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June 12, 2020

Are states' reopenings to blame for new coronavirus spikes? Experts are split.

Daily Briefing

    Some public health experts say spikes in new coronavirus cases that are occurring in nearly half of the United States stem from states reopening nonessential businesses and Americans relaxing social distancing as the country approaches summer—but other experts aren't so sure.  

    10 takeaways: What health systems must consider as they mull reopening

    US cases of new coronavirus surpass 2M, death toll nears 114K

    U.S. officials as of Friday morning reported 2,034,100 cases of the new coronavirus—up from 2,010,900 cases as of Thursday morning.

    In recent weeks, the United States as a whole has seen a slowdown in the country's growth rate of newly reported cases, largely because of progress being made in the Northeast and Midwest.

    However, according to the Associated Press, rates of newly reported cases of the new coronavirus are accelerating in nearly half of states. An AP analysis of data gathered by The COVID Tracking Project found that 21 states as of Monday had reported higher seven-day averages of newly confirmed cases per capita than they had seven days earlier. And on Thursday, at least five states—Arizona, California, Florida, North Carolina, and Texas—reported four-digit increases in their daily numbers of newly confirmed cases of the virus, the Washington Post reports.

    As of Friday morning, U.S. officials also had reported a total of 113,974 U.S. deaths linked to the new coronavirus—up from 113,097 deaths reported as of Thursday morning.

    What's driving the spikes?

    Some health experts have said states are seeing spikes in Covid-19 cases because officials over the past month have reopened nonessential businesses, lifted stay-at-home orders, and eased other measures aimed at curbing the new coronavirus' spread.

    Bill Miller, the senior associate dean for research at Ohio State University's College of Public Health, said, "As places have been opening up, many people are taking it as a message that everything is OK and back to normal." He added, "I'm definitely worried that we're going to see some upswings, maybe not everywhere, but in many places across the country."

    Arizona Public Health Association Executive Director Will Humble said Arizona's uptick in new coronavirus cases stems from Gov. Doug Ducey's (R) decision to end Arizona's stay-at-home order on May 15 and loosen coronavirus-related restrictions on businesses. According to the AP, 10 days after Ducey lifted the state's stay-at-home order and eased those restrictions, Arizona experienced a spike in new cases of infections from the new coronavirus and hospitalizations related to Covid-19.

    "It seems pretty clear to me that what we're seeing is directly related to the end of the stay-at-home order," Humble said. Humble noted that state residents not following social distancing measures intended to curb the virus' spread likely added to the spike.

    And some experts worry that, as the United States approaches summer, Americans' desire to partake in typical summer activities—such as gathering at resort locations—could continue to drive up the country's rate of new infections, the Wall Street Journal reports.

    But experts also have argued that there could be other explanations for the spikes that aren't necessarily tied to states' reopenings.

    For instance, Humble said other factors that may have contributed to Arizona's spike in cases include the state not requiring residents to wear face masks or coverings in public, not scaling up infection control activities at nursing homes, and not increasing contact tracing to detect and eliminate outbreaks. "Those are missed opportunities that, if implemented today, could still make a big difference."

    Another explanation for states' recent spikes might be that the new coronavirus is spreading in states that haven't yet experienced the full brunt of their first wave of the country's epidemic, according to some experts.

    Former FDA Commissioner Scott Gottlieb during an appearance on CNBC on Thursday said, "When you look at states like Arizona and Texas, South Carolina, North Carolina—those are where the big outbreaks are right now; Florida to some degree seems to be going up—it's not a second wave. … They never really got rid of the first wave."

    Gottlieb said these states have not yet identified and isolated sources of new coronavirus infections, which is causing the spikes.

    Increases in testing for the new coronavirus also might explain why rates of newly reported cases have spiked in Arizona and other states, some officials have said, because broader testing could result in officials simply identifying more cases of infections that already exist—and not necessarily reflect increasing transmission of the virus.

    However, some experts have noted that the percentages of tests that have been coming back positive in recent weeks also have increased, indicating that the rate of new cases is rising, as well. For example, in Greenville County, South Carolina, the percentage of positive tests increased from 2.9% on May 27 to 9.4% on June 3, which prompted state health officials to declare the county a hot spot of new coronavirus transmission. Similarly, Arkansas, North Carolina, and Texas have seen their percentages of positive tests rise.

    Ashish Jha, director of the Harvard Global Health Institute and a professor of medicine at Harvard Medical School, during an appearance on NBC's "Today" show on Thursday said, "Some of what we're seeing can be [explained by testing], but not all of it by any means."

    Other experts have said there is no single explanation for states' recent spikes in confirmed cases of the new coronavirus.

    "This virus is much more spotty," said Arnold Monto, professor of epidemiology at the University of Michigan School for Public Health. "It is so complicated that when people give you a simple answer to this, it's probably not right."

    Jay Butler, who oversees CDC's coronavirus response work, said, "It is a disaster that spreads. It's not like there's an entire continental seismic shift and everyone feels the shaking all at once."

    Americans should continue social distancing, experts say

    But in light of the recent spikes, public health officials and experts are continuing to urge Americans to remain vigilant about practicing social distancing and other tactics that can reduce their likelihood of transmitting or contracting the new coronavirus, particularly as states continue to reopen.

    Alabama State Health Officer Scott Harris said, "I think reopening the economy gave a lot of people the wrong impression ... that, 'Hey everything is fine. Let's go back to normal.' … Clearly, it is not that way. Really, now more than ever we need people to stay six feet apart, wear face coverings, and wash their hands."

    Jeffrey Shaman, professor of environmental health at Columbia University's Mailman School of Public Health, said, "The take home message to me is that the virus is still around. It's everywhere, it's not going to go away. … We can't be complacent" (Collins/Findell, Wall Street Journal, 6/11; Rodriguez, USA Today, 6/11;Bellware/Dupree, Washington Post, 6/11; Stobbe, Associated Press, 6/11; New York Times, 6/12).

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