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Why the pandemic does not ebb in the United States as in Europe

The coronavirus curve is falling back in Europe, but the United States has been stranded for two months on a “plateau”, a sign according to experts that the American epidemic hides several, managed in different ways according to regions and political affinities.

Two epidemics

With 30,000 new cases detected per day in April and more than 20,000 since the beginning of May, the United States is stagnating, because one part of the country has taken over from the other.

“We did not act fast and hard enough to prevent the virus from spreading initially, and it has apparently moved from the original outbreaks to other urban and rural areas,” said Tom Frieden, former director of the Centers for Disease Control. disease prevention and control (CDC).

On the one hand, there are five states in the northeast, from New Jersey to Massachusetts with New York in the middle, where half of the American deaths from the Covid-19 have been recorded. This region, large as a European country, has largely started the descent – New York has 2,600 people hospitalized against 19,000 in mid-April, according to the governor.

These states, marked with the sharp one, were also most prudent in the deconfinement. Masks are ubiquitous. The reopening of New York only started on Monday, the restaurants remain closed.

Conversely, the less urbanized regions, the Midwest, the South and part of the West have not experienced the bottlenecks of emergencies and morgues. These states ordered containment later and lifted it earlier. This is where the virus circulates the most today.

– A political divide –

The politicization of the pandemic has reinforced the phenomenon: the governors of “red” states, that is to say Republicans, have tended to minimize the risk like President Donald Trump.

“The blue states are more applied than the red states to reopen safely,” observes Sten Vermund, dean of the school of public health at Yale University, who adds that ideologically, “most Americans do not don’t like to be told what to do. “

In Georgia, Florida, Texas, we see few masked people, including in restaurants and shops, even among employees.

In Texas and North Carolina, there are currently more Covid-19 patients hospitalized than a month ago.

South Carolina is also at the “worst” of its epidemic today, says Melissa Nolan, a professor of epidemiology at the University of South Carolina, noting outbreaks of infection in marginalized populations like Hispanic workers.

Mobile phone data confirm that physical distance is widely respected: at the height of confinement, the movement of residents of New York or Washington fell by almost 90% for several weeks, compared to 50% or less in many areas from the South, according to the Unacast company.

Not enough tests

With half a million tests performed per day, the United States has become world champion in screening, per capita. But that’s still not enough to contain the virus, says Jennifer Nuzzo of Johns Hopkins University, because the American epidemic was much larger than elsewhere.

“We are not yet detecting all infections,” insists the expert.

Only 14% of American tests are positive, against less than 5% in Europe: in other words, the United States still misses many asymptomatic cases, which continue to infect friends and neighbors.

Screening is not an end in itself, says Jennifer Nuzzo: testing must be immediately accompanied by isolation and contact tracing. However, the deconfinement started before these procedures were ready.

– Mysteries of the virus –

The picture is not entirely bleak: in several places, such as Arizona, the increased availability of tests has increased the number of cases detected, but these are apparently mainly mild cases.

Georgia reopened very early, in late April, raising fears of the worst … But the resurgence did not occur for a long time, the number of cases stagnating throughout the month of May, before an increase in recent days, illustrating at what point the mechanics of the coronavirus remains mysterious.

“All my friends are stumped,” said William Schaffner, an infectious disease specialist at Vanderbilt University.

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