Data shows that the rates of newly reported cases of the novel coronavirus are accelerating in 22 states, and some state leaders in response have paused their plans to reopen nonessential businesses and relax social distancing measures—while leaders in other states are warning they might have to reimplement business closures and stay-at-home orders.

10 takeaways: What health systems must consider as they mull reopening

Nearly half of US states see rising growth rates of new coronavirus cases

U.S. officials as of Monday morning reported 2,086,900 cases of the new coronavirus—up from 2,034,100 cases as of Friday morning.

Data collected by the New York Times shows that Puerto Rico and at least 22 states—Alabama, Alaska, Arizona, Arkansas, California, Florida, Georgia, Hawaii, Idaho, Kentucky, Louisiana, Missouri, Montana, Nevada, North Carolina, Oklahoma, Oregon, South Carolina, Texas, Utah, Vermont, and Wyoming—have seen their growth rates of newly reported cases of the novel coronavirus accelerate over the past 14 days.

Meanwhile, that data shows that the growth rates of newly reported cases over the past two weeks remained nearly constant in Iowa, Kansas, Maine, Mississippi, New Mexico, North Dakota, South Dakota, Tennessee, and Washington.

In addition, Washington, D.C., and 19 states—Colorado, Connecticut, Delaware, Illinois, Indiana, Maryland, Massachusetts, Michigan, Minnesota, Nebraska, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, Virginia, West Virginia, and Wisconsin—saw their growth rates of newly confirmed cases decrease over the past 14 days.

As of Monday morning, U.S. officials also had reported a total of 115,472 U.S. deaths linked to the new coronavirus—up from 113,974 deaths reported as of Friday morning.

Some states, localities pause plans to reopen

As many states over the past couple weeks have seen their rates of newly reported cases of the novel coronavirus accelerate, some state and local officials have been reevaluating their plans for reopening nonessential businesses and easing social distancing measures that had been in place to slow the virus' spread—and some state and local officials have even announced that they are temporarily pausing those plans.

For example, Oregon Gov. Kate Brown (D) and Utah Gov. Gary Herbert (R) last week separately announced plans to suspend their states' reopening plans for at least a week. Brown's announcement came after Oregon saw its daily rate of newly reported coronavirus infections double over the past week.

"The virus makes the timeline," Brown said. "We don't make the timeline."

Similarly, Nashville Mayor John Cooper (D) said he is pausing the city's reopening plans. Cooper noted that, although Nashville's rate of newly reported cases of the virus is declining overall, there is a growing outbreak of the new coronavirus in the city's southeastern region.

Officials warn more business closures, stay-at-home orders could be needed

Meanwhile, officials in other states and cities are warning that they may have to reimpose coronavirus-related business closures and restrictions to curb the virus' continued spread.

New York Gov. Andrew Cuomo (D) said he may roll back reopening plans in areas of the state where social distancing and other measures intended to curb the country's new coronavirus epidemic are not followed. Cuomo said state officials have received 25,000 complaints over violations of social distancing and other coronavirus-related restrictions that are currently in place in New York.

"Before I reverse a statewide position, I'll tell you what I'm going to do. I'm going to reverse it in those areas that are not in compliance with the rules," Cuomo said.

In Dallas and Houston, officials similarly warned that they may need to reimplement measures aimed at slowing transmission of the new coronavirus. Texas on Friday reported its highest number of patients hospitalized because of the new coronavirus, as newly reported cases of the virus in recent weeks have been rising particularly quickly among the state's biggest cities.

"It feels like we're going back to where we were several months ago," said Umair Shah, a top public health official in Texas' Harris County, which includes Houston.

"I'm very concerned about it," said Dallas Mayor Eric Johnson (D), adding that people have stopped following social distancing guidelines and are not wearing masks. "They've been asked for quite some time to not be around people they love, and that they want to spend time with. Wearing a mask is not pleasant. And I think people are tired."

CDC Director Robert Redfield on Friday said states may need to reimpose stay-at-home orders and close nonessential businesses to slow down the virus' spread.

Jay Butler, CDC's deputy director for infectious diseases, said, "If cases begin to go up again, particularly if they go up dramatically, it is important to recognize that more mitigation efforts such as what were implemented back in March may be needed again."

HHS Secretary Alex Azar said, "We think we have the tools we need to avoid the shutdowns in the future–at least on a national level," but noted that "[t]here could be isolated communities that have outbreaks that may create the need to implement mitigation measures."

Most states, cities move forward with reopening plans

But in most states and cities, officials so far have hesitated to pause their reopening plans or reimplement coronavirus-related restrictions, because they are concerned such moves would further hurt their economies and frustrate residents.

In addition, President Trump and some officials in his administration have encouraged states to move forward with their reopening plans. According to Politico, the Trump administration largely has minimized the recent spikes in newly reported cases, saying the increases are the result of expanded testing for the virus and contact tracing efforts.

But some public health experts have disagreed. For instance, Angela Dunn, Utah's state epidemiologist, said she's traced the state's resurgence in new coronavirus cases to the state's moves to reopen nonessential businesses and relax social distancing measures.

"The timing directly correlates with our loosening up restrictions," Dunn said. "That definitely has something to do with it."

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, urged Americans to continue practicing social distancing and taking other precautions to protect themselves against contracting or transmitting the new coronavirus, including wearing face masks or covering in public (Goldberg et al., Politico, 6/12; Shumaker, Reuters, 6/14; Bosman/Smith, New York Times, 6/14; New York Times, 6/15; Joseph/O'Donnell, Reuters, 6/12; Rubin/Restuccia, Wall Street Journal, 6/13; Stracqualursi/Azad, CNN, 6/13; Forgey, Politico, 6/12;  Hill, Associated Press, 5/14; Holcombe, CNN, 6/13; New York Times, 6/12).