Dr. Birx to Thanksgiving travelers: ‘Assume that you were exposed’

By Madeline Holcombe and Holly Yan | CNN
With more than 1 million travelers dispersing across the country in one day, health experts are asking those who gathered with people outside their households over Thanksgiving week to get tested for Covid-19.
Sunday marked the busiest US air travel day since the coronavirus pandemic began. And that means countless travelers could be carrying the virus home and infecting others unknowingly.
“If your family traveled, you have to assume that you were exposed and you became infected,” White House coronavirus task force coordinator Dr. Deborah Birx told CBS on Sunday.
She also recommended those older than 65 get tested immediately if they develop any symptoms.
“If you’re over 65 or you have comorbidities and you gathered at Thanksgiving — if you develop any symptoms, you need to be tested immediately,” Birx said.
November has been a month of unprecedented Covid-19 surge. More than 30% of all cases ever reported in the US happened just this month, according to data from Johns Hopkins University.
Testing has also increased, but not at the same pace as new cases. About 23% of all Covid-19 tests were performed in November, according to the Covid Tracking Project.
Now the big concern is overwhelmed hospitals — which inevitably leads to more deaths.
A record-high 93,238 Covid-19 patients were hospitalized Sunday, according to the Covid Tracking Project.
“There’s no way that the hospitals can be fully prepared for what we’re currently facing,” emergency medicine physician Dr. Megan Ranney said.
“This is like a natural disaster occurring in all 50 states at the same time. There are not adequate beds. There are not adequate staff. And because of the lack of national preparation, there are still not adequate supplies.”
And that’s before any Thanksgiving-related infections and hospitalizations, which won’t be known for days or weeks.
Statistics reported in the days after the holiday might show a relative dip in Covid-19 cases, followed by a surge due to a lag in government agencies’ reporting over the long weekend.
And given coronavirus’ lengthy incubation time and how long it takes an infected person to test positive, cases related to Thanksgiving are unlikely to show in public data until the first full week of December at the earliest.
“When you look at people who are hospitalized today, they were infected two weeks ago, maybe more,” said Dr. Jonathan Reiner, a professor of medicine at George Washington University.
“And then it takes usually another week for folks to succumb to the illness.”
(More) good news on the vaccine front
Health experts are asking the public to hunker down for just a few more months, until a vaccine becomes publicly available.
Moderna said it plans to apply Monday for emergency use authorization (EUA) of its Covid-19 vaccine.
The company will ask the US Food and Drug Administration to review expanded data showing the vaccine is 94.1% effective at preventing Covid-19 and 100% effective at preventing severe cases of the disease.
“This is striking,” said Dr. Paul Offit, a member of the FDA’s vaccine advisory committee. “These are amazing data.”
Moderna’s application will be the second emergency authorization request for a coronavirus vaccine. Pfizer/BioNTech applied on November 20, with data showing similarly high efficacy.
An FDA advisory committee is scheduled to meet December 10 to discuss the Pfizer/BioNTech vaccine, and on December 17 to discuss the Moderna vaccine.
If all goes well, “we could be seeing both of these vaccines out and getting into people’s arms before Christmas,” US Health and Human Services Secretary Alex Azar told “CBS This Morning” on Monday.
But with limited supplies, health experts say the majority of Americans probably couldn’t get vaccinated until next spring or summer.
In the meantime, it’s critical to keep wearing masks and social distancing.
Most states are struggling
As of Monday morning, 43 states had test positivity rates higher than 5% — meaning more than 5% of tests taken were positive for coronavirus, according to Johns Hopkins University and the Covid Tracking Project.
For perspective, the World Health Organizations has recommended governments not reopen until they maintain a test positivity rate of 5% or less for 14 days.
Some states are far exceeding that threshold — including Idaho (44.35%), South Dakota (41.36%), and Iowa (40.26%).
Arizona’s test positivity on Monday was almost 20%. If officials there don’t address the rise in cases in the next few weeks, the state will suffer hundreds of preventable deaths, the University of Arizona’s Zuckerman College of Public Health said in a report Friday.
“While targeted measures might have sufficiently slowed transmission weeks ago, I believe shelter-in-place orders offer the most certain chance to achieve the improvements needed,” said the report’s main author, assistant professor Dr. Joe Gerald.
But some parts of the country are slowly returning to normal.
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In New York City, once the epicenter Covid-19 in the US, public school students up to fifth grade will return to in-person learning in early December, Mayor Bill de Blasio said.
Students will be tested weekly and parents will be required to sign a consent form for every student that will take in-person classes, de Blasio said.
Even so, New York had a test positivity rate of 4.27% Sunday — the highest rate since May, Gov. Andrew Cuomo said.

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