It’s like déjà vu all over again.
Stare long enough at those ubiquitous state-by-state charts of new daily COVID-19 cases, and you’ll notice a pattern: infections seem to be peaking in the hard-hit states of Texas, Florida and Arizona.
Or, as Vice President Pence might say, under the leadership of President Trump, our whole-of-America approach is flattening the curve.
In the coming days, you may hear about these improving numbers from Pence, Trump and others in the administration as a sign that the tide is turning in America’s battle against the coronavirus.
If so, the U.S. faces a choice. Either the rest of the country — including the 40 or so states where cases are still climbing — can learn from how New York and neighboring New Jersey and Connecticut responded when they reached their peaks in the spring: cautious, vigilant, data-driven and slow to return to normal.
A woman is tested for COVID-19 in Orlando, Fla. (Paul Hennessy/NurPhoto via Getty Images)
Or we can make the same myopic mistakes other states made, and set ourselves up for another big resurgence in the fall.
The positive trend lines are real. In Texas, new daily cases hit an all-time high of 15,038 on July 16. Yet every day since then, cases have fallen. The count for July 20 — 7,636 — was half the peak of four days earlier.
Reporting fluctuations aside, this means Texas’s seven-day rolling average of new cases, which had been rising steeply since mid-June, appears, for now, to have plateaued.
Same goes for Florida: A high point on July 12 (15,300 cases) followed by falling daily case counts and a seven-day average that seems to have leveled off.
Arizona, meanwhile, looks even better. There, the seven-day average of new cases has actually been declining for the last two weeks, from a high of 3,849 to 2,750 today.
As a result, the nationwide average of new cases has also stopped rising for the first time since early June. Over the past month, the number of new coronavirus cases in the U.S. shot up by 20 percent a week. Over the last week, it rose by a comparatively modest 7 percent — even as the cumulative total of cases closed in on 4 million Thursday.
America may be hitting another coronavirus peak. Again, this is good news — assuming it sticks.
The problem is that it’s not enough.
Remember, we’ve been here before. To fully prepare for the fall — when students may partially return to school, when colder weather will force much of the country indoors and when viruses like SARS-CoV-2 really tend to take off — complacency could be a recipe for disaster. The safest path would be to continue doing whatever it takes to shrink the U.S. outbreak to a manageable size.
This can be done. In fact, the Northeast has already done it.
Health care workers wheel a COVID-19 patient into a hospital in Brooklyn, N.Y. (Wang Ying/Xinhua via Getty Images)
Around April 10, New York — then the epicenter of America’s coronavirus pandemic — saw its daily toll of new COVID-19 cases start to decline after weeks of terrifyingly rapid spread.
By the end of May, the state’s seven-day average of new daily cases had plummeted from a high of nearly 10,000 to a little more than 1,000. Confirmed case counts in New Jersey and Connecticut followed a similar trajectory.
The cause wasn’t a mystery. As the New York Times reported this week, “State leaders responded, after some hesitation, with aggressive lockdowns and big investments in testing and tracing efforts,” while “residents … largely followed rules and [remained] surprisingly supportive of tough measures, even at the cost of economic pain.”
Because testing was limited at that point, and because most of the outbreak was concentrated in the New York metro area, America’s overall new case numbers began to tick down as well. By Memorial Day, reopening was well underway across much of the country. Americans let down their guard. Everyone knows what happened next.
So will states like Florida, Arizona and Texas learn their lesson? There are three reasons this time may be harder than the last.
The first is geography. The virus is a lot more widespread than it was in the spring. Yes, fewer people are dying from COVID-19, and yes, the U.S. is conducting a lot more tests.
But consider hospitalizations.
On April 15, 59,539 U.S. residents were hospitalized with COVID-19, according to the COVID-19 Track Project, with 18,335 of them in New York and 8,270 in New Jersey. More than half were in the Northeast.
On Wednesday, U.S. hospitalizations passed that earlier peak for the first time, reaching 59,628. More Americans are now sick from COVID-19 than in the spring. And unlike before, cases are showing up in many parts of the country.
Florida and Texas each have about half as many hospitalizations as New York did in April; Arizona has one-sixth as many. The rest are dispersed throughout the country: Louisiana, California, Nevada, Mississippi, Alabama, South Carolina, Tennessee, Georgia, Oklahoma — the list goes on.
Suppressing the virus across so many jurisdictions will be much more challenging than keeping it in check across the relatively compact, relatively cooperative Northeast. As we saw in June, COVID-19 will spread wherever and whenever people gather without precautions.
Making matters worse is the fact that our current tool kit is far more limited than it was back then. In April, much of the country was locked down. Today, almost no one seems willing to lock down again. Instead, leaders are relying on public health recommendations (wear a mask) and limited rollbacks (no indoor dining) to stop the spread.
To be sure, these measures have value. After rejecting mask mandates and resisting efforts to roll back reopening, the Republican governors of Texas, Florida and Arizona eventually relented, to one degree or another, late last month. At least some residents got the message, and cases seem to be stabilizing as a result.
But there’s no evidence from the rest of the world that relying on people to behave themselves can actually suppress the virus to a manageable level, as opposed to merely slowing its spread. So far, only lockdowns have done that. Nationwide, mobility fell nearly 30 percent in April compared to the year before, according to the Cubeiq Mobility Index. Today, it’s just 1 percent lower than it was last July. Americans are done “staying at home.”
That brings us to the final hurdle: politics. The 2020 elections — presidential, congressional, statewide and local — are roughly 100 days away. Much of the current spread is in states with strong conservative resistance to COVID-19 mitigation measures. At the slightest sign of progress, fatigue and polarization will incentivize politicians who are on the ballot to push for an even faster “return to normal” than in the spring.
The consequences could be enormous. In May, America plateaued at about 22,000 new cases per day. Right now we’re averaging 66,000 — three times that number. Florida and Texas are still averaging about 10,000 cases per day.
Testing doesn’t account for the difference: America’s positive test rate is now 8.6 percent nationally, up from a low of 4.5 percent in June. New York, by comparison, has a 1.15 percent positivity rate.
Meanwhile, a new study by the CDC suggests that the actual number of coronavirus infections across the country may be 10 times higher than the number of reported cases. That’s a lot of virus to control — especially without the motivation or methods most other countries have found necessary to control it.
The latest case numbers from Florida, Arizona and Texas are a hopeful sign. But unless they plummet like New York’s numbers did in the spring — and unless the numbers everywhere else follow suit — the U.S. may be on track for a very difficult fall.
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