Data: The Center for Systems Science and Engineering at Johns Hopkins; Chart: Andrew Witherspoon/Axios

The number of new coronavirus cases nationally hovered around 30,000 a day during the entire month of April, meaning that the virus has managed to spread in spite of stringent social distancing measures.

Why it matters: Many states have already started to lift these measures, which will enable the virus to spread even faster.

Between the lines: Many Americans — like health care workers, grocery workers and emergency personnel — haven't been able to stay home, as their jobs are considered essential. That's enabled the virus to spread among these populations.

  • It has also been able to spread among people who live close together, including families, nursing home residents, incarcerated Americans and those experiencing homelessness.

The big picture: The fewer people who have the virus once society reopens, the easier it will be to control. That's part of why we shut down — the caseload had already outgrown our public health infrastructure's ability to respond to it.

  • We've built up our testing capacity over the last several weeks and are starting to do the same with contact tracing, but these tools can only do so much against exponential spread — even when fully developed, which they're not yet.
  • Even if we're able to keep the caseload at current levels, that's still an enormously challenging reality to live with.

What they're saying: "Everyone thought we’d be in a better place after weeks of sheltering in place and bringing the economy to a near standstill," former FDA commissioner Scott Gottlieb wrote in a Wall Street Journal op-ed yesterday.

  • "Continuing spread at something near current levels may become the cruel 'new normal.' Hospitals and public-health systems will have to contend with persistent disease and death," he added.

The bottom line: April was tough, but as states begin to reopen, we don't yet know what lies ahead of us.

  • Things could get worse, or today's status quo could be in place for a long time.
  • And as has been true this whole time, what happens will look different from one community to another.

Go deeper

Aug 9, 2020 - Health

Ex-FDA head: U.S. will "definitely" see 200,000 to 300,000 virus deaths in 2020

Former FDA commissioner Scott Gottlieb said on CBS News' "Face the Nation" that the coronavirus death toll in the U.S. will be "definitely" somewhere between 200,000 and 300,000 by the end of 2020.

Why it matters: "Whether we're closer to 200,000 or closer to 300,000 depends on what we do now and how it evolves," Gottlieb warned on Sunday as the U.S. surpassed five million confirmed coronavirus cases.

Updated 5 hours ago - Health

World coronavirus updates

Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Axios Visuals

The number of COVID-19 cases surpassed 20 million worldwide on Monday evening, Johns Hopkins data shows.

The big picture: World Health Organization chief Tedros Adhanom Ghebreyesus told a virtual press conference as the world approached the milestone that 750,000 deaths were set to be recorded this week. "Behind these statistics is a great deal of pain and suffering. Every life lost matters," he said. "But I want to be clear: there are green shoots of hope and... it's never too late to turn the outbreak around."

19 hours ago - Health

How to do smarter coronavirus testing

Illustration: Eniola Odetunde/Axios

With testing once again a huge vulnerability to America’s coronavirus response, public health officials are calling for a revamped strategy that features the use of more tests, even if they're imperfect.

Why it matters: The system is overwhelmed by the demand for tests, and yet prolific testing is key to identifying asymptomatic or pre-symptomatic coronavirus cases. Experts say the solution is smarter testing — which doesn't require perfect accuracy.