Covid-19 numbers show promise, but health experts warn each state is a different battleground

Epidemiologist Jennifer Nuzzo, former FDA Commissioner Mark McClellan and economist Paul Romer weigh in on how the US should conduct Covid-19 testing.

Posted: Apr 13, 2020 5:01 PM
Updated: Apr 13, 2020 5:01 PM

The White House wants the country to "reopen" soon and New York's governor says a regional reopening is in the offing, but experts warn that in the United States' coronavirus fight, different states will see different peaks.

More than 22,800 people have died from Covid-19 since the virus arrived on American shores, according to Johns Hopkins University's numbers, but the daily tally of deaths dropped Saturday and Sunday, which could be a sign for optimism.

The number of infections -- which stood at more than 560,000 on Monday afternoon -- were also down Saturday and Sunday.

This comes as US Surgeon General Dr. Jerome Adams says cases in some of the country's hotspots -- New York, New Jersey, Detroit and New Orleans -- appear to be "leveling off" or even declining. The situations in California and Washington, meanwhile, remain stable.

"In the midst of tragedy, there IS hope," Adams tweeted Monday. "Social distancing and mitigation IS working. There is a light at the end of this dark tunnel, so keep at it."

Still, many states are in the throes of an intense effort to stem the illness' spread. New York crossed the 10,000-death threshold Monday, as its cases topped 190,000, Gov. Andrew Cuomo said. New Jersey and Michigan also have frightening death tolls, with more than 2,300 and 1,400 respectively.

The upside to New York's numbers is that the three-day average for hospitalization, new hospitalizations, intensive care admissions and intubations are all down, Cuomo said Monday morning.

The Northeast joins forces

Cuomo announced Monday the beginning of a "geographically coordinated" reopening plan in conjunction with leaders in New Jersey, Connecticut, Pennsylvania, Delaware and Rhode Island. Each state will name health and economic officials to join the governors' chiefs of staffs to a working group, which will begin discussions Tuesday.

The group will come up with "parameters to go forward," Cuomo said, and while they may not agree on every aspect of the strategy, finding areas where they can coordinate will be important, especially given the states' close economic, health and transportation ties.

Calling the commuter thoroughfare from his state of Connecticut to New York the "Covid corridor," Gov. Ned Lamont said it was vital that "you don't pull the trigger too early," but applauded the partnership.

"The reality is this virus doesn't care about state borders, and our response shouldn't either," Rhode Island Gov. Gina Raimondo said.

"By working, sharing our information and intelligence, I think will help each of us make better decisions," Delaware Gov. John Carney added, while Pennsylvania Gov. Tom Wolf said, "We can do anything better when we work together in this region."

Trump is scheduled Tuesday to announce the formation of the "Opening our Country Council," which is expected to focus on ways to stimulate the economy. Another panel, the White House's coronavirus task force, has been focusing on providing advice to the states on what to do once reopening is advised.

The task force is weighing potential benchmarks that would precede reopening the states, but have yet to settle on specific targets, people familiar with the discussions said.

Doctors in wait-and-see mode

All 50 states are under a federal disaster declaration for the first time in US history. There are more than 29,000 members of the National Guard deployed across the country to deal with the pandemic, according to the National Guard Bureau. Guardsmen have been called to serve a variety of roles, from staffing emergency operations centers to restocking grocery shelves.

Key to how optimistic Americans should be will depend on what comes next. The country's testing trajectory will be hugely important, experts say.

While President Donald Trump says he wants to reopen the country next month -- even telling state governments to "be ready" as he plans to announce a special council to reopen the country -- health officials say they're still in wait-and-see mode even if the numbers look promising.

"It's important to look at the country as many different separate situations," said Dr. Robert Redfield, director of US Centers for Disease Control and Prevention, on NBC's "Today" show.

"This pandemic has affected different parts of the country differently," Redfield said. "We're looking at the data very carefully, county by county by county, and we will be assessing that."

Public health capabilities need to be improved to perform early case detection, isolation and contact tracing, he said, and officials need to "start working to rebuild confidence in the community, so the community has confidence to reopen."

Testing and social distancing

The US is "nearing the peak right now," Redfield told the morning show.

"You'll know when you're at the peak when the next day is less than the day before," he said. "We are stabilizing across the country in terms of the state of this outbreak."

As for getting the country back to normal, Redfield said it has to be done correctly and "it's going to be a step-by-step, gradual process."

The call for caution is being echoed on the world stage as World Health Organization Director-General Tedros Adhanom Ghebreyesus asked people to remember the virus accelerates faster than it decelerates, so "control measures can only be lifted if the right public health measures are in place."

Redfield concurred with Adams that social distancing is working -- and said the potential death toll "while sadly too high, was far less than we anticipated" -- but said relaxing those guidelines would need to be done carefully.

Testing is still not widely available, and many states have still tested only small percentages of their populations.

The White House has worked to develop a more robust testing strategy, including shipping new rapid tests developed to states, and has worked to scale up serology testing, used to detect antibodies that would identify people who are likely immune to coronavirus and who could return to work or other aspects of normal life.

Antibody tests, which reveal past coronavirus infection -- an especially important test for health care workers -- will "give us a good idea from a surveillance point of view of how significant the outbreak was."

Weather adds to social distancing stress

As millions of Americans worried about stay-at-home orders and social distancing Sunday, about 95 million people in nearly 20 states experienced severe weather and tens of millions more will see storms Monday.

A majority of the storms were across the South and East Coast, according to the National Weather Service, with at least 34 tornadoes reported in Texas, Louisiana, Mississippi and Georgia as of early Monday. At least 18 people died.

Emergency officials said Sunday people sheltering from tornadoes and protecting themselves from severe weather take priority over the social distancing guidelines Americans are adhering to during the coronavirus pandemic.

Forecast models show the worst of the weather sweeping up the eastern portions of Georgia, the Carolinas and Virginia, but even as far north as New York, officials were urging caution.

New York City Mayor Bill de Blasio told residents the best protection from the weather is to continue to practice social distancing.

"We have strong winds and heavy rain coming our way on Monday, New York City, so it's really simple: if you do not need to be outside tomorrow then STAY HOME," de Blasio tweeted.

Indiana Coronavirus Cases

Data is updated nightly.

Confirmed Cases: 48626

Reported Deaths: 2717
CountyConfirmedDeaths
Marion11723689
Lake5212244
Elkhart332051
Allen2815132
St. Joseph198168
Cass16399
Hamilton1596101
Hendricks1414100
Johnson1288117
Porter73637
Tippecanoe7279
Madison66364
Clark66044
Bartholomew58944
Howard58057
LaPorte57926
Vanderburgh5706
Kosciusko5564
Marshall4926
Noble48428
Jackson4723
LaGrange4719
Delaware45050
Boone44943
Hancock44935
Shelby43025
Floyd38244
Morgan32931
Monroe30128
Montgomery29720
Grant29526
Clinton2892
Dubois2836
Henry28016
White26510
Decatur25532
Lawrence24625
Vigo2368
Dearborn23323
Warrick22129
Harrison21622
Greene19032
Miami1842
Jennings17612
Putnam1708
DeKalb1634
Scott1628
Daviess14717
Wayne1426
Orange13523
Perry1359
Steuben1302
Franklin1268
Ripley1227
Jasper1212
Wabash1132
Carroll1102
Fayette1017
Newton9910
Whitley965
Starke933
Gibson872
Randolph804
Huntington782
Wells751
Jefferson722
Fulton711
Jay680
Washington671
Pulaski661
Knox640
Clay604
Rush583
Adams501
Owen491
Benton480
Sullivan451
Posey440
Spencer411
Blackford392
Brown391
Crawford320
Fountain322
Tipton311
Switzerland270
Martin230
Parke230
Ohio170
Vermillion140
Warren141
Union130
Pike110
Unassigned0193

Ohio Coronavirus Cases

Data is updated nightly.

Confirmed Cases: 58904

Reported Deaths: 2970
CountyConfirmedDeaths
Franklin10587431
Cuyahoga8048379
Hamilton6158204
Lucas2788303
Marion273439
Pickaway220141
Summit2175207
Montgomery213431
Mahoning1849238
Butler163747
Columbiana130660
Stark1133113
Lorain105167
Trumbull97473
Warren88124
Clark7729
Delaware58815
Fairfield58516
Tuscarawas56810
Belmont55422
Medina53632
Lake50819
Licking49612
Miami47231
Portage44959
Ashtabula43644
Wood43651
Clermont4226
Geauga40843
Wayne36352
Richland3475
Allen32341
Mercer2879
Greene2769
Darke25326
Erie24622
Holmes2393
Huron2232
Madison1999
Ottawa15024
Sandusky13714
Crawford1365
Washington13520
Ross1303
Putnam12915
Coshocton1272
Hardin12312
Morrow1171
Auglaize1074
Jefferson912
Monroe8917
Union891
Muskingum861
Hancock791
Hocking788
Preble781
Guernsey743
Lawrence720
Williams722
Shelby694
Clinton680
Logan641
Athens631
Fulton620
Ashland601
Carroll593
Wyandot595
Brown581
Knox521
Defiance513
Fayette460
Highland451
Scioto450
Champaign411
Van Wert380
Perry351
Seneca342
Henry300
Paulding260
Adams241
Jackson240
Pike240
Vinton222
Gallia181
Harrison121
Meigs120
Morgan110
Noble110
Unassigned00
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