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On June 26, Vice President Mike Pence, chair of the White House Coronavirus Task Force, put a positive spin on the surge in new cases that has gripped the nation since the middle of June. “To one extent or another the volume of new cases coming in is a reflection of a great success in expanding testing across the country,” Pence said, adding that “the fact that we are finding more younger Americans who have contracted the coronavirus is a good thing.”
“I believe that at this point in the course of the pandemic we can still take some comfort in the fact that fatalities are declining all across the country,” Pence said.
So far, deaths have indeed declined even as cases have surged across the country, with many of the cases being diagnosed in people under the age of 40. But experts say it’s too early to say whether this trend will continue.
There may be a lag of three to four weeks between any rise in confirmed cases and an increase in recorded deaths — due to the disease’s incubation period, the time between diagnosis and death for those who become fatally ill, and a delay before each death shows up in official counts. That means that any rise in deaths may not be seen until around the second week of July at the earliest.
“We hope it doesn’t come, but it might,” Kate Grabowski, an epidemiologist at Johns Hopkins University, told BuzzFeed News.
The fact that younger people are making up more of the new cases means it could take even longer to see an increase in deaths, since those who are now being infected may need to pass the virus onto more vulnerable older people before deaths start to rise.
“That’s going to take multiple weeks longer,” Grabowski said.
Daily new cases and deaths for the entire US
In part, the steady decline in deaths from COVID-19 seen so far may reflect improved treatment, as doctors have learned more about how to treat those who become seriously ill. “We of course have improved treatment in the hospital that we didn’t have in March and April,” Deborah Birx, the White House coronavirus response coordinator, said at the June 26 briefing.
Since the pandemic first hit, researchers have shown that the antiviral drug remdesivir and a commonly used steroid may help severely ill patients. Placing patients in a prone position, lying on their stomach, may also help patients with dangerously low blood oxygen to breathe. And doctors are experimenting with treatments involving blood plasma from people who have recovered from COVID-19, which should contain antibodies to fight the virus.
Despite Pence’s optimistic statements, however, the current surge in cases can’t simply be attributed to increased testing. “We’re seeing a rise in cases that far exceeds the rise in the expansion of testing,” Grabowski said.
The age of people being diagnosed does seem to have fallen dramatically. According to an analysis of Florida Department of Health data by the South Florida Sun Sentinel, the median age of newly diagnosed cases in the state dropped from 65 at the start of March to 36 by the week of June 20. And on June 26, the University of Texas Southwestern Medical Center reported that in the Dallas-Fort Worth area, the recent surge was mostly due to rising infections of younger people: “New daily COVID-19 cases have sharply jumped among those aged 21-40 while staying largely stable among other age groups,” it said.
The surge in new cases started a couple of weeks after Memorial Day weekend, and seems most pronounced in states that reopened businesses including bars and restaurants before that holiday. Because of that, many experts believe that the surging numbers of infected younger people in large part reflect increased transmission of the virus in social situations and in the workplace. Several reports of clusters of infections tied to bars — including in Michigan, Florida, and Arizona — have also surfaced in the last two weeks.
“This is not a mystery,” Ezekiel Emanuel, vice provost of global initiatives at the University of Pennsylvania and a former health policy adviser to the Obama administration, told BuzzFeed News.
Specialists in public health warn that infection can cause lasting lung damage even among younger patients, and the CDC notes that people of any age with conditions including kidney disease, obesity, serious heart disease, and Type II diabetes are at increased risk of severe illness.
Even though young people are less likely to die from COVID-19 than the elderly, “that doesn’t mean they don’t get serious illness,” Emanuel said. “We shouldn’t think it’s of no consequence.”
Indeed, many of the states with the largest surges of new cases are already seeing corresponding rises in the number of hospitalized patients.
Hospitalized COVID-19 patients for selected states
If this continues and hospital capacity gets overwhelmed, the death rate seems certain to rise. “We saw that in New York. We saw that in Italy,” Grabowski said. “30% of people being admitted to some hospitals were dying.”
The biggest worry is that the growing numbers of infected young people will pass the virus on to older, more vulnerable people. “In fact, such transmission is very likely,” Anirban Basu, a health economist at the University of Washington in Seattle, told BuzzFeed News.
This means that protecting older people will become increasingly crucial. A New York Times investigation published on June 27 found that residents and workers at nursing homes for older people have so far accounted for just 11% of all US COVID-19 cases, but a massive 43% of the nation’s deaths. “This is the time to be really vigilant” about protecting the elderly from infection, Grabowski said.
As concern about the surge in cases across the South and West has grown, states experiencing spikes in COVID-19 cases have started to roll back their reopening plans.
On June 26, Texas governor Greg Abbott closed bars across the state and ordered restaurants to operate at no more than half of their indoor capacity. That same day, Florida suspended the consumption of alcohol at bars statewide. On June 28, California governor Gavin Newsom ordered bars to close in seven counties, including Los Angeles County, home to more than 10 million people. And on June 29, Arizona governor Doug Ducey paused the operation of bars, gyms, movie theaters, and waterparks for a month.
So far, there is no sign that the surge in new cases is diminishing. “We are now having 40,000-plus new cases a day,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, testified to the Senate on Tuesday. “I would not be surprised if we go up to 100,000 a day if this does not turn around.”
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