New York City residents, gradually emerging from more than 100 days of coronavirus lockdown, celebrated an easing of social-distancing restrictions on Monday by shopping at reopened stores, dining at outdoor cafes and getting their first haircuts in months.
But even as New Yorkers, confined for weeks at the epicenter of the global pandemic, returned to some semblance of normalcy, alarming spikes in coronavirus infection rates elsewhere around the country worried public health experts.
Chief among the latest hotspots was Florida, one of the last states to impose stay-at-home restrictions and one of the first to begin lifting them, with nearly 3,000 new infections reported over the previous 24 hours. Arizona, meanwhile, had almost 2,200 additional cases since Sunday.
The two are prime examples of a troubling trend, mostly in the South and West, where the percentage of positive test results among all people who are screened - a metric called the positivity rate - has climbed.
That is a consequence of people venturing back into public spaces without wearing masks and not practicing safe social-distancing, said Eric Toner, a senior scholar at the Johns Hopkins Center for Health Security in Baltimore.
"Wherever people mix, wherever people have person-to-person contact, there will be spread of the virus," Toner told Reuters. "The question is not whether it will spread - that's a certainty. The question is how big that increase will be, and that's largely a function of what government and individuals do."
The World Health Organization considers positivity rates above 5% to be especially concerning, and widely watched data from Johns Hopkins University shows a dozen states with average rates over the past week exceeding that level and rising.
At least four were averaging double-digit rates, according to Johns Hopkins - Arizona at 20%, Florida and Utah both at 11%, and Texas at 10%. Texas also reported a record 5,000-plus new cases in a single day. The same states often have experienced surging hospitalizations.
Beginning to relax
States hardest hit earlier in the pandemic, mainly in the Northeast, have generally been slower to resume commerce and public life.
New York City, the nation's most populous metropolitan area, was the last region to move into Phase 2 of New York state's economic reopening plan. Restaurants and bars began offering outdoor service and many retailers started to allow patrons back into their stores. Barber shops and hair salons welcomed customers for the first time since mid-March, with some fully booked for the next two weeks.
Playgrounds also reopened on Monday in New York City, which still accounts for more than a quarter of all U.S. lives lost to Covid-19, more than 120,000 to date, as the number of known infections nationwide rose above 2.3 million.
At the height of the outbreak, New York City's usually bustling streets were largely deserted, echoing around the clock with the wailing of ambulance sirens. New York state as a whole was losing 1,000 lives a day, hospitals were overwhelmed, and the dead filled makeshift morgues.
On Monday the state reported 10 additional deaths from the coronavirus. The usual traffic jams clogged city streets, and the sound of honking cars brought a welcome sense of a return to the ordinary.
Customers wearing face coverings lined up outside Clementine Bakery in the Brooklyn neighborhood of Bedford-Stuyvesant on Monday, and a few enjoyed the warm summer morning sipping iced coffee at scattered tables on the sidewalk.
"It feels like my life is starting to get back to normal a little bit. It feels really nice the fact that I can sit and have a coffee," said Arden Katine, 34, a teacher who lives nearby.
The outbreak in distant parts of the country worried New York Governor Andrew Cuomo, who said he was talking with neighboring states about placing restrictions on travelers from places such as Arizona and Florida. Earlier this year, Florida ordered arriving New Yorkers to self-quarantine for two weeks.
"It's more effective if we act as a regional collaboration, and I'm talking to them about putting in guidelines so we don't have people coming from these other states," Cuomo told MSNBC.
Even if the growth in confirmed cases partly reflects transmission among younger people less likely to require hospitalization, those individuals are still contagious and could infect the elderly and others at high risk of severe illness due to underlying health conditions, experts warn.
New York and New Jersey, another major hotspot months ago, are now at record lows of infection rates with 1% or 2% of diagnostic tests coming back positive.
On the West Coast, the number of new cases hit a record of nearly 5,400 in California, the first to impose statewide stay-at-home orders. Los Angeles County, the most populous in the state with 10 million residents, accounted for the bulk of the latest tally with 2,588 new infections.