CDC Warns of 'Impending Doom' as Cases Rise

Lindsay Kalter and Carolyn Crist

March 29, 2021

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

The United States faces "impending doom" as COVID-19 numbers continue to rise and more states loosen restrictions, CDC Director Rochelle Walensky, MD, said during a news briefing Monday.

"When I first started at CDC about 2 months ago, I made a promise to you: I would tell you the truth even if it was not the news we wanted to hear. Now is one of those times when I have to share the truth, and I have to hope and trust you will listen," she said. "I'm going to pause here, I'm going to lose the script, and I'm going to reflect on the recurring feeling I have of impending doom."

Walensky, whose voice wavered with emotion, pleaded with the public to continue practicing safety measures to prevent another surge.

"I know that feeling of nausea when you read the crisis standards of care and you wonder whether there are going to be enough ventilators to go around," she said. "I'm speaking today not necessarily as your CDC director, not only as your CDC director, but as a wife, as a mother, as a daughter, to ask you to just please hold on a little while longer."

Over the last week, there has been a steady rise in cases, along with hospitalizations and deaths, Walensky says.

The U.S. surpassed 30 million COVID-19 cases on Thursday. She said the 7-day average is hovering between 60,000 and 70,000 cases — a 10% increase — and deaths are up about 3%, to 1,000 per day.

Walensky said she will be speaking with governors Tuesday about "opening up at levels we wouldn't necessarily recommend."

More than two dozen states are reporting a 10% increase in new coronavirus cases, compared to the previous week, and public health officials are voicing their concerns that another COVID-19 surge is coming.

As vaccines roll out across the country, many of the new infections are showing up in younger age groups.

"People over 65, a large proportion of them, have been vaccinated, are protected. That's one of the reasons we have not seen a huge spike in hospitalizations," Ashish Jha, MD, dean of the Brown University School of Public Health, told CNN.

"A lot of the spread is happening among younger people," he said. "That's the group that is moving around, kind of relaxing, getting infected."

States are beginning to lift their COVID-19 restrictions, and spring break crowds have overwhelmed some areas, such as southern Florida. Governors and health officials have expressed concerns about the latest coronavirus data in their states.

Michigan, for instance, is already in the middle of another COVID-19 surge, with most cases increasing in ages 10-19, Joneigh Khaldun, MD, the state's chief medical executive, told CNN on Sunday. Community spread is happening as people gather and businesses reopen.

New York and New Jersey now have the highest COVID-19 case rates in the county, according to the New York Post . New Jersey has averaged 647 cases per 100,000 residents, and New York has average 548 cases per 100,000. The increases seem to be linked to relaxed restrictions and coronavirus variants, the newspaper reported.

In Illinois, state officials said on Friday that rapid response vaccination teams were being deployed to several counties to address the increases in COVID-19 cases and hospitalizations.

"We don't want to go down the same path we've seen before and experience a resurgence in the pandemic," Ngozi Ezike, MD, director of the Illinois Department of Public Health, said in a statement on Friday.  "We cannot move forward if our metrics are going backward."

Vermont officials reported the highest single-day case total on Friday since the beginning of the pandemic, with more than 250 new infections.

New Hampshire has also reported an increase in the average number of daily new cases and the test positivity rate, especially among teens and people in their 20s. The cases will likely continue and lead to a "spring surge," Gov. Chris Sununu said in a statement on Thursday.

In Pennsylvania, the cases and positivity rates increased last week, and 25 counties had substantial transmission, Gov. Tom Wolf said in a statement last week.

Iowa reported a 34% increase in daily cases last week, which was the largest change during a week since early January, when cases increased 36% following holiday travel, according to KCRG, an ABC affiliate in Cedar Rapids.

Health officials are paying particular attention to Florida, which has lifted the most COVID-19 restrictions, as a signal of what's ahead for the country, according to The New York Times .

The recent trends aren't great. Cases have been rising, and the variants -- particularly the B.1.1.7 variant first identified in the U.K. -- are growing exponentially. The U.S. has reported 10,579 cases of the variant, according to the latest CDC tally updated on Sunday, and Florida has reported the most of any state, with 2,274 cases.

"Wherever we have exponential growth, we have the expectation of a surge in cases, and a surge in cases will lead to hospitalizations and deaths," Bill Hanage, PhD, an epidemiologist at the Harvard T.H. Chan School of Public Health, told The New York Times.

Miami-Dade County, which has seen crowds of spring break tourists on Miami Beach, has reported one of the worst outbreaks in the country. Orange County, which includes Orlando and Disney World, has reported an increase in cases among ages 45 and younger.

At the same time, Gov. Ron DeSantis has threatened to sue the federal government if cruises aren't allowed to resume this summer, according to The Associated Press. The state is the nation's cruise capital, with three of the world's busiest ports and more than 8 million passengers per year.

But federal officials have said the U.S. is facing the risk a new surge and lifting safety measures is "premature," Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, said Sunday on CBS News' Face the Nation .

COVID-19 cases have hovered between 50,000 and 60,000 per day, and on Friday, the total reached higher than 71,500.

"When you're coming down from a big peak and you reach a point and start to plateau, once you stay at that plateau, you're really in danger of a surge coming up," Fauci said. "And unfortunately, that's what we're starting to see."


CNN: "Some US states report concerning Covid-19 case increases -- and one warns the surge is already here."

New York Post: "New York, New Jersey now lead the country in COVID-19 infections."

Illinois Department of Public Health: "Illinois Taking Aggressive Action to Address First Signs of Possible Resurgence." "Office of Governor Christopher T. Sununu, Press Conference, Thursday, March 25, 2021 at 3:00 p.m."

Gov. Tom Wolf: "Pennsylvania COVID-19 Early Warning Dashboard Update for March 12-18."

KCRG: "Average daily COVID-19 cases in Iowa up nearly 34% compared to a week ago."

The New York Times: "Cases in Florida, a national Covid bellwether, are rising -- especially among younger people."

CDC: "US COVID-19 Cases Caused by Variants."

The Associated Press: "Florida to feds: Allow cruise ships to operate or we'll sue."

CBS News: "Fauci warns against potential new COVID-19 surge as cases remain high."