As the United States surpasses 3 million coronavirus infections, forecasters are updating their models to account for the recent resurgence and reaching a grim consensus: the next few months are going to be bad.
The national death toll is now expected eclipse 200,000 by Election Day, according to the latest models.
It’s a clear signal that, six months into the worst public health crisis in a century, the coronavirus pandemic remains as disruptive as ever. The disease has tested American leaders’ patience and political will, and outlasted efforts to contain it — swamping any hopes of a summer lull and leaving the nation’s top public health experts resigned to several more months of crushing outbreaks.
“I am despairing for the future,” said David Eisenman, the director of the UCLA Center for Public Health and Disasters. “I don’t see anything happening to indicate that [the future] will be much better.”
It took just four weeks for the U.S. to jump from 2 million coronavirus infections to the 3 million mark. Most forecasters now say that, as case counts accelerate at a record pace, it will likely take even less time to surpass 4 million.
The dubious milestone comes a week after President Donald Trump again said coronavirus would just disappear and on the day that he threatened to cut federal funding to states that don’t fully reopen schools in a matter of weeks.
During Wednesday’s briefing with the White House coronavirus task force, Vice President Mike Pence acknowledged the severe spikes across the South and West but nevertheless offered an optimistic view of the weeks to come.
“We are encouraged that the average fatality rate continues to be low and steady,” he said, adding that he saw evidence that the resurgence is beginning to crest. “We believe the takeaway from this for every American, particularly in those states that are impacted, is keep doing what you're doing."
While the mortality rate has decreased since April as testing has improved and older Americans are more likely to remain cautious, Pence’s outlook runs counter to the growing ranks of health researchers and scientists who have charted the pandemic’s progression across the U.S. for months, and concluded that the nation’s attempts to rein in the virus have fallen well short of what was needed to secure any significant and lasting progress.
Christopher Murray, director of the University of Washington’s Institute for Health Metrics and Evaluation, on Tuesday predicted more than 208,000 people could be dead from the virus by November. The IHME model, favored by the White House, has generally offered rosier forecasts than most, but Murray now is factoring in a greater reluctance to impose new restrictions and increased transmissions from having schools and universities reopen in the fall.
“Many states are expected to experience significant increases in cases and deaths in September and October,” he said of his modeling.
With the nation now reporting more than 50,000 new infections every day, most experts say the concept of a second wave is outdated. The first wave is likely to continue for months, with spikes popping up in various states. That could be followed by a possible surge in the fall when the weather turns, Murray said.
“It’s a much less meaningful distinction to talk about a first and second wave because, at least in our model, it seems unlikely we will get to zero levels,” he said.
Public health modelers initially envisioned a summer of progress, where tools refined during the nation’s lockdown — testing, contact tracing, social distancing — would be widely used, and Americans chastened by the severity of the pandemic’s early months would collectively work toward keeping the virus in check.
Yet little of that has happened. The Trump administration failed to take advantage of the time to ramp up its defenses, public health experts said — and instead of becoming a moment of national solidarity, the pandemic response has been fractured and disorganized.
Contact tracing remains woefully inadequate and mask use has become politicized. Three-quarters of Democrats who responded to a recent Pew poll said they wore masks most or all of the time in public, while just 53 percent of Republicans did the same.
“We just didn’t reopen smartly,” said David Rubin, the PolicyLab director at the Children’s Hospital of Philadelphia. “The nature of the response and what it takes to actually keep this thing at bay is fairly straightforward — and we could not agree as a country to those basic responses.”
Rubin, who heads a team modeling the virus’ spread on a county-by-county level, told POLITICO that the nation’s outlook is worsening far faster than anticipated, making it difficult to keep up with the mushrooming hotspots.
The deterioration in places like Arizona and Texas has also raised new questions about how much of the spread states are actually capturing amid severe testing backlogs. CDC Director Robert Redfield has suggested that the U.S.'s actual case count could be 10 times the number that officials have confirmed.
And as much of the nation reopened, forecasters fear that people seeded new outbreaks not just in their own states but in neighboring ones as well.
“We did not have sufficient protections in place to assure that as people traveled you wouldn’t see spread,” he said. “These hotspots have now grown into regions. It’s not just Arizona anymore, it’s the entire Southwest. It’s not just Texas, it’s moving into the heartland.”
Inside the PolicyLab, Rubin’s team recently discussed whether something as extreme as another national lockdown would even be enough at this point to get the U.S. back on track ahead of a fall that’s expected to bring both the coronavirus and seasonal flu.
“Everything is upside down right now,” he said. “We’re at a place where many of us didn’t think we’d be by the beginning of July.”
Lily Wang, an associate professor of statistics at Iowa State University, said that at the end of April after most of the country had locked down, her models suggested that some states could see almost no new infections in the summer. But that would have required the nation stay home far longer than it did.
Now, she predicts 50,000 more deaths by the beginning of September, 80,000 additional deaths by the end of October, and says the United States could hit 4 million infections before the end of July.
Quanquan Gu, an assistant professor of computer science at UCLA, also said his models look very different today than they did a couple months ago. Back then, Gu thought there could be 131,000 deaths by October. The U.S. has already surpassed that total, and now Gu believes it could see 162,000 deaths by October.
“The good news is, for many states, including California, we have already started talking about shutting down non-essential businesses like bars and restaurants,” he said. “If we do that, we will be able to flatten the curve again.”
Models are only as good as their assumptions and human behavior; political changes and dumb luck are all variables that could affect the outcome. IHME’s Murray believes that high levels of mask wearing, for example, could save more than 45,000 lives over the next four months.
The University of Texas' model predicts another 15,000 people will die in July but what happens beyond that depends on whether people follow CDC guidelines, socially distance and wear a face covering, said Lauren Ancel Meyers, director of the University of Texas’s Covid-19 modeling consortium.
Government policies will also play a crucial role, but even as the projections have become increasingly dire, Trump administration officials continued to downplay the crisis, insisting that the virus should not disrupt daily life across much of the nation.
On a private call with governors on Monday, coronavirus response coordinator Deborah Birx acknowledged “significant issues” in Arizona, California, Florida and Texas — which account for about 50 percent of new cases — according to notes of the call obtained by POLITICO.
The administration is also keeping a close eye on growing caseloads in South Carolina and Georgia, with Birx planning a tour next week through parts of the deep South.
Still, top officials have focused their efforts largely on reviving the economy and encouraging Americans to learn to live with an ever-present pandemic.
"As the President has said, the cure cannot be worse than the disease," White House spokesperson Judd Deere said in an email. "The United States will not be shut down again."
The White House has also demanded that schools reopen fully in the fall. While it is unknown how much children spread the virus it’s a stretch to think that reopening schools won’t have at least some impact on transmission, said Justin Lessler, an associate professor of epidemiology at the Johns Hopkins School of Public Health.
Yet Trump remains adamant that the U.S. seek a return to normalcy in spite of warnings from public health experts and even some of his own advisers that it may be dangerous to do so.
The White House's dismissals have prompted “anger, fury and rage” among scientists and health researchers who specialize in fighting these kinds of public health crises, said Mark Rosenberg, a longtime former senior CDC official based in the Atlanta area.
“It’s tantalizing because you can see how easy it would be to do so much better, and yet we can’t seem to reach in this state the critical decisionmakers, and nationally, the critical decisionmakers,” he said.
Still, he argued that there is still time to correct course and salvage what’s left of the summer months to prepare for new threats in the fall — as long as federal and state leaders are willing to confront the hard work that needs to be done.
“We can change, and we’re not going to give up,” Rosenberg said. “The worst thing is fatalism.”
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