Mike Pence, commander of the U.S. coronavirus task force for some reason.
Photo: ERIC BARADAT/AFP via Getty Images
In February, the Centers for Disease Control and Prevention warned that the United States should brace for a domestic coronavirus outbreak. Throughout March and April, the number of confirmed cases of COVID-19 in the U.S. rose dramatically, and the U.S. now has the highest confirmed case count in the world. As of May 4, more than 1.1 million people across every state, Washington, D.C., and four territories have tested positive for the disease, and more than 67,000 people with the virus have died in the U.S. Fatalities have been confirmed in all 50 states.
Globally, more than 3.5 million confirmed cases of COVID-19 have been reported in at least 177 countries, with at least 248,816 deaths so far. In March, the World Health Organization officially declared COVID-19 a pandemic, and President Trump declared a national state of emergency.
Here’s everything we know about the spread of the virus in the U.S. so far.
As of May 4, there are at least 1,161,185 confirmed cases of COVID-19 in the U.S., and at least 67,798 people with the virus have died.
Over the past month, the national death toll has increased by over 1,000 people — and sometimes more than 2,000 people — every day, and at least 25,000 new cases are being identified daily across the country. However, even as President Trump has encouraged states to begin reopening their economies, the New York Times reports that privately, his administration is projecting that the worst of the outbreak is still to come. According to internal documents, the Trump administration predicts that the number of cases and deaths will continue to rise steadily in the coming weeks, and that by June 1, there may be as many as 200,000 new cases and 3,000 deaths each day.
An additional complication is that that rates of testing still vary widely from state to state: As of last week, just over 6 million people had been tested in the U.S., according to data from Johns Hopkins — less than 2 percent of the population. As a result, epidemiologists estimate that the true number of cases may be ten times the official count, and that several thousand more people have died from the virus than is reflected in the official death toll. Additionally, new research suggests that COVID-19 cases were spreading rapidly in the U.S. far earlier than was reported: researchers at Northeastern University estimate that on March 1, when New York confirmed its first case of coronavirus, more than 10,000 people in the state may already have been infected. Preliminary results from antibody tests suggest that as many as 2.7 million New York City residents may have already been infected with the virus without realizing it.
New York has had by far the largest outbreak in the country, with at least 321,833 confirmed cases and 24,576 deaths as of Monday morning, including those presumed to have died from the virus who had not tested positive. New Jersey and Massachusetts are also among the states that have been hardest hit by the virus. Though the vast majority of confirmed cases and deaths from COVID-19 have been in cities and suburbs, the New York Times reported in early April that coronavirus has reached more than two-thirds of the country’s rural counties, where cases are growing fast. And now, as some big cities are starting to see the number of cases level off, a number of small Midwestern factory towns are experiencing outbreaks.
Speaking on Fox News on Sunday night, President Trump acknowledged that the pandemic has been more devastating than he anticipated, and said that the U.S. death toll may reach 100,000. While the national death toll continues to rise, the number of hospitalizations and deaths in some of the hardest hit areas has appeared to plateau: Over the past few days, New York governor Andrew Cuomo has reported single-day death tolls in the high 200s, a substantial decrease from the peak of the outbreak. But as some states start to lift stay-at-home orders and reopen nonessential businesses, public-health experts have cautioned that the situation remains dire, and that we could still see a second wave of cases.
As the number of confirmed cases of COVID-19 has continued to rise, many states have urged or ordered residents to stay at home to slow the spread of the virus. As of mid-April, 316 million Americans in 42 states were under orders to stay at home except for essential activities, which include buying food, seeking medical treatment, and exercising outdoors, provided they stay six feet away from anyone not part of their household. Medical professionals, caregivers, public-safety officials, sanitation workers, and other essential workers, such as those who work in grocery stores and pharmacies, are exempt. More than 40 states have suspended in-person classes for the rest of the school year.
The widespread lockdowns have had serious economic consequences: The Labor Department reports that at least 30 million Americans have filed for unemployment since the outbreak began. In mid-April, the Trump administration issued a set of federal guidelines for states to begin slowly reopening their economies, recommending that states not do so until the number of coronavirus cases has steadily declined for at least 14 days. Last week, however, President Trump said that he would not extend the federal guidelines on social distancing, which expired on April 30, and would instead leave the decision to ease restrictions up to the states.
The Times reports that about half of states have announced plans to gradually re-open businesses in the coming days despite warnings from public-health officials that reopening too soon — and without widespread testing available — could lead to a resurgence of cases. According to the Times, some of the states that have begun reopening are still seeing an increase in the number of cases, including Iowa, Minnesota, Tennessee, and Texas. Meanwhile, at least a dozen other states have extended their stay-at-home orders until early May, at a minimum.
In March, President Trump declared a national emergency over the coronavirus pandemic, effectively freeing up to $50 billion in federal funds to help states and territories fight the spread of the virus, which he said would include expanding access to testing.
Still, there have been many issues with the availability of the coronavirus test. Though testing capacity has improved, there are still widespread shortages. In many areas, state health officials and medical providers say they are unable to test as many people as they would like to, and tests remain available only to those who meet specific criteria. Public-health officials say that far more testing — for both the virus and antibodies — will be needed in order to safely reopen the economy.
Speaking April 27, President Trump announced a plan to increase federal support to states to provide increased testing, saying that the U.S. would “double” the number of tests it had been conducting. However, experts say this would still fall far short of the number of tests needed, which is more like 5 million tests a day by June and 20 million tests a day by late July.
On March 19, Secretary of State Mike Pompeo announced that the U.S. would close its borders with Canada and Mexico, barring entry to all nonessential travelers. President Trump has also barred entry of all foreign nationals who have been in high-risk countries, including China, Iran, and much of Europe, within the last 14 days. The CDC has advised against all nonessential travel throughout most of Europe, South Korea, China, and Iran and has advised older and at-risk Americans to avoid travel to any country.
On March 27, President Trump signed a $2 trillion stimulus plan, the largest in modern American history, which will send direct payments of around $1,200 to millions of Americans who earn less than $99,000, along with an additional $500 per child. The first round of deposits went out on April 11. The plan also substantially expands unemployment benefits, including extending eligibility to freelance and gig workers, and provides aid to businesses and companies in distress. Treasury Secretary Steven Mnuchin has also extended the tax-filing deadline to July 15. President Trump signed another $484 billion relief package on Friday, which will provide aid to small businesses and funding for hospitals and testing.
As the number of COVID-19 cases in the U.S. increased dramatically over the past two months, President Trump has been criticized for the federal government’s slow and ineffective response. On April 14, in an apparent attempt to shift the blame, Trump accused the World Health Organization of “severely mismanaging and covering up” the spread of the virus, and said that the U.S. would halt funding to the organization while it reviewed its actions. The decision to deprive the world’s leading health organization of funding amid a global pandemic was met with sharp criticism from other world leaders. And on April 19, the Washington Post reported that “more than a dozen U.S. researchers, physicians and public health experts” within WHO began transmitting real-time information to the Trump administration when the virus surfaced in China late last year.
In most cases, COVID-19 is not fatal, but it appears to pose the greatest risk to elderly people and those with preexisting conditions that compromise their immune systems. The New York Times reports that among those who have died in the U.S., almost all have been in their 70s, 80s, and 90s. However, a recent report by the CDC found that American adults of all ages have been seriously sickened by the virus, noting that 38 percent of American patients who have been hospitalized with the virus were between the ages of 20 and 54. Doctors and medical workers may also be at greater risk, due to their higher-than-average odds of exposure, and preliminary data suggests that black Americans may be dying at disproportionate rates.
On April 10, President Trump said that the CDC is now recommending that Americans wear masks when they are out in public, though he stressed that the guidelines were voluntary, and said he would not wear a mask himself. On April 15, Cuomo signed an executive order requiring New York residents to wear face coverings in public settings where they are not able to stay six feet away from other people, including buses, subways, sidewalks, and grocery stores. Los Angeles has also ordered residents to wear masks when visiting essential businesses. The guidance on masks seems to be driven in part by concern about the number of asymptomatic individuals who may be infected and transmitting the virus. Speaking on April 5, Fauci estimated that between 25 and 50 percent of those infected with the virus may not experience any symptoms.
If you have symptoms associated with coronavirus — coughing, fever, respiratory issues — call your doctor before showing up at their office: The virus is highly contagious and you want to limit the possibility of spreading it. If you are sick, the CDC recommends that you stay home and self-isolate, confining yourself to one room as much as possible and wearing a face mask when you have to interact with others. Wash your hands frequently — soap and water and at least 20 seconds of scrubbing — and avoid touching shared household items, cleaning “high-touch” surfaces (like your phone) regularly. Your health-care provider and even local health department will help you determine how long it’s appropriate for you to keep up these precautions.
This post has been updated.
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Everything to Know About the Coronavirus in the U.S.
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