The three sizable urban centers in the United States where the coronavirus is currently spreading the fastest have one thing in common: They are major tourist destinations in warm weather.
Miami-Dade County, Fla., Honolulu County, Hawaii, and San Juan, PR, all have an average of at least 85 new cases per day per 100,000 residents, with test positivity rates of more than 20 percent, according to a DailyExpertNews database. By contrast, the nation as a whole has an average of 34 newly reported cases per day per 100,000 residents, with a 13 percent positivity rate.
As of Wednesday, new confirmed cases in the United States have roughly flattened out over the past two weeks, averaging about 110,000 a day, according to a DailyExpertNews database, after rising from less than 30,000 a few months ago. And those are just the reported cases; widespread use of home testing means many positive test results never make it to official results, experts say, and many people with mild or no symptoms may never get tested at all.
“Much of the US is dealing with summer weather, but Covid-19 cases are on the rise,” said Dr. Sandra Albrecht, an assistant professor of epidemiology at Columbia University. “So I wouldn’t expect this pattern to look different for warm-weather destinations.”
The only places in the country with higher recent numbers than those three urban centers are smaller communities in Puerto Rico or Hawaii and a few isolated rural counties elsewhere.
Some US regions hit early by the latest wave, such as the Northeast, have shown signs of improvement lately. But Miami-Dade has steadily gotten worse since early April, with the daily average of new cases rising more than tenfold, hospitalizations more than threefold and deaths ticking up.
The CDC now considers it, along with much of Florida, a high virus level area where extra precautions are recommended, including wearing masks on public transportation and in indoor public areas.
dr. Mary Jo Trepka, chief of the epidemiology department at Florida International University, pointed to several factors that could be driving the surge, including crowds of spring break tourists, recent major events like the Miami Grand Prix race, and growing public apathy about the pandemic.
“I think people are no longer taking precautions like they used to,” said Dr. Trepka. “People masked more here in the province, and we see that less. People are less careful because they are tired.”
Mayor Daniella Levine Cava dropped all of Miami-Dade’s pandemic security mandates in February, around the time the CDC shifted its strategy on measures such as masks and social distancing. At the time, the federal agency said, many such restrictions were no longer necessary in most of the country, although counties must calculate their deductibles if circumstances change.
When the latest surge came in April, Ms Levine Cava urged residents to get vaccinated, wear masks, disinfect surfaces and maintain social distancing, but the county has not mandated any of these measures.
In a statement on Wednesday, Ms Levine Cava once again called on residents to take precautions themselves: get vaccinated and boosted, get tested if they show symptoms and stay home if they feel sick. “The best tools to fight the virus are the same that we know and continue to use,” she wrote.
Ms. Levine Cava noted that Miami-Dade was “the most vaccinated county in Florida: and those efforts paid off with fewer hospitalizations than in previous peaks. But caution remained.
“We have not defeated this virus, but we know how to control it,” she wrote.
Honolulu County Mayor Rick Blangiardi has taken a similar approach.
“The coronavirus is not going away,” he wrote in a statement on Wednesday. “I encourage everyone to continue to show personal responsibility and wear your masks when you are around others, get tested if you’re not feeling well, and make sure you get your booster.”
Mr Blangiardi said his government is not considering reintroducing mask mandates or other restrictions, but will “consider all possible solutions to any situation that requires a response”.
The county, which includes the islands of Oahu, Molokai, and Lanai, has seen significant gains similar to Miami-Dade’s since early April, but in the case of Honolulu, there are signs that it has peaked. The number of new virus cases has fallen slightly in the past two weeks to 85 cases per day per 100,000 inhabitants, and the positivity rate stopped rising in mid-May.
Hawaii had some of the strictest travel restrictions in the country, forcing anyone arriving in the state to complete a 14-day quarantine. In March, it lifted its travel restrictions, allowing travelers from the continental United States to enter the country without testing and became the last state in the nation to abolish the indoor masking requirement.
A month later, the state’s tourism industry recorded its highest traffic since the start of the pandemic, with more than 800,000 visitors arriving in the Hawaiian Islands, according to the state’s Department of Commerce, Economic Development and Tourism.
Mike McCarthy, the department’s director, said in a statement that the tourism industry “recovered strongly from the Covid-19 pandemic”. He said he expected a gradual resumption of international travel by Japanese citizens – typically a large proportion of visitors to Hawaii – to bolster the recovery.
In Puerto Rico, Governor Pedro Pierluisi lifted almost all pandemic restrictions in March, and new confirmed cases soon began to pile up. But tourism to the island has returned: While cruise ship arrivals hadn’t reached prepandemic levels, business travel for meetings and conventions was improving, Discover Puerto Rico, the island’s official tourism website, said in late April.
Kenira Thompson, chair of the coalition of scientists and vice president for research at Ponce Health Sciences University in Puerto Rico, said older and immunocompromised people there should consider continuing to wear masks in crowded places, and those eligible come for booster shots have to look them up.
dr. Alain Labrique, the director of the Johns Hopkins University Global Health Initiative, said the summer tourist season meant large gatherings and more people-to-people contacts, a recipe for the easy spread of infection even when fewer people experience serious illness.
“Covid-19 hasn’t gone as much as our patience for precautions,” he said.