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Daily death toll from virus is on the rise again

The daily death toll from America's coronavirus crisis rose sharply this week amid a dramatic surge in confirmed infections across the South and West that has inundated hospitals with ill patients and forced several states to pause or reverse plans to reopen businesses. 

Texas, Arizona and South Carolina have all seen their death tolls rise by more than 100 percent in the past four weeks, according to an analysis of state and county health data by The Washington Post. Four more states - Mississippi, Tennessee, California and Louisiana - have seen at least a 10 percent jump in that time span.

"They're starting to tick up," said Jennifer Nuzzo, a senior scholar at the Johns Hopkins Center for Health Security. "Deaths are a lagging indicator, so we always expected that if they were going to go up, it would take some time."

After mid-April, the daily death toll declined as shutdown orders took effect across the country and the virus curve began to flatten. The low point came July 5, with 217 recorded coronavirus deaths, the lowest toll since March 24, when the pandemic was in its initial upswing.

Since then, amid record-breaking case numbers in several states, the death count has begun to rise, surpassing 800 deaths each of the past four days. Although still below the highs in April and May, when more than 2,000 people per day were regularly dying from the virus, experts warn that the trend could continue to get worse.

"This is just the early wave of a lot of suffering and death. The longer we wait to act aggressively, the harder it's going to be for us to get out of the tailspin," said Ashish Jha, who directs the Harvard Global Health Institute.

The spike in deaths this week remains a small sample.

Nuzzo said she and other public health experts prefer to make judgments on trends that are consistent over one or two weeks, not just a few days.

"I would give it two weeks to know for sure," she said, but added, "I'm expecting to see that this trend will hold."

Nicholas Reich, a University of Massachusetts biostatistician who aggregates more than 30 epidemiological models to create a forecast of the coming weeks of the pandemic, on Wednesday predicted that by Aug. 1, the country would see its COVID-19 death toll rise to 147,466, an increase of about 16,000 over 2 [1/2] weeks.

"The model's best guess is that we will see a slow and steady increase in new #COVID19 deaths in the US over the next four weeks, between 3,800 and 5,000 per week. This captures declines in some states, and increases in others," Reich wrote on Twitter.

In an email to The Post, he said these models can be useful for things like planning hospital staffing and communicating to the public about the trajectory of the pandemic. But he cautioned that the models are not crystal balls.

The increase in testing rates, along with the fact that more young people are being tested, makes it challenging for modelers to create forecasts based on what happened earlier in the pandemic, when the testing rates were lower and the confirmed cases more often involved older people at greater risk of death, Reich said.

The surge in coronavirus cases in recent weeks has been driven by states that were first to loosen shutdown restrictions and begin reopening their economies. With the flood of new cases, more than a dozen states have now paused reopenings, and others have reimposed bans or limits on bars and indoor gatherings.

Nevada plans to shut down bars in counties where virus cases are increasing, including Clark County, home to Las Vegas. Gov. Steve Sisolak, a Democrat, said Thursday evening that the order, which goes into effect Saturday, will not apply to counties with only a small number of cases. For now, indoor dining is still allowed.

Michigan Gov. Gretchen Whitmer, a Democrat, issued an executive order Friday instructing businesses to refuse service to customers who aren't wearing masks or risk a suspension of their licenses.

Many of the problems that defined the country's first encounters with the coronavirus in the spring have reared up again in different areas as the virus has pushed into new territory. As patients pour into emergency rooms, hospitals have reported shortages in personal protective equipment for doctors and nurses and rushed to add more intensive care beds. There have also been fresh complaints about a lack of testing and slow results.

Even President Donald Trump's favorite possible remedy - the antimalarial drug hydroxychloroquine, which he has taken as a prophylactic and called a "game changer" - is being resurrected, although the Food and Drug Administration revoked its approval last month after safety warnings about potential cardiac problems.

White House trade adviser Peter Navarro has been leading a Trump administration effort to demand that the FDA renew its emergency authorization for the controversial drug.

"It feels like Groundhog Day. They're repeating same thing. And that's because there's only so many denial tactics you can employ," said Jha, of the Harvard Global Health Institute. "The federal government is just AWOL."

The public has grown increasingly critical of the government's pandemic response. Two-thirds of Americans now disapprove of Trump's handling of the coronavirus, his worst numbers to date, according to an ABC News-Ipsos poll released Friday.

The poll found that 67 percent disapprove of Trump's handling of the pandemic, while 33 percent approve. Trump's disapproval number has risen nine points since mid-June.

Federal health officials Friday made public the coronavirus testing plans prepared by each state, several major cities and U.S. territories. The Trump administration has chosen to rely on these individual plans, spurning a congressional requirement to adopt a uniform nationwide testing strategy.

The plans are designed to meet one of the few standards the administration has set: for states to test at least 2 percent of their populations.

Few of the plans mention how many days it should take for people to get test results - a particular concern now that testing times are lengthening again. One exception is the New York City report, which says that any private labs on city contracts must deliver results within two days.

A few plans, including Houston's, promise to test people with or without symptoms of COVID-19. Public health officials have said that spikes in cases are being fueled in large part by younger adults who are less likely to become seriously ill when infected. But most states' plans focus on testing their most vulnerable residents - older adults, nursing home residents and health-care workers, among others.

Several state plans emphasize that they need federal help to secure enough testing supplies. "If the federal government reduces, or ceases to send, test kits to ... Georgia, this could result in an [insurmountable] challenge and the state will not meet the 2% testing goal without additional private lab resources," that state's plan said. Louisiana's said, "The greatest threat to our test plan success is the inability to obtain the needed supplies and reagents to successfully execute the state testing plan."

At least two states' plans name specific local industries whose workers are particularly vulnerable to infection, with Nebraska mentioning its meatpacking plants and Delaware noting that it is home to a robust poultry industry.

Federal health officials also announced Friday that they will devote an additional $4 billion in relief funds to two sets of hospitals and other providers of care that are financially struggling because of the pandemic. The money is part of $175 billion in health-care relief that Congress included in laws in March and April - about $115 billion of which has been committed so far, officials said.

According to the officials, approximately $3 billion will be available to an estimated 215 hospitals, doctors or other providers that treat many poor patients and run on thin or negative profit margins. They did not qualify for $10 billion devoted last month to safety-net hospitals. The other $1 billion is for rural hospitals, or suburban facilities that treat many rural patients.

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The Washington Post's Jaqueline Dupree, Chelsea Janes, Rachel Weiner, John Wagner and Antonia Farzan contributed to this report.

 

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