Q&A: COVID-19 cases spike after states loosen restrictions

Many states are experiencing spikes in COVID-19 cases after reopening businesses and loosening social distancing restrictions that were put in place to help prevent the spread of the virus.

For instance, the Florida Department of Health reported 5,266 new COVID-19 cases on June 28, up from the 2,926 new cases reported during the previous week.

“While the past few weeks saw cases begin to trend downwards, there are a number of states across the United States, particularly in the Southeast and Southwest, that are seeing increases,” CDC Director Robert R. Redfield, MD, said during a press briefing. “Evidence tells us that these increases are driven by many factors, including outbreaks in settings that are particularly challenging, as well as increased testing, and community transmission as well.”

To mitigate rising case numbers, some states that have experienced sharp increases in COVID-19 cases have closed certain types of businesses — such as bars and restaurants — and have attempted to mandate the use of face masks in public places.

Healio Primary Care spoke with Ravina Kullar, PharmD, MPH, FIDSA, an infectious diseases specialist and epidemiologist and a spokesperson for Infectious Diseases Society of America, to learn more about whether some states reopened too early and what these states can do to prevent further increases in COVID-19 cases.

Q: Did some states reopen too early? If so, can you provide examples?

A: Yes. More than 30 states have seen a spike in cases — COVID-19 has come back with a vengeance. All 50 states have begun to reopen in some way, but there are substantial variations in how states are deciding to open up. Tanning salons, bars, pools, casinos, places of worship, nail salons, tattoo parlors — all too early to have opened back in May or early June — [opened in] states such as Texas, Georgia, Florida, South Carolina [and] Arizona. Many of these states let their stay-at-home orders expire at the end of April. Simply reopening the state didn’t mean that everyone could walk around like they did pre-pandemic. The message has not been consistent state to state. Also, many people have started to relax masking, physical distancing and infection prevention, thinking that this virus behaves like influenza — in other words, thinking that because summer has hit, this virus will disappear. This is not the case, as we can clearly see with the spike in cases in the states mentioned above.

Q: Should states that reopened and are now experiencing a spike in cases consider reinstating stay-at-home orders?

A: I think reinstating stay-at-home orders is too harsh right now; however, closing certain highly crowded areas such as bars, pools, casinos or putting more strict measures in place in these settings is more realistic — Texas, for instance, is now closing bars. There has to be a continual discussion from the states emphasizing [that] we are still in a pandemic, to wear masks/face shields, physically distance, avoid large crowds, and the importance of hand-washing. There have been more deaths due to this virus than cancer or heart disease.

Q: In some cases, is it too late to reinstate stay-at-home orders?

A: Yes. In all of the states, I believe, it will be very hard for people to go back to stay-at-home orders. That’s why closing certain businesses first may be the better way to go.

Q: Some people are showing hardened resistance toward masking orders, let alone calls to close the economy. How can experts and public health officials get through to people about the necessity of taking simple but important precautions against the disease?

A: I think messaging about the seriousness of this disease is important. People don’t see the hurt and impact that COVID-19 is having, so they think it’s gone. We are very visual people; seeing statistics doesn’t resonate with many individuals. We aren’t seeing the consequence of this virus on the TV, the way we were in the earlier days of the pandemic — the corpses being brought out body by body in New York City, etc. I think that the consequence of not wearing masks, not physically distancing, [and] going out in crowds needs to be emphasized more.

Q: In light of the uptick in cases in states that have loosened restrictions, should these states enforce orders on social distancing, masking and mass gatherings? Should other states uphold and continue to enforce these orders?

A: Yes. The masks, physical distancing and stopping mass gatherings need to be mandated again, like the early days of the pandemic.

References:

• Florida Health. Florida Department of Health Updates New COVID-19 Cases, Announces Twelve Deaths Related to COVID-19. http://www.floridahealth.gov/newsroom/2020/06/062220-1301-covid19.pr.html. Accessed June 29, 2020.
• Florida Health. Florida Department of Health Updates New COVID-19 Cases, Announces Twenty-Eight Deaths Related to COVID-19. http://www.floridahealth.gov/newsroom/2020/06/062920-1158-covid19.pr.html. Accessed June 29, 2020.