Coronavirus hospitalizations rise across U.S. is cause for concern

Patients suffering from covid-19 are rapidly filling hospitals across the South and West, with Mississippi, Tennessee, Texas, Nevada and Arizona setting records for hospitalizations Thursday, a sign that the coronavirus pandemic is entering a dangerous new phase.

In Arizona, where the virus appears to be spreading out of control, hospitals rushed to expand capacity and adopted practices similar to those employed at the height of the outbreak in New York City and Italy, including doubling up hospital beds in rooms, pausing elective surgeries and bringing in health-care workers from other states.

Perhaps most chillingly, at the urging of doctors and advisers, state officials this week activated “crisis standards of care” protocols, which determine for hospitals which patients get ventilators and care as the system becomes overwhelmed under the crush of patients.

“I think it’s pretty obvious that we are not going in the right direction,” Anthony Fauci, the country’s top infectious-disease expert, said during a YouTube live stream.

The coronavirus continued its recent surge across swaths of the United States, with more than 55,000 new cases reported Thursday, eclipsing the record for the largest single-day total that was set on Wednesday.

Deaths, which had declined steadily for several months, also are rising. States reported that 700 people died Thursday of covid-19 — an increase of more than 25 percent compared to the previous seven-day average.

“We are not flattening the curve right now,” Brett Giroir, the U.S. government’s coronavirus testing coordinator, said during a House hearing. “The curve is still going up.”

Not all states report on the number of current covid-19 hospitalizations, but even with incomplete data the increases are alarming, since they may presage a rise in deaths following the documented explosion in cases in the South and West and increases in scattered states elsewhere.

“There’s a lag between confirmed case and hospitalization, and between hospitalization and death. So you look at the numbers and you can see how hospital capacity could quickly become strained in coming weeks,” said Saskia Popescu, an epidemiologist at University of Arizona.

As hospitals have become overwhelmed, deaths have risen — not just among covid patients who get insufficient care, but among those facing other medical crises who don’t seek care from an overwhelmed system because they think they won’t receive it.

The Centers for Disease Control and Prevention estimated that since Feb. 1, about 20,000 to 49,000 more people have died of all non-covid-19 causes than would have been expected.

The fear is the same will soon happen in states such as Arizona, Texas and Florida as their health-care systems are strained to capacity.

In Arizona, if hospitalizations push past capacity, patients will be given a score based on life expectancy and underlying conditions.

“You look at what happened in Lombardy, Italy. What happened in New York. That’s what is about to happen here. People are going to die because our system is overwhelmed,” said Will Humble, who was director of Arizona Department of Health Services for six years under its previous Republican governor. “It’s important for other states to learn from us. This wasn’t bad luck. It was avoidable. Don’t let this happen to you. You look back at the past few months and we’re an example of what not to do.”

In a pair of public appearances at the White House on Thursday, President Donald Trump downplayed the danger, saying: “We have some areas where we’re putting out the flames or the fires, and that’s working out well.”

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Trump also hailed a stronger than expected jobs report Thursday, and promised a robust economic rebound in the third quarter, even though numerous states are moving to slow the reopening of their economies or shut down bars and other businesses in a desperate attempt to bring the outbreak under control.

“Today’s announcement proves that our economy is roaring back. It’s coming back extremely strong,” Trump said during a news conference in the White House press room, after receiving word that the U.S. economy added 4.8 million new jobs in June.

The new jobs sent the June unemployment rate down to 11.1 percent, from a high of 14.7 percent at the height of the coronavirus lockdown in April. But new data also released by the Labor Department showed that 1.4 million people filed unemployment claims for the first time last week, marking the 15th straight week of claims that exceeded 1 million.

With new infections surging, economists are growing increasingly concerned that temporary layoffs are turning into permanent job losses. Earlier this week, Federal Reserve Chair Jerome Powell warned Congress that unless the virus is brought under control, the nation’s economic outlook is “extraordinarily uncertain.”

Florida on Thursday reported 10,109 new cases, marking a new single-day record for the state. There were 68 new deaths, for a total of 3,718.

Thursday marked the 25th consecutive day that Florida has set a record high in its seven-day rolling average, and Gov. Ron DeSantis, a Republican, said Thursday that perhaps Floridians had been a bit too lax in recent weeks.

“I think the end of May, beginning of June, coronavirus kind of fell off the headlines a little bit and people said, ‘Hey, it seems good.’ And I think that some of the behaviors that have been preached, I think some of that eroded a little bit,” DeSantis said.

Hosting Vice President Mike Pence in Tampa for an emergency visit to discuss the pandemic, DeSantis did not, however, second-guess his own decisions to lift stay-at-home restrictions beginning in May.

Pence endorsed Florida’s moves to reimpose some restrictions and urged caution over the July 4 holiday weekend. It was a similar message to one he had delivered Wednesday in Arizona as part of a public show of support for hard-hit states.

Asked whether he would advise older or potentially vulnerable Republicans to skip the planned Republican National Convention next month in Jacksonville, Fla., Pence avoided a direct answer.

“We’re excited about coming to Jacksonville,” he said, adding that Florida and the rest of the country are well-equipped to handle the current rise in cases.

“No one wants to see these numbers where they are or no one wants to see them go up,” Pence said.

Texas Gov. Greg Abbott, a Republican, reversed course Thursday and ordered masks be worn in public. The order applies in counties with 20 or more positive covid-19 cases. “Wearing a face covering in public is proven to be one of the most effective ways we have to slow the spread of COVID-19,” Abbott said in a news release.

In Texas, the number of hospitalizations was 60 percent higher this week over last week.

Fauci attributed rising case numbers in the United States at least partially to American lockdown measures being more lenient than those in some European countries.

“If you look at the different curves between the European Union, the U.K. and others, how they’ve handled the outbreak, they’ve had big spikes and then they’ve brought it down almost or even to baseline in some countries,” Fauci said in an interview the BBC released Thursday. “The situation in the United States has been more problematic.”

Fauci said while some countries in Europe locked down around 97 percent of activity to control the virus, even the strictest U.S. lockdowns only shut down about 50 percent.

“That allowed the perpetuation of the outbreak that we never did get under very good control,” he said. The United States has been hit worse than any other country in terms of case numbers and deaths, he noted.

In few places is that more evident than in Arizona, where bars were packed before some restrictions went back into effect and where Trump held a crowded indoor political rally last week where very few people wore protective masks.

After insisting for weeks that hospitals had adequate capacity, Arizona Gov. Doug Ducey, a Republican, said for the first time last week that hospitals could reach surge capacity “very soon.”

Banner Health — the largest health-care delivery system in Arizona with 17 hospitals across the state — said Thursday they are exploring “all options” to increase beds, including repurposing pediatric beds, using spaces in their hospitals not usually used for care.

Other hospital systems said they are enacting similar surge plans. And state leaders are now preparing to reopen a shuttered Phoenix hospital — St. Luke’s Medical Center — as a field hospital.

“We would like to continue to remind the community that we cannot fight this virus alone,” said Banner Health spokeswoman Becky Armendariz, who pleaded for residents to avoid gatherings, wash hands and wear masks.

For months, missteps marred Arizona's response, experts say. Health officials abruptly cut off data access from a university modeling team when its projections showed a rising caseload. Even as the state moved aggressively to reopen businesses, few restrictions were put in place and almost none enforced.

Until recent days, cities and counties were forbidden from passing local ordinances requiring masks.

“It was clear to anyone with any observational skills that this was coming,” said Humble, the former Arizona health official. “You think back to Memorial Day, when bars and night clubs were filled at capacity with zero mitigation. Clearly the voluntary, honor system approach to mitigation was not working.”