Birx on the southern surge in COVID cases: What we have right now are three New Yorks

This is an unfortunate description, as it risks leading the uninformed to believe that deaths are piling up in Arizona, Florida, and Texas on the same scale as New York saw in March and April. That’s not true and never has been. Yesterday all three states combined for around 450 deaths, which is a bit more than half the daily total in New York at its peak even though their combined population is much larger than New York State’s is. All three states also appear to be past their peaks in new cases, which means that deaths should start to decline within a few weeks.

I don’t think Birx meant to mislead. All she meant was that America now has three states with challenging epidemics to control whereas in early April it had only one. (Well, two, unless you consider New Jersey an entity meaningfully distinct from New York.) But it’s jarring to hear her use language like that when one of the distinguishing features of the summer “second wave” we’re experiencing is that it *hasn’t* produced quite the same fearsome death toll that we saw in the spring. “Why?” is one of the great mysteries of the pandemic.

Watching everyone freak out this morning about Fauci’s maskless moments at the Nats game yesterday reminded me of one of the ironies of the White House’s COVID response. He’s the lightning rod for praise and criticism among the public but to all appearances it’s Birx who’s been the more meaningful contributor behind the scenes — and not necessarily in a good way. It didn’t get much attention online but this NYT story from a few days ago accused Birx of having miscalculated the trajectory of the pandemic back in April in a fateful way. She thought America’s curve would look like Italy’s, which would mean case counts would completely collapse within a few weeks of passing the peak and opening up would be safe. She was sort of right: New York’s epidemic curve ended up looking like Italy’s. But the confidence she gave Trump on reopening turned out to be misplaced. Whether he would have been more cautious about that if Birx had been more skeptical is a question for historians, but his decision to move ahead when he did may end up costing him the presidency:

“All metros are stabilizing,” she would tell [White House staff this past spring], describing the virus as having hit its “peak” around mid-April. The New York area accounted for half of the total cases in the country, she said. The slope was heading in the right direction. “We’re behind the worst of it.” She endorsed the idea that the death counts and hospitalization numbers could be inflated.

For Dr. Birx, Italy’s experience was a particularly telling — and positive — comparison. She routinely told colleagues that the United States was on the same trajectory as Italy, which had huge spikes before infections and deaths flattened to close to zero…

Dr. Birx would roam the halls of the White House, talking to Mr. Kushner, Ms. Hicks and others, sometimes passing out diagrams to bolster her case. “We’ve hit our peak,” she would say, and that message would find its way back to Mr. Trump.

Dr. Birx began using versions of the phrase “putting out the embers,” wording that was later picked up by the press secretary, Kayleigh McEnany, and by Mr. Trump himself.

By the middle of May, the task force believed that another resurgence was not likely until the fall, senior administration officials said.

The difference between Italy and the U.S., notes the Times, is that Italians diligently followed lockdown orders and social-distancing rules until cases were crushed whereas Americans, being Americans, decided that the worst was behind us circa late April and it was time to get back to normal. Fast-forward to this week and Birx is now warning the public about “three New Yorks” and reportedly warning state and local officials that there are 11 major cities whose positivity rates are rising and which need to act aggressively immediately to halt the spread. At this stage, the odds of the U.S. crushing the curve nationally before the expected true “second wave” of COVID-19 arrives in the fall are basically zero.

We’re now at the point of such collective exasperation about controlling the virus that 56 percent of Americans who say that the economy is their most important issue nonetheless would support states closing down sectors of their economies in the name of containing the spread. Various other surveys show that hardly any American adults support completely in-person instruction for kids in schools this fall even though it’s universally agreed that that would be better for their educational and emotional development than remote learning. Gallup also published a poll today showing that pessimism about the state of the pandemic has reached a new high:

Trump’s polling against Biden began to collapse during the first week of June, not coincidentally right around the time that pessimism about the COVID situation began to grow among Americans.

God knows there’s plenty of blame to go around on the U.S. response, but if you’re the head of a national task force that’s overseen this outcome, I’d say that your task force had failed:

Another question for historians: Did Birx believe her own models in April all along or did the White House’s political urgency to reopen as soon as possible lead her towards an overly optimistic interpretation of the data? I ask that because the CDC finally issued its guidelines on reopening schools this afternoon and, wouldn’t you know it, they’re also right in line with Trump’s “reopen everything” agenda. Historians will be taking a hard look at Robert Redfield’s contribution to the U.S. “response” as well.

The one bright spot right now is that testing continues to increase. The U.S. recorded more than 900,000 tests today, easily its best showing ever. The less bright spot is that the total number of hospitalizations nationwide is about where it was during the worst of the spring epidemic. Deaths still aren’t as high as they used to be, thankfully, but they’ve been consistently north of 1,000 per day lately after having dropped to 600 or thereabouts in late June/early July. Hopefully next week will be better.