Once again, most of the country is in trouble.
As of Monday, 31 states have reported more new COVID-19 cases this past week compared to the previous week, according to data from Johns Hopkins University.
And nine states reported record-high COVID-19 hospitalizations on Sunday, according to the COVID Tracking Project: Arkansas, Kansas, Missouri, Montana, Nebraska, North Dakota, Oklahoma, Wisconsin and Wyoming.
"These are extremely alarming trends, and there should be warning bells going off around the country," emergency medicine physician Dr. Leana Wen said.
"Some will say, 'well look, we are having increasing numbers of cases because we're testing more.' But we also know that in more than 15 states, the test positivity rate is over 10% -- which means that we're not doing nearly enough testing."
On top of that, many people have no idea where they caught the virus.
"Many parts of the country are reporting that 50% or more of their cases cannot be traced back to any single infectious source -- which also means that there is a high level of community spread," Wen said.
"We know what's coming next ... we're going to get increasing numbers of hospitalizations," she said.
"Hospitals could again become overwhelmed. And then we're not just talking about patients with coronavirus who might be in trouble. It's also about other patients who might be coming in for heart attacks and strokes and car accidents who may find a situation that's really untenable."
The states headed in the wrong direction
Five states are grappling with a 50% increase in new cases this past week compared to the previous week: Montana, New Mexico, Tennessee, North Carolina and Vermont.
Another 26 states had increases between 10% and 50%: Arkansas, Oregon, Idaho, Utah, Arizona, Colorado, Wyoming, North Dakota, South Dakota, Nebraska, Oklahoma, Minnesota, Iowa, Missouri, Illinois, Indiana, Michigan, Ohio, Kentucky, Mississippi, Florida, Virginia, West Virginia, Pennsylvania, New Jersey and Rhode Island.
Only three states -- Maine, Texas and Washington -- had fewer new cases compared to the previous week. The remaining 16 states are relatively steady.
No one is off the hook -- not even states that have improved
Several states, especially in the Northeast, have enjoyed much better success at fighting coronavirus after implementing strict and innovative ways to limit the virus' spread.
But those residents can't let their guard down, White House coronavirus task force coordinator Dr. Deborah Birx said.
"We're seeing those early suggestions here in the Northeast and what we wanted to make clear is the actions this time have to happen at the personal level, in our private homes, rather than just the public spaces," Birx said Friday during a briefing in Massachusetts.
She said people need to learn from the summer outbreaks in the South, where seemingly harmless gatherings contributed to the spreading of the virus.
"People let down their guard when they were with friends and family. And they took off their masks. And they share dinner, or they share drinks inside. And those become spreading events," Birx said.
20,000 deaths 'inevitable' this month
Public health experts have warned that the fall and winter could bring an explosion of new cases as Americans spend more time indoors, where there is a greater likelihood of transmission.
An additional 20,000 COVID-19 deaths in the last three weeks of October are "inevitable," said Dr. Tom Frieden, former director of the US Centers for Disease Control and Prevention.
"From the infections that have already occurred, we will see something like 20,000 deaths by the end of the month -- additional deaths," Frieden said Saturday.
"Anytime we ignore, minimize or underestimate this virus, we do so at our peril and the peril of people whose lives depend on us."
As of Monday, coronavirus has infected more than 7.7 million and killed more than 214,000 people in the US, according to Johns Hopkins University.
The overall death toll could nearly double to about 400,000 by February, according to the University of Washington's Institute for Health Metrics and Evaluation.
Fellow former CDC Director Dr. Richard Besser said it's up to all Americans to make sure grim projections don't become reality.
"What we do matters," he said. "If we follow the lead of CDC and do the things that are working around the globe, in terms of wearing masks and social distancing and washing hands and investigating cases, ensuring people have what they need to isolate and quarantine, we can have a very different trajectory and we can get this in control."
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