America’s Shifting Covid-19 Epidemic in Five Charts

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The virus is on the move.

The curve that flattened out in April and May, albeit at a high level, is steepening again. Since the middle of June, a long plateau of newly recorded cases in the U.S. has begun to tilt upward.

Behind the trendline, the terrain of Covid-19 is shifting. Places that endured dark days in April have driven the number of cases down, while areas spared early on now face uncontrolled epidemics. On Monday in New York City, restaurants resumed sit-down service with outdoor-only seating. By Friday, Texas ordered taverns to close.

On Thursday, June 24, the U.S. reported a new record for daily Covid-19 cases, an increase of more than 40,000, exceeding the previous daily record in April, when New York morgues were overflowing. As measured by a rolling 7-day average to smooth out lumpy reports, the number of new Covid-19 cases in the U.S. increased daily between June 15 and June 24.

New cases are concentrated in rising hotspots in the U.S. south and west. Four states that saw their daily case numbers jump sharply in June — Arizona, California, Florida, and Texas — are home to about 3 in every 10 Americans. These states now account for about as many new Covid-19 cases as the rest of the country does.

Of course, cases only show up in data when they’re detected by testing, so the case counts here cannot measure the full scope of the virus’s spread. But they do not merely reflect more expansive testing. While testing has increased for the U.S. as a whole, the percentage of tests coming back positive is also rising, according to data from Johns Hopkins University. The virus is spreading faster than we are searching for it.

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That’s true in the Sun Belt states. In Arizona, more than 20% of tests now come back positive. Florida and Texas are both above 10%, while California’s test positivity rate has recently crept above the 5% threshold. Below that, states are thought be testing sufficiently, but 22 states are above it.

The combination of increased testing and rising number of cases in those four states is driving the national trend. These are places that didn’t see a huge spike in cases when much of the Northeast did. In some cases, they moved to re-open without meeting the official proposed criteria from the White House, which called for two-week downward trajectories of cases.

Remove those four states from the mix, and the national picture looks better. But there is still a recent upturn. While big states put up big case numbers, smaller states and less densely populated areas may face even more severe Covid-19 outbreaks for their size. While Houston battles the virus with world-class medical institutions, Lowndes County, Alabama, has a lone doctor to face a devastating outbreak. The plight of small towns and rural areas is harder to discern in a national trendline.

Many of the newer cases are among younger people, who tend to be less likely to suffer the worst outcomes from the virus. Treatment and understanding of the disease have improved since the first wave of Covid-19 swept the U.S. in the spring. If the newly infected skewed to a more resilient population — people catching the virus now at bars and parties rather than in nursing homes  — more of them may survive. Still, Covid-19 has killed young, otherwise healthy people, and this week the Centers for Disease Control and Prevention said pregnant women face higher risk for severe disease.

 

The news is not entirely bleak. In New York and other large states that endured the worst of America’s epidemic in the early weeks, numbers of new cases have dropped dramatically and stayed down, for now. The last time the average daily cases peaked, in the second week of April, four states accounted for more than half of new recorded cases: Massachusetts, New Jersey, New York, and Pennsylvania.

Looking only at the cases in those states shows a curve successfully flattened. Testing seems to be keeping up: Only about 1% of New Yorkers are testing positive. As life in the Northeast begins to orbit closer to normalcy, the question is whether those places will be able to stay ahead of the virus.

Areas where cases are spiking will have to find their way back to the other side of new peaks. As New Yorkers — and Italians, and Chinese, and a growing number of people around the world can attest — the journey can be grim. Orders in New York, New Jersey, and Connecticut for visitors arriving from hot spot states to quarantine are one sign of the challenge ahead: People move, and viruses move with them.

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