Consider This from NPR - New Cases Plateau For Now As States Chart Their Own Course

Episode Date: May 4, 2020

One model forecast 60,000 Americans would die from COVID-19 by August. But fatalities keep rising, and the United States has surpassed that number.Around the country, different states are taking different approaches to reopening. Donald Kettl, professor of public policy at the University of Texas at Austin, says this pandemic has brought up questions about federalism.Few online grocery delivery services accept payments from the Supplemental Nutrition Assistance Program, also known as SNAP. That causes problems for recipients at high risk for COVID-19.Plus, NPR's reporter in Nairobi finds his parents connecting with his kids through TikTok.Find and support your local public radio stationSign up for 'The New Normal' newsletterThis episode was recorded and published as part of this podcast's former 'Coronavirus Daily' format.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

Every day in the U.S., there are around 30,000 new confirmed cases of COVID-19. That average hasn't gone up much since late March, but it hasn't gone down either. So while mitigation didn't fail, I think it's fair to say that it didn't work as well as we expected. Former FDA Commissioner Scott Gottlieb said on CBS over the weekend, cases are still rising in about 20 states, including states that are moving to reopen. We expected that we would start seeing more significant declines in new cases and deaths around the nation at this point. And we're just not seeing that. Coming up, why so many states are doing so many different things.

And what happens when grandma gets on TikTok. This is Coronavirus Daily from NPR. I'm Kelly McEvers. It's Monday, May 4th. We all know the hit to the economy from this pandemic has been devastating. And as the weather warms up in many places, people are getting pretty sick of staying home. The number of people who have died from

COVID-19 is high, but still just the numbers themselves can be hard to fully comprehend. It looks like we'll be at about a 60,000, 60,000, 70,000, it's far too many. Anywhere from 75, 80 to 100,000 people. That's a horrible thing. We shouldn't lose one person over there. Since the pandemic began, the president has not talked much about the victims. And when he is talking about how many more people could die, he usually says the most optimistic number. Our projections have always been between 100 and 240,000 American lives lost. And that's with full mitigation and us learning from each other of how to social distance.

Deborah Birx on Fox News this weekend repeated the official administration forecast. Under this model, up to 240,000 people could die with full mitigation. That means serious social distancing and everything except essential businesses closed. Which isn't happening as much as it was before. Fewer people are staying home. People are making a lot more, about 30 percent more trips. It was almost like people were waiting for May 1st to get out. Lejean is a transportation engineer at the University of Maryland. He has analyzed mobile device location data for millions of devices. And he told NPR correspondent Alison Aubrey that data suggests people are spending more time outside their homes.

We are observing major changes in mobility behavior and decrease in social distancing all across the nation. But still, every day, around 2,000 people die from COVID-19. And that number is not going down. In fact, an internal CDC document obtained by the New York Times reportedly says it could go up, up to 3,000 people dying every day by early June, as some states reopen.

The leaked CDC projection also says the U.S. could see some 200,000 new cases of COVID-19 per day by the end of this month. In a statement, the White House said the CDC document had not been presented to its coronavirus task force or vetted. If cases do rise, though, without sufficient testing or contact tracing capacity, many states might have to decide whether to order people back inside all over again. If we don't have these tools in place to really manage this in an ongoing way, then I think the only tool we have is social distancing,

unfortunately. Crystal Watson, senior scholar at Johns Hopkins University, says hospitals will show the first sign of an increase. Because this hasn't gone away, it will ramp up again as we start to come together. Watson talked to NPR's Morning Edition. So why are there so many different approaches to reopening U.S. states? Donald Kettle, a professor at the LBJ School at the University of Texas at Austin, says it starts, of course, with politics. He talked to Morning Edition host Steve Inskeep. The problem here has been that there's been a difficulty in trying to get consistent messaging from Washington. And that's led to different responses in different states

in ways that don't necessarily match the pattern of the disease. Yes, we need substantial variation among the states, but the variation ought to be based on differences in facts and differences in treatments that are effective. But instead, it's tended to break down much more on partisan lines. And that's really created some serious problems in which the country has responded. Defenders of federalism will sometimes say that the states are 50 different laboratories for approaching problems in different ways.

Could some of that be true now as the country starts to reopen? We get to find out if South Carolina can establish a way to reopen stores without a massive increase in cases. We get to find out if Georgia can reopen tattoo parlors in some safe manner, and the rest of us can watch from a distance while trying a different approach. The problem is that we're proceeding without much information, and we don't even have a consistent idea about what a test ought to look like, who it ought to be given to, how to measure the results, and how to compare them. And so that's the great problem of trying to run 50 different experiments across the country

when we can't agree on what the common ground is for figuring out whether or not those experiments work. The subtitle of your book, The Divided States of America, is Why Federalism Doesn't Work. Has this experience proved your subtitle correct? Yeah, I'm afraid it has. And on the one hand, I'm a huge fan of federalism. And I think that there is tremendous advantage in having different states experiment with different kinds of ideas on everything from health care to environmental policy. But the underlying problem is the one that Madison and Hamilton and others were battling about back in the 1700s, which was just how much national

authority do we need? Hamilton at the time was warning that at some point there would be some things that really required national action and required a strong enough national government to be able to steer our way through. And my great fear is that we are going to prove this coronavirus problem that Hamilton was right. That's the grand experiment in many ways that are going on. And it gets to the fundamental question about just how much difference in this country are we willing to tolerate? And what kind of risks are we willing to subject our citizens to at the cost of allowing states to experiment and go in such different directions? Donald Kettle with Morning Edition host Steve Inskeep.

Even before the coronavirus pandemic, almost 40 million Americans were on SNAP. That's the Supplemental Nutrition Assistance Program. Once known as Food Stamp, SNAP helps low and no-income people buy food. One thing SNAP recipients cannot do at a time when we're all being told that the safest thing to do is stay at home is pay for groceries to be delivered. Reporter Naomi Gingold explains. Not long after the shelter-in-place went into effect in California last month, Melissa Santos and her wife established new rules.

Breakfast? They'd eat. Dinner, sure. But we don't really have lunch. They'll just eat snacks or I've been drinking more coffee to suppress my hunger sometimes. Santos is a student at the University of California, Berkeley. At 32, she's older than most of her undergrad peers. She spent years taking care of a grandmother with Alzheimer's before considering her own career and education. Now, the shelter-in-place means Santos can go to the grocery store, but her obesity puts her in a high-risk group for COVID-19, and her doctor said stay home. But no grocery delivery app would let her pay with her Snap card. So they go out as little as possible and stock up as much as they can.

We're students, so we already ration as it is. So even now, like, we're having to, sorry, we're just having to make sure that we have enough for, you know, the next day, you know. The fact that Snap users can't get delivery has been a problem. Many have disabilities or restrictive medical conditions. So in 2016, the U.S. Department of Agriculture started a pilot program to enable purchases online. In a statement, the USDA told NPR they approved the states that wanted to join. Just six. I have been living and breathing this thing for years. It is much more complicated than it should be, probably. Christina Herman is the director for underserved populations at Amazon.

What we're hearing from the states is that it is a series of multiple weeks of work for their back end to get ready. The USDA now says it'll fast track any state that wants in. And 11 more were just approved, including California. And many should be online with authorized retailers by some point in May. That's four retailers. Only two are national. So limited even where possible. And for the majority of SNAP recipients, still not an option.

And that brings us to... Instacart is here to help. Instacart. Their app lets customers buy from 25,000 stores in 5,200 cities. But the U.S. government says because Instacart is not a retailer itself, it can't join the program. Eliza Kinsey researches public health at Columbia, and she says this is about more than just getting food. The more that people are of higher risk are out in the community, potentially getting exposure, the more pressure we're going to be putting on the whole health care system. Because if high-risk people have to be out getting groceries, it could mean

more cases and more difficult ones. For NPR News, I'm Naomi Gingold. Spending so much time in social isolation has been especially hard on older people. NPR's East Africa correspondent Eder Peralta says he never thought of his parents as vulnerable. They lived through the Nicaraguan Civil War. But his dad, he says, is a nervous wreck. That's Eder's mom in Miami telling him over FaceTime how his dad has them washing their vegetables outside the house. While they're stuck at home, they're praying for a vaccine, doing puzzles and taking walks. And a few weeks ago, they sent a video. Ader's parents had started using TikTok. That's the app that helps you make and share short videos. Their video showed them stepping on the scale, horrified at the numbers.

Ader says they are totally into it, even though his mom calls it tip-top. TikTok. TikTok. Now he says his parents and his kids chat and watch each other's TikToks. Ay, mira la que es. They've done the coronavirus one, the merengue dance challenge, and now they are on to blinding lights. For more on the coronavirus, you can stay up to date with all the news on your local public radio station and in our daily coronavirus newsletter. It's called The New Normal.

You can sign up at npr.org slash newsletters. We'll be back with more tomorrow. I'm Kelly McEvers.