This story has been updated to correct the number of states that have not met White House Coronavirus Task Force guidelines. A previous version of the story counted states as not meeting the guidelines if they did not show fewer cases and a declining percentage of positive tests. The guidelines only require states to meet one of those criteria, not both.
Around the U.S., states are debating whether and how to reopen their economies and lift social-distancing measures. But are they ready?
Whether they are or not, many are moving ahead. President Donald Trump insisted on Tuesday that the country had to reopen its economy, even at the risk of more infections.
“Will some people be affected? Yes. Will some people be affected badly? Yes. But we have to get our country open and we have to get it open soon,” Trump said.
Last month, the White House Coronavirus Task Force laid out a series of “gating criteria” meant to guide states on lifting restrictions and getting back to normal. They include a decline in symptoms of the virus as monitored by local health networks, fewer cases or a declining percentage of positive tests, and hospitals systems that can handle the strain of the outbreak.
Bloomberg News’s analysis found that states that have lifted restrictions don’t meet the White House guidelines for reopening. Many are moving ahead anyway.
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For weeks, states have faced pressure to lift restrictions and get their economies running again, even at the risk of more illnesses. “The cure can’t be worse than the disease,” Trump tweeted on March 22, in apparent reference to the measures states have taken. In the weeks since, Trump has alternated between urging states to lift restrictions, chiding some who have moved to do so, and backing away from taking charge of the reopening.
By mid-April, the president said 29 states would be able to reopen “relatively soon.” According to a Bloomberg News analysis of state data, at least states still fail to meet the White House’s criteria. In some states, rates of infection are still rising.
Testing is one of the core criteria for reopening agreed upon by the Trump administration and health experts, though some health experts have said the White House guidelines are too loose. The task force says that states should either have a 14-day downward trajectory of documented cases, or a 14-day downward trajectory of positive tests, as a percentage of total tests, so long as the volume of tests is flat or increasing.
“You can have a downward slope and it’s meaningless,” George Rutherford, the head of infectious disease and global epidemiology at the University of California San Francisco, told Bloomberg News in April. With the “or” criteria, states fail to meet the White House’s guidelines. If states had to meet both criteria, would fail.
The nation’s governors are effectively in charge of reopening efforts, and New York, California and other Democrat-governed states have been cautious about moving ahead.
In Iowa, which is in the first phase of reopening, influenza-like illness symptoms and case counts grew. Like many other states, Iowa is seeing workers return to their jobs, even if they are worried about their health during an ongoing pandemic.
South Dakota, which never implemented the harsh measures some other states did, has had a significant outbreak at a meat processing plant in Sioux Falls. In Texas, protesters called for reopening the state’s economy by mid-April, despite increasing case counts.
Some Republican-run states have moved ahead quickly, including GOP strongholds like Texas, Alabama and Georgia. Texas’ reopening is focused on reducing occupancy to only 25% in non-essential businesses like retail stores, restaurants, movie theaters, malls, museums and libraries. The first phase of the state’s reopening, which includes statewide testing and contact tracing, will last until May 18.
As states begin opening back up, local health authorities are watching for a potential surge in new infections. Some experts have warned that, because there are more cases “seeded” in the community, a second wave could be far worse than the first.
“We have to have something in place that is efficient and that we can rely on, and we’re not there yet,” Fauci said in an interview with The Associated Press in mid-April. “I’ll guarantee you, once you start pulling back there will be infections.”