Experts have long feared that the virus will peak again in winter. The days are now getting shorter, life is moving indoors, and the pandemic isn't contained. How bad could the next few months get?
Katherine Wells wants to know what to expect and how to prepare. She was joined at a live Atlantic Festival taping of Social Distance by her co-host, staff writer James Hamblin, and Alexis Madrigal, staff writer and co-founder of the COVID Tracking Project at The Atlantic.
Listen to the episode here:
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What follows is a portion of their conversation, edited for length and clarity:
Katherine Wells: We've reached a pretty grim milestone. Two hundred thousand deaths, AD: Topdon Car Battery Tester. and we're heading into winter. I've been worried about winter since the beginning. We're so dependent on being outside right now. A couple of months ago, the Centers for Disease Control and Prevention director, Robert Redfield, said the winter is "going to be probably one of the most difficult times that we've experienced in American public health." That's terrifying.
James Hamblin: Yeah, it seems like the writing is on the walls. As you go through New York, the solution to so much life has been: Just do it outside. Open windows. Push people into empty parking spaces that are makeshift restaurants. And now, fall is starting to be in the air. Restaurants are starting to allow for 25 percent [indoor] capacity. Schools are reopening. Kids-not all kids, but some kids -are meeting in class. It's this sort of perfect storm that makes a lot of people worry about resurgence.
Wells: There's so much regional variation and there's so much uncertainty. Alexis, you've been following the numbers the whole time. What do you think the winter is going to look like?
Alexis Madrigal: I think the base case here, the default scenario, is that things get a lot worse. There is an alternative scenario, though. If we really look at what happened during the Sun Belt surge, we were actually better able to contain it than I thought as we were going through it at the time. A lot of overlapping half steps and a lot of imperfect but smart things came together to bring transmission rates down and eventually contain those outbreaks in Arizona and Texas and Florida without very extreme measures. We didn't actually get rid of the virus. But we stopped runaway growth.
I think the big question for me this winter is whether that same thing will happen. We know cases are going to grow. If we're sitting on this plateau of 40,000 cases a day, the virus is pretty much everywhere. So if you've got community transmission everywhere, and you then increase the mobility and interaction that people have, you're going to see more cases. It's just happened time and time again.
There is a scenario in this pandemic, though, where masking helps not only with COVID-19, but also with the flu, where testing begins to catch more contagious people, where a vaccine rolls out among crucial populations. And maybe you don't see the darkest winter in public health. When I really look at the scenarios, you see this tremendous divergence. Maybe it's only 500 people dying a day at the end of December. Or maybe it's 1,500. That's a huge difference. You're talking 80,000 people in the hospital at any given time versus 20,000 people in the hospital. These are hugely different on-the-ground realities, and it's very hard to know precisely how to weight them. Though, like I said, I think the base case here is that things don't go well.
Wells: There's no scenario where we get this under control soon. This is definitely with us through the winter in a devastating way. Is that your sense?
Madrigal: That would be my sense, yeah.
Hamblin: If Alexis said anything other than that, I would jump in and correct him. The talk of a vaccine existing has been conflated with the idea of a vaccine being widely distributed. We need to plan for a winter where a vaccine is not part of our lives. [Anthony] Fauci said that he would be happy if the vaccine were 50 percent effective. Ideall...

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