EMS medics with the Houston Fire Department transfer a affected person with Covid-19 signs onto a stretcher earlier than transporting him to a hospital on August 14, 2020 in Houston, Texas.
John Moore | Getty Images
White House coronavirus advisor Dr. Anthony Fauci warned members of Congress in late June that the U.S. may report greater than 100,000 every day new cases of the virus “if this does not turn around.””
But months later, Fauci’s worst fears have not come to pass as daily new cases have steadily fallen across much of the U.S. While testing has declined in recent weeks, the number of new cases is falling faster than testing rates, indicating that at least some of the drop is real.
Epidemiologists credit a more unified health message in the U.S. that has more people following social distancing rules. They also say that keeping some businesses closed has helped slow the outbreak. And President Donald Trump started endorsing masks in late July, bringing the White House in line with recommendations from the Centers for Disease Control and Prevention after months of resistance.
The number of daily new cases in the U.S. peaked on July 22 at about 70,000 new infections and have steadily fallen to about 42,600 new cases per day, based on a seven-day average, according to a CNBC analysis of data compiled by Johns Hopkins University. The percent of all tests coming back positive has also steadily fallen as well, from a high of 8.5% in late July to 6.2% this week, according to Hopkins data. That, along with the four weeks of sustained decline and the falling number of Covid-19 hospitalizations, has epidemiologists feeling more confident that the U.S. is finally getting a grip on its coronavirus outbreak.
“The present plan — carrying a masks, watching your distance, washing your arms, supplemented by good testing, based on the state plans, surge testing and excessive technical help by CDC in addition to our craft groups — continues to yield outcomes,” Assistant Secretary for Health Adm. Brett Giroir told reporters on a conference call last week.
But the country remains in a delicate spot, epidemiologists from some of the hardest hit states in the country, Florida, Texas and Arizona, who spoke with CNBC said. While new cases are falling by at least 5% in 31 states, daily new cases are still rising by at least as much in more than a dozen states, based on a seven-day average, according to Hopkins data.
In Texas, cases are down from an average of about 10,400 new cases reported on July 22 to an average of about 5,500 average new cases per day. While irregularities in the state data led some local health officials and epidemiologists to question the data, Catherine Troisi, an infectious disease epidemiologist at UTHealth School of Public Health in Houston, said that the state data is “with a grain of salt, trying good.”
She added that the Texas Gov. Greg Abbot’s July 2 masks mandate “actually” helped reduce the spread as well as the closing of bars, “as a result of we all know that these have been spreading an infection.” She added, however, that as the number of new cases continue to drop and as society reopens that people may experience “pandemic fatigue” and begin to disregard some public health guidelines.
“What we’re actually involved about are colleges opening, Labor Day weekend and pandemic fatigue,” she said. “We have been all drained of this 5 months in the past. Now we’re actually drained, so if folks see the quantity of cases come down, they could assume it is okay to do issues that are somewhat bit riskier.”
“I might not be stunned if we see an uptick after Labor Day,” she added.
In Florida, cases have fallen from an average of about 11,100 new cases reported on July 22 to about 3,900 average new cases per day this week. Cindy Prins, an epidemiologist at the University of Florida, attributed much of the drop to changing behavior across the state, prompted by news coverage and effective public health messaging.
“I believe it form of obtained to folks that opening up did not imply going again to regular,” she said. “I believe it obtained very a lot in the public eye that we weren’t the place we wanted to be and that we needed to take higher management.”
Prins echoed Troisi’s concern that as new cases continue to fall, people might get comfortable and ease up on their commitment to the public health guidance.
“My concern is that we’ll have folks form of falling away from this notion of menace as our cases decline and that we might wind up with somewhat bit of a curler coaster,” she said.
However, she added that Florida and many of the other Sun Belt states that were hit hard by the virus this summer, have an advantage over the Northern parts of the country: comparatively warmer weather. Various studies have shown that the virus spreads more easily in crowded, in-door, poorly ventilated environments. Officials, including New York Gov. Andrew Cuomo, have warned that colder weather could present a new challenge as dining and gathering outdoors becomes more difficult.
Arizona has reported an average of about 650 new cases per day over the past week, down from about 2,750 per day on July 22, according to Hopkins data. Will Humble, executive director of the Arizona Public Health Association and former director of the Arizona Department of Health Services, attributed the drop in cases to “three core issues.”
First, he said, Gov. Doug Ducey “lastly” allowed towns, cities and counties to implement their own mask mandates in mid-June. Before that mid-June announcement, Ducey had prevented local officials from implementing their own face mask requirements.
“We undoubtedly know that was an enormous issue,” Humble said in a phone interview. He added that the following week, Ducey ordered the closure of bars and nightclubs, which he said was another major cause in reversing the direction of the outbreak.
The third factor that could be driving the drop in new cases, Humble said, is that enough of the population might have been infected earlier in the outbreak that “the virus is having a tougher time discovering new hosts.” Particularly hard-hit parts of Arizona might be benefiting from some level of herd immunity, he said, adding that not nearly enough of the population has been infected to actually halt the spread of the virus.
“Arizona adopted the Swedish mannequin,” he said. “We threw our arms up and mentioned, ‘alright, let’s get it.’ That’s what occurred. And we did it. And loads of folks died. And loads of folks recovered. And these folks are now protected.”
Humble added that he’s nervous about the weeks and months ahead, both for the country and for Arizona. He said that under the governor’s reopening plan, bars and nightclubs could reopen as soon as this week in some communities. But he said he’s not satisfied with the state’s plan to ensure compliance with capacity restrictions and other requirements.
He said that if bars and clubs reopen without a proper enforcement mechanism, it could lead to a major resurgence and “June 2.0.”
“When the bars and nightclubs open with no mitigation measures in place as a result of there was no compliance, who’s going to endure from that? The mother and father and the youngsters who might have benefited from in-person instruction,” he said, “as a result of it should transfer the metrics up, after which youngsters are going to have to return on-line and in-person instruction will not be an choice anymore.”
Trouble in the heartland
Director of the Centers for Disease Control and Prevention Dr. Robert Redfield warned last week that while cases are falling nationally, driven by the former hot spots, there are some worrying indicators in the center of the nation.
“We’re beginning to see some of the cases now in the pink zone areas are falling, however in the event you have a look at these states that are in what we name the yellow zone, between 5% and 10%, they are not falling, so center America proper now could be getting caught,” he mentioned in an interview with Dr. Howard Bauchner of the Journal of the American Medical Association. “This is why it is so necessary for center America to acknowledge the mitigation steps that we talked about, about masks, about social distancing, hand washing, closing bars, being good about crowds.”
He said cases are not rising substantially in the region, but the fact that cases appear to be plateauing could be cause for concern, especially as the country enters the colder months of the year and seasonal influenza spreads. Redfield has repeatedly warned that the confluence of a major flu outbreak along with the Covid-19 pandemic could overwhelm hospitals and cause preventable deaths. He encouraged Americans to get this year’s flu vaccine as soon as it’s available to mitigate the risk of an overwhelming flu season.
“We need not have a 3rd wave in the heartland proper now,” he said. “We want to stop that notably as we’re coming to the fall.”
— CNBC’s Nate Rattner contributed to this report.