As coronavirus cases increase mainly in the southern and western United States, the country will soon “see more deaths,” White House health adviser Dr. Anthony Fauci warned Friday.
Deaths from Covid-19 lag behind other data points, such as hospitalizations, that delayed confirmed infections since the disease can take weeks to fully develop in one person. The United States reported 39,972 new cases Thursday, more cases in a single day than ever, according to data compiled by Johns Hopkins University.
As cases have increased in recent weeks, new deaths have steadily decreased, but Fauci, director of the National Institute of Allergy and Infectious Diseases, warned that the trend may not last long.
“There are more cases. There are more hospitalizations in some of those places and they will see more deaths soon,” Fauci said in an interview with CNBC’s Meg Tirrell that was broadcast by the Milken Institute. “Although deaths are shrinking as a country, that does not mean that you are not going to start seeing them now.”
The virus is infecting most young people now, Fauci said, compared to the previous outbreak when older, more vulnerable people were exposed, causing more severe symptoms among patients and increasing the death rate. According to data from the Centers for Disease Control and Prevention, otherwise healthy young people are less likely to become seriously ill and die of Covid-19 compared to 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 states are effectively protecting their most vulnerable residents. But Fauci said that a backdrop of increased infection means more risk for everyone in the community.
“Young people who are infected and don’t know they are infected … may inadvertently infect people who are susceptible to more complications. Then they start to see more hospitalizations and deaths,” Fauci said. “It may take a few weeks, but we will see that and that is my concern.”
Later Friday, Vice President Mike Pence said Americans can “take comfort in the fact that deaths are declining across the country.” He added that about half of all new cases in the United States are from people under the age of 35, which he called “very encouraging news.”
“This week, there were two days when we lost less than 300 Americans and you can see from this chart what has been a precipitous decline in some of the worst times 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 meeting with Fauci and others. “The reality is that we are in a much better place.”
However, in the briefing, Fauci emphasized that if young people do not take precautions to stop the spread of the virus, they will infect older and vulnerable people.
“People are infecting other people and ultimately you will infect someone who is vulnerable,” he said after Pence spoke. “This is part of a process where we can be part of the solution or part of the problem.”
Beyond the change in the age of the average infected person, better treatment is also helping to prevent deaths, Fauci told CNBC. Since doctors began treating the first Covid-19 patients in the US earlier this year, standard patient care has evolved and has become more effective.
Although there is still no Food and Drug Administration-approved drug to treat or prevent Covid-19, researchers have found some success in accelerating recovery among Gilead remdesivir patients. And earlier this month, researchers in the UK discovered that dexamethasone, a cheap and widely available steroid, reduces the risk of death by one-third for Covid-19 patients with respirators, and by a fifth for those with supplemental oxygen.
“We certainly know how to better treat people. Definitely,” Fauci said. “But remember, deaths lag behind hospitalizations that lag behind people who get sick that lag behind infected people.”
The recent increase in new cases, especially in Florida, California, Arizona and Texas, is a “serious situation,” Fauci said, adding that he is “very concerned.” He said the increase in cases “is not just because they are doing more tests.”
People in those states, Fauci said, are considering reopening and taking precautions as an “all-or-nothing phenomenon” that is causing problems.
“Either we are locked up or we rob the bars, we go to the beach, without masks,” he said. “If you are going to open, you have to do it in a prudent and gradual way. If you go from the confinement to be cautious in the wind, you will get in trouble.”
Some states may have to consider closing businesses and implementing restrictions on movement again to prevent the health system from being overwhelmed, Fauci said. On Thursday, Florida and Texas officials said they were pausing to reopen, but on Friday, Texas Governor Greg Abbott announced that the state would order some companies to close again amid record spikes in cases there.
“If you say you’re going to go back to the running of the bulls, there will be an absolute pullback on that. You may have to. You never take it off the table,” Fauci said. “But before you do that, how about you do the things we said all the time you should do? For God’s sake, avoid the crowds. Wear masks.”
Fauci also said efforts to trace contacts “are not going well.”
Contact tracing occurs when trained personnel contact infected people to investigate where they might have been infected and to whom they may have been exposed to the virus. It is a way to stop the spread of the virus, especially when combined with widespread testing and the ability to isolate potentially infectious people.