COVID-19 cases have surged in the majority of states in the USA over the last two weeks.  Many governors claim that the surge in cases is mostly due to expanded testing.  A detailed look at the data shows that while some of the increase in case counts is due to expanded testing the majority is not.  The number of tests performed increased throughout April and May in the USA to near 600,000 tests per day, but have not been able to keep up with the surge in newly confirmed cases in June as states reopened too quickly, and individuals failed to follow masking and social distancing guidelines.  The graph below shows that for the largest 3 states, California (CA), Texas (TX), and Florida (FL), the percent of Polymerase Chain Reaction (PCR) tests returning positive results (plotted as 7-day moving averages) have increased in CA to 6%, and surged to historic and alarmingly high levels near 16% in TX and FL. 

More importantly, the number of hospital admissions have risen dramatically in June as well.  Florida does not report the number of patients currently in hospitals, but only the cumulative total of hospital admissions for COVID-19.  From this data, we can calculate the number of new hospital admissions each day.  This number has risen from a low of 100 per day in early June to a recent 7-day average of 178 per day.  At this rate, many hospitals in FL are approaching full occupancy. TX and CA do report the number of patients currently occupying hospital beds.  This allows us to calculate the net number of hospital admits (new admits minus discharges) per day.  Over the last two weeks, this statistic has increased from a stable level near zero (admissions equal to discharges) to near full capacity in many TX hospitals and even a few CA hospitals.  This is not a good sign for governors who are pushing the theory that most of the new cases are young adults who are only mildly symptomatic and do not require much healthcare resources. 

To truly understand how seriously ill the newly admitted patients are we need to have an accurate census of ICU beds.  Unfortunately, states such as TX and FL do not track this consistently or accurately or have chosen to suppress such data.  In CA, this data is tracked and it is not pretty.  For an 8 week period from the end of April to mid-June ICU admits balanced discharges and ICU occupancy level was stable.  Since 6/16 it has gone up steadily over the last two weeks.  This does not bode well for other states. 

Diagnosis leads to hospitalizations, leads to ICU usage, leads to deaths 2-3 weeks later.  Death counts have begun to rise in TX and we forecast will soon rise in FL and CA as well.  All of this foretells a tragic summer for the USA.  The governors of some of the most infected states such as Arizona, California, and Texas are finally taking action to halt and in some cases to reverse reopening steps until their testing, contact tracing and selective isolation could catch up with this latest surge.  Hopefully, this will flatten the curve again, but it is also incumbent upon individuals to exercise more vigilance in terms of masking, social distancing, and washing hands appropriately.