With Thanksgiving next week and coronavirus cases exploding across the country, the Centers for Disease Control and Prevention on Thursday recommended against traveling for the holiday, urging Americans to consider celebrating in their own households instead.
In the agency's first news briefing in months, officials said they were alarmed to see 1 million new cases reported across the United States within the past week. They spoke of the risks of travel and gatherings in stark terms, warning that as families get together over the holidays, they could inadvertently carry the deadly virus with them.
"At the individual household level, what's at stake is basically the increased chance of one of your loved ones becoming sick and then being hospitalized and dying," said Henry Walke, the CDC's covid-19 incident manager.
Beyond that, he said, holiday-related infections could further spread through communities, reaching other vulnerable individuals.
The CDC had previously noted the risk of holiday travel and recommended that travelers take steps, including checking local restrictions, wearing masks, maintaining distances and getting flu shots. The new guidance says "postponing planned travel and staying home is the best way to protect yourself and others this year" and offers a list of questions Americans should ask themselves before making a trip.
Among those questions: whether anyone included in Thanksgiving plans is at increased risk of becoming very sick from covid-19, the disease caused by the virus, and whether cases are high or increasing, or hospitals are overwhelmed in a traveler's community or destination. Those wanting to travel should also consider whether they or those they plan to visit recently had contact with others and whether they would need to take a bus, train or airplane, where distancing could be more difficult, the CDC said.
"If the answer to any of these questions is 'yes,' you should consider making other plans, such as hosting a virtual gathering or delaying your travel," the new guidance says. "It's important to talk with the people you live with and your family and friends about the risks of traveling."
On Wednesday, White House press secretary Kayleigh McEnany questioned government guidelines for the holiday on Fox News.
"I think a lot of the guidelines you're seeing are Orwellian," she said. "The American people know how to protect their health, they've dealt with it for many months, but it's Orwellian for a place like Oregon to say if you gather in numbers more than six, we might come to your house and arrest you and you get 30 days of jail time. That's not the American way."
On Thursday, the American Hospital Association, American Medical Association, and American Nurses Association issued an open letter to Americans asking them to scale back holiday gatherings, urging people to wear masks and socially distance, citing surges in the virus after previous holidays.
The Thanksgiving holiday comes as coronavirus cases have skyrocketed across the United States, with the seven-day average of new cases hovering at more than 160,000 on Thursday, according to Washington Post tracking. The nation's death toll since the start of the pandemic reached 250,000 Thursday, and on Wednesday alone, nearly 1,900 deaths were reported, marking the deadliest day since May.
Meanwhile, hospitals are struggling to keep up with non-coronavirus cases ranging from broken bones to heart attacks in states where covid-19 cases are tying up resources.
In Kansas, rural hospitals are running into difficulty trying to transfer patients to larger hospitals for more advanced care.
"Whether it is regular pneumonia or appendicitis or fractures that need surgery, they have a limited amount of beds in their facilities and they are not taking a lot of these routine cases," said Perry Desbien, a nurse practitioner who works in Smith Center and other rural communities. "They are saying, 'Send them home. Have them follow up in the office. Unless it is life-threatening, we don't want to see them either.'"
Earlier this month, the Mayo Clinic Health System in Wisconsin announced that it was suspending elective medical procedures.
Illinois Gov. J.B. Pritzker noted that with covid-19 patients claiming a quarter of the state's hospital beds, there are fewer resources for heart attack patients, expectant mothers or cancer patients.
"When we let our hospitals get overrun or even close to it, it is all of us suffering," Pritzker said.
The Mayo Clinic Health System, a Midwest network of hospitals and clinics run by the world-renowned Mayo Clinic, reported that 905 staff members have been diagnosed with covid-19 in the past two weeks.
Dr. Amy Williams, executive dean of Mayo Clinic Practice, said the vast majority were exposed in the community and not at work.
"It shows how widely spread this is in our communities and how easy it is to get covid-19 in the communities here in the Midwest," she said.
In Kansas, 178 employees and doctors at a Topeka hospital had active coronavirus cases or were isolated and on leave because of contact with someone who had coronavirus. And the University of Kansas Hospital in Kansas City and nearby clinics had 206 employees, including physicians, nurses and support staff members, out as of Tuesday after testing positive. An additional 260 were not at work and quarantining while they awaited test results.
The positivity rate -- the percentage of tests coming back positive for the virus -- has taken on a more prominent role in the nation's response to the crisis in recent days.
New York City shut down in-person classes in the nation's largest school system this week after the positivity rate surpassed 3%. That angered families who believe it is too stringent a standard, and question why bars and restaurants can remain open.
The positivity rate has soared to record levels all around the nation. South Dakota, Iowa and Wyoming's rate are all averaging above 50%, and the national average is now 10%.
Health experts caution that there are weaknesses in the positivity data because states calculate the rate differently. But they say the overall trend is not in dispute, and it indicates severe spread and, in many places, insufficient testing.
Separately, federal regulators have authorized emergency use of another covid-19 treatment, the anti-inflammatory drug baricitinib, to be used in combination with a drug already used to treat severely ill, hospitalized patients.
The Food and Drug Administration on Thursday cleared the new use for Eli Lilly's pill baricitinib plus remdesivir for hospitalized adults and children 2 years and older requiring oxygen or ventilation therapy.
Remdesivir is the first and only drug approved by the FDA to treat covid-19. The emergency clearance for baricitinib acts as a preliminary approval until more data is available showing the drug works for covid-19.
The FDA said the drug combination appeared to reduce recovery time in hospitalized patients, compared with patients who received only remdesivir.
The agency said ongoing research will be needed to confirm the benefit.
Information for this article was contributed by Brittany Shammas and William Wan of The Washington Post; by Kristen V. Brown and Josh Wingrove of Bloomberg News; and by Mike Stobbe, Heather Hollingsworth and staff members of The Associated Press.