As the US nears 2 million coronavirus cases, 21 states have reported an increase in infections and 9 have seen hospitalizations climb

• The US's coronavirus case total is approaching 2 million. Most of the country has reopened businesses, and people are starting to resume normal routines.
• But 21 states are seeing an increase in new infections, and nine states have also seen hospitalization rates go up.
• The number of new infections in Texas, Utah, and Arizona began to climb on May 27 after an action-packed Memorial Day weekend.
• The protests that have brought people together to demand justice for George Floyd and an end to police violence and racism might also enable the virus to spread.
• "It's a delicate balance because the reasons for demonstrating are valid," Anthony Fauci, the nation's top infectious-disease expert, said. "And yet the demonstration itself puts one at an additional risk."

The US continues to face the worst coronavirus outbreak in the world, with nearly 2 million confirmed cases and more than 112,600 deaths.

All 50 states, however, are taking steps toward reopening businesses and allowing people to resume normal activities. Georgia and Alaska started the trend in late April. Now 21 states have reported an uptick in new cases, according to The New York Times.

More than 1,100 cases in Yakima County, Washington, were reported in June — out of only 5,000 total, The Times reported. A similar situation is playing out in Maricopa County, Arizona, where 4,000 people diagnosed with COVID-19 of about 14,300 total picked up the infection this month. Even Alaska has seen 100 new cases this week; a coronavirus death there on Tuesday was the first in more than a month.

This surge is not merely a result of increased testing. Since Memorial Day, nine states have confirmed an increase in hospitalizations: Texas, California, Arizona, Utah, Arkansas, North Carolina, South Carolina, Oregon, and Mississippi.

The uptick could be tied to Memorial Day socializing

This Kaiser Family Foundation reported on Wednesday that the number of new infections in Texas, Utah, and Arizona began to tick upward on May 27, which followed a busy Memorial Day weekend.

In late May, hundreds of people descended on beaches to enjoy the warm weather, flouting social-distancing rules and leaving their faces uncovered. They also packed bars, restaurants, and pools, and enjoyed boat parades.

—Larry Levitt (@larry_levitt) June 10, 2020

John Henry, a contact tracer with the Columbus Health Department in Ohio, said on June 4 that he'd noticed "an increased number of contacts specifically tied" to Memorial Day.

"When I first started doing COVID-19 contact tracing, I had about a dozen people to call each day," he said, adding that was in late March. "That number is now up to an average of 15 people per day. But recently I had 32 individuals to call in a single day. And the average daily number continues to multiply, especially within communities of color."

Protests also put people at risk of catching the virus

Relaxed lockdown restrictions in the US have also coincided with protests, as tens of thousands of Americans have taken to the streets every day for more than two weeks.

They are protesting the police killing of George Floyd on May 25 in Minneapolis. The 46-year-old Black man died while he was handcuffed, pinned under the knee of a police officer for nearly nine minutes and gasping for breath. The tragedy spurred a global cry for justice and demands for an end to police brutality and systemic racism.

Because the coronavirus typically spreads via droplets when a person coughs, talks, or sneezes, the yelling and chanting at tightly packed demonstrations has concerned experts, especially since not all protesters have worn masks.

Anthony Fauci, the director of the National Institute for Allergy and Infectious Diseases, told the radio station WTOP that he was "very concerned" that the Black Lives Matter protests could trigger new infections.

"Every time I hear about or see the congregation of large crowds at a time and geographic area where there is active infection transmission, it is a perfect setup for the spread of the virus in the sense of creating these blips that might turn into some surges," Fauci said.

"A situation where you have a lot of confusion and a little bit of chaos, people running back and forth, taking their masks off, being close in proximity, that does pose a risk," he added.

Videos have also shown police officers spraying tear gas at crowds, which makes people cough, sneeze, and rub their eyes — all of which ups the risk of spreading the coronavirus.

"It is a difficult situation," Fauci said. "We have the right to peaceably demonstrate, and the demonstrators are exercising that right ... It's important to exercise your constitutional rights to be able to demonstrate, but it's a delicate balance because the reasons for demonstrating are valid. And yet the demonstration itself puts one at an additional risk."

It's too early to know, however, to what degree the protests might lead coronavirus case counts to rise, since there's a lag time in reported infections. New cases and hospitalizations reported today are a reflection of the coronavirus' spread about two weeks ago because the average incubation period is five days, and symptoms worsen over a week or two. Then after a person gets tested, it takes a few days for results to come back, and that then gets reported to local and state health authorities. If someone is hospitalized, it may take many more days before they get dangerously sick or die.

That's why the White House guidelines advise states to see a 14-day "downward trajectory" in cases before they reopen. Public-health experts suggest that once states do reopen, they should combine widespread testing with contact tracing and social distancing to keep outbreaks from flaring back up.