The number of new coronavirus infections in some of the states hit hardest by the pandemic in the last month is easing, but public health officials warn that widespread transmission is still taking place, and that a return to normal life is a long way off.
New daily case counts have declined in the last two weeks in eleven states where the virus surged after lockdowns eased and people began venturing out more, raising hopes that the second wave of infections has crested.
“Our numbers seem to be stabilizing, which is fantastic. I’ll take stable, but I’d rather see them stable at a lower rate,” said Mandy Cohen, North Carolina’s secretary of Health and Human Services. “We still have work to do to go from stable to decline.”
In interviews with state health officials this week, most said they remain concerned that the drop in new cases may be a plateau at an unacceptably high level of transmission, rather than a sustained decline. Arizona has reported more than 17,000 new cases in the last week; Florida added 71,800 new cases; and Texas piled on another 55,000 new cases.
“We are not at a point where we can get back to normal,” said Daniel Ruiz, Arizona’s chief operating officer. “The governor has been very clear with Arizonans, we may not be back to normal until the end of the year.”
Positive trends in some states are a reflection of new concerns about the coronavirus among people who once thought they were invulnerable, either because the virus was not spreading widely in their communities or because they mistakenly believed the virus poses no risk to younger people. Now that the virus has spread more broadly in states previously spared in the spring, social distancing practices have increased, according to cell phone data.
In many places, evidence suggests the most vulnerable populations — older people and those with underlying conditions — are doing a far better job protecting themselves than are younger, healthy people.
In Arizona, more than half of all new cases in the last few weeks have occurred in those under 45 years old. In Idaho, the average age of a confirmed coronavirus case was about 35 years old earlier this month, state officials said. In South Carolina, people between the ages of 21 and 30 make up the largest cohort of cases.
“What we are seeing is widespread community transmission. We had a significant increase with the cases in our 20-44-year-olds, but primarily our 20-30-year-olds,” said Cara Christ, director of Arizona’s Department of Health Services. “We probably should have been stronger messaging our younger demographic, because I think they understood it as this isn’t a risk for me, I’m not going to get sick.”
Many states have closed bars or limited alcohol service after dark to discourage social gatherings, after several bars and parties became epicenters of major clusters.
The vast majority of transmission, however, is still happening in communities, and especially in households where one family member might get several others sick.
“We’re not finding hotspots so much right now with our contact investigations. The majority is just community spread in households,” Christ said.
The states coming off their recent highs are being steadily replaced by new states where counts are rising. Colorado, Illinois, Indiana, Kentucky, Maryland, Virginia and Pennsylvania, all epicenters of the first spike in cases, have seen their numbers tick up. Missouri, Oklahoma and Mississippi, which avoided the first surge, are still marching toward new highs.
As case counts rise, a familiar specter is coming back to haunt health officials. The nation’s testing capacity has not increased fast enough to handle demand, leading to long delays of up to two weeks. In that span, someone who may be infected but asymptomatic is a risk to others.
“That’s a real problem for us, because if a person starts to feel ill, they’re probably not going to go to the doctor immediately,” said Kathryn Turner, Idaho’s deputy state epidemiologist. “If we don’t get the results for six days, we’re talking ten days into this person’s illness before we even know about them.”
Public health officials have called for mask mandates, even in states where governors have so far refused to implement such drastic steps. Eighteen states still do not have statewide mandates in place, even if some cities and local governments are imposing their own requirements.
“Fortunately, several local governments in our state have begun requiring face masks for anyone in public,” said Linda Bell, South Carolina’s state epidemiologist. “As the state’s public health agency, we’re strongly supportive of these local leaders’ initiatives that are centered on protecting the health and well-being of their communities.”
On Thursday, Wisconsin Gov. Tony Evers (D) became the latest executive to order residents to wear masks.
The positive effects of basic steps like wearing masks in public have become a pillar of public health messaging in recent weeks, a reflection that government can only do so much if its constituents do not take responsibility for their own health. Even as some who deny the seriousness of the virus garner media attention, polls show more Americans are taking those messages to heart and using face coverings.
“If you want to keep Idaho businesses open, put your masks on,” Turner said. “Everybody wants things to go back to normal, and what we have to do as individuals is to accept a little bit of non-normalcy.”