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The Final Pandemic Surge Is Crashing Over America

More older Americans, and residents of nursing homes, are also getting sick. This week, nursing homes and similar facilities reported 29,606 new virus cases among residents and staff, the largest increase in six months. This surge is especially foreboding because the virus is deadliest in these places; about 40 percent of all U.S. coronavirus deaths have happened in long-term-care facilities. For weeks, White House officials have argued that the virus should be allowed to spread freely as long as nursing-home residents are protected. The new data make clear that this approach is failing.

The virus continues to hammer every region of the country. Fifteen states hit all-time records for new cases this week. Five of those record-breaking states are in the Northeast; no state in that region had set a new case record since May 31.

In short, the United States is plunging into what may be the darkest period of the pandemic so far, even as it lacks the public-health orders or congressional assistance that buffered it in the spring. Because the virus is so widespread, America’s medical system is facing a greater test now than it did then; one in five hospitals nationwide reported a staffing shortage this week, according to federal data.

A vaccine is at hand. But for tens of thousands of Americans, it will come too late.

Here are five big lessons from the data we collected this week at the COVID Tracking Project.


First: Cases are increasing exponentially nationwide, and it may be months before they fall in some states.

For the past few weeks, outbreaks have been worsening rapidly in more densely populated midwestern states like Illinois and Michigan. At the same time, cases have been steadily rising in every region of the country. Nationally, the seven-day average for daily reported cases has almost doubled since November 1.

But what does it mean to see the country report 1 million cases in a single week? Leaving aside that this number accounts only for detected cases—true infections are almost certainly higher—we know this wave of newly diagnosed cases will crash into hospital systems that are, in many areas, already over capacity. And we know that three or four weeks behind each jump in cases, we expect to see a spike in reported deaths.

Ominously, this effect might be hitting multiple regions at once. Cases in the South have grown closer to that region’s summer peak, while the Midwest continues to post enormous increases and the West and Northeast creep upward.

bubble chart showing cases per million people by region by week in the US. Cases per million in the Midwest is at record highs this week (921 per million). All 4 regions are seeing cases/million rise.

This increase in cases can’t be chalked up to testing. While our national expansion in testing has seen the number of tests rise linearly, cases are now growing exponentially. In fact, the testing infrastructure may be coming under strain again, as it did during earlier outbreaks. News organizations are once again reporting long lines at drive-through COVID-19 testing sites, and Quest Diagnostics, which makes both PCR and antigen tests, this week said high demand and limited supplies are delaying the delivery of some results. Data reporting, too, is increasingly difficult as case numbers soar, case investigations and contact tracing even more so. And at the moment, we don’t see any indications that cases have reached a peak nationwide.


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