The seven-day average of new COVID-19 cases — which had been on the decline nationally since September — first plateaued and is now ticking upward, with states in different regions experiencing the most pronounced increase in cases.
The seven-day average of COVID-19 cases in the United States remained below 80,000 since Oct. 18. As of Nov. 14, it sat at 86,778, according to Johns Hopkins University's worldwide case tracker.
The upward trajectory precedes the Thanksgiving holiday, which is expected to involve greater travel and congregation than in 2020. "Well, look, we're going to see a post-holiday spike, there's no question about that," Scott Gottlieb, MD, former FDA commissioner and current Pfizer board member, told CBS News on Nov. 14.
Thanksgiving travel is expected to be near pre-pandemic levels this year, with a rebound in air travel making the greatest difference. The AAA forecasts 53.4 million people will travel for the Thanksgiving holiday, up 13 percent from 2020. The CDC updated its guidance for holiday gatherings in mid-October, noting that precautions such as getting tested in advance and avoiding crowded spaces before travel should be taken if attending a gathering with guests from different parts of the country.
Dr. Gottlieb's remarks about a post-holiday spike come one week after he forecasted the country's entrance to "a more endemic phase" of the virus.
On Nov. 14, he maintained optimism — largely driven by early results of new antiviral drugs to curb COVID-19's severity and child vaccinations — but said the delta wave has not waned. Certain states and regions, like the South and Pacific Northwest, are stable. "But if you're in the southwest right now, you're in the Great Lakes region, Wisconsin, Minnesota, Michigan, you're in parts of New England or western Pennsylvania or northern New York, or certain mountain states like Colorado, things don't look good. You haven't experienced the delta wave yet, and things are going to get worse before they get better," Dr. Gottlieb said.
Last week, California health officials tied gains in COVID-19 hospitalizations to low uptake of booster shots. The state expanded booster eligibility to all fully vaccinated adults Nov. 10. New Mexico and Colorado did the same.
Dr. Gottlieb sees boosters as an important tool in the nation's arsenal to counter virus transmission, but says mixed messages around the additional shots "may end up being one of the biggest missed opportunities in this pandemic."
Anthony Fauci, MD, told Michael Barbaro on the Nov. 12 episode of "The Daily" podcast, produced by The New York Times, that boosting is an absolutely essential component of the nation's COVID-19 response. "Not a bonus, not a luxury, but an absolute essential part of the program," he said.
As of Nov. 14, 16 states reported double-digit percentage increases in cases of COVID-19 over the past 7 days, with the five states with the most pronounced gains in the Midwest, West and Northeast, according to Johns Hopkins Coronavirus Resource Center:
- Nebraska: 100 percent increase
- California: 81.5 percent increase
- Pennsylvania: 79.03 percent increase
- Vermont: 42.61 percent increase
- Ohio: 40.48 percent increase
States in those same three regions have been hit hardest by hospitalizations for COVID-19, as well. As of Nov. 14, the following states have experienced the greatest increase in COVID-19 hospitalizations over the past 14 days, according to HHS data presented by The New York Times:
- Rhode Island: 24 percent increase
- Michigan: 21 percent increase
- Minnesota: 19 percent increase
- New Mexico: 17 percent increase
- Arizona: 15 percent increase