As the coronavirus has made its alarming American comeback in recent weeks — with dozens of states across the South and West regularly reporting record numbers of new cases and propelling the nationwide total of new daily infections past 50,000 for the first time — President Trump and others have sought to downplay the disturbing data by reciting a simple refrain: Yes, but what about the deaths?
On Tuesday, Dr. Anthony Fauci, the country’s top infectious disease expert, answered them, warning that even though fewer Americans are dying from COVID-19 today than when New York City was the raging epicenter of the pandemic, that’s no guarantee the disease won’t grow more deadly again.
“It’s a false narrative to take comfort in a lower rate of death,” Fauci said during a press conference with Sen. Doug Jones, D-Ala. “Don’t get into false complacency."
The numbers, it turns out, are on Fauci’s side: COVID-19 deaths are now beginning to creep up in U.S. hot spots such as Florida, Texas, Arizona, South Carolina and California.
For a time, Trump and company seemed to have a point. Though COVID-19 cases have been rising nationally since early June, COVID-19 deaths — which peaked at an average of 2,200 per day in mid-April — have been falling by 50 percent a month. On May 1, the seven-day average of COVID-19 deaths was 1,935. On June 1, it was 989. On July 1, it was 481.
Observers floated various theories to explain why more cases seemed to be producing fewer deaths. Post-lockdown, new COVID-19 infections have been affecting more people in their 20s and 30s and fewer old people, and younger patients are less likely to die from the disease. Doctors have gotten better at treating the patients who do end up in the hospital, often with novel therapeutics like remdesivir and dexamethasone. And America’s vastly expanded testing capacity is doing two things at once: catching a lot of nondeadly cases that previously went unnoticed while also detecting potentially deadly cases earlier, when the disease is less likely to be fatal.
“We have tested over 40 million people,” Trump boasted on July 4, summing up his side’s argument. “By so doing, we show cases, 99 percent of which” — not true — “are totally harmless.” (Even infections that don’t resolve with death may still land patients in the hospital, on ventilators, and cause serious and potentially lifelong damage to the lungs and other organs.)
Yet all along, experts such as Fauci have been warning that it can take a month or more for COVID-19 to be fatal — meaning it could only be a matter of time before deaths start to climb as well.
The wait, sadly, may be over.
During the past two weeks, the seven-day average of COVID-19 deaths has climbed 37 percent in Florida, from 35 per day to 48. In Texas, it has increased 114 percent, from 28 per day to 60. In Arizona, it has risen 71 percent, from 24 daily to 41. In California, it has jumped 20 percent, from 64 to 77. And in South Carolina, it has climbed 89 percent, from nine daily to 17.
With other hard-hit states also reporting more daily COVID-19 deaths, on average, than they did during the spring, it may not be long before the overall U.S. death curve starts to turn upward as well. In fact, it may already be happening.
Either way, COVID-19 deaths are almost certain to continue rising across the Sun Belt in the weeks ahead. Cases are still increasing exponentially — and far faster than testing — in Florida, Texas, Arizona and South Carolina. Huge percentages of tests are coming back positive: 27 percent in Arizona, 19 percent in Florida, 17 percent in South Carolina and 16 percent in Texas. California is doing a little better, at 8 percent — but the positivity rate there is also heading in the wrong direction.
Hospitalizations are increasing too. The number of Texans hospitalized for COVID-19 has doubled in the past two weeks, to almost 8,700. In Florida, 43 hospital ICUs in 21 counties, including in Miami, Orlando and Tampa, have hit capacity. In South Carolina, an internal report recently warned the state is “starting to see hospital strain,” with 1,324 residents hospitalized Tuesday, a new record. And in Arizona, COVID-19 patients currently occupy more than one in five inpatient beds — the highest level in the nation, according to the Centers for Disease Control and Prevention. Data from the Arizona Department of Health Services shows that 89 percent of the state’s intensive care unit beds are full. As a result, the state recently became the first in the country to trigger “crisis care” standards to help doctors and nurses decide who gets treatment — and who doesn’t.
The good news — if you can call any news about the American pandemic “good” at this point — is that the U.S. case fatality rate declined from around 6 percent in mid-April to about 4.3 percent by early July, which means it’s now lower than in many other wealthy countries. The reason is some combination of the factors listed above, with more testing at the top of the list. The bigger the denominator — that is, reported cases — the lower the case fatality rate will be, even if the number of deaths holds steady.
Yet Trump and others will almost certainly continue to tout this statistic, even as more and more people die — and even though it’s considered a poor measure of mortality risk during a pandemic, when the total number of infections and deaths remain unknown.
“Why does the Lamestream Fake News Media REFUSE to say that China Virus deaths are down 39%, and that we now have the lowest Fatality (Mortality) Rate in the World,” the president tweeted Monday — again, inaccurately. (According to Johns Hopkins University, America actually has the world’s ninth worst mortality rate, which is the number of COVID-19 deaths relative to the overall population.) “They just can’t stand that we are doing so well for our Country!”
Yet according to the latest projections by the Institute for Health Metrics and Evaluation, an independent global health research center at the University of Washington that the Trump administration has relied on to guide its own internal modeling, more than 1,300 Americans could be dying every day of COVID-19 by Nov. 1, absent new lockdown orders.
That would set the U.S. back to mid-May in terms of daily COVID-19 deaths. It would amount to the equivalent of another 9/11 every two days.
It would be easy to understand if Americans “just can’t stand that.” It’s harder to imagine them accepting it, more than nine months after the U.S. reported its first COVID-19 case, as proof that their country is “doing so well.”
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