From the very beginning of this outbreak, epidemiologists and other public health experts have been focused on the fall and winter of 2020 as the time of greatest risk to the public’s health. This is true not just for the US, but for the rest of North America and much of Europe as well. The question that was posed as far back as March was, “What would happen if we failed to control this virus and then went into the colder months of fall and winter?” Well, hang on because we are about to find out and it will not be pretty.

The Federal government of the United States has utterly failed to lead, in any manner, in attempting to address a deadly virus that has attacked its citizens. Total failure – whether through sheer ineptitude or through a combination of willful ignorance and political corruption. Whatever the reason, almost no matter what the individual states attempt from now through the end of this pandemic, the public health disaster that we are about to experience can be laid at the doorstep of the White House and the feet of the Orange occupant. All the illness, all the hospitalizations, all the misery, and all the deaths for this fall and winter campaign by the Covid virus through our vulnerable population can be blamed on one incompetent moron.

We had months to control this virus. Months to get on top of it. We had months to convey the right message to our citizens. Months to put proper and necessary testing in place. Months to prepare. However, you can’t say the Orange One wasted these months. He was busy. He attempted to core out the “good science” from the number one public health agency in the world – the CDC – by placing non-scientist Republican apparatchiks in position of approval and authority over CDC’s decisions and messages. He practically ordered Republican governors to ignore all scientists and their own state’s Covid metrics and open their economies, colleges, and schools with horrible consequences. He railed against the emerging science and was a font of false pronouncements about the virus’s early demise. He sullied the reputations of outstanding public servants like Tony Fauci simply because Dr. Fauci was more popular than him. (Hell, Jeffrey Epstein is more popular than Trump right now.) As a country, we didn’t actually waste these summer months, we dug ourselves a deeper hole. Ok, I’m done talking about him. Where are we and where are we headed?

Current – The upper Midwest and the Midwest are on fire with Covid. (The Western US is literally on fire, but that’s climate change and another whole chapter of abject government failure and mistrust of science.) Hospitalizations are increasing rapidly and many cities and geographical regions are setting new records every day. For the last 2 days, the US has seen the highest reported number of Covid cases ever and the actual numbers are undoubtedly higher. Part of these record numbers of cases is due to increased testing, but other Covid metrics reveal clearly that we once again have an out-of-control outbreak on our hands. The good news is that the clinical side has made great advancements in the treatment and care of these patients, reducing hospital stays, ICU utilization, and deaths. Nevertheless, hospitals in North and South Dakota and some other states are reaching critical mass. Nationally, we are at 80,000 cases reported yesterday and 76,000 the previous day. These might be considered unsustainable levels, but they are about to become much worse.

Near Future – From November through March, the US will go from bad to awful. As a nation, we will consistently be over 100,000 reported cases per day, even without universal testing. Hospitalizations will rise dramatically and deaths will consistently top 1000 per day. The populous Northeast states will once again see their Covid numbers rise, though not to the levels of last Spring. Because of foolish Governors, the South will be back in play with spikes in all Covid metrics. (You cannot open all restaurants and bars to 100% capacity with a highly infectious virus residing in your population. Why do you not understand that?) I think the upper Midwest may see some respite mostly because the virus spread there is so dramatic right now that it will abate somewhat. Across the board, I think large cities in all areas of the country will have a difficult Winter and early Spring with this virus.

The main reason for this bleak outlook is that we are heading into the colder months when almost all of our citizens will be spending increasing time indoors, where the virus spread is most destructive. Also, a not-insignificant proportion of our population refuses to adopt even rudimentary safety measures and continues to jeopardize the health of those they contact and the health of their entire community. Finally, all of us are experiencing some level of “Covid fatigue” – we are tired of not seeing friends and family, not communing with other people, not doing the things that make life worth living. With this level of fatigue, even those with the best intentions make mistakes and mistakes with this virus can be costly.

Vaccine – What about a vaccine? Well, what about a vaccine? My best guess is some type of vaccine will be available by late-March or early-April. I am not sure how significant a public health measure a vaccine will be throughout 2021, though. Beyond the incredibly difficult logistics of trying to distribute a vaccine to 330 million Americans and 5 billion people worldwide, I have a series of simple questions for you. How will your Covid life change if you are one of the 50% of the population who accepts inoculation with a vaccine that, at best, is 50-60% effective at providing immunity to the virus? How much do you go out? Do you eat in an indoor restaurant ? Do you attend concerts? Fly? Get together with your extended family? Weddings? Funerals? Do you ditch the mask? Are you free?

The vaccine will help, but, in my view, a vaccine is no panacea. We’ll be safer with a vaccine, but a vaccine will not stop the little voice that every once in a while, deep in the recesses of your mind, you hear say, “Hey, I could die from this.” You probably won’t, but, yes, you could. I know much about this virus and I still hear that voice.

We need to do better.

STAY OUTSIDE. STAY APART. STAY SAFE. WEAR THE MASK.

VOTE