A number of governors across the United States are easing coronavirus restrictions in their states or are announcing plans to do so, despite warnings from public health experts that the nation needs better and more widespread Covid-19 testing capacity before severe social distancing measures can be safely scaled back.
Friday, Gov. Tim Walz of Minnesota reopened golf courses, bait shops, outdoor shooting ranges, parks, trails, driving ranges, and said other outdoor activities will be allowed. Also on Friday, Gov. Ron DeSantis of Florida allowed some beaches and parks to reopen and Texas Gov. Greg Abbott announced imminent plans to reopen state parks, allow retail stores to provide pickups, and to loosen surgery restrictions.
The announcements came as President Donald Trump began releasing guidance for governors on ways they could reengage the economy in phases. Thursday, the president indicated it would be up to state leaders to decide when to roll back restrictions on social distancing and in-person work, despite initially saying he has the “ultimate authority” on the matter.
With more than 700,000 cases and 37,000 deaths nationwide as of April 18 — as well as 22 million unemployment claims filed nationally in the last four weeks, state leaders weighing their choices are increasingly caught between public health concerns and suffering economies. The International Monetary Fund has said the “Great Lockdown” is likely to cause the largest global economic meltdown since the Great Depression.
But in order to ease restrictions, states would need widespread testing to be certain that cases are actually decreasing, and that relaxed social distancing does not lead to an uptick in cases.
Vice President Mike Pence said April 17 that the “best scientists and health experts assess that states today have enough tests to implement the criteria of phase one, if they choose.” But leading experts disagree. While the country has come a long way since early March, nationwide testing is still floundering, with levels too low to paint a comprehensive picture of how the virus is spreading in states, making it unclear whether people congregating — as they did at Florida beaches Friday after restrictions were lifted there — is safe.
More robust testing is necessary to ease restrictions
According to the Covid Tracking Project, the US has averaged fewer than 150,000 tests per day over the last week. Researchers at Harvard University estimate that to reopen the US by the middle of May, daily tests would need to be closer to 500,000 to 700,000. And other experts argue millions of tests would need to be conducted each day.
And the rate of positive tests in the US — about 20 percent — suggests testing is currently inadequate. Experts at the World Health Organization have said countries with robust testing find positive results in fewer than 10 percent of tests, the New York Times notes. This typically indicates a country is testing a wide swath of people, rather than only those who are symptomatic, as US guidelines currently dictate.
To have its confirmed case rate more closely match other countries believed to have similar rates of infection, the US will need to scale up testing rapidly — and in part, this is what social distancing strategies were instituted to help do.
“The whole point of this social distancing is to buy us time to build up capacity to do the types of public health interventions we know work,” Natalie Dean, a biostatistics professor at the University of Florida, told Vox’s German Lopez. “If we’re not using this time to scale up testing to the level that we need it to be … we don’t have an exit strategy. And then when we lift things, we’re no better equipped than we were before.”
But testing has recently plateaued, which state officials say is due to shortages in testing equipment like nasal swabs, reagents, test kits, testing machines, and personal protective equipment. Others argue that the Centers for Disease Control and Prevention’s narrow testing criteria — which prioritizes testing for vulnerable populations, health care workers and hospitalized patients — is leaving many ineligible for testing, Politico’s David Lim reported.
As Vox’s German Lopez noted:
To fix the gaps, experts argue, the federal government needs to relax criteria for testing, invest in new supplies and labs, and better coordinate supply chains to address, among other issues, chokepoints. States, with limited resources and little control of the national supply chain, simply can’t do this all on their own.
Public health officials and experts say that having robust testing will make it possible to trace the spread of the disease if people return to work.
“I want to be able to identify everybody who is even mildly symptomatic,” Ashish Jha, the director of the Harvard Global Health Institute, told Keith Collins of the New York Times. “So when I wake up one morning and have a sore throat and a fever, I should be able to go get tested. And then I want to be able to test all of my contacts if I turn out to be positive, so that I can do the test, trace, and isolate strategy that’s so critical to allowing us to open up and stay open.”
Epidemiologists say there’s a possibility states reopening businesses and easing social distancing requirements too quickly could lead to a second wave of cases and deaths — in a worst-case scenario, that could mean up to 1.7 million Americans dead.
That projection, is of course, based on a number of assumptions that may not be met. And it is possible things could change: As scientists learn more about the coronavirus and its spread, there’s a chance some intervention could make it possible for the country to safely reopen more quickly. However, it’s more likely that states are far from ready to reopen their economies — and that the public should plan to hunker down for stringent social distancing a little longer.