Then cases surged upward again, propelled by states like Florida where Gov. Ron DeSantis seemed intent on practicing herd immunity, even if his herd did not agree; and by Texas where Gov. Greg Abbott was one of several Republican governors to pass an executive order specifically prohibiting local officials from requiring masks. A month after those 20,000 case days, the nation was averaging over 70,000 cases a day. It wasn’t until Abbott, and others like Gov. Doug Ducey in Arizona, actually let off the “open no matter what” button that the Sunbelt surge began to fade.
But where the case count settled after that was on a value actually higher than the average at the April-May peak. What September 6 marked was not a decline in cases, it was a low point in testing around the Labor Day holiday weekend. And just like the low point in June, it was just a momentary deflection in a line that was angling back up.
Since Labor Day, the number of new cases has gone up every single week. Just as it did following the first slight decline, that new surge is driven largely by states that escaped the worst of the effects of the previous outbreaks. In this case, that surge is centered in the Midwest. But it’s not just the Midwest. Every day brings a new set of awful statistics: 41 states trending the wrong way, 20 states setting new daily records on the same date, 38 states reporting higher rates of hospitalization.
Each week, the number of new cases seems to come in pulses, with the lowest number of cases reported on Sunday and Monday following a weekend in which many testing locations are closed. The number of cases then proceeds upward toward a peak that usually comes on Friday, before the weekly cycle starts again. On October 2, the Friday peak was at 52,000 new cases. A week later, it hit 61,000. And last Friday it reached over 71,000.
There is every reason to believe that this Friday will reach or exceed the record number of new cases set back on July 24. World Meters called that day at 78,000 cases. Johns Hopkins had it at 77,000 cases. Either way, this Friday could see those numbers eclipsed. But what might be more frightening is that there seems to be no indication that this is anywhere near the peak.
When cases topped out in May, it was because they were centered in the Northeast and tough regional action put the nation on the road that—had it been generally followed—could have led toward genuine control of the disease. When cases topped out again in July, it was because southern state governors finally relented and allowed city and county officials to impose necessary restrictions.
But this third “surge” isn’t a localized event. It’s an almost everywhere event. At one point this week, fully 48 states had new cases of COVID-19 that were greater than last week. Not only are states like Ohio, Tennessee, and both Dakotas seeing all-time highs, even states like Illinois and New Jersey that have maintained some level of enforced social distancing are seeing rising caseloads. In states like Florida, Missouri, Iowa, and South Dakota, Republican governors have kept on removing restrictions, even though cases are up enormously from the point where those restrictions were put in place. CDC guidelines aren’t even getting a mention.
Local reports in many cities show ICU beds aren’t just full, they’ve been full for days. Fourteen states reported new records this week. Some states have seen cases go up by 50% or more in the last two weeks. In El Paso, Texas, they’re up by 500%. It would be nice to check the CDC Dashboard for details on nationwide hospitalization values, but that information has not been updated since July 14 when data collection from hospitals was taken private.
And, as predicted almost as many times as there are cases, the pandemic is now overlapping the beginnings of flu season. There may be no doubt about which disease is more deadly, but flu is also widespread, easily transmissible, and generates large numbers of hospitalized patients—patients who will be competing for bed, attention, and resources with COVID-19 patients. Hospitalized patients with the flu are going to be prime candidates to become infected by COVID-19. Hospitalized patients with COVID-19 are going to be at risk from the flu. And yes, you definitely can catch both.
Despite two trials being on hold in the United States, trials of vaccines are still moving ahead and there remains a good chance that by early 2021 a vaccine will roll out to more vulnerable patients, with a general release by spring or summer. And despite low availability at the moment, antibody “cocktails” are proving to be effective treatments when given to patients in the early stages of disease.
But all of that is still months away. New cases are not. As the nation heads for another sorry peak, it’s unclear how we ever climb down.