The United States reported a record number of new cases of coronavirus on its way to a holiday weekend. Officials and health experts attribute the increase in cases to reopens across the country, uneven use of masks, and increased travel. Three experts discuss what they’ve learned about coronavirus transmission during reopens, and demand caution over the upcoming holiday weekend.
Where has reopening in the United States succeeded and where it has led to a surge In cases?
Saskia Popescu: Washington state reopened over the course of several months. In Arizona, where I live, we began allowing elective surgery on May 1 and let our stay-at-home orders expire on May 15. This was very, very fast. [Editor’s note: In Washington, cases are slowly rising, whereas Arizona has seen a more dramatic increase.]
As a state reopens, you really want to see steady decreases in cases for about two weeks. You want to take an incremental approach, to make sure you’re not getting a bunch of new cases and you’re obstructing public health.
What are we learning about transmission as cities and states reopen? What activities are high risk versus low risk?
David Rubin: Clearly, the interior bars have been a big part of this outbreak in terms of transmission. Closing bars, particularly during the current wave of the epidemic, would be very helpful.
Popescu: We know that going to the bar is high risk. We have been saying this since February. Taking a walk or having a picnic is less of a risk. As we learn more about asymptomatic transmission, that really emphasizes the importance of wearing masks.
Karan: The interior transmission is significantly higher than the exterior transmission. On top of [Boston’s] epidemic, most of the cases I saw were people who had [confirmed] Covid-19 cases at home. We know that the workplace is high risk because they are not really designed for an epidemic.
The vast majority of us in public health expected an increase in protests, even though we knew they were critically important. Lack of it [surge] It talks about the fact that masking works and being outdoors helps a lot.
Do you think states will have to go back to full locks?
Popescu: People see it as a dichotomy: you are open or closed. Right now is a good time to focus on communicating harm and risk reduction; You can still run errands or see a friend or two and do it safely.
Karan: Blocks are not a strategy: they are an emergency backup that represents a failure to stay on top of the outbreak. The strategy for this is to use personal protection, such as masks, tests, tracing, and quarantine.
Rub: Places like Texas, Florida, and Arizona may need to stop, which means going back to quarantine and only allowing them to be taken to restaurants, for a few weeks so cases drop and health centers begin to recover.
Reported cases are increasing, but deaths are decreasing. Why?
Rub: More youth are represented in the cases, which will reduce their aggregate fatality. Secondly, we may be improving a little in the treatment of the disease.
The concern is that people will become complacent, and then in the fall we will see transmission and doom come up again. That is what happened in the 1918 flu pandemic.
Popescu: Part of this is that mortality rates are a lagging indicator, but I also hope that as we detect more cases, they are from a less serious illness.
Will the new infections inevitably spread to places like New York, which has significantly reduced its number of cases?
Rub: What’s really concerning is that this week, after all the hard work the Northeast and Midwest did (they waited longer to reopen), their risk of transmission is increasing. That includes New York.
People talk about Florida, Texas, and Arizona, but we also see heightened activity on the I-90 corridor in upstate New York. The Chicago area is also warming up again. These areas that we had touted as successes could be engulfed and consumed by the surrounding risk and travel from high-risk areas.
What this shows is that we needed a national response to meet this challenge.
There was a surge in cases after Memorial Day weekend – when many Americans traveled for the first time since the blockades began. Are you worried about the next holiday weekend?
Popescu: Arizona closed bars for 30 days, and the governor has [urged caution] entering the weekend. But President Trump is hosting an event at Mount Rushmore where you can’t socially distance yourself and the masks haven’t been encouraged. It is difficult when you have competitive messages.
Rub: Clearly [the current surge in cases] It started after Memorial Day, when travel resumed. And now we are adding an explosive cocktail in the midst of a deteriorating situation. It is very worrying.
Dr. Fauci’s warning about the potential of 100,000 new cases per day was conservative.
Experts:
.
