The Problem with the Rush to Reopen
When President Donald Trump announced his “Guidelines for Opening Up America Again” this week, there were lots of feel-good, public-relations niceties attached. The guidelines, which described “a three-phased approach based on the advice of public health experts,” would “help state and local officials when reopening their economies, getting people back to work, and continuing to protect American lives.”
The key term used in the plan is “downward trajectory.” Before states consider proceeding to the first phase of reopening their businesses and other private activities, they are advised to demonstrate:
- a fourteen-day period with a downward trajectory of reports of “covid-like syndromic cases”;
- a fourteen-day period with a downward trajectory of “influenza-like illnesses”; and
- a fourteen-day period with either a downward trajectory of documented COVID-19 cases or a downward trajectory of positive COVID-19 tests (assuming the volume of testing doesn’t shrink).
On the surface, this seems fairly simple. If a state meets those downward-trajectory criteria over a fourteen-day period, it is advised to pass on to “Phase One” of the reopening. If the numbers do not go down during that period, then start over again. So, on a plain reading of these guidelines, if a state wanted to begin the process of reopening its businesses and cultural activities today, on April 18, it would have to show it has had a downward trajectory in documented cases since April 4.
Trump predicted that there are 29 states that can begin the opening soon and several that could start the process right away. Those “right away” states, he said, include Utah, Montana, Wyoming, and North Dakota. Those states “are in great shape already,” Trump said Thursday. “They will be able to go literally tomorrow, yes.”
Let’s take a closer look at those states. While the national news media has, understandably, been focused on some of the huge case numbers declining a bit in New York, California, and Washington—where COVID-19 cases first hit and may have peaked—the middle of the country is now seeing increases. The disease hit the coasts first but now seems to be moving inland. The case numbers in these more rural Middle America states may not be huge, but politically these states tend to be more red than blue, and the Trump administration appears to want them to move on from the crisis quickly.
But here’s the problem: the “downward trajectory” that the White House laid out as the key to reopening the economy is just not there. The numbers are going up in Middle America, not down.
Consider the four states that Trump indicated could open up “literally tomorrow.” None of them has big case numbers, but over the last fourteen days, the number of cases has been going up on about half of their day-to-day comparisons.
In Utah, the count of newly reported cases from April 13 to 15 went up from 48 to 122 to 134. In North Dakota, the new cases identified daily by the state health department from April 12 to 16 have been 23, 10, 24, 28, and 46. While the numbers in Wyoming are tiny, there were five days during the last two weeks in which the number of new confirmed cases was equal to or higher than the day before. In Montana, on several days in the past two weeks (including April 8 and April 10), the new cases were higher than the day before.
For the sake of argument, let’s accept that the “downward trajectory” criteria are the right ones for starting to reopen state economies. What, exactly, does the term “downward trajectory” mean? Does it mean that during each day of the fourteen-day period, the relevant numbers must be lower than the day before? Or does it mean that the overall trend must point downward during those fourteen days, if you draw an average line through the graph, even if specific days might blip higher than the days that came before? And, given the lag time in data reporting, is fourteen days—roughly the outside of the normal range of the coronavirus incubation period—a long enough period for demonstrating declining cases?
Again, the number of cases in these four states is still low, and the day-to-day increases are, in some states, in the single digits. It may seem unwise to, say, shut down restaurants in Bozeman, Montana because Gallatin County has reported just 142 total COVID-19 cases so far, and no deaths.
Fair point, but the problem here is not just these states but the other twenty-plus that Trump thinks will soon be able to get back to open restaurants and sporting events and no quarantining. Trump is trying to sell his base on the idea that it is not him, it’s the Democrats who are doing them damage.
In Michigan and Texas, there have already been protests over the stay-at-home orders, with some of the protesters claiming that a decline in cases means their state should open back up. (See Charlie Sykes’s Bulwark piece on “the coming populist libertarian rebellion,” in case you missed it.) But there has not been a clear decline in those states during the last two weeks.
In Michigan, from April 10 to April 16, the number of new cases added each day has been 900, 545, 679, 888, 667, 1,197, and 647. In Texas, the daily new cases numbers from that same time period have been 1,441, 890, 923, 422, 718, 868, and 963. Hardly a downward trajectory.
Much the same is the case in Oklahoma, Kansas, and Kentucky. In Florida, one of the last of the big states to shut down, Republican governor Ron DeSantis has talked about reopening very soon. “You’re not going to have large gatherings out there. You just got to do it in a way that is going to have low risk,” he said at a recent press briefing. Meanwhile, the rate at which new cases are being reported in the state looks more like a plateau so far than a clear decline:
In recent days, several governors have raised the issue that unless COVID-19 testing is vastly ramped up, reopening state economies will be very risky. Trump completely dismissed that concern. “We’ve already built sufficient testing capacity nationwide so states can begin their reopenings,” he said on Friday.
He also took some political potshots on Twitter, including this:
Biden/Obama were a disaster in handling the H1N1 Swine Flu. Polling at the time showed disastrous approval numbers. 17,000 people died unnecessarily and through incompetence! Also, don’t forget their 5 Billion Dollar Obamacare website that should have cost close to nothing!
— Donald J. Trump (@realDonaldTrump) April 17, 2020
The same day Trump was tweeting about the number of swine flu deaths a decade ago, the U.S. death toll from the coronavirus passed 37,000 and the total U.S. number of confirmed cases crossed 700,000. Fourteen days ago there were 7,000 deaths recorded, and about 260,000 cases.
Meanwhile, Texas governor Greg Abbott on Friday announced the creation of a statewide task force of medical and economic experts to reopen the state in early May. “Because of the efforts by everyone to slow the spread, we’re now beginning to see glimmers that the worst of Covid-19 may soon be behind us,” Abbott said at a news conference. But in the week since April 10, Texas has seen its cumulative confirmed cases of COVID-19 rise by 49 percent and its death count rise by 89 percent. I’m not sure what “glimmers” Abbott is seeing, but the Texas statistics certainly don’t yet look like a “downward trajectory.”