Category Archives: Personal Protective Equipment (PPE)

‘The virus doesn’t care about excuses’: US faces terrifying autumn as Covid-19 surges

Posted on by • Posted in 2020 Election Issues, Asymptomatic Transmission, Blame, Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Credibility, Crisis, Crisis Management, Economic Crisis, Economy Reopening, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Expert Opinion, False Hope, False Narrative, False Reassurance, Health Policy, Health System, Herd Immunity, Hospital, Hospital Industry, Infection Control, Infection Control Plan, Infectious Virus, Job, Job Loss, Job Market, Job Search, Job Security, Leadership Decentralized, Misinformation, Mislead, Misleading, Mistake, Mistrust, Mixed Message, Mortality, National Strategy, Pandemic, Partisanship, Personal Protective Equipment (PPE), Preexisting Conditions, Public Health, Public Safety, Quarantine, School Reopening, Scientists, Social Distancing, Trust, Truth, Uncertainty, Underinsured, Unemployment, Unemployment Insurance, Uninsured, Vulnerable Populations, Wishful Thinking • Leave a comment

https://www.theguardian.com/world/2020/jul/18/us-coronavirus-fall-second-wave-autumn

The breathing space afforded by lockdowns in the spring has been squandered, with new cases running at five times the rate of the whole of Europe. Things will only get worse, experts warn.

In early June, the United States awoke from a months-long nightmare.

Coronavirus had brutalized the north-east, with New York City alone recording more than 20,000 deaths, the bodies piling up in refrigerated trucks. Thousands sheltered at home. Rice, flour and toilet paper ran out. Millions of jobs disappeared.

But then the national curve flattened, governors declared success and patrons returned to restaurants, bars and beaches. “We are winning the fight against the invisible enemy,” vice-president Mike Pence wrote in a 16 June op-ed, titled, “There isn’t a coronavirus ‘second wave’.”

Except, in truth, the nightmare was not over – the country was not awake – and a new wave of cases was gathering with terrifying force.

As Pence was writing, the virus was spreading across the American south and interior, finding thousands of untouched communities and infecting millions of new bodies. Except for the precipitous drop in New York cases, the curve was not flat at all. It was surging, in line with epidemiological predictions.

Now, four months into the pandemic, with test results delayed, contact tracing scarce, protective equipment dwindling and emergency rooms once again filling, the United States finds itself in a fight for its life: swamped by partisanship, mistrustful of science, engulfed in mask wars and led by a president whose incompetence is rivaled only by his indifference to Americans’ suffering.

With flu season on the horizon and Donald Trump demanding that millions of students return to school in the fall – not to mention a presidential election quickly approaching – the country appears at risk of being torn apart.

“I feel like it’s March all over again,” said William Hanage, a professor of epidemiology at the Harvard TH Chan School of Public Health. “There is no way in which a large number of cases of disease, and indeed a large number of deaths, are going to be avoided.”

The problem facing the United States is plain. New cases nationally are up a remarkable 50% over the last two weeks and the daily death toll is up 42% over the same period. Cases are on the rise in 40 out of 50 states, Washington DC and Puerto Rico. Last week America recorded more than 75,000 new cases daily – five times the rate of all Europe.

“We are unfortunately seeing more higher daily case numbers than we’ve ever seen, even exceeding pre-lockdown times,” said Jennifer Nuzzo, an epidemiologist at the Johns Hopkins Center for Health Security. “The number of new cases that occur each day in the US are greater than we’ve yet experienced. So this is obviously a very worrisome direction that we’re headed in.”

The mayor of Houston, Texas, proposed a “two-week shutdown” last week after cases in the state climbed by tens of thousands. The governor of California reclosed restaurants, churches and bars, while the governors of Louisiana, Alabama and Montana made mask-wearing in public compulsory.

“Today I am sounding the alarm,” Governor Kate Brown said. “We are at risk of Covid-19 getting out of control in Oregon.”

As dire as the current position seems, the months ahead look even worse. The country anticipates hundred of thousands of hospitalizations, if the annual averages hold, during the upcoming flu season. Those hospitalizations will further strain the capacity of overstretched clinics.

But a flu outbreak could also hamper the country’s ability to fight coronavirus in other ways. Because the two viruses have similar symptoms – fever, chills, diarrhea, fatigue – mistaken diagnoses could delay care for some patients until it’s too late, and make outbreaks harder to catch, one of the country’s top health officials has warned.

“I am worried,” Dr Robert Redfield, the director of the Centers for Disease Control (CDC), said last week. “I do think the fall and the winter of 2020 and 2021 are probably going to be one of the most difficult times that we have experienced in American public health because of … the co-occurrence of Covid and influenza.”

Other factors will be in play. A precipitous reopening of schools in the fall, as demanded by Trump and the education secretary, Betsy DeVos, without safety measures recommended by the CDC, could create new superspreader events, with unknown consequences for children.

“We would expect that to be throwing fuel on the fire,” said Hanage of blanket school reopenings. “So it’s going to be bad over the next month or so. You can pretty much expect it to be getting worse in the fall.”

The list of aggravating circumstances goes on and on. A federal unemployment assistance program that gave each claimant an extra $600 a week is set to expire at the end of July. A new coronavirus relief package is being held up in Congress by Republicans’ accusations that states are wasting money, and their insistence that any new legislation include liability protections for businesses that reopen during the pandemic.

Cable broadcasts and social media have been filled, meanwhile, with video clips of furious confrontations on sidewalks, in stores and streets over wearing facial masks. In Michigan, a sheriff’s deputy shot dead a man who had stabbed another man for challenging him about not wearing a mask at a convenience store. In Georgia, the Republican governor sued the Democratic mayor of Atlanta for issuing a city-wide mask mandate.

The partisan divide on masks is slowly closing as the outbreaks intensify. The share of Republicans saying they wear masks whenever they leave home rose 10 points to 45% in the first two weeks of July, while 78% of Democrats reported doing so, according to an Axios-Ipsos poll.

Another divide has proven tragically resilient. As hotspots have shifted south, the virus continues to affect Black and Latinx communities disproportionately. Members of those communities are three times as likely to become infected and twice as likely to die from the virus as white people, according to data from early July.

The raging virus has prompted speculation in some corners that the only way out for the United States is through some kind of “herd immunity” achieved by simply giving up. But that grossly underestimates the human tragedy such a scenario would involve, epidemiologists say, in the form of tens of millions of new cases and unknown thousands of deaths.

“I think that every single serology study that’s been done to date suggests that the vast majority of Americans have not yet been exposed to this virus,” Nuzzo said. “So we’re still very much in the early stages.

“Which is good, that’s actually really good news. I don’t want to strive for herd immunity, because that means the vast majority of us will get sick and that will mean many, many more deaths. The point is to slow the spread as much as possible, protect ourselves as much as possible, until we have other tools.”

But the ability of the US to take that basic step – to slow the spread, as dozens of other countries have done – is in perilous doubt. After half a year, the Trump administration has made no effort to establish a national protocol for testing, contact tracing and supported isolation – the same proven three-pronged strategy by which other countries control their outbreaks.

Critics say that instead, Trump has dithered and denied as the national death toll climbed to almost 140,000. The Democratic presidential candidate, Joe Biden, who is hoping to unseat Trump in November, blasted the president for refusing until recently to wear a mask in public.

“He wasted four months that Americans have been making sacrifices by stoking divisions and actively discouraging people from taking a very basic step to protect each other,” Biden said in a statement last weekend.

Meanwhile the White House has attacked Dr Anthony Fauci, the country’s foremost expert on infectious diseases whose refusal to lie to the public has enraged Trump, by publishing an op-ed signed by one of the president’s top aides titled “Anthony Fauci has been wrong about everything I have interacted with him on” and by releasing a file of opposition research to the Washington Post.

Trump claimed the number of cases was a function of unusually robust testing, though experts said that positivity rates of 20% in multiple states suggested that the United States is testing too little – and that in any case closing one’s eyes to the problem by testing less would not make it go away.

“We’ve done 45 million tests,” Trump said this week, padding the figure only slightly. “If we did half that number, you’d have half the cases, probably around that number. If we did another half of that, you’d have half the numbers. Everyone would be saying we’re doing well on cases.”

Such statements by Trump have encouraged unfavorable comparisons of the US pandemic response with those in countries such as Italy, which recorded just 169 new cases on Monday after a horrific spring, and South Korea, which has kept cases in the low double-digits since April.

But the United States could also look to many African countries for lessons in pandemic response, said Amanda McClelland, who runs a global epidemic prevention program at Resolve to Save Lives.

“We’ve seen some good success in countries like Ghana, who have really focused on contact tracing, and being able to follow up superspreading events,” said McClelland. “We see Ethiopia: they kept their borders open for a lot longer than other countries, but they have really aggressive testing and active case-finding to make sure that they’re not missing cases.

“I think what we’ve seen is that you need not just a strong health system but strong leadership and governance to be able to manage the outbreak, and we’ve seen countries that have all three do well.”

But in America, the large laboratories that process Covid-19 tests are unable to keep up with demand. Quest Diagnostics announced on Tuesday that the turnaround time for most non-emergency test results was at least seven days.

“We want patients and healthcare providers to know that we will not be in a position to reduce our turnaround times as long as cases of Covid-19 continue to increase dramatically,” the lab said.

“You can’t have unlimited lab capacity, and what we’ve done is allow, to some extent, cases to go beyond our capacity,” said McClelland. “We’re never going to be able to treat and track and trace uncontrolled transmission. This outbreak is just too infectious.”

Public health experts emphasize that the United States does not have to accept as its fate a cascade of tens of millions of new cases, and tens of thousands of deaths, in the months ahead. Focused leadership and individual resolve could yet help the country follow in the footsteps of other nations that have successfully faced serious outbreaks – and brought them under control.

But it is clear that the most vulnerable Americans, including the elderly and those with pre-existing conditions, face grave danger. Republicans have argued in recent weeks that while cases in the US have soared, death rates are not climbing so quickly, because the new cases are disproportionately affecting younger adults.

That is a false reassurance, health experts say, because deaths are a lagging indicator – cases necessarily rise before deaths do – and because large outbreaks among any demographic group speeds the virus’s ability to get inside nursing homes, care facilities and other places where residents are most vulnerable.

“If we don’t do anything to stop the virus, it’s going to be very difficult to prevent it from getting to people who will die,” said Nuzzo.

There is a question of whether the United States, for all its wealth and expertise – and its self-regard as an exceptional actor on the world stage – can summon the will to keep up the fight. People are tired of fighting the virus, and of fighting each other.

“I think unfortunately people are emotionally exhausted from having to think about and worry about this virus,” said Nuzzo. “They feel like they’ve already sacrificed a lot. So the worry that I have is, what willingness is there left, to do what it takes?”

It is as if the country is “treading water in the middle of the ocean”, Hanage said.

“People tend to be shuffling very quickly between denial and fatalism,” he said. “That’s really not helpful. There are a number of things that can be done.

“What I would hope is that this marks a point when the United States finally wakes up and realizes that this is a pandemic and starts taking it seriously.

“Folks tend to look at what has happened elsewhere and then they make up some kind of magical reason why it’s not going to happen to them.

“People keep making these excuses, and the virus doesn’t care about the excuses. The virus just keeps going. If you give it the opportunity, it will take it.”

 

 

 

 

Pinning hopes on vaccine is not the right coronavirus strategy, expert says

Posted on by • Posted in 2020 Election Issues, Asymptomatic Transmission, Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Infection Control, Infection Control Plan, Infectious Virus, Intensive Care (ICU), Mortality, National Strategy, Pandemic, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Social Distancing, Vaccine • Leave a comment

https://www.cnn.com/2020/07/22/health/us-coronavirus-wednesday/index.html

As cases continue to rise, Americans looking to a vaccine as the way out of the coronavirus pandemic should consider a more comprehensive approach, a leading medical expert told CNN on Wednesday.

“Pinning all our hopes on a vaccine that works immediately is not the right strategy,” Dr. William Haseltine, a former professor at Harvard University’s medical and public health schools, told CNN’s Wolf Blitzer.
Haseltine said a broad public health strategy is a better way to contain the spread of the virus along with the help of a vaccine and therapeutic drugs. Mandating masks will help but Haseltine said, “we need a lot more than masks to contain this epidemic that’s running through our country like a freight train.”
Haseltine recommended closing bars and other places where young people congregate at night and ban holding large meetings in the worst-hit regions. Life won’t get better until people make major changes to their behavior and public health services come forward with more resources, he said.
He said a vaccine is still six months away at the earliest and he warned not to underestimate a coronavirus. Haseltine, known for his work on fighting cancer and HIV/AIDS, said it won’t be easy to develop a vaccine.
“These are tricky viruses,” he said. “It’s not as simple as measles or mumps. It’s going to be a lot more complicated”.
Any Covid-19 vaccine that’s sponsored by the US government will be free or affordable for the American public, Health and Human Services Secretary Alex Azar told CNBC on Wednesday.
“For any vaccine that we have bought — so for instance the Pfizer vaccine — those hundred million doses would actually be acquired by the US government, then given for free to Americans,” Azar said.
He said the same would apply with the AstraZeneca and the Novovax vaccines.
“We will ensure that any vaccine that we’re involved in sponsoring is either free to the American people or is affordable,” Azar said.
And while some anti-mask protesters refuse to wear a piece of cloth to help save American lives, enormous signs of altruism have emerged.
More than 100,000 people have volunteered to participate in Covid-19 vaccine clinical trials, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.
“I think we’ll be fine with regards to getting enough people,” Fauci said during a webinar Wednesday with the TB Alliance.

1 million more cases in two weeks

The US is heading in the wrong direction with Covid-19 numbers, and it’s doing so with astonishing speed.
Just after 1,000 people died in a single day, the country is about to reach 4 million Covid-19 cases.
To put that in perspective, the first reported case came on January 21. After 99 days, 1 million Americans became infected.
It took just 43 days after that to reach 2 million cases.
And 28 days later, on July 8, the US reached 3 million cases. The 4 millionth case could come just two weeks after that.
As of Wednesday night, more than 3.96 million people had been infected across the US, and more than 143,000 have died, according to data from Johns Hopkins University.
Some states are reporting record-breaking numbers of new cases. Johns Hopkins reported at least 68,706 new cases and 1,152 deaths in the US on Wednesday.
More governors are requiring masks, and dozens of hospitals are out of intensive care unit beds.
President Donald Trump said the United States has now conducted more than 50 million coronavirus tests. He told reporters at a White House briefing that people should wear masks, pay attention to social distancing and wash their hands. While hot spots like Florida and Texas have popped up, it’s all going to work out, he said.
“We’re all in this together,” he said.

Covid-19 a leading cause of death in L.A. County

California, the most populous state and the first to shut down months ago, appeared to have Covid-19 under control — only to suffer a massive resurgence and surpass New York with the most coronavirus cases in the nation.
This month, state Gov. Gavin Newsom shut down bars and indoor restaurant services again due to an influx of cases after reopening.
Covid-19 is set to become one of the leading causes of death in Los Angeles County, according to Barbara Ferrer, the county’s health director.
“It’s killing more people than Alzheimer’s disease, other kinds of heart disease, stroke and COPD,” Ferrer said, referring to chronic obstructive pulmonary disease, which causes airflow blockage and breathing issues.
Comparing Covid-19 to the flu, Ferrer said data shows Covid-19 killed twice as many people in six months as the flu did in eight months.

Where cases are surging

Some politicians, including the President, have insisted that much of the soaring case numbers are a reflection of increased testing.
But the surge is new cases has greatly outpaced the increase in testing, with troubling rates of transmission and test positivity in many states.
A CNN analysis of testing data from the Covid Tracking Project reveals the positive test rate — or the average number of positive test results out of 1,000 tests performed — has increased significantly in many of the current hotspots, including Florida, Arizona, Texas and Georgia.
Florida saw an average rate of 35 positive results per 1,000 tests during the month of May. But in June, that number nearly tripled to 105. So far in July, the average rate of test positivity has been 187 out of 1,000.
But Florida Gov. Ron DeSantis said the state is on the “right course” in the fight against the virus.
“I think we will continue to see improvements,” the governor said Tuesday. “We just have to, particularly Floridians, have to continue doing the basic things.”
Over the weekend, nearly 50 Florida hospitals said they were out of ICU beds. Statewide, the ICU bed availability had dwindled to 15.98% on Tuesday, down from about 18.1% on Monday.
And new data from the CDC also show infections could be more than 10 times higher than the number of reported cases in some parts of the US.

More mask mandates lead to decreased death projections

Researchers estimate the US will have 219,864 total Covid-19 deaths by November 1, according to the Institute for Health Metrics at the University of Washington.
That’s actually a decrease of about 5,000 deaths from the IHME’s previous forecast of 224,546 by that date.
The reasons for the slightly better forecast include more face masks mandates, more people wearing masks, and more people practicing social distancing, the researchers said.
“So a mandate is very important and helping, and a national mandate, of course, would do much better,” said Ali Mokdad, a professor of health metrics sciences at the IHME.
If Americans wore masks nationwide, the number of total deaths by November 1 would drop to 185,887, the researchers project. But if the mandates ease more, the US could have 231,012 deaths by November 1.
At least 41 states have some kind of mask requirement in place or planned. Starting Saturday, Minnesota will require people to wear masks inside businesses or indoor public settings. People who have conditions that make “it unreasonable for the individual to maintain a face covering are exempt from the order,” Gov. Tim Walz said.
Trump said Wednesday he would make a decision over the next day on whether to mandate masks on federal property.

Major testing delays make tracing almost useless

With the high transmission levels of the virus, traditional contact tracing has now become “impractical and difficult to do,” said California Health Secretary Dr. Mark Ghaly.
The state is working to refine strategies and continue to work with counties to build up their “tracing army,” but Ghaly warns that “even a very robust contact tracing program will have a hard time reaching out to every single case.”
Contact tracing is now harder all over the nation while testing results take days, Fauci said.
Quest Diagnostics, a leading commercial testing lab, said in a news release Monday that for some patients, testing results can take up to two weeks.
“The time frame from when you get a test to the time you get the results back is sometimes measured in a few days,” Fauci said Tuesday.
“If that’s the case, it kind of negates the purpose of the contract tracing because if you don’t know if that person gets the results back at a period of time that’s reasonable, 24 hours, 48 hours at the most … that kind of really mitigates against getting a good tracing and a good isolation.”

 

 

 

5 COVID-19 myths politicians have repeated that just aren’t true

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Coronavirus, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, False Hope, False Narrative, Herd Immunity, Misinformation, Misinterpret, Mislead, Misleading, Mistrust, Mixed Message, Pandemic, Partisanship, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Social Distancing, Transparency, Trust, Truth, Wishful Thinking • Leave a comment

https://theconversation.com/5-covid-19-myths-politicians-have-repeated-that-just-arent-true-141972

5 COVID-19 myths politicians have repeated that just aren't true ...

The number of new COVID-19 cases in the U.S. has jumped to around 50,000 a day, and the virus has killed more than 130,000 Americans. Yet, I still hear myths about the infection that has created the worst public health crisis in America in a century.

The purveyors of these myths, including politicians who have been soft peddling the impact of the coronavirus, aren’t doing the country any favors.

Here are five myths I hear as director of health policy at the University of Southern California’s Schaeffer Center that I would like to put to rest.

Myth: COVID-19 is not much worse than the flu

President Donald Trump and plenty of pundits predicted early on that COVID-19 would prove no more lethal than a bad flu. Some used that claim to argue that stay-at-home orders and government-imposed lockdowns were un-American and a gross overreaction that would cost more lives than they saved.

By the end of June, however, the director of the Centers for Disease Control and Prevention announced that national antibody testing indicated 5% to 8% of Americans had already been infected with the virus. With over 130,000 confirmed COVID-19-related deaths – and that’s likely an undercount – the case fatality rate is around 0.49% to 0.78% or about four to eight times that of the flu.

Brazilian President Jair Bolsonaro, who also downplayed COVID-19 as the death toll grew, calling it a “little flu,” announced on July 7 that he had tested positive for the coronavirus.

5 COVID-19 myths politicians have repeated that just aren't true

 

Myth: Cases are increasing because testing is increasing

At one point, the idea that COVID-19 case numbers were high because of an increase in testing made intuitive sense, especially in the early stages of the pandemic when people showing up for tests were overwhelmingly showing symptoms of possible infection. More testing meant health officials were aware of more illnesses that would have otherwise gone under the radar. And testing predominately sick and symptomatic people can result in an overestimate of its virulence.

Now, with millions of tests conducted and fewer than 10% coming back positive, the U.S. knows what it is facing. Testing today is essential to finding the people who are infected and getting them isolated.

Unfortunately, Trump has been a leading purveyor of the myth that we test too much. Fortunately, his medical advisers disagree.

Myth: Lockdowns were unnecessary

Given the current spike in infections after reopening the economy, more people are arguing that the lockdowns were unsuccessful in crushing the virus and shouldn’t have been implemented at all. But what would the country look like today if state governments had tried to build herd immunity by letting the disease spread rather than promoting social distancing, prohibiting large gatherings and telling the elderly to stay home?

Most epidemiologists who study pandemics believe that reaching herd immunity could only be achieved at enormous cost in terms of illness and death. About 60% or 70% of Americans would have to become infected before the spread of the virus diminished. That would result in 1 to 2 million U.S. deaths and 5 to 10 million hospitalizations.

These are horrific, yet conservative estimates, given that mortality rates would surely rise if that many people were infected and hospitals were overrun.

5 COVID-19 myths politicians have repeated that just aren't true

Myth: The epidemiological models are always wrong

It is not surprising that many people are confused by the proliferation of predictions about the course of the virus. How many people become infected depends on how individuals, governments and institutions respond, which is hard to predict.

Faced with the warning early in the pandemic that 1 to 2 million Americans could die if the U.S. simply let the coronavirus run its course, federal and state governments imposed restrictions to constrain the spread of the virus. Then, they relaxed those restrictions as new cases ebbed and pressure mounted to reopen the economy.

Now, they must consider reimposing some of those restrictions as infection rates rise in a majority of states, including Texas, Arizona, Florida and California. The models were based on data and assumptions at that time, and likely influenced responses which in turn changed underlying conditions. For example, new cases of COVID-19 are rising in the U.S., while fatalities are falling. This reflects a shift in infection rates toward younger populations, as well as improved treatment as providers learn more about the virus.

Just like an investment disclaimer that past returns do not guarantee future performance, modeling a pandemic should be seen as suggestive of what might happen given current information and not a law of nature.

Myth: It’s a second wave

Sadly, the myth here is that we have contained the virus enough to buy time to prepare for a second wave. In fact, the first wave just keeps getting bigger.

A second wave would require a trough in the first wave, but there is little evidence of that from either an epidemiologic or economic perspective.

5 COVID-19 myths politicians have repeated that just aren't true

During the 1918-1919 flu pandemic, the weekly UK death toll from influenza and pneumonia, shown here, reflected three clear waves. Taubenberger JK, Morens DM. 1918 Influenza: the Mother of All Pandemics. Emerg Infect Dis. 2006;12(1)

The U.S. recorded a record number of new cases during the first week of July, exceeding 50,000 per day for four straight days. The rising number of cases led several states to halt or roll back their reopening plans in hopes of stemming the spread of the virus.

Meanwhile, most consumers are reticent to return to “normal” economic activity: Fewer than one-third of adults surveyed by Morning Consult in early July were comfortable going to a shopping mall. Only 35% were comfortable going out to eat, and 18% were comfortable going to the gym. For almost half of the population, an effective treatment or vaccine may be the only way they will feel comfortable returning to “normal” economic activity.

COVID-19 is an immediate threat that requires a unified, science-based response from governments and citizens to be successful. But it is also an opportunity to rethink how we prepare for future pandemics. Some misinformation is inevitable as a new virus emerges, but perpetuating myths for political or other reasons ultimately costs lives.

 

 

The Constitution doesn’t have a problem with mask mandates

Posted on by • Posted in 2020 Election Issues, Asymptomatic Transmission, Common Good, Coronavirus, Free Speech, Freedom, Freedom of the Press, Fundamental Rights, Infection Control, Infection Control Plan, Infectious Virus, Mortality, Pandemic, Personal Protective Equipment (PPE), Police Power, Public Good, Public Health, Public Safety, Public Welfare, Quarantine, Social Distancing, Supreme Court, Vaccination • Leave a comment

https://theconversation.com/the-constitution-doesnt-have-a-problem-with-mask-mandates-142335?utm_medium=email&utm_campaign=Latest%20from%20The%20Conversation%20for%20July%2022%202020%20-%201684316250&utm_content=Latest%20from%20The%20Conversation%20for%20July%2022%202020%20-%201684316250+Version+A+CID_3a4842bdc1542ab5ad1725fad090f099&utm_source=campaign_monitor_us&utm_term=The%20Constitution%20doesnt%20have%20a%20problem%20with%20mask%20mandates

The Constitution doesn't have a problem with mask mandates

Many public health professionals and politicians are urging or requiring citizens to wear face masks to help slow the spread of the COVID-19 virus.

Some Americans have refused, wrongly claiming mask decrees violate the Constitution. An internet search turns up dozens of examples.

“Costco Karen,” for instance, staged a sit-in in a Costco entrance in Hillsboro, Oregon after she refused to wear a mask, yelling “I am an American … I have rights.”

A group called Health Freedom Idaho organized a protest against a Boise, Idaho, mask mandate. One protester said, “I’m afraid where this country is headed if we just all roll over and abide by control that goes against our constitutional rights.”

As one protester said, “The coronavirus doesn’t override the Constitution.”

Speaking as a constitutional law scholar, these objections are nonsense.

The objections

It is not always clear why anti-maskers think government orders requiring face coverings in public spaces or those put in place by private businesses violate their constitutional rights, much less what they think those rights are. But most of the mistaken objections fall into two categories:

Mandatory masks violate the First Amendment right to speech, assembly, and especially association and mandatory masks violate a person’s constitutional right to liberty and to make decisions about how to their own health and bodily integrity.

They’re not mutually exclusive claims: A lawsuit filed by four Florida residents against Palm Beach County, for example, argues that mask mandates “interfere with … personal liberty and constitutional rights,” such as freedom of speech, right to privacy, due process, and the “constitutionally protected right to enjoy and defend life and liberty.” The lawsuit asks the court to issue a permanent injunction against the county’s mask mandate.

Responding to a reporter who asked why President Donald Trump appeared unconcerned about the absence of masks and social distancing at a campaign rally in Tulsa, Vice President Mike Pence said: “I want to remind you again freedom of speech and the right to peaceably assemble is in the Constitution of the U.S. Even in a health crisis, the American people don’t forfeit our constitutional rights.”

What the First Amendment does – and doesn’t – do

The First Amendment protects freedom of speech, press, petition, assembly and religion.

There are two reasons why mask mandates don’t violate the First Amendment.

First, a mask doesn’t keep you from expressing yourself. At most, it limits where and how you can speak. Constitutional law scholars and judges call these “time, place, and manner” restrictions. If they do not discriminate on the basis of the content of the speech, such restrictions do not violate the First Amendment. An example of a valid time, place and manner restriction would be a law that limits political campaigning within a certain distance of a voting booth.

Additionally, the First Amendment, like all liberties ensured by the Constitution, is not absolute.

All constitutional rights are subject to the goverment’s authority to protect the health, safety and welfare of the community. This authority is called the “police power.” The Supreme Court has long held that protecting public health is sufficient reason to institute measures that might otherwise violate the First Amendment or other provisions in the Bill of Rights. In 1944, in the case of Prince v. Massachusetts, for example, the Supreme Court upheld a law that prohibited parents from using their children to distribute religious pamphlets on public streets.

The right to liberty

Some anti-maskers object that masks violate the right to liberty.

The right to liberty, including the right to make choices about one’s health and body, is essentially a constitutional principle of individual autonomy, neatly summarized as “My body, my choice.”

The 1905 case of Jacobsen v. Massachusetts shows why mask mandates don’t violate any constitutional right to privacy or health or bodily integrity. In that case, the Supreme Court upheld a smallpox vaccination requirement in Cambridge, Massachusetts.

The court said that the vaccination requirement did not violate Jacobsen’s right to liberty or “the inherent right of every freeman to care for his own body and health in such way as to him seems best.”

As the court wrote, “There are manifold restraints to which every person is necessarily subject for the common good. On any other basis, organized society could not exist with safety to its members.” In a 1995 New York case, a state court held that an individual with active tuberculosis could be forcibly detained in a hospital for appropriate medical treatment.

Even if you assume that mask mandates infringe upon what the Supreme Court calls “fundamental rights,” or rights that the court has called the “very essence of a scheme of ordered liberty,” it has consistently ruled states can act if the restrictions advance a compelling state interest and do so in the least restrictive manner.

Rights are conditional

As the Jacobsen ruling and the doctrine of time, place and manner make clear, the protection of all constitutional liberties rides upon certain necessary – but rarely examined – assumptions about communal and public life.

One is that is constitutional rights – whether to liberty, speech, assembly, freedom of movement or autonomy – are held on several conditions. The most basic and important of these conditions is that our exercise of rights must not endanger others (and in so doing violate their rights) or the public welfare. This is simply another version of the police power doctrine.

Unfortunately, a global pandemic in which a serious and deadly communicable disease can be transmitted by asymptomatic carriers upsets that background and justifies a wide range of reasonable restrictions on our liberties. Believing otherwise makes the Constitution a suicide pact – and not just metaphorically.

 

 

 

 

Hospital margins could sink to a negative 7% this year: 5 things to know

Posted on by • Posted in Bankruptcy, Cash, Cash Reserves, Cash-Flow Improvements, Coronavirus, Credit, Credit Quality, Credit Ratings, Crisis, Crisis Management, Economic Stimulus, Financial Pressure, Financial Viability, Financially Distressed, Health Policy, Health System, Hospital, Hospital Industry, Net Income, Nonoperating Income, Operating Expenses, Operating Income, Operating Margin, Operating Performance, Operating Revenue, Pandemic, Personal Protective Equipment (PPE), Supply Chain, The CARES Act • Leave a comment

https://www.beckershospitalreview.com/finance/hospital-margins-could-sink-to-a-negative-7-this-year-5-things-to-know.html?utm_medium=email

New Kaufman Hall Report: Hospital Finances Crashed in April ...

The COVID-19 pandemic has created financial challenges for hospitals and health systems, and, without additional federal aid, half of US hospitals could be operating in the red in the second half of this year, according to an analysis released by the American Hospital Association on July 21.

Five takeaways from the analysis: 

1. Before the COVID-19 pandemic, the median hospital margin was 3.5 percent. COVID-19 is expected to drive the median hospital margin from positive to negative. 

2. Without funding from the Coronavirus Aid, Relief and Economic Security Act, hospital margins would have been a negative 15 percent in the second quarter of 2020. Margins are still expected to drop to a negative 3 percent in the second quarter.

3. Without additional aid from the federal government, hospital margins could sink to a negative 7 percent in the second half of this year. 

4. In the second quarter of this year, nearly half of U.S. hospitals had negative margins. Those hospitals will remain with negative margins without further financial support.  

5. “Heading into the COVID-19 crisis, the financial health of many hospitals and health systems were challenged, with many operating in the red,” said hospital association President and CEO Rick Pollack in a news release. “As today’s analysis shows, this pandemic is the greatest financial threat in history for hospitals and health systems and is a serious obstacle to keeping the doors open for many.” 

The full report, prepared by Kaufman, Hall & Associates and released by the AHA, is available here. 

 

 

 

 

Mask resistance during a pandemic isn’t new – in 1918 many Americans were ‘slackers

Posted on by • Posted in 2020 Election Issues, Change, Change Management, Changing Behavior, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy Reopening, Evidence-Based Care, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, False Hope, False Narrative, History, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Misinformation, Misinterpret, Mislead, Misleading, Mistake, Mistrust, Mixed Message, Mortality, National Strategy, Pandemic, Partisanship, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Scientists, Social Distancing, Social Responsibility, Wishful Thinking • Leave a comment

https://theconversation.com/mask-resistance-during-a-pandemic-isnt-new-in-1918-many-americans-were-slackers-141687?utm_medium=email&utm_campaign=The%20Weekend%20Conversation%20-%201680716207&utm_content=The%20Weekend%20Conversation%20-%201680716207+Version+A+CID_c211e1b0b6c4b69b3a29a9d1624a2ab6&utm_source=campaign_monitor_us&utm_term=Mask%20resistance%20during%20a%20pandemic%20isnt%20new%20%20in%201918%20many%20Americans%20were%20slackers

Mask resistance during a pandemic isn't new – in 1918 many ...

We have all seen the alarming headlines: Coronavirus cases are surging in 40 states, with new cases and hospitalization rates climbing at an alarming rate. Health officials have warned that the U.S. must act quickly to halt the spread – or we risk losing control over the pandemic.

There’s a clear consensus that Americans should wear masks in public and continue to practice proper social distancing. While a majority of Americans support wearing masks, widespread and consistent compliance has proven difficult to maintain in communities across the country. Demonstrators gathered outside city halls in Scottsdale, Arizona; Austin, Texas; and other cities to protest local mask mandates. Several Washington state and North Carolina sheriffs have announced they will not enforce their state’s mask order.

I’ve researched the history of the 1918 pandemic extensively. At that time, with no effective vaccine or drug therapies, communities across the country instituted a host of public health measures to slow the spread of a deadly influenza epidemic: They closed schools and businesses, banned public gatherings and isolated and quarantined those who were infected. Many communities recommended or required that citizens wear face masks in public – and this, not the onerous lockdowns, drew the most ire.

Mask resistance during a pandemic isn't new – in 1918 many ...

In mid-October of 1918, amidst a raging epidemic in the Northeast and rapidly growing outbreaks nationwide, the United States Public Health Service circulated leaflets recommending that all citizens wear a mask. The Red Cross took out newspaper ads encouraging their use and offered instructions on how to construct masks at home using gauze and cotton string. Some state health departments launched their own initiatives, most notably California, Utah and Washington.

Nationwide, posters presented mask-wearing as a civic duty – social responsibility had been embedded into the social fabric by a massive wartime federal propaganda campaign launched in early 1917 when the U.S. entered the Great War. San Francisco Mayor James Rolph announced that “conscience, patriotism and self-protection demand immediate and rigid compliance” with mask wearing. In nearby Oakland, Mayor John Davie stated that “it is sensible and patriotic, no matter what our personal beliefs may be, to safeguard our fellow citizens by joining in this practice” of wearing a mask.

Health officials understood that radically changing public behavior was a difficult undertaking, especially since many found masks uncomfortable to wear. Appeals to patriotism could go only so far. As one Sacramento official noted, people “must be forced to do the things that are for their best interests.” The Red Cross bluntly stated that “the man or woman or child who will not wear a mask now is a dangerous slacker.” Numerous communities, particularly across the West, imposed mandatory ordinances. Some sentenced scofflaws to short jail terms, and fines ranged from US$5 to $200.

Mask resistance during a pandemic isn't new – in 1918 many ...

Passing these ordinances was frequently a contentious affair. For example, it took several attempts for Sacramento’s health officer to convince city officials to enact the order. In Los Angeles, it was scuttled. A draft resolution in Portland, Oregon led to heated city council debate, with one official declaring the measure “autocratic and unconstitutional,” adding that “under no circumstances will I be muzzled like a hydrophobic dog.” It was voted down.

Utah’s board of health considered issuing a mandatory statewide mask order but decided against it, arguing that citizens would take false security in the effectiveness of masks and relax their vigilance. As the epidemic resurged, Oakland tabled its debate over a second mask order after the mayor angrily recounted his arrest in Sacramento for not wearing a mask. A prominent physician in attendance commented that “if a cave man should appear…he would think the masked citizens all lunatics.”

In places where mask orders were successfully implemented, noncompliance and outright defiance quickly became a problem. Many businesses, unwilling to turn away shoppers, wouldn’t bar unmasked customers from their stores. Workers complained that masks were too uncomfortable to wear all day. One Denver salesperson refused because she said her “nose went to sleep” every time she put one on. Another said she believed that “an authority higher than the Denver Department of Health was looking after her well-being.” As one local newspaper put it, the order to wear masks “was almost totally ignored by the people; in fact, the order was cause of mirth.” The rule was amended to apply only to streetcar conductors – who then threatened to strike. A walkout was averted when the city watered down the order yet again. Denver endured the remainder of the epidemic without any measures protecting public health.

Mask resistance during a pandemic isn't new – in 1918 many ...

In Seattle, streetcar conductors refused to turn away unmasked passengers. Noncompliance was so widespread in Oakland that officials deputized 300 War Service civilian volunteers to secure the names and addresses of violators so they could be charged. When a mask order went into effect in Sacramento, the police chief instructed officers to “Go out on the streets, and whenever you see a man without a mask, bring him in or send for the wagon.” Within 20 minutes, police stations were flooded with offenders. In San Francisco, there were so many arrests that the police chief warned city officials he was running out of jail cells. Judges and officers were forced to work late nights and weekends to clear the backlog of cases.

Many who were caught without masks thought they might get away with running an errand or commuting to work without being nabbed. In San Francisco, however, initial noncompliance turned to large-scale defiance when the city enacted a second mask ordinance in January 1919 as the epidemic spiked anew.

Many decried what they viewed as an unconstitutional infringement of their civil liberties. On January 25, 1919, approximately 2,000 members of the “Anti-Mask League” packed the city’s old Dreamland Rink for a rally denouncing the mask ordinance and proposing ways to defeat it. Attendees included several prominent physicians and a member of the San Francisco Board of Supervisors.

It is difficult to ascertain the effectiveness of the masks used in 1918. Today, we have a growing body of evidence that well-constructed cloth face coverings are an effective tool in slowing the spread of COVID-19. It remains to be seen, however, whether Americans will maintain the widespread use of face masks as our current pandemic continues to unfold.

Deeply entrenched ideals of individual freedom, the lack of cohesive messaging and leadership on mask wearing, and pervasive misinformation have proven to be major hindrances thus far, precisely when the crisis demands consensus and widespread compliance.

This was certainly the case in many communities during the fall of 1918. That pandemic ultimately killed about 675,000 people in the U.S. Hopefully, history is not in the process of repeating itself today.

 

 

 

Europe’s lessons on reopening schools

Posted on by • Posted in 2020 Election Issues, Asymptomatic Transmission, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Mortality, National Strategy, Pandemic, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, School Reopening, Social Distancing • Leave a comment

https://www.axios.com/europe-lessons-reopening-schools-b713801e-26d6-4ba1-bb9e-c0b0b5809a11.html

Europe's lessons for the U.S. on reopening schools - Axios

American parents and policymakers hoping for a safe return to schools in the fall have been looking to Europe, where several countries reopened as early as April without a subsequent spike in cases.

Why it matters: There’s a growing body of evidence suggesting that schools can operate safely, at least under certain circumstances. But no country that closed schools has attempted to reopen them with outbreaks still raging as they are across much of America.

  • The first countries to bring students back, as Denmark did in April, didn’t detect much spread in schools — but the virus was also under control in the broader communities.
  • Harder-hit countries, like France or Belgium, contained the spread through lockdowns before bringing students back — something the U.S. has largely failed to do.
  • America’s unenviable position as a global epicenter complicates matters, but the challenge is similar: adapting schools to our pandemic reality.

Social distancing: Danish class sizes were initially limited to around 12, and arrival times were staggered to avoid crowding.

  • As they plan for the fall, though, countries like Belgium are dropping distancing mandates for younger students, while France is trimming its spacing requirements from 4 meters (about 12 feet) to 1 (3 feet), per the Washington Post.
  • That’s due to space limitations and the difficulties of keeping children apart, as well as indications that young students are unlikely to spread the virus to one another.

Masks: Similarly, countries including Austria initially required masks but loosened those restrictions over time.

  • Masks are optional for both students and teachers in Denmark, Norway, the U.K. and Sweden, per Science. Some German schools force students to wear them in the hallway, but not in class.
  • Masks are required for both students and teachers in several Asian countries, including China. Some experts argue that mask requirements would make reopening safer, particularly for teachers and older students.

“Bubbles”: When the U.K. fully reopens schools in September, smaller subsets of students will spend classes, lunch and recess together — an approach several other countries have experimented with.

  • If a student gets the virus, the logic goes, there are only so many people they could give it to, or who would need to self-isolate.
  • Italy is asking schools to open on Saturdays to allow for lower daily attendance, and schools are encouraged to hold classes outdoors or in larger venues like cinemas, per The Local. Funding has been allocated to update schools and hire more teachers.

Hybrid learning: Several countries have resumed in-person schooling on a more limited basis, supplemented by online education. School districts across the U.S. are designing such approaches now.

  • Belgian students over 12 will attend school four days a week in the fall, with an additional half-day online. If cases increase, so will the proportion of online education.

What to watch: It remains unclear how susceptible children are to the virus, though findings from a hard-hit town in France — which are consistent with other evidence — suggest it spreads significantly less easily among teens than adults, and hardly at all among young children.

The bottom line: The risks to schools remain uncertain, but will almost certainly depend on what’s happening outside their walls.

 

 

 

 

Coronavirus updates: U.S. infections top 76,000 in a day as virus’s spread continues unabated

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy Reopening, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Mortality, National Strategy, Pandemic, Partisanship, Personal Protective Equipment (PPE), Public Health, Public Safety, Public Trust, Quarantine, Social Distancing • Leave a comment

https://www.washingtonpost.com/nation/2020/07/18/coronavirus-updates-us-infections-top-76000-day-virus-spread-continues-unabated/?utm_campaign=wp_main&utm_medium=social&utm_source=facebook&fbclid=IwAR3cnVHnhbmPw7a_og-oZc1Ocgfs-A_y4Qr6Ht8OKDkxpiWv7E7ydb67EqA

Coronavirus in the U.S.: Latest Map and Case Count - The New York ...

The United States on Friday set another record for daily coronavirus infections, with states reporting a combined 76,403 new confirmed cases — more than double the amount the country was reporting daily during the initial surge of cases in the spring.

Coronavirus-related deaths are rising, too, after declining nationally throughout May and June. The country reported 963 fatalities from the virus Friday, the most in a single day since June 3.

Here are some other significant developments:

  • A federal appeals court blocked a lower-court ruling that would have allowed the Republican Party of Texas to proceed with its planned in-person convention in downtown Houston. Mayor Sylvester Turner (D) said the event poses too great a health risk with infections in the area spiraling out of control. “In the middle of a pandemic, the doors remain locked,” Sylvester said of the appeals court’s decision.
  • The nine largest brick-and-mortar retail companies — including Walmart, Lowe’s and CVS — have adopted new policies requiring customers to wear masks inside U.S. stores.
  • President Trump affirmed in a Fox News interview he does not favor requiring face coverings nationwide. “I want people to have a certain freedom,” Trump told Chris Wallace in an interview set to air in full on Sunday.
  • California Gov. Gavin Newsom (D) on Friday announced new guidelines that will bar schools in 32 hotspot counties from reopening in the fall unless they meet strict standards for preventing the spread of the coronavirus. Iowa Gov. Kim Reynolds (R) said Friday the state’s schools must resume in-person instruction.

Infections and deaths are rising in states around the country, led by Texas, California, Florida, Georgia and Arizona. Texas on Friday reported a record 14,916 new cases and 174 new deaths related to the virus. Other states, including Ohio, Utah and the Carolinas, have reported single-day records in the past week.

The sharp increases have prompted many states to adopt new public health measures to prevent the virus spread. California ordered most of its schools to conduct remote instruction in the new academic year unless counties can meet strict benchmarks for reducing community transmission. More than half of all U.S. states have instituted some form of statewide mask requirements, including Alabama and Arkansas, where governors previously balked at mask mandates.

 

 

 

U.S. blows past coronavirus record with more than 70,000 new cases in one day

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Data Governance, Data Integrity, Data Interpretation, Data Ownership, Economic Crisis, Economy Reopening, False Hope, False Narrative, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Misinformation, Mislead, Misleading, Mixed Message, Mortality, National Strategy, Pandemic, Partisanship, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Scientists, Social Distancing, Trust, Truth, Wishful Thinking • Leave a comment

https://www.washingtonpost.com/nation/2020/07/17/coronavirus-live-updates-us/?utm_campaign=wp_post_most&utm_medium=email&utm_source=newsletter&wpisrc=nl_most

FirstFT: Today's top stories | Financial Times

There was a time in the United States when 40,000 coronavirus cases in a day seemed like an alarming milestone. That was less than three weeks ago.

Now, the number of new infections reported each day is reaching dizzying new heights. On Thursday, the daily U.S. caseload topped 70,000 for the first time, according to data tracked by The Washington Post.

Record numbers of covid-19 fatalities were reported in Florida, Texas and South Carolina on Thursday, and officials throughout the Sun Belt are worried that hospitals could soon reach a breaking point.

Here are some significant developments:

  • Masks are now mandatory in more than half of U.S. states — with the governors of Arkansas and Colorado the latest to issue face-covering orders. Major retailers phased in new mask policies, and Maryland Gov. Larry Hogan (R), chairman of the National Governors Association, said that masks should be mandated in states across the country.
  • Larry Fink, the chief executive of investment firm BlackRock, said that if states moving forward with reopening plans required masks, the economy would recover much sooner.
  • Atlanta Mayor Keisha Lance Bottoms (D) blasted Georgia’s Republican governor, Brian Kemp (R), for suing to stop block her city’s mask ordinance, accusing him of “putting politics over people.”
  • An unpublished report from the White House Coronavirus Task Force suggests that nearly 20 hard-hit states should enact tougher public health measures.
  • Real-time coronavirus tracking data temporarily disappeared from the Centers for Disease Control and Prevention’s website, sparking an outcry.
  • President Trump faces rising disapproval and widespread distrust on coronavirus, according to a new Post-ABC poll.
  • India on Friday surpassed 1 million confirmed coronavirus cases, becoming the third country to cross that threshold, behind the United States and Brazil..

 

 

 

 

Florida And Texas Both Set Coronavirus Death Records Thursday

Posted on by • Posted in 2020 Election Issues, Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy Reopening, Evidence-based Leadership, Evidence-Based Plan, Evidence-Based Policy, Expert, False Hope, False Narrative, Infection Control, Infection Control Plan, Infectious Virus, Leadership Decentralized, Mortality, National Strategy, Pandemic, Partisanship, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Scientists, Social Distancing, Wishful Thinking • Leave a comment

https://www.forbes.com/sites/nicholasreimann/2020/07/16/florida-and-texas-both-set-coronavirus-death-records-thursday/?utm_source=newsletter&utm_medium=email&utm_campaign=dailydozen&cdlcid=5d2c97df953109375e4d8b68#226e63bb720a

Florida coronavirus: State marks Covid-19 case record as July ...

TOPLINE

Coronavirus deaths are again on the rise in the U.S., with all three of the nation’s largest states setting new highs for daily death tolls Thursday following weeks of record increases in new cases and hospitalizations, even as President Donald Trump and other conservatives have touted death statistics as a sign the U.S. is handling the pandemic well.

KEY FACTS

California, Texas and Florida all reported new record daily highs for deaths Thursday.

California reported 149 deaths, while Florida reported 120 and Texas set a new record for the third-straight day, with 105.

Deaths are rising rapidly in Texas, with the 105 deaths breaking Wednesday’s record of 98, which shattered the record of 60 that was set on Tuesday.

Coronavirus deaths in the U.S. declined from early May through mid-June, but have picked up recently, and are now pacing at just under 1,000 per day.

The rise is being driven by record new death tolls in the nation’s largest states—the same states that have in large part contributed to the U.S.’s record rise in new cases recently.

Experts have said that deaths lag behind increases in cases and hospitalizations, with former FDA Commissioner Scott Gottlieb saying in an interview Sunday that “the total number of deaths is going to start going up again.”

KEY BACKGROUND

Coronavirus deaths reached a peak nationally in April through early May with over 2,000 a day on many days, largely driven by the severe outbreak in New York. Now the pandemic has eased in the Northeast while states in the South and West are the new national epicenters for coronavirus.

CHIEF CRITICS

Trump and Republican politicians had used the decline in deaths and a decrease in mortality rates to argue that the U.S. response to coronavirus has worked. However, there has also been a massive increase in testing, meaning that many less severe cases are now being identified.

BIG NUMBER

4.3%. According to Johns Hopkins University, that’s what the current mortality rate is among confirmed coronavirus cases in the U.S., a number that’s continually dropped as testing has increased. However, health experts like Dr. Anthony Fauci said early on in the pandemic that they believe the actual mortality rate is around 1%, which is still at least 10 times the lethality of the seasonal flu. And Gottlieb noted that even if the reported death rate continues to drop, if there is an increase in infections, the amount of deaths will ultimately rise, as well.

CRITICAL QUOTE

“It’s a false narrative to take comfort in a lower rate of death,” Fauci said on Tuesday, adding “There’s so many other things that are very dangerous and bad about this virus, don’t get yourself into false complacency.”