Positive COVID-19 tests are up in several states. There have been more reported cases here in South Carolina, but according to USA Today, other southern states like North Carolina, Florida, Tennessee, Kentucky, Arkansas, Mississippi and Texas are seeing more COVID-19. Out west, California, New Mexico, Utah, Oregon, and Alaska have seen recent increases in cases.

Many news organizations are reporting state data on daily new cases and deaths. Others are reporting positive tests among all people tested and the number of people hospitalized.

While rising numbers are cause for concern, there’s more information we need to know. Throughout this program, I’ll share my thoughts on data we need to better understand if the coronavirus crisis is truly getting worse, and if so, specifically what state and local governments and public health experts can do to better contain it.

Cases vs. deaths

While COVID-19 cases are increasing in states across the country, in many of these states, we have not seen a similar increase in deaths.

Using graphs published by The Post and Courier, the daily newspaper in Charleston, South Carolina, daily cases started to rapidly increase on May 30, when the protests were at their peak. (I’m not saying the protests are a cause, just a correlation based on time). But the average deaths over a 7-day period since that day have been stable, ranging from 7.43 to 9.57.

Yes, there’s a lag of 1-2 weeks between cases and deaths. But if we’re going to see a spike in deaths based on these surges in new cases, it should occur this week. If not, we might be seeing a trend similar to what’s happening globally.

According to the international statistics website Worldometers, daily new cases, not just in the U.S, but across the world, continue to increase, but daily deaths have been steadily decreasing since mid-April.

Hospitalizations, emergency room cases

We know a majority of people with positive COVID-19 tests don’t become sick enough to be hospitalized, much less placed into ICUs or on ventilators.

Some states are reporting that overall hospitalizations have increased. What is less clear is whether those hospitalizations are solely due to COVID-19.

Most hospitals are now doing elective surgeries, many of which were necessary surgeries postponed due to the pandemic.

In many hospitals across the country, people undergoing any kind of surgery are now tested for COVID-19, whether or not they have symptoms. What percentage of a state’s new cases come from these screening tests of asymptomatic people?

We might be catching a lot of asymptomatic cases due to increased screening, rather than more people sick from COVID-19. It would explain the disconnect between emergency room visits and hospitalizations. On Friday, the CDC announced that nationally, the percentages of outpatient doctor visits and emergency room visits for  flu-like illness and COVID-19-like illness continue to decline or remain stable at low levels.

Who are the people testing positive?

Many states experiencing recent surges in COVID-19 cases are reporting the cities and counties with the largest spikes. That information is certainly helpful, but there is more that would help us know what to do about it.

What age groups were the new cases found in? The elderly? Or young adults and children?

It would also be really important to know specifically how they contracted the virus. This is where contact tracing comes in, where health officials question people with COVID-19 to see what they did and who they came into contact with in the days before they developed symptoms and in the few days after.

Contact tracing is hard because it requires a lot of time and effort to figure out where someone was likely infected and who they have been in contact with.

But knowing what the high-risk activities are (Are they restaurants? Gyms? Stores? We don’t really know), with data showing what’s truly high risk, we can better and more specifically implement activity restrictions that decrease exposure risk while allowing most people to get back to their work and lives.