Covid-19: Infection in USA is Getting Worse
The news in the US has been dominated by anti-racism protests for the past couple of weeks, but coronavirus is now back in the headlines.
Several states have seen a record number of cases in recent days, leading to fears that the country is experiencing a second wave of infections.
But Vice-President Mike Pence said those fears were "overblown" and accused the media of using "grim predictions" to scare the American people.
So what is going on in the US?
The number of infections is going up
With more than two million coronavirus cases, the US has the highest number of confirmed infections in the world - about a quarter of the global total.
The situation got really bad in late March but by May, cases were declining and most states had begun to ease restrictions put into place to halt the spread of the virus.
The number of new cases rarely fell below 20,000 though, because as some states were bringing their outbreaks under control, others were only just beginning to see flare-ups.
For this reason, the top US health official for infectious diseases, Anthony Fauci, sees the current situation as a continuation of the initial outbreaks.
"People keep talking about a second wave," he told a reporter last week. "We're still in a first wave."
Spikes in cases in those new hotspots mean the country's overall seven-day average has now risen for several days in a row for the first time since cases peaked in early April.
There are big regional differences
The North East has been by far the worst-hit region, with about a quarter of all US cases and more than a third of all US deaths occurring in the states of New York and New Jersey. But in recent weeks, the region has brought its outbreaks under control.
The South and West of the country, on the other hand, have seen a big rise in the number of infections, according to data compiled by the COVID Tracking Project.
There's no debate over whether cases are going up again, but there is over why.
President Donald Trump blames it on increased testing, telling the Wall Street Journal he thinks "testing is overrated" because "in many ways, it makes us look bad."
The US has conducted more tests than any other country - about 25 million so far - so that does go some way to explaining why it has the highest number of cases in the world, although international comparisons are difficult to make for a number of reasons.
But there's plenty of evidence to suggest the recent rise in infections is down to more than just a higher number of people being tested.
The rise in cases isn't just down to more testing
Twice last week, Arizona saw more new cases on its own than the entire nine-state North East region and that's not just down to increased testing.
This is clear when you look at the rate of coronavirus tests that are coming back positive.
If lots of tests are being done and the spread of the virus has been reduced, then the positive case rate would go down too. If the virus is still being spread widely, it goes up.
At the moment the positive case rate is just below 5% nationally, which is the level the World Health Organization recommends countries be at or below for 14 days before they ease restrictions on movement.
But about a third of states are above that level, as the chart below shows, and all of them have reopened to some extent over the last month.
The number of people being hospitalised has also risen in a number of these states, including Texas, where some reopened bars and restaurants are now closing their doors again, reports the Texas Tribune, because of fears over a new surge of cases.
Faced with rising case numbers and an economy that desperately needs to get going again, many public officials are looking to facemasks to help slow the spread of the virus. California, North Carolina and several US cities mandated or urged their use last week.
But masks have become increasingly politicised in recent weeks, with President Trump saying some people wear them primarily to show opposition to him.
Deaths are trending downwards - for now
Amid all of the fears about new hotspots, the most positive news in the US at the moment is that daily deaths continue to fall.
They peaked back in May when the outbreaks in the Northeast were at their most intense, with New York state alone registering around 1,000 a day. This week, that figure is about 40 a day.
However, deaths is a metric that lags behind cases and hospitalisations because it can take several weeks for those who are worst-hit to die from the disease. That means the consequences of the current spikes in cases won't be seen for a couple of weeks at least.
If we do see the number of deaths edging up, there will likely be some pressure on governors to reintroduce restrictions but Dr Fauci doesn't think that will happen.
"I don't think we're going to be talking about going back to lockdown," he said last week. "I think we're going to be talking about trying to better control those areas of the country that seem to be having a surge of cases."
Researchers are racing to produce a vaccine but it's clear that Americans, and the rest of the world, are going to be living with the virus until next year at the earliest.
One forecasting model run by experts at the University of Washington, which has been cited by the White House in the past, predicts the US death toll will have passed 200,000 by October - a month before the election./BBC
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