US tops 100,000 coronavirus deaths with no end in sight

More than 100,000 Americans have died from the coronavirus, a staggering wave of death that has brought the world's largest economy to its knees as the federal government struggles even now to mount a concerted nationwide response.

As of Wednesday evening, the U.S. had recorded 1,695,776 confirmed cases of COVID-19 and 100,047 deaths, according to a Johns Hopkins University tracker.

The crisis shows few signs of easing. And as states begin loosening restrictions on business closures and social distancing requirements, many fear the country could be headed for a second wave of infections even before the first has been fully contained.

The two months of lockdowns meant to buy time to build the necessary testing and tracing capacity to bring COVID-19 under control have passed with only modest improvements, epidemiologists and public health experts said, at the cost of millions of American jobs and trillions in lost economic activity. 

At the same time, the U.S. has made only the barest progress in stemming the spread of the virus. The country has averaged nearly 23,000 new cases a day over the first three weeks of May, down from an April peak of 29,000 cases per day.

In April, an average of 1,800 people died from the virus every day; so far this month, that has eased to 1,360 a day, a still-shocking number that has made the United States the epicenter of a pandemic that other countries have brought to heel far faster.

"We're making progress too slowly, and we're making progress much more slowly than most of the rest of the developed world," said Jeremy Konyndyk, a senior fellow at the Center for Global Development who headed the U.S. Agency for International Development's Office of Foreign Disaster Assistance in the Obama administration. "American exceptionalism is killing us. Our tendency to do things our own way and not learn from other countries is directly contributing to how poorly we're managing this."

The virus has spread beyond its early urban epicenters in New York and Seattle, and new cases are now growing both in smaller cities and outside metropolitan areas. The number of cases reported in nonmetropolitan areas grew by 12 percent last week and by 10 percent in cities with more than 500,000 residents, according to data compiled by Brookings Institution demographer William Frey.

Like so many other elements of American life, the coronavirus response has become mired in the bog of partisanship. President Trump has lobbed insults at his political rivals and Democratic governors even as he declares victory; armed protestors have rallied at state Capitols in North Carolina, Michigan, Montana and Washington; and leaders in some states have faced allegations that they are manipulating or hiding data about the true scope of the outbreak.

In interviews, epidemiologists and public health experts said they saw only modest indications that the United States is using its brief window of opportunity to make changes. 

The number of coronavirus tests the country is conducting on a daily basis has risen by about half over the last month, a positive indicator that still leaves most states well short of what they will need to safely monitor the virus's spread over the long term. Laboratories across the country have processed around 400,000 tests most days this week, up from about 250,000 a day at the beginning of the month and about 150,000 a day in the middle of April.

The number of contact tracers employed by state and local governments has grown substantially. And the number of promising vaccine candidates in some form of early testing has given hope even if introduction, production and distribution remain months away.

"The United States has a health care system that's much better prepared than it was two months ago. The number of tests has increased substantially. We've gotten a bit of a start on contact tracing. Positivity rates are going down. The virus activity is going down in much of the country," said Tom Frieden, the former director of the Centers for Disease Control and Prevention who now runs Resolve to Save Lives, a global health nonprofit. "The physical distancing that we did was effective at reducing the spread. Now the challenge is the balancing act. How do we reopen without rekindling?"

Other nations have made far more rapid progress. Eighty days after Spain ordered nationwide lockdowns, the number of new cases reported on any given day had declined by 93 percent from their peaks. After an equal number of days in lockdown in Italy, daily case counts were 80 percent off their highs. In the United States, 80 days after our own lockdowns began, daily case counts have fallen only 28 percent.

"Unfortunately, we did not implement social distancing measures early enough and aggressively enough in most of the country. The result of that is we haven't suppressed cases and transmission fast enough," said Celine Gounder, a physician and global health expert at New York University's Grossman School of Medicine. "Had everyone across the country implemented social distancing measures promptly and aggressively until transmission was suppressed, frankly I think it would have been a shorter lockdown period with less damage to the economy and fewer deaths."

The future looks bleak even as Americans tell pollsters they are not willing to return to their daily lives for fear of contracting the virus. A study by the University of Washington's Comparative Health Outcomes, Policy and Economics Institute projects the number of deaths across the country could more than triple by year's end even if social distancing practices continue.

But instead of continuing lockdowns in hopes of starving the virus of new victims, all 50 states have taken initial steps toward resuming economic activity.

Tourists flocked to the boardwalk in Ocean City, Md., and to a raucous pool party in Missouri's Lake of the Ozarks over Memorial Day weekend, alarming epidemiologists. Stay-at-home orders have been lifted everywhere except Washington, D.C., which is set to do so on Friday, and cellphone data shows more Americans are leaving their homes on a daily basis.

The number of confirmed cases will rise, possibly substantially, as testing capacity improves and those tests identify more people who show few or no symptoms of COVID-19.

But the number of cases is also likely to rise as more people venture out in public even before the first wave subsides.

"I'm very concerned that we're going to see a second peak, wave, layered on top of what's already an ongoing first wave," Gounder said.

As the country loosens its restrictions, governors and local leaders have a new opportunity, this time to learn from other countries that have gone before. France, Australia and New Zealand have reopened schools and traced some new hot spots as they have emerged. In South Korea, a nightclub and a gym have both been catalysts for new outbreaks.

"Everywhere that's been hit that responded had a sort of slightly difference response and outcome is a data point. That's a useful learning tool. Retrospectively, when we go through what happened here, we shouldn't be dismissing any of it," said Nita Bharti, a biologist at the Center for Infectious Disease Dynamics at Penn State University. "A lot of those things are just going to be different. Some of them just have to be new. We have to be innovative and creative about building from the ground up for some things."

As Trump runs a reelection campaign that has suddenly become more about his pandemic response than his handling of the economy, he has repeatedly declared victory over a virus that still rages and pushed governors in swing states to allow businesses to reopen. On Friday, Trump designated houses of worship as “essential” services.

But epidemiologists and economists alike warn that the public health crisis and the economic crisis go hand in hand and that activity will not return to whatever the new normal is until people feel safe venturing out and opening their wallets. They warn of the potential damage that could come when a second wave of the virus hits, damage that could amplify that which has already been done.

"The desire for a rapid economic recovery will in fact make the economic recovery much slower and much weaker than if there were just some discipline in controlling the outbreak," Konyndyk said.

"It's like a nationwide marshmallow test," he added. "We're eating the marshmallow."