A second coronaviruses death surge is coming.

The downward drift of cases, hospitalizations, and deaths resulting from the spring outbreak in northeastern states obscured the rising severity of the current moment in the United States. Deaths have been rising in the Sun Belt, but falling deaths in the Northeast masked the trend.

If hospitalizations were not rising, that might suggest that the outbreak is not as deadly as it was in the spring. The data from the COVID Tracking Project suggested otherwise as early as June 23. hospitalizations began to tick up across the South and West on that date. It is possible that we will match the peak number of hospitalizations from the spring outbreak over the next week.

The proportion of infections in younger people increased in June and July. Young people have a lower risk of dying than older people. Early evidence shows that the virus is already spreading to older people in Florida. The New York Times analyzed CDC data and found that younger Black and Latino people have a higher risk of dying from COVID-19 than white people the same age. According to the racial data compiled by the COVID Tracking Project, Hispanics in Arizona, California, Florida, and Texas are 1.3 to 1.6 times more likely to be diagnosed with HIV than their proportion of the population would suggest. The border region has been leading the state in deaths per capita despite the recent outbreak.

There was always a simple explanation for why cases and hospitalizations rose through the end of June, and why deaths did not: It takes a while for people to die of COVID-19 and for those deaths to be reported to authorities. If new treatments and knowledge of the disease have improved outcomes by 25 or even 50 percent, so many people will die in the hospital.

The daily average case rate across the U.S. dropped to 20,000 over the past two weeks, down from 30,000 in April and 25,000 in May. The seven-day average of cases has tripled since the assertion was made. Florida alone reported 15,000 cases, more than any state had before, on an absolute or per capita basis, as several individual states reported more than 10,000 cases in a day. There has been a lot of confusion about the death toll. The second surge is inconvenient for the Trump administration and the Republican governors who followed its lead, as well as for Mike Pence, the head of the coronaviruses task force, who declared victory in a spectacularly incorrect Wall Street Journal op-ed.

There were lots of cases, lots of hospitalizations, lots of deaths. The compression of memory is a part of this. The deaths in March are remembered by most of us as quickly as the cases. That is not what happened. The nation saw cases rise weeks before the death toll went up. We had more than 100 cases for each death we recorded in March. The perceived gap between cases and deaths is a crucial metric. It tells us that there was a lag between rising cases and deaths in the spring.

There is another reason for the confusion about the severity of the outbreak. The outbreak initially landed on American shores and started killing people. The virus ran free in February and March because there was no testing. There was only one way to know the severity of the outbreak, and that was to count the dead. We figured out how bad the outbreak was by using that method. Thousands of people died in the New York City area and a few other cities in the country in April. The peak of the seven-day average for new cases was on April 10, followed by the peak of the seven-day average for daily deaths a few days later.

The U.S. came most of the way down the curve from the dark days of April, and now we are watching the surge happen again. The first time was a tragedy, the second time was even more tragic. Without really wanting to know the answer, one must ask, How bad could this round get?

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