The death toll in the United States from the novel coronavirus has surpassed 20,000 meaning the country has overtaken Italy for the highest number of confirmed fatalities from the pandemic.

This grim milestone was expected, as the US recorded more than 2,000 deaths in a single day Friday. It was the highest number of deaths any country has recorded in 24 hours since the start of the outbreak.

The global number of confirmed coronavirus cases is now greater than 1.7 million, and the number of deaths around the world topped 100,000 on April 10, according to data from Johns Hopkins University.

Officials had previously warned that the US should brace for a sharply rising death toll in what was likely to be its toughest week yet of the coronavirus pandemic. “This is going to be the hardest and the saddest week of most Americans’ lives, quite frankly,” US Surgeon General Jerome Adams said last week on Fox News Sunday.

The magnitude of the crisis differs among states and localities. New York alone has more confirmed cases than any other country right now. The state registered more than 8.600 deaths as of April 11, including 783 in the past 24 hours. These figures are likely an undercount, as people are dying at home without having had a coronavirus test, and so haven’t made it into the official count.

New Jersey and Michigan are the two other US states with fatality numbers that exceed 1,000. Wyoming is the only state, so far, without any reported coronavirus deaths.

“This is the end of the week, that famous week that we spoke about last week, in what was predicted to happen, happened,” Dr. Anthony Fauci, the nation’s top infectious disease expert, said Friday at a White House press briefing.

Has the United States reached its coronavirus peak?

At the end of March, the White House presented data that suggested between 100,000 and 200,000 people could die from the coronavirus. Though there have been some questions about the statistical models the administration used to make that estimate, Fauci said Thursday the estimates are now closer to 60,000 — in part because aggressive stay-at-home measures are working. That is still an astounding figure.

Though the US now leads the world in confirmed coronavirus fatalities, Dr. Deborah Birx, coordinator of the White House coronavirus task force, said Friday the country had not yet reached the peak of the pandemic.

“We have not reached the peak,” Birx said. “Every day we have to continue to do what we did yesterday, and the week before, and the week before that, because that’s what in the end is going to take us up across the peak and down the other side.”

Different states are expected to peak at different times, and despite the startling death tolls, there are some glimmers of optimism. New York Gov. Andrew Cuomo said Friday that, on average, the state is seeing a decline in hospitalization and ICU admissions. Experts say there are signs the curve is beginning to flatten in other hard-hit places, such as Michigan.

Birx, and Fauci, emphasized that, despite some promising signs, maintaining social distancing measures remained imperative. “It’s important to remember that this is not the time to feel that, since we have made such important advances and success of the mitigation, that we need to be pulling back at all,” Fauci said Friday.

This, though, is going to be a likely source of tension as the US begins to get a handle on the pandemic. The extreme measures that are limiting the spread of the virus have brought the US economy to a near-standstill, with businesses shuttered and millions of workers unemployed. The number of jobless claims filed in the week ending April 4 reached 6.6 million; in the past three weeks combined the number of claims has exceeded 16 million.

A few weeks ago, President Donald Trump said he wanted to see packed churches for Easter, a vision he had to rescind once it became clear that, far from being back to normal, the country would be bracing for devastation if the administration did not extend its social distancing guidelines.

But Trump made that decision back when cases and deaths were increasing and increasing by the day; now, if the US begins to see signs that the virus is under control, pressure may intensify to try to ease restrictions and reopen segments of the economy. The Trump administration is reportedly pushing to reopen much of the country by May.

And that, public health experts warn, could quickly mean a resurgence of coronavirus cases if it happens too abruptly.

“If you ease up prematurely the epidemic can rebound right back to the level we are at now in a matter of weeks,” Chris Murphy, a researcher for the Institute for Health Metrics and Evaluation, which has been modeling Covid-19 projections for the US, told NPR. “So the potential for rebound is enormous if we let up on social distancing.”

Of course, Trump doesn’t just have the power to simply re-open the economy. Those decisions will fall to states and localities, who will make their own determinations on when it’s safe to ease restrictions.

And this means, regardless of what recommendation the federal government chooses to make, reopening the country by May 1 is looking unlikely. Los Angeles County, for example, just extended its lockdown until at least May 15. New York City Mayor Bill de Blasio said an opening was possible in May or June, if New Yorkers “really work hard” and abide by social distancing. On Saturday, de Blasio said schools would be closed for the rest of the school year, though Cuomo, the governor, described it as an “opinion” and wanted to coordinate with other localities in metropolitan area.

Any initiatives to end current social distancing measures — even if they are rolled out in the summer depend on having an aggressive plan to keep the number of infections low. Any such plan will almost certainly require widespread testing and contact-tracing (identifying those infected, and who they’ve come in contact with, so everyone can be quickly quarantined), two things the US does not yet have the capacity, or a clear plan, to implement on such a massive scale.


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