The disease caused by the novel coronavirus has killed at least 109,000 people in the United States since February. By April 13, it had killed in every state.
The overall daily death toll began to decline in May, largely because of a sharp decrease in deaths and reported infections in some of the hardest-hit urban centers such as Detroit, Seattle, New Orleans, and, most notably, New York City.
But the virus continues to accelerate in pockets of more rural areas, and public health officials fear new surges as states loosen restrictions after weeks of near-total sheltering in place. Raucous Memorial Day crowds flooded newly opened bars, lakes and beaches.
Criteria for reporting deaths has changed in some states and cities. New York City in mid-April added more than 3,700 deaths of people who were presumed to have covid-19 but were never tested. Even now, jurisdictions continue to fine-tune their counting and reporting procedures, so numbers in this story may fluctuate as authorities reclassify cases.
Most health officials — including the country’s foremost epidemiologist, Anthony S. Fauci, in testimony before the Senate — say the virus has killed more people than official death tolls indicate.
Health officials agree that the number of reported cases is also much lower than the actual number of people who now have, or did have, covid-19. Testing was slow to begin, and far fewer U.S. residents have been tested than experts say is necessary to get a true picture of the virus’s reach.
The virus continues to kill in New York, where at least 378,000 cases have been reported and at least 28,000 have died. But the pace has slowed considerably from the peak weeks in March and April when more than 1,000 died on some days.
Meanwhile, smaller pockets of the virus continue to arise in nursing homes, prisons, factories and other facilities in more rural areas. The disease has hit communities of color especially hard especially hard.
In Florida, home to millions of retirees, 1 of every 4 covid-19 deaths has been associated with a long-term care facility. Nationwide, the virus has killed at least 26,000 nursing home residents, according to numbers released June 1. Most deaths worldwide have occurred among people older than 50 and those with underlying health problems, as they are often most vulnerable to respiratory disease.
However, researchers have also linked the disease to a mysterious and deadly inflammatory syndrome in hundreds of U.S. children, an indication that much is still unknown about the virus and the way it affects different people.
Meat and poultry processing plants have experienced large, localized outbreaks. In states including South Dakota, Iowa, Nebraska, Washington and Indiana, plants were forced to cut production or close. By late May, thousands of workers had tested positive even as plants overhauled their safety measures, causing industry experts to predict supply shortages and higher meat prices this summer.
Sparsely populated rural areas don’t have the huge raw numbers of cases or deaths that cities are reporting, but some rank highly in deaths and cases per capita. People in very rural areas are more likely to die of flu than urbanites and may be more vulnerable to covid-19 as well, according to a Post analysis of CDC data.
Thousands have become ill in Navajo Nation, a reservation with a land area similar in size to West Virginia covering swaths of Arizona, New Mexico and Utah but with a population of only 350,000. Medical care in the area is sparse and far-flung, cell service is spotty and about a third of homes lack running water.
A handful of counties in southwestern Georgia have some of the highest and most persistent rates of infection and deaths in the country.
According to the president’s April 16 guidelines for reopening, accurate and thorough test results are necessary so that officials can make informed decisions about easing stay-at-home restrictions.
Because there is no coordinated national testing system, testing criteria and frequency vary widely among states and even among localities within states. Widespread implementation of testing has also experienced significant delays. As a result, some states and areas test much higher percentages of their populations than others, according to the Covid Tracking Project.
And plenty of states are opening without meeting benchmarks for testing and other criteria.
Data on deaths and cases comes from Post reporting and Johns Hopkins University. Post-reported data is gathered from state sites and from county and city sites for certain jurisdictions. Deaths are recorded on the dates they are announced, not necessarily the dates they occur. All numbers are provisional and may be revised by the jurisdictions.
By Joe Fox, Brittany Renee Mayes, Kevin Schaul and Leslie Shapiro. This story was originally posted on The Washington Post