Trump Says Some States Are Ready to Reopen. The States Aren't So Sure.
Trump Says Some States Are Ready to Reopen. The States Aren't So Sure.
(Bloomberg) -- The White House is encouraging states to begin opening back up and lifting social-distancing measures put in place to stop the spread of the coronavirus. But a review of the outbreaks in states mentioned by the administration as ready to go indicated that they don’t actually meet the criteria to do so.
On Thursday, President Donald Trump cited several states including Montana and Utah as being close to safe to reopen, and said that 29 states will be able to reopen “relatively soon.” He followed up Friday morning, tweeting that states such as Minnesota, Michigan and Virginia, should “liberate” themselves.
Under White House guidelines released Thursday, for states to open up they should have decreasing signs of illness as monitored by health surveillance networks and fewer cases being confirmed by tests over a two-week period, a health-care system capable of treating all patients, and sufficient diagnostic capacity in place.
“You're talking about those states that are in great shape already?” Trump said when asked about when states would meet the White House criteria. “They will be able to go literally tomorrow, yes—because they've met all of the guidelines.”
Few of the states name-checked by Trump actually appear to meet the task force’s criteria, however.
Responding to a question Thursday, Trump suggested that Hawaii was ready to go. But a spokesperson for Hawaii Governor David Ige, a Democrat, told Bloomberg that the islands haven’t met the goals laid out by the administration. The state has in fact seen a steady increase in documented cases in the last 14 days, and the Hawaii Health Department's data shows a decrease in the volume in tests in that period. Under the White House criteria, states can open up if a smaller percentage of tests are coming back positive—but only if the number of tests is steady or increasing.
Wyoming’s inclusion by Trump was a surprise to the office of Republican Governor Mark Gordon, said spokesman Michael Pearlman. “We certainly don’t meet all the requirements,” Pearlman said. No shelter-in-place order has been issued there but the governor has stuck with April 30 as the end date for other restrictions put in place by the state.
Utah, one of the states acknowledged by Trump as “able to go literally tomorrow,” has seen a decline in the number of positive cases since an April 2 high of around 200. The number of tests the state has conducted has also been steadily declining, according to the state’s health department, meaning that cases could be falling only because they aren’t being tested for. That appears to violate the White House’s criteria, which requires testing rates to steady or increase.
Opening Up
Some states are moving ahead. On Friday, Texas Governor Greg Abbott, a Republican, announced he’d relax restrictions next week. In Idaho, the state is beginning to reopen some non-essential businesses, including flower shops and jewelry stores for curbside pick up ahead of Mother’s Day. North Dakota Governor Doug Burgum, also a Republican, has set guidelines for a gradual reopening process after April 30. Montana will start a “phased reopening” from April 24, Governor Steve Bullock tweeted on Friday, adding “Because once we begin to reopen, we want to be able to stay open.”
Health experts question the White House’s rules and say they’re too easy to meet. Under the White House guidelines, state health departments should show a downward trajectory of documented cases or of positive tests as a percent of total tests, within a 14 day period. Healthcare experts take issue with the “or,” saying both should be proven before reopening.
“You can have a downward slope and it’s meaningless,” said George Rutherford, the head of infectious disease and global epidemiology at the University of California San Francisco. A state with 5,000 positive cases per day that fall to 4,000, and a state that had 100 cases that drop to 20, would both meet the criteria despite huge differences in the prevalence of the virus, he explained.
The guidelines are little more than a “speed bump” to reopening, rather than an order to thoroughly assess whether a state is ready, Rutherford said. “The criteria are pretty easily met.” He said he is concerned about more potential outbreaks, particularly in large southern and midwestern cities that were slow to adopt social-distancing measures.
A key tool in the effort to reopen states is testing. Health workers on the ground need large-scale diagnostic tools to identify patients and track down anyone they might have been in contact with. On Friday, the administration task force said that it aimed for the country to be processing more than the 1 million to 1.2 million it's currently doing per week.
“We’ve already built sufficient testing capacity nationwide so states can begin their re-openings,” the president said Friday at the White House, where the task force said the U.S. aims to process at least 1 million tests per week.
While testing has expanded significantly over the last month and a half, laboratories continue to report shortages of everything from swabs and protective equipment to collect samples to the chemicals and technicians to run the tests. The White House has said it’s investigating how it can help labs address issues so that they might reach their maximum capacity, but it is unclear how quickly such myriad and complex issues might be resolved.
John Ioannidis, a professor of medicine and epidemiology at Stanford University, called the task force’s measures “crude” ways of tracking the spread of a virus in the community.
“In principle they’re reasonable. It makes sense you want to see cases going down for a while, and hospital bed capacity improving and testing readily available,” he said. “But the devil is in the details.”
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