President Donald Trump has claimed over and over in the past week – at campaign rallies, on Twitter and in an interview with “60 Minutes” – that the US is only seeing so many coronavirus cases because the country is doing so much testing. “Cases up because we TEST, TEST, TEST. A Fake News Media Conspiracy,” he wrote on Twitter on Monday morning. Trump made similar claims during the summer spike in cases. They were flat wrong then, as we explained in a July fact check, and they are flat wrong now. Facts First: The spike in US coronavirus cases is not being caused by an increase in testing. The number of confirmed new cases is increasing at a faster rate than the number of new tests. And the number of hospitalizations and deaths is also rising, which shows that, contrary to Trump’s repeated claims, the increase in the case numbers isn’t merely being caused by tests capturing mild cases. Taken together, the numbers tell a consistent story: the situation in the US is genuinely getting worse. “To say that cases aren’t actually increasing is to deny reality,” Dr. Tom Frieden, who served as director of the Centers for Disease Control and Prevention under President Barack Obama, said in a Sunday email. “Not only are cases and infections increasing, but hospitalizations – which follow case increases by several weeks – and deaths – which follow hospitalization increases by a week or two – are also increasing. What’s more, the proportion of tests that are positive has increased, and this correlates with increased actual spread of infection.” Frieden added: “The most reliable information is positivity, and this increased in all regions of the country.” The national positivity rate as of Saturday was 6.1%, per Johns Hopkins University data, up from 4.6% a month prior. If the increase in reported cases “were due to a very high level of testing, we would expect to see the percentage of tests that are positive be very low, certainly less than 3%. However that is not what we are seeing,” said Aubree Gordon, associate professor of epidemiology at the University of Michigan. Worsening numbers On Friday, the US set a new record for reported daily coronavirus cases: 83,757, according to Johns Hopkins data. Through Saturday, the seven-day average for daily new cases was 66,970 – the highest since late July. The increase in daily cases is far outpacing the increase in daily testing. The COVID Tracking Project, an initiative that assembles and analyzes coronavirus data, tweeted on Saturday that “tests rose 3.8% from a week ago, while cases are up 20.6%.” Trump has repeatedly suggested that the increase in confirmed cases is happening simply because tests are capturing cases like the one he says his 14-year-old son Barron experienced. Barron, he has been telling his rally crowds, recovered in “seconds” with no significant problems. But the hospitalization numbers prove that many new Covid-19 patients are getting quite sick. Eleven states set new records on Saturday or Sunday for the number of people hospitalized with the coronavirus, according to COVID Tracking Project data. The national number of hospitalizations hit 41,882 on Saturday, according to the tracking project, the highest level since late August. Surgeon General Dr. Jerome Adams told a virtual conference on Friday that “we’re starting to see hospitalizations go up in 75% of our jurisdictions across the country.” “Since the week ending September 26 … weekly hospitalization rates have increased for all age groups combined, driven primarily by an increase in rates among adults aged 50 years and older,” the CDC said in its report for the week ending October 17. You can already see the impact of the hospitalization spike in communities around the country. Amid a surge in El Paso, the government of Texas has converted a convention center into a makeshift hospital to free up space in regular hospitals. With the Wisconsin health system “being overwhelmed,” according to Gov. Tony Evers, the state has opened a field hospital at the park where its state fair is held. Some Utah hospitals have had to open overflow intensive care units because the permanent units have been filled. “Our hospitals are being overwhelmed and the stress they are experiencing is unsustainable,” Gov. Gary Herbert tweeted on Thursday. One piece of good news Trump has accurately touted is the fact that treatment for the coronavirus has improved, which means a smaller percentage of hospitalized people are dying today than at the outset of the pandemic. But as Frieden noted, the number of deaths is nonetheless starting to rise. The seven-day average as of Saturday was 800 deaths per day, up from 738 a month prior. Testing doesn’t create cases Despite all the troubling data, Trump has continued to lean on the same false message that testing produces cases. Trump said the exact same thing at a Wisconsin rally on Saturday and in his “60 Minutes” interview: “If we did half the testing, we’d have half the cases.” This is, of course, not true – in both obvious and less obvious ways. The obvious: testing does not cause cases to exist. If the government does not record someone’s coronavirus infection, that person still has the coronavirus. In addition, testing is a pandemic-fighting tool that, over time, should help reduce the number of actual cases in the community. Doing testing informs people they are infected and should prompt them to take steps to avoid spreading the virus to others. (It is also essential to the process of contact tracing.) Finally, Dr. Scott Gottlieb, who served under Trump as commissioner of the Food and Drug Administration from 2017 to 2019, has noted on Twitter that demand for tests rises as more people experience symptoms of the virus. So the quantity of tests conducted is driven in part by the spread of the virus. A pattern of downplaying Trump’s attempts to wave away the spike in cases is part of his months-long effort to minimize the severity of the crisis. As he has dismissed the rising case numbers, he has also continued to falsely claim that the country is “rounding the corner” on the pandemic, though all of the key trendlines are rising, and that the pandemic is “going away,” though he has been baselessly making that claim for more than eight months. Experts have been clear: the situation is likely to worsen, not improve, in the late fall and in the winter, as temperatures drop and people spend more time indoors. “We’re likely to see a very dense epidemic. I think we’re right now at the cusp of what’s going to be exponential spread in parts of the country,” Gottlieb said on CNBC on Monday morning.