Study says actual number of Covid-19 cases is far greater than thought

Depending on the region, the number of people infected was sometimes six to 24 times the number of reported cases, the CDC team said.

"For most sites, it is likely that greater than 10 times more ... infections occurred than the number of reported Covid-19 cases," the team concluded.

These numbers are likely conservative, according to the study in the Journal of the American Medical Association. The data used in the analysis was published on the CDC website.

CDC Director Dr. Robert Redfield said earlier this month that testing had likely missed 90% or so of cases.

The country remains far from a level that would give the population herd immunity.

Testing overwhelms labs

Meanwhile, record-breaking numbers of people are testing positive for coronavirus across the US and the surge in cases is slowing the time it takes to get test results.

Labs across the country are now facing what seems like an almost "infinite" demand, one expert says.

"We really do need to improve our turnaround times, primarily in areas and counties of outbreaks," Adm. Brett Giroir, a White House coronavirus task force member, said.

Diagnostic labs are feeling the effects of the spike in cases, with a leading commercial lab saying test results can now take up to two weeks for some patients.

The delays come even as labs work to scale up their capacity, Quest Diagnostics said in a news release.

And the pandemic is still in its early stages, said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

A total of 56,750 cases of Covid-19 and 372 virus-related deaths were recorded in the US on Monday, according to Johns Hopkins University's tally of cases. At least 3.8 million coronavirus cases have been identified. More than 141,000 people have died.

Nearly 40 states now have some type of mask requirement in place as communities battle the spread of the virus. Masks, experts say, are one of the most powerful tools to prevent spread.

But keeping people apart is just as important, Osterholm stressed. "It's all about distancing. And that's what actually drove down the numbers last spring," he said.

"We really did create a lot of distancing and until we do that, we're going to have an impossible time driving this virus down to a level which then we can test and trace on a routine basis like other countries and open up our economy again safely."

Coronavirus: Your questions, answered

Tightening measures

In Texas, Hidalgo County Judge Richard Cortez issued a shelter-at-home order following a sharp uptick in cases. The order, which includes a curfew, travel limitations and facial covering requirements, comes as the county's hospitals have hit capacity, Cortez said.

"To care for the patients that are already with the virus, we need more personnel ... meaning doctors, nurses, technicians, respiratory technicians," the judge told MSNBC's Rachel Maddow.

Tuesday on CNN's "New Day," Dr. Peter Hotez of the Baylor College of medicine, suggested some of the reasons why southern states such as Texas and Florida are seeing increased deaths. "We had 34 deaths in the last 24 hours in not a very large county, so South Texas is just getting hit incredibly hard," Hotez said. "The hospitals are overwhelmed."

He said many of the Hidalgo County victims are poor, Hispanic, working in jobs deemed essential and that they have to be at work to support their families. "There are many stories across Texas and across the southern United States among Hispanic and Latinx communities just getting hammered, and we're not really getting a full accounting of this," Hotez said.

The US Navy said in a statement Friday it was deploying some 70 medical personnel to support civilian hospitals in Texas.

Texas Gov. Greg Abbott, who previously pushed for one of the most aggressive reopenings, has more recently emphasized the importance of masks. He issued a mandate on face coverings earlier this month but has said there will not be another lockdown.

White House coronavirus response coordinator Dr. Deborah Birx said Monday taking the right precautions could be nearly as powerful as another lockdown.

At least 27 states have now halted or rolled back reopening measures in response to soaring cases.

Track the coronavirus

Tuesday morning, Arizona reported a record 134 deaths from Covid-19 over the previous 24 hours, state data show. The previous record high was 117 on July 7.

The state, which has been experiencing a surge in cases, improved many of its metrics over the last week. Hospitalizations, ventilator use, and emergency room visits from those with the disease have all decreased from last week's record levels, the data show.

In Phoenix early Tuesday, people waited in long lines in their cars for tests.

In California, the governor shut down indoor operations for restaurants, movie theaters, wineries and closed down bars last week. Thirty counties on the state's watch list were required to close indoor operations for fitness centers, salons and places of worship.

The governor's office said Monday hair salons and barbershops in 33 counties could reopen outside. That's as Los Angeles County broke its record for daily hospitalizations for the fourth time in a week, said Dr. Barbara Ferrer, the county's public health director.

These are the states that require masks

California is expected to top New York in a few days as the state with the most cases, according to numbers reported by Johns Hopkins.

In Florida, the Intensive Care Unit bed availability statewide is 15.98%, according to the Agency for Healthcare Administration. On Monday, it was 18.1%.

There are 54 hospitals in 27 counties that have no ICU beds left.

Governor says children are 'going to get over it'

City of Miami summer camps will close this week after at least three children contracted Covid-19, Mayor Francis Suarez announced during a news conference Tuesday. The closure will be effective this week.

States are now deciding what will happen next month, when students are slated to return to class. Many districts throughout the country have already announced they are beginning the year with online instruction.

President Donald Trump has said he's pressuring governors to reopen classrooms.

But on Tuesday, US Surgeon General Dr. Jerome Adams said the country needs to lower the transmission rate to reopen schools.

Speaking on "CBS This Morning," Adams said, "The biggest determinant of whether or not we can go back to school actually has little to nothing to do with the actual schools -- it's your background transmission rate."

Adams said lowering the transmission rate will also help teachers -- and adults living with school-age children -- stay safe.

"We know the risk is low to the actual students. But we know they can transmit to others. ... We need to take measures to make sure we protect those who are vulnerable either because they are older or they have chronic medical conditions."

In Missouri, Gov. Mike Parson said Monday the state has to move forward with sending children back, saying the students are the "least likely to have a problem" if they contract the coronavirus.

"And if they do get Covid-19, which they will -- and they will when they go to school -- they're not going to the hospitals. They're not going to have to sit in doctor's offices. They're going to go home and they're going to get over it," he said on a radio interview.

But new research from South Korea reveals older children -- between the ages of 10 and 19 -- can transmit the virus just as much as adults can.

While the CDC is still studying the role children play in transmission, the agency recommends children socially distance at 6 feet apart from people they don't live with and anyone 2 years and older wear masks in public when socially distancing is difficult.

CDC analyzed test results of 16,000

In the study shared Tuesday, the CDC wanted to see if the official test tally showed the actual numbers of infections. Teams analyzed test results from 16,000 people in 10 geographically diverse cities and states between March and early May. These people were tested not because they had coronavirus symptoms but for other reasons -- for instance, if they were having surgery and the hospital did the test as a matter of course.

These tests would give a broader sense of who has been infected by the novel coronavirus than just the number of people who have sought tests because they didn't feel well and suspected they had Covid-19.

This methodology has limits. The people tested may not have been representative of the general population, and it doesn't take into account the disease exposure risk. It's possible there could be some overlap, and people may have been tested more than once, the CDC said. The infections may not be evenly distributed even in these regions.

The results show the majority of people in these 10 sites have not had Covid-19. It also shows that people who are asymptomatic are still spreading it. So, the authors argue that the public should continue to wear masks, stay physically distant, and remain at home as much as possible.