As new hot spots emerge, the pandemic may be entering another phase.
The simplest way to track the progress of any outbreak is by seeing how many new cases and deaths are reported in a given area each day. And in the United States, falling numbers in some of the hardest-hit places have offered glimmers of hope. Totals for the country have been on a downward curve, and in former hot spots like New York and New Jersey, the counts appear to have peaked.
But infections and deaths are rising in more than a dozen states, as they are in countries around the world, an ominous sign that the pandemic may be entering a new phase.
Wisconsin saw its highest single-day increase in confirmed cases and deaths this week, two weeks after the state’s highest court overturned a stay-at-home order. Cases are also on the rise in Alabama, Arkansas, California and North Carolina, which on Thursday reported some of the state’s highest numbers of hospitalizations and reported deaths since the crisis began.
In metropolitan areas like Fayetteville, Ark.; Yuma, Ariz.; and Roanoke and Charlottesville, Va., data show new highs may be only days or weeks away.
Outbreaks have accelerated especially sharply in Argentina, Brazil, Colombia, Mexico and Peru, leading the World Health Organization to say on Tuesday that it considered the Americas to be the new center of the pandemic.
And although much of the Middle East seemed to avert early catastrophe even as the virus ravaged Iran, case counts have been swelling in Kuwait, Saudi Arabia, Qatar and the United Arab Emirates.
Reported cases are not perfect measures to chart the spread of the virus because they depend on how much testing is done. Death counts are less dependent on testing, though official numbers are typically undercounts. Both counts, though, can indicate how the outbreak is evolving, especially in places where lockdown rules are easing or where governments have been ineffective at slowing the spread, and offer early clues about new hot spots.
That is why Wisconsin is being closely monitored. Two weeks ago, the conservative majority on the State Supreme Court overturned that state’s stay-at-home order, effectively removing the most serious restrictions on residents.
It can take several weeks after changes in behavior — like the increased movement and interactions associated with the end of a stay-at-home order — for the effect on transmissions to be reflected in the data. In Wisconsin, there were indications that the virus was still spreading before the order was lifted. But in the weeks since restrictions were overturned, the case numbers have continued to grow.
“It worries us,” said Dr. Nasia Safdar, the medical director for infection prevention at the University of Wisconsin Hospital in Madison. “We wonder if this is a trend in an unfavorable direction.”
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