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The number of new cases reported by states has doubled in the last three weeks. Outbreaks are growing not in one city, state, or region, but in dozens of places simultaneously. The number of people currently hospitalized is far from the all-time high during the spring, but is moving up steadily in lock-step with newly confirmed positive cases. Nationally, deaths are still decreasing, but more slowly than they were in early June. In the states hit earliest in this second surge, they are rising.

It was another record week for new COVID-19 cases, and the biggest week-over-week jump since the third week in March, when testing had just begun to increase in the United States. Cases continue to rise despite widespread problems in Arizona, Florida, and Texas in actually getting people swabbed, tests run, and results reported. As happened in the Northeast, when the surge really began, the testing infrastructure was quickly overwhelmed. After reporting by our team and others, even the White House testing czar, Admiral Brett Giroir, admitted that “it is absolutely correct that some labs across the country are reaching or near capacity.”

Four states that represent approximately 29% of the US population—Arizona, California, Florida, and Texas—account for 52% of new cases this week. 

But it would be a mistake to think the outbreak is limited to these high-profile geographies. We are seeing almost all of the South and West light up. Nineteen states hit record highs for new cases in the last two weeks, and thirteen of them hit new record highs since Sunday, June 28. 

In the regions with the worst outbreaks, testing is rising quickly, but the positivity rates—how many tests come back positive for COVID-19 out of all tests performed—have also continued to rise, with the South cresting 11 percent and the West over 8 percent positive. In the Midwest, the percent-positive rate is also slowly rising. In the Northeast, where all COVID-19 metrics have been improving since the early outbreak’s peak in mid-April, the percent-positive rate has stopped falling, though it remains at levels that indicate the virus has been effectively suppressed by months of communal and individual interventions.

Although the worst outbreaks this week are still concentrated in the South and West regions, the number of COVID-19 patients currently in the hospital has risen enough that the increase is clearly visible in the national numbers. All but four states—Florida, Idaho, Hawaii, and Kansas—and three territories currently report current COVID-19 hospitalizations. We now have a much clearer national picture of outbreak severity than we had through the spring, when hospitalization reporting was much less consistent. And thanks to the hard work of local journalists, Florida has agreed to begin reporting the number of patients currently hospitalized with COVID-19 in the next few days, and we will finally have a number that covers roughly 98% of the U.S. population. 

The good news about testing in the United States is that we’re doing four times as many tests this week as we did in early April. The bad news is twofold: 

  • First, based on the newest recommendation from the Harvard Global Health Institute, we must double our current number of daily tests to slow the pandemic’s spread. To actually suppress the pandemic in the United States, the Harvard team estimates that we need to perform 4.3 million tests per day, about seven times our current level. It took us eleven days to get from 500,000 to 600,000 average tests per day. If we keep up that pace, we won’t reach 1.2 million tests per day—the number needed just to slow the spread of COVID-19—until mid-September

  • The second problem is that, as noted above, our testing capacity may be hitting a wall in the regions where it’s needed the most. 

In three of the four states with the worst summer outbreaks, COVID-19 cases, hospitalizations, and deaths are rising. (Florida doesn’t yet provide current COVID-19 hospitalization data, but its cases and percent-positive rate are rising sharply.)

States we’re watching

In Arizona, all indicators continue rising sharply. The state has reached a weekly percent-positive rate of 24 percent, the highest in the United States. There are more than 2,500 people hospitalized with COVID-19 in Arizona this week, and 257 people died. Deaths have risen for three weeks now in Arizona.

In Arizona, race and ethnicity information is reported for roughly half of cases. For the cases for which we do have that data, there is a marked increase in the percentage of cases affecting Latinx people. On June 1, Latinx people made up 35 percent of new cases where ethnicity was known, slightly above their 31 percent share of the state’s population. By July 1, Latinx people made up 47.5 percent of new cases.

In Texas, the curve for COVID-19 hospitalizations closely follows the new-case curve. The percent-positive rate this week in Texas is more than 14 percent. More than 5.5k Texans have been hospitalized with COVID-19 this week, and 232 people have died of COVID-19. Deaths in Texas have risen for three weeks, and this week’s increase is the largest in over a month.

In Florida, tests and new cases are both way up, and the percent-positive rate continues to climb from 4.3 percent the first week of June to 16 percent this week. Deaths in Florida have gone up for the second week in a row, and 213 people died of COVID-19 in the state this week.

In California, new cases are spiking and hospitalizations are up, but the positivity rate remains much lower than in the other states with large outbreaks, at 6.4 percent this week. The regional picture within California is extremely varied, with case spikes concentrated in Southern California; The Los Angeles Times has detailed coverage of the pandemic by county and city and of the San Quentin outbreak. In California, deaths have begun to edge up.

As we noted at the top of this post, 13 states have hit new record highs by Wednesday of this week. One state we’re watching especially closely is Georgia.

In Georgia, new cases and hospitalizations are spiking, percent positive has risen from 5.8 percent in the first week of June to 13.3 percent this week, and deaths have slowly begun to rise.

Since last week, we published a deep dive on the death lag and changing age demographics for new cases, a preview of new COVID-19 data that all US testing labs will be required to report next month, and a look at an under-used COVID-19 metric that may improve the way we talk about testing

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