The First Wave Is Not Over: Dr. Sanjay Gupta's coronavirus podcast for June 19

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Dr. Sanjay Gupta: Sometimes it can feel like people are living in totally different worlds during this pandemic. Some are having parties and taking advantage of newly reopened restaurants. Others are listening to dire warnings from public health officials of a coming spike in infections. So it raises the question: Where does the United States really stand today?

President Trump offered a pretty optimistic outlook on Wednesday in an interview with Gray TV.

Jacqueline Policastro, Washington bureau chief, Gray Television Washington News Bureau: Coronavirus cases are rising in 22 states, including Oklahoma, where you plan to hold a big rally this week. Aren't you worried about people getting sick?

President Donald Trump: No, because if you look, the numbers are very minuscule compared to what it was. It's dying out.

Gupta: And on Tuesday, Vice President Pence gave his own version of where we are. He wrote an op-ed in the Wall Street Journal, where he said that the panic about an increase in infections is overblown. Instead, he said we should be celebrating the progress that we have made in tackling the coronavirus.

But what is the true picture of where the United States stands? Today I'm going to directly address some of those claims that have been made by the White House — and also talk about the path forward to combat the virus.

I'm Dr. Sanjay Gupta, CNN's chief medical correspondent. And this is "Coronavirus: Fact vs. Fiction."

The title of Vice President Pence's op-ed is "There Isn't a Coronavirus 'Second Wave.'" Now keep in mind, the vice president is also the head of the coronavirus task force, so what he says carries a lot of weight. I spent all day looking at that op-ed, reading it and rereading it. So I want to share with you some of the assertions he makes in his piece one by one.

First of all, the vice president writes, "while talk of an increase in cases dominates cable news coverage, more than half of states are actually seeing cases decline or remain stable."

That's true — according to the Johns Hopkins Covid-19 tracker, compared to last week, 19 states are seeing a decline in daily cases and eight remain stable.

But it's also true that 23 states have seen an increase in cases week over week. And 10 states saw a record number of new Covid-19 cases this week.

Here's the point. Instead of a true nationwide decline, which is what we hoped to be seeing by now, what we're really seeing is a sort of shift of where the case counts are in this country. Remember, it was largely in the Northeast before, and now it's starting to move. Look at the West, look at the South in particular.

Here's Dr. Ashish Jha, director of the Harvard Global Health Institute, speaking on Tuesday:

Dr. Ashish Jha, faculty director, Harvard Global Health Institute, and professor of medicine, Harvard Medical School: The reality is that the virus is with us. The reality is that the first wave only hit a small number of places. Now it's coming to every other place and coming to a county or a city or a state near you.

And so if you don't live in one of these places that was hit initially, you're about to start experiencing it.

Gupta: So yes, if you only point to the states where cases are decreasing, that would give you a pretty incomplete picture of what's happening in the United States.

And that's significant because we have so many states that are reopening while their cases are still on the rise. Remember, the original White House guidelines from the task force itself, from the vice president himself, said states should have a "downward trajectory" of cases or a declining share of positive tests for a 14-day span before gradually reopening.

Now let's take a look at another assertion from Vice President Pence. He writes that some of the increases in cases we're seeing is a reflection of a dramatic increase in testing.

In fact, he made that same claim on a call with governors on Monday.

United States Vice President Mike Pence: In most of the cases where we are seeing some marginal rising number, that's more a result of the extraordinary work you're doing expanding testing.

Gupta: Look, the data just doesn't bear that out. The numbers don't lie. In Florida, for example, testing is roughly holding steady, and yet coronavirus cases are climbing and climbing. There's a real concern in Florida now that it may become the new epicenter of coronavirus in the United States. Take Oklahoma, for example. Cases have continued to go up significantly. But testing rates have actually gone down.

And if that isn't enough, forget about the number of people who've been infected. Let's talk about hospitalizations. They have also gone up in many states. They wouldn't go up in response to more testing. So I think it's pretty clear that the amount of testing going on does not account for the increase in the number of cases.

This is a bit of a counterintuitive point, but I think it's really important. As you increase testing, case counts should go down over time, not up. That's because as you find people who are carrying the virus, you can isolate them and you can hopefully prevent future spread. That's the whole point of testing. It's ultimately to decrease the pace at which the infection is spreading.

And that leads us directly to another assertion by the vice president. He touted the amount of testing we've done, saying, "as of this week, we are performing roughly 500,000 tests a day, and more than 23 million tests have been performed in total."

OK, that's true, according to data from the Covid tracking project. But that doesn't mean it's nearly enough. Researchers at Harvard said that we would need some 5 million tests per day by early June. And we would need 20 million tests per day by late July to safely reopen. That means we shouldn't have even been reopening until we were at that level. Again, we are at 500,000 tests per day, not 20 million.

And I can tell you personally from talking to my colleagues at the hospital — it is still very hard to get tested. Even for people out there who have symptoms, even people who have a doctor's referral for testing may still have a hard time getting a test. That's simply not the way it should be five and a half months into this pandemic.

Here's another claim that the vice president made. He says that panic over a second wave of coronavirus infections is overblown.

CNN news anchor: Pence writing in a Wall Street Journal op ed, "The media has tried to scare the American people every step of the way, and these grim predictions of a second wave are no different. We slowed the spread. We've cared for the most vulnerable. We've saved lives. That's a cause for celebration."

Gupta: Look, the truth is — it would be a luxury to talk about a second wave. We haven't even gotten out of the first wave yet. So we can't begin to talk about what a second wave might look like.

Let's compare overall infection rates in the United States versus Italy. Italy had a similar sort of pattern as the United States just a few weeks earlier. So if you look at a graph of new confirmed cases in the US, it looks like it's come from a peak to a plateau. And we are still hovering around 20,000 cases per day for the last couple months.

But the graph of Italy's cases looks like a true wave. Over there, they peaked at around 6,000 cases per day and then had a dramatic decline to just a few hundred new cases per day ... that's more of what you want to see to declare the first peak or first wave close to ending. We're simply not there in the United States. And keep in mind we are reopening. So instead of continuing to go down, those numbers of several hundred deaths per day are sadly likely to go up.

And look, it's not just me or the media saying we could have another spike. The White House often cites the coronavirus forecast model of the Institute for Health Metrics and Evaluation at the University of Washington. Their statistical data suggests that Covid-19 is very seasonal. Here's the institute's director Dr. Christopher Murray:

Dr. Christopher Murray, director, University of Washington's Institute for Health Metrics and Evaluation: That makes us pretty sure there's going to be a second wave. It'll start at the end of August and intensify through the fall. And unless we are effective at other things ... like wearing a mask, avoiding contact ... it's going to pretty inexorably lead to the second wave.

Gupta: But so many people are not taking those basic steps to prevent the spread. The story line has become reports of people ignoring guidelines and gathering in crowds all over the country.

And you've probably heard by now that President Trump is scheduled to hold an indoor campaign rally on Saturday in Tulsa, Oklahoma. During a White House roundtable on Monday, Vice President Pence claimed that Oklahoma has seen a decline in the number of coronavirus cases.

Pence: Oklahoma has really been in the forefront of, of our efforts to slow the spread. And, and in a very real sense, they flattened the curve. And today their hospital capacity is, is abundant. The number of cases in Oklahoma has declined precipitously. And we feel very confident going forward.

Gupta: That is simply not true. Oklahoma's infection curve has been rising since late May. In its latest weekly report, Oklahoma's State Department of Health reported a nearly 13% increase over the previous week.

And in Tulsa, where the rally is being held, they set a record this week for total daily positive cases. Here's Dr. Bruce Dart of the Tulsa Health Department speaking on Wednesday:

Bruce Dart, executive director, Tulsa Health Department: Early last week, we began to see a marked increase in the number of new cases reported daily. On our four- and seven-day rolling averages, we saw that those began to climb as well. Unfortunately, we continue to set new records on the number of cases reported in Tulsa counties.

Gupta: So there's a lot to be concerned about with this rally. It's being held indoors in a venue with a capacity of nearly 20,000 people, and they want all those seats filled. The Trump campaign has said that attendees will have their temperature checked and be offered a face mask. But they won't be required to wear it.

Now we have seen increasing evidence of masks being effective in slowing down the spread of the virus.

Let's say I have the virus and you're within 6 feet of me. You may have wondered, what is the likelihood that I would transmit the virus to you if I'm not wearing a mask? Well, according to a study in the Lancet, the chance is around 17.4%. It's not inevitable that I will spread it to you, but it's pretty high. Now what if I wear a mask? Well, then the number actually drops to around 3.1%. So you get a sixfold decrease in transmission by simply wearing a mask. It's not perfect but it can make a huge difference.

It's also why it's so important to follow the guidelines that public health experts have been pushing for so long. Here's Dr. Anthony Fauci:

Dr. Anthony Fauci, director, National Institute of Allergy and Infectious Diseases: When you're in a large crowd, if you have the congregation of people that are much, much close to each other, you definitely increase the risk that you will either acquire or spread infections. And I have said there are some people that are going to do that anyway, no matter what I say. But the issue is, if they do, please wear a mask all the time, because a mask will give you some protection. The best thing to do is to avoid crowded areas. But if you're not going to do that, please wear a mask.

Gupta: I wish I could paint a rosier picture for you. I am very hopeful still about how things are going to progress. But for right now I think honesty has got to be the best policy. The vice president's op-ed doesn't paint an accurate picture of how the country is faring.

Our fight is far from over. More than 117,000 people have already died and one model is projecting more than 200,000 deaths by October 1. At the same time, our coronavirus task force hasn't held a public briefing in weeks.

So yes, there are some states that are improving. But the country as a whole is still quite sick. And given that we are the United States of America, the country can't be healthy unless every state is also healthy.

Scientists all over the world are researching vaccines and therapeutics. But we need to buy them time. We have to do the very basic things that we know work: Wear a mask, stay at home as much as possible and when you're out and about, make sure to keep physical distance.

And our public health officials, they've gotta make sure they're providing the basics, as well. What does that mean? More testing, more contact tracing and more leadership so that we can all beat this together.

We'll be back Monday. Thanks for listening.

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"Coronavirus: Fact vs. Fiction" is a production of CNN Audio.

Megan Marcus is the executive producer. Felicia Patinkin is the senior producer, along with Amanda Sealy and Nadia Kounang from CNN Health. Raj Makhija is the senior manager of production operations.

This week's episodes were produced by Anne Lagamayo, Evan Chung, Zach St. Louis and Zoë Saunders. With additional help from Michael Nedelman.

Our associate producers are Emily Liu, Eryn Mathewson, Madeleine Thompson and Rachel Cohn.

Nathan Miller is our engineer, and David Toledo is the team's production assistant.

Special thanks to executive producer of CNN Health Ben Tinker, as well as Ashley Lusk, Courtney Coupe and Daniel Kantor from CNN Audio.