States Don't Need New Lockdowns to Cut Covid Spread
(Bloomberg Opinion) - Whether you call it a second wave, or more precisely the predictable continuation of a pandemic, Covid-19 is still spreading unchecked in several American states. Florida, Arizona, Texas and other states report record numbers of new cases. And many neglect to take measures that could prevent Covid 19 outbreaks and deaths from potentially causing unmanageable waves.
The heads of state understandably oppose the idea of issuing new instructions for staying at home that would be painful, unpopular, and currently difficult to enforce. Lockdowns averted millions of potential cases in the spring, and they may still be needed when case growth gets out of control. Dull quarantine is not the only way to check Covid-19. In the past few months, scientists around the world have better understood how infections occur and what specific measures they can most effectively prevent. States can and should pay attention to what the experts have learned and use it to guide public behavior towards security.
It won't help dismiss rising case numbers as concentrated outbursts or illusions created by intensified testing, as the Texas and Florida governors did last week. While hot spots are responsible for some of the case growth and testing is ongoing, neither of these reasons explains why thousands of new infections occur in the two states every day. Case growth is widespread and the percentage of tests that are positive - a measure of the extent of uncontrolled spread across the community - is steadily increasing.
Current hospitalizations are increasing in Texas and Arizona. The same may or may not apply in Florida, where this data is inexcusably not reported daily. While the governors want to point out that hospitals have spare capacity, this advantage could quickly disappear. Hospital beds fill up faster than they empty, and Covid-19 doesn't strike, depending on where beds are available. As more beds and hospital staff have to be dedicated to Covid, other care is being pushed aside, which has harmful consequences.
The potentially reassuring news is that Covid-19 mortality remains constant in the four states with the largest new outbreaks. This may be due to improved treatment, more extensive testing that can identify cases early, if they are easier to use, and widespread precautions to protect the most vulnerable, including the elderly. On the other hand, this can simply reflect the fact that mortality rates are a lagging indicator. It takes time to develop a Covid infection that is so severe that intensive care is required, and the sickest patients often spend weeks on ventilators. Many of the deaths this week were due to infections that had occurred in the past month.
A younger outbreak will lead to fewer deaths in the short term. However, each case is a path for possible transmission to an at-risk person, and scientists are still assessing the long-term effects of infection on people of all ages.
Governors should understand that if they pay attention to what experts have observed about the Covid-19 infection, they can lower their fall rates without blocking their economies: well-distributed outdoor activities appear to pose a low risk. Humans do not appear to be easily absorbed by food or surfaces that have touched others. However, the disease spreads easily among people who have been in close contact for long periods in crowded and poorly ventilated spaces. It is therefore possible to limit the transmission by restricting crowds and demanding social distancing indoors. People who are only a meter away from others have a dramatically lower risk of infection than people who come closer, and the risk decreases with distance.
The widespread use of masks in high-risk situations further reduces the risk of infection. Mask mandates in 15 states may have prevented up to 450,000 Covid cases in the US, according to a recent study published in Health Affairs.
Effective public health efforts to track new infections and to track and isolate infected people's contacts can reduce the risk of infection by more than half in a population, according to a new model by UK researchers. While such efforts are useful to curb any infectious disease, they are especially for those like Covid, who often do not cause symptoms and are easily transmitted in private households.
The limitation is, the more viruses circulate in a community, the more difficult it is to be ahead of the spread with testing and contact tracking. Targeted repression measures take longer than extensive blocking. In other words, to avoid the need for new jobs to stay at home, states need to act more urgently to take more targeted action.
Of course, most states, including those where the number of cases is increasing, recommend social distancing and maintain some capacity limits for retailers. However, widespread reports of careless behavior and re-growth of cases suggest that either the rules are too lax or people simply don't follow them. Of course, it is not enough to just ask people to protect themselves. It takes effort and consistent communication to change behavior enough to change transmission dynamics.
This is especially true for masks that have been politicized in the United States. Covering your face before entering a grocery store is seen as an easy way to protect yourself and others. Unfortunately, neglecting this basic human courtesy has become a form of protest against government overreach.
Heads of state can and should try to counter such protests - also by largely requiring that masks be worn, as California Governor Gavin Newsom did last week. Governors who still have their feet on masks don't seem to care so much about saving lives. Faced with the worst new Covid outbreak in the country, Arizona governor Doug Ducey has finally allowed local officials to request masks, but he still leaves politics up to local communities. Texas Governor Greg Abbott now allows local mask mandates, but only if officials indirectly impose them on business rather than people.
There are many ways that heads of state can lead people to behave safer, bend their Covid 19 curves down, and strengthen their economies. It's just about paying attention to how the corona virus spreads.
This column does not necessarily reflect the opinion of the editors or Bloomberg LP and its owners.
Max Nisen is a Bloomberg Opinion columnist who deals with biotechnology, pharmaceuticals and healthcare. Previously, he wrote about management and corporate strategy for Quartz and Business Insider.
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