Winter could be ‘most difficult time in the public health history’ of the US, CDC director says

Robert Redfield, director of the Centers for Disease Control and Prevention.Elijah Nouvelage/Bloomberg

The head of the Centers for Disease Control and Prevention said Wednesday the upcoming months could be “the most difficult in the public health history of this nation” because of the stress on the country’s health care system from the coronavirus.

“The reality is, December and January and February are going to be tough times,” said Dr. Robert Redfield, speaking at an event with the US Chamber of Commerce. “I actually believe they’re going to be the most difficult time in the public health history of this nation.”

Redfield warned that total deaths in the US could near 450,000 by February if people don’t follow public health recommendations to mitigate the virus’s spread, including wearing masks, practicing social distancing, washing hands, and opting to do things outdoors instead of indoors when possible.

“We’re not defenseless,” Redfield said. “The truth is mitigation works. And the challenge with this virus is it’s not going to work if half of us do what we need to do. It’s not even going to work probably if three quarters of us do what we need to do. This virus really is going to require all if us to really be vigilant about wearing a mask.”

“We’re in that range potentially now, [of] starting to see 1,500 to 2,000 to 2,500 deaths a day from this virus,” Redfield said. “The mortality concerns are real.”

The country is at a “very critical” time of the COVID-19 pandemic right now, he added, as 90 percent of the country’s hospitals are in the “red zones and hot zones” and at risk for increased hospitalization rates with the potential to put pressure on hospital capacity.

In earlier phases of the pandemic when the virus was surging in a cluster of cities, the US was better equipped to shift health care capacity, Redfield said, but that is no longer an option now that the virus is so widespread across the country.

The coronavirus is surging across the nation. More than 1 million people per week were hospitalized in November, Redfield noted. The US surpassed 250,000 COVID-19 deaths in mid-November, and is nearing the 275,000 milestone, registering nearly 273,000 total deaths in the country as of Wednesday, according to a tally by Johns Hopkins University. Also on Wednesday, Massachusetts reported its highest single-day total of new coronavirus infections, and officials in Rhode Island warned on Monday hospitalizations are reaching near-record levels, prompting the state to open field hospitals.

Redfield noted a major source of transmission of the virus is in-home gatherings, where people “let down their guard” around family members, a message that comes as the CDC again urged people to stay home for the upcoming holiday season — advice the agency issued ahead of Thanksgiving, but for which millions of Americans still traveled.

“The major presentation of this virus for individuals under the age of 40 is it’s totally asymptomatic,” Redfield said. “You don’t know you’re infected. Communities don’t recognize it until unfortunately, that virus then gets transmitted in somebody that’s vulnerable, older, and then they end up developing symptomatic illness and they end up in the hospital.”

Redfield said his biggest disappointment as CDC director during the pandemic was the inconsistency of the American public embracing the message about the importance of wearing a mask, adding that it’s “not a political decision.”

In terms of intra-school virus transmission, the data do not show K-12 schools as a source of significant clusters or infections, Redfield said, and face-to-face learning, particularly in elementary and middle schools, can be conducted in “a safe and responsible way.”

Redfield was “disappointed” when New York City, the nation’s largest public school system, opted to pause in-person learning in mid-November to try to stop the spread of the coronavirus.

When teachers are infected, the agency found that the source of the infection was from their “spouse or communities.”