Data: Nephron and JHU; Table: Axios Visuals

Most of the states facing large coronavirus outbreaks today didn't build up their public health systems enough ahead of time.

Why it matters: States like Arizona, Florida and Texas had months to learn from the mistakes of New York and other early hotspots, yet find themselves now in similar situations.

The big picture: The U.S. has rapidly scaled up its testing and contact tracing capabilities, but they're still not nearly enough.

  • States should have at least 30 contact tracers per 100,000 people during the pandemic, according to the National Association of County and City Health Officials. Most states' workforce falls far short of that metric, according to a Nephron Research analysis.
  • The World Health Organization has said 5% or less of diagnostic tests should come back positive for at least 14 days before governments allow reopening, but many states are now well above this threshold, per Johns Hopkins University.
  • In some hotspots, people are having a hard time getting tested, leading to long lines and crowding, the NYT reports. Overall, the U.S. still isn't doing the number of tests that many experts say it needs to be.

Between the lines: Part of the reason the U.S. economy shut down was to buy states time to build up their public health infrastructure. Many states failed to do so before reopening, leading to today's predictable results.

The bottom line: There's no reason why any city or state in the U.S. can't eventually become a coronavirus hotspot.

  • Arizona, Texas and Florida are learning this the hard way, but there are plenty of places that still have more time to build up their testing, tracing and isolation capabilities.

Go deeper: Bigger, wealthier cities lead on coronavirus recovery

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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.

Updated 8 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."

Updated 49 mins ago - Politics & Policy

Coronavirus dashboard

Illustration: Annelise Capossela/Axios

  1. Global: Total confirmed cases as of 3 a.m. ET: 20,092,855 — Total deaths: 736,254 Total recoveries — 12,350,879Map.
  2. U.S.: Total confirmed cases as of 3 a.m. ET: 5,094,565 — Total deaths: 163,465 — Total recoveries: 1,670,755 — Total tests: 62,513,174Map.
  3. Politics: Trump claims he would have not called for Obama to resign over 160,000 virus deathsHouse will not hold votes until Sept. 14 unless stimulus deal is reached.
  4. Business: Richer Americans are more comfortable eating out.
  5. Public health: 5 states set single-day coronavirus case records last week — A dual coronavirus and flu threat is set to deliver a winter from hell.
  6. Sports: The cost of kids losing gym class — College football is on the brink.
  7. World: Europe's CDC recommends new restrictions amid "true resurgence in cases."