US braces for COVID-19 'slow burn'


The U.S. is likely to enter a period of “slow burn” of coronavirus cases through the summer, with coronavirus cases and deaths down from their peak but still taking a heavy toll, experts say. 

As the country passes the grim milestone of 100,000 deaths, experts say the pace of harm might be slower in the coming months, but there is unlikely to be a steep drop-off in the virus. There even could be some significant upticks as restrictions on businesses and movement are eased around the country. 

Risk looms even higher in the fall and winter, as experts expect a new spike in cases of the virus as the weather gets colder, combined with the added damage from flu season. 

“The virus is likely to continue to circulate,” Scott Gottlieb, President Trump’s former Food and Drug Administration commissioner, said Sunday on CBS’s Face the Nation. “We're likely to have this slow burn through the summer and then face renewed risk in the fall that we're going to have bigger outbreaks and potentially epidemics in certain states and cities.”

Experts are hoping that the warmer weather in the summer will hinder the transmission of the virus, as is the case with flu, but the extent of this seasonal effect is not yet clear. 

The counteracting force is the relaxing of restrictions keeping people from co-mingling and spreading the virus. As the country reopens, it is expected to push the number of cases up even as some forms of social distancing continue. 

William Schaffner, an infectious disease expert at Vanderbilt University, said the net effect of these opposing forces is not yet clear but “I would be surprised if there were a substantial decrease” in cases.

During the summer, there could be continued smaller outbreaks around places like churches, camps and nursing homes, ahead of a more serious spike in the fall, he said.

“Farther down the road we’re all concerned about late fall and winter,” he said. “That’s where we anticipate a really substantial uptick in cases.”

Even now, with new cases declining somewhat nationally, there are several states reopening with rising cases, according to data compiled by The New York Times, including Alabama, Arkansas and North Carolina.

Maryland, Minnesota, and Virginia all have more than 10 percent of their coronavirus tests coming back positive, according to data compiled by Johns Hopkins University, a warning sign of high levels of transmission. The number of coronavirus patients in Minnesota ICU beds hit a new high of 258 on Tuesday.  

And new cases in those three states are either flat or rising, not declining, according to The New York Times data. 

Nationally, there are still around 20,000 new cases and over 1,000 deaths per day. 

Gottlieb pointed to small recent upticks in coronavirus hospitalizations in several states, including Florida and Georgia, which he linked to the effects of reopening businesses, parks and other sites.  

Some state leaders acknowledged the upticks but said they cannot keep their states closed down indefinitely. 

Arkansas Gov. Asa Hutchinson (R) said over the weekend his state is having a “second peak” of coronavirus cases. But he did not point to more restrictions as the answer.

“We have to manage the risk,” he said on Fox News Sunday. “We take the virus very seriously. It's a risk, it causes death. But you can't cloister yourself in a home. That is just contrary to the American spirit.” 

Ashish Jha, director of the Harvard Global Health Institute, said a broad view of various models indicates that there could be another 70,000 to 100,000 deaths between now and the end of summer. 

“While the pace will slow down because we are doing some amount of social distancing and testing is ramping up, we're going to unfortunately see a lot more sickness and unfortunately a lot more deaths in the upcoming months,” Jha said Tuesday on NPR. 

He said he hopes those models turn out to be “too pessimistic” if the warm summer weather has a big enough effect. 

The flip side of a possible benefit from warmer weather in the summer is a looming second wave in the fall and winter. 

Experts are urging preparations so that the country will be better able to handle that wave. The Trump administration took heavy criticism for an extremely slow rollout of testing earlier this year. 

Improved testing in the fall, along with robust contact tracing and isolation of infected people, could help contain the outbreak. 

While testing has been improving recently, it is still not close to where experts say it needs to be. The U.S. is now testing about 400,000 people per day, well short of the 900,000 per day that Harvard researchers estimated as a minimum safe level. 

The danger is that if transmission levels stay high enough throughout the summer and into fall, it will be much harder to prevent a second wave from getting out of hand through testing and contact tracing when there is already a high level of virus circulating. 

In the near-term, as restrictions are lifted, experts are urging the public to help prevent upticks by continuing to stay six feet away from people, wearing masks when in close proximity to others and washing hands frequently.