The US could be in the early stages of a fourth wave of the Covid-19 pandemic that is taking renewed hold across the country, with coronavirus cases increasing in 25 states, according to reports.

The US has tallied, on average, 63,000 new cases daily over the past week–an increase of 17% from the week prior, news website Axios reported. Only five states have recently seen declines in new cases. The third wave of the pandemic, which peaked in January, saw about 250,000 people daily testing positive for Covid-19, the Hill reported.

This new rise in cases is most pronounced in Michigan and New York but is becoming widespread across large swaths of the country. The threat of a fourth wave comes as many states have loosened Covid-19 restrictions – disregarding public health officials’ many warnings that doing so was premature.

Dr Rochelle Walensky, the federal Centers for Disease Control and Prevention (CDC) director, said Monday that a fourth wave is all but guaranteed, remarking: “I’m going to lose the script, and I’m going to reflect on the recurring feeling I have of impending doom.”

“We have so much to look forward to, so much promise and potential of where we are, and so much reason for hope. But right now I’m scared,” Walensky also said during an emotional moment of a White House briefing.

Joe Biden has implored regional officials to keep or reinstate mask their mandates, because of the alarming trend in US case numbers.

“I’m reiterating my call for every governor, mayor, and local leader to maintain and reinstate the mask mandate,” the president said hours after Walensky’s comments. “Please, this is not politics. Reinstate the mandate if you let it down.”

Any fourth wave is likely to be less deadly than previous waves, especially amongst the elderly where 73% of seniors have received at least one dose of coronavirus vaccine. But a fresh surge of the virus can easily thwart progress in fighting the pandemic. Even with fewer fatalities, millions of people will remain at risk of illness and death and a new surge will strain the overburdened US healthcare system.

Meanwhile, millions of younger Americans with health conditions that put them at higher risk have still not received vaccination despite a US vaccine rollout that has largely won wide praise for its speed. Covid-19 hospitalizations have gone up amid the virus’s apparent resurgence, albeit less than before.

The ongoing pandemic also sets the stage for the emergence of variant strains of the virus. The variants presently driving this outbreak are more contagious than Covid-19’s initial strain. The Covid-19 vaccines now available might also be less effective against these variants.

The loosened restrictions and increasingly lax behavior among pandemic-weary Americans have further fanned the flames of Covid-19’s resurgence. Some states, including Texas, have abandoned their mask mandates. Even states which historically imposed stronger restrictions during the pandemic have loosened regulations despite this uptick.

Wan Yang, professor of epidemiology at Columbia University’s Mailman School of Public Health, told the New York Times that shifting habits might cause an continued rise in coronavirus cases in New York City and state. More New York residents are interacting inside buildings, given increased access to indoor dining and group fitness classes.

In Rockland county, New York, which is north of the city, teenagers, as well as persons between the ages of 20 and 49, have led the increase in cases. “They are kind of done with this, they want to go out,” the county’s health commissioner, Dr Patricia Schnabel Ruppert, told the Times.

New Jersey, which has seen one of the highest coronavirus case rates across the US, noted a 20% surge over the past 14 days. Despite this, the New Jersey governor, Phil Murphy, on Monday said he would relax seating capacity restrictions on sports venues, as well as indoor catered events.

Although case data are increasingly dire, vaccination efforts have expanded dramatically. Biden said Monday that up to 90% of US adults would be eligible for a Covid-19 jab by 19 April.

This content first appear on the guardian

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