America set a world record for new daily cases over the weekend as Covid-19 cases spread across the midwest and hospitalizations increased.
The increases come just as Americans anxiously ready themselves for an election season climax, in which the incumbent Donald Trump has attacked healthcare providers and adopted Covid-19 misinformation in his final arguments for re-election.
Over the weekend Trump hinted he might fire Anthony Fauci, the US’s foremost infectious diseases expert, if re-elected. “Don’t tell anybody, but let me wait until a little bit after the election. I appreciate the advice. I appreciate it,” said Trump after the Florida crowd chanted: “Fire Fauci.”
Trump also falsely claimed: “Our doctors get more money if someone dies from Covid. You know that, right?”
Dr Jim Souza, chief medical officer for St Luke’s, a hospital system with several locations in Idaho, responded: “If you’ve never seen a patient intubated on mechanical ventilation, connected to a dialysis machine, in a prone position, sedated and paralyzed – if you’ve never been part of that care – it’s heavy physical labor, it’s psychologically heavy work.
“It is just not OK to be calling into question the professional ethics of the very people who are on the frontlines fighting this fire,” said Souza.
Idaho has seen a 10% increase in cases in the last week. It is among a handful of the worst-hit states per capita in the nation, including neighboring Montana and Wyoming. North and South Dakota continue to lead the nation in new Covid-19 cases per capita. More than 231,000 people have died from Covid-19 in the US, according to the Johns Hopkins University Coronavirus Resource Center.
While the outbreak is worse in the west, it is not confined to that region. Infection and hospitalization rates have trended upward across the United States in the last two-week period, according to Covid Exit Strategy.
Uncontained spread makes one of the central tenets of lowering transmission – contact tracing – extremely difficult to impossible, as evidenced last month when North Dakota told residents to trace and notify their own contacts.
But even as an autumn wave swells, Trump has spent the final days of his campaign insisting the US is “rounding the corner” on the Covid-19 pandemic; holding in-person rallies which may have spread the disease to as many as 30,000 people by one estimate.
Trump’s attacks on his rival, the Democratic nominee, Joe Biden, have also been focused on Covid-19, as he told a crowd in North Carolina that Biden would “lock down” the nation again and make the country a “prison state” to contain the virus.
“More and more facilities are requesting [personal protective equipment],” said Dr Shikha Gupta, executive director of Get Us PPE, a non-profit which supplies healthcare facilities with PPE, when they cannot find equipment through suppliers. “We are deeply unprepared for what that’s going to bring as hospitals reach capacity across the US with surging caseloads.”
Nursing homes, where less than 1% of Americans live but which account for 41% of Covid-19 deaths, also remain extremely vulnerable to outbreaks.
“We lack personal protective equipment, we lack comprehensive surveillance and testing, and, to be honest, a number of nursing homes still struggle with infection control,” David C Grabowski, a health policy professor at Harvard Medical School, said. “We’ve seen this play out now twice.”
Nancy Roberts, a respiratory therapist at St Luke’s, said she had seen Covid-19-positive patients come in, “and they’re on just a little bit of oxygen, and in 24 hours they could be intubated and on a ventilator, and they’re terrified.
“For somebody to not believe this is happening, it blows my mind. I cannot personally wrap my head around that,” Roberts said. ‘One death is one too many deaths from this virus.”