(Bloomberg) – The first states to endure the coronavirus this spring hoped the worst was behind them.
Instead, the virus is coming back.
Many places that suffered the most in the first wave of infections, such as California, Louisiana, Michigan, and Washington state, are seeing case counts rise again after months of decline. It’s not just about more testing. Hospitalizations and, in some places, deaths are also increasing.
The disease is at its peak: Florida reported 15,300 cases Sunday, the largest single-day increase in the U.S. pandemic, and experts say the revival on the original battlefields has common causes. They include a population that is no longer willing to stay indoors, Republicans who reject facial masks as a political statement, street protests about police violence, and young people convinced that the virus will not seriously harm them.
And even though some of the states led by Democratic governors delayed the restart of their economies until weeks after more anxious peers like Georgia, they still jumped too early, critics say.
“I don’t think there is any doubt about it anymore. Even in California, we open too fast, “said John Swartzberg, a physician who is a clinical professor emeritus at the University of California, Berkeley.
So far, the rebound has not reached the states most affected by the first wave: New York, New Jersey, and Massachusetts. But New York Governor Andrew Cuomo said Friday that he is on his way.
“We are going to go through a raise, and I can feel it coming,” he told WAMC radio. “The only question is how high does our rhythm go? But you can’t have it all over the country and then never have it again. “
While public attention focused last week on a disease explosion in the Sun Belt states that largely missed the first wave, Arizona, Florida and Texas, California hospitalizations and the number of daily deaths reached new highs. . The state, first to shut down its economy, reported a record 149 deaths on Wednesday and more than 300 since then.
“We are seeing community spread and hospitalizations as we saw it in late April, and what we expected would be the height of infection,” said Barbara Ferrer, director of public health for Los Angeles County, who reported 3,322 new cases Sunday and 18 new deaths
Louisiana’s daily case count is nearing its previous peak, reached in April, according to Johns Hopkins University. And Washington, the first to detect an outbreak, is seeing a record number of infections, though deaths remain well below their March peak of 34 in one day.
As traumatic as the initial wave may have been, the number of people infected did not come close to providing the so-called collective immunity, according to experts. The vast majority still have no natural protection.
“Basically we are in the same place we were in early March, in terms of how much of the population is vulnerable,” said Carl Bergstrom, a biology professor at the University of Washington in Seattle.
And people’s willingness to stay home most of the time, and wear masks when they don’t, has been eroded. For many Republicans, rejecting the masks has even become an act of defiance, as President Donald Trump refused to wear one in public until Saturday, when he visited a military hospital.
“It is utter exhaustion,” said Los Angeles Mayor Eric Garcetti, who threatened to reimpose an order to stay home if the outbreak now affects his city. “Quarantines are the most frustrating things for human beings. Nobody likes to be told what to do. “
States, and their people, may have let their guard down.
Michigan’s two-month shutdown made infection rates low enough to lift orders to stay home in June. Within a few weeks, they began to appear again. One of the biggest new outbreaks was at Harper’s Restaurant & Brew Pub, an East Lansing bar near Michigan State University. More than 180 cases have been traced there, according to health officials. Smaller outbreaks have been documented in a bar in Romulus and in Royal Oak, a trendy city north of Detroit.
“Bars and restaurants were opened, and that caused a big change, as well as any percentage of people who don’t want social distance or wear a mask because they think it’s all a hoax,” said Linda Vail, Ingham County Health Officer. , which covers most of East Lansing.
In response, Governor Gretchen Whitmer banned indoor bar service on July 1, and on July 10 made wearing masks mandatory.
Although hospitals in southeast Michigan are better equipped than in March, doctors and nurses are on the edge, said Teena Chopra, a doctor and professor of infectious diseases at Wayne State University in Detroit. “Given what we’ve seen before, and the shock and trauma we’ve been through, even one or two cases if they go up, it makes us nervous, Chopra said.
California officials are trying to assure residents that they are better prepared this time. Governor Gavin Newsom said last week that Covid victims occupied only 8% of available hospital beds. The state also has 46 million N95 masks, he said, compared to 1 million in March.
“We have never been better positioned,” Newsom said.
But Los Angeles County could use its beds in weeks, officials warn. And rural Imperial County along the Mexican border has been so badly affected that some patients have been transferred to San Francisco, more than 400 miles away.
Newsom alternately scolds residents for not taking the virus seriously and reminds them of the shared resolution they showed this spring, when an outbreak in the San Francisco Bay area threatened to spiral out of control.
“We did an amazing job, collectively, as a state, 40 million of you,” he said last week. “We have the ability to do that again.”
Officials in the Seattle area have also tried to reassure residents, and attribute some of the increase to young people. More than 130 recent cases have been linked to fraternity houses at the University of Washington. This week, the city’s Space Needle was crowned with a massive flag: “Mask Up”.
In Louisiana, Governor John Bel Edwards made the mandatory masks on Saturday and limited the size of the meetings. Confirmed Covid-19 cases peaked at a day high of just over 2,700 in April, but more than 2,600 cases were reported Friday.
Joseph Kanter, the assistant state health officer, said the deadly spring is still vivid for residents of Louisiana’s largest cities.
“People in New Orleans have a real gut memory of the increase in March and April and have a real understanding of what this virus can do,” he said. Memory drives behavior here. People are more aware, because they know how serious this virus can be. “
Now, the smaller cities and parishes in western Louisiana are also seeing an increase. Calcasieu, a parish of some 200,000 near the Texas border, has more than 3,000 cases and has seen an increase in recent days.
“People didn’t really get a chance to see the virus in the community,” said Lacey Cavanaugh, a physician who is the area’s director of public health. “People did not know their friends and family who got sick and were hospitalized. I think for a lot of people, it felt like something was happening in big cities, not small communities. ”
The Baton Rouge area has also seen an increase, particularly among people ages 18-29, and 95% of cases are spread across the community, said Dawn Marcelle, a physician who is the regional medical director.
Swartzberg, the Berkeley professor, said ignorance and fatigue from the crisis are not adequate reasons for the United States not to domesticate the virus.
“That does not explain why Europeans are not exhausted. That does not explain why the Taiwanese are not exhausted, “he said. “Everyone has been through this.”
Instead, he blames a lack of national leadership, or worse, leadership that has been detrimental to fighting the virus. “I am very frustrated by how badly we have done it,” Swartzberg said.
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