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September 1, 2020

What's next for America's coronavirus epidemic? 'Rolling hot spots.'

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    America's overall average daily number of newly reported coronavirus cases has fallen from its peak in July as some hard-hit states are showing signs of improvement, but the number of newly reported cases is now accelerating in the Midwest, signaling the country is on pace to face a long-sustained epidemic with "rolling" hot spots, public health experts say.

    How Covid-19 is changing the future of the health care industry

    US new coronavirus cases surpass 6M, deaths top 183K

    U.S. officials as of Tuesday morning had reported a total of 6,044,600 cases of the novel coronavirus virus since the country's epidemic began—up from 6,008,300 cases reported as of Monday morning.

    The country's coronavirus epidemic had reached a new peak in July, when U.S. officials were reporting an average of nearly 70,000 new coronavirus cases per day—about double the average number of new cases the country had reported each day during a previous peak in the spring. However, the country's daily average of newly reported cases declined in August, and a CNBC analysis of data from Johns Hopkins University found that U.S. officials have reported an average of between 41,000 and 43,000 new coronavirus cases per day over the past week.

    Despite the nation's overall decline in its daily average of newly reported coronavirus cases, some states—particularly in the Midwest—are seeing spikes in their daily numbers of new coronavirus cases. For example, data from the New York Times shows that Guam and 10 states—Alabama, Connecticut, Iowa, Kansas, Minnesota, Montana, Nebraska, North Carolina, North Dakota, and South Dakota—saw their average daily numbers of newly reported coronavirus cases rise over the past 14 days.

    The Times' data also shows that the average daily numbers of newly reported coronavirus cases over the past two weeks remained mostly stable in 25 states: Alaska, Arkansas, Colorado, Hawaii, Illinois, Indiana, Kentucky, Maine, Massachusetts, Michigan, Mississippi, Missouri, New Hampshire, New Jersey, New York, Ohio, Oklahoma, Rhode Island, South Carolina, Tennessee, Utah, Vermont, Virginia, West Virginia, and Wisconsin.

    In addition, the Times' data shows that Puerto Rico; Washington, D.C.; the U.S. Virgin Islands; and 15 states saw their average daily numbers of newly confirmed coronavirus cases decrease over the past 14 days: Arizona, California, Delaware, Florida, Georgia, Idaho, Louisiana, Maryland, Nevada, New Mexico, Oregon, Pennsylvania, Texas, Washington, and Wyoming.

    U.S. officials as of Tuesday morning also had reported a total of 183,474 deaths linked to the coronavirus since the country's epidemic began—up from 182,986 deaths reported as of Monday morning.

    According to the Times' data, 15 states saw their average daily numbers of newly reported deaths linked to the coronavirus rise over the past 14 days: Alabama, Arkansas, Hawaii, Idaho, Iowa, Kentucky, Maryland, Mississippi, Missouri, Montana, Nebraska, Oklahoma, Rhode Island, Virginia, and West Virginia.

    US likely to see 'rolling hot spots' of coronavirus transmission

    The surge in newly reported coronavirus cases in the Midwest comes after Sun Belt states—including Arizona, California, Florida, and Texas—emerged as coronavirus infection hot spots during the summer. Those states eventually implemented more stringent measures intended to prevent the coronavirus' spread, including certain business closures and local face covering mandates, which has helped to curb their outbreaks, according to public health experts.

    But Rob Murphy, a professor of infectious diseases and biomedical engineering and the executive director of the Institute for Global Health at Northwestern University's Feinberg School of Medicine, said the new hot spots in the Midwest reflect fatigue over coronavirus mitigation measures.

    "The Midwest was relatively spared" from the country's coronavirus epidemic early on because the region was "prepared because [of] what happened in New York; [it] was such a catastrophe that things got very serious out here in the Midwest—Republican and Democratic governors alike—really were very careful. And that was good, so we had really a low rate of cases," Murphy explained. However, he said, "And then what happened in the Midwest ... because it wasn't … as bad as New York, wasn't as bad as the last Southern wave—things just kind of slowly crept out of control and it became incredibly political. And people forgot about the fact that this is a pandemic."

    Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, told CNN that he expects the United States will continue "to see … rolling hot spots" like it's experiencing now, as governors struggle to "right-size their response" to new coronavirus outbreaks and areas throughout the country "have more or less controls in place."

    "Many governors do their own thing as best as they can and some do better than others. … So it's not surprising to me that you see this kind of slipping out of control in certain places and getting back under control … and then the same thing being repeated over and over again," Adalja said. "I think this will be the new normal," he added.

    Ashish Jha, director of the Harvard Global Institute of Health, said the rolling hot spots are a result of "one mishap after another" in the United States' response to the country's coronavirus epidemic. "We didn't get here overnight," he said, adding, "The single factor that really differentiates us from everybody else is denialism that has pervaded our entire approach."

    HHS seeks communications contract to 'defeat despair and inspire hope' on coronavirus epidemic

    As the novel coronavirus continues to spread throughout the country, HHS is seeking to award a communications firm a more than $250 million contract to launch a public campaign intended to "defeat despair and inspire hope" on the country's coronavirus epidemic, according to internal HHS document obtained by Politico.

    According to Politico, HHS weeks ago sent a "performance work statement" to several communications firms that stated the department is looking for a firm to create public service advertisements that's primarily focused on encouraging Americans to "engage in behavior that actively promote[s] health behaviors or good citizenship."

    Politico reports that HHS in the document also wrote that the contract's goals are to:

    • "[D]efeat despair and inspire hope, sharing best practices for businesses to operate in the new normal and instill confidence to return to work and restart the economy";
    • Deliver public health, treatment, and vaccine information regarding the novel coronavirus as the country reopens businesses and eases coronavirus-related restrictions;
    • Establish a "coalition of spokespeople" around the United States; and
    • Provide the public with information on phases of the country's reopening.

    "By harnessing the power of traditional, digital, and social media, the sports and entertainment industries, public health associations, and other creative partners to deliver important public health and economic information, the [Trump] administration can defeat despair, inspire hope, and achieve national recovery," the document states, according to Politico.

    According to Politico, HHS wrote that the contract winner would spend most of the contract's funding from September of this year until January. The firm that receives the contract would work with HHS' assistant secretary for public affairs, Politico reports.

    Commenting on the proposed contract, a senior HHS official reportedly told Politico, "In the run-up to a vaccine that's going to save American lives, there is a lot of amount of public health information that we need to get out there and it includes how to live your lives, run your offices and businesses in the time of Covid, but it's also about the flu vaccine and the Covid vaccine, and all of this is fundamentally important." The official continued, "Defeating the mental health challenges of the coronavirus, the despair, is nearly as important as defeating the physical dangers of the virus" (Kane, CNN, 8/25; New York Times [1], 9/1; Feuer, CNBC, 8/31; Sullivan, The Hill, 8/27; Lippman, Politico, 8/31; Klar, The Hill, 8/31; New York Times [2], 9/1).

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