Florida? Arizona? Experts weigh in on which states are primed to be next COVID-19 hot spots

Florida is reporting record daily totals of new coronavirus cases. (Eva Marie Uzcategui/AFP via Getty Images)
Florida is reporting record daily totals of new coronavirus cases. (Eva Marie Uzcategui/AFP via Getty Images)

While the Northeastern parts of the U.S. are seeing a decrease in new confirmed cases of COVID-19, many states across the Southern portion of the country are seeing surges.

Ten states saw a sharp increase in the number of COVID-19 cases this week – Alabama, Arizona, California, Florida, Nevada, North Carolina, Oklahoma, Oregon, South Carolina and Texas, according to the COVID-19 data tracking website COVID Exit Strategy.

Florida and Arizona are particularly worrying, Dr. Amesh A. Adalja, senior scholar at the Johns Hopkins Center for Health Security, tells Yahoo Life. He describes these areas as “new hot spots.”

As of Friday morning, data from COVID Exit Strategy found that Florida had a 141 percent increase in positive cases over the past 14 days. At the same time, there is low availability of intensive care unit beds in the state. Florida Gov. Ron DeSantis and other public health officials in the state have repeatedly come under fire for the handling of the state’s response to the virus, both for delayed stay-at-home orders and reopening beaches in April.

In Arizona, where a stay-at-home order expired a month ago, cases have also increased 108 percent over the past 14 days, according to COVID Exit Strategy data. ICU bed use and ER visits have hit new highs for the state because of COVID-19 cases, according to the Arizona Republic.

But Texas, Alabama, Oregon and South Carolina also have “worrying trends,” and more are behind them, epidemiologist Henry F. Raymond, associate director for public health at the Center for COVID-19 Response and Pandemic Preparedness at the Rutgers Global Health Institute, tells Yahoo Life.

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This isn’t the case for every state that’s becoming a COVID-19 hot spot, but “in broad strokes, states that didn’t really take many measures in the beginning of the pandemic and opened up earlier are experiencing surges — that’s the pattern right now,” Raymond says. This is a concern, Adalja says, because there’s a chance that cases could spread into neighboring states and expand across the country from there.

What doesn’t the data show?

It can be alarming when you look at the case counts that are often shown on state public health websites. But these are sometimes aggregate counts and don’t necessarily reflect the most recent number of positive cases. (Florida’s public health office, for example, currently shows the state as having 85,926 positive cases as of Thursday morning, while the state actually saw about 2,400 new positive cases in the past 14 days, according to COVID Exit Strategy data.)

“It’s not just the number of cases you need to look at but if the percentage of positive cases is rising — that’s when it’s concerning,” Adalja says.

The data also doesn’t indicate where these states are testing. “A lot depends on where they’re testing,” Dr. William Schaffner, an infectious disease specialist and professor of preventive medicine in the Department of Health Policy at the Vanderbilt University School of Medicine, tells Yahoo Life. “If they’re going into high-risk areas such as nursing homes, prisons, manufacturing plants and meat-packing plants, they’re going to find more cases.” While that can indicate the virus is also spreading quickly among the general population, it doesn’t necessarily mean that is the case, he says.

How taxed a hospital system is and the dynamics of the population matter too, Schaffner says. “The populations of Florida and Arizona are enriched with retired people,” he says. “That means they’re older, and many of them will have some chronic underlying illness of one sort or another.” Schaffner calls that “worrisome” for public health officials “because they’re concerned more people will become more seriously ill, translating into more hospitalizations and a more taxed hospital system.”

The numbers also don’t show things like whether the state has done contact tracing to try to understand where the new cases have come from, Adalja says. “It’s important to know how many cases are occurring from unknown chains of transmission,” he says. “Oregon, for example, has new cases that are linked to chains of transmission that they already know. That’s really important because it tells you how much situational awareness you have. If a lot of new cases are coming up and you don’t know how those people are getting infected, that’s worrying.”

It’s important to note too that states that are becoming hot spots can continue to be in this situation for a long time. “The virus burns through more dense areas, like cities, first,” Raymond says. “That doesn’t mean less dense areas are exempt. They’re not going to be spared. The virus is just going to have a different rate and progression of the spread.”

What should you do if you live in one of these areas?

Schaffner recommends being “mindful” of what’s happening in your state and region. And, if you live in one of these hot spots, Adalja says it’s important to be especially careful about following known methods of preventing the spread of COVID-19. “You’re going to have to be more mindful of your contacts and where you’re going,” he says. “Try to practice social distancing and avoid congregate settings.”

If you live in an area where new case counts are low, Adalja says it’s important to understand that may not be the case forever. “There are going to be different areas that have flare-ups of cases, and it’s going to vary over time,” he says. “We should expect rolling waves in different parts of the country over the next two years.”

“Everyone should realize that no one is immune to this,” Raymond says. “I hope people aren’t complacent and think they got off scot-free because they didn’t experience this in early spring. That’s not the case. It gets everywhere eventually.”

For the latest coronavirus news and updates, follow along at According to experts, people over 60 and those who are immunocompromised continue to be the most at risk. If you have questions, please reference the CDC’s and WHO’s resource guides.

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