It’s impossible to view a newspaper, turn on a news channel, or browse social media without being confronted by a chart showing that the United States is spiraling into a massive burst of new COVID-19 cases, rising hospitalizations, and increasing deaths. This article is no different.
Starting with the first known cases in the U.S., it’s been over nine months since the coronavirus first began to circulate across the nation. Over that time, 230,000 Americans have died and millions have become ill. But the pandemic we’re seeing now isn’t just larger: It’s different in a fundamental way that makes addressing it more difficult.
Joe Biden … has a big task ahead of him, and right now, Trump is doing everything he can to make it worse.
From the start of the coronavirus outbreak in the United States, cases have been distributed coast to coast. This was largely due to a failure to recognize that cases were coming in from many other sources than China, and because an abject failure of testing meant that community spread of the virus wasn’t recognized until literally days before hospitals in New York began filling up with victims. But the lack of a coordinated federal response has meant that each surge has been fought on a local level, with governors, mayors, and county officials taking the steps necessary to fight the disease within their very limited borders, using their very limited authority. As each little flame has been momentarily dimmed, the sparks have spread out and the overall temperature of the nation has risen to a level where fires can, and are, starting everywhere. All the time.
Testing has been left to the states, where it has gone on in what can charitably called an “erratic” fashion. On Thursday, Rhode Island tested at a rate that was 12 times that of Nevada, even though Nevada has far more active cases and is reporting a horrendous 23% rate of positive tests to Rhode Island’s much more reasonable 3% rate. Some states have had flurries of intense testing, especially when there were spikes in that region. Other states have very deliberately reduced testing when cases were at their maximum—looking at you, Florida.
While Donald Trump insists that the United States has more cases simply because it has done more testing, that’s far from true. Some of the states with the lowest rates of testing are showing the highest rates of disease, and states with very high rates of testing are doing fantastic jobs of controlling the outbreak (like Vermont, where I’ll be interviewing a state health official next week about their well-nigh miraculous results).
What the testing has done is generate a huge amount of daily noise. The erratic actions at the state level, along with weekend drops in testing that result directly from mostly leaving testing to small private sites, means that the daily chart of new cases is at a point where “we had 90,000 cases today” doesn’t mean anything out of context.
The uncoordinated testing strategy means that case counts can swing by 15,000 or more in a single day, which is clearly not reflective of anything actually happening in the real world.
To get a better sense of the nature of the pandemic, here’s another view. In this case, the numbers have been averaged over the course of weeks. Then each week has been compared to the preceding week.
The result isn’t the actual new cases on each day, but the way those new cases are changing compared to the previous week. So orange bars represent periods in which the rate is going up. Blue bars represent those periods of recovery. The actual number of new cases may be, and in many cases is, higher during one of the blue bar weeks than in an orange bar week—but these are periods in which the rate of new cases is decreasing.
As the chart shows, the most recent surge has already gone on longer than the previous periods of increasing rate. And it’s not just starting from a higher point: it’s also increasing at a greater rate.
The biggest reason for this goes back to all those little fires, and all those sparks they’ve cast across the nation. The first spike was highly regional, with more than half the cases occurring in a few Northeastern states. The second spike was still regional, though less so, with about one-third of cases restricted to large states in the South. But this third spike is essentially everywhere. On Thursday, 33 states reported more than 1,000 new cases. There are certainly states that are seeing more COVID-19 than others—North and South Dakota in particular have become the first states to have more than 5% of their total population test positive for COVID, putting them at almost twice the national average. But there are very few states where COVID is not well-established and widespread.
That isn’t just making this surge larger—it means it’s going to be much more difficult to get the nation back into a “blue” period. The first surge could be largely arrested with tough social distancing restrictions in a handful of states, and something as simple as Republican governors in Texas and Arizona allowing counties to implement mask mandates could make a big dent in the second surge. But the broad base of this new surge means that no small group of governors or local officials can put out this fire.
It needs the one thing we’re unlikely to get before January: coordinated national action.