On Thursday, Donald Trump previewed his nightmare plan to encourage state governors and local officials to loosen social distancing guidelines put in place to slow the spread of the novel coronavirus through the nation, saying people need to be allowed to physically return to their workplaces soon.
As the virus surged to all 50 states, DC, and three U.S. territories (with over 81,000 cases reported as of Thursday afternoon—more than any other nation on Earth), markets have gone into a nosedive and millions have lost their jobs. States and localities have imposed shutdowns of non-essential businesses and restrictions on gatherings, while the Centers for Disease Control and Prevention has put in place advisories calling for school closures, working from home when possible except in in “critical infrastructure” industries, and avoiding all indoor and outdoor venues where people gather.
These measures are necessary to lower the number of people who contract the virus at the same time; hospitals in some regions are already overwhelmed by the scale of the outbreak. One in Queens, New York, ordered a refrigerated truck to store corpses. Social distancing guidelines can help delay and lessen these kinds of outcomes but take a great deal of time for the effort to pay off. The U.S. has only been recommending those measures on a national scale for a bit over a week.
Meanwhile, Trump has openly bristled at these restrictions and their impact on the economy. He thinks they could be a “cure worse than the problem” and people should go back to work as soon as possible, suggesting the absurd timescale of that happening by Easter, which is in few weeks. Hence the president’s letter to governors on Thursday, in which he said the White House would classify individual counties throughout the country as “high-risk, medium-risk, or low-risk,” as well as “suggest” guidelines for those areas:
Our expanded testing capabilities will quickly enable us to publish criteria, developed in close coordination with the Nation’s public health officials and scientists, to help classify counties with respect to continued risks posed by the virus. This will incorporate robust surveillance testing, which allows us to monitor the spread of the virus throughout the country. Under these data-driven criteria, we will suggest guidelines categorizing counties as high-risk, medium-risk, or low-risk.
Trump added in the letter that the data would give governors and local authorities information they need for “maintaining, increasing, or relaxing social distancing and other mitigation measures they have put in place.”
That’s nice in theory. But Trump can’t lift state and local restrictions himself, and his intent is clearly pressuring policymakers who imposed them to loosen restrictions on large stretches of the country for the sake of a mythical economy that just needs to be kicked back into motion. Public health experts are instead warning that the worst is still yet to come and that officials need to maintain harsh measures or even increase them to prevent the potential collapse of the entire health care system.
The most troubling thing about this is that put-people-back-to-work conservatives and public health experts are actually agreed on one point: doing so prematurely will harm efforts to slow down community spread of the outbreak, raising the number of cases, and ultimately killing more people than if stricter rules remained in place. The opponents of the stricter emergency measures just are haggling about how many more deaths would be caused while explicitly saying that they view that number as an acceptable tradeoff.
Aside from the jaw-dropping lack of concern for the effect this will have on vulnerable populations, this line of thinking overlooks the fact that deaths and panic may, in fact, not be so great for the economy. (Per Slate, even some prominent Republicans like Ohio Governor Mike DeWine and South Carolina Senator Lindsey Graham have cautioned that this is way too early to back down on mitigation efforts.) Then there’s the fact that Trump’s plan relies on a widespread coronavirus testing infrastructure that does not exist—tests are still in limited supply—and which he said as recently as yesterday might not even be necessary.
“We could go to certain states right now that have virtually no problem or a very small problem,” Trump opined to reporters on Wednesday, per CNN. “We don’t have to test the entire state in the middle west, or wherever they may be. We don’t have to test the entire state. I think it’s ridiculous. We don’t have to do it. A lot of those states could go back right now, and they probably will because at some point in the not-too-distant future, certain states are going to come off the rolls.”
Per BuzzFeed, Trump’s own health experts including Surgeon General Jerome Adams, coronavirus task force coordinator Dr. Deborah Birx, and National Institute of Allergy and Infectious Diseases director Dr. Anthony Fauci have all pushed back on Trump’s ambition to have restrictions eased in a few weeks.
“We really need to expect that the whole country’s at risk here, and we have to look across our health care system within each jurisdiction to have them be as strong as possible,” CDC principal deputy director Anne Schuchat told the Hill on Thursday. “... It would be surprising to me, based on what I’ve seen about how this virus spreads, if it were not going to increase in many other parts of the country. I would be very reluctant to let up on measures in the nation as a whole. There are probably geographies where the virus hasn’t yet arrived in great force but where the health-care system needs to be prepared for it.”
According to the Atlantic, experts they consulted find it highly unlikely that life will return to normal for at least three to four months. Because it takes weeks from infection to patients showing up in intensive care units, Harvard T. H. Chan School of Public Health epidemiology professor William Hanage told the magazine, solid data showing which containment efforts work and which don’t will take time to emerge. Per Wired, due to this protracted timeline, the effects of national social distancing recommendations for the first two weeks won’t “start showing up until the end of April or beginning of May at the earliest.”
“You can’t call off the best weapon we have, which is social isolation, even out of economic desperation, unless you’re willing to be responsible for a mountain of deaths,” NYU Langone Medical Center bioethics professor Arthur Caplan told the New York Times earlier this week. “Thirty days makes more sense than 15 days. Can’t we try to put people’s lives first for at least a month?”
“Anyone advising the end of social distancing now needs to fully understand what the country will look like if we do that,” John Hopkins health security expert Dr. Tom Inglesby told the Times. “Covid would spread widely, rapidly, terribly, and could kill potentially millions in the year ahead, with huge social and economic impact.”
“Most infectious disease experts are concerned about right now being too soon—far too soon—to end social distancing measures here in the U.S.,” computational epidemiologist Maia Majumder told BuzzFeed. “The thing about public health interventions is that it usually takes some time before we actually see their effects at the population level.”
It’s true that social distancing cannot go on forever. But ending it will require the kind of massive federal effort that Trump has so far resisted. Per Vox, medical experts say that will require surveillance testing en masse to track where the virus is spreading, coupled with much more rapid tests, intervention to isolate the unwell, tracing individuals that came into contact with the sick, and increased production of crucial medical supplies like personal protective equipment and ventilators.
As CNBC noted, there is no nationwide surveillance testing system in place, and the Senate only allocated $500 million for the CDC to create one in the relief bill it passed this week.