By The Washington Post · Griff Witte, Ben Guarino · NATIONAL, HEALTH
To the Trump administration, this was evidence that its strategy for combating covid-19 was working. To medical experts, it was only a matter of time before the trajectory changed.
And now it has. Nationwide, deaths have begun to rise again. In some of the worst-hit states, especially across the South and the West, new death records are being set daily. As a virus-scarred summer wears on, public health specialists say the numbers are almost certain to continue to climb.
"Even if we could magically lock everyone in their room and no one transmits to anyone, we would still be seeing an increase in deaths for the next several weeks," said Catherine Troisi, an epidemiologist with UTHealth School of Public Health in Houston.
That grim assessment came as the United States on Friday set another record for total cases, with more than 76,000 - including a new high of nearly 15,000 in Texas alone.
More than 900 people died, matching a death count of recent days that has consistently hovered just below 1,000. That is well beneath the toll during the virus's most devastating stretch, in April, when 2,000 or more people were dying daily nationwide. But it is also well above the totals earlier this month, when the average number of daily deaths dropped below 500.
More than 136,000 people in the United States have died of covid-19, the disease caused by the novel coronavirus.
The recent increase in fatalities follows a nationwide surge in cases that has brought the country record numbers of new infections. Public health experts have long said that the death count is a lagging indicator - with patients typically taking two to three weeks after diagnosis to succumb - and that the number of new deaths would inevitably follow the case count higher.
But Trump administration officials - and the president himself - have repeatedly sidestepped that view and used lower mortality rates as an argument for why concerns about a coronavirus resurgence were overblown.
"When you look at the mortality rate, we're seeing that our efforts here at the federal government have been working," White House press secretary Kayleigh McEnany said this week.
Experts say there are legitimate reasons mortality rates are lower now than in the spring, when covid ravaged New York City and other major urban centers.
For one thing, doctors have learned new techniques for attacking the virus.
"We've gotten better at treating patents," Troisi said, "so they're less likely to die."
For another, the latest spike of infections has been concentrated among younger people, many of whom have contracted the virus while at work, bars or restaurants. They are generally less vulnerable to severe consequences from covid-19 than older people, many of whom have continued to stay home despite economic reopenings.
But that phenomenon can only last for so long as working-age Americans meet up with their elderly parents or grandparents.
"Young people are not living in a vacuum," said Farshad Fani Marvasti, director of public health at the University of Arizona College of Medicine Phoenix. "They're interacting with people who are more susceptible."
That is likely contributing to the spike in deaths now, Marvasti said.
In Arizona, home to one of the nation's fastest growing coronavirus infection rates, the average daily death toll has risen by around 60% just in the past week, up to 91 on Friday. The cumulative number of dead in the state topped 2,500.
Worries have been rampant in Arizona that morgues could run out of room. The medical examiner's office has ordered more portable storage coolers. Funeral directors, meanwhile, have been busy ensuring they have sufficient capacity, said Heather Long, executive director of the trade group that represents Arizona funeral homes, cemeteries and crematoria.
"It's 115 degree in Arizona. So we want to make sure we have everything in place if there is a surge," Long said. That includes preparing for "the ability to cremate when we need to," she said. "If that means cremating 24/7, we can."
In other states, the rise in deaths has been even more dramatic than in Arizona.
Texas reported 174 new deaths on Friday, smashing its earlier record of 129 - which was set just a day earlier. The state has more than 10,000 coronavirus patients still in the hospital, and the strain is showing.
Ivan Melendez, who leads public health efforts in Hidalgo County, on the Mexican border, said the body of a patient may lie on a stretcher for up to 10 hours before it can be removed from an overcrowded intensive care unit.
"Before someone gets a bed in the covid ICU unit, someone has to die there," Melendez told the Associated Press.
Some hospitals in surging areas are also suffering critical drug shortages. Sergio Segarra, the chief medical officer for Baptist Hospital of Miami, said the 11 hospitals in the Baptist Health system ran out of their remdesivir supply on Friday.
"We were able to do a full-court press on everyone" thanks to that drug, Segarra said, "but now without our tools we just don't have that ability." The lack of remdesivir and the short supply of convalescent plasma, coupled with the older age of patients, contributes to the ongoing rise in mortality, the doctor said.
Florida's new reported deaths rose to 130 on Friday, an increase of 35% compared with the previous seven-day average. About two dozen people died in Miami-Dade, the county with the highest deaths, bringing that region's overall body count to almost 1,300.
Jackson Memorial Hospital, a public 1,550-bed hospital in Miami, needed at least one mobile morgue unit earlier during the pandemic but has not requested one recently, said spokeswoman Lidia Amoretti. The Jackson Health System had 445 coronavirus patients across its hospitals as of Friday afternoon.
Miami-Dade county officials enacted a new ordinance on Thursday that allows fines of $100 for residents who do not wear masks outdoors or inside public spaces. Statewide, however, Gov. Ron DeSantis, a Republican, has not mandated wearing masks.
The governor told reporters on Friday that Florida was taking additional actions to halt the disease's spread, including accelerated testing for symptomatic people and expanding the number of coronavirus-only nursing homes.
Florida has also tested all 200,000 staff members at its 4,000 long-term care facilities within the last two weeks, DeSantis said. Slightly less than 3% of those workers tested positive - below the rate for the statewide population. Any staff who test positive are isolated.
Florida and other states are seeking to avoid the deadliest features of America's spring experience with coronavirus, when the virus ripped through nursing homes from New York to Seattle.
But some of the pandemic's most horrific aspects of the spring surge are recurring now: the virus is already spreading fast in Florida nursing homes, possibly via workers. Texas hospitals overwhelmed with bodies recently requested refrigerated trucks, just as New York hospitals stored cadavers in freezer trucks in March.
More than 20,000 people in New York City have died of covid-19, far more than in any other city. But the case numbers have dropped precipitously since the spring. This week, New York celebrated its first day in months without a coronavirus-related death.
States where numbers are surging will have to take dramatically more aggressive action if they, too, want to bend the fatality curve, experts say.
A number of states - including Alabama, Arkansas and Colorado - added mask mandates this week, pushing the national total to more than half of all states.
Companies have also contributed to the push for masks, with Lowe's on Friday joining Walmart, Target, CVS and other national retailers in announcing that shoppers will now be required to mask up.
Some governors, however, continued to resist the idea. Arizona Republican Gov. Doug Ducey has allowed municipalities to enact mask ordinances, but he has declined to issue one statewide or to reverse key pillars of the state's reopening.
Experts say the response has been insufficient to save lives.
"I don't think that's enough when you're a hot spot," Marvasti said. "A statewide [mask] mandate would make sense."
Georgia Republican Gov. Brian Kemp has gone so far in his opposition to mask mandates that he struck down local rules on Wednesday, then on Thursday he sued to block implementation of Atlanta's requirement. Kemp has argued the rules are "unenforceable." But medical experts, including the head of the CDC, say masks are one of the most effective tools available in curbing the spread of a virus that has claimed more than 3,000 Georgians.
In an appearance on NBC's "Today" show, Atlanta Democratic Mayor Keisha Lance Bottoms accused Kemp on Friday of "putting politics over people."
"I'm in quarantine as we speak, so I take this very seriously, and I will continue to do everything in my power to protect the people of Atlanta," said Bottoms, who with her husband and her son is one of more than 100,000 positive coronavirus cases in the state. "And the governor has simply overstepped his bounds and his authority, and we'll see him in court."
Trump has long been dismissive of the need for masks, as have many Republican governors. But not all.
Maryland Gov. Larry Hogan, chairman of the National Governors Association, said Friday in an appearance on ABC's "Good Morning America" that masks should be mandated in states across the country, calling them "the most effective thing" to stop the spread of the coronavirus.
"If everyone were wearing masks when they're in public and in contact, the virus cannot spread," Hogan said.