What's driving the spike in COVID-19 cases?

By Physician Sense
Published June 28, 2020

Key Takeaways

Despite the summer temperatures, it’s starting to feel like early March all over again. With states in the South and West showing signs of a second wave, it’s hard to not to wonder if we’re flirting with erasing progress in containing COVID-19. CNN reports that only two states -- Connecticut and Rhode Island -- saw week-over-week declines in their new case numbers. Florida saw a single-day record high on Saturday. On Friday, the U.S. broke its single-day new case record with about 40,000 new infections.

The spike is raising an alarm among governors nationwide. CNN reports that a dozen states have paused reopening efforts. Texas has closed bars and limited restaurant capacity. Arizona expects worse numbers in the weeks ahead. While none of this may come as a surprise to most physicians, what is surprising is the number of younger patients who are contracting the virus. 

How we ended up here is apparent. States attempted to re-open too soon. People failed to take the virus and social distancing seriously. But why we ended up here is a far more interesting question, one that reveals how cognitive biases may be at play. But more on that later. Here are the big stories from the weekend.

Weekend headlines

  • In a scathing news analysis, The New York Times reports on the systemic failure of state-level governments and governors to contain the spread of COVID-19. Those failures include politicization of the virus, willful disregard of inconvenient facts in favor of optimistic narratives, unrealistic expectations, and disjointed or insufficient testing and contact tracing. Americans have been pummeled by the virus and its economic impact. Our leaders, according to the Times, may have needlessly prolonged this suffering by failing to maintain social distancing. All one has to do is look to Florida, Texas, and Arizona to see this playing out. Read this report, and you have to wonder what the repercussions will be at the ballot box in November. 

  • MSNBC reports on Johns Hopkins University data, which shows the global number of cases to be about 10 million on Sunday, with the U.S. accounting for about 25% of those numbers. Brazil (about 1 million) and Russia (about 600,000) trail the U.S. (about 2.5 million).

  • The New York Times reports that some ICUs in Mississippi are full and Houston has issued its highest emergency alert level. 

  • A leader of the movement to re-open Maryland has tested positive for COVID-19, CNN reports.

  • While vaccines are getting all of the attention, it’s another research arena that’s delivering some hope during the pandemic. CNN reports in-depth on antibody treatments for COVID-19. Though an effective vaccine is likely months, if not a year or more, away, we’re beginning to see progress with plasma-derived options. 

  • Healthcare workers, confronted with previously unseen levels of death and suffering, are contending with PTSD symptoms, CNBC reports. Their suffering is also affecting their families.

Here’s what we’re keeping an eye on this week:

Thinking about thinking

The present situation makes us think of the Talking Heads song, Once in a Lifetime. Reviewing all that has transpired to date, you may ask yourself, well, how did I get here? There is no one definitive answer to that question, as much as we’d like to point the finger at insufficient testing, social distancing, or poor leadership. The answer is all of the above, plus other factors we haven’t included. COVID-19 represents such a vast, complex problem that it’s often hard to decide where to begin solving. That’s why a critical examination of how we think about COVID-19 may be in order. Specifically, what cognitive biases have contributed to present circumstances?

The Dunning-Kruger Effect may explain in part how we got here. Psychology Today defines the Dunning-Kruger Effect as “a cognitive bias in which people wrongly overestimate their knowledge or ability in a specific area. This tends to occur because a lack of self-awareness prevents them from accurately assessing their own skills.” You might think of this as knowing enough to be dangerous, the danger lying in a lack of awareness regarding your own ignorance. Perhaps you're a veteran family medicine physician. Does that make you qualified to opine on the complexities of COVID-19? Maybe you’re a medical and science journalist (ahem). Does that make you authoritative enough to analyze the crises on public radio? Or, maybe you're an accountant whose uncle is a physician. Does that give you sufficient perspective to make informed decisions about social distancing?

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