Urquiza, whose father Mark died of Covid in June when the virus swept through Phoenix.
Urquiza described it as “watching a slow hurricane” ripping apart their childhood neighborhood, where many people have no choice but to keep working and risk their health.
“I speak to dozens of strangers daily who are going through what I did in June, but the magnitude and haunting similarities between our stories six months later are really difficult,” said Urquiza, who spoke at the Democratic National Convention in August . She co-founded Marked By COVID to organize grieving families and supporters. The group calls for a faster government response and a national memorial for pandemic victims.
Due to the large population, the US death rate from Covid remains lower than many other countries. But the death toll of 400,000 now exceeds any other country – almost twice that of Brazil and four times that of the UK.
“It is very hard to deal with such a large number, especially when we have had large numbers assaulting our senses for 10 months and really, really horrific images coming out of our hospitals and morgues,” said Dr. Kirsten Bibbins-Domingo, Chair of Epidemiology at the University of California-San Francisco.
Scientists had long expected winter to plunge the country into its deadliest months yet, but even Bibbins-Domingo wasn’t ready for the sheer pace of deaths or the magnitude of accumulated losses. The mortality burden has plummeted in their own state of California, which averaged less than 100 deaths a day over long stretches of the pandemic but has been up to more than 500 in recent days.
She said California has been following science in dealing with the pandemic, but the devastation in places like Los Angeles shows how fragile any community can be.
“It’s important to understand virology. It is important to understand the epidemiology. Ultimately, however, we learned that human behavior and psychology are an important force in this pandemic, “she said.
The US recorded an average of more than 3,300 deaths a day in mid-January – well above the most devastating days of the early spring surge, when the daily average death toll was 2,000.
“When I look at the numbers, the question for me is, is there any way I can avoid half a million deaths before the end of February?” said Dr. Ashish Jha, dean of Brown University School of Public Health.
“I think of how much suffering we seem as a nation to accept that we have this number of people who are infected and dying every day.”
How did the US go from 300,000 deaths to 400,000?
The path to 400,000 deaths was painfully familiar, repeating disease and death patterns from earlier in the pandemic.
A shocking number of people in nursing homes and assisted living facilities continue to die each week – more than 6,000 in the first week of January.
Long-term care-related deaths account for more than a third of all deaths in the United States since the pandemic began. In a handful of states, long-term care accounted for half of all deaths.
Certain parts of the country have disproportionately high mortality rates. Alabama and Arizona in particular had high rates due to their populations. The virus continues to kill black and indigenous Americans at much higher rates than whites.
The likelihood of dying from Covid is still much higher in rural America than in urban centers.
People over 65 make up the vast majority of deaths, but Jha said more young people are dying than they did earlier in the pandemic simply because the virus is so prevalent.
In this newest and grimest chapter of the pandemic, the virus has conquered a public that is weary of restrictions and rules and likes to mingle with family and friends during the holiday season.
Like many other health workers, Dr. Panagis Galiatsatos of Johns Hopkins Hospital now the tragic consequences of his daily rounds.
“My heart is breaking because we could have prevented this,” said Galiatsatos, an assistant professor of medicine who cares for covid patients in the intensive care unit.
“A lot of what we saw during the vacation trip was the inability to reach loved ones or family members – not like a public announcement, but one on one when we talk to them [about the exposure risks]. … I really felt that we had failed. “
Galiatsatos still remembers a grandmother who was brought from her home to his hospital for six hours – because there were nowhere closer to beds. On the phone he heard her family’s shock at her sudden death.
They said, ‘But she was so healthy. She made us all Thanksgiving dinners and we had the whole family with us, ”he said. “You said it sincerely, but she probably got it there.”
Light at the end of a very long tunnel
The tremendous loss of life this winter, paradoxically, came at a time when many hopes mark the beginning of the final chapter of the pandemic.
A quarter of all deaths occurred in the five weeks since the Food and Drug Administration approved the first vaccine.
“The trickle of the vaccine is so tragically small. What we need is more of a flow of it, ”said Dr. Howard Markel, who directs the University of Michigan Center for the History of Medicine.
Markel, who wrote about the 1918-19 pandemic flu, said it is estimated that more than 700,000 Americans were killed.
About the covid pandemic, he said, “I hope we’re not talking … 600,000 or more.”
At this point about 3 out of 100 people were vaccinated, which places America ahead of many other countries but behind the optimistic promises made in the early days of the rollout. Given the current rate of vaccination, experts warn, Americans cannot rely on the vaccine alone to prevent a devastating number of additional deaths in the coming months.
UCSF’s Bibbins-Domingo fears that the relief of knowing a vaccine will eventually become widespread – the light at the end of the tunnel – could actually lull millions more Americans into a false sense of security.
“This tunnel is actually a very long tunnel, and the next few months, like the last few months, will be very dark times,” she said.
The emergence of more contagious variants of SARS-CoV-2, the Covid virus, complicates the picture and makes it all the more imperative for Americans to use the same tactics – masks and physical distancing – that have kept many people safe up in the coming months now.
But Brown University’s Jha says the country now faces a different task than it did in the fall, when it took “big behavioral changes and big economic costs” to prevent deaths.
“Right now it is necessary to get people vaccinated with vaccines that we already have,” he said. “The fact that it’s still going very slowly is incredibly frustrating.”
It is this dichotomy – the advent of life-saving vaccines as hospitals are filled with more dying patients than ever before – that makes this moment in the pandemic so confusing.
“I can’t help but feel this immense darkness,” said Kristin Urquiza. “I know that a vaccine won’t make a difference to the people who are in the hospital or who will be in the hospital next week or even next month.”
This story comes from a reporting partnership with NPR.