The coming Thanksgiving massacre

The coming Thanksgiving massacre
The doctor Annalisa Silvestri during COVID-19 pandemic 2020 in Italy // Alberto Giuliani, CC BY-SA 4.0 <https://creativecommons.org/licenses/by-sa/4.0>, via Wikimedia Commons

Though doctors are significantly more prepared to fight COVID-19 and save patients' lives from the coronavirus than they were when the pandemic first spread across the world in early 2019, the infection remains a deadly and devastating assault on the human body. And just as experts predicted, the cold fall weather has facilitated a resurgence in the virus, with well over 100,000 Americans being diagnosed with the illness each day, a rate that was once unimaginable. On Wednesday, the COVID Tracking Project reported that there were 1,869 deaths from the virus, a level not seen since May, and hospitalizations reached a record-high of 79,000.

We're in a horrifying time of unmitigated community spread in much of the country. Hospitals are once again getting overwhelmed, and health care workers are at their wits' ends.

And on top of all that, Thanksgiving is around the corner. With so much of the country desperate to reclaim their lives and disregard worries about the virus, many families are expected to gather in large numbers, perhaps for the first time all year, under the same roof and with no masks. The tragic and predictable result of such gatherings will almost certainly be an even greater increase in the chilling levels of mass death that we're already seeing.

How can we be confident about this? It's already happened in Canada, which celebrates its Thanksgiving on the same day as Americans recognize Columbus Day. Dr. Laura Rosella explained that there is evidence that Thanksgiving gatherings are partly to blame for the increase in cases the country has seen.

"We were seeing an increase of cases leading up to Thanksgiving," the epidemiologist at the University of Toronto told CBS News. "Cases were indeed increasing already, but we definitely saw an increase in the rate of transmission after Thanksgiving. And we know that Thanksgiving is important for a couple of reasons. One is through contact tracing data."

She continued: "We've seen quite a big acceleration in the two weeks following Thanksgiving, and it's not the only reason the cases are increasing, it's not the only setting in which transmission is occurring, but definitely when people gathered indoors it did transmit COVID."

As I said at the start, the case-mortality rate has significantly decreased since the beginning of the pandemic, largely because we understand the disease much better. But one of the biggest fears about virus has always been that, because it spreads so rapidly, it can easily overwhelm health care systems. And when a hospital is overwhelmed, patients may not be able to get the same level of care as they otherwise would, and the mortality rate will increase. Since we're already at an exceptionally high level of infection in the United States, particularly in regions such as North Dakota, South Dakota, and south Texas, we may be approaching those limits. A new surge in the level of infection could push the limits even further.

When the country was first hit hard with the virus in the spring, the worst outbreak was concentrated in New York City, and it was brutal. But because it was so localized, support from much of the rest of the country, including health care relief workers, were able to flood in and buoy the stressed system. With surges taking place all over, though, it seems less likely this support will be available for hardest-hit areas.

We know many people are planning to travel for Thanksgiving, despite the risks. United Airlines has added over 1,400 extra flights for the holiday due to a surge in demand.

We also know there are ways to spend time together that greatly mitigate the risks of viral spread. Spending time together outside, limiting cross-household interactions, wearing masks while in the company of others, can make everyone much safer. And be particularly cautious about people who are elderly or are otherwise in a significant risk group for the virus. The CDC has put out helpful guidance for celebrating Thanksgiving safely.

But much of the country, unfortunately, has followed President Donald Trump's lead in dismissing the risks posed by the virus. Right-wing commentator Dave Rubin, for example, openly mocked safety guidelines for Thanksgiving in a video:

(It's worth considering how people would react to a similar open disregard for health guidelines related to sexually transmitted infections.)

And Trump's favorite medical adviser, Dr. Scott Atlas, sparked blowback when he spoke out against the idea that family events should be limited to reduce the risk of spreading the virus to vulnerable people.

"This kind of isolation is one of the unspoken tragedies of the elderly, who are now being told 'don't see your family at Thanksgiving,'" Atlas said on Fox News. "For many people, this is their final Thanksgiving believe it or not."

Of course, if the country had done a better job controlling the spread of the virus before now, as many other countries have done, we'd have much freedom to safely spend time with our families. Instead, people like Atlas pushed an approach to the virus that guaranteed that Thanksgiving gatherings would be a cruel form of gambling with families' healths.

And because there has been so much positive news recently about the possibility that we'll have several highly effective vaccines to choose from by next spring, there's an even stronger case for embracing restrictive countermeasures to the virus now. If we can keep infection rates down now and until the vaccines are widely available, we may be able to save tens of thousands, if not more. Accepting the real costs of foregoing a favorite holiday now may mean that some people will survive for many more holidays that they would otherwise not be alive to enjoy.

But we know much of the country will reject any insistence that we curtail our desires now so that many more of us can live to see the future. That's just reality, and it means we'll see even more widespread and unnecessary death.

Some people have changed their minds about the pandemic, of course, and take it more seriously than they once did. But far too often, this change of heart comes far too late. Consider the case of Eli Saslow, who told his story in the Washington Post:

I used to call it the "scamdemic." I thought it was an overblown media hoax. I made fun of people for wearing masks. I went all the way down the rabbit hole and fell hard on my own sword, so if you want to hate me or blame me, that's fine. I'm doing plenty of that myself.

The party was my idea. That's what I can't get over. Well, I mean, it wasn't even a party — more like a get-together. There were just six of us, okay? My parents, my partner, and my partner's parents. We'd been locked down for months at that point in Texas, and the governor had just come out and said small gatherings were probably okay. We're a close family, and we hadn't been together in forever. It was finally summer. I thought the worst was behind us. I was like: "Hell, let's get on with our lives. What are we so afraid of?"

...

I woke up Sunday morning feeling a little iffy. I have a lot of issues with sleeping, and I thought that's probably what it was. I let everyone know: "I don't feel right, but I'm guessing it might be exhaustion." I was kind of achy. There was a weird vibration inside. I had a bug-eye feeling.

A few hours later, my partner was feeling a little bad, too. Then my parents. Then my father-in-law got sick the next day, after he'd already left and gone to Austin to witness the birth of his first grandchild. I have no idea which one of us brought the virus into the house, but all six of us left with it. It kept spreading from there.

...

Six infections turned into nine. Nine went up to 14. It spread from one family member to the next, and it was like each person caught a different strain. My mother-in-law got it and never had any real symptoms. My father is 78, and he went to get checked out at the hospital, but for whatever reasons, he seemed to recover really fast. My father-in-law nearly died in his living room and then ended up in the same hospital as me on the exact same day. His mother was in the room right next to him because she was having trouble breathing. They were lying there on both sides of the wall, fighting the same virus, and neither of them ever knew the other one was there. She died after a few weeks. On the day of her funeral, five more family members tested positive.

It's difficult to avoid the conclusion that this kind of story will be far more common within in a couple weeks. It's avoidable, but we won't avoid it. The virus will carry out a Thanksgiving massacre, and we'll let it happen.

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