As coronavirus cases spike mostly across the American South and West, the country will soon “be seeing more deaths,” White House health adviser Dr. Anthony Fauci warned Friday.
Deaths caused by Covid-19 lag behind other data points such as hospitalizations, which lag behind confirmed infections as the disease can take weeks to fully develop in a person. The U.S. reported 39,972 new cases Thursday, more cases in a single day than ever before, according to data compiled by Johns Hopkins University.
As cases have risen in recent weeks, new deaths have steadily decreased, but Fauci, director of the National Institute of Allergy and Infectious Diseases, warned that trend might not last for long.
“There are more cases. There are more hospitalizations in some of those places and soon you’ll be seeing more deaths,” Fauci said in an interview with CNBC’s Meg Tirrell. ”Even though the deaths are coming down as a country, that doesn’t mean that you’re not going to start seeing them coming up now.”
The virus is infecting mostly young people now, Fauci noted, as opposed to earlier in the outbreak when older and more vulnerable people were exposed, leading to more severe symptoms among patients and driving the death rate up. According to data from the Centers for Disease Control and Prevention, otherwise healthy young people are less likely to become severely sick and die from Covid-19 compared with older people.
Officials in some states with expanding outbreaks, such as Florida and Texas, have pointed to the shift in infections toward younger people as an indication that the states are effectively protecting their most vulnerable residents. But Fauci said a backdrop of greater infection means more risk for everyone in the community.
“The young people who are infected and don’t know they’re infected … they may be inadvertently infecting the people who are susceptible to greater complications. Then you start seeing greater hospitalizations and deaths,” Fauci said. “It may take a few weeks, but we’ll see that and that’s my concern.”
Later Friday, Vice President Mike Pence said that Americans can “take some comfort in the fact that fatalities are declining all across the country.” He added that roughly half of all new cases in the U.S. are among people younger than 35 years old, which he called “very encouraging news.”
“This week, there were two days where we lost less than 300 Americans and you can see from this chart what has been a precipitous decline from some of the worst moments of this pandemic as it impacted areas of New York and New Jersey and the Northeast,” he said at a White House coronavirus task force briefing with Fauci and others. “The reality is we’re in a much better place.”
At the briefing, however, Fauci emphasized that if young people fail to take precautions to curb the spread of the virus, they will infect older and vulnerable people.
“People are infecting other people and ultimately you will infect someone who’s vulnerable,” he said after Pence spoke. ”This is part of a process that we can be either part of the solution or part of the problem.”
Beyond the shift in age of the average infected person, better treatment is also helping to prevent deaths, Fauci acknowledged. Since clinicians began to treat the first Covid-19 patients in the U.S. earlier this year, standard care for patients has evolved and become more effective.
Even though there’s still no drug approved by the Food and Drug Administration to treat or prevent Covid-19, researchers have found some success in hastening recovery among patients with Gilead‘s remdesivir. And earlier this month, researchers in England found that dexamethasone, a cheap and widely available steroid, cut the risk of death by a third for Covid-19 patients on ventilators, and by a fifth for those on supplemental oxygen.
“Certainly, we know how to treat people better. Definitely,” Fauci said. “But remember, deaths lag behind hospitalizations that lag behind individuals getting sick that lag behind people getting infected.”
The recent surge in new cases, especially in Florida, California, Arizona and Texas, is a “serious situation,” Fauci said, adding that he’s “very concerned.” He said the increase in cases “isn’t just because they’re doing more testing.”
People in those states, Fauci said, are looking at reopening and taking precautions as an “all or none phenomenon,” which is causing problems.
“Either we’re locked down or let’s storm the bars, go to the beach, no masks,” he said. “If you’re going to open up, you’ve got to do it in a stepwise, prudent fashion. If you go from lockdown to complete caution to the wind, you’re going to get into trouble.”
Some states might have to consider shutting down businesses and implementing restrictions on movement again to keep the health-care system from getting overwhelmed, Fauci said. On Thursday, officials in both Florida and Texas said they were pausing their reopening, but on Friday, Texas Gov. Greg Abbott announced the state would order some businesses to close again amid record spikes in cases there.
“If you say you’re going to go back into lockdown, there’ll be an absolute push back on that. You might have to do it. You never take it off the table,” Fauci said. But before you do that, how about doing the things that we said all along you should do. For goodness sake, avoid crowds. Wear masks.”
Fauci also said that efforts to conduct contact tracing are “not going well.”
Contact tracing occurs when trained personnel contact infected people to investigate where they might have been infected and who they might have exposed to the virus. It is one way to stem the spread of the virus, especially when combined with widespread testing and the ability to isolate potentially infectious people.