The number of coronavirus cases worldwide recently topped 500,000, and it’s expected to keep climbing.

In the U.S., where there are over 100,000 confirmed cases, certain regions are being hit significantly harder than others. And the growing number of cases is worrying many public health experts, including NYU Langone Health Assistant Professor Alison Bateman-House.

“I’m deeply concerned about where we see spikes happening right now,” Bateman-House said. “The latest I’ve seen is we anticipate spikes in Boston, which has a relatively good health care system, Detroit, [and] New Orleans. These are places that have already been hit hard for numerous reasons over the last decade or so, and now to have a public health epidemic on top of everything. I’m deeply concerned.”

Detroit, devastated by the 2008 Financial Crisis, declared bankruptcy in 2013. New Orleans, which was ravaged by Hurricane Katrina back in 2005, accounts for nearly half of all coronavirus cases in Louisiana. Some attribute it to Mardi Gras celebrations that occurred at the end of February.

Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Disease, said that officials in the city were likely caught by surprise until the number of cases kept growing.

“It putters along and you think you’re OK, then it starts to go up a little and then bingo — it goes up in an exponential way,” Fauci told CNN. “That’s what’s happening in New Orleans right now.”

Other public health experts were also sounding the alarm on the spread to other U.S. cities.

“Coronavirus is going to hit every city in America,” Harvard Global Health Institute Director Dr. Ashish Jha said. “There is no question about it. New York is going first. Will [the spread] be at the same ferocity? It may or may not in different cities. ... I am incredibly worried about Louisiana, and specifically New Orleans. I am very worried about Atlanta.”

‘Trying to build upon a very shaky foundation’

Although public health officials have recommended putting restrictions in place, like shelter-at-home orders, not every state has followed suit. So far, only 23 states have it on a statewide level. Other states have it on a city or county level.

“It really is your local mayors, your governors, who are making these decisions, and most of the people don’t have public health backgrounds,” Bateman-House said. “And it’s been systematically defunded for years, so you’re suddenly trying to build upon a very shaky foundation in a crisis situation.”

Social distancing has been one of the top recommendations for containing the spread of the virus. This means keeping six feet apart from others at all times, and only leaving the house for essential things, like grocery shopping or seeing the doctor. Some local officials have had to enforce social distancing measures, like police officers breaking up large groups of people on Bourbon Street in New Orleans.

“What we’re seeing across the nation is very different,” Bateman-House said. “Some places only have a few cases at this point. Other places like New York City, where I live, are in the middle of a mass epidemic. So, the responses happening on the ground are very differential, and I think that’s disturbing to those of us in the public health world who do believe that we need to implement social distancing as quickly as possible, especially given the fact that people can spread the virus before they even have the start of symptoms.”

‘We’re in the middle of a terrible, terrible situation’

More than half of the coronavirus cases in the U.S. are based out of New York, which has been deemed the national epicenter of the outbreak in the country. Governor Andrew Cuomo told reporters that the city is planning to close certain streets, and possibly public parks and playgrounds to enforce social distancing.

“I think New York is probably one of the best case scenarios and right here, we’re in the middle of a terrible, terrible situation,” Bateman-House said.

With the virus starting in China and then hitting Italy particularly hard, why haven’t Americans done more to prepare for the outbreak? Bateman-House has one particular theory.

“When we started hearing the numbers from Italy, I think there was this perception amongst many people: ‘That’s Italy, it will be different here,’ sort of overestimating how good the U.S. health care system is and how, in comparison, ill-prepared the Italian system was perceived to be,” she said.

However, she continued, “the Italian health care system is actually really great, but I think we had a false sense of comfort that things would be better when they got to the United States. And now that it’s in the United States, I think the most important thing here is to keep in mind that public health is a local government responsibility. It’s not a federal responsibility. It’s not something that the CDC steps in and tells every locality what to do.”

Adriana is a reporter and editor for Yahoo Finance. She can be reached at [email protected]. Follow her on Twitter @adrianambells.

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