Confirmed COVID-19 cases are rising again in the United States, building a new crescendo of disease that is likely to exceed earlier waves of infection in a pandemic that has already killed more than 200,000 on U.S. soil.
As Americans venture back to school, to the workplace and — in spite of warnings from public health officials — to bars and restaurants, cases have begun to rise in the last two weeks. The United States has averaged about 40,000 new cases a day over the past week, up from a recent low of about 34,000 cases a day earlier this month.
The country is now averaging about the same number of new infections on a daily basis as it was in June, when case counts were building to an ominous peak. The average number of people who are dying on a daily basis stands at about 700, the same level as early July.
“We all basically have come back into the public domain. We are experiencing pandemic fatigue in a major way, and we’re seeing weddings, funerals, bars, restaurants, sporting events,” said Michael Osterholm, an epidemiologist who runs the Center for Infectious Disease Research and Policy at the University of Minnesota.
Models maintained by the PolicyLab at the Children’s Hospital of Philadelphia that accurately predicted surges during the summer show states in the upper Midwest and the Mountain West are particularly at risk in the coming weeks, as hot summer weather gives way to a chilly fall.
Alarm bells are flashing in states like Wisconsin, which recorded more than 12,000 new cases in the past week alone, and Minnesota, where 5,700 people were infected last week after a late summer lull.
“The colder weather is coming. You need look no more than what’s going on in Wisconsin to say, ‘woah,’ ” said David Rubin, a pediatrician who directs the PolicyLab. “It kind of feels like we’re in the eye of a hurricane this week, where we passed through one eye wall. I think most public health folks recognize that when we enter into the fall and winter here, we’re going to pass through the other side.”
The models also show Chicago, Michigan cities like Grand Rapids and Flint, and states like Montana, Colorado, Utah and parts of Arizona at increased risk of substantial spread.
The number of cases confirmed over the last week has risen in 39 states and the District of Columbia, according to The Hill’s analysis of state data. Just five states — Alabama, Hawaii, Indiana, Louisiana and Virginia — have seen the number of confirmed cases decline for two consecutive weeks.
Wisconsin, a key battleground state in the presidential election, has the third-highest rate of per capita infections in the nation. For every 100,000 residents there, 224 contracted the virus in the last week. Only North Dakota and South Dakota have higher per capita rates.
The per capita rate of infection is higher than 100 out of every 100,000 in 20 states across the nation. The rate is lowest in Northeastern states like Vermont, Maine and New Hampshire, where the virus has never spread widely, and New York, Connecticut and New Jersey, where aggressive testing and tracing regimes have reduced positivity rates and controlled the spread.
Eight of the 10 states with the highest per capita infection rates do not have statewide mask mandates. Nine of the 10 states with the lowest per capita infection rates have mask requirements.
Sun Belt states that were some of the hardest hit in the summer months are showing improved outlooks, as good weather extends into the fall. Florida, once the epicenter of the pandemic’s spread through the United States, is now showing more manageable case counts, Rubin’s models show.
South Carolina and Tennessee, where Republican governors resisted mask mandates that have been shown to reduce transmission and where case counts spiraled out of control over the summer, are also showing signs of improvement.
Public health experts say the coming fall, when more Americans will move indoors and when efforts to return to a semblance of normalcy will bring them back into close quarters, is likely to result in a substantial spike in infections.
Some resist the wave analogy, because the number of infections has never truly receded. After an April peak of about an average of 32,000 new cases a day, the number of new infections dipped to just over 20,000 through May. By July, the daily average had spiked to about 67,000 new cases a day before dropping again in September to a 35,000-case daily average — higher than the initial April surge.
“We were shocked in April at 32,000 cases. The house was on fire. Then we got to 67,000, which wouldn’t have been imaginable in April,” Osterholm said. “This next peak is going to be even higher yet.”
If public health experts have any reason for optimism, it is in early indications that the dominant strain of influenza this year may infect fewer people than usual. That, coupled with social distancing measures that would deprive the flu virus of new hosts, could make for a calmer than average flu season, a break health officials could desperately use.
“I would predict that we’re not going to have a bad flu season in this year. Whether we have one in January, February or March, the flu is predictably unpredictable,” said Tom Frieden, who led the Centers for Disease Control and Prevention (CDC) during the Obama administration.
In testimony before the Senate Health, Education, Labor and Pensions Committee on Wednesday, CDC Director Robert Redfield said the agency had secured almost 28 million extra doses of influenza vaccine this year. Public health officials have been working on a special test that would screen a sick patient for both flu and the coronavirus, a necessary tool because the two share such common symptoms.
Nearly 7 million Americans have tested positive for the coronavirus, though millions more are likely to have been infected without suffering severe symptoms. The true death toll is likely far higher than has been reported, but it is far higher in the United States than in any other country.
Even with so much spread, Redfield told senators that the country remains at risk.
“A majority of Americans are still susceptible to this virus,” he said.