FORT LAUDERDALE, Fla. -- Four U.S. states -- Arizona, California, Florida and Texas -- reported a combined 25,000 new confirmed coronavirus cases Thursday as the infection curve rose in 40 of the 50 states and the number of daily confirmed coronavirus cases nationwide climbed past 50,000 heading into the July Fourth holiday weekend.
"What we've seen is a very disturbing week," Dr. Anthony Fauci, the government's top infectious disease expert, said in a livestream with the American Medical Association.
In a major retreat that illustrated how dire things have become in Texas, Republican Gov. Greg Abbott ordered the wearing of masks across most of the state after refusing until recently to let even local governments impose such rules.
The surge has been blamed in part on Americans not covering their faces or following other social distancing rules as states lifted their lockdowns over the past few weeks. Fauci warned that if people don't start complying, "we're going to be in some serious difficulty."
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The U.S. recorded 51,200 new confirmed cases Wednesday, according to a tally kept by Johns Hopkins University. That represents a doubling of the daily total over the past month and is higher even than what the country witnessed during the most lethal phase of the crisis in April and May, when the New York metropolitan area was easily the worst hot spot in the U.S.
All but 10 states are showing an upswing in newly reported cases over the past 14 days, according to data compiled by the volunteer COVID Tracking Project. The outbreaks are most severe in Arizona, Texas and Florida, which together with California have reclosed or otherwise clamped back down on bars, restaurants and movie theaters over the past week or so.
Nebraska and South Dakota were the only states outside the Northeast with a downward trend in cases.
While some of the increases may be explained by expanded testing, other indicators are grim, too, including hospitalizations and positive test rates. Over the past two weeks, the percentage of positive tests has doubled in Georgia, Kansas, Montana, Michigan, Missouri, Tennessee, Mississippi, South Carolina and Ohio. In Nevada, it has tripled. In Idaho, it is five times higher.
MASK FINE: UP TO $250
In Texas, where new cases in the past two weeks have swelled from about 2,400 a day to almost 8,000 on Wednesday, the positive rate ballooned from 8% to 14.5%. In Arizona, it has gone from 5.7% to 10.3%.
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Abbott, who in May began one of the most aggressive reopening schedules of any governor, ordered the wearing of masks in all counties with at least 20 covid-19 cases.
The mask order takes effect today.
Mask order violators can be fined up to $250. There are exceptions for people who have a medical condition or disability, who are exercising outdoors, or who are participating in a religious service or voting. Texas this week began its monthlong early voting period for its primary elections.
Abbott also gave mayors and county authorities the ability to ban outdoor gatherings of more than 10 people.
In his order and a statement, Abbott said wearing a mask is a proven method to slowing down the virus's spread and said if Texans comply "more extreme measures may be avoided."
Abbott has said he doesn't want to roll back his previous orders to reopen the economy. But last week he moved to reclose bars and limit dine-in capacity in restaurants to 50%.
Abbott said in a video posted on Twitter that the state's lower infection rate and case counts after his stay-home order in April might have led some to think the "coast was clear."
But the number of people hospitalized in Texas because of covid-19 has quadrupled since late May, after businesses began reopening.
"We are now at a point where the virus is spreading so fast, there is little margin for error," Abbott said. "I know that wearing a face covering is not the convenient thing to do, but I also know that wearing a face covering will help us to keep Texas open for business. And it will help Texans earn the paycheck they need."
"The move to mandate facemasks comes far too little, far too late for Governor Abbott," Texas Democratic Party communications director Abhi Rahman said. "Texans are still getting sick. Families are still suffering ... All of this could have been prevented if Governor Abbott had listened to experts and medical professionals in the first place."
The Texas Medical Association applauded the mask order. The doctors' group had urged the state Republican Party to cancel its in-person convention, which starts July 16 in Houston. A statement from the group did not address the convention
"There is no question about it, face masks reduce the spread of COVID-19. They help protect the people wearing masks, and they help protect the people around them," said the association's president, Dr. Diana L. Fite.
FLORIDA TALLIES SOAR
The surge comes as Americans head into a Fourth of July holiday that health officials warn could add fuel to the outbreak by drawing big crowds. Many municipalities have canceled fireworks displays. Beaches up and down California and Florida have been closed.
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Florida reported more than 10,000 new confirmed cases for the first time Thursday. That is six times higher than the daily count of less than a month ago. The state also reported 67 deaths for the second time in a week and 325 new hospitalizations, one of the biggest 24-hour jumps in Florida yet. Georgia likewise saw its biggest single-day increase yet, nearly 3,500 cases.
"I'm discouraged because we didn't act fast enough to shut things down, and we could have done a much better job getting a handle on the virus," said Megan Archer, 39, from West Palm Beach, Fla., who lost her job with a county parks department during the outbreak.
Kansas' governor and its top public health official said Thursday that they worry that the state won't be able to reopen its K-12 schools for the new school year in August if it doesn't reverse a recent surge in reported cases.
Democratic Gov. Laura Kelly told legislative leaders that a desire to reopen schools is a key reason for her executive order requiring Kansas residents to wear masks in public and their workplaces. The order takes effect at 12:01 a.m. today, with a fine of up to $2,500 possible for violators.
"The trend is going in the wrong direction," Kelly said during a meeting to review her order. "If we continue that way, we will not be able to open our schools for in-classroom learning in the fall."
Kelly and other state officials don't expect strict enforcement with decisions about pursuing violations left up to prosecutors in each of the state's 105 counties. Attorney General Derek Schmidt, a Republican, can pursue violations but said he will leave them to local officials.
Also, counties can opt out of the order under a new pandemic law that took effect in June and resulted from a compromise between Kelly and lawmakers.
CRITICAL WEEKS AHEAD
Several Northeastern states have seen new infections slow down significantly, including New York, Massachusetts, Connecticut, Rhode Island and New Jersey, which allowed its Atlantic City casinos to reopen Thursday, though with no smoking, drinking or eating.
Pennsylvania, an outlier among Northeastern states, reported its highest one-day total of new cases since May, with more than 830, more than one-quarter of them in Pittsburgh's Allegheny County, which will impose a one-week shutdown of bars and restaurants and all gatherings of more than 25 people starting today.
Other states, like Colorado, a major summer destination where increases in infections have been less dramatic, are keeping a close eye on their neighbors.
"I've been watching that map. ... We're well aware of what's going on around us and we're very anxious," said Dr. Michelle Barron, medical director of infection prevention and control at UCHealth University of Colorado Hospital. "The next couple of weeks are critical."
President Donald Trump on Wednesday seemed optimistic the virus would soon subside, telling Fox Business: "I think that, at some point, that's going to sort of just disappear, I hope."
The U.S. has reported at least 2.7 million cases and more than 128,000 dead, the highest toll in the world. Globally there have been 10.7 million confirmed cases and over 517,000 deaths, according to Johns Hopkins' count. The true toll is believed to be significantly higher, in part because of limited testing and mild cases that have been missed.
Other countries are also reporting an upswing in cases.
"We have now entered a new and treacherous phase in the life cycle of this pandemic," South African President Cyril Ramaphosa warned in a broadcast to the nation, which recorded more than 8,100 new infections, a one-day record, and has the biggest caseload on the continent.
India, the world's second-most populous country with more than 1.3 billion people, has reported nearly 100,000 new cases in the past four days alone.
HEART DISEASE
Separately, the coronavirus killed tens of thousands in the United States during the pandemic's first months, but it also left a lesser-known toll -- thousands more deaths than would have been expected from heart disease and a handful of other medical conditions, according to an analysis of federal data by The Washington Post.
The analysis suggests that in five hard-hit states and New York City there were 8,300 more deaths from heart problems than would have been typical in March, April and May -- an increase of about 27% over historical averages.
That spike contributed to Illinois, Massachusetts, Michigan, New Jersey, and New York state and the city having a combined 75,000 "excess deaths" during that period, 17,000 more than the number officially attributed to covid-19, the disease the virus causes.
While several experts said some of the excess deaths in the analysis were almost certainly unrecognized fatalities from covid-19, the review suggests that many patients suffering from serious conditions died as a result of delaying or not seeking care as the outbreak progressed and swamped some hospitals.
Normally, heart disease is the leading cause of death in the United States. But in the early months of the pandemic, some hospital departments were nearly devoid of the heart, cancer, stroke and other patients who populated them before.
More than 50 patients a day "died excess deaths just from heart disease, just in New York City," said John Puskas, a cardiovascular surgeon at Mount Sinai Hospital in Manhattan. "Frankly, that would explain where all the patients went."
The analysis of data from March 1 to May 30, using a model previously developed by the Yale University school of public health, shows that heart disease is the major driver of excess deaths, excluding those officially attributed to covid-19.
Information for this article was contibuted by Jake Coyle, Terry Spencer, Jim Vertuno, John Hanna, Adriana Gomez Licon, Kelli Kennedy, Cara Anna and David Rising of The Associated Press; and by Reis Thebault, Lenny Bernstein, Andrew Ba Tran and Youjin Shin of The Washington Post.
