US daily COVID-19 hospitalizations have hovered above 100,000 for a month – but experts say the post-holiday surge is yet to come

• Saturday marked one month of more than 100,000 consecutive, daily coronavirus hospitalizations in the US.
• Those numbers likely reflect people who were infected before the Christmas holiday.
• Experts anticipate that hospitalizations will continue to climb, meaning the pandemic’s worst days may still be ahead.
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The US coronavirus outbreak has continuously shattered records this winter, but Saturday marked a particularly gruesome milestone: one month of more than 100,000 consecutive, daily coronavirus hospitalizations.

Average daily cases also reached an all-time high of more than 275,000 on Saturday, according to data from the COVID Tracking Project. The US death toll has surpassed 350,000. 

The US’s average daily hospitalizations have more than tripled over the last three months, fueled by holiday travel, pandemic fatigue, and many state officials’ resistance to impose new lockdown restrictions. 

As of December 28, at least 280 of the nation’s hospitals had reached or exceeded maximum ICU capacity out of 4,824 hospitals for which data was available, according to data from the Department of Health and Human Services. In the week leading up to Christmas, nearly one-fifth of US hospitals with intensive care units reported that at least 95% of their ICU beds were full.

But hospitalizations are a lagging indicator: They usually reflect cases that were diagnosed a week ago.

“It takes somewhere between five and 10 days after an exposure to actually get sick from COVID and then it takes another week or so after that to be sick enough to need hospitalization,” Megan Ranney, an emergency-medicine physician at Brown University, told Business Insider.

That means people who were hospitalized around Christmas could have been infected around Thanksgiving. Experts don’t expect infections that occurred over the Christmas holiday to factor into hospitalization data for at least another week – perhaps more. 

“We’re all stealing ourselves for a really difficult next couple of months,” Ranney said in December.

The approval of coronavirus vaccines, she added, represents “a light at the end of the tunnel” – but the pandemic’s worst days may still be ahead.

The US could see another 210,000 coronavirus deaths from now until April, bringing the total death count to more than 560,000, the University of Washington’s Institute for Health Metrics and Evaluation (IHME) predicts.

Overflowing hospitals make it harder to treat patients

With the holidays over, US hospitals say they’ve never been more strained. 

Many hospitals are running low on ventilators and personal protective equipment (PPE) like masks, face shields, or gowns, forcing them to reuse these materials as many times as possible. In a December survey from the Association for Professionals in Infection Control and Epidemiology, 73% of infection prevention experts said they had sacrificed their normal standards of care due to respirator shortages.

Without enough beds to treat patients, hospitals are also having to make tough calls about who to admit or prioritize for treatment.

“This is by far one of the most difficult things for me and my colleagues, sending a patient home when we would normally admit them,” Dr. Frank LoVecchio, an emergency room physician at Arizona’s Valleywise Health, told Fox 10 Phoenix. “But you reach that point when the needs exceed what is available.”

Some hospitals have had to transfer patients to alternate care sites, while others are forced to examine patients in outdoor tents or waiting rooms. Dr. Elaine Batchlor, CEO of Martin Luther King Jr. Community Hospital in Los Angeles, California, told CNN her hospital has started treating patients in the gift shop and chapel.

A tsunami of coronavirus patients also poses an increased risk of hospital staff getting sick themselves. When that happens, hospitals can become even more stretched. 

Josh Mugele, an emergency-room doctor at Northeast Georgia Medical Center in Gainesville, Georgia, told Business Insider he was “really nervous” about getting the virus in December. His hospital had reached maximum ICU capacity, having seen more coronavirus patients than at any other time during the pandemic. 

Mugele was diagnosed with COVID-19 last week. He suspects he got infected while working the night shift on Christmas.

“It’s frustrating now that somebody has to cover my shift,” he said. “The shifts these days are really, really hard. They’re just stressful. There’s a lot of sick people.”