U.S. death toll approaches 180,000

The total number of cases reported in the United States was also approaching a worrying new milestone, on track to exceed 6 million in the next few days, according to The Post's data.

The rolling average for new daily cases trended slightly downward nationwide over the past week, and hospitalizations fell by about 9%. The country is consistently reporting more than 40,000 new infections per day - nearly double the number reported daily in May and June - and states across the Midwest and the South continued to report spikes.

The data presented a mixed outlook on the pandemic's trajectory going into the fall, said former Food and Drug Administration commissioner Scott Gottlieb.

"We should have seen infection levels come down in July and August. They didn't. We saw an epidemic cross over the Sun Belt, and we saw infections actually increase," Gottlieb told CBS News's "Face the Nation" on Sunday.

"They're coming down now, so that's a good sign," he said, adding that the decline in hospitalizations was "the most objective near-term measure" of the state of the epidemic. "But as we head into September and October - kids return to school, people are starting to return to work - we're likely to see infections start to go back up again, and we know that hospitalizations lag infections." 

The country has reported at least 1,000 deaths per day for most of the past six weeks, pushing the U.S. death toll far beyond what officials optimistically predicted in the early stages of the pandemic. California, Florida and Texas regularly tally more than 100 deaths daily, even as those states have reported progress in slowing the spread of new cases. Some smaller states, including Arizona, Georgia and Louisiana, have added several dozen deaths per day on average over the past month.

After declining for weeks, daily deaths started rising again in early July, lagging several weeks behind the wave of cases that swept across the South and the West the previous month. This marked a change from earlier in the pandemic, when deaths followed infections more closely. Health experts say the longer time lag was probably the result of expanded testing, earlier diagnoses, and young, healthy people passing on the virus to older, more vulnerable adults, who died later of their infections.

The most concerning trend, Gottlieb said, was an uptick in cases in rural parts of the country, where outbreaks could quickly overwhelm local health-care systems. "They don't have the same kinds of hospitals and the same kinds of resources to deal with an epidemic like this," he said.

Infections trended upward over the past week in the Dakotas, Iowa, Kansas, Minnesota and Nebraska, and have flatlined in Illinois and Wisconsin, according to The Post's tracking.

Iowa recorded the biggest jump, with per capita infections rising 106% over the past week and daily cases topping 1,000 for several days straight. Until last week, the state was reporting about 500 cases per day on average and had never reported more than 900 in a day.

The spike was attributable to a combination of factors, including outbreaks at the University of Iowa and Iowa State, said Jorge Salinas, a hospital epidemiologist at the University of Iowa health-care system. More than 600 students at the University of Iowa and 130 students, faculty and staff members at Iowa State have tested positive since the academic year began in mid-August, according to the schools.

"It's already catastrophic and terrible that this many young people would get sick," Salinas told The Post. "That should have been avoided.

"But the main problem is the transition to the general population - to older communities to nursing homes," he said. "The more virus is circulating in the community, the more likely it is that it will invade those sanctuaries that we're trying to preserve." 

Technical glitches in the state health department's data collection also have contributed to the recent high numbers, Salinas said, though he emphasized that infections were still rising overall.

State officials acknowledged this month that the department's computer system had been incorrectly dating some recent test results to several months ago, causing a backlog that had to be fixed. That error and others have led local officials and experts to voice doubts about the accuracy of the state's reporting, which has informed crucial decisions about whether to reopen schools and businesses.

The Dakotas are grappling with similar spikes, with both states reporting record numbers of daily cases in recent days. South Dakota's per capita infections climbed more than 100% over the past week, while North Dakota's rose about 41%, according to The Post's tracking.

"The Midwest is warming up, and we're seeing relatively similar patterns to what was seen in the Southern United States," Salinas said.

The virus is also resurging in Alabama, with a cluster of infections growing rapidly at the University of Alabama's Tuscaloosa campus. School officials have reported more than 1,000 cases since classes began Aug. 19, marking the largest outbreak at any educational institution since the start of the new academic year. Statewide, new daily cases rose by more than 53% over the past week.

Even as the virus has cropped up in new places, nationwide coronavirus testing has declined over the past month. The rolling weekly average for tests performed in a day has fallen from a peak of about 821,000 at the end of July to about 698,500 on Aug. 29, according to the Covid Tracking Project.

In Washington, the Trump administration again signaled that it was prepared to fast-track a vaccine if the benefits outweighed the risks. Food and Drug Administration Commissioner Stephen Hahn said the agency was open to granting emergency approval for a vaccine before Phase 3 clinical trials were complete.

"It is up to the sponsor [vaccine developer] to apply for authorization or approval, and we make an adjudication of their application," Hahn told the Financial Times in an interview published Sunday. "If they do that before the end of Phase Three, we may find that appropriate. We may find that inappropriate, we will make a determination."