Health Team

US coronavirus death totals compiled by CDC will now include 'probable' cases

The US Centers for Disease Control and Prevention is now counting "probable" cases of coronavirus among its tabulations, according to the agency's website.

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Steve Almasy
Christina Maxouris, CNN
CNN — The US Centers for Disease Control and Prevention is now counting "probable" cases of coronavirus among its tabulations, according to the agency's website.

The inclusion of such cases will add thousands to the total number of patients and deaths by including people who didn't have a positive test but showed signs of having the virus.

It comes after the Council of State and Territorial Epidemiologists suggested the CDC and state health departments add probable cases.

Previously, the CDC was only counting cases that had been confirmed by them or cases where the agency had yet to confirm a test done by a local or private entity.

A probable case or death is defined as one that meets clinical criteria such as symptoms and evidence of the disease with no lab test confirming Covid-19. It can also be classified as a probable case if there are death or other vital records listing coronavirus as a cause. A third way to classify it is through presumptive laboratory evidence and either clinical criteria or evidence of the disease.

New York City's Health Department said Tuesday it is now reporting "probable" Covid-19 deaths of individuals who have not been tested for the coronavirus but are presumed to be positive. The 4,059 probable cases pushed the death toll in New York City to nearly 11,000 victims.

"The fact is, we have to be honest and always acknowledge the full impact," Mayor Bill de Blasio told CNN's "New Day."

"We think it is smart and really fair to those families and to everyone to say, look, a lot of these deaths ... the medical professionals ... they couldn't confirm it was Covid because there wasn't time do a test but they thought that's what it was."

New York Gov. Andrew Cuomo announced Wednesday that the state will begin counting probable deaths, based on the CDC's guidance.

The CDC count is 605,390 cases of novel coronavirus in the United States and 24,582 people deaths.

According to Johns Hopkins University -- data used by CNN -- at least 614,482 people have contracted the novel coronavirus in the US, and 27,085 people have died.

The US recorded its highest number of coronavirus deaths in a day Tuesday after several days in which the death toll had fallen or was nearly flat.

The daily death toll was 2,405 on Tuesday, according to the Johns Hopkins tally.

Protesters don't want to stay at home

All but seven states are under stay-at-home orders from their governors. And medical experts have said the key to having fewer daily reports of coronavirus is for people to adhere to those edicts.

But in at least two states, groups of people have gone to the state capital to protest, saying their individual freedoms are being trampled on.

In Lansing, Michigan, on Wednesday, several streets around the Capitol were jammed with vehicles in a protest organized by conservative groups against Gov. Gretchen Whitmer, a Democrat.

CNN affiliate WLNS reported that many protesters gathered on the Capitol property.

"It's time for our state to be opened up. We're tired of not being able to buy the things that we need," Brenda Essman of Kalamazoo told the station. "We need to open our businesses."

Another woman told WLNS that her husband was on unemployment for the first time ever.

"We want to go back to work. We have employees. We have bills to pay," Renee Aldrich said. "The only stores open are Walmart. That's ridiculous."

The governor said she understood people were frustrated and respected their opinions. She said she was disappointed in protesters who endangered people by congregating and not wearing masks.

She told reporters she was working on a data-driven approach to reopening.

"I want to be very clear that our decision to reengage sectors is going to be based on the best facts and the best science," she said.

She said if the state acts too early there will be a second wave of cases.

In Raleigh, North Carolina, dozens of demonstrators gathered Tuesday outside the state legislative building to protest the state's stay-at-home order, CNN affiliate WRAL reported.

After an hour, police officers asked the group to disperse, saying too many people were there, too close together. Most left; one person was taken away in handcuffs after refusing to leave, WRAL reported.

Are cases topping out?

Despite the grim numbers, health officials have said they believe US numbers are leveling,

"There's no doubt what we've seen over the last several days is a flattening out," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Wednesday on NBC's "Today."

Still, officials are warning that states shouldn't yet ease up on social distancing measures because a resurgence of the virus is highly likely once Americans begin getting out of the house again.

What will be key to preventing another deadly wave in the country are the tools to track and monitor new cases.

"You want your resources to be able to very efficiently in real-time identify, isolate, and contact trace," Fauci said.

In the meantime, finding the right time to reopen the country is still a work in progress.

The US Centers for Disease Control and Prevention is working to make sure testing, contact tracing and an expanded public health capacity is in place as the country begins talking about opening back up, CDC Director Dr. Robert Redfield said.

"This is going to be fundamental to maintain and contain cases as they occur and then make sure we have the health capacity to deal with this, as we work to regain the confidence of the American public that it's safe to go back to work," Redfield said Wednesday on "CBS This Morning."

A team led by the CDC and the Federal Emergency Management Agency has drafted a strategy to return the country to work that includes guidance for local and state governments on how to reopen safely and in phases, the Washington Post reported.

Meanwhile, governors have begun diving into discussions about the first steps toward reopening their economies, with many of the nation's stay-at-home orders, as well as the federal government's social distancing guidelines, set to expire at the end of the month.

But many state leaders who are still seeing their number of cases climb say it's too soon to begin thinking about lifting any measures.

How will states know when to reopen?

Nearly a dozen states have begun working together to determine what the first steps should be once stay-at-home orders are lifted. But with experts cautioning that each state should be treated as a separate situation and assessed individually, there are still few answers to the questions of when each part of the country will begin reopening and what that will look like.

All that some state leaders have offered so far are indicators of when their state may begin thinking about reopening.

California Gov. Gavin Newsom, who said he'll be working with Washington and Oregon to determine a path forward, announced Tuesday a set of indicators that will help the state pin down the right time to begin lifting measures.

Those include the state's ability to track and monitor infected individuals through testing, contact tracing and isolating procedures, as well as its ability to prevent infection of at-risk groups.

"Science, not politics must be the guide. It cannot be ideological," he said. "We can't get ahead of ourselves. ... I don't want to make a political decision. That puts people's lives at risk."

Massachusetts Gov. Charlie Baker told residents of his state he was expecting "difficult days and weeks ahead." He said officials have begun conversations around reopening the state but there's still a lot of work that needs to be done before a plan is set into motion.

The state will need to have testing, tracing, isolation and quarantine procedures in place to reopen, the governor said.

Baker, who will work together with other governors of the Northeast in a plan toward reopening said that while his priority is doing "what's right for Massachusetts," it will also help staying in sync with other state leaders.

"I think it's going to be really important that we all pay attention to what the others are up to, and to make sure that nobody does anything that puts somebody in a really bad spot, because they just weren't thinking about what that impact was going to be on some other part of the Northeastern part of the US," he said.

In Ohio, Director of the Department of Health Dr. Amy Acton said that the state would first need to see a sustained decrease in the number of new cases -- so low that officials could trace each infected resident -- before considering reopening the state.

But even when that happens, until there's a vaccine, daily life won't look like it did before, the state's governor said, and institutions will need to take precautions to prevent further infections.

"Until there is a vaccine -- this monster is going to be working around us. When we start opening businesses and schools back up, it's going to be different," Ohio Gov. Mike DeWine said.

We might not go back to normal for another 2 years

DeWine's assessment was underscored by researchers from the Harvard T.H. Chan School of Public Health who published findings Tuesday that projected the US may have to endure social distancing measures -- such as stay-at-home orders and school closures -- until 2022, unless a vaccine becomes available.

"Intermittent distancing may be required into 2022 unless critical care capacity is increased substantially or a treatment or vaccine becomes available," they wrote in their report.

Those findings directly contradict research cited by the White House that suggests the pandemic could stop by this summer.

And much like experts have already warned, the Harvard team warned that another round of the virus is possible once social distancing measures are lifted.

"Even in the event of apparent elimination, SARS-CoV-2 surveillance should be maintained since a resurgence in contagion could be possible as late as 2024," they wrote.


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