The United States reported a record number of new coronavirus cases as it headed into a holiday weekend. Health officials and experts attribute the rise in cases to reopenings across the country, uneven use of masks and increased travel. Three experts discuss what they have learned about coronavirus transmission during reopenings \u2013 and urge caution over the upcoming holiday weekend.<\/p>\n

Where has re<\/strong>opening in the US<\/strong> been successful and where has it led to a surge<\/strong> in cases?<\/strong><\/h2>\n

Saskia Popescu: <\/strong>Washington state reopened over the course of several months. In Arizona, where I live, we started allowing elective surgery on 1 May and let our stay-at-home orders expire on 15 May. This was very, very quick. [Editor\u2019s note: In Washington, cases are slowly rising, whereas Arizona has seen a more dramatic increase.]<\/em><\/p>\n

As a state reopens, you really want to see consistent decreases in cases over about two weeks. <\/strong>You want to take an incremental approach, to make sure that you\u2019re not getting a bunch of new cases and obstructing public health.<\/p>\n

What are we learning about transmission as cities and states reopen? What activities are high-risk versus low-risk?<\/strong><\/h2>\n

David Rubin:<\/strong> Clearly, indoor bars have been a huge part of this outbreak in terms of transmission. Closure of bars, particularly during the current wave of the epidemic, would be very helpful.<\/p>\n

Popescu: <\/strong>We know going to the bar is high-risk. We\u2019ve been saying this since February. Going outside for a walk or a picnic is a lower risk. As we learn more about asymptomatic transmission, that really stresses the importance of mask-wearing.<\/p>\n

Karan:<\/strong> Indoor transmission is significantly higher than outdoor transmission. At the peak of [Boston\u2019s] epidemic, most of the cases I saw were people who had [confirmed] Covid-19 cases at home. We know that the workplace is high-risk because they\u2019re not really designed for an epidemic.<\/p>\n

The vast majority of us in public health expected a spike from the protests, even though we knew they were critically important. The lack of that [surge] speaks to the fact that masking works and being outdoors helps a lot.<\/p>\n

Do you think states are going to have to go back into full-on lockdowns?<\/strong><\/h2>\n

Popescu:<\/strong> People view it as a dichotomy \u2013 you\u2019re either open or closed. Right now is a really good time to focus on communicating risk and harm reduction; you can still run errands or see a friend or two and do it safely.<\/p>\n

Karan: <\/strong>Lockdowns are not a strategy \u2013 they\u2019re an emergency backstop that represents a failure to stay on top of the outbreak. The strategy out of this is one of using personal protection, like masks, tests, tracing and quarantining.<\/p>\n

Rubin: <\/strong>Places like Texas, Florida and Arizona might need to pause \u2013 meaning going back to quarantine and only allowing carry-out from restaurants \u2013 for a few weeks to get case counts down and let healthcare facilities start to recover.<\/p>\n

Reported cases are going up but deaths are going down. Why?<\/strong><\/h2>\n

Rubin: <\/strong>More young people are represented in the cases, which will bring down your aggregate fatality. Second, we may be getting a little better at treating the disease.<\/p>\n

The worry there is people will become complacent, and then in the fall, we\u2019ll see both transmission and fatality go up again. That\u2019s what happened in the 1918 flu pandemic.<\/p>\n

Popescu:<\/strong> Part of this is that mortality rates are a lagging indicator, but I\u2019m also hopeful that as we detect more cases, they\u2019re of less severe disease.<\/p>\n

Will new infections inevitably spread to places like New York, which has significantly reduced its number of cases?<\/strong><\/h2>\n

Rubin:<\/strong> What\u2019s really concerning is that this week, after all the hard work that the north-east and the midwest did \u2013 they waited the longest to reopen \u2013 their risk of transmission is going up. That includes New York.<\/p>\n

People are talking about Florida, Texas and Arizona, but we\u2019re also seeing elevated activity across the I-90 corridor in upstate New York. The Chicago area is also heating up again. These areas we had touted as successes might get engulfed and consumed by surrounding risk and travel from high-risk areas.<\/p>\n

What this shows is that we needed a national response to meet this challenge.<\/p>\n

There was a surge<\/strong> in cases following Memorial Day weekend <\/strong>\u2013 when many Americans traveled for the first time since the lockdowns began. Are you concerned about the upcoming holiday weekend?<\/strong><\/h2>\n

Popescu:<\/strong> Arizona closed bars for 30 days, and the governor has [urged caution] going into the weekend. But then President Trump is hosting an event at Mount Rushmore<\/a> where you can\u2019t socially distance and masks haven\u2019t been encouraged. It\u2019s hard when you have competing messaging.<\/p>\n

Rubin:<\/strong> Clearly [the current surge in cases] began after Memorial Day, when travel resumed. And now we\u2019re adding an explosive cocktail in the middle of a deteriorating situation. It\u2019s very concerning.<\/p>\n

Dr Fauci\u2019s warning about the potential for 100,000 new cases a day<\/a> was conservative.<\/p>\n

Experts:<\/strong><\/p>\n

<\/p>\n

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  David Rubin<\/strong>, director of PolicyLab at Children\u2019s Hospital of Philadelphia and a professor of pediatrics at the Perelman School of Medicine at the University of Pennsylvania<\/p>\n<\/li>\n<\/ul>\n

  <\/span><\/p>\n

  \n
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    Saskia Popescu<\/strong>, <\/strong>epidemiologist with George Mason University and University of Arizona<\/p>\n<\/li>\n<\/ul>\n

    <\/span><\/p>\n

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      Abraar Karan<\/strong>, <\/strong>emergency room physician at Brigham & Women\u2019s hospital<\/p>\n<\/li>\n<\/ul>\n

      <\/span><\/p>\n<\/div>\n<\/div>\n

      Read More<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

      The United States reported a record number of new coronavirus cases as it headed into a holiday weekend. Health officials and experts attribute the rise in cases to reopenings across the country, uneven use of masks and increased travel. Three experts discuss what they have learned about coronavirus transmission during reopenings \u2013 and urge caution…<\/p>\n","protected":false},"author":1,"featured_media":51779,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"tdm_status":"","tdm_grid_status":"","footnotes":""},"categories":[23],"tags":[1498,160],"class_list":{"0":"post-51778","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-news","8":"tag-learning","9":"tag-were"},"yoast_head":"\n