The pandemic has become somewhat of a partisan issue. Many Republican states are reopening early while Democratic states are playing it cautious. The resulting differences in both the impact of the Coronavirus and the local economies are likely to play into this year’s elections.
Several weeks ago, the White House put forth a proposed plan for reopening the country. Triggers for the plan included a 14-day downward trajectory of cases reporting influenza and COVID-like symptoms, a 14-day downward trajectory of confirmed COVID cases or positive tests, the ability of hospitals to treat all patients with crisis care, and having a robust testing program in place. I’m not sure that any state meets these benchmarks, particularly the call for robust testing.
There are fundamental, nonpolitical differences between the majority of red and blue states. Blue states, which are congregated along the coasts, have higher population densities and more urban. This may be why, as Axios points out, blue states have so far had higher rates of both infection and death from COVID-19.
That doesn’t mean that red states are out of the woods yet, however. In the last half of April red states saw higher percentage increases. Statistically this makes sense because an increase of the same number of cases will yield a higher percentage increase where the total number of cases was lower. For example, the addition of 10 cases would be a 10 percent increase in a state that had 100 cases previously, but it would be a one percent increase where there were 1,000 old cases.
Red states, which tend to be more rural and sparsely populated, are more difficult territory for Coronavirus to spread through. That doesn’t mean that it can’t happen. When rural people congregate, the virus can spread rapidly if it is present. Here in Georgia, some of the worst outbreaks outside of Atlanta were spread through religious services.
Where COVID-19 takes hold in red states, it can be deadly. Residents of nonmetro areas tend to be both older and have more underlying health problems than city dwellers. Often age and health problems go hand-in-hand. Both categories are high-risk for COVID-19. Further, demographic data from many southern states show that blacks are far more at-risk for negative outcomes from COVID-19 than whites.
When it comes to reopening, new cases are a more useful metric than deaths. Because COVID-19 takes about three weeks to kill on average, deaths are more of a form of historical data, hinting at the number of infections several weeks ago. New confirmed cases are more useful in determining how fast the virus is currently spreading.
Despite the bad press regarding Georgia’s reopening, Gov. Brian Kemp has handled the situation relatively well. Although the state did not meet the recommended 14-days of decreasing numbers when it reopened, Georgia’s seven-day moving average of Coronavirus cases has now been sharply trending down since April 22. On May 4, Georgia reported only 44 new cases. This is a positive sign that the state has seen the worst of the first wave of cases.
The downside is that many Georgians seem to be no longer following social distancing guidelines. Gov. Kemp lifted the general shelter-in-place order but encouraged Georgians to stay home when possible, but social distancing guidelines and shelter-in-place for “medically fragile” and elderly Georgia residents are still the order of the day. However, many residents seem to think that social distancing and mask recommendations are yesterday’s news. On my recent trips to town, I’ve noted that people congregating more closely and fewer are wearing masks.
In Florida, another hot-button state, cases peaked in late March but have trended down slowly. Per the Florida Department of Health, the Sunshine State is still recording 4,512 new cases per week, more than 600 per day. Yet, Florida began its phase one of reopening on Monday, as it recorded 819 new cases in one day.
The difference between the two states likely reflects a different strategy on reopening. There are at least two schools of thought on when to reopen. One is to move the IHME trend line down to the point where hospitals can cope with the surge of cases. The second is to move the trend line down even further to the point where transmission of the virus is drastically reduced and a secondary flareup is unlikely, at least in the short term. In Florida’s case, the state has achieved the first goal per the current IHME modeling for the state. It is possible that Georgia has achieved the second.
Gov. Greg Abbott of Texas is also taking an aggressive approach. Texas State Health Services reports a stable level of new cases, which increased slightly in late April and early May. Unsurprisingly, the highest levels of Texas cases are in Houston’s Harris County and Dallas County. KHOU reported that there were hundreds of complaints in the days following reopening that Houston businesses were not following the social distancing guidelines established by the governor’s office.
At least two other red states have taken a more conservative approach. In Mississippi, Republican Gov. Tate Reeves delayed the state’s reopening last week after a spike in new cases. The state’s Department of Health website shows a downward trend but notes that recent data may not be complete. Yesterday, Gov. Reeves amended his emergency order to allow some restaurants and businesses to reopen on May 7 if they follow strict social distancing and sanitary guidelines.
In Ohio, the Department of Health reports a 21-day average which has been declining since May 1. At 560 on May 4, the state is far off of its April 19 peak of 1,380 new cases. As a result, Gov. Mike Dewine, a Republican, plans to open about 90 percent of the state by next week.
Governors of both parties are walking a tightrope between rekindling the pandemic and mitigating economic damage. The situation is made all the more difficult by a vocal minority of citizens who are demanding that states be reopened immediately. Recent polling shows that a large majority of Americans, including most Republicans, support social distancing, however, and are more concerned about reopening too quickly than too late.
The rush to reopen states paired with a growing abandonment of social distancing measures at the grassroots level has led to an uptick in projected Coronavirus deaths. In early April, forecasted deaths were revised down to 60,000 following the implementation of the mitigation strategy. The US hit the 60,000 mark last week, however, and, as mitigation strategies are jettisoned, death estimates have more than doubled to 134,000.
To put that number in perspective, it would be more than the number of American soldiers killed in World War I, a number which incidentally included a large number of casualties from the Spanish flu pandemic of 1918. This year the US has had to relearn many lessons of past pandemics such as the Spanish flu. One of those lessons is that reopening too early leads to more loss of life.
“One clear lesson of the 1918 pandemic is to be wary of that kind of thinking,” said James Leloudis, a history professor at the University of North Carolina. “Letting down the guard, in that case, turned out to be disastrous. It’s the same situation we are in now.”
In the midst of the emergency, it is difficult to see what the correct moves are because we don’t have all the information. We don’t know how many people are infected and not tested. We don’t know if there will be additional waves of infections. We don’t know if or when effective treatments and vaccines will be discovered. We don’t even know how many asymptomatic carriers are spreading the disease. What we do know is that reopening earlier will cost an unknown number of lives.
Republican governors are gambling that the disease has largely run its course and that the loss of life from reopening will be minimal enough to be acceptable to the majority of their state’s voters. We won’t know for some time, possibly years, whether these gambles were correct. In November, voters will begin to rule on whether those gambles a good bet.