U.S. Coronavirus Cases Rise, Continuing Pandemic Cycle : Consider This from NPR Coronavirus cases fall, so people let their guard down. Cases rise, so they get more vigilant. That's the cycle the U.S. is stuck in.

In most states across the country, the number of new coronavirus cases each day is up. That's the situation in Wisconsin, where cases are surging. Infectious disease specialist Dr. Michael Landrum spoke with NPR about what he's been seeing the last several weeks.

As a whole, the U.S. is seeing around 50,000 new cases each day. That's an increase from 35,000 a month ago. NPR's Will Stone charts the course of the pandemic's ups and downs over the last nine months, from early cases in Washington state to the current spread of the virus into rural America. And the predictions for winter are grim, as people are likely to spend more time indoors.

In participating regions, you'll also hear a local news segment that will help you make sense of what's going on in your community.

Email us at considerthis@npr.org.
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The U.S. Pandemic Is Stuck In A Cycle Of Endless Ups And Downs

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The U.S. Pandemic Is Stuck In A Cycle Of Endless Ups And Downs

The U.S. Pandemic Is Stuck In A Cycle Of Endless Ups And Downs

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In most states in America, the number of new coronavirus cases each day is up. Right now, the country is seeing around 50,000 new cases each day, an increase from 35,000 a month ago. Some places are faring worse than others.


MICHAEL LANDRUM: Our hospitalizations and numbers have really gone up dramatically just since early September to the point where our resources are stretched pretty thin, especially in the hospital staff are - we're getting tired.

CORNISH: Dr. Michael Landrum is an infectious disease specialist at Bellin Health, a hospital in Green Bay, Wis. Wisconsin has a major problem with the virus right now. Last week, the governor said hospitals are overwhelmed. This week, they'll open a field hospital in a state park with space for more than 500 patients. What explains the increase there and in so many places?


LANDRUM: You know, when coronavirus was brand-new in the spring to all of us in the country, the fear of the unknown, I think, motivated people to lay low and be extra safe. But now that's not the case. And so I think the really hard thing now is trying to somehow now get the message out there to rein things back in again a second time.

CORNISH: CONSIDER THIS - the story of the pandemic in America is one of ups and downs. Cases rise; people get cautious. Cases drop; people let their guard down. That's the cycle we're in. From NPR, I'm Audie Cornish. It's Tuesday, October 13.



CORNISH: So let's retrace the story of the pandemic in this country. It's a story that starts about nine months ago, January 19. A 35-year-old man walks into an urgent care clinic north of Seattle. He complains of four days of coughing and fever and says he's just visited family in Wuhan, China. The doctor takes a few swabs. A few days later...


UNIDENTIFIED REPORTER #1: The alarming new development of that deadly mystery virus outbreak - the first case in the U.S. confirmed.

CORNISH: Three weeks later, the disease caused by that virus is given a name by the World Health Organization.


UNIDENTIFIED REPORTER #2: COVID-19 - CO for corona, VI for virus, D for disease and 19 because it started last year.

CORNISH: NPR's Will Stone has been tracing the course of the U.S. pandemic from its earliest days in Washington state.

Hey there, Will.


CORNISH: So, Will, we're going to talk through five key moments from this year that got us to where we are today. And we just told the story of the first known case in Washington. The next big story of the pandemic clearly was New York - right? - the Northeast.

STONE: Yeah. When it hit New York City, the rest of the country realizes this isn't just a Washington problem.


DAVID LIN: Every single person that rolled in - tubed, unstable, respiratory failure...

STONE: People like David Lin see the ERs in New York start filling up. He's a medical resident at the Mount Sinai Hospital.


LIN: COVID - next one, same. Next one, same. And they were anyone - young, old.

CORNISH: And the city's standing up these makeshift hospitals. I mean, the Navy hospital ship arrives.


UNIDENTIFIED PERSON: Yeah, the Comfort now is just pulling into dock here in midtown Manhattan.

STONE: And by early April...


ANDREW CUOMO: And we talk about numbers.

STONE: ...Governor Cuomo is reporting these huge death tolls every day.


CUOMO: That's 731 people who we lost. Behind every one of those numbers is an individual, is a family.

STONE: And it becomes clear that health care workers are getting sick, too. They're burning out. They're worried about their health.


SACHITA SHAH: We're afraid for each other. I'm afraid for myself. I'm a single mom.

STONE: Here was Dr. Sachita Shah at Harborview Medical Center in Seattle at the time.


SHAH: I'm afraid to leave my kids without a parent. This week, we started taking care of our own. You know, our - some of our residents are sick. This is a disease of health care workers, too.

STONE: And there's also this realization that no one is going to have enough of anything to make it through - masks, gowns, test kits.

CORNISH: Which sounds really bad and was really bad, but then things sort of slowed down as the country moved into May, right?

STONE: Yeah. So this is sort of the third big moment of the pandemic, this temporary reprieve towards the end of May as the bigger cities are seeing deaths go down.

CORNISH: And it leads to a sense of complacency going into Memorial Day, right?



DEBORAH BIRX: You can't tell who's infected, and so that's why you have to continue to social distance.

STONE: And officials like Deborah Birx of the White House coronavirus task force are worried.


BIRX: When you go out for this weekend, Memorial Day, and you want to do some kind of social gathering, it's very important to maintain that 6-feet distance and very important to have your mask with you...

CORNISH: So it's not long before we start to see things basically tick back up again.

STONE: That's right. And that's when we get to the fourth big moment - this summer surge in California, Arizona, Texas, the South - which is also when we realized the type of people driving up the case numbers now is shifting. It's young people.

CORNISH: It sounded like officials in a way were starting to blame young people or millennials for what was going on. Here's how the mayor of St. Petersburg, Rick Kriseman, put it.


RICK KRISEMAN: All of you millennials who thought you were immune to this virus, that the only people who were afflicted by coronavirus were baby boomers and those older than them, you were wrong.

STONE: Yeah, but that focus on young people also becomes somewhat of a distraction from the real problem, which is that states never closed down enough, and they're reopening too fast. You saw this playing out, especially in Texas.


GREG ABBOTT: We don't have to choose between jobs and health. We can have both.

STONE: That was Governor Greg Abbott. That didn't turn out to be true. They needed further lockdowns.

CORNISH: And that's when you see states like Florida - right? - breaking records with daily case numbers - at one point, 15,000 new cases a day, which was even worse than during New York's peak. And ERs are filling up.


DAVID DE LA ZERDA: So we are working many hours, I think at least three times more than we worked in the past.

CORNISH: Here's Dr. David De La Zerda at Jackson Memorial Hospital in South Florida.


DE LA ZERDA: I am really worried. If we continue to see the influx we've seen in the last few days, we are going to reach our capacity by the end of the week.

STONE: By midsummer, cases are peaking. And then by mid-August, they descend significantly.

CORNISH: There's another lull - right? - a brief one. It feels like a moment of calm. Is this when the U.S. starts to feel - the government starts to feel that things are somewhat under control?

STONE: Yeah, cases are coming down. But even during this dip, we were still seeing more than 30,000 cases a day. And then by late August, we started to see a pickup of cases in the middle of the country. And in September, nationally, cases start rising again. And that sort of brings us to the fifth moment, where we are right now.

CORNISH: And where we are right now is 215,000 people in this country who have died from coronavirus.

STONE: That's right, Audie.

CORNISH: Looking back at that, the way the virus has moved across the U.S., early on, we heard about different waves. Is that actually a good way to think about it?

STONE: A wave does not quite capture it because the pandemic has not crashed across the country all at once and then gone away. This is how Dr. Roger Shapiro at Harvard describes the U.S. coronavirus outbreak.

ROGER SHAPIRO: A better way of thinking about it is a wave that went into a pool. And in that pool, it's sloshing around. Wherever it hasn't been yet, it's going to go. The places where it has already been, it could go back.

STONE: So what we have now is this constant reservoir of disease splashing around, infecting people at different times in different places.

CORNISH: At the same time, it was forecast that the Midwest in the middle of the country might face what they're facing now - right? - a lot of cases. What do we know about where things stand there?

STONE: The virus got a foothold in that region toward the end of the summer, and that's persisted. Oklahoma, Missouri, Nebraska and the Dakotas all have quite high infection rates. More recently, Wisconsin has become one of the worst hot spots. And there's another trend that's really concerning - the virus is spreading into rural America.

TARA SMITH: There's just been this message that this is kind of an urban problem.

STONE: Professor Tara Smith is at Kent State University in Ohio. And she says in her state, earlier in the pandemic, the virus hit the big cities like Cleveland and Columbus. But now, Smith says, the virus is spilling into rural areas and, to a lesser extent, the suburbs.

SMITH: I don't think they're prepared in a lot of ways. I think they've actually been actively misinformed. They've been told, you don't have to worry about it. You don't have to defend yourself.

STONE: What's interesting is that other public health problems have followed this pattern, like HIV. It started in the cities and then moved to more rural areas. But the problem is that when that happens, it's harder to deal with because there are less resources for health care in these communities, on top of higher poverty and other challenges.


CORNISH: Now it's fall. We're going to be heading into winter. I know I'm not the only one who's heard these predictions that the U.S. is going to see a big rise in cases as people spend more time indoors. Is the country prepared for this?

STONE: It's not. Overall, it looks pretty grim. The hope early on was that the country could take advantage of the summer, bring infections down a lot to get some breathing room before the fall and flu season. But as a country, we never got there. So now the prediction is that by the end of the year, the death toll will reach about 360,000. That estimate comes from modelers at the University of Washington, like professor Ali Mokdad. And Mokdad says the U.S. is just stuck in a cycle.

ALI MOKDAD: We are in this, like, roller coaster in every location in the United States where it goes up, and then we change our behavior. We bring it down, then we let down our guard. Then it goes up again.

STONE: And Mokdad says the data show this pattern of behavior all over the country, and this means places that have already gone through a really bad outbreak are vulnerable to another one. And immunity won't help because most of America still hasn't been infected.

CORNISH: So the biggest question going forward - are a lot of places that shut down in the spring - are they going to have to do that again in the winter?

STONE: As painful as they are, shutdowns can be effective. But professor Mokdad also told me that timing matters. Shutdowns have to be in place before hospitalizations spike. Otherwise, they're not nearly as effective as they could be, and you still get the economic pain.


CORNISH: That's NPR's Will Stone. It's CONSIDER THIS FROM NPR. I'm Audie Cornish.

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