Over the past several weeks, with the lifting of stay-at-home orders across the country, we have seen a day-over-day increase in the number of new Covid-19 cases reported in several states. Some observers are sounding the alarm that another public-health crisis looms. Implicit to this message is the need to return to a more restrictive mitigation policy.

But when we take a closer look at the public-health data, the situation does not merit this level of anxiety. It was obvious that as we lifted stay-at-home orders and simultaneously expanded testing, the number of new cases reported each day would trend upward. Before we declare the rise in cases a resurgence of the public-health crisis of March and April, we need to understand the difference in context between then and now.

The major public-health concerns when stay-at-home orders were mandated were the increasing number of deaths, hospitalizations, and admissions to critical-care units. Also, policymakers knew that we did not have sufficient availability of antigen tests, ICU beds, and personal protective equipment (PPE) to combat the virus spread and prevent deaths and hospitalizations. The dramatic steps the United States took in March and April made a major impact on our social and commercial life; they were necessary to prevent the spread of the virus to vulnerable people and protect the health-care system and workers.

Today, the situation is different, and our response should be different. Covid-19 deaths, hospitalizations, and emergency-department visits are down almost everywhere in the country, most likely due to our improved ability to protect the vulnerable and to treat those who need hospitalization. In addition, testing is more widespread, contact-tracing capacity has increased, and PPE is more widely available.

We see the disconnect between the number of daily cases and deaths in Florida. The state relaxed its stay-at-home orders in mid-May. Two weeks later, at the start of June—and about the time that one would expect to see increasing cases if the lifting of stay-at-home orders had an impact on transmission—the number of new cases started growing day-over-day. Since then, the number of daily cases has continued to grow; but over the same period, the number of daily deaths has dropped by more than half.

If the context has changed, what should our current policies on reopening the economy be? The data support moving forward with gradual reopening of commercial and social activities. As with all public policy, permitting normal life to resume will bring costs and benefits. Based on current conditions, the cost of limiting social and commercial activities outweighs the benefit of preventing further spread of the infection. This assumes that we continue to protect those most vulnerable for severe illness—the elderly and those with serious preexisting conditions—and closely monitor high-risk places such as prisons and long-term-care facilities. This approach also requires that we practice consistent containment strategies such as wearing facial masks where appropriate, practicing diligent hand-washing, and maintaining social distancing to the extent possible—especially indoors—to protect others. We must not lose sight of what caused a public-health crisis in March and April, but we should also consider how the context of the pandemic has changed since then.

Photo by Al Bello/Getty Images


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