Within days, that trend reversed sharply. In the past week, the United States has consistently seen new records in the seven-day average of new cases. The initial coronavirus spike faded for a while while never fully vanishing — and then reemerged in shocking fashion.
That pattern is unique globally. In most countries, the virus emerged, sometimes spreading quickly and dangerously (as in Italy) before coming under control. No other country which has tamped down on the initial surge in infections to any significant degree has seen a subsequent reemergence like ours.
President Trump has argued that this is solely a function of the U.S. increasing its testing capacity. That’s not true; while the number of cases has increased in part due to increased testing, it’s also the case that more tests in states like Arizona, Texas, Florida and California are coming back positive — strongly suggesting expanding infection rates. That suggestion is bolstered by hospitalization data showing increases in the number of people actually seeking treatment for the virus.
Why is this happening in the U. S.? It’s almost certainly due in part to what The Atlantic’s exceptional science writer Ed Yong dubbed the “patchwork pandemic”: the lack of a coordinated response at the federal level which has led to individual states determining for themselves how to approach the issue.
This is an explicit decision from Trump’s White House. Last week, Pence pushed Americans to listen to state and local leaders, deferring from offering an opinion on wearing face masks in deference to governors (and in order not to frustrate Trump, who is at best indifferent to the idea). On Monday, White House press secretary Kayleigh McEnany told reporters that Trump echoed that sentiment.
The result has been waves of new infections marked not by its reemergence in places that had tamped down on the virus but in different places around the country. Just as nations were shown to be more or less ready to handle the pandemic as it spread around the world, states and even counties have been shown to be more or less ready to deal with the virus — especially after the White House dropped its national recommendation that people try to contain its spread.
Viewing per capita data on the spread of the virus makes that obvious. The initial surge in cases in the U.S. was driven by the rapid spike that hit New York City in April. Testing at the time was mediocre enough that we probably captured only a fraction of the actual spread of the virus, but the rate of expansion of just those confirmed cases was striking.
That surge occurred shortly after the city hit its 100th confirmed case. It took far longer for surges to occur in places like Arizona and Florida after passing that benchmark — but, as noted above, it has been recent surges in those states which has spurred the new uptick in cases.
It’s important to note that the growth of cases in places like Phoenix (Maricopa County, Ariz.) has been sharp, but not as rapid as the eruption in New York City. Adjusting the growth in new cases per capita to the point at which jurisdictions first hit 5 cases per 100,000 residents, you can see that the growth in the Phoenix area hasn’t increased as fast, particularly considering that the number of cases in New York were likely undercounted.
It’s also worth noting that California’s rate of growth (driven, recently, by growth in Los Angeles) is tangibly different than the surges in Texas and Arizona. California had seen a slow increase in new cases that has sped up. Arizona, Texas and Florida saw a much faster increase more recently.
While the national picture reflects the emergence and fading of outbreaks in different parts of the country, there are places that have seen a similar pattern. In Miami-Dade County, for example, the per capita rate rose to 16 cases per 100,000 in early April before the new case rate fell again a few weeks later. Then it surged again.
The pattern seen in the U.S. isn’t solely a function of leaving response to local governments. After all, the European Union is a decentralized organization of countries which has nonetheless managed to keep new case totals down. But that the U.S. has a stronger central government which is explicitly downplaying the current threat makes a difference.
“We’re aware that there are embers that need to be put out,” McEnany said of the recent surge in new cases during Monday’s briefing.
There are now more new “embers” each day than there were when the pandemic first spiked in March and April.