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U.S. health officials planning for what re-entry to 'normality' will look like

U.S. health officials are planning ways for the country to return to normal activities if distancing and other steps to mitigate COVID-19 this month prove successful in curbing the outbreak, the top U.S. infectious disease official said on Wednesday.

White House coronavirus task force lead warns 'acute 2nd wave' could occur if states aren't careful

A member of the U.S. Army National Guard moves boxes of free food provided by multiple New York City agencies for distribution to local residents in Harlem and Manhattan. (Mike Segar/Reuters)

U.S. health officials are planning ways for the country to return to normal activities if distancing and other steps to mitigate COVID-19 this month prove successful in curbing the outbreak, the top U.S. infectious disease official said on Wednesday.

The Trump administration has called for 30 days of measures, including staying at least two metres away from other people, that have upended American life as most people stay isolated at home. Schools are shuttered and businesses are closed  through at least the end of April, with some states continuing certain closures through May and June.

Dr. Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, said such steps must continue, but he said there are hopeful signs they are working.

"If in fact we are successful, it makes sense to at least plan what a re-entry into normality would look like. That doesn't mean we're going to do it right now, but it means we need to be prepared to ease into that," Fauci, a member of the White House coronavirus task force, told Fox News in an interview.

He and other public health experts have said the strict measures are needed to control the fast-spreading and potentially fatal disease, even as the shutdowns have roiled the country.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, is shown at a White House briefing on March 31, along with Dr. Deborah Birx, the White House coronavirus response co-ordinator. (Alex Brandon/The Associated Press)

Dr. Deborah Birx, another task force member, said isolation measures must continue for now or else the country could risk a repeated spike despite the allure of warmer spring weather.

"What's really important is that people don't turn these early signs of hope into releasing from the 30 days to stop the spread. It's really critical," she told NBC's Today. "If people start going out again and socially interacting, we could see a really acute second wave."

Asked if 30-day distancing practices would be enough or that steps might have to continue longer, she said officials were looking at each area of the country differently as they weigh the data.

"Clearly, there are metro areas that are struggling."

The comments came as the U.S. Centers for Disease Control and Prevention (CDC) on Wednesday reported 395,011 cases of the coronavirus, an increase of 20,682 cases from its previous count, and said the number of deaths had risen by 690 to 12,754.

The CDC reported its tally as of 4 p.m. ET on April 7.

The U.S. is seeing burgeoning hotspots in such places as Washington, D.C., Louisiana, Chicago, Detroit, Colorado and Pennsylvania. The New York metropolitan area, which includes northern New Jersey, Long Island and lower Connecticut, accounts for about half of all virus deaths in the U.S.

New York has more cases than Spain or Italy

New York's governor said Wednesday he believed efforts at social distancing are working to get the coronavirus pandemic under control even as the number of deaths over the past 24 hours hit a new single-day high of 779 across the state.

"Don't start doing a retrospective like it's over," Gov. Andew Cuomo told a daily briefing on the states' coronavirus response, urging residents to stay at home as much as possible. "We are not through it. It's not over."

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In New York City, the epicentre of the outbreak in the U.S., Mayor Bill de Blasio said mitigation efforts such as ordering all non-essential workers to remain at home "actually are starting to yield some progress."

But he warned against relaxing any restrictions too soon. 

"Double down, double down, because this is finally some evidence that these strategies can work," de Blasio told CNN. "One thing we know about it is that it's unpredictable and it's ferocious."

De Blasio and Cuomo each cautioned that the official death toll was overlooking people who die at home without seeking care, as did a New York City councillor.

"Every single measure of this pandemic is an undercount. Every. Single. One," Mark Levine, chairman of the city council's health committee, wrote on Twitter. "Confirmed cases? Skewed by lack of testing. Hospitalizations? Skewed by huge # of sick people we are sending home because there's no room in ERs. Deaths? Massive undercount because of dying at home."

A Reuters tally puts the overall number of cases in New York state alone, over 149,300, as higher than any Western nation, including hard-hit Italy or Spain.

'Not waiting around any longer'

While New York is scrambling to provide care, California Gov. Gavin Newsom said his state made a breakthrough in supplies by securing a deal for 200 million medical face masks per month, mostly coveted N95 as well as surgical masks, by working through a consortia of nonprofits and a state manufacturer.

"We've been competing against other states, against other nations, against our own federal government for PPE.... We're not waiting around any longer," he told MSNBC in an interview late Tuesday night. "We decided enough's enough. Let's use the purchasing power of the state of California as a nation state."

Newsom said he was confident the state would have enough personal protective equipment and could possibly export some to other states within the next few weeks.

Meanwhile, a university model often cited by U.S. and state policymakers projected on Wednesday that 60,000 Americans could die, a 26 per cent reduction in its most recent forecast death toll.

Brothers Claim Ho, front left, and Lee Ho wait in line to purchase face masks and toilet paper outside Masataco, a taco shop in Whittier, Calif., on Tuesday. Masataco has managed to sell thousands of face masks at cost. (Damian Dovarganes/The Associated Press)

The University of Washington model's downward revision coincides with relative optimism from political leaders that caseloads may have reached a plateau in certain areas, albeit with the U.S. death toll climbing by 1,800 on Tuesday as nearly 30,000 new infections were reported.

The University of Washington's Institute for Health Metrics and Evaluation model is one of several that the White House task force has cited.

The White House coronavirus task force has previously projected 100,000 to 240,000 Americans could die.

Worldwide, more than 1.5 million people have been confirmed infected and about 90,000 have died, according to Johns Hopkins University. The true numbers are almost certainly much higher because of limited testing, different rules for counting the dead and concealment by some governments.

For most, the virus causes mild to moderate symptoms such as fever and cough. But some older adults, the infirm and those with underlying medical conditions, are more likely to develop life-threatening pneumonia. Over 300,000 people are confirmed to have recovered from COVID-19.

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