The number of Americans who have died from Covid-19 has surpassed the death toll from the 1918 Spanish flu pandemic as the US struggles to respond to a resurgence of the virus.
The grim milestone coincides with a new wave of severe illness and hospitalisations among largely unvaccinated people in southern and mid-western US states. This has driven the seven-day rolling average of daily Covid-19 deaths to about 1,900 — levels not seen since last winter’s deadly surge.
Experts warn the spread of the highly contagious Delta variant is pushing health systems in the worst-affected states into crisis and threatening the economic recovery in the US. Political bickering over mask wearing, vaccine mandates and booster shots continues to complicate the fight against the pandemic and risks prolonging it, they say.
US deaths from Covid-19 stood at 675,446, according to the latest estimate from Johns Hopkins University published on Monday afternoon. That is roughly the same as the total number of US deaths from Spanish flu, the most severe pandemic in recent history, which killed at least 50m people worldwide, according to Centers for Disease Control and Prevention estimates.
“Controlling the pandemic depends on two factors: the leadership provided by government and public behaviour,” said Dr Ali Mokdad, professor of global health at University of Washington. “On both fronts the US has done poorly compared to other countries.”
Mokdad noted the mortality rate was higher during the Spanish flu pandemic, which began in 1918, given the US population was less than a third of its current size of 328m. But the rising death toll from Covid-19, which the institute forecasts will surpass 775,000 by January 1, is still shocking given the better standards of hygiene and medical care available today, he said.
Despite enjoying a head start in gaining access to Covid-19 vaccines, the US has fallen behind other wealthy nations in terms of inoculations. Experts say vaccine hesitancy among Republican voters, and to a lesser extent some black and Latino communities, is being fuelled by the spread of misinformation. That has left people vulnerable to infection with just 54.6 per cent of residents fully vaccinated nationally.
Some hospitals in the worst affected states are rationing care due to the latest Covid-19 wave. In Idaho, officials warned last week that Covid-19 hospitalisations of mainly unvaccinated individuals had climbed to record levels, exhausting the supply of staff, available beds and resources.
Just over 40 per cent of people in Idaho are fully vaccinated, one of the lowest rates in the US.
“It is so frustrating that we are facing another Covid surge in hospitals, which could have been prevented,” said Matthew Crecelius, an intensive care unit nurse working at a Michigan hospital. “About 99 per cent of Covid patients we see in ICU are unvaccinated . . . That is the impact of misinformation.”
Crecelius said the psychological impact of witnessing so much death and illness, particularly among young people, has forced him to seek counselling and explore other job opportunities in healthcare.
The pandemic has caused one in five healthcare workers to reconsider their careers, according to a survey of 5,000 working in the University of Utah health system.
“Nurses on the frontline are really at the end of their rope in terms of being able to cope,” said Amy Witkoski Stimpfel, assistant professor at Rory Meyers College of Nursing at New York University.
“There is a lot of emotional strain and trauma . . . being at the bedside, seeing so many very sick patients and seeing patients dying alone, without family or loved ones.”
Existing staff shortages in many states has added to the sense of crisis. Tennessee’s department of health has called on the National Guard to provide support at some hospitals while in Alabama some nurses temporarily walked off the job this month in protest at low pay and poor conditions.
Doctors are also feeling the strain and expressing frustration at politicians and the public’s failure to take effective precautions to tackle the Covid-19 crisis.
“This wave is so difficult because we didn’t have to do this all again. The vast majority of our patents in our ICU are unvaccinated,” said Dr Jennifer Caputo-Seidler, a doctor working at Tampa General Hospital in Florida.
At one point during the recent wave, fully awake and alert patients with Covid-19 had to be put into the ICU alongside patients on ventilators due to severe space restrictions, she added.
Florida’s governor Ron DeSantis issued an order in July banning mandatory mask wearing in schools, citing parents’ freedom to choose how their children are educated. He is also one of more than a dozen Republic governors opposing the Biden administration’s Covid-19 mandate requiring public and larger private employees to ensure their staff are inoculated.
“Masking is another problem particularly in our state because our governor is very opposed to mandating masks in school . . . Now we are seeing more children than ever before hospitalised,” Caputo-Seidler said.
Over recent weeks the number of new cases and hospitalisations in Florida has begun to fall but daily death rates remain close to record levels.
Caputo-Seidler said stronger leadership was required to turn the tide against Covid-19. Some unvaccinated patients hold religious or other personal beliefs against vaccines, but others were just confused by all the mixed messages, she said.
“If people saw our leaders unanimously promoting masks and vaccines and having a unified message then that would have a stronger impact than every state and city doing its own thing.”