Coronavirus infections were expected to rise with the economic re-opening, and they have. But the news has raised alarms nonetheless, probably because it has failed to follow the forecasted script laid out by the authorities. Part of the concern reflects the regional distribution of infections. Former hot spots have seen little rise. Rather, increased infections have appeared in rural areas and parts of the country that earlier looked relatively safe. This new round of infections has also concentrated among the young. This is not what the experts told us to expect. Since reverting to blanket lockdowns and quarantines seems unlikely, the question of the moment is what to do next.
The flow of data during the last few weeks certainly offers reason for lots of “how’s” and “whys.” Once hard-hit regions – the Northeast and the Midwest –have done better than expected, while former relative havens – the West and the South – seem to have lost control altogether.
Center for Disease Control and Prevention (CDC) records almost no increase in infections as the Northeast has begun to re-open. From a peak of some 20,000 new cases a day in the region back in April, the number had dropped to about 5,000 in May. That improvement prompted re-opening steps in June but, despite expectations of a rise in cases, the number of new infections has continued to fall, to some 2,500 a day in most recent weeks. Also the Midwest, a particularly bad spot in May where infections had risen to about 8,000 a day, up from some 5,000 in April, has seen a drop in June to some 2,500 new cases a day, despite some economic re-opening, .
In contrast, the formerly safe – or relatively safe – South and West have suffered horribly with the reopening, seemingly inexplicably. The western states, including the nation’s most populous, California, after seeing a relatively low 2,500 daily rate of infections in April and May, have recorded a rise to 10,000 a day in late June, four times the earlier number. The southern region, which includes Texas, the second most populous state in the union, has seen daily rates of infection rise from 7,000 in April and May to some 20,000 more recently, almost three times the number.
Perhaps less surprising but more disconcerting, the rise in infections has centered almost entirely on the young and middle-aged and not the elderly where it formerly lodged. Back in April, fully 45% of the Covid-19 infections occurred in the relatively small part of the population over the age of 65. The vast majority of the population under this age was considered safer – less susceptible and able to deal with the disease with only light symptoms. But the June data has reversed the pattern. The young are still more likely to survive a bout with the virus than the old, but they are catching it at a much greater rate than previously. In June, the CDC reports, only some 20% of new infections have occurred among those over 65. Some 20% have occurred in those between 50 and 65, while fully 60% of the new cases are among younger people. The disease is running through clubs and festivals more than through nursing homes where the greatest concern had once centered.
Some of the infection surge may reflect more widespread testing. With greater testing resources, the medical establishment has extended its efforts from those with acute symptoms, where it had almost exclusively focused, to those with milder symptoms or none at all. That may explain why they are finding more cases in parts of the county where they had seen less need for effort in the past and among the young, where symptoms still tend to be less severe. Some have further explained the rise in the virus among the young by pointing to the widespread and less than “socially distant” protests in response to the death of George Floyd at the hands of a police offer in Minneapolis. There may be truth in these suppositions, but there is also no avoiding the fact that the jump in infections also and probably mostly comes for the various economic re-openings across the country.
Some states – notably California – have threatened renewed the lockdowns and quarantines in response to the news, but most have taken more moderate steps. Texas, an early re-opener, has re-closed the bars and insisted that restaurants operate at 50% instead of 75% of capacity. The state has also banned “recreational tubing.” (Is there any other kind?) In Florida, where new cases have surged, Miami has re-closed its beaches. Washington State has paused in its plan to move to the fourth phase in its re-opening. Arizona, where ICU beds are already 90% occupied, though not all with Covid-19 cases, has launched a drive to encourage mitigation techniques especially among the young – masks, for instance, and the by-now familiar hand washing.
The reasons for this reluctance to return to the widespread lockdowns and quarantines of April and May are clear. Those running state capitals and in Washington now know, as perhaps they did not last spring, that this epidemiological solution has a terrible cost that people are no longer willing to pay. Those lockdowns and quarantines caused the steepest decline in this country’s economic activity ever. In the space of a few weeks over 45 million Americans – some 28% of the nation’s workforce and more than one working person in four – had lost his or her job and applied for unemployment insurance. The figures were reminiscent of the Great Depression. Bankruptcies spiked to levels not seen since the great recession of 2008-2009, especially among smaller, less well-capitalized businesses, those among the least advantaged people in the country. A continuation of last spring’s policies, even if it does not kill the virus, would surely all now know would kill the economy and people’s livelihoods – their lives and those of their families — and do so on the backs of the most vulnerable groups in society, .
The only answer now is to balance urgent economic needs against urgent medical needs — try to moderate the rise in infections by slowing the re-openings, selectively perhaps, as in Texas, even while relaxing economic restrictions so that all the masses of unemployed can find new jobs. Only in this way can the country avoid a cure that kills while also holding this infectious disease at bay in the hopes/expectations that the near future will bring more effective therapies and, better still, an effective vaccine.