Today, Explained - Lockdown, reopen, repeat

Episode Date: June 29, 2020

Hospitals are stretched to their breaking point in Texas, Arizona, and other states where Covid-19 cases are rising sharply. Vox’s Dylan Scott says the US could be in store for more lockdowns. And more reopenings. And more lockdowns… Transcript at vox.com/todayexplained. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Get groceries delivered across the GTA from Real Canadian Superstore with PC Express. Shop online for super prices and super savings. Try it today and get up to $75 in PC Optimum Points. Visit superstore.ca to get started. Over the weekend, we reached a new COVID-19 milestone, half a million deaths worldwide. And more than a quarter of those deaths have been here in the U.S., where we've had 2.5 million confirmed COVID cases. Four states hitting one-day records. Nearly 10,000 positive tests in Florida. Almost 2,000 new cases in Georgia.

In Arizona this weekend, almost one in 10 testing positive. But the Trump administration is still super excited about states reopening. We have made truly remarkable progress in moving our nation forward. We've all seen the encouraging news as we open up America again. More than three million jobs created in the last jobs report. And the president's top economic advisor, Larry Kudlow, says the risk of more COVID deaths is just the cost of doing business. We're going to have hotspots.

No question. We have them now in, you know, Texas and parts of the South, the Carolinas, Arizona. We just have to live with that. But local leaders are sounding the alarm. We're going to have to dial it back because of what we see with the data. And we're going to have to dial it back because I want to make sure that if we have to help somebody, that we can help somebody. Right now, Team Reopen Everything seems to be winning. Dylan Scott has been covering the reopening for Vox.

Florida, Texas, Arizona in particular are the places that people are watching closely now because they have a number of worrying trends. It's not only that their raw number of cases is increasing, but they're also seeing increased hospitalizations, and they're seeing an increase in the number of tests that are being conducted that are coming back positive. Is that to say this can't be explained away just by having an increase in testing? Exactly. There is some truth to the idea that, you know, if you start conducting a lot more tests, you're going to find more cases, especially with a disease like this,

where a lot of people experience mild or even no symptoms at all. What's concerning and what we're seeing in some of these states is when we're either maintaining the same level of testing or increasing testing, and the level of positive tests coming back is increasing. That's what suggests to experts that the virus is actually spreading in the community and more people are catching it. Do we know why this is happening?

Can we peg this to all the reopening in the last few weeks? So it's difficult to ignore that this has started to happen a month or so after states started relaxing their stay-at-home orders, allowing businesses and restaurants and bars to reopen. As any good scientist would tell you, correlation is not causation. But I do think a consensus is starting to form that as people are starting to resume daily life, coming into contact with more people, this virus is finding a way to spread again. And to some extent, this was expected. But what's concerning is when you start to see hospitals in the Houston area, most recently I saw over the weekend, and some in California, that are starting to reach their

maximum capacity in terms of the patients that they're able to accommodate. And once we start to reach those levels where the health system is at risk of being overwhelmed, that's when public health experts and political leaders get worried. Is it possible that some of the mass protests we've seen over the last month have contributed to the surge too? The data so far is inconclusive and seems to lean no. I spoke last week with a researcher in Minnesota because it seemed to me anyway that Minneapolis would be one of the first places

you might see any kind of new surge as a result of protests since that's where the protests started. And she told me that there really hadn't been anything thus far. The public health experts I've spoken with have said, in terms of just the number of exposures and the level of exposure, all this reopening activity, people going back to bars and restaurants and businesses, and the number of people who are going to be doing that far outweighs, you know,

whatever number of people went to a protest for a day or two that was outdoors when they might have been wearing masks. You know, it's hard to draw an equivalence between the two. The level of exposure that we're risking through reopening is much higher than what people risked by going to the protest. Is this surge the same as earlier ones? Is it still mostly affecting older people? So it does seem like the virus is now spreading more among younger people as opposed to older people compared to some of the earlier waves of the virus. I've never seen anything that is so protean in its ability to make people sick or not. There's no other infectious disease that goes from 40% of the people having no symptoms to some having mild symptoms, to some having severe, some requiring staying at home for

weeks, some going to the hospital, some getting intensive care, some getting intubated, some getting ventilated, and some dying. There was a really interesting study that came out of Tennessee, which is one of the states people have been watching closely, where they described their COVID case mix. And basically what that means is they looked at, you know, how many people had been infected and as a result, how many people you would expect to end up in the hospital based on what we know about this disease. And in the early weeks of the pandemic, the case mix clearly skewed sicker, like more,

even more people were ending up in the hospital than we might have expected based on the raw number of infections. And what's happened over the last few weeks is that has flipped. And now slightly fewer people are actually ending up in the hospital than you might expect based on the case numbers. And now what that seems to indicate is that it's younger, healthier people who are more resilient against the disease compared to the elderly are the ones getting sick. A lot of young people do end up in the hospital. I know somebody, another reporter in D.C., he had caught the coronavirus, said it was the sickest he had ever been in his life.

And we're still learning a lot about the long-term complications and the potential permanent damage that might be done to somebody who does recover from COVID, but that doesn't mean that they're necessarily going to be completely healthy, at least right away.

I think what we're missing in this is something that we've never faced before, is that a risk for you is not just isolated to you. Because if you get infected, you are part, innocently or inadvertently, of propagating the dynamic process of a pandemic. And I talked to a Harvard professor a week or so ago asking about this very question. You know, have we seen as infections start to pick up in the younger population, are we seeing any corresponding spread to more vulnerable populations? And he sent me a trove of links of new outbreaks in nursing homes in Arizona and Florida and California and Tennessee. And I think that is just an indication

of how difficult it is to completely isolate the vulnerable populations. And once community spread picks up, that also increases the risk that the virus is going to find its way to the people where it can do the most harm. You know, you mentioned a place like Houston where the hospital system is close to being overwhelmed.

Is Texas, is Houston taking any measures, any more serious measures now that the virus seems to be spreading so intensely? Yeah, I think a good indicator of the seriousness of the situation is that Texas Governor Greg Abbott has reimposed some restrictions that had previously been lifted. I believe he closed all of the bars again in Texas. And come Monday, restaurants have to go from using 75% to 50% capacity. And lastly, outdoor gatherings of 100 or more people must be approved by local government. You know, and Abbott, because all of this has to some degree become politicized, you know, Abbott and his team were always pretty gung-ho about reopening and believing that they could allow business to resume while containing the virus.

And so I think the fact that even he has seen the need to reimpose some restrictions tells you how worried people are about this spiraling out of control. Is it possible for a state to have a second shutdown at this point? Is that politically feasible? restrictions tells you how worried people are about this spiraling out of control. Is it possible for a state to have a second shutdown at this point? Is that politically feasible? That's a great question. And I think the big unknown is whether a state would be willing to go all the way back into lockdown, you know, stay at home orders, almost all businesses are closed. Clearly, for right now, states are trying to mitigate these new spikes with some targeted restrictions, closing bars, maybe limiting restaurant capacity, restoring bans on large gatherings, or delaying the openings of places where there'd be large

gatherings, like California has delayed the opening of Disneyland. And so I think for now, everybody wants to see what happens if we take some of these more targeted measures. Are we able to start containing the virus, keep our numbers in check, keep some health system capacity to absorb new infections and new hospitalizations, and see how that goes? I think that's sort of the question that we're all wrestling with right now is, can we manage the virus while maintaining some level of normal activity again, or is the only way to keep this thing in check to have stay-at-home orders, closed restaurants, you know, the really strict social distancing that we saw in March, April, and May. After the break, why the lockdown, reopen, repeat cycle

may just be beginning. I'm Noam Hassenfeld filling in for Sean Ramos-Furham. This is Today Explained. Support for Today Explained comes from Ramp. Ramp is the corporate card and spend management software designed to help you save time and put money back in your pocket. Ramp says they give finance teams unprecedented control and insight into company spend. With Ramp, you're able to issue cards to every employee with limits and restrictions and automate expense reporting so you can stop wasting time at the end of every month. And now you can get $250 when you join Ramp. You can go to ramp.com slash explained, ramp.com slash explained,

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There's a mutuality and there's a recognition of our interdependence that requires of this moment that we direct a statewide order for people to stay at home. What happened? How did California drop the ball? I think what's happening in California is to a large degree the same story as Florida and Texas. Let's call it a calculated risk. As the state began to reopen more businesses, state leaders expected cases to rise and hospitalizations. Tonight, both are happening, and leaders say they're concerned.

Officials there have pointed to relaxing social distancing, you know, businesses reopening. They've cited people, you know, maybe not being as diligent about wearing their masks as they should be. But I don't think that there's any great mystery. I mean, it's a big state, ton of people, a large susceptible population,

and it, like most of these other places, has started to ease up on some of its social distancing restrictions. I don't necessarily think of it as there's anything unique to California's situation, other than it's sort of reliving something that other states are now going through for the first time. But it does, I think, indicate some of the risks of reopening and potentially portends some of the actions that will be necessary to contain some of these new outbreaks. How much is what's going on in California a sort of warning from the future for other states like New York, New Jersey, Massachusetts, these places that had big surges the first time around and kind of managed the spread, but are now reopening.

I mean, there's all kinds of confounding factors with all of this stuff. I was looking at this before we started talking, and I think Ohio is actually an interesting corollary to California because it's another place that was, you know, had some pretty sharp increases in the early days that caused them to take aggressive action. Governor Mike DeWine, especially among Republican governors, was one of the first to impose a statewide stay-at-home order. And the virus, you know, grew very slowly, kind of plateaued through that lockdown period. But now as they have started to reopen, they're starting to see the same kind of increase in new cases and hospitalizations.

And I saw that Governor DeWine has been talking about taking actions very similar to what Governor Newsom has done in terms of identifying particular cities or particular counties where the numbers look a little bit scary. Where we're seeing potential problem areas identifying particular cities or particular counties, where the numbers look a little bit scary. Where we're seeing potential problem areas,

or problem areas, we're gonna work with the local officials and in conjunction with them, make decisions about what else needs to be done. So it seems like for the time being, we are gonna see if we can't have these really narrowly targeted interventions and hope that those are able to contain the virus. You know, when you talk about targeted interventions, I just think about what Ruth Bader Ginsburg said

after a key part of the Voting Rights Act was struck down. She said something like, if you're out in the rain with an umbrella and you're dry, you don't just say, oh, this umbrella clearly isn't doing anything. You keep the umbrella. Yeah. And I think that's what we're discovering right now. It was something that public health experts were cognizant of even before the stay-at-home orders really were imposed was there's this sort of paradox in public health, where if your intervention is really effective, then it's going to seem like you overreacted

because the worst never happened because of the intervention you took. And so there became a lot of energy and pressure around reopening because obviously there's been a lot of economic and even mental health pain from people being forced to quarantine. And while I certainly understand that instinct,

it does not comport with what we know about how disease outbreaks work. And now we're seeing that if you give the virus more vectors with which to transmit, it's going to take advantage of that. And now we're seeing the consequences. And those consequences could be felt by states that are reopening more slowly, right? As long as there are places in the United States where a virus this contagious is still spreading, that means that the whole of the United States is to some degree vulnerable, unless we're willing to build walls between North and South Carolina or between Ohio and Indiana or what have you.

There's no way, as you say, to totally protect against the virus finding its way back to some of these other places. And so as we see the virus continue to find its way to new places, it is a reminder that we're all connected. And unless we're willing to take steps to protect not only ourselves, but other people, the virus is gonna keep taking advantage of the opportunities that we give it. A few months ago, I kept hearing that some experts were saying,

we're just going to have a series of outbreaks followed by lockdowns, followed by outbreaks, followed by lockdowns. And it seemed kind of hard for me to believe that that would happen, because if we have outbreaks, we should follow it by a lockdown and then we'll be fine. It's starting to seem more likely to me. I mean, does that seem like the most likely outcome in the end, that we're just going to have a series of outbreaks and lockdowns until we get a vaccine? It does seem like this cycle of lockdown, outbreak, lockdown is going to continue until there is some kind of permanent solution to COVID-19, whether a totally effective treatment or a vaccine.

We're going to keep kind of turning the dial to try to figure out if there's some happy medium we can find where some amount of daily life is allowed to continue without the virus spreading out of control and risking, you know, finding its way to nursing homes or risking too many people getting hospitalized and the health care system being overwhelmed. But right now, what's, I guess, a little bit scary is right now we're in the middle of that process and we just don't know. And it may turn out that lockdowns really are the only way to keep COVID-19 contained. And that reality is frightening in its own way, given the level of economic pain that we've seen and just the sort of social toll that quarantine places on people. So I have no good answers for, you know, unfortunately, because it's a it's an unprecedented situation. And the only thing we know for sure is that, you know, we're going to be living with this virus

and the necessary effect that it has on our society and our everyday lives for quite a long time. Thank you.