COVID Cases Could Top 20 Million in January, Model Shows

Carolyn Crist

November 24, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

The U.S. could nearly double its current 12.4 million coronavirus cases and reach more than 20 million cases by late January, according to a new forecasting model by Washington University in St. Louis.

The Washington University model, which accurately forecast the rate of COVID-19 growth during the summer, issued a new update published Monday in Scientific Reports. The prediction gives four scenarios, based on the level of social distancing that happens in coming months. With strict lockdown measures, infections could remain below 15 million. But at the current level, cases will likely climb to 20 million. If people "return to normal" during the holidays and don't follow any precautions, infections could soar as high as 25 million, though the forecasters see that as less likely.

"Even small increases in social distancing can have a large effect on the number of cases we observe in the next two and a half months," Raphael Thomadsen, PhD, a marketing professor who helped to develop the model, said in a statement.

"Going back to a 50% return to normalcy, which was the average level of distancing in early August, would likely result in 5 million fewer cases by the end of January," he said. "We could effectively squash out the COVID growth within a few weeks if we went back to the levels of social distancing we experienced in April."

Models are merely predictions, the forecasting team noted, and aren't always accurate. But with the upcoming holiday season, the researchers said that an increase in travel will likely make their predictions look "optimistic" come January.

Public health officials are urging people to wear face masks and follow social distancing guidelines, especially during the holidays and the tough winter months ahead when everyone is indoors.

"I just would like to have each family…know and understand that we're in a very difficult situation, where the rate of infections is really very, very steep," Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, told The Washington Post on Monday during a live interview.

"You've got to use some common sense in the situation that you're in," he said. "The safest thing you can do is to confine the activities in your own home with the immediate occupants of that home."

Travel, social gatherings, and relaxed public health behaviors in the coming months could lead to a "surge superimposed upon a surge" already happening, Fauci said. Cases, hospitalizations, and deaths lag by weeks, so what's happening now will show up in official reports in 2 or 3 weeks, he said.

More than 3 million infections have been reported so far in November, which is the most reported in 1 month this year, according to CNN. Hospitalizations are also at a high, with nearly 86,000 patients in hospitals across the country on Monday, according to the COVID Tracking Project. Hospitalization numbers have broken records for 14 days in a row.

Individual states are reporting major increases in hospitalizations as well. In California, hospitalizations jumped 77% during the past 2 weeks, CNN reported, and in Ohio, hospitalizations increased 59% in 2 weeks. State officials are warning that intensive care unit beds could be gone within the week. Health care workers are posting on social media about burnout and overwhelming work.

On top of that, COVID-19 deaths will continue to increase in coming months. More than 10,000 people have died from the coronavirus in the past week, CNN reported. Another 130,000 people could die by next month, according to a new projection from the University of Washington's Institute for Health Metrics and Evaluation.

"What kind of Thanksgiving we have is going to go a long way to determining what December looks like, what our holiday season is going to look like," Scott Harris, MD, the state health officer for Alabama, said Monday during a media briefing.

He said the state's numbers look worse than ever and that hospitalizations are reaching July levels, when hospitals ran out of room for patients. He encouraged people to think about their vulnerable family members when making holiday plans.

"Are we going to be here a month from now, trying to have the same conversation?" he asked. "I really, really hope not."


Washington University: "COVID-19 cases could nearly double before Biden takes office."

The Washington Post: "The Path Forward: Combating COVID-19 with Anthony S. Fauci, Director, National Institute of Allergy and Infectious Diseases."

Scientific Reports: "Forecasting the spread of COVID-19 under different reopening strategies."

CNN: "A new model projects Covid-19 cases in the US will nearly double over the next two months."

COVID Tracking Project: "U.S. data, November 23, 2020."

University of Washington: "IHME COVID-19 Projects, U.S. deaths."

Alabama Public Health Training Network: "COVID-19 Holiday and Vaccine Update News Conference."