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The US Centers for Disease Control and Prevention believes the more transmissible B.1.1.7 variant, which was first identified in the United Kingdom, will be the dominant strain within weeks. There are also concerns about governors and local officials prematurely loosening public health restrictions in a slew of states.

A fourth surge would be the first on President Joe Biden's watch and a major test for the new administration

a half-dozen Biden administration officials told CNN they believe the federal government is better prepared than ever before to handle a surge.

the accelerating pace of vaccinations is helping to head off a potential surge. One in five people in the US have now gotten at least one shot, including nearly 65% of people 65 and older, who account for about 80% of all Covid-19 deaths in the US.

"While many indicators are going in the right direction and more and more people are being vaccinated every day, we need to be ready for wild cards and worsening.

A senior official said one example of this effort would involve vaccinating workers in high-risk settings such as a meat processing plant in areas where cases are beginning to surge.

To that end, the White House has invested hundreds of millions of dollars to boost surveillance testing and close testing supply gaps, including $200 million to boost genomic sequencing to track the spread of variants. The American Rescue Plan, which Biden signed into law on Thursday, invests another $47.8 billion in coronavirus testing measures. The bill also adds $7.66 billion to hire 100,000 public health workers to boost vaccination and contact tracing efforts.

One official said the administration is also considering administering monoclonal antibody treatments -- of which the administration bought another 100,000 doses in February -- in hotspots as a prophylaxis.

"A lot can happen. Conditions can change. The scientists have made clear that things may get worse again as new variants of the virus spread," Biden said during a prime-time address to the nation last Thursday. "If we don't stay vigilant and the conditions change, then we may have to reinstate restrictions to get back on track."

"We have more consistent messaging now around the interventions that we know work: masks, social distancing measures," said Schuchat, who also served as deputy CDC director during the Trump administration. "There's a strong commitment at CDC and in this administration to transparent communication -- if there's bad news, to share it, if there's good news, to be open and honest about it -- to make sure we can communicate clearly and consistently about what we think is going on and what we think needs to be done."

the administration has declined to change the game entirely, rejecting calls to prioritize getting more first doses of two-dose vaccines in Americans' arms and delaying the administration of second doses -- as the UK did.

the White House has prioritized giving full protection to fewer Americans

the White House has sought to work more closely with state and local officials.

Biden officials say they watched as Trump tried and failed to pressure states to adopt or discard certain public health measures and have sought to avoid putting themselves in a similar position

But even as the White House looks to prepare governors for a potential fourth surge, officials are also contemplating the possibility that a fourth surge will not strain hospitals or lead to as many deaths as previous surges."In 2020 we'd say, OK, we see a rising number of cases, we know we're going to see a rising number of hospitalizations and deaths," a senior administration official said. "But today ... it's not a very clear picture."

The legend of the surge has become this era’s equivalent of the legend that America was winning in Vietnam until, in the words of Richard Nixon’s former defense secretary Melvin Laird, “Congress snatched defeat from the jaws of victory by cutting off funding for our ally in 1975.”

In the late 1970s, the legend of the congressional cutoff—and it was a legend; Congress reduced but never cut off South Vietnam’s aid—spurred the hawkish revival that helped elect Ronald Reagan. As we approach 2016, the legend of the surge is playing a similar role. Which is why it’s so important to understand that the legend is wrong.

The surge was not intended merely to reduce violence. Reducing violence was a means to a larger goal: political reconciliation. Only when Iraq’s Sunni and Shia Arabs and its Kurds all felt represented by the government would the country be safe from civil war. As a senior administration official told journalists the day Bush announced the surge, “The purpose of all this is to get the violence in Baghdad down, get control of the situation and the sectarian violence, because now, without it, the reconciliation that everybody knows in the long term is the key to getting security in the country—the reconciliation will not happen.”

But although the violence went down, the reconciliation never occurred. According to the legend of the surge, Iraq’s collapse stems from Obama’s decision to withdraw all U.S. troops at the end of 2011. “If we’d had a residual force of 10,000 to 12,000,” Senator Lindsey Graham said last year, “I am totally convinced there would not have been a rise of al-Qaeda.” In reality, the prime minister of Iraq, Nouri al-Maliki, began persecuting the Sunnis—thus laying the groundwork for their embrace of ISIS—long before American troops departed the country. As early as 2007, writes Emma Sky, who advised both Petraeus and his successor, General Ray Odierno, “the U.S. military was frustrated by what they viewed as the schemes of Maliki and his inner circle to actively sabotage our efforts to draw Sunnis out of the insurgency.”

The tragedy of post-surge Iraq has its roots in America’s failure to make the Iraqi government more inclusive—a failure that began under Bush and deepened under Obama

These errors came well before Obama’s decision to remove American troops at the end of 2011. The fact is, the U.S. failed to stop Maliki’s slide into sectarian tyranny even when it still had 100,000 troops patrolling Iraqi soil. That’s because America had already lost much of its leverage. Once the surge succeeded in reducing violence, Maliki no longer needed American troops to keep him in power

The problem with the legend of the surge is that it reproduces the very hubris that led America into Iraq in the first place. In 2003, the Bush administration believed it could shatter the Iraqi state and then quickly and cheaply construct a new one that was stable, liberal, democratic, and loyal to the United States. By 2006, many conservatives had realized that was a fantasy

in 2007 and 2008, through a series of bold innovations, the United States military bribed, cajoled, and bludgeoned Iraqis into multiple cease-fires. The Iraqi state was still broken; its new ruling elite showed little of the political magnanimity necessary to reconstruct it in an inclusive fashion. And the Band-Aids that Petraeus and his troops had courageously affixed began peeling off almost immediately. Nonetheless, Republicans today say the Iraq War was won, and would have remained won, had the U.S. left 10,000 troops in the country after 2011.

the same wild overestimation of American power that fueled the war in Iraq now fuels the right’s opposition to the nuclear deal with Iran. To hear hawks tell it, the United States can scuttle the current deal, intensify sanctions, threaten war, and—presto—Tehran will capitulate. But Iranians have been living under the threat of attacks from America or Israel for more than a decade now. And British and German diplomats have warned that if the U.S. Congress torpedoes the agreement, sanctions pressure on Iran will go not up but down, as countries that have lost billions by limiting their trade with Tehran stop doing so.

One day, Republicans will resume the painful work they began in 2006—the work of reconciling conservative attitudes with the limits of American power. Let’s hope they don’t do too much damage before that day comes.

Senator Gordon Smith of Oregon called the president’s Iraq policy “absurd” if not “criminal.” George Will, the dean of conservative columnists, deemed neoconservatism a “spectacularly misnamed radicalism” that true conservatives should disdain.

With respect to crime, poverty and homelessness, Brown argued,One thing that may occur is that disinvestment in city downtowns will alter the spatial distribution of these elements in cities — i.e. in which neighborhoods or areas of a city is crime more likely, and homelessness more visible. Urban downtowns are often policed such that these visible elements of poverty are pushed to other parts of the city where they will not interfere with commercial activities. But absent these activities, there may be less political pressure to maintain these areas. This is not to say that the overall crime rate or homelessness levels will necessarily increase, but their spatial redistribution may further alter the trajectory of commercial downtowns — and the perception of city crime in the broader public.

“The more dramatic effects on urban geography,” Brown continued,may be how this changes cities in terms of economic and racial segregation. One urban trend from the last couple of decades is young white middle- and upper-class people living in cities at higher rates than previous generations. But if these groups become less likely to live in cities, leaving a poorer, more disproportionately minority population, this will make metropolitan regions more polarized by race/class.

the damage that even the perception of rising crime can inflict on Democrats in a Nov. 27 article, “Meet the Voters Who Fueled New York’s Seismic Tilt Toward the G.O.P.”: “From Long Island to the Lower Hudson Valley, Republicans running predominantly on crime swept five of six suburban congressional seats, including three that President Biden won handily that encompass some of the nation’s most affluent, well-educated commuter towns.

In big cities like New York and San Francisco we estimate large drops in retail spending because office workers are now coming into city centers typically 2.5 rather than 5 days a week. This is reducing business activity by billions of dollars — less lunches, drinks, dinners and shopping by office workers. This will reduce city hall tax revenues.

Public transit systems are facing massive permanent shortfalls as the surge in working from home cuts their revenues but has little impact on costs (as subway systems are mostly a fixed cost. This is leading to a permanent 30 percent drop in transit revenues on the New York Subway, San Francisco Bart, etc.

Insofar as fear of urban crime grows, as the number of homeless people increases, and as the fiscal ability of government to address these problems shrinks, the amenities of city life are very likely to diminish.

First, “Saved commute time working from home averages about 70 minutes a day, of which about 40 percent (30 minutes) goes into extra work.” Second, “Research finds hybrid working from home increases average productivity around 5 percent and this is growing.” And third, “Employees also really value hybrid working from home, at about the same as an 8 percent pay increase on average.

three other experts in real estate economics, Arpit Gupta, of N.Y.U.’s Stern School of Business, Vrinda Mittal, both of the Columbia Business School, and Van Nieuwerburgh. They anticipate disaster in their September 2022 paper, “Work From Home and the Office Real Estate Apocalypse.”

“Our research,” Gupta wrote by email,emphasizes the possibility of an ‘urban doom loop’ by which decline of work in the center business district results in less foot traffic and consumption, which adversely affects the urban core in a variety of ways (less eyes on the street, so more crime; less consumption; less commuting) thereby lowering municipal revenues, and also making it more challenging to provide public goods and services absent tax increases. These challenges will predominantly hit blue cities in the coming years.

the three authors “revalue the stock of New York City commercial office buildings taking into account pandemic-induced cash flow and discount rate effects. We find a 45 percent decline in office values in 2020 and 39 percent in the longer run, the latter representing a $453 billion value destruction.”

Extrapolating to all properties in the United States, Gupta, Mittal and Van Nieuwerburgh write, the “total decline in commercial office valuation might be around $518.71 billion in the short-run and $453.64 billion in the long-run.”

the share of real estate taxes in N.Y.C.’s budget was 53 percent in 2020, 24 percent of which comes from office and retail property taxes. Given budget balance requirements, the fiscal hole left by declining central business district office and retail tax revenues would need to be plugged by raising tax rates or cutting government spending.

Prior to the pandemic, these ecosystems were designed to function based on huge surges in their daytime population from commuters and tourists. The shock of the sudden loss of a big chunk of this population caused a big disruption in the ecosystem.

Since March 2020, Manhattan has lost 200,000 households, the most of any county in the U.S. Brooklyn (-88,000) and Queens (-51,000) also appear in the bottom 10. The cities of Chicago (-75,000), San Francisco (-67,000), Los Angeles (-64,000 for the city and -136,000 for the county), Washington DC (-33,000), Seattle (-31,500), Houston (-31,000), and Boston (-25,000) make up the rest of the bottom 10.

Just as the pandemic has caused a surge in telework, Loh wrote, “it also caused a huge surge in unsheltered homelessness because of existing flaws in America’s housing system, the end of federally-funded relief measures, a mental health care crisis, and the failure of policies of isolation and confinement to solve the pre-existing homelessness crisis.”

The upshot, Loh continued,is that both the visibility and ratio of people in crisis relative to those engaged in commerce (whether working or shopping) has changed in a lot of U.S. downtowns, which has a big impact on how being downtown ‘feels’ and thus perceptions of downtown.

The nation, Glaeser continued, isat an unusual confluence of trends which poses dangers for cities similar to those experienced in the 1970s. Event#1 is the rise of Zoom, which makes relocation easier even if it doesn’t mean that face-to-face is going away. Event#2 is a hunger to deal with past injustices, including police brutality, mass incarceration, high housing costs and limited upward mobility for the children of the poor.

Progressive mayors, according to Glaeser,have a natural hunger to deal with these problems at the local level, but if they try to right injustices by imposing costs on businesses and the rich, then those taxpayers will just leave. I certainly remember New York and Detroit in the 1960s and 1970s, where the dreams of progressive mayors like John Lindsay and Jerome Patrick Cavanagh ran into fiscal realities.

Richard Florida, a professor of economic analysis and policy at the University of Toronto, stands out as one of the most resolutely optimistic urban scholars. In his August 2022 Bloomberg column, “Why Downtown Won’t Die,”

His answer:

Great downtowns are not reducible to offices. Even if the office were to go the way of the horse-drawn carriage, the neighborhoods we refer to today as downtowns would endure. Downtowns and the cities they anchor are the most adaptive and resilient of human creations; they have survived far worse. Continual works in progress, they have been rebuilt and remade in the aftermaths of all manner of crises and catastrophes — epidemics and plagues; great fires, floods and natural disasters; wars and terrorist attacks. They’ve also adapted to great economic transformations like deindustrialization a half century ago.

Florida wrote that many urban central business districts are “relics of the past, the last gasp of the industrial age organization of knowledge work the veritable packing and stacking of knowledge workers in giant office towers, made obsolete and unnecessary by new technologies.”

“Downtowns are evolving away from centers for work to actual neighborhoods. Jane Jacobs titled her seminal 1957 essay, which led in fact to ‘The Death and Life of Great American Cities,’ ‘Downtown Is for People’ — sounds about right to me.”

Despite his optimism, Florida acknowledged in his email thatAmerican cities are uniquely vulnerable to social disorder — a consequence of our policies toward guns and lack of a social safety net. Compounding this is our longstanding educational dilemma, where urban schools generally lack the quality of suburban schools. American cities are simply much less family-friendly than cities in most other parts of the advanced world. So when people have kids they are more or less forced to move out of America’s cities.

What worries me in all of this, in addition to the impact on cities, is the impact on the American economy — on innovation. and competitiveness. Our great cities are home to the great clusters of talent and innovation that power our economy. Remote work has many advantages and even leads to improvements in some kinds of knowledge work productivity. But America’s huge lead in innovation, finances, entertainment and culture industries comes largely from its great cities. Innovation and advance in. these industries come from the clustering of talent, ideas and knowledge. If that gives out, I worry about our longer-run economic future and living standards.

The risk that comes with fiscal distress is clear: If city governments face budget shortfalls and begin to cut back on funding for public transit, policing, and street outreach, for the maintenance of parks, playgrounds, community centers, and schools, and for services for homelessness, addiction, and mental illness, then conditions in central cities will begin to deteriorate.

There is reason for both apprehension and hope. Cities across time have proven remarkably resilient and have survived infectious diseases from bubonic plague to cholera to smallpox to polio. The world population, which stands today at eight billion people, is 57 percent urban, and because of the productivity, innovation and inventiveness that stems from the creativity of human beings in groups, the urbanization process is quite likely to continue into the foreseeable future. There appears to be no alternative, so we will have to make it work.

As a general, I got it wrong. Like my peers, I argued to stay the course, to persist and persist, to “clear/hold/build” even as the “hold” stage stretched for months, and then years, with decades beckoning. We backed ourselves season by season into a long-term counterinsurgency in Iraq, then compounded it by doing likewise in Afghanistan. The American people had never signed up for that.

those who served deserve an accounting from the generals. What happened? How? And, especially, why? It has to be a public assessment, nonpartisan and not left to the military. (We tend to grade ourselves on the curve.) Something along the lines of the 9/11 Commission is in order.

Today we are hearing some, including those in uniform, argue for a robust ground offensive against the Islamic State in Iraq. Air attacks aren’t enough, we’re told. Our Kurdish and Iraqi Army allies are weak and incompetent. Only another surge can win the fight against this dire threat. Really? If insanity is defined as doing the same thing over and over and expecting different results, I think we’re there.

I’d like to suggest an alternative. Maybe an incomplete and imperfect effort to contain the Islamic State is as good as it gets. Perhaps the best we can or should do is to keep it busy, “degrade” its forces, harry them or kill them, and seek the long game at the lowest possible cost. It’s not a solution that is likely to spawn a legend. But in the real world, it just may well give us something better than another defeat.

Michigan's surge is a combination of two factors, Gounder says: the spread of the B.1.1.7 variant combined with people relaxing on mitigation measures before enough residents are vaccinated.

Florida has the highest number of cases of the variant, followed by Michigan, Minnesota and Massachusetts, according to data from the Centers for Disease Control and Prevention.

Experts say it's more contagious, may cause more severe disease and may potentially be more deadly. And it's rapidly spreading across the country.

Here's why: It takes about two weeks after the Pfizer and Moderna second doses and about two weeks after the Johnson & Johnson vaccine before people are immune, she said. Meanwhile, Gounder added, "the incubation period, which is the time from when you are exposed to when you are infected with coronavirus, is four to five days."close dialogSign up for the Results Are In NewsletterGet the latest expert advice to live a healthier and happier lifeSign me upNo, ThanksBy subscribing you agree to ourPrivacy PolicySign up for the Results Are In NewsletterGet the latest expert advice to live a healthier and happier lifePlease enter aboveSign me upNo, ThanksBy subscribing you agree to ourPrivacy PolicyYou have successfully subscribed.By subscribing you agree to ourPrivacy Policyclose dialog

"So there is no way that a surge in vaccination is going to help curb this when transmission is happening right now," she said.

the only thing that will curb transmission right now are measures that take effect immediately.

Michigan is now reporting thousands of new Covid-19 cases daily, when just weeks ago, state data showed the daily reported case count was as low as 563 cases.

"Hospitals are being inundated," Dr. Jonathan Reiner, a professor of medicine and surgery at George Washington University, told CNN. "Michigan needs to shut down."

The first warning sign came when case numbers, after weeks of steep declines, appeared to level off -- with the country still averaging tens of thousands of new cases daily.

But governors cited fewer Covid-19 cases and more vaccinations while lifting measures aimed at curbing the spread of the virus.

Chicago officials earlier this month raised indoor capacity for bars, restaurants and other businesses and Baltimore leaders announced Wednesday they were easing restrictions on places including religious facilities, retail stores and malls, fitness centers and food service establishments -- changes that will go into effect next week.

Delaware, Montana, Alabama and West Virginia have also seen big increases.

The B.1.1.7 variant, she said this week, is projected to become the dominant variant in the US by the end of this month or early April.Despite the warnings, spring break crowds are gathering -- with Florida officials reporting too many people and not enough masks -- and nationwide, air travel numbers are hitting pandemic-era records.

Now, as the country inches closer to 30 million reported infections, cases are rising by more than 10% in 14 states this week compared to last week,

We're in a race to get the population vaccinated. At the same time, we're fighting people's exhaustion with the restrictions that public health has put in place and we're fighting the move by so many governors to remove the restrictions that are keeping us all safe."

Michigan cases are increasing the fastest, with more than a 50% jump this week compared to last,

All that while cases of the worrying variants -- notably the highly contagious B.1.1.7 variant -- climbed. The variants have the potential to wipe out all the progress the US made if Americans get lax with safety measures,

In West Virginia, Gov. Jim Justice said Wednesday that Covid-19 hospitalizations have "jumped up" slightly

Those include the rolling back of restrictions, a prison outbreak, Covid-19 fatigue, a failure to wear masks, and the B.1.1.7 variant fueling the surge, Morse told CNN. Michigan Gov. Gretchen Whitmer eased restrictions earlier this month, upping capacity limits at restaurants as well as in retail stores, gyms and other facilities.

There's a long list of factors contributing to the spike in cases in Michigan,

Justice had eased restrictions earlier this month, increasing capacity at bars, restaurants and other businesses to 100% and upping the social-gathering limit.

During Wednesday's news briefing, he added that the state has had "seven outbreaks in our church community" across five counties.

what could play a key role in helping control the pandemic will be more accessible, inexpensive coronavirus tests, top health officials

"I do believe that once we have teachers vaccinated that we can use testing in the schools -- serial testing, cadence testing -- to identify potential infections, asymptomatic infections, shut down clusters and keep our schools open."

Her remarks came the same day the CDC released updated guidance about testing, saying more and better testing should help catch asymptomatic cases and control the spread.

More than 73.6 million Americans have received at least one dose of a Covid-19 vaccine, according to CDC data. And more than 39.9 million people are fully vaccinated -- roughly 12% of the US population. But challenges -- including vaccine hesitancy, disinformation and inequities -- remain, and it's not entirely clear when the US will hit herd immunity -

On Wednesday, both Fauci and Walensky pushed back against questions about herd immunity, saying a lot depended on how quickly Americans take vaccines.

For now, the US still has a long way to go to overcome vaccine hesitancy,

Vaccination is the country's best hope to get beyond the pandemic, he said, "and yet there's all this overlay, and some of it is politics and some of it's social media conspiracy theories and some of it is just distrust of anything that the government had anything to do with."

Additionally, in the first two and half months of vaccine distribution, counties considered to have high social vulnerability had lower vaccine coverage than counties considered to have low social vulnerability,

The agency's social vulnerability index identifies communities that may need additional support during emergencies based on more than a dozen indicators across four categories: socioeconomic status, household composition, racial/ethnic minority status and housing type.

By March 1, vaccination coverage was about 2 percentage points higher in counties with low social vulnerability than in counties with high social vulnerability -- and the differences were largely driven by socioeconomic disparities, particularly differences in the share of the population with a high school diploma and per capita income.

Only five states -- Arizona, Montana, Alaska, Minnesota and West Virginia -- had higher coverage in counties with high social vulnerability.

Achieving vaccine equity, the CDC said, is an important goal requiring "preferential access and administration to those who have been most affected"

“The new generation has been re-politicized,” Lagodinsky said. “We thought about these young people as people who only stare at their screens. But they can walk the streets. And that has an impact on their parents and grandparents.”

Green issues have reverberated outward: Leaders from other parties, seeing a Green success bubbling in opinion polls, emphasized climate issues in the campaign

“Green is not the sole property of the Green Party,” Frans Timmermans, a senior Dutch politician who was the European center-left coalition’s lead candidate, said at a debate last month. He said other political parties — notably his own — were also focusing on the environment

But it had never enjoyed a night like Sunday, when it vaulted into second place nationwide with nearly 21 percent of the vote. The surge for the Greens was mirrored by a collapse for the Social Democrats, traditionally the dominant party on the left of German politics but perhaps now supplanted.

Exit polls in Germany showed the Greens to be the overwhelming top choice for young voters and for first-time voters. The party also did especially well in cities, taking voters from the center-left and center-right parties

In a reflection of just how much the Greens are steering the debate in Germany, far-right Alternative for Germany (AfD) leader Alexander Gauland declared that the party was now “our main enemy.”

The AfD, which denies the science behind man-made climate change, had a disappointing night on Sunday, failing to match its performance in the 2017 federal elections.

As in Germany, France saw a humiliating loss for the center-left but surprising gains for the Greens. They came in third place, with approximately 13.5 percent of the vote. The Socialists, by contrast, won only 6.2 percent.

Although the Greens also placed third in 2009, winning 16.3 percent of the vote then, Sunday’s victory came in the context of the near-total flatlining of the older political movements that dominated France for decades.

 In France as elsewhere, the left seems not to have died but merely to have changed form. To the extent that a muscular leftist movement exists, it is now green.

“The Greens represent the only project of the future,” French Greens leader Yannick Jadot said Monday on French television.

Climate change, said an editorial in France’s Liberation newspaper, “has become the principal criteria of judging political action in the European Union.

The scientific link between Zika and infant brain damage has not yet been proven. But the rising reports of microcephaly in parts of Brazil stricken by Zika have caused enough alarm that the World Health Organization declared an international public health emergency on Monday, noting that its “experts agreed that a causal relationship between Zika infection during pregnancy and microcephaly is strongly suspected.”

“They come to my office and ask, ‘Is there a chance for my baby to have microcephaly?’”

Dr. Timerman said. “We need to inform them there is. They ask if the chance is big or small. I respond, ‘I don’t know.’ They ask what I would do in their position. I tell them it’s a personal decision, only that the chance is a real one.”

“Later,” Dr. Timerman said, “both patients told me they had abortions.”

“With microcephaly, the child is already very much formed and the parents are conscious of this

“Getting an abortion creates guilt that will stay with the woman for the rest of her life.”

I know this is very difficult because the subject is new, requires thorough discussion and a great deal of religious influences persists,” said Mr. Coelho de Alcântara, a judge in Goiás State. “But my position is that abortion for microcephaly should be allowed.”

“Some children with severe-appearing brain malformations seem to be relatively unaffected,” said Dr. Hannah M. Tully, a neurologist at Seattle Children’s Hospital who specializes in brain malformations. “Yet others with relatively minor structural problems may have profound disabilities.”

"Firearm sales spiked in March 2020 and have remained at unprecedented levels since. It's a remarkable feat of firearm manufacturers to keep pace with this blistering demand."

No state has seen more gun sales this year than Illinois.

Illinois' FOID Act, which requires gun purchasers to obtain a special ID from state police, was established in 1968, but the system was overwhelmed with requests a year ago when the pandemic fueled a national surge in first-time gun buyers.

"We continue to sell everything that comes into the store within a couple of days," Eldridge said. "When people that live in high crime areas hear a lot of talk and even legislative action to defund the police, it's reasonable for them to take steps to protect themselves."

Eldridge and Oliva said gun sales have been limited by supply. Since the panemic began, Americans buying firearms faster than gun makers can manufacture them.

April gun sales across the nation were down 25% from March, which set a new record for monthly gun sales thanks to a series of high-profile mass shootings that spurred President Joe Biden and Democrats in Congress to push for passing new federal gun control measures that would expand background check requirements and limit or ban future sales of so-called assault weapons.

B.1.1.7 is projected to become the dominant variant in the US by the end of this month or early April, US Centers for Disease Control and Prevention director Dr. Rochelle Walensky said Monday. Because it is highly contagious, it could cause a surge in cases, and vaccination levels are not high enough to stop such a spike, experts have said.

"Then we can truly let go of some of the restrictions that are in place. But if we do this too quickly, we could see an increase in cases, we could see a backslide that is occurring in many European countries and that does not have to be the outcome here in America," he added.

A subsequent analysis in the study that accounted for missing and potentially miscategorized test results found the overall increased risk of death may be somewhat higher — around 61% more than earlier strains.

In what would be a first, the White House is drawing up plans to surge vaccines to emerging hotspots in an attempt to blunt the virus' trajectory and protect those at highest risk, two senior administration officials told CNN.

That focus has increased in recent weeks as the decline in new daily cases slowed, leveling off at a worryingly high level.

A fourth surge would be the first on President Biden's watch and a major test for the new administration. And while some constraints still remain — including the lopsided authority of state and local officials over the federal government in implementing public health restrictions — a half-dozen Biden administration officials told CNN they believe the federal government is better prepared than ever before to handle a surge.

The CDC reported Tuesday that 110,737,856 doses have been administered – about 77% of the 142,918,525 doses delivered.

The seven-day average remains above 2.4 million doses per day.

Nearly 22% of the population – about 72 million people – has received at least one dose of vaccine

And the newfound optimism comes with three big caveats: The worst may be over if too many people don't let down their guard too fast, if the more dangerous variants don't make cases surge before enough people get vaccinated, and if the vaccination campaign doesn't stumble badly.

But if none of those problems occurs, life could slowly but steadily return to something much more normal.The optimism is based on the rapid ramp-up of the vaccination campaign combined with the fact that a significant proportion of the country already has some immunity from being exposed to the virus, and the warmer weather that is linked to slower viral spread.

Now, not everyone is quite ready to say the worst might be over. Several experts worry about the more contagious variants combining with too many communities lifting mask mandates and other restrictions and too many people letting down their guard, especially over spring break and Easter.

In fact, new hot spots look like they could already be emerging, especially in Michigan and other parts of the Midwest, and in the Northeast, especially New York City and New Jersey.But while most experts agree that combination of factors is the big sword of Damocles hanging over the nation's hopes, most think that the country could avoid another big surge such as the one that occurred over the winter.

this spring, as more people are vaccinated, more people may be able to return safely to stores, restaurants and work, more children could return to in-person learning, and small groups of fully vaccinated people getting together for dinner parties indoors without masks.

the Centers for Disease Control and Prevention recently issued guidelines that say vaccinated people can already start to get together that way.And if case counts continue to decline and vaccination rates increase, many public health authorities think the summer could be even better.

Americans still need to be careful: Hot spots could flare up due to the variants, people getting careless, triggering superspreader events, and among pockets of people who haven't gotten vaccinated.

By the fall, while young children still won't be vaccinated because scientists have just started testing the vaccines on them, their teachers hopefully will be. So in places where infections are low, schools should be pretty safe, experts told NPR.Students will probably still wear masks and may still need to keep their distance from one another. But hopefully no more slogging through school on laptops at the kitchen table for most kids.

Researchers such as Fauci hope that more aspects of our day-to-day lives could edge back closer to pre-pandemic times.

Some experts worry the virus could follow a seasonal pattern like the flu and surge again in the late fall or early winter. And that threat may be even greater because of the variants, especially the strains originally spotted in South Africa and Brazil that appear to be better at evading natural immunity and the vaccines.

The vaccine works against the U.K. variant, says Mokdad of the University of Washington, so with more vaccination, other variants may become dominant. "And by winter we assume these two will become the dominant one unless we have more that show up. And they will cause more infections and more mortality."But even if there is no new winter surge, the virus won't be gone. It just hopefully won't be causing anything like the suffering that's already occurred.

It could, however, still be causing significant problems in parts of the world that haven't gotten vaccinated, which could spawn new, even more dangerous variants that could travel to the United States.As a result, the country will probably need new versions of the vaccines for the variants and booster shots. And many experts say it's crucial that the U.S. help the rest of the world vaccinate as quickly as possible, too.

But even if the country is on the road out of this, the impact has been tremendous, and the aftereffects are likely to be long-lasting, many experts say.

The pandemic revealed some deep problems, such as how society treats older people, poor people and people of color.

It could change so many parts of our lives. Our homes. Our work. Travel. How we touch each other. Will the the elbow bump replace the handshake for good?

The Black Death led to the Renaissance. The 1918-19 flu pandemic gave way to the roaring 20s. We've just begun the new 20s. It's impossible to know what world will emerge as the virus recedes. But it seems pretty clear we'll be hearing the echoes of this pandemic for a long time.

Researchers from the University of Washington's Institute for Health Metrics and Evaluation project that 399,163 Americans could lose their lives to Covid-19 by February 1.

As of Tuesday afternoon, the US reported 9.3 million cases of the virus and more than 232,000 people have died, according to data from Johns Hopkins University.

Hospitalizations are also surging, with the number of patients nationwide rising by more than 10,000 in just two weeks, according to data from the Covid Tracking Project.

However, more than 130,000 lives could be saved by March if Americans wore masks, Dr. Francis Collins, director of the National Institutes of Health, wrote in a blog post on Tuesday.

For those who are hoping to cast their ballot Tuesday, the CDC told CNN people recovering from Covid-19 or quarantining from being exposed to the virus can still go vote safely

"When possible, alternative voting options -- which minimize contact between voters and poll workers -- should be made available for people with Covid-19, those who have symptoms of Covid-19, and those who have been exposed," the CDC spokesperson said.

Meanwhile, more bad news, this time on Covid-19 cases in children.

There were 61,000 new cases in children during the last week of October, "which is larger than any previous week in the pandemic," the AAP said in a statement. And since the start of the pandemic through October 29, more than 853,000 children have tested positive for the virus, the AAP said. Nearly 200,000 of those cases were during the month of October.

“Our home was destroyed, there is no food in this town, so we have to flee,” she said, standing with her teenage granddaughter who held their only drinking water, a nearly empty plastic bottle that even when full would only hold perhaps two cups.

Rosemary Balais, 39, said that a very large proportion, possibly more than half, of the 5,000 people in her hometown Tanauan, near Tacloban, seemed to be missing. “My sister and their children were there and we have not heard from them since last Thursday,

In a country cursed with a succession of natural disasters, from earthquakes to violent storms to volcanic eruptions, the typhoon has emerged as especially deadly and destructive. “It’s going to be classified as one of the worst, if not the worst, in decades,”

With exactly half of the 26 Republican-held seats up for grabs in 2018 being left open by a departing governor, a surge of Democratic turnout could overwhelm any goodwill individual GOP incumbents may have built up in tight states. “We’re playing [on] a little bit of an uphill playing board,” said Tennessee Gov. Bill Haslam, the Republican Governors Association chairman. “Add that to the traditional challenges of having your party be in the White House, and for that president’s first midterm, and I think there’s no question we have our work cut out for us."

Democrats’ ebullience could be tempered by a series of potentially messy primary contests that could mar the party’s prospects in battlegrounds in at least a half-dozen states. Between the Republicans’ strong fundraising and the history of states like Iowa — which has had just two Democratic governors in the past half-century — there’s still some hope on the right.

But amid talk of another 2006, Democrats have uncharacteristically stepped up their fundraising operation around these races, often pitching donors on their importance to the next round of redistricting. That push has brought in checks from party mega-donors, like Haim Saban and Mark Gallogly, who previously primarily gave to federal candidates, according to filings. So entering the year, the DGA had raised four times more from individual donors than it had at this point four years earlier — on top of quadrupling its number of contributors.

“For far too long our party has focused on the presidential [election] every four years and hasn’t done what it needed to do on the state level,” said outgoing Virginia Gov. Terry McAuliffe, a Democrat who has pledged to spend the year campaigning for gubernatorial candidates across the country. That focus, he said, is finally starting to shift. “There’s a tsunami coming in 2018,” he predicted. “We saw it in Virginia with a record voter turnout. We saw it in Alabama."

To contain such a pathogen, nations must develop a test and use it to identify infected people, isolate them, and trace those they’ve had contact with. That is what South Korea, Singapore, and Hong Kong did to tremendous effect. It is what the United States did not.

That a biomedical powerhouse like the U.S. should so thoroughly fail to create a very simple diagnostic test was, quite literally, unimaginable. “I’m not aware of any simulations that I or others have run where we [considered] a failure of testing,”

The testing fiasco was the original sin of America’s pandemic failure, the single flaw that undermined every other countermeasure. If the country could have accurately tracked the spread of the virus, hospitals could have executed their pandemic plans, girding themselves by allocating treatment rooms, ordering extra supplies, tagging in personnel, or assigning specific facilities to deal with COVID-19 cases.

None of that happened. Instead, a health-care system that already runs close to full capacity, and that was already challenged by a severe flu season, was suddenly faced with a virus that had been left to spread, untracked, through communities around the country.

With little room to surge during a crisis, America’s health-care system operates on the assumption that unaffected states can help beleaguered ones in an emergency.

That ethic works for localized disasters such as hurricanes or wildfires, but not for a pandemic that is now in all 50 states. Cooperation has given way to competition

Partly, that’s because the White House is a ghost town of scientific expertise. A pandemic-preparedness office that was part of the National Security Council was dissolved in 2018. On January 28, Luciana Borio, who was part of that team, urged the government to “act now to prevent an American epidemic,” and specifically to work with the private sector to develop fast, easy diagnostic tests. But with the office shuttered, those warnings were published in The Wall Street Journal, rather than spoken into the president’s ear.

Rudderless, blindsided, lethargic, and uncoordinated, America has mishandled the COVID-19 crisis to a substantially worse degree than what every health expert I’ve spoken with had feared. “Much worse,”

“Beyond any expectations we had,” said Lauren Sauer, who works on disaster preparedness at Johns Hopkins Medicine. “As an American, I’m horrified,” said Seth Berkley, who heads Gavi, the Vaccine Alliance. “The U.S. may end up with the worst outbreak in the industrialized world.”

it will be difficult—but not impossible—for the United States to catch up. To an extent, the near-term future is set because COVID-19 is a slow and long illness. People who were infected several days ago will only start showing symptoms now, even if they isolated themselves in the meantime. Some of those people will enter intensive-care units in early April

A “massive logistics and supply-chain operation [is] now needed across the country,” says Thomas Inglesby of Johns Hopkins Bloomberg School of Public Health. That can’t be managed by small and inexperienced teams scattered throughout the White House. The solution, he says, is to tag in the Defense Logistics Agency—a 26,000-person group that prepares the U.S. military for overseas operations and that has assisted in past public-health crises, including the 2014 Ebola outbreak.

The first and most important is to rapidly produce masks, gloves, and other personal protective equipment

it would also come at a terrible cost: SARS-CoV-2 is more transmissible and fatal than the flu, and it would likely leave behind many millions of corpses and a trail of devastated health systems.

This agency can also coordinate the second pressing need: a massive rollout of COVID-19 tests.

These measures will take time, during which the pandemic will either accelerate beyond the capacity of the health system or slow to containable levels. Its course—and the nation’s fate—now depends on the third need, which is social distancing.

There are now only two groups of Americans. Group A includes everyone involved in the medical response, whether that’s treating patients, running tests, or manufacturing supplies. Group B includes everyone else, and their job is to buy Group A more time. Group B must now “flatten the curve” by physically isolating themselves from other people to cut off chains of transmission.

Given the slow fuse of COVID-19, to forestall the future collapse of the health-care system, these seemingly drastic steps must be taken immediately, before they feel proportionate, and they must continue for several weeks.

Persuading a country to voluntarily stay at home is not easy, and without clear guidelines from the White House, mayors, governors, and business owners have been forced to take their own steps.

when the good of all hinges on the sacrifices of many, clear coordination matters—the fourth urgent need

Pundits and business leaders have used similar rhetoric, arguing that high-risk people, such as the elderly, could be protected while lower-risk people are allowed to go back to work. Such thinking is seductive, but flawed. It overestimates our ability to assess a person’s risk, and to somehow wall off the ‘high-risk’ people from the rest of society. It underestimates how badly the virus can hit ‘low-risk’ groups, and how thoroughly hospitals will be overwhelmed if even just younger demographics are falling sick.

A recent analysis from the University of Pennsylvania estimated that even if social-distancing measures can reduce infection rates by 95 percent, 960,000 Americans will still need intensive care.

There are only about 180,000 ventilators in the U.S. and, more pertinently, only enough respiratory therapists and critical-care staff to safely look after 100,000 ventilated patients. Abandoning social distancing would be foolish. Abandoning it now, when tests and protective equipment are still scarce, would be catastrophic.

If Trump stays the course, if Americans adhere to social distancing, if testing can be rolled out, and if enough masks can be produced, there is a chance that the country can still avert the worst predictions about COVID-19, and at least temporarily bring the pandemic under control. No one knows how long that will take, but it won’t be quick. “It could be anywhere from four to six weeks to up to three months,” Fauci said, “but I don’t have great confidence in that range.”

there are three possible endgames: one that’s very unlikely, one that’s very dangerous, and one that’s very long.

The first is that every nation manages to simultaneously bring the virus to heel, as with the original SARS in 2003. Given how widespread the coronavirus pandemic is, and how badly many countries are faring, the odds of worldwide synchronous control seem vanishingly small.

The second is that the virus does what past flu pandemics have done: It burns through the world and leaves behind enough immune survivors that it eventually struggles to find viable hosts. This “herd immunity” scenario would be quick, and thus tempting

The U.S. has fewer hospital beds per capita than Italy. A study released by a team at Imperial College London concluded that if the pandemic is left unchecked, those beds will all be full by late April. By the end of June, for every available critical-care bed, there will be roughly 15 COVID-19 patients in need of one.  By the end of the summer, the pandemic will have directly killed 2.2 million Americans,

The third scenario is that the world plays a protracted game of whack-a-mole with the virus, stamping out outbreaks here and there until a vaccine can be produced. This is the best option, but also the longest and most complicated.

there are no existing vaccines for coronaviruses—until now, these viruses seemed to cause diseases that were mild or rare—so researchers must start from scratch.

The first steps have been impressively quick. Last Monday, a possible vaccine created by Moderna and the National Institutes of Health went into early clinical testing. That marks a 63-day gap between scientists sequencing the virus’s genes for the first time and doctors injecting a vaccine candidate into a person’s arm. “It’s overwhelmingly the world record,” Fauci said.

The initial trial will simply tell researchers if the vaccine seems safe, and if it can actually mobilize the immune system. Researchers will then need to check that it actually prevents infection from SARS-CoV-2. They’ll need to do animal tests and large-scale trials to ensure that the vaccine doesn’t cause severe side effects. They’ll need to work out what dose is required, how many shots people need, if the vaccine works in elderly people, and if it requires other chemicals to boost its effectiveness.

No matter which strategy is faster, Berkley and others estimate that it will take 12 to 18 months to develop a proven vaccine, and then longer still to make it, ship it, and inject it into people’s arms.

as the status quo returns, so too will the virus. This doesn’t mean that society must be on continuous lockdown until 2022. But “we need to be prepared to do multiple periods of social distancing,” says Stephen Kissler of Harvard.

First: seasonality. Coronaviruses tend to be winter infections that wane or disappear in the summer. That may also be true for SARS-CoV-2, but seasonal variations might not sufficiently slow the virus when it has so many immunologically naive hosts to infect.

Second: duration of immunity. When people are infected by the milder human coronaviruses that cause cold-like symptoms, they remain immune for less than a year. By contrast, the few who were infected by the original SARS virus, which was far more severe, stayed immune for much longer.

scientists will need to develop accurate serological tests, which look for the antibodies that confer immunity. They’ll also need to confirm that such antibodies actually stop people from catching or spreading the virus. If so, immune citizens can return to work, care for the vulnerable, and anchor the economy during bouts of social distancing.

Aspects of America’s identity may need rethinking after COVID-19. Many of the country’s values have seemed to work against it during the pandemic. Its individualism, exceptionalism, and tendency to equate doing whatever you want with an act of resistance meant that when it came time to save lives and stay indoors, some people flocked to bars and clubs.

“We can keep schools and businesses open as much as possible, closing them quickly when suppression fails, then opening them back up again once the infected are identified and isolated. Instead of playing defense, we could play more offense.”

The vaccine may need to be updated as the virus changes, and people may need to get revaccinated on a regular basis, as they currently do for the flu. Models suggest that the virus might simmer around the world, triggering epidemics every few years or so. “But my hope and expectation is that the severity would decline, and there would be less societal upheaval,”

After infections begin ebbing, a secondary pandemic of mental-health problems will follow.

But “there is also the potential for a much better world after we get through this trauma,”

Testing kits can be widely distributed to catch the virus’s return as quickly as possible. There’s no reason that the U.S. should let SARS-CoV-2 catch it unawares again, and thus no reason that social-distancing measures need to be deployed as broadly and heavy-handedly as they now must be.

Pandemics can also catalyze social change. People, businesses, and institutions have been remarkably quick to adopt or call for practices that they might once have dragged their heels on, including working from home, conference-calling to accommodate people with disabilities, proper sick leave, and flexible child-care arrangements.

Perhaps the nation will learn that preparedness isn’t just about masks, vaccines, and tests, but also about fair labor policies and a stable and equal health-care system. Perhaps it will appreciate that health-care workers and public-health specialists compose America’s social immune system, and that this system has been suppressed.

Attitudes to health may also change for the better. The rise of HIV and AIDS “completely changed sexual behavior among young people who were coming into sexual maturity at the height of the epidemic,”

Years of isolationist rhetoric had consequences too.

“People believed the rhetoric that containment would work,” says Wendy Parmet, who studies law and public health at Northeastern University. “We keep them out, and we’ll be okay. When you have a body politic that buys into these ideas of isolationism and ethnonationalism, you’re especially vulnerable when a pandemic hits.”

Pandemics are democratizing experiences. People whose privilege and power would normally shield them from a crisis are facing quarantines, testing positive, and losing loved ones. Senators are falling sick. The consequences of defunding public-health agencies, losing expertise, and stretching hospitals are no longer manifesting as angry opinion pieces, but as faltering lungs.

After COVID-19, attention may shift to public health. Expect to see a spike in funding for virology and vaccinology, a surge in students applying to public-health programs, and more domestic production of medical supplies.

The lessons that America draws from this experience are hard to predict, especially at a time when online algorithms and partisan broadcasters only serve news that aligns with their audience’s preconceptions.

“The transitions after World War II or 9/11 were not about a bunch of new ideas,” he says. “The ideas are out there, but the debates will be more acute over the next few months because of the fluidity of the moment and willingness of the American public to accept big, massive changes.”

One could easily conceive of a world in which most of the nation believes that America defeated COVID-19. Despite his many lapses, Trump’s approval rating has surged. Imagine that he succeeds in diverting blame for the crisis to China, casting it as the villain and America as the resilient hero.

One could also envisage a future in which America learns a different lesson. A communal spirit, ironically born through social distancing, causes people to turn outward, to neighbors both foreign and domestic. The election of November 2020 becomes a repudiation of “America first” politics. The nation pivots, as it did after World War II, from isolationism to international cooperation

The U.S. leads a new global partnership focused on solving challenges like pandemics and climate change.

In 2030, SARS-CoV-3 emerges from nowhere, and is brought to heel within a month.

On the Global Health Security Index, a report card that grades every country on its pandemic preparedness, the United States has a score of 83.5—the world’s highest. Rich, strong, developed, America is supposed to be the readiest of nations. That illusion has been shattered. Despite months of advance warning as the virus spread in other countries, when America was finally tested by COVID-19, it failed.

“The window of opportunity is still there, but the window of opportunity is narrowing,” WHO Director General Tedros Adhanom Ghebreyesus said on Friday. “We need to act quickly before it closes completely.”

At the beginning of any disease outbreak, public health experts painstakingly trace the contacts of every person who becomes sick. The experts build a family tree of possible illness, with branches that include anyone who might have shaken hands with, or been sneezed on by an infected person

with confirmed infections approaching 80,000 people, contact tracing on a case-by-case basis could soon be impractical.

“What we find is that this virus is going to be very difficult to contain,” said Jeffrey Shaman, an infectious disease researcher at Columbia University and co-author of the study posted Monday. “Personally, I don’t think we can do it.”

The word ‘pandemic’ invokes fear, but it describes how widespread an outbreak may be, not its deadliness.

“I think we should assume that this virus is very soon going to be spreading in communities here, if it isn’t already, and despite aggressive actions, we should be putting more efforts to mitigate impacts,”

The virus would be easier to contain if people who are contagious were obviously so, as was the case with SARS, which started an outbreak that burned itself out in 2003. But the new virus appears to spread among people who in some cases are not noticeably sick.

among the more than 600 passengers from the Diamond Princess cruise ship who have tested positive, about half had no obvious symptoms.

If the coronavirus becomes a true pandemic, a large proportion of the human population — a third, a half, two-thirds even — could become infected

Harvard epidemiologist Marc Lipsitch estimates that 40 to 70 percent of the human population could potentially be infected by the virus if it becomes pandemic. Not all of those people would get sick

The novel coronavirus may be particularly suited for stealth community transmission since its symptoms can be indistinguishable from those of a cold or flu, and testing capabilities are still being ramped up.

Experts estimate it takes about a week for the number of people infected in a given community to double. Based on that, it would likely take several weeks for a new infection cluster to be picked up by a local health department

By mid-March, he estimated, officials should know if there is community transmission and a true pandemic.

“I want to be clear that we are not seeing community spread here in the United States yet,” she said Friday. “But it’s very possible, even likely, that may eventually happen.”

“If a large number of countries are unsuccessful in preventing sustained multi-generation transmissions, then we could witness the next pandemic.”

A pandemic is a line in the sand, and every expert has a slightly different definition for when an outbreak crosses it. Generally, it means that there are self-sustaining lines of infection in multiple countries and continents — where the family tree of possible illness begins to encompass the entire population.

I think we’re not in as dire straits as we might be, and that’s because everyone is pulling together internationally.”

Public health experts are devising strategies on how to conserve N95 respirators, specialized masks that are in a limited supply amid surging demand.

“Extrapolating from some of the numbers we’ve seen on the impact to the health care system in China, it means we’ll have to surge fast.”

But the pandemic has revealed a dearth of reliable data about the key parts of the nation’s health-care system now under assault. That leaves decision-makers operating in the dark

Given the limitations, The Washington Post assembled data to analyze the availability of the critical-care resources needed to treat severely ill patients who require extended hospitalization. The Post conducted a stress test of sorts on available resources, which revealed a patchwork of possible preparedness shortcomings in cities and towns where the full force of the virus has yet to hit and where people may not be following isolation and social distancing orders.

More than half of the nation’s population lives in areas that are less prepared than New York City, where in early April officials scrambled to add more ICU beds and find extra ventilators amid a surge of covid-19 patients.

To compare available resources across the country, The Post examined a year-long scenario in which the coronavirus would sicken 20 percent of U.S. adults, and about 20 percent of those infected would require hospitalization

Under that scenario, about 11 million adults would need hospitalization for nearly two weeks, and almost 2.5 million would require intensive care.

This level of hospitalization is considered by Harvard researchers to be a conservative outcome for the pandemic, while others have described it as severe.

about 76 million people, or 30 percent of the nation’s adult population, live in areas where the number of available ICU beds would not be enough to satisfy the demand of virus patients. The scenario for ventilator availability is even more dire: Nearly half of the adult population lives in regions where the demand would exceed the supply.

We need to know where our weapons are. We need to coordinate all of that,” said Retsef Levi, a Massachusetts Institute of Technology professor leading a health-care data initiative called the COVID-19 Policy Alliance. “This is a war.”

Kahn likened the task of evaluating the current readiness of the U.S. health-care system to peering into a dark room.

“We’re outside of it, and we’re all looking through different keyholes and seeing different aspects of it,” he said. “But there’s no way to just open the door and turn on the lights, because of how fragmented the data are. And that is a really, really depressing thing at all times, let alone during a pandemic, that we don’t have an ability to look at these things.”

Bergamo, as the ground zero of the Italian outbreak, was beset by ICU bed and ventilator shortages. “We think Italy may be the most comparable area to the United States, at this point, for a variety of reasons,” Vice President Pence said April 1 in a CNN interview.

The MIT research group, the COVID-19 Policy Alliance, has mapped high-risk areas in the United States where sudden spikes could inundate hospitals as the surge in northern Italy did.

In their U.S. analysis, MIT researchers considered several risk factors, including elderly population, high blood pressure and obesity.

The takeaway, the researchers said, is that across the nation, “micro-geographies” of individual Zip codes or small towns have the potential to generate surges of covid-19 patients that could overwhelm even the most-prepared hospitals.

Levi said nursing home populations should be prioritized for virus testing across the country, because outbreaks in such close quarters can rapidly sicken dozens of people, who then flood into area hospitals.

By The Post’s analysis, the general Seattle region would need all of its available ICU beds — plus a 15 percent increase — to handle an outbreak in which 20 percent of the population is infected with the coronavirus and 20 percent of those people need hospitalization. But the demand for ICU beds could be lower because the curve of infections in Washington appears to be flattening, according to officials.

The Society of Critical Care Medicine estimates that there are nearly 29,000 critical-care specialized physicians like Johnson who are trained to work in ICUs in the United States. Yet about half of all acute-care hospitals have no specialists dedicated to their ICUs. Because of the demands of treating covid-19 patients, the lack of dedicated physicians “will be strongly felt” through a lack of high-quality care, the society said in a statement.

The society also projects that the nurses, respiratory therapists and physician assistants specially qualified to work with ICU patients may be in short supply as patient demand increases and the ranks of medical workers are thinned by illness and quarantine.

what has the hospital been doing as a prevention epicenter in the four years between the Ebola epidemic and the emergence of the coronavirus pandemic?

“Drilling and preparing for it,” said Jorge Salinas, an infectious-disease physician working on the effort. “You may be preparing and training for 10 years and nothing happens. But if you don’t do that, when these pandemics do occur, you will not be prepared.”

Salinas said the pandemic has exposed the long-standing flaws in the nation’s “individualistic” health-care system, where hospitals look out for themselves. Electronic health-monitoring systems vary hospital to hospital. Supply tallies are kept in-house and generally not shared. To counter this in Iowa, he said, all hospitals have begun sharing daily information with state officials.

“The name of the game is solidarity,” Salinas said. “If we try to be individualists, we will fail.”