On The Trail: A third coronavirus wave builds just before Election Day

A new wave of viral infections is washing over the nation just weeks before Election Day, putting a new spotlight on a crisis that has come to define President Trump’s struggle for reelection.

For months, public health experts have warned of an increase in the number of cases that would accompany lower temperatures in the fall and winter. As people move inside more, they said, the coronavirus was likely to spread.

Those predictions have come true — earlier and more significantly than expected.

“We’re in a really precarious time,” said David Rubin, a pediatrician who runs the PolicyLab at the Children’s Hospital of Philadelphia, whose models show devolving situations across much of the nation. The pandemic “is accelerating, and it’s accelerating quickly. We’re now seeing hospitals exceeding capacity in the Upper Midwest, in Salt Lake, where hospitals are filling up, and it’s just mid-October.” 

The number of new coronavirus infections confirmed over the last week rose in 44 states compared to the week prior, according to The Hill’s analysis. Cases have declined for two or more consecutive weeks in just two states, California and Hawaii.

Several states now rank at the top of the worst outbreaks in the world. In North Dakota, where Gov. Doug Burgum (R) has resisted any new restrictions, the per capita infection rate last week was 711 per 100,000 residents — a rate more than twice as high as New York’s during its initial surge in April, and almost two times larger than the worst outbreaks in states like Arizona and Florida over the summer.

More than one in every 200 residents of South Dakota, and more than one in every 250 residents of Montana and Wisconsin, tested positive for the virus in just the past seven days. Texas recorded 36,000 new cases in the last week, while Illinois, California and Florida all reported more than 20,000 additional cases.

Case data show that more younger people are contracting the virus. While those younger people are less likely to be hospitalized or die, more infections will by nature lead to more people in the hospital. And those younger people, even asymptomatic ones, may become vectors who expose older and less healthy people with whom they come into contact.  

“What we know from the experience from the summer is that rising cases in younger people tends to be followed by a rise in cases among more vulnerable people,” said Rich Besser, a former director of the Centers for Disease Control and Prevention who now heads the Robert Wood Johnson Foundation. “If you look at the curves and the trends in America, they’re very concerning.”

Already, Wisconsin has opened an auxiliary field hospital to deal with surging demand for care. More than 80 percent of intensive care unit beds in Alabama, Kentucky and Rhode Island are occupied. Hospitalizations have increased in 38 states over the last two weeks, according to the Covid Exit Strategy, a group of independent researchers.

The spike in cases comes at a disastrous time for Trump’s reelection campaign. Trump has tried to change the focus of the contest to Democratic presidential nominee Joe Biden’s son Hunter Biden’s business dealings in Ukraine and China, to sometimes violent protests in Democratic-controlled cities, and to an economic comeback he says has already begun. 

But voters give Trump disastrous marks on handling a pandemic that has already killed more Americans than the population of Tacoma, Wash., or Baton Rouge, La. Polls conducted this month for NPR; NBC and The Wall Street Journal; ABC and The Washington Post; and CNN all show between 37 percent and 41 percent of Americans approve of Trump’s handling of the virus, while a majority say they disapprove.

“He’s not going to be able to escape what the news is on the ground because this is happening very quickly,” Rubin said.

The polls show voters trust Joe Biden to handle the pandemic far more than Trump: The NPR poll, conducted by Marist College, found 55 percent trusted Biden to better handle the virus, compared to just 41 percent who thought Trump would do a better job. In the ABC/Washington Post poll, Biden led 55 percent to 38 percent.  

The Trump administration has shown little appetite for renewed lockdowns or mitigation efforts to stem the spread of the virus. Governors have chafed at the lack of federal planning, even seven months after the first wave of lockdowns; personal protective equipment remains in short supply, there is no national testing strategy, and Trump himself has continued to promise a miracle that has not materialized.

Instead, he has pushed states to lift restrictions and reopen the economy as he listens to advisers like Scott Atlas, a medical doctor who does not have training in epidemiology or virology. The White House has embraced the Great Barrington Declaration, a document that advocates allowing the virus to run its natural course through younger people — who are still at risk of death or long-term disease.

“It’s frightening to envision a strategy of allowing an infectious agent to spread through the community in order to eventually lead to decreases in spread. It makes no sense,” Besser said. “It would benefit us to have a big dose of humility in terms of how much we know about this infection.” 

Trump has also begun taking the most overt shots yet at Anthony Fauci, the director of the National Institute of Allergy and Infectious Disease — a man the public trusts far more than they trust Trump. 

Public health experts and economists alike warn that the economic catastrophe wrought by the pandemic will not let up until the health crisis is under control. 

“The time to act is now so that you don’t have to put more burdensome restrictions on later,” Rubin said. “People’s unwillingness to do practical restrictions is going to end up in restrictions that are more noxious later on.”

Governors who have taken the most dramatic steps to combat the virus are being rewarded with high approval ratings and easy reelection bids. New Hampshire Gov. Chris Sununu (R) and Vermont Gov. Phil Scott (R) are both waltzing to reelection in deep-blue states in part because they have implemented restrictions to protect public health. So is Washington Gov. Jay Inslee (D). 

There are other signs that bold action to combat the virus pay electoral dividends: In New Zealand, where Prime Minister Jacinda Ardern’s government led a crackdown that has virtually eliminated the virus there, voters gave her Labour Party an outright majority of seats in national elections last week — the first time any party has won a majority since the country began using a mixed-member proportional system to elect its representatives in 1996.

The government’s handling of the coronavirus pandemic was a top concern of voters in New Zealand, just as it will be in the United States.

Trump “is reaping what he has sown,” said Jeremy Konyndyk, a former head of USAID’s Office of Foreign Disaster Assistance. “Just as Jacinda Ardern did a few days ago, in a rather different way.”

On The Trail is a reported column by Reid Wilson, primarily focused on the 2020 elections.