States and cities all but completely shut down earlier this year in an attempt to stem the spread of the novel coronavirus disease COVID-19. Many of those state and local authorities have now eased up on restrictions, allowing people to return to their pre-pandemic habits and behaviors. In many of those regions, COVID-19 cases are now on the rise, but the White House is pushing the message that COVID-19 spikes are due to an increase in testing and nothing more.
President Donald Trump said during a meeting on Monday, “If we stop testing right now, we’d have very few cases, if any.” Vice President Mike Pence doubled down on that messaging in a call with several states governors later in the day, trying to downplay any new outbreaks in their states.
“I would just encourage you all, as we talk about these things, to make sure and continue to explain to your citizens the magnitude of increase in testing,” Pence told the governors, according to a recording of the meeting obtained by The New York Times.
The Vice President has headed up the administration’s official coronavirus response task force since late February. That task force has consistently sidelined critics and downplayed expertise in an apparent effort to move past the pandemic’s economic effects as quickly as possible.
Pence echoed Trump in referring to pockets where COVID-19 exists as “embers,” a framing that was echoed by Health and Human Services Secretary Alex Azar. Certain locations, such as nursing homes and particularly meat-processing plants, have seen large outbreaks. “If any of them light on fire,” Azar said, speaking metaphorically, “we’ve got to get there right away.”
Encourage people with the news that we are safely reopening the country. That, as we speak today, because people are going back to hospitals and elective surgery and getting ordinary care, hospitalization rates may be going up. But according to our most current information, hospitalizations for coronavirus are going down across the country.
Unfortunately, Pence was wrong. According to pretty much all major trackers (Johns Hopkins University, New York Times, NPR) COVID-19 cases and related hospitalizations are on the rise in well over a dozen states.
Back to the bad days
More than 2.1 million people in the United States have been diagnosed with novel coronavirus disease COVID-19 this year, and more than 110,000 have died. The consequences, however, have not been evenly spread. Early on, urban hot spots such as Seattle and New York City seemed to account for a high percentage of the ill. Six months into the year, the disease is much more widespread.
Increased testing does result in increased diagnosis, but only up to a point. Testing zero people will certainly result in zero positive results—that much is true. During the first weeks and months of the pandemic, the US did indeed have woefully insufficient testing capacity, so every newly available batch of tests seemed to make the data spike.
But the testing situation has roughly stabilized, with an average of 461,000 tests performed per day in June, and we now have clearer data available about positivity rates—the number of performed tests that come back positive for SARS-CoV-2.
If testing is up and the prevalence of the disease is stable or decreasing, you should see a lower positivity rate in the data on average. For example, if you hypothetically tested an average of 1,000 people per day for a week, and an average of 50 tests per day came back positive, you’d have a 5 percent positivity rate. If you increased that hypothetical testing capacity to an average of 1,500 people per day, and the case levels were stable or dropping, you might still see about 50 positives per day—about a 3 percent positivity rate. But if you keep testing capacity at 1,500 people per day and start to see 100 cases per day, your positive rate is now up to more than 6 percent, and your local case counts are growing.
Virginia’s current positivity, as of June 16, stands at 7.4 percent according to state data. That’s a significant improvement for the commonwealth, overall: in April, the rate peaked at a high of more than 20 percent and has been generally working its way downward since then as testing has increased.
Arizona, on the other hand, is on the opposite trajectory. Although it reports an overall positivity rate of 8.7 percent, state data shows that number has been going up every week since May 17. Last week, the state hit a record high of 14 percent positivity, and so far—as of June 16—the rate for this week stands at 21 percent. (That may decrease as more test results come in during the rest of the week.)
Similar situations are unfolding elsewhere. For example, Texas reported record-high COVID-19 hospitalizations on Monday, according to The Texas Tribune. North Carolina also recorded a hospitalization high on Monday, according to the state. And Oregon, after a long decrease in hospitalizations, began to see those numbers creep back up again in June, coinciding with a stark increase in new cases, The Oregonian reports.
Public health experts in Arizona have linked that increase to the state’s early reopening efforts. The increase was not unforeseeable—even by the administration. Trump in May said in an interview that he expected “there’ll be more death” as the country came back online, telling ABC News, “Will some people be affected? Yes. Will some people be affected badly? Yes. But we have to get our country open and we have to get it open soon.”