The pressure is on for local leaders to respond to regional COVID-19 spikes and records, and some are turning to mask mandates.
Statewide, Californians will be required to wear face coverings in indoor public places, Gov. Gavin Newsom announced Thursday. To the north, Oregon Gov. Kate Brown announced a similar mandate for seven counties beginning June 24.
Similar measures are being considered in North Carolina and Arizona, where Scottsdale Mayor Jim Lane is developing an ordinance with a legal team.
Each of those four states, along with sixothers, is currently reporting its highest seven-day average of new coronavirus cases per day since the crisis began, according to a CNN analysis of data from Johns Hopkins University. The others are Alabama, Florida, Nevada, Oklahoma, South Carolina and Texas.
Florida could be the next epicenter, experts say. And Oklahoma, where cases are up 110% from last week, is preparing to welcome large crowds in Tulsa on Saturday for a rally for President Donald Trump.
Dr. Jonathan Reiner, a cardiologist and professor of medicine at George Washington University, told CNN's Erin Burnett that social distancing will be near impossible there and county health officials should shut it down.
All told, 23 states have seen spikes in cases compared to last week. Part of the reason could be that the nation was too early to relax stay-at-home restrictions meant to curb the virus' spread.
"Things opened up prematurely," Dr. Peter Hotez of the Baylor College of Medicine told CNN. "We didn't complete that social distancing period that we needed to do, and now we're seeing this very sharp acceleration."
Leaders hoping to slow the acceleration of the outbreak will have to consider how to implement measures that will both protect health and economy in the long term, Dr. Colleen Kraft, associate chief medical officer at Emory University Hospital, said Thursday on CNN Newsroom.
"Now we've got to figure out how can we protect people at the same time they're going about their daily lives," Kraft said. "We have to focus on living with COVID. There's not going to be a post-COVID world for a long time."
According to data from Johns Hopkins University:
• 23 states are seeing upward trends in newly reported cases from one week to the next: Alabama, Alaska, Arizona, Arkansas, California, Delaware, Florida, Georgia, Hawaii, Idaho, Kansas, Oregon, Louisiana, Montana, Nevada, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Washington, West Virginia and Wyoming.
• Eight states are seeing steady numbers of newly reported cases: Indiana, Maine, Mississippi, Missouri, Nebraska, Ohio, South Dakota and Utah.
• 18 states are seeing a downward trend: Colorado, Connecticut, Illinois, Iowa, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, New Hampshire, New Mexico, New Jersey, New York, North Dakota, Pennsylvania, Rhode Island, Virginia and Wisconsin.
• One state, Vermont, has seen a decrease of at least 50%.
Nationwide, more than 2.1 million people have been infected and at least 118,421 people have died of the virus.
Living with COVID
As Americans continue to re-enter public life this summer, the US Centers for Disease Control laid out recommendations for safety at the beach on Thursday.
Many of the recommendations include precautions health experts have been preaching all along.
Facemasks, for instance, should be worn even at the beach (expect when in the water to keep airways clear), beach blankets should be set up 6 feet apart and food, supplies and toys should not be shared, according to the CDC guidelines.
The same guidance about keeping a safe distance from others and wearing a face covering apply to other situations as well, health experts have said.
"Uniform masking would go a long way," Dr. Scott Gottlieb, former commissioner of the US Food and Drug Administration, said during an appearance on "Morning Joe" Thursday, citing a study that showed the virus could decline rather than continue to expand if only 60% of people wore masks that were 60% effective.
Millions of lives were saved when states shutdown and people stayed home at the outbreak of the pandemic, the nation's top infectious disease expert, Dr. Anthony Fauci, said in an episode of the US Department of Health and Human Services' podcast "Learning Curve" on Wednesday.
And now that states are seeing spikes once again, they may have to take a step back, Hotez said.
"I don't see any option other than to start re-implementing significant levels of social distancing," he said.
Disparities in coronavirus' impact
Local leaders also need to reassess how they are responding to the racial disparities of the pandemic that make ethnic minorities so vulnerable to the disease, an expert on racial justice said Thursday.
"The coronavirus has revealed to us that we also need to invest massive amounts of resources in our communities," David Harris, managing director of the Charles Hamilton Houston Institute for Race and Justice at Harvard Law School, said on a Facebook Live discussion.
Fauci also addressed the disproportional impact of the virus on Black Americans an an episode of the "Learning Curve" podcast on Wednesday.
"They've suffered in that their rate of infection is higher because of the nature of the economic status that many of them find themselves in where they're outside working, being unable to physically separate," said Fauci, director of the National Institute of Allergy and Infectious Diseases.
Given social determinants -- which include the conditions into which people are born and in which they live -- when Black Americans are infected, they are at a much greater risk of serious outcomes including death, Fauci said.
Many homeless people also are facing higher health hazards during the coronavirus pandemic, US District Judge David Carter.
Last month, Carter issued an order for people living under freeway underpasses and overpasses in Los Angeles as well as homeless people that are vulnerable or over 65 to relocate.
The city and county of Los Angeles have reached a deal to relocate almost 7,000 homeless individuals over the span of 18 months to new beds the city will provide, Los Angeles County Supervisor Mark Ridley-Thomas's office announced in a news release on Thursday.
"This is a new milestone in our partnership to ensure that everyone in Los Angeles has a life of dignity and worth," said Ridley-Thomas.