Millions of Americans were on the move Thursday during one of the busiest travel days of the holiday season, as coronavirus infections with the omicron variant surpassed the peak of the delta wave and hospitals ran out of space for patients.
A Christmastime testing crunch compounded the country's problems, with pharmacy appointments in big cities all booked, government sites overwhelmed and home kits nowhere to be found in some places.
President Joe Biden, who as a candidate blasted his predecessor Donald Trump for failures on the same issue, promised this week to stand up more testing sites and ship out half a billion home kits, beginning in January.
At a newly opened federal testing site in New York City's Travers Park, people formed long lines, wearing puffy winter gear to protect against the bone-chilling weather.
"I was planning to meet up with my family, but I might be positive for COVID, so that's something that I don't think is going to be happening," Queens resident Maria Felix said as she awaited her results.
Government workers also handed out home tests to passersby on the street, but with only 2,000 set aside for each of the five boroughs in a city of 8.4 million, the items are likely to remain scarce for some time to come.
But there was little sign of testing holdups deterring travel: American Airlines, for instance, said it was operating 5,000 daily flights between December 19 and January 1, representing 86% of capacity compared with 2019.
"There is tremendous pent-up demand for air travel," a spokesperson said.
The American Automobile Association estimated 109 million people, a 34% increase from 2020, will hit the road, board airplanes or take other transport on trips of 50 miles or more between December 23 and January 2.
Omicron passes delta
The festivities are expected to further drive up COVID-19 cases as the omicron variant pushes the nation's stretched hospitals — and exhausted health workers — to the brink.
The strain now accounts for more than 90% of all cases in some regions.
Even though early evidence suggests its rate of severe cases is lower, it is by far the most infectious version of the virus seen to date, meaning its mildness advantage could be negated.
According to Covid Act Now, the seven-day average of new daily cases is running at 171,000, about to pass the delta peak seen in September.
Intensive care units are running at more than 90% of capacity in many parts of the country, an official tracker showed.
"There are more people in the hospitals this year, at this time of the year, than there were last year," John Carney, governor of Biden's home state of Delaware, said in a weekly briefing, where he announced all elective surgeries will be postponed.
In New England, hospitals in Rhode Island and Massachusetts have found it hard to retain health workers, with many leaving because of burnout, Steve Walsh, CEO of the Massachusetts Health and Hospital Association, told Boston.com.
And in New York, Mayor Bill de Blasio announced there would be scaled back New Year's Eve celebrations at Times Square, with the event fully outdoors, masked, and attendees required to show proof of vaccination.
Viewing areas will allow fewer people to allow for social distancing.
Absent adequate testing, American health authorities are banking on high levels of vaccinations to moderate the number of severe COVID-19 cases, and vaccination numbers have been strong all week.
"+1.86M doses reported admin over yest total, incl 1.30M boosters," tweeted White House official Cyrus Shahpar.
The Food and Drug Administration, meanwhile, authorized a COVID-19 capsule, developed by Merck, as a treatment for high-risk adults, after greenlighting Pfizer's more effective pill a day earlier.
The two oral treatments are intended to complement vaccines and help relieve some of the burden of severe cases.