You would have thought the sight of overflow hospital tents and refrigerated trucks to contain the bodies of victims in New York City would have been enough to directly frighten us all in mid-March and early April, when infection rates peaked at 32,000. new cases per day. , or nearly 10 cases per 100,000 inhabitants, making social distancing, wearing a mask and washing hands universal practices. But soon after that peak, warm weather arrived and several states cautiously reopened some public spaces for Memorial Day.
This, as we wrote at the time, quickly led to worrying signs of rising in several states, pushing the national rate slightly north again. By the end of June, the moving average of new cases per day had far exceeded the April peak, prompting some states to withdraw their plans to reopen. But the damage was done. In mid-July, a second wave peaked more than twice the value of the first, exceeding 67,000 cases per day, or more than 20 cases per capita. There was some good news buried in that bad news, however: once the peak was reached, the decline was at least faster and steeper than it was the first time around.
But now for the worst news: As fall and winter approach, there are clear signs of a third resurgence that looks a lot like what we saw in early June. Since the most recent nadir of September 9, when the national rate was 34,300 cases per day – still a notch above the April peak – cases have risen to 45,300 per day, a 32% increase. The numbers paint an alarming and familiar picture that portends trouble – despite President Donald Trump’s repeated but false claims that the country is “reaching the last turning point” in the pandemic. “The latest information indicates that 90% of the country has not yet been exposed to the virus,” says Dr Tom Inglesby, director of the Johns Hopkins Center for Health Security at the Bloomberg School of Public Health. “The virus has not changed and has the ability to spread quickly if given the chance.”
He now has that chance. The politicization of the wearing of masks; conflicting guidelines from the White House, the Centers for Disease Control and Prevention, and the Food and Drug Administration; and national and local policies that contribute to viral transmission help make the disease work for her.
“A single, coordinated strategy could have taken us to a different place,” says Dr. Jon Samet, dean of the Colorado School of Public Health. “Even in some states, counties can do it independently. The credit given to disinformation varies widely, some coming from the Administration and even from the President. “
Samet’s own state provides a vivid example of the rise of the third wave, with its graph from the spring forming an austere three-peaked mountain range, much like a sight you might find while hiking in the Rockies. from Colorado:
In some ways, however, Colorado is an outlier in the new wave – or at least is at its forefront. The first wave hit the hardest in the northeast; the second to the south and west. Now, even as cases rise again in the south (driven largely by Texas and Florida), the Midwest has overtaken the west in cases, with dramatic peaks from Wisconsin and Minnesota to the Dakotas and Utah and Wyoming:
At a more granular level, geographic trends become even clearer. There are more than 3,000 counties (or county equivalents, like parishes) in the United States, almost all of which report individual daily figures for new positive COVID-19 tests. Dividing them into three categories – small, medium, and large, each with roughly one-third of the U.S. population – reveals that the 62 largest counties, which are home to 110 million people, were responsible for more cases than either or l other of the other two categories. until mid-August. Now the story has shifted, with the block of smaller counties – encompassing the same number of people in total but spread over a much larger, more rural geography – contributing to the new cases:
“Given that these are rural areas, the behaviors of individuals are likely to be a dominant driver: not to adhere to distancing and not to wear masks”, explains Samet. “By checking the mask orders in these states, there is a wide range. I suspect compliance with the use of masks is lower in these rural counties than in urban areas, such as Colorado according to anecdotal reports.
There has also been a shift in the age demographics of COVID-19 which in turn affects the regional situation. “In part of the Midwest, the rise is being driven by young adults who appear to have caught the coronavirus in college,” says Inglesby. It doesn’t help that students – who are by nature less risk averse than older people – are empowered in their recklessness by the lack of guidance from adults who should be better informed. It’s also worth noting that many young Americans work in jobs that increase the risk of exposure, such as retail or restaurant business.
Whatever the multiple causes of the third wave, there is reason to fear that it may turn out to be worse than the first two. The onset of colder weather in some states means more time spent indoors, where viruses are more easily transmitted through aerosols produced when people sneeze, cough, or just talk. While the pandemic is still raging, many people will likely give up seasonal travel and family reunions for Thanksgiving, Christmas, etc., but many will likely continue regardless, meaning minimal social distancing on planes and trains. crowded and around holiday tables.
“We are concerned that there may be a holiday peak with severity depending on the position of the epidemic curve before the start of the season at the end of November,” says Samet.
That the third wave is followed by a fourth is, paradoxically, both impossible to say and entirely under our control. Hopefully, more Washington policy coherence, uniform national rules around masking and distancing, and broad public acceptance of a possible vaccine – once it’s proven to be safe and effective – will eventually. plunge the COVID-19 genius back into its bottle. Until then, the United States, which represents just 4% of the world’s population and has reported more than 20% of its COVID-9 cases and deaths, will continue to fight. It’s up to all of us, by working together, to end this suffering.