Eighteen days from the presidential election, the U.S. has more confirmed COVID-19 cases and deaths than any other country, and cases are growing at a speed not seen since the summer peak.
At the current rate of growth, the nation could set a weekly case count record within the first few days of November, according to a USA TODAY analysis of data compiled by Johns Hopkins University. But if the spread of cases picks up momentum – as was seen in late June and July – the U.S. could set a weekly case record in little more than a week.
"I don't think it's out of the question. Yesterday, we had about 50,000 new cases," Caitlin Rivers, an epidemiologist at Johns Hopkins, said Thursday. "It's not crazy to think that we would get there sooner than we would all like."
The U.S. added more than 373,000 cases in the past week – a number nearly 46,000 higher than the tally the previous week, which is a speed of growth not seen since July.
"We're going to have a huge increase as we head into the colder months, and this could be potentially the worst part of the epidemic in the U.S., both in terms of new cases and even deaths," said Dr. Peter Hotez, dean of the National School of Tropical Medicine at the Baylor College of Medicine in Texas. "Our lives will get better as we get vaccines early next year, but we’re going to go through a very troubled time."
There are more than 8 million confirmed cases of COVID-19 in the U.S. and more than 218,000 people have died, according to Johns Hopkins. The pandemic has touched all but three counties, and the share of positive coronavirus tests is increasing in the Northwest, Midwest and other northern states. As of Thursday evening, 14 states had set records for new cases in a week while two had a record number of deaths in a week.
US coronavirus map: Tracking the outbreak
"It's from a relatively high watermark that we're starting this third resurgence. We're seeing hot spots all around the country, and that really concerns me because it makes it more difficult to control," Rivers said.
Cases are surging across the Midwest at a blistering pace: North Dakota reported cases at a speed a third faster, on a per capita basis, than any U.S. state experienced in the worst of the spring or summer surges.
South Dakota and Montana are also ahead of the summer records, while Wisconsin is not far below, a data visualization of Johns Hopkins University by University of Illinois computer scientist Wade Fagen-Ulmschneider shows.
New cases aren't the only numbers going up. The percentage of tests coming back positive and hospitalizations are rising, too, Rivers said. Test positivity, in particular, helps determine whether an increase in cases is merely the result of expanded testing or an actual increase in transmission.
"Taken together, that’s a pretty reliable indicator that things are headed in the wrong direction," she said.
Thirty-three states have higher than recommended positivity rates, and more than 30 reported an increase in the percent of tests coming back positive from the week before, according to Johns Hopkins, which notes that the quality of testing varies by state.
Epidemiologists are divided on whether the surge constitutes a second "wave" or merely a continuation of the first. New daily cases peaked in the spring in mid-April at a seven-day average of nearly 32,000 cases a day.
Cases began to decline after that but peaked again in mid-July, at an average of more than 67,000 new daily cases. Cases declined again and reached a low in mid-September at an average of more than 34,000 new daily cases.
Michael Osterholm, one of the nation’s leading epidemiologists and director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said the coronavirus outbreak is more like a wildfire than a "wave."
"It will just keep burning human wood out there wherever it can find it. If you don’t put it out, those embers lie there, and if you remove your suppression activities, it comes right back. That’s what Europe is seeing right now," he said. "If we let our foot off the brake completely, you’re going to see widespread transmission everywhere."
The surge is fueled by three main factors, Osterholm said. People are returning to social activities because of pandemic fatigue. Young people back at school are spreading the virus to more vulnerable populations. And indoor transmission is increasing as cooler fall weather drives people inside.
Dr. Greg Poland, director of the Mayo Clinic's Vaccine Research Group, warned of "a point when there's no going back," when the nation exceeds testing capability, any feasibility of contact tracing and the medical system's ability to meet the surge demand. The quality of health care will go down, and the mortality rate will rise, Poland said.
"This is a very bad premonition in what we’re seeing in the last week or two in the uptick in cases, and we would be fools to wait until it’s blatantly obvious," Poland said.
It's hard to predict when, exactly, the next peak will be, but several epidemiologists said models may provide an imperfect guide. At the current rate, new daily cases will peak at the end of December, and daily deaths will peak in mid-January, according to the Institute for Health Metrics and Evaluation at the University of Washington. Nationwide masking would cut the projected case peak in half, but easing mandates would double it, according to the model.
President Donald Trump continues to push for a vaccine by Election Day on Nov. 3, but experts said that timeline is unlikely. Doses of any Food and Drug Administration-authorized vaccine could be shipped by the end of the year or early 2021, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said this week.
Mercedes Carnethon, vice chair of preventive medicine at Northwestern University Feinberg School of Medicine, encouraged people to wear masks and maintain social distance into the fall and winter.
"We have to sustain this level of vigilance at this time, and it’s very hard over the holidays," she said. "As I think about not seeing my family, it's really hard. But that chance can be a real gamble – almost a Russian roulette."
Contributing: Mike Stucka, USA TODAY Network
This article originally appeared on USA TODAY: COVID cases in US grow at a speed not seen since July peak