'Never expected this to happen in the US': How the COVID-19 pandemic exploded from March to December - USA TODAY

Posted: 08 Dec 2020 12:00 AM PST

Experts say side effects from the COVID-19 vaccine range from soreness to fatigue. USA TODAY

As the COVID-19 pandemic rages unabated across the United States, December is already breaking records – only a week in.

Public health experts warned for some time that a winter surge would come. But four who spoke with USA TODAY said they have been stunned by the dismal trajectory of the virus over nine grueling months, and they never expected the nation to be in as bad a position as it is right now.

"I don't think there's a single person anywhere who thought that we would still be facing this in December, let alone that this would be at such a peak at this particular time," said Dr. Robert Amler, dean of New York Medical College's School of Health Sciences and Practice and a former chief medical officer at the federal Centers for Disease Control and Prevention.

Ali Mokdad, chief strategy officer for population health at the University of Washington, is more blunt: "I never expected this to happen in the U.S."

As the nation slides into a dark and dangerous winter and states are turning to stricter restrictions and lockdowns, what has changed since March and how did it go so wrong?

Stark numbers of deaths, hospitalizations tell the story

On March 31, a White House prediction said 100,000 to 240,000 could die by the end of the year. More than 2 million would die without social distancing and other mitigation. The latest modeling, however, from the University of Washington's Institute for Health Metrics and Evaluation projects more than 345,000 deaths by Jan. 1.

Monica Schoch-Spana, a senior scientist in the Department of Environmental Health and Engineering at the Johns Hopkins Bloomberg School of Public Health, called COVID-19 in the U.S. "a protracted, open-ended and ongoing type of crisis."

"I assumed this would have gotten under control like it did in other countries," she said. "I didn't expect that we would have such a fragmented and uneven response that would keep us in such an acute stage of the crisis."

Coronavirus surge: How a third wave of COVID-19 engulfed the US

Without masks and a vaccine, we could reach Herd Immunity from COVID-19, but deaths would skyrocket. We break down the science of it. USA TODAY

The U.S. saw its two deadliest days last week, surpassing the daily death peaks of April, according to Johns Hopkins data, as Wednesday reached 2,804 deaths and Thursday reached 2,879 deaths.

Friday, with 2,607 deaths, had the same number of fatalities as what had been the the country's worst day since the start of the pandemic, April 15.

"Where we are right now, in my personal opinion, is it's not unexpected but it's higher than we thought it would be," said Jennifer Balkus, an infectious disease epidemiologist at the University of Washington School of Public Health.

Before December, there hadn't been more than 2,500 deaths in a single day since April 29, when 2,527 people died.

Only eight days since the start of the pandemic have seen more than 2,500 deaths in the U.S. Four were in April. Four are in December.

"We are in a bad position," said Mokdad, also a professor at the health metrics institute.

COVID-19 hospitalizations near 100,000 in US. And experts fear facilities soon be 'overrun' by patients and a lack of staff

Hospitalizations across the U.S. have soared past where they peaked in April and later in July.

Hospitalizations in April and July never surpassed 60,000 people on a given day, according to the COVID Tracking Project's data, but in this surge of the virus, hospitalizations have mounted. The U.S. moved past the 60,000 threshold on Nov. 10 and has increased almost every day since, passing the 100,000 mark on Wednesday.

Balkus said she's worried because peaks in hospitalizations precede peaks in deaths, meaning even more records will be broken. "Given where we are right now, it's really concerning," she said.

A summer respite that never happened

Some epidemiologists thought the worst of the virus was happening in April, Mokdad said. The hope, he said, was to get cases to a more manageable level in the summer months. Then, when the weather turned cold and people spent more time inside, community spread would be at a level where testing and contact tracing could be effective.

That didn't happen. Instead many states prematurely reopened and the U.S. saw summer peaks, Mokdad said.

Schoch-Spana said the U.S. had the tools in place for a better pandemic response. "Had they been applied I think we would have had a different outcome, regardless of what we did or did not know about the virus itself."

For Schoch-Spana, the politicization around the virus and the U.S. response is an area where there has been consistency – but to the country's detriment.

The racial scapegoating of China, the lack of national support for mask wearing and the rush to promote drugs such as hydroxychloroquine were all tactics to manipulate public perceptions of the pandemic for political reasons, she said.

"The Trump administration saw value in social fragmentation. And that's the one thing you can't have in the middle of a pandemic," she said. "It has prevented the country and localities from pulling together in the same direction."

Amler said one of the biggest changes from March through December has been scientists' understanding of the role of airborne transmission and asymptomatic infections.

That shift in understanding of transmission highlights how important the changed guidance on masks was, Balkus added, saying she wished the U.S. overall had done better early on in trying to understand that the nature of the pandemic was evolving.

What we know about face masks has changed: Here's what experts say and which states mandate masks

"Changes in guidance are not a bad thing when you're trying to understand the dynamics of a brand-new virus," she said. "Updating guidance, that's good ... (and) one of the areas where we could have done better."

Some strategy hasn't changed

While doctors and public health officials have a greater respect for how the virus is able to spread compared with the early days, Amler said, the guidance of avoiding others to block exposure has not changed.

"The overall strategy is if there's no exposure, there can be no infection, and if there is no infection, there's no illness, and if there's no illness, there's no risk," he said.

Social distancing: It's not about you, it's about us

"I think that's one of the challenges," Balkus said. "The tools we have had since April are the tools we have now. That consistency is good, but it can feel frustrating.

"We are in that same place of being socially distant, washing your hands and wearing a mask."

According to a Gallup poll at the end of October, 62% of Americans said that their lives were "not yet back to normal."

But some may be less likely than in April to stay home if new stay-at-home orders were introduced, such as in California.

In the same Gallup poll from Oct. 19 to Nov. 1, just under half of Americans said they would be "very likely" to stay home for a month if public health officials recommended doing so because of a serious outbreak in their communities.

A Gallup poll from March 30 to April 5, however, showed that 67% of people said they'd be "very likely" to stay home.

California reintroduced stay-at-home orders for most of its residents this week, and many other states are reinstituting similar restrictions on bars, restaurants and other businesses that had been enacted in the spring and rolled back over the summer and fall.

Data shows some people have returned to traveling, too.

The Transportation Security Administration saw its busiest day of fliers since March on Nov. 29 as more than 1.1 million people passed through its checkpoints.

Holiday travel: CDC says Americans should avoid travel during winter holiday season, get COVID-19 tests if they do

Before that day, more than 1.1 million people hadn't passed through TSA checkpoints since March 16.

While much of the travel could be attributed to the Thanksgiving holiday, TSA numbers from throughout October and November indicate many people are flying again. The U.S. crossed the 1 million screenings in a day threshold for the first time since March on Oct. 18, and numbers never dipped below 560,000 in either month. The low in April bottomed out to as few as 87,534 fliers screened on the 14th.

Cellphone mobility data tracked by the Institute for Health Metrics and Evaluation also shows less social distancing. Though mobility has leveled off in recent weeks, the change is still much higher than the declines seen at the end of March and early April.

Better treatments and now the 'home stretch'

Unlike in March and April, how doctors treat COVID-19 is a positive change in the fight against the pandemic, Mokdad said.

The U.S. Food and Drug Administration has eight active emergency use authorizations for drug and biological products to treat COVID-19. One drug, remdesivir, has received approval for treating COVID-19 in adults and children 12 and older and weighing at least 88 pounds.

Among the options available to doctors treating COVID-19 patients are antibody, convalescent plasma and antiviral therapies.

Mokdad said such treatments have led to a decrease in hospital fatality rates. Overall case fatality rates have dropped over the course of the pandemic in the U.S.

"Clinicians have learned, sadly the hard way, how to better manage" COVID-19, Schoch-Spana said.

COVID-19 vaccine: Side effects from the COVID-19 vaccine means 'your body responded the way it's supposed to,' experts say

The nation also is closer than ever to having a vaccine authorized for use. "Although we are not at the finish line, I think we're beginning to get into a home stretch," Amler said.

The FDA could grant emergency use authorization to a COVID-19 vaccine as soon as this week. Schoch-Spana said more managing of public expectations needs to be done, however.

"I think there's a public expectation that the vaccine is coming and we're all going to get it. The reality is it's going to be coming slowly at first and in limited amounts," she said.

Balkus said the news around the vaccine is "remarkable and thrilling." It can often take years to get a safe and effective vaccine for a disease and is something some work their entire careers on, but now, "the biggest thing at this point is to stay vigilant."

"This is the time to go all in on protecting your family, protecting yourself, so you and your loved ones are able and still there to get the vaccine," she said.

Follow USA TODAY's Ryan Miller on Twitter @RyanW_Miller

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How scammers siphoned $36B in fraudulent unemployment payments from US - USA TODAY

Posted: 30 Dec 2020 05:29 PM PST

In a Zoom session with the camera turned off, Mayowa describes how he scoops up U.S. unemployment benefits fattened by COVID-19 relief, an international imposter attack that has contributed to at least $36 billion being siphoned away from out-of-work Americans.

Mayowa is an engineering student in Nigeria who estimates he's made about $50,000 since the pandemic began. After compiling a list of real people, he turns to databases of hacked information that charge $2 in cryptocurrency to link that name to a date of birth and Social Security number.

In most states that information is all it takes to file for unemployment. Even when state applications require additional verification, a little more money spent on sites such as FamilyTreeNow and TruthFinder provides answers – your mother's maiden name, where you were born, your high school mascot. Mayowa said he is successful about one in six times he files a claim.

"Once we have that information, it's over," Mayowa said. "It's easy money."

Mayowa agreed to take USA TODAY inside the fraud in an interview arranged by security firm Agari, using only his first name to hide his identity. The security company gives him another source of cash: It pays him in Bitcoin to provide information about active scams.

Help us report on coronavirus scams

Are you a government contract officer? A vendor? A purchasing agent in the private sector? Do you know about a scam tied to coronavirus we should know about? Email us at covidscams@usatoday.com.

Coronavirus-era unemployment fraud was first identified in the state of Washington in May and since has spread to all 50 states, skipping to new targets as government agencies plug holes exposed by the massive scams. Mayowa and his crew of foreign scammers focused in November on Hawaii, Florida and Pennsylvania.

In addition to the crushing volume of legitimate claims during COVID-19 and public pressure to speed up payments, mobile banking apps and prepaid debit cards issued by some state unemployment offices paved the way for fraud this year, security experts said.

The step-by-step playbook the scammers follow is shared on Telegram, an app that provides cloud-based anonymous messaging and acts as an internet bulletin board of tips and questions.

Asked whether he feels bad about stealing from unemployed Americans, Mayowa pointed out that 70% of his peers in school are working the scams as side hustles, too.

"No, no remorse," Mayowa said. "We don't know them. We don't know who they are; it's nobody."

States for years had prepared for low-level fraud, focusing on whether actual state residents filing for unemployment were telling the truth. The recent wave of imposter fraud – including from overseas – caught them off guard.

In Washington, alarms began flashing red for Suzi LeVine on May 12. It was 10 p.m. and the message was clear: We are under attack.

The commissioner of the state's unemployment system knew claims were increasing as the pandemic and its economic devastation spread. But suddenly claims were 10-fold what LeVine expected.

Things got crazy quickly. Within two weeks of CARES Act funding enriching weekly benefits, $600 million had been bled from the state system – roughly 8% of the $8.6 billion paid over the summer. The state pulled the plug on all payments for two days while it struggled to figure out what was happening.

Eventually, the state's computers started to flag anomalies: out-of-state banks, duplicate email addresses and multiple names using the same bank accounts. But there and elsewhere, antiquated state computer systems failed to flag foreign IP addresses, repeated computer serial numbers and techniques to mask that number.

Washington generally sees a few dozen fraudulent claims from imposters a year. Since March, the state has identified 122,000.

"When you consider the policy factors accelerating benefits and getting them to the neediest people and the expanded $600 available &mldr; we had the perfect storm," said LeVine, who served as ambassador to Switzerland during the Obama administration. "They have been lying in wait for this moment."

Suzi LeVine, commissioner of Washington state's Employment Security Department

When you consider the policy factors accelerating benefits and getting them to the neediest people and the expanded $600 available … we had the perfect storm. They have been lying in wait for this moment.

Washington should've been a wakeup call for every other state. Instead, it took some states six months or more to introduce new two-factor authentication systems and third-party ID verification tools and to block suspicious addresses. Many also began relying more heavily on a national shared database to detect suspicious actors.

A failure to move quickly combined with the ingenuity of the scammers has allowed the fraud to continue rippling across the country, contributing to delays in payments to out-of-work Americans, according to Michele Evermore, a policy analyst at the National Employment Law Project.

Key pieces of imposter unemployment scam

"These fraudsters are like velociraptors," Evermore said. "Once they find one piece of the gate is mended, they'll move on to another part to attack."

The Department of Labor's Office of the Inspector General estimated in a November report that these schemes and others targeting pandemic unemployment payments represented about $36 billion in losses through November.

USA TODAY contacted unemployment departments in all 50 states to ask how much fraud had been paid out, and how much had been recovered. Of the half that responded, only eight have released the amount of taxpayer dollars they improperly paid out in fraud – a fraction of the national estimate.

Many states are reticent to discuss the situation, citing security concerns as well as difficulty quantifying what meets the definition of a fraud scheme. Some declined to even estimate loss numbers – or downplayed their significance.

Nevada officials say determining that a claim is fraudulent requires interviews with claimants and a "due process opportunity to present evidence."

The Arkansas Division of Workforce Services "has chosen not to respond to this request," wrote Zoë Calkins, spokeswoman for the unemployment insurance agency.

In September, the federal Labor Department gave $100 million to state systems to combat fraud. But state unemployment commissioners say they're still chronically underfunded, working with decades-old technology that can't keep up with increasingly complex schemes to bypass identity safeguards.

"One of the consequences of having a system that hasn't been modernized is that it is extremely challenging to deal with the concerted fraudulent attacks," said Rosa Mendez, a Nevada spokeswoman.

The Department of Labor, the FBI and the Secret Service say they're working together to uncover fraud, plug holes in identity verification systems and claw back millions in improper payments.

Prosecutors have tracked down a handful of "threat actors" and "money mules" – U.S. residents who help carry out the schemes. Agari, the security contractor, estimated that Nigerians are responsible for half of all international scams that fall under the umbrella of business email compromise, including unemployment, romance and "get rich quick while you work from home" offers. About a quarter of those reach the U.S.

The goal is to recover as much of the pilfered funds as possible. Washington state, for instance, has recovered $357 million of the $600 million stolen.

In late October, Kelly Maculan received a letter from the Illinois unemployment system confirming her last day of work had been April 3.

Except Maculan wasn't out of work. She was employed full time as an office manager near Chicago. So, she called the number on the letter to notify the state of the error and figured that would be the end of it.

States say they are underfunded, using antiquated equipment to try to keep scammers at bay.

Days later, she received another notice that an $822 direct deposit to her had been flagged as fraud – and that she would need to repay it or face legal action.

Maculan was irate. She has spent the past eight weeks struggling through long wait times and unfulfilled promises to call her back. After her employer got involved, the state told her this month to disregard all the notices.

Scammers need actual people to file their fictitious claims, looking for those who have not already filed on their own. In Maculan's case, she has no idea how someone got her personal information, although she noted that her Discover card was breached years ago.

She blames the state for not having "a system set up to avoid this issue."

Illinois officials declined to comment specifically on Maculan's case, and they were among those who wouldn't estimate how much in improper payments they've issued since March. Spokesman Will Gomberg did say the Illinois Department of Employment Security has stopped over 341,000 claims due to identity theft since March 1.

"If a victim received a notice stating that they owe us money after they reported fraud, this notice of overpayment was sent in error," Gomberg said. "We want to apologize for any anxiety this may have caused, and we want to reassure victims that they do not owe any money as a result of a fraudulent claim."

Unemployment payments rarely flow directly to the scammers. Instead, experts say fraudsters launder the money through online accounts and people with legitimate U.S. bank accounts.

That not only obscures the scammer's identity but makes it harder for the government to detect the fraud and recoup funds.

Scammers avoid ATMs, which are equipped with cameras, in favor of online banking and new banking apps.

Mobile banking and other online money-transfer apps have opened up new avenues for moving money around more easily. They allow access to accounts without anyone ever appearing in person – even avoiding cameras at ATMs – and offer debit cards that are easily moved on the black market.

Scammers used Green Dot accounts to transfer funds in bulk in the Washington fraud, LeVine said. Mayowa, the scammer in Nigeria, said fraudsters also use Venmo, PayPal, Cash App and Walmart2Walmart to extract funds.

"Once those funds go to a Green Dot account, they're often transferred through a series of movements into mules based in the U.S. probably, then moved offshore in two to three hops," said Armen Najarian, chief identity officer of Agari, the security firm.

Armen Najarian, chief identity officer of Agari, the security firm

Once those funds go to a Green Dot account, they're often transferred through a series of movements into mules based in the U.S. probably, then moved offshore in two to three hops.

Philip Lerma, chief risk officer at Green Dot, said the company is aware of its role in the unemployment fraud and is taking an active role in identifying problems.

"For cases related to unemployment funds, we immediately engage state agencies and other third parties to make them aware of potentially fraudulent activity and help them assess, confirm and address it quickly and effectively," Lerma wrote. "In many cases, using advanced device forensics, data analysis and other proprietary controls, we've been able to identify suspicious activity and prevent fraudulent transfers before they go through."

A network of so-called "money mules" includes full co-conspirators and those who have been groomed – sometimes for years – and may be unaware of their role. Najarian estimated that half are unwitting partners of puppeteers in Nigeria, South Africa or the United States.

Judy Middleton, 70, of Ridgeland, Mississippi, is accused by federal prosecutors of serving as a money mule for a sophisticated scam, one of those that targeted Washington's unemployment system. She appears to have no other criminal history. The retiree and grandmother told the court she has two homes, a motor home and two vehicles.

In a federal case filed in Jackson, Mississippi, in November, prosecutors said a criminal ring filed unemployment claims on behalf of eight people whose direct deposit payments flowed to Middleton's bank account, $79,922 in total. It's unclear from the court records who was orchestrating the scam.

Prosecutors say Middleton withdrew the money via ATMs and cashier's checks. She also bought Walmart and Kroger gift cards and sent money via wire transfers to other bank accounts.

In one instance, prosecutors say, Middleton packaged up $19,000 in cash and mailed it through the U.S. Postal Service to a man in Colorado.

If convicted of all 19 fraud charges, Middleton would face hundreds of years in prison, fines and supervision. Her trial has been delayed until March. Neither she nor her attorney answered phone calls seeking comment.

Since March, backlogs and political pressure have forced the resignation of two state insurance commissioners in Florida and Oklahoma. Two others, in Kentucky and Wisconsin, have been fired.

Pressure mounted for Washington Gov. Jay Inslee to fire his commissioner, LeVine, too, after hundreds of millions in public funds were stolen.

As unemployed Americans continue to file for assistance, scammers keep searching for workarounds to states' efforts to keep them out.

So far, LeVine has kept her job. She says the department worked quickly to find holes and plug them while alerting other states to prepare. She got training from her staff on verifying identification and worked alongside the National Guard, which had offered emergency help.

"We've been humbled by being the first out of the gate to suffer this attack, but we've grown and improved our responsiveness," LeVine said.

California officials drew headlines recently for announcing they suspect as much as $2 billion was paid out in improper payments. Other states have reported lower losses: $242 million in Massachusetts, $200 million in Michigan, $18 million in Rhode Island, $8 million in Arizona and $6 million in Wisconsin.

Three states that declined to share their numbers – Oregon, Tennessee and West Virginia – issued identical statements to USA TODAY, saying they "cannot discuss details involving ongoing fraud prevention tactics, investigations, or the scope of potentially fraudulent activity."

None of those officials would say where the statement came from. All states belong to the same lobby organization, the National Association of State Workforce Agencies. That association did not respond to requests for comment.

Nick Penzenstadler is a reporter on the USA TODAY investigations team. He can be reached at npenz@usatoday.com or @npenzenstadler, or on Signal at (720) 507-5273.

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