Despite dramatic surge in cases, Nevada, rest of the country still experiencing first wave

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John Locher / AP

People wearing masks pause while riding bicycles along the Las Vegas Strip devoid of the usual crowds as casinos and other business are shuttered due to the coronavirus outbreak, Tuesday, April 14, 2020.

Fri, Jun 26, 2020 (2 a.m.)

Two weeks after Nevada entered the second stage of its reopening plan, the state started experiencing rapid upticks in the number of new COVID-19 cases.

On Thursday, state health officials reported the biggest one-day increase in new coronavirus cases since the virus outbreak began: 507 new cases. And in four of eight days, the state established a new high for infections.

Nevada isn’t alone, with cases surging in more than half the states in the country, most notably Arizona and Florida.

Health experts have already warned about the possibility of a second wave of cases for months, but what Nevada and much of the rest of the country is experiencing isn’t a second wave at all, said UNLV epidemiologist Brian Labus.

“We’re still in the first wave because the changes that we’re seeing in the case counts are due to actions of how we dealt with that first wave,” he said, adding that daily new reported cases in the state never had the chance to dip low enough to classify new cases as a “second wave.”

“What we’re seeing now is a ripple on that first wave,” he said.

Infectious disease expert Dr. Anthony Fauci of the White House’s coronavirus task force told the Associated Press that it was premature to even be talking about a second wave following the plateau of cases reported last month.

“When you have 20,000-plus infections per day, how can you talk about a second wave?” Fauci said. “We’re in the first wave. Let’s get out of the first wave before you have a second wave.”

World Health Organization officials also say that while many countries have already seen the peak of the first wave, the disease still hasn’t reached a maintained, low enough level to constitute resurgences as another wave.

“It’s not surprising at all that any country coming out of this so-called lockdown can have clusters of disease, reemergence of disease,” said Mike Ryan, executive director of the WHO’s Health Emergencies Programme, during a media briefing this month.

While new cases may be related to more widespread testing, Labus said it’s safe to assume that’s not the only culprit, with the positivity rate trending upward. On June 23, the Nevada Department of Health and Human Services reported that the seven-day moving average was at 11.9%, almost 2 percentage points higher than the WHO’s maximum recommended positivity rate for reopening.

Nevada’s cumulative positivity rate still hovers at just above 5%, near the WHO’s recommended goal. But that number is slowly creeping back up again.

“A lower positivity rate indicates that there is widespread testing in the community and that they are not just testing the sickest people,” Labus said. “It shows that we are testing mild and asymptomatic people, which is important to our ability to conduct contact tracing. It is based on the experience of countries that have successfully been able to control the outbreak.”

There has also been a corresponding increase in hospitalizations and ventilator use, according to the health and human services department.

“We’re seeing more disease when we want to see less disease, so naturally we should be concerned about that,” Labus said.

Labus, who also serves on Gov. Steve Sisolak’s coronavirus task force, said upticks two to three weeks after reopening some businesses and casinos were anticipated, which is why restrictions on businesses were initially put in place to mitigate the spread of infection.

“Ultimately, we didn’t want to roll things back as our goal was ultimately to take a slow and measured approach,” he said.

The state will remain in Phase 2 for the foreseeable future, and Sisolak recently ordered a mandate on masks and face coverings in both public spaces and private businesses. Research indicates that effective mask wearing does help in some cases. One 2013 National Center for Biotechnology Information study found that masks have a more than threefold reduction in how much virus is sprayed into the air by people.

But masks won’t be enough to get Clark County and the rest of Nevada to trend downward in cases, Labus said.

“It’s not just masks, it’s really all these social distancing steps combined to protect us,” he said. “None of these things work in isolation. That’s why we talk about limiting the amount of people in places, putting Xs on the floor so you’re not standing too close to someone in the grocery line. All those things work together to provide some level of protection.”

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