As the worldwide coronavirus case count passed 10 million and the death toll topped 500,000 on Sunday, 36 U.S. states continued to struggle with alarming spikes in COVID-19 infections.

Experts cautioned that Florida could become the next epicenter for infections while Texas has seen record-breaking case counts and hospitalizations, CNN reported. Officials across the country are also warning of an increase in cases among younger people.

Over the weekend, Florida shattered its previous records and reported 9,585 new cases on Saturday and 8,530 on Sunday, The New York Times reported. Six-hour lines formed in Jacksonville as thousands showed up to get drive-through tests. Orange County, home to Orlando, has seen an explosion of coronavirus: nearly 60 percent of all cases there have come in the past two weeks.

Much of Florida’s surge in cases has followed the reopening of beaches, bars, restaurants and other social activities. Florida Gov. Ron DeSantis blamed the increase on a “test dump,” largely from younger residents getting themselves tested for COVID-19.

“I’m one of the people who contributed to the 9,000-person day,” said Ian Scott, a 19-year-old college sophomore in Orlando who tested positive on Friday. He told the Times he has no idea how he got it.

“We’re seeing positive, positive, positive, positive,” he said. “My generation says: ‘Let’s get this over with. Let’s suck it up for two weeks, sit in our rooms, play video games, play with our phones, finish online classes, and it’s over.”

Scott barely felt sick, and was fine by the time the test results came back. Patients like him could account for the fact that while Florida’s daily case count has increased fivefold in two weeks, the rate of deaths has not increased so far.

Meanwhile health experts are reporting that another troubling symptom of COVID-19 has emerged. Called hospital delirium, the condition is bedeviling coronavirus patients of all ages with no previous thinking deficits, the Times reported.

Reports from hospitals and researchers suggest between two-thirds and three-quarters of coronavirus patients in intensive care have experienced it in various ways. Some have “hyperactive delirium,” paranoid hallucinations and agitation; some have “hypoactive delirium,” internalized visions and confusion that cause patients to withdraw; and some have both, the newspaper reported.

Rising cases in South alarm federal health officials

Coronavirus response task coordinator Dr. Deborah Birx said last week that rising positive test rates in states across the South, including Texas, Arizona, Florida and Mississippi, were causing significant concern among health officials, and that they had created an “alert system” to track them.

She used Texas as an example where higher positive test rates suggest a kind of spread that could not be explained completely by higher rates of testing. Texas is part of a group of states with test positive rates above 10 percent, a threshold the White House has used to identify areas of particular concern, she explained.

Texas Gov. Greg Abbott, speaking in Dallas on Sunday, said that the virus had taken a “very swift and a very dangerous turn” in his state, the Times reported. The increase in the rate of positive coronavirus tests, to over 13 percent in the past month from less than 4 percent, is an “alarm bell,” he warned.

Coronavirus-related hospitalizations are also surging in that state, reaching a record high for the 16th day in a row on Saturday, the Washington Post reported.

A handful of states have actually brought the virus under control after being slammed in the early stages of the pandemic. Determined to keep case counts low, New York, Connecticut and New Jersey have said they will now mandate quarantines for travelers coming from states that are experiencing large spikes in new cases, the Times said.

On Sunday, New York Gov. Andrew Cuomo announced that only five coronavirus-related deaths had been reported over the previous 24 hours, the lowest single-day death toll in the state since March 15. The number of COVID-19 patients being hospitalized also dropped below 900 for the first time since March, the Post reported. In a statement, Cuomo noted the numbers would “shoot right back up” if people failed to follow social distancing protocols.

By Monday, the U.S. coronavirus case count passed 2.5 million as the death toll neared 126,000, according to a Times tally.

According to the same tally, the top five states in coronavirus cases as of Monday were: New York with over 397,000; California with over 216,000; New Jersey with more than 173,000; Texas with over 152,000 and Illinois with over 143,000.

Millions infected unknowingly in March

Meanwhile, a new study suggests that as many as 8.7 million Americans came down with coronavirus in March, but more than 80% of them were never diagnosed, CNN reported.

A team of researchers looked at the number of people who went to doctors or clinics with influenza-like illnesses that were never diagnosed as coronavirus, flu or any of the other viruses that usually circulate in winter. There was a giant spike in these cases in March, according to the study published June 22 in the journal Science Translational Medicine.

Only 100,000 cases were officially reported during that time period, but there was a shortage of coronavirus testing kits at the time, CNN reported.

The team turned to CDC data collected from each state for influenza-like illness. The agency asks doctors to report all cases of people coming in for treatment for fever, cough and other symptoms caused by influenza.

“The findings support a scenario where more than 8.7 million new SARS-CoV-2 infections appeared in the U.S. during March and estimate that more than 80% of these cases remained unidentified as the outbreak rapidly spread,” said Justin Silverman, of Penn State University, and colleagues, CNN reported.

An old drug brings new hope

There has been some good news in recent weeks, however. Researchers at Oxford University in England announced that dexamethasone, a widely used, low-cost steroid, appears to cut the death rate for ventilated COVID-19 patients by one-third. It also lowered the death rate for patients who require oxygen (but are not yet on a ventilator) by one-fifth, the Times reported.

“Bottom line is, good news,” Fauci, who directs the U.S. National Institute of Allergy and Infectious Diseases, told the Associated Press. “This is a significant improvement in the available therapeutic options that we have.”

But at least three manufacturers of the drug have reported shortages, according to the American Society of Health-System Pharmacists, STAT News reported. Two of the manufacturers cited increased demand as a reason for their shortages.

Meanwhile, the search for an effective vaccine continues. The U.S. Department of Health and Human Services (HHS) has said that it would provide up to $1.2 billion to the drug company AstraZeneca to develop a potential coronavirus vaccine from Oxford University, in England.

The fourth, and largest, vaccine research agreement funds a clinical trial of the potential vaccine in the United States this summer with about 30,000 volunteers, the Times reported.

The goal? To make at least 300 million doses that could be available as early as October, the HHS said in a statement.

The United States has already agreed to provide up to $483 million to the biotech company Moderna and $500 million to Johnson & Johnson for their vaccine efforts. It is also providing $30 million to a virus vaccine effort led by the French company Sanofi, the Times reported. Moderna said a large clinical trial of its vaccine candidate could begin in July.

Nations grapple with pandemic

Elsewhere in the world, the situation remains challenging.

Even as the pandemic is easing in Europe and some parts of Asia, it is worsening in India. Officials in New Delhi plan to test all of the city’s 29 million residents in the next week or so, as the number of coronavirus cases passed 500,000 on Monday and pushed many hospitals to their breaking point, the Times reported.

Brazil has also become a hotspot in the coronavirus pandemic, with more than 1.3 million confirmed infections by Monday, according to the Hopkins tally. U.S. President Donald Trump has issued a ban on all foreign travelers from Brazil because of the burgeoning number of COVID-19 cases in that country, CNN reported.

Cases are also spiking wildly in Russia: As of Monday, that country reported the world’s third-highest number of COVID-19 cases, at more than 640,000, the Hopkins tally showed.

Worldwide, the number of reported infections passed 10 million on Monday, with over 500,000 deaths, according to the Hopkins tally.

More information

The U.S. Centers for Disease Control and Prevention has more on the new coronavirus.

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