Now, we are seeing the consequences of rapid reopening. On Tuesday, top health officials testified before a Senate committee that 29 states are seeing increasing numbers of infections, and 12 states have set record highs in the past week. The nation’s top infectious-disease expert, Anthony S. Fauci, warned: “We are now having 40-plus thousand new cases a day. I would not be surprised we go up to 100,000 a day if this does not turn around.”
We need to make that turnaround right now. Let’s start it on the Fourth of July. Here’s how.
States with escalating infections must take urgent, large-scale action. Closing bars, as some state and local officials have already mandated, is a critical first step, since crowded indoor bars have clearly been identified as the source of numerous outbreaks. But just closing bars will drive people to congregate in other locations. Officials need to restrict all indoor gatherings, including at restaurants, theaters and private parties.
But this time they should impose a different type of population-wide order — not a lockdown, but rather a mandate not to get together indoors. In high-virus areas, even relatives who don’t live together should avoid visiting inside each other’s homes, and choose instead to see one another in a backyard or a park. I don’t think people will comply with another shelter-in-place order, but they might be willing to modify how they socialize.
Similarly, I’m concerned that re-closing such lower-risk outdoor recreational sites as parks and beaches would backfire and simply drive people indoors. Instead of prohibitions, policymakers should consider creative approaches to make shared spaces safer. For example, an alternative to closing beaches altogether is to allow beaches for walking and swimming only. Ask people to stay for a maximum of, say, an hour or two, so that others can also enjoy the shared public space. Issue explicit instructions for people to stay six feet away from anyone not part of their home group, and use “social distancing circles” when possible.
Many parts of the country hit hard by the virus’s resurgence urgently need federal support. This begins with testing: There is no way communities can get their infections under control if they are so short of tests that people are waiting in line for 13 hours, as they have had to in Phoenix. Meanwhile, intensive care units in parts of Texas, Florida and Arizona are already reaching capacity. Los Angeles County said Monday that it could run out of hospital beds within two weeks. The federal government needs to mobilize and assist with supplies and staffing, as it did back in March.
For states that are holding steady in infection rates: Be warned that it may not last. The New York City area is one place where covid-19 appears to be under control, but the virus that ravaged the region three months ago could well take hold there again. As we are seeing, even states, such as California and Oregon, that reopened cautiously are now experiencing rapid spread.
What’s to be done? If they haven’t already, states that are holding steady can institute real-time surveillance mechanisms. These include regular testing in high-risk settings such as nursing homes and jails as well as random population testing, with specific focus on testing racial minorities disproportionately affected by covid-19. Now is the time to bolster states’ capacity for contact tracing and to establish quarantine facilities.
It’s not too late to follow federal guidelines for reopening, which include reassessment between phases to examine the impact of removing restrictions as it progresses. Also, since people in their 20s and 30s are the drivers of this new surge, health officials should put out educational messaging that helps young people live their lives safely. Universal mask-wearing is a no-brainer that all states, regardless of current infection level, should be mandating.
Finally, now that we know the rapid spread of covid-19 indoors, states must be particularly cautious about monitoring these spaces. Policymakers need to consider their medium-term priorities. If it’s critical to resume in-person schooling in the fall, they may need to keep bars closed over the summer.
At this point, most of us have come to terms with the unfortunate reality that we will be living with covid-19 for the foreseeable future. The best we can hope for is a slow burn that allows schools to resume and most of the economy to get back to business. At the moment, this seems a distant dream, as outbreaks surge throughout the country. But it’s not an unconquerable problem. We must act now to prevent a summer of great suffering and death, beginning with our actions over this Fourth of July.