The New York Times is releasing a series of data files with cumulative counts of coronavirus cases in the United States, at the state and county level, over time. We are compiling this time series data from state and local governments and health departments in an attempt to provide a complete record of the ongoing outbreak.

Since late January, The Times has tracked cases of coronavirus in real time as they were identified after testing. Because of the widespread shortage of testing, however, the data is necessarily limited in the picture it presents of the outbreak.

We have used this data to power our maps and reporting tracking the outbreak, and it is now being made available to the public in response to requests from researchers, scientists and government officials who would like access to the data to better understand the outbreak.

The data begins with the first reported coronavirus case in Washington State on Jan. 21, 2020. We will publish regular updates to the data in this repository.

This file contains COVID-19 death counts and rates by month and year of death, jurisdiction of residence (U.S., HHS Region) and demographic characteristics (sex, age, race and Hispanic origin, and age/race and Hispanic origin). United States death counts and rates include the 50 states, plus the District of Columbia. Deaths with confirmed or presumed COVID-19, coded to ICD–10 code U07.1. Number of deaths reported in this file are the total number of COVID-19 deaths received and coded as of the date of analysis and may not represent all deaths that occurred in that period. Counts of deaths occurring before or after the reporting period are not included in the file. Data during recent periods are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes. This delay can range from 1 week to 8 weeks or more, depending on the jurisdiction and cause of death. Death counts should not be compared across jurisdictions. Data timeliness varies by state. Some states report deaths on a daily basis, while other states report deaths weekly or monthly. The ten (10) United States Department of Health and Human Services (HHS) regions include the following jurisdictions. Region 1: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont; Region 2: New Jersey, New York; Region 3: Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia; Region 4: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee; Region 5: Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin; Region 6: Arkansas, Louisiana, New Mexico, Oklahoma, Texas; Region 7: Iowa, Kansas, Missouri, Nebraska; Region 8: Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming; Region 9: Arizona, California, Hawaii, Nevada; Region 10: Alaska, Idaho, Oregon, Washington. Rates were calculated using the population estimates for 2021, which are estimated as of July 1, 2021 based on the Blended Base produced by the US Census Bureau in lieu of the April 1, 2020 decennial population count. The Blended Base consists of the blend of Vintage 2020 postcensal population estimates, 2020 Demographic Analysis Estimates, and 2020 Census PL 94-171 Redistricting File (see https://www2.census.gov/programs-surveys/popest/technical-documentation/methodology/2020-2021/methods-statement-v2021.pdf). Rate are based on deaths occurring in the specified week and are age-adjusted to the 2000 standard population using the direct method (see https://www.cdc.gov/nchs/data/nvsr/nvsr70/nvsr70-08-508.pdf). These rates differ from annual age-adjusted rates, typically presented in NCHS publications based on a full year of data and annualized weekly age-adjusted rates which have been adjusted to allow comparison with annual rates. Annualization rates presents deaths per year per 100,000 population that would be expected in a year if the observed period specific (weekly) rate prevailed for a full year. Sub-national death counts between 1-9 are suppressed in accordance with NCHS data confidentiality standards. Rates based on death counts less than 20 are suppressed in accordance with NCHS standards of reliability as specified in NCHS Data Presentation Standards for Proportions (available from: https://www.cdc.gov/nchs/data/series/sr_02/sr02_175.pdf.).

In 2020, there were around ******* deaths in the United States caused by COVID-19, compared to ******* COVID-19 deaths in 2021. This statistic shows the total number of deaths due to COVID-19 in the United States in 2020, 2021, and 2022.

Between the beginning of January 2020 and June 14, 2023, of the 1,134,641 deaths caused by COVID-19 in the United States, around 307,169 had occurred among those aged 85 years and older. This statistic shows the number of coronavirus disease 2019 (COVID-19) deaths in the U.S. from January 2020 to June 2023, by age.

As of April 26, 2023, the number of both confirmed and presumptive positive cases of the COVID-19 disease reported in the United States had reached over 104 million with over 1.1 million deaths reported among these cases.

Coronavirus deaths by age in the U.S. Daily new cases of COVID-19 hit record highs in the United States at the beginning of 2022. Underlying health conditions can worsen cases of coronavirus, and case fatality rates among confirmed COVID-19 patients increase with age. The highest number of deaths from COVID-19 have been among those aged 85 years and older, with this age group accounting for over 300 thousand deaths.

Where has this coronavirus come from? Coronaviruses are a large group of viruses transmitted between animals and people that cause illnesses ranging from the common cold to more severe diseases. The novel coronavirus that is currently infecting humans was already circulating among certain animal species. The first human case of this new coronavirus strain was reported in China at the end of December 2019. The coronavirus was named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and its associated disease is known as COVID-19.

Deaths involving coronavirus disease 2019 (COVID-19) by month of death, region, age, place of death, and race and Hispanic origin.

This dataset represents preliminary estimates of cumulative U.S. COVID-19 disease burden for the 2024-2025 period, including illnesses, outpatient visits, hospitalizations, and deaths. The weekly COVID-19-associated burden estimates are preliminary and based on continuously collected surveillance data from patients hospitalized with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. The data come from the Coronavirus Disease 2019 (COVID-19)-Associated Hospitalization Surveillance Network (COVID-NET), a surveillance platform that captures data from hospitals that serve about 10% of the U.S. population. Each week CDC estimates a range (i.e., lower estimate and an upper estimate) of COVID-19 -associated burden that have occurred since October 1, 2024.

Note: Data are preliminary and subject to change as more data become available. Rates for recent COVID-19-associated hospital admissions are subject to reporting delays; as new data are received each week, previous rates are updated accordingly.

References

1. Reed C, Chaves SS, Daily Kirley P, et al. Estimating influenza disease burden from population-based surveillance data in the United States. PLoS One. 2015;10(3):e0118369. https://doi.org/10.1371/journal.pone.0118369 
2. Rolfes, MA, Foppa, IM, Garg, S, et al. Annual estimates of the burden of seasonal influenza in the United States: A tool for strengthening influenza surveillance and preparedness. Influenza Other Respi Viruses. 2018; 12: 132– 137. https://doi.org/10.1111/irv.12486
3. Tokars JI, Rolfes MA, Foppa IM, Reed C. An evaluation and update of methods for estimating the number of influenza cases averted by vaccination in the United States. Vaccine. 2018;36(48):7331-7337. doi:10.1016/j.vaccine.2018.10.026 
4. Collier SA, Deng L, Adam EA, Benedict KM, Beshearse EM, Blackstock AJ, Bruce BB, Derado G, Edens C, Fullerton KE, Gargano JW, Geissler AL, Hall AJ, Havelaar AH, Hill VR, Hoekstra RM, Reddy SC, Scallan E, Stokes EK, Yoder JS, Beach MJ. Estimate of Burden and Direct Healthcare Cost of Infectious Waterborne Disease in the United States. Emerg Infect Dis. 2021 Jan;27(1):140-149. doi: 10.3201/eid2701.190676. PMID: 33350905; PMCID: PMC7774540.
5. Reed C, Kim IK, Singleton JA,  et al. Estimated influenza illnesses and hospitalizations averted by vaccination–United States, 2013-14 influenza season. MMWR Morb Mortal Wkly Rep. 2014 Dec 12;63(49):1151-4. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6349a2.htm 
6. Reed C, Angulo FJ, Swerdlow DL, et al. Estimates of the Prevalence of Pandemic (H1N1) 2009, United States, April–July 2009. Emerg Infect Dis. 2009;15(12):2004-2007. https://dx.doi.org/10.3201/eid1512.091413  
7. Devine O, Pham H, Gunnels B, et al. Extrapolating Sentinel Surveillance Information to Estimate National COVID-19 Hospital Admission Rates: A Bayesian Modeling Approach. Influenza and Other Respiratory Viruses. https://onlinelibrary.wiley.com/doi/10.1111/irv.70026. Volume18, Issue10. October 2024.
8. https://www.cdc.gov/covid/php/covid-net/index.html">COVID-NET | COVID-19 | CDC 
9. https://www.cdc.gov/covid/hcp/clinical-care/systematic-review-process.html 
10. https://academic.oup.com/pnasnexus/article/1/3/pgac079/6604394?login=false">Excess natural-cause deaths in California by cause and setting: March 2020 through February 2021 | PNAS Nexus | Oxford Academic (oup.com)
11. Kruschke, J. K. 2011. Doing Bayesian data analysis: a tutorial with R and BUGS. Elsevier, Amsterdam, Section 3.3.5.

As of March 10, 2023, the death rate from COVID-19 in the state of New York was 397 per 100,000 people. New York is one of the states with the highest number of COVID-19 cases.

Updates

• Notice of data discontinuation: Since the start of the pandemic, AP has reported case and death counts from data provided by Johns Hopkins University. Johns Hopkins University has announced that they will stop their daily data collection efforts after March 10. As Johns Hopkins stops providing data, the AP will also stop collecting daily numbers for COVID cases and deaths. The HHS and CDC now collect and visualize key metrics for the pandemic. AP advises using those resources when reporting on the pandemic going forward.

  • CDC Weekly case and death counts (national and state level)
  • CDC County level cases and deaths
  • HHS New hospital admissions
  • CDC NowCast COVID variant proportions (national and regional level)

• April 9, 2020

  • The population estimate data for New York County, NY has been updated to include all five New York City counties (Kings County, Queens County, Bronx County, Richmond County and New York County). This has been done to match the Johns Hopkins COVID-19 data, which aggregates counts for the five New York City counties to New York County.

• April 20, 2020

  • Johns Hopkins death totals in the US now include confirmed and probable deaths in accordance with CDC guidelines as of April 14. One significant result of this change was an increase of more than 3,700 deaths in the New York City count. This change will likely result in increases for death counts elsewhere as well. The AP does not alter the Johns Hopkins source data, so probable deaths are included in this dataset as well.

• April 29, 2020

  • The AP is now providing timeseries data for counts of COVID-19 cases and deaths. The raw counts are provided here unaltered, along with a population column with Census ACS-5 estimates and calculated daily case and death rates per 100,000 people. Please read the updated caveats section for more information.

• September 1st, 2020

  • Johns Hopkins is now providing counts for the five New York City counties individually.

• February 12, 2021

  • The Ohio Department of Health recently announced that as many as 4,000 COVID-19 deaths may have been underreported through the state’s reporting system, and that the "daily reported death counts will be high for a two to three-day period."
  • Because deaths data will be anomalous for consecutive days, we have chosen to freeze Ohio's rolling average for daily deaths at the last valid measure until Johns Hopkins is able to back-distribute the data. The raw daily death counts, as reported by Johns Hopkins and including the backlogged death data, will still be present in the new_deaths column.

• February 16, 2021

  - Johns Hopkins has reconciled Ohio's historical deaths data with the state.

  Overview

The AP is using data collected by the Johns Hopkins University Center for Systems Science and Engineering as our source for outbreak caseloads and death counts for the United States and globally.

The Hopkins data is available at the county level in the United States. The AP has paired this data with population figures and county rural/urban designations, and has calculated caseload and death rates per 100,000 people. Be aware that caseloads may reflect the availability of tests -- and the ability to turn around test results quickly -- rather than actual disease spread or true infection rates.

This data is from the Hopkins dashboard that is updated regularly throughout the day. Like all organizations dealing with data, Hopkins is constantly refining and cleaning up their feed, so there may be brief moments where data does not appear correctly. At this link, you’ll find the Hopkins daily data reports, and a clean version of their feed.

The AP is updating this dataset hourly at 45 minutes past the hour.

To learn more about AP's data journalism capabilities for publishers, corporations and financial institutions, go here or email kromano@ap.org.

Queries

Use AP's queries to filter the data or to join to other datasets we've made available to help cover the coronavirus pandemic

• Filter cases by state here

• Rank states by their status as current hotspots. Calculates the 7-day rolling average of new cases per capita in each state: https://data.world/associatedpress/johns-hopkins-coronavirus-case-tracker/workspace/query?queryid=481e82a4-1b2f-41c2-9ea1-d91aa4b3b1ac

• Find recent hotspots within your state by running a query to calculate the 7-day rolling average of new cases by capita in each county: https://data.world/associatedpress/johns-hopkins-coronavirus-case-tracker/workspace/query?queryid=b566f1db-3231-40fe-8099-311909b7b687&showTemplatePreview=true

• Join county-level case data to an earlier dataset released by AP on local hospital capacity here. To find out more about the hospital capacity dataset, see the full details.

• Pull the 100 counties with the highest per-capita confirmed cases here

• Rank all the counties by the highest per-capita rate of new cases in the past 7 days here. Be aware that because this ranks per-capita caseloads, very small counties may rise to the very top, so take into account raw caseload figures as well.

Interactive

The AP has designed an interactive map to track COVID-19 cases reported by Johns Hopkins.

@(https://datawrapper.dwcdn.net/nRyaf/15/)

Interactive Embed Code

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Caveats

• This data represents the number of cases and deaths reported by each state and has been collected by Johns Hopkins from a number of sources cited on their website.
• In some cases, deaths or cases of people who've crossed state lines -- either to receive treatment or because they became sick and couldn't return home while traveling -- are reported in a state they aren't currently in, because of state reporting rules.
• In some states, there are a number of cases not assigned to a specific county -- for those cases, the county name is "unassigned to a single county"
• This data should be credited to Johns Hopkins University's COVID-19 tracking project. The AP is simply making it available here for ease of use for reporters and members.
• Caseloads may reflect the availability of tests -- and the ability to turn around test results quickly -- rather than actual disease spread or true infection rates.
• Population estimates at the county level are drawn from 2014-18 5-year estimates from the American Community Survey.
• The Urban/Rural classification scheme is from the Center for Disease Control and Preventions's National Center for Health Statistics. It puts each county into one of six categories -- from Large Central Metro to Non-Core -- according to population and other characteristics. More details about the classifications can be found here.

Johns Hopkins timeseries data - Johns Hopkins pulls data regularly to update their dashboard. Once a day, around 8pm EDT, Johns Hopkins adds the counts for all areas they cover to the timeseries file. These counts are snapshots of the latest cumulative counts provided by the source on that day. This can lead to inconsistencies if a source updates their historical data for accuracy, either increasing or decreasing the latest cumulative count. - Johns Hopkins periodically edits their historical timeseries data for accuracy. They provide a file documenting all errors in their timeseries files that they have identified and fixed here

Attribution

This data should be credited to Johns Hopkins University COVID-19 tracking project

In June 2022, it was estimated that 159 people died from Long COVID in the United States. During the given period, the highest number of Long COVID deaths in the U.S. was 393 in February 2022. This statistic shows the number of deaths from Long COVID in the United States from January 2020 to June 2022, by month.

Note: Reporting of new COVID-19 Case Surveillance data will be discontinued July 1, 2024, to align with the process of removing SARS-CoV-2 infections (COVID-19 cases) from the list of nationally notifiable diseases. Although these data will continue to be publicly available, the dataset will no longer be updated.

Authorizations to collect certain public health data expired at the end of the U.S. public health emergency declaration on May 11, 2023. The following jurisdictions discontinued COVID-19 case notifications to CDC: Iowa (11/8/21), Kansas (5/12/23), Kentucky (1/1/24), Louisiana (10/31/23), New Hampshire (5/23/23), and Oklahoma (5/2/23). Please note that these jurisdictions will not routinely send new case data after the dates indicated. As of 7/13/23, case notifications from Oregon will only include pediatric cases resulting in death.

This case surveillance public use dataset has 19 elements for all COVID-19 cases shared with CDC and includes demographics, geography (county and state of residence), any exposure history, disease severity indicators and outcomes, and presence of any underlying medical conditions and risk behaviors.

Currently, CDC provides the public with three versions of COVID-19 case surveillance line-listed data: this 19 data element dataset with geography, a 12 data element public use dataset, and a 33 data element restricted access dataset.

The following apply to the public use datasets and the restricted access dataset:

• Data elements can be found on the COVID-19 case report form located at www.cdc.gov/coronavirus/2019-ncov/downloads/pui-form.pdf.
• Data are considered provisional by CDC and are subject to change until the data are reconciled and verified with the state and territorial data providers.
• Some data are suppressed to protect individual privacy.
• Datasets will include all cases with the earliest date available in each record (date received by CDC or date related to illness/specimen collection) at least 14 days prior to the creation of the current datasets. This 14-day lag allows case reporting to be stabilized and ensure that time-dependent outcome data are accurately captured.
• Datasets are updated monthly.
• Datasets are created using CDC’s Policy on Public Health Research and Nonresearch Data Management and Access and include protections designed to protect individual privacy.
• For more information about data collection and reporting, please see https://www.cdc.gov/coronavirus/2019-ncov/covid-data/about-us-cases-deaths.html.
• For more information about the COVID-19 case surveillance data, please see https://www.cdc.gov/coronavirus/2019-ncov/covid-data/faq-surveillance.html
  

Overview

The COVID-19 case surveillance database includes individual-level data reported to U.S. states and autonomous reporting entities, including New York City and the District of Columbia (D.C.), as well as U.S. territories and affiliates. On April 5, 2020, COVID-19 was added to the Nationally Notifiable Condition List and classified as “immediately notifiable, urgent (within 24 hours)” by a Council of State and Territorial Epidemiologists (CSTE) Interim Position Statement (<a href="https://cdn.ymaws.com/www.cste.org/resource/resmgr/ps/positionstatement2020/Interim-20-ID-01_COVID

Deaths involving coronavirus disease 2019 (COVID-19) by month of death, region, age, place of death, and race and Hispanic origin: May-August 2020.

As of March 10, 2023, there have been 1.1 million deaths related to COVID-19 in the United States. There have been 101,159 deaths in the state of California, more than any other state in the country – California is also the state with the highest number of COVID-19 cases.

The vaccine rollout in the U.S. Since the start of the pandemic, the world has eagerly awaited the arrival of a safe and effective COVID-19 vaccine. In the United States, the immunization campaign started in mid-December 2020 following the approval of a vaccine jointly developed by Pfizer and BioNTech. As of March 22, 2023, the number of COVID-19 vaccine doses administered in the U.S. had reached roughly 673 million. The states with the highest number of vaccines administered are California, Texas, and New York.

Vaccines achieved due to work of research groups Chinese authorities initially shared the genetic sequence to the novel coronavirus in January 2020, allowing research groups to start studying how it invades human cells. The surface of the virus is covered with spike proteins, which enable it to bind to human cells. Once attached, the virus can enter the cells and start to make people ill. These spikes were of particular interest to vaccine manufacturers because they hold the key to preventing viral entry.

In June 2022, approximately 1.7 percent of COVID-19 deaths in the United States were attributed to Long COVID, a decrease from the 2.4 percent reported a month earlier. This statistic displays the percentage of COVID-19 deaths in the United States that were from Long COVID from January 2020 to June 2022, by month.

US Covid-19 Cases, Deaths and Mobility by State/County

Analyzing the Impact of the Pandemic on Low-Income Populations

By Liz Friedman [source]

About this dataset

Welcome to the Opportunity Insights Economic Tracker! Our goal is to provide a comprehensive, real-time look into how COVID-19 and stabilization policies are affecting the US economy. To do this, we have compiled a wide array of data points on spending and employment, gathered from several sources.

This dataset includes daily/weekly/monthly information at the state/county/city level for eight types of data: Google Mobility; Low-Income Employment and Earnings; UI Claims; Womply Merchants and Revenue; as well as weekly Math Learning from Zearn. Additionally, three files- Accounting for Geoids-State/County/City provide crosswalks between geographic areas that can be merged with other files having shared geographical levels.

Our goal here is to enable data users around the world to follow economic conditions in the US during this tumultuous period with maximum clarity and precision. We make all our datasets freely available so if you use them we kindly ask you attribute our work by linking or citing both our accompanying paper as well as this Economic Tracker at https://tracktherecoveryorg By doing so you are also agreeing to uphold our privacy & integrity standards which commit us both to individual & business confidentiality without compromising on independent nonpartisan research & policy analysis!

More Datasets

For more datasets, click here.

Featured Notebooks

• 🚨 Your notebook can be here! 🚨!

How to use the dataset

This dataset provides US COVID-19 case and death data, as well as Google Community Mobility Reports, on the state/county level. Here is how to use this dataset:

• Understand the file structure: This dataset consists of three main files: 1) US Cases & Deaths by State/County, 2) Google Community Mobility Reports, and 3) Data from third-parties providing small business openings & revenue information and unemployment insurance claim data (Low Inc Earnings & Employment, UI Claims and Womply Merchants & Revenue).
• Select your Subset: If you are interested in particular types of data (e.g., mobility or employment), select the corresponding files from within each section based on your geographic area of interest – national, state or county level – as indicated in each filename.
• Review metadata variables: Become familiar with the provided variables so that you can select which ones you need to explore further in your analysis. For example, if analyzing mobility trends at a city level look for columns such as ‘Retailer_and_recreation_percent_change’ or ‘Transit Stations Percent Change’; if focusing on employment decline look for columns such pay or emp figures that align with industries of interest to you such as low-income earners (emp_{inclow},pay_{inclow}).
• Unify dateformatting across row values : Convert date formats into one common unit so that all entries have consistent formatting if necessary; for exampe some entries may display dates using YYYY/MM/DD notation while others may use MM//DD//YY format depending on their source datasets; make sure to review column labels carefully before converting units where needed..

• Merge datasets where applicable : Utilize GeoID crosswalks to combine multiple sets with same geographical coverageregionally covering ; example might be combining low income earnings figures with specific county settings by reference geo codes found in related documents like GeoIDs-County .
  6 . Visualise Data : Now that all the different measures have been reviewed can begin generating charts visualize findings . This process may include cleaning up raw figures normalizing across currency formats , mapping geospatial locations others ; once ready create bar graphs line charts maps other visual according aggregate output desired Insightful representations at this stage will help inform concrete policy decisions during outbreak recovery period..

  Remember to cite

Research Ideas

• Estimating the Impact of the COVID-19 Pandemic on Small Businesses - By comparing county-level Womply revenue and employment data with pre-COVID data, policymakers can gain an understanding of the economic impact that COVID has had on local small businesses.
• Analyzing Effects of Mobility Restrictions - The Google Mobility data provides insight into geographic areas where...

It is estimated that by the end of 2021 the COVID-19 pandemic had caused around 932,458 excess deaths in the United States. This statistic shows the cumulative mean number of excess deaths associated with the COVID-19 pandemic in the United States in 2020-2021, by month.

Provisional COVID-19 death counts, rates, and percent of total deaths, by jurisdiction of residence

  Description

This file contains COVID-19 death counts, death rates, and percent of total deaths by jurisdiction of residence. The data is grouped by different time periods including 3-month period, weekly, and total (cumulative since January 1, 2020). United States death counts and rates include the 50 states, plus the District of Columbia and New York City. New York state… See the full description on the dataset page: https://huggingface.co/datasets/HHS-Official/provisional-covid-19-death-counts-rates-and-percen.

Dataset

This dataset was created by Venkatesh Vaishnav

Released under Other (specified in description)

Contents

Daily count of NYC residents who tested positive for SARS-CoV-2, who were hospitalized with COVID-19, and deaths among COVID-19 patients.

Note that this dataset currently pulls from https://raw.githubusercontent.com/nychealth/coronavirus-data/master/case-hosp-death.csv on a daily basis.

Among COVID-19 patients in the United States from February 12 to March 16, 2020, estimated case-fatality rates were highest for adults aged 85 years and older. Younger people appeared to have milder symptoms, and there were no deaths reported among persons aged 19 years and under.

Tracking the virus in the United States The outbreak of a previously unknown viral pneumonia was first reported in China toward the end of December 2019. The first U.S. case of COVID-19 was recorded in mid-January 2020, confirmed in a patient who had returned to the United States from China. The virus quickly started to spread, and the first community-acquired case was confirmed one month later in California. Overall, there had been approximately 4.5 million coronavirus cases in the country by the start of August 2020.

U.S. health care system stretched California, Florida, and Texas are among the states with the most coronavirus cases. Even the best-resourced hospitals in the United States have struggled to cope with the crisis, and certain areas of the country were dealt further blows by new waves of infections in July 2020. Attention is rightly focused on fighting the pandemic, but as health workers are redirected to care for COVID-19 patients, the United States must not lose sight of other important health care issues.