For months Americans were cooped up at home, doing their part to slow the spread of the coronavirus. But in recent days tens of thousands of them have filled the streets in at least 380 cities and towns across all 50 states to protest police brutality and systemic racism — threats they believe are even more dangerous to people of color than COVID-19.
They are marching shoulder-to-shoulder for hours on end. They are chanting, shouting and singing, often without masks. Meanwhile, police officers are spraying them with cough-inducing tear gas, herding them into tight corners and loading the hundreds they arrest into buses, vans and holding cells.
The question now is whether this apparent recipe for COVID-19 disaster will spark a resurgence right when the United States seemed to be getting its epidemic under control.
Experts and epidemiologists say that we won’t know the answer for weeks. After infection, symptoms can take up to 14 days to present; testing positive or requiring hospitalization can take even longer. Today’s data is a window into the past.
Yet today’s data, it turns out, is worrisome enough.
While the country has shifted its attention from the pathogen to the protests, and while COVID-19 infections have continued to decline in some of America’s hardest-hit cities, cases have been climbing elsewhere — especially in the South and the West, and most of all in states that moved to reopen early.
More than a month has passed since the first wave of reopenings — enough time to start to gauge the impact of looser restrictions, increased interaction and more relaxed attitudes toward social distancing.
The fact that infections already appear to be increasing in places that have taken these relatively tentative steps back toward normalcy suggests that the coronavirus may start to spread even more rapidly and widely as a result of the tinderbox-like conditions at today’s mass protests.
Last Wednesday this column singled out South Carolina as an example of one of the 17 or so states where coronavirus is on the rise. It’s worth checking back in to see how the situation has evolved since then.
At the time, the Palmetto State had just posted the country’s biggest increase in new COVID-19 cases: 42.4 percent, according to the Reuters coronavirus database, which measures and compares the total number of new cases each week.
For the week ending Sunday, May 31, South Carolina saw an additional 37.9 percent jump in new cases — the fourth-highest in the nation and the state’s highest weekly total since the pandemic began.
And while South Carolina has conducted more testing in recent weeks, testing alone does not account for the uptick in COVID-19 infections there. In fact, the state conducted more tests per day between May 12 and May 19 than it did between May 27 and June 2 — 150 more, on average — yet it found 663 more new cases during the latter week than the former.
Meanwhile, the percentage of positive COVID-19 tests in South Carolina has more than doubled over the last two weeks, rising from about 3 percent to 7 percent, according to the state’s Department of Health and Environmental Control. Hospitalizations have increased as well, remaining above 400 for three straight days. And the state’s Rt — an epidemiological statistic that represents transmissibility, or the number of people a sick person infects at a particular point in an epidemic — is now estimated to be 1.08. An Rt below 1.0 indicates that each person infects, on average, less than one other person; an Rt above 1.0 indicates that an outbreak is growing.
South Carolina officials are “partly blam[ing]” the rising number of infections on “poor social distancing,” according to a story Wednesday in the Greenville (S.C.) News. Over the last week, Greenville County reported more new COVID-19 cases (412) than any other county in the state. That weekly tally was roughly a quarter of the total reported there since mid-March, which suggests a growing outbreak.
“The virus thrives on people coming in contact with other people,” Dr. Eric Ossmann, chief of preparedness and mobile integrated health care for Prisma Health, told the paper. “That is how it gets transmitted. So as social distancing is relaxed, as we see very limited mask-wearing in various locations where people cannot social distance, I do think this is to a certain degree a result of that.”
Beyond testing, added Greenville Mayor Knox White, the “bigger issue is just people’s day-to-day activity, letting their guard down, and I would plead guilty to that certainly myself.”
State Rep. Neal Collins of Easley told the Greenville News that he had heard about people who tested positive for COVID-19 “going to public events or going to parties,” sharing drinks and “the whole group becoming positive.”
“It should be a wake-up call to too many people who are letting social distancing lapse,” White warned. “It should get everyone’s attention.”
“If these gains are sustained over the course of next week, then yes, I think you are probably looking at potentially a second wave,” predicted Ossmann.
South Carolina is not alone in this. Last week Arizona experienced a bigger increase in COVID-19 infections (49.8 percent) than any other state, according to Reuters. On Monday, the state recorded more than 1,000 COVID-19 hospitalizations for the first time. The next day, health authorities there reported 1,127 new cases, the highest daily number since the outbreak began.
“We are seeing some indicators that cases in Maricopa County are starting to rise beyond the increase from additional testing,” public health officials in the state’s hardest-hit region said Tuesday. “We will watch to see if this represents a trend or an anomaly.”
In Virginia, cases were up 42.8 percent week-over-week. In Alabama they were up 39.9 percent. In Kentucky they were up 28.3 percent. In Utah they were up 21.8 percent. In Texas they were up 18.2 percent. States that also saw double-digit increases included Mississippi, Arkansas, Wisconsin and North Carolina — which was scheduled to host the Republican National Convention in August, until President Trump balked at Gov. Roy Cooper’s insistence on measures to prevent it from seeding a new coronavirus outbreak. Even Washington (up 9 percent) and California (up 28.9 percent) — two early-to-lockdown states that were among the first to bend the curve — saw weekly infections rise.
More up-to-the-minute data from Johns Hopkins — which averages new daily cases over the last five days — hints at additional states that may soon join this list, including Tennessee, Alaska, Montana and Missouri, where shirtless, maskless, spring-break-style revelers were filmed packing into a pool at the Lake of the Ozarks over Memorial Day weekend.
Perhaps this is the inevitable cost of living with the coronavirus: the unavoidable, even acceptable trade-off for leaving home, for returning to work, for aspiring to some semblance of normalcy. For now, the increase in infections across the South and West is modest. It seems manageable. Rural South Carolina is not New York City. It never will be. Hospitals have not been overrun. Treatment has improved. Nearly all of these states have the ICU beds they need. Death rates — admittedly a lagging indicator — are still going down.
But if infections start to climb in as many as 20 states when people simply start to return to normal, then what will happen after they gather in conditions that could be far more conducive to the spread of COVID-19?
We’ll know more in a few weeks.
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