The Washington PostDemocracy Dies in Darkness

Coronavirus recommendations ignored as case numbers rise

A server takes a customer order at a bar in San Diego. California is one of 10 states that hit new highs for hospitalized patients on Sunday.
A server takes a customer order at a bar in San Diego. California is one of 10 states that hit new highs for hospitalized patients on Sunday. (Bing Guan/Bloomberg News)

Coronavirus infections continued to rise in many parts of a divided nation on Monday, with public health recommendations under attack from communities tired of staying home and officials eager to restart local economies.

Even as the number of infections rose and hospital beds filled in some places, voices clamored for an end to mandatory mask-wearing. And relaxation of restrictions designed to curb the novel coronavirus continued.

“They’re either just over it, or they’ve come to believe it’s a phony pandemic because their own personal grandmother hasn’t been affected yet,” said Andrew Noymer, an epidemiologist at the University of California at Irvine, in Orange County. Elected officials last week forced the county health department to scale back a mask-wearing order. “People just think this is a nothingburger. So they think the risk is exaggerated.”

Two associations of local health officials released a statement warning that “public health department officials and staff have been physically threatened and politically scapegoated,” and “the vital work of public health departments is also being challenged.”

“Public health departments are facing lawsuits over their authority to close businesses, schools, and places of worship in order to protect the community at large — the very action that is credited with saving hundreds of thousands of American lives from this virus,” the National Association of County and City Health Officials and the Big Cities Health Coalition said.

Ten states — Alabama, Arkansas, California, Florida, Nevada, North Carolina, Oklahoma, South Carolina, Tennessee and Texas hit new highs for hospitalized patients on Sunday, according to data maintained by The Washington Post.

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“While we are coping with it now, this is not sustainable in the long term,” said Don Williamson, president and chief executive of the Alabama Hospital Association and a former state health officer. “We’re sort of at a tipping point. . . . What I am concerned about is that we are not seeing the response to that from the citizens that we have to [have] if we’re going to get this under control. We are not seeing people wear masks, we are not seeing social distancing in the way that needs to happen.”

Experts said a combination of factors is sharpening the tension between warnings issued by public health experts and the reality in places where cases are increasing. People are moving around more in good weather, said Ali Mokdad, a professor of health metrics sciences at the University of Washington, which produces an influential model that predicts future deaths from covid-19, the disease caused by the virus.

Mokdad’s organization, the Institute for Health Metrics and Evaluation, issued new numbers Monday evening that predicted the United States would have 201,129 covid-19 deaths by Oct. 1, an increase Mokdad said is attributable to premature relaxation of restrictions and increased mobility.

Some political leaders, from President Trump on down, are refusing to issue a consistent public health message about wearing masks and maintaining social distance, said Vin Gupta, an assistant professor at the same University of Washington institute. Gupta called Trump’s planned rally this month in Tulsa “medical malpractice.

“It’s as though they’re actively trying to oppose their public health professionals,” he said. “There isn’t a lot of ICU bed capacity out there, so if they get this wrong or Tulsa ends up being a superspreader event . . . who knows what’s going to happen?”

Mary Kay Henry, president of the Service Employees International Union, which represents 80,000 registered nurses, said “the idea that we are going to tolerate a certain number of deaths as a nation is outrageous. . . . It’s irresponsible of these governors to be so blasé about the idea that more people are going to be infected and die because they made a decision to reopen without the safety precautions that workers and consumers need.”

And Francis S. Collins, director of the National Institutes of Health, said, “I understand how people must be very tired of this at this point. But the virus doesn’t care that we’re tired. The virus is still out there.

“I do support the idea that it’s time to try to get people out in the workplaces and public spaces, but let’s do that with the utmost care.”

In St. Lucie County, Fla., where the number of cases has risen sharply during the past week and data maintained by the state showed just 10 percent capacity remaining in the county’s intensive care units, there are no plans to re-tighten restrictions, according to a spokesman.

“We are seeing some complacency with the public not wearing masks,” said Erick Gill, the county’s communications director. Though the overall numbers are small in comparison with outbreaks in major cities, the percentage of coronavirus tests that are positive also has increased, another worrisome sign, Gill said.

Nevertheless, the county reopened two libraries on a limited basis during the weekend. Restaurants and bars are allowed to seat people at half their former capacity. Public pools have not reopened, but that is because the county was unable to train lifeguards in March, at the height of the pandemic, he said.

Fernando Petry, chief medical officer for Cleveland Clinic Martin Health, which runs three hospitals in St. Lucie County, said its major facility, Cleveland Clinic Tradition Hospital, has experienced an increase in hospitalized patients in recent weeks but is not at capacity. The hospital “has the ability to significantly increase the ICU and general bed capacity we have today if there is a surge,” Petry said.

At a news conference on Monday, Arkansas Gov. Asa Hutchinson (R) said he expects “over the next week that the cases will continue to go up. I don’t think we’ve reached this second peak.” But, he said, the state’s hospitals have the capacity to deal with a surge.

State epidemiologist Jennifer Dillaha agreed, saying most cases are coming not from newly reopened businesses but from high-risk facilities such as nursing homes and prisons or social gatherings such as birthday parties. But, she said, the reopening appears to have convinced people that the pandemic is over and social distancing is no longer necessary. “They’re going back to their daily lives as before the pandemic hit.”

South Carolina Hospital Association President Melanie Matney said she is often one of the few people wearing a mask when she goes to the store.

However, an Axios-Ipsos poll shows that, nationally mask-wearing has not declined in about a month. In a poll conducted June 5-8, 48 percent of Americans said they wear a mask “at all times” when they leave home and 28 percent said they wear one “sometimes, but not all the time.” That figure does not vary significantly from the responses in a survey taken May 8-11.

Still, Matney said she thinks lax social distancing is reflected in the state’s rising case numbers and positivity rate on coronavirus tests.

“We’ve got to do better,” she said. “I do believe that people can do the right thing, but they have to understand and take it seriously.”

Jacqueline Dupree and Emily Guskin contributed to this report.

Coronavirus: What you need to know

Vaccines: The CDC recommends that everyone age 5 and older get an updated covid booster shot designed to target both the original virus and the omicron variant. Here’s some guidance on when you should get the omicron booster and how vaccine efficacy could be affected by your prior infections.

Variants: Instead of a single new Greek letter variant, a group of immune-evading omicron spinoffs are popping up all over the world. Any dominant variant will likely knock out monoclonal antibodies, targeted drugs that can be used as a treatment or to protect immunocompromised people.

Tripledemic: Hospitals are overwhelmed by a combination of respiratory illnesses, staffing shortages and nursing home closures. And experts believe the problem will deteriorate further in coming months. Here’s how to tell the difference between RSV, the flu and covid-19.

Guidance: CDC guidelines have been confusing — if you get covid, here’s how to tell when you’re no longer contagious. We’ve also created a guide to help you decide when to keep wearing face coverings.

Where do things stand? See the latest coronavirus numbers in the U.S. and across the world. In the U.S., pandemic trends have shifted and now White people are more likely to die from covid than Black people. Nearly nine out of 10 covid deaths are people over the age 65.

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