The Week America Lost Control of the Pandemic

Sixteen states have reported record caseloads since Sunday.

The Atlantic

The American pandemic is careening out of control. Yesterday, the United States reported more than 52,000 new cases of the coronavirus, setting a new all-time daily record, according to the COVID Tracking Project at The Atlantic. The surge has put the country’s supply of coronavirus tests under strain, especially in some of the worst-hit states, such as Arizona, Texas, Florida, and California. But unlike in past weeks or months, the outbreak is no longer limited to a handful of states or cities. Many places across the country are seeing caseloads spike.

To the degree that the U.S. ever built an infrastructure to contain and suppress the coronavirus, it frayed this week.

Along the way, nearly every previous landmark for measuring the pandemic has been overwhelmed. The country reported about 300,000 new COVID-19 cases in the past week, more than in any previous week of the pandemic so far. This shattered the old record of more than 215,000 new cases, which was set last week. On June 16, Vice President Mike Pence bragged that the U.S. was seeing an average of 20,000 new infections a day, a decline from the April high of about 30,000 new daily cases. Since Pence’s boast, the U.S. has recorded more than 30,000 new cases on every day but four. Six days ago, the country reported more than 40,000 daily cases for the first time. Now it has smashed through the 50,000 mark.

These cases aren’t all mild. At least 37,000 Americans are now hospitalized with COVID-19, the same number as were in sick beds in late May. This number is likely a substantial undercount: Florida, which is facing one of the largest outbreaks, does not report its total hospitalization figures, though it says it will publish that data soon. What data we do have suggest that health-care systems are overwhelmed. In Houston, for instance, the Texas Medical Center has filled 100 percent of its intensive-care-unit beds.

The one statistic that has yet to turn in the wrong direction, thankfully, is deaths. National deaths continued to fall this week, averaging fewer than 500 a day. But the pace of their decline has slowed. It’s still too early to know whether deaths will keep decreasing in the next few weeks, but the early signs are not good. There will always be an inherent lag between a rise in coronavirus cases and an associated rise in coronavirus deaths: On average, 14 days pass between someone experiencing the first symptoms and someone dying, according to the Centers for Disease Control and Prevention. In Arizona, where COVID-19 cases started surging about two weeks ago, deaths have begun to increase. The state reported 267 new deaths in the past week, an all-time high.

This flood of cases is being propelled by outbreaks across the Sun Belt, especially in Arizona, Texas, Florida, and Southern California. Arizona, which confirmed more than 24,000 cases in the past week, now reports more new COVID-19 cases per capita than New York State did at the peak of its outbreak in the spring. Until last week, only New York had ever reported more than 5,000 new cases in a single day; since then, California, Texas, and Florida have all seen several days with more than 5,000 cases. And today, for the first time ever, Florida reported more than 10,000 new cases, another record previously held only by New York. (It’s not clear whether these outbreaks are truly worse than what New York or New Jersey saw in the spring, because access to testing was so restricted then that many sick people never got tested.)

But the outbreak is growing beyond that group. Twenty states have reported record caseloads in the past two weeks, most of them in the past few days. Ten states, mostly in the South, reported more than 1,000 new cases today alone.

Georgia is among the most worrying states right now. This past week, it reported more than 14,800 new cases, thousands more than any previous week, as well as a record number of hospitalizations. This surge in cases cannot be explained by an increase in testing: New cases rose this past week at about twice the rate of tests. COVID-19 cases, in other words, have simply become easier to find in the Peach State: At the beginning of June, about one in 14 tests came back positive. Last week, about one in nine tests did; today, one in seven tests did.

States outside the South are now also flashing warning signs. Ohio, which saw new cases rise much faster than tests this week, is of particular concern. One in 13 tests came back positive this week, whereas last week, one in 22 tests did. The state has also seen its cases and hospitalizations increase in the past two weeks. A rise in all these numbers at the same time tends to presage a larger surge in cases.

What should concern all Americans is that, as more and more states see their outbreaks intensify, the country will lose its ability to understand what is happening. As my colleague Alexis C. Madrigal and I reported this week, some of the country’s major testing providers are backlogged and overwhelmed, and are no longer able to turn around test results as quickly as is epidemiologically useful. Yesterday, Brett Giroir, who coordinates COVID-19 testing in the Trump administration, said: “It is absolutely correct that some labs across the country are reaching or near capacity.”

It’s not clear why these outbreaks are happening in certain states. As I’ve previously written, the governors of Texas, Arizona, and Florida had opened at least part of their states by the first weeks of May, and they never aggressively signaled the danger of the virus to their residents. From April to mid-June, Governor Doug Ducey of Arizona and Governor Greg Abbott of Texas blocked cities and counties from imposing any stricter pandemic rules than were imposed by the state. (Abbott reversed course today and ordered most Texans to wear a mask.)

But not every state with surging cases took the same route. Governor Gavin Newsom of California enacted some of the strictest pandemic rules outside the Northeast, but Los Angeles is seething with cases right now. Many of the states now facing outbreaks did not struggle much with the virus in March or April—except for Louisiana, which saw a major outbreak in March and is seeing cases spike again now. What seems to unite many of the most affected states is that they reopened indoor dining, bars, and gyms. What will distinguish them is how they react now.

The country has not yet faced a moment like this in its pandemic. The calamity in the Northeast happened when most Americans were sheltered at home. No matter how much infection raged in New York, Connecticut, or Pennsylvania, the country’s adherence to social distancing kept new conflagrations from sparking elsewhere. But now the country is divided: The South is burning with infection at the same time other regions are trying to reopen. This feat—opening one region while suppressing the pandemic in another—has never been done before, and there is no guarantee that it can be done. Many public-health leaders signaled this week that they do not think it is possible.

“This is really the beginning,” Anne Schuchat, the principal deputy director of the CDC, told Congress this week. “I think there was a lot of wishful thinking around the country that Hey, it’s summer. Everything’s going to be fine. We’re over this—and we are not even beginning to be over this. There are a lot of worrisome factors about the last week or so.” Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, also said this week that the U.S. could soon see 100,000 new cases a day. If that prediction comes true, then what befell the Northeast could look like mere preamble.

For months this spring, Americans clawed back ground from the coronavirus. Many of us stayed home, canceled vacations, and avoided friends and family. It was awful, but it worked: The U.S., by one estimate, avoided more than 4 million infections. We are now losing that work, watching weeks of pandemic suppression vanish in days. It took the country acting in concert to subdue the virus in the spring. We may need to do the same, again, to avoid the worst now.