
For instance, in my state of Pennsylvania, COVID-19 cases have been slowly decreasing since their peak in early April. But when I check today’s numbers, new cases are still just as high as they were on March 29. Would I have felt safe going out to a restaurant that day? Absolutely not. That’s when we were realizing that a short lockdown wouldn’t be enough, and schools and businesses would remain closed for a longer time.
Cases continued to rise for weeks after that, despite new distancing measures. It’s likely they will surge again whenever restrictions are loosened. As a widely-shared Facebook post reminds us: 'The end of stay-at-home orders doesn’t mean the pandemic is over. It means there’s now space for you in the ICU.'
The number of cases continued to climb for several weeks despite the new distancing measures. We can expect another surge when restrictions are eased. As a popular Facebook post says: 'The end of stay-at-home orders doesn’t mean the pandemic is over. It means there is now room for you in the ICU.'
Another crucial point often overlooked is that choosing to stay home (when possible, for those with the means) isn’t just about safeguarding yourself. It’s about removing yourself from the transmission chain that could otherwise spread COVID-19 from a severely ill individual to someone’s elderly relative.
Reopening does not equate to safety.
Easing restrictions is more of a political decision than a scientific one. 'Reopening' often means businesses can pressure employees to return to work if they wish to keep their jobs, for instance.
Gina Kolata recently pointed out that historians differentiate between the 'social' and 'medical' end of a pandemic. We could simply grow tired of dealing with the pandemic and start behaving as though it’s over, even while the virus continues to spread. From a medical perspective, this could lead to disaster. (As one historical example: during the 1918 influenza pandemic, a deadly first wave hit in the spring, followed by a much larger second wave that autumn after restrictions were lifted, claiming far more lives than the first wave.)
Each state government has devised its own criteria for determining when it might be safe to reopen. However, these metrics seem to be chosen more for convenience and public perception than for ensuring actual safety, as Michael Hobbes writes in the Huffington Post, and I agree with him.
Only time will reveal the true impact.
When determining when and how to reopen, many states are looking for a decrease in case numbers, but these numbers always trail actual infections by weeks. It takes time for symptoms to appear, and even more time for a person to get tested and receive results. Today's case count doesn’t reflect the infections occurring today; we won’t know that for weeks. Death counts lag even further because this virus can take a month or longer to cause death. As Undark explains here, at any point on an upward curve, if you time-traveled back to that day, the curve would give the impression that deaths had already peaked and were dropping—but this is simply because the data hadn’t been fully reported yet.
Another layer of complexity comes from the varying interpretations of 'reopening.' (I’ve mentioned before that our shared vocabulary for pandemic-related phenomena is woefully inadequate.) Each state or country may look to others that have begun easing restrictions earlier, but that doesn’t mean they will adopt the same approach. Some areas may have opened gyms and salons early; others may open them much later. In some regions, people may rush out maskless as soon as they’re allowed; in others, people may remain cautious and continue staying home even though it's no longer required.
I find it fascinating to compare a state’s reopening plan with national guidelines, and then with the World Health Organization’s checklist. The latter is particularly insightful, especially when considering the transmission control section. Do we have a strong enough infrastructure for testing and contact tracing to identify every case and stop it from spreading? Once we have that, I’ll feel much more comfortable with easing restrictions.
