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Despite Expectations, Coronavirus Cases And Deaths Kept Growing In April

ARI SHAPIRO, HOST:

With the start of a new month, it's a good time to take a step back and take stock of this pandemic. The U.S. spent April more or less in lockdown. During that time, the number of infections and deaths from COVID-19 continued to grow while many governors and President Trump said it's time to start reopening the economy. Jeremy Konyndyk is a public health expert with the Center for Global Development. He worked on international disaster response in the Obama administration, and he joins us now to talk about where the U.S. stands compared to a month ago.

Good to have you back on the program.

JEREMY KONYNDYK: Thanks, Ari. Good to be here.

SHAPIRO: You argued on Twitter that the U.S. has basically been treading water for the last month, and I'd like you to walk us through the numbers that you based that conclusion on. Let's start with how many cases there are in the U.S. today compared with the start of April. What do you see?

KONYNDYK: Well, we've been basically on a plateau. So in the first day of April we had about 25,000 cases. On the last day of April we had around 29,000 cases. And through the entire month, we've kind of fluctuated within that basic range, kind of never getting too far out of the low 30s but never dipping below the low 20s. And that seems to be where we're continuing now heading into May. That suggests that we have limited transmission at a certain level, but we're not yet driving it down, and that's not a good place to be.

SHAPIRO: Our understanding of the number of cases is informed by the availability of testing, right? So how are we doing on the number of tests being given? What's the number today compared to a month ago and compared to where we ought to be?

KONYNDYK: Well, so in the first week of March, the U.S. was averaging about 144,000 tests per day. And by the end of the month, that had gone up about 50% to 220,000 tests per day.

SHAPIRO: You said the first day of March. Did you mean the first of April?

KONYNDYK: Excuse me.

SHAPIRO: So a month ago?

KONYNDYK: The first...

SHAPIRO: OK.

KONYNDYK: Yes, the first week of April.

SHAPIRO: So it's about doubled in the last month.

KONYNDYK: It's gone up about 50% over the course of April in terms of the average. And, you know, that's progress, but where we need to be to even really think about beginning to open and reopen some parts of the economy is at least half a million tests per day...

SHAPIRO: Wow.

KONYNDYK: ...And probably several million.

SHAPIRO: OK. And then let's talk about deaths. I mean, in the U.S., this disease has now killed more people than the entire American death toll of the Vietnam War. Where is that trend line today?

KONYNDYK: Well, deaths tend to lag cases. Usually, by the time someone shows up in the official case count, they are, you know, ending up in an emergency room. And it's a few more weeks then before they either are discharged or they pass away. So I think we can expect that wherever cases are today, that's indicative of where deaths are going to be in a few more weeks. So as long as we stay on this plateau of cases, we'll stay on a plateau of deaths as well.

SHAPIRO: So help us understand why this is. The U.S. economy has been almost entirely shut down for more than a month. Why hasn't that been enough to stop this disease from spreading and put the trend lines in a steep downward direction?

KONYNDYK: Well, because I think if you compare the U.S. to other countries that have been going through the same thing, the countries that have really bent the curve downward - not just held it flat but bent it downward - have had lockdowns that typically are more stringent than we've seen in the United States. And they have also not relied solely on lockdowns. They've also done much more extensive testing and contact tracing and those kind of targeted public health measures in addition to the lockdown. We haven't really done that in a consistent way in this country, and we're only just beginning to start that in some states.

SHAPIRO: And some states are now starting to open up again. Businesses are accepting customers again. That being the case, what do you expect to see happen in May?

KONYNDYK: I'm very nervous about what happens in May. You know, we don't yet have - so what you want to have is you want have a different way to control cases, not just reliance on lockdowns. And you have to build that because we don't have a strong public health infrastructure in this country that could achieve that. We need to be able to do the kind of contact tracing that China did, that South Korea did, that Singapore is doing. And, you know, South Korea should be the model. They built their model on widescale testing, widescale tracing. And we not going to deliver that through the states alone. The federal government has to step up and play a much more aggressive role than we've seen so far.

SHAPIRO: And so just in our last 30 seconds, do you expect the trend lines for the month of May are going to continue this plateau or go up or down? what are you looking for?

KONYNDYK: I think it really depends on the choices we make. If we reopen prematurely as a number of states seem to be considering, then I would expect the cases and deaths will go back up. If we just continue doing what we're doing, we can probably hold them steady but not improve. So we need to do something else. We need to build that big investment of public health capacity and tools.

SHAPIRO: That's Jeremy Konyndyk from the Center for Global Development.

Thanks for your time today.

KONYNDYK: My pleasure. Thank you. Transcript provided by NPR, Copyright NPR.