What Have We Learned About Reopening?

https://www.nytimes.com/2020/06/18/opinion/coronavirus-reopening.html

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On Thursday, Mayor Bill de Blasio announced that New York City, which was once the epicenter of the coronavirus pandemic, will proceed with its second phase of reopening next week. Diners will eat on restaurant patios, shoppers will file into stores, and up to 300,000 workers will get back to work — just in time for the subways to break down in the summer heat.

Interminable as lockdown may have seemed here, it was only on March 13 that President Trump declared the coronavirus a national emergency. Some three months of social distancing, 2,186,900 cases and 118,000 deaths later, here’s what people are saying about the easing of restrictions not just in New York, but also across the country.

On Tuesday, Vice President Mike Pence argued in an op-ed for The Wall Street Journal that “the panic” over a second wave of coronavirus infections was overblown. “Thanks to the leadership of President Trump,” he wrote, “and the courage and compassion of the American people, our public health system is far stronger than it was four months ago, and we are winning the fight against the invisible enemy.” As evidence of “success,” he cited the stabilization of cases, “with the daily average case rate across the U.S. dropping to 20,000 — down from 30,000 in April and 25,000 in May.”

(Mr. Pence did not cite a source for these figures. On the same day his op-ed ran, a leaked update from the Centers for Disease Control and Prevention pegged the average new case rate at 21,398 per day, according to Yahoo News.)

Setting aside the question of whether a strategy that permitted the worst outbreak in the world ought to be considered “a success” worthy of “celebration,” Caitlin Rivers, an epidemiologist at Johns Hopkins, pointed out that the data undermines Mr. Pence’s intimation that the virus is under control.

For countries that succeeded in heading off disastrous initial outbreaks, such as New Zealand, Vietnam, Mauritius and Cuba, reopening may be a comparatively manageable affair. But many countries fell behind the curve, and the United States is far from the only one struggling to safely lift restrictions:

Brazil, for example, Latin America’s largest country, now has the highest daily death toll in the world, and the number of new cases there has skyrocketed in recent weeks. The country’s president, Jair Bolsonaro, has downplayed the pandemic since its beginning and fought to end state lockdowns. “We are sorry for all the dead, but that’s everyone’s destiny,” he said earlier this month.

In India and Pakistan, leaders imposed more serious restrictions, but said they could no longer sustain them without risking economic catastrophe, especially for their poorest citizens.

There are, however, some countries in Europe — namely Germany, France, Spain and Italy — that, like the United States, were initially ravaged by the virus but drove their case rates down much further and have managed to reopen without setting off a spike. Here’s a chart that compares the United States with a contiguous 16-country region of Western Europe with a nearly equivalent population:

Why are these countries faring better? As my colleague David Leonhardt writes, “European countries have used a combination of lockdowns, public health guidance, tests and contact tracing to beat back the virus,” while “the U.S. response has been more scattered and less successful.”

China was even more successful in suppressing new cases, from a peak of more than 15,000 in February to zero in May, by which point many schools and restaurants had reopened. But a small outbreak in Beijing this week has put the country back in “wartime mode,” exemplifying the risks of “going back to normal.” As Adam Taylor writes in The Washington Post, “Beijing’s outbreak shows that even when the virus recedes, there can be no return to normality.”

In terms of its regional variation, the outbreak in the United States resembles the world’s in microcosm. For example, Donald McNeil, who covers infectious diseases for The Times, told Mr. Leonhardt that the states hit hardest and earliest by the virus, like New York and New Jersey, have followed a path similar to those of some European countries: a ghastly peak, followed by an aggressive response and falling caseloads.

The decline of new cases in New York and New Jersey is probably attributable to many factors, including prolonged lockdowns, high testing capacity, orders for residents to wear face masks and gradual reopenings. Whether those states continue to follow the path of Western European countries remains to be seen.

But other states, Mr. McNeil said, have “reopened pretty willy-nilly after pressure from small businesses and citizens who were out of work and frustrated by lockdown and who had not seen the virus hit anyone they knew yet.” Many of those states are now seeing cases and hospitalizations spike: This week, South Carolina, Oklahoma, Arizona, Florida, Nevada, Oregon, California and Texas all reported their largest one-day increases in new cases.

As the pandemic has worn on, our understanding about how the coronavirus spreads has become more sophisticated. Many scientists now agree, for instance, that it transmits less easily outside and from surfaces or animals. At the same time, aerosol scientists have raised concerns that, contra the World Health Organization, Covid-19 may be an airborne disease, meaning the virus may spread through microscopic particles that hang in the air for long periods of time.

The protest factor: Many public health officials and doctors feared that the widespread protests against police brutality would lead to a spike in cases, even if some believed that the cause was worth the potential cost. Interestingly, though, New York City, an epicenter of both the virus and the protests, hadn’t seen a substantive increase in the rate of positive tests as of June 15. But it may still be too early to know whether the protests are contributing to the spread, and we may never know, Mr. McNeil told “The Daily” — especially since the protests are happening at the same time as restrictions are being lifted.

The George Floyd protests were also preceded by the much smaller and much whiter protests against the coronavirus restrictions themselves in April and May. By that point, The Times columnist Jamelle Bouie observed, it had become clear that the coronavirus was disproportionately killing African-Americans and Latinos. The anti-lockdown protests, then, were born in part of a perceived violation of a social contract that holds black and brown suffering as a matter of course, the background music against which American life plays out.

This weekend, President Trump is planning to hold an enormous rally in Tulsa, Okla. Because it will be held indoors in a 19,000-person arena, the city’s top health official said he was “absolutely” worried it could become a “superspreader” event.

Daniela J. Lamas, a critical care doctor in Boston, writes in The Times that when the pandemic first hit, medical workers “were tragically unprepared for the initial deluge of patients.” While there is still no cure for the virus, of course, her hospital is more prepared now, more familiar with the disease and how to treat it, and it helps that Massachusetts has ramped up testing and contact tracing.

Some medical workers have even expressed feeling (very cautiously) optimistic. Ariana Eunjung Cha reported for The Washington Post that doctors “have devised a toolbox, albeit a limited and imperfect one, of drugs and therapies many believe give today’s patients a better shot at survival than those who came only a few weeks before.”

At the same time, “everyone is tired,” Dr. Lamas writes. “The adrenaline of those early days has turned to profound fatigue.” Even as they’re celebrated, medical workers still have to contend with a shortage of personal protective equipment, along with heightened risks of burnout, anxiety, depression and suicide.

Wisdom sometimes attends trauma, but it is not necessarily transferable. “I see photos of the doctors and nurses there gearing up in their P.P.E., and I feel only exhaustion and dread, knowing what comes next — isolated deaths, terrible FaceTime goodbyes,” Dr. Lamas writes. “I had believed that the hard-won knowledge of those of us in hard-hit places like New York City and Boston would begin to spread as efficiently as the virus, but now I am not so hopeful.”

Do you have a point of view we missed? Email us at debatable@nytimes.com. Please note your name, age and location in your response, which may be included in the next newsletter.

“America’s Patchwork Pandemic Is Fraying Even Further” [The Atlantic]

“Can Coronavirus Contact Tracing Survive Reopening?” [The New Yorker]

“All 50 States Are Now Reopening. But at What Cost?” [The New York Times]

“A college reality check” [The New York Times]

Here’s what readers had to say about the last debate: Why the Supreme Court Ruling on L.G.B.T.Q. Rights Is Such a Big Deal

Rosemary from California: “I’ve long wondered why those so adamantly opposed to protecting minority groups from losing their jobs for no reason other than ‘who they are’ don’t consider that if they deny these groups a job, they will have to go on welfare or unemployment which apparently is also not acceptable to them either, to hear them whine and scream about it.”

Benjamin Moser, who was awarded the Pulitzer Prize this year for his biography of Susan Sontag: “I’m astonished by how quickly the oppression of gay people has been forgotten.”