At coronavirus crossroads, U.S. weighs ‘one more chance’ to quell escalating outbreak

“We have perhaps one more chance to get this right,” said Aileen Marty, an infectious-disease specialist at Florida International University whose argument for meticulous asymptomatic testing went unheeded in April when a sampling site opened at the Miami school. Three months later, she is renewing her appeal as cases soar in Miami-Dade County, the center of the outbreak in Florida, which Thursday reported 10,109 new infections.

This week, Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, warned the country could soon record 100,000 cases a day — more than half the total recorded by such peer democracies as France and Germany since the pandemic began. An outbreak on that scale could force whole swaths of the nation back into lockdown, depressing consumer activity, accelerating layoffs and further damaging the American economy as much of the developed world climbs back toward normalcy.

“This weekend, the next week-and-a-half, perhaps the next two weeks are make or break,” said Marty, a former Navy physician whose dire warnings were circulated in a letter this week among Miami-Dade commissioners. “If we don’t massively change our behavior right now, to stop facilitating the transmission of the virus, then we are facing either another lockdown or a massive number of hospitalizations and deaths.”

With the menace newly visible in Republican-controlled states, some in the party’s leadership have shifted their stance about masks. Vice President Pence has begun covering his face for public appearances, and President Trump said he liked the way he looked in one and would wear it when he saw fit.

Scarred by surging cases after Memorial Day, state and local leaders from Los Angeles to Miami Beach prepared for the Fourth of July holiday by closing businesses and imposing curfews. In California, which took some of the earliest and most aggressive actions to contain the virus but saw cases explode after easing restrictions, Gov. Gavin Newsom (D) shut down bars and suspended indoor dining in much of the state.

On Thursday, the mayor of Miami-Dade County took the extraordinary step of imposing a 10 p.m. to 6 a.m. curfew.

“This curfew is meant to stop people from venturing out and hanging out with friends in groups, which has shown to be spreading the virus rapidly,” Mayor Carlos A. Giménez wrote in a statement, which cited the death of an 11-year-old in the county from covid-19, the disease caused by the coronavirus.

Leaders who once ordered residents indoors reached instead for ultimatums, signaling that more painful measures were on the horizon. Oregon Gov. Kate Brown (D) cautioned students and parents this week that their “actions will determine, frankly, whether we can open schools in the fall.” She joined governors of both parties, many of them reluctant to take more sweeping actions, in “urging” and “asking” residents to stay home and to practice social distancing.

In Georgia, Gov. Brian Kemp (R) embarked on a “wear a mask” tour of his state. Gov. Ron DeSantis (R) encouraged Floridians to be “diligent.”

“It’s a small sacrifice to make if we know we’re protecting others,” said Cara Conlogue, a first-grade teacher in Palm Beach, Fla.

Nearby, Jason Higgins was loading $500 worth of fireworks into his SUV. He planned to set them off in his backyard, observing, “We need to get on with life, but we need to be cautious.”

Few, however, can agree on how to strike that balance. Ron Ayala, a sales manager in Phoenix, said the precautions taken by some do not compensate for the disregard of others.

“The problem is that you’ve got some people that they’ll go all in — they’re wearing gloves and masks, they’ve got the eye protection, they don’t leave the house unless it’s absolutely necessary,” Ayala said. “And then there’s others that they don’t care. They’ll do whatever they want.”

That divide is on vivid display for nurses and emergency physicians, who finish 12-hour shifts in coronavirus wards and then walk the aisles of grocery stores, sometimes the only shoppers in masks.

“It’s very discouraging,” said Serena Bumpus, the Austin-based director of practice for the Texas Nurses Association. “We’re still waiting to see if the public will change their behavior.”

A turning point was marked Thursday, as Texas Gov. Greg Abbott (R) stopped waiting and imposed a statewide mask mandate requiring face coverings in counties with more than 20 cases. Mark McClellan, a former commissioner of the Food and Drug Administration who has been advising Abbott on his response, said the governor became concerned by how quickly the rate of hospitalizations was intensifying, with the state’s average of daily covid-19 hospitalizations 60 percent higher than it was a week ago, according to Washington Post data.

Abbott, who once blocked efforts by local officials to require masks, said of his decision, “Covid-19 is not going away. In fact, it’s getting worse.”

That much is true nationally, as the country Friday reached a new high in its seven-day average of cases, as it has done consecutively for the past 25 days. At least 35 states this week reported single-day increases that eclipsed new cases in all of Italy, the center of the European outbreak.

“We’ve all been looking at these charts of Europe and the U.S.,” said David O’Sullivan, a former Irish civil servant who served as ambassador from the European Union to the United States from 2014 to 2019. “At one point, we were more or less at the same point on the graph, but then we’ve gone down and down, even with opening back up, and in the U.S., the numbers are soaring.”

Americans submitted to stay-at-home orders in March and April in a bid to preserve medical resources and buy the country’s leaders time to develop an effective regime of testing, contact tracing and isolation. But they emerged this summer to conflicting messages about the scale of sacrifice still required; squabbles over the partisan signals sent by wearing masks; and inadequate resources, from testing reagents to hospital beds, to keep them safe.

Universities that once entertained the prospect of resuming ordinary operations in the fall are increasingly committing to alternative plans. From the White House to governor’s offices, trade-offs are crystallizing.

Kellyanne Conway, Trump’s senior counselor, defined the decision this way in a recent appearance on Fox News: “Do you want to open the bars now, or do you want to open the schools and the day-care centers in a few short weeks? I vote for the latter.”

In Georgia, Kemp threatened to take away college football, saying this year’s season would be a “tall task” if the state’s numbers kept rising.

South Carolina Gov. Henry McMaster (R) invoked the favorite pastime as an incentive. “Let me make it very clear,” he tweeted Wednesday. “Wear a mask and social distance now so we can enjoy high school and college football in South Carolina this fall.”

Congressional Republicans were at pains to dispel the stigma of masks for some in their party as even Trump seemed to shift his stance this week. “I’m all for masks,” he said in an interview on Fox Business Network.

At the same time, the president renewed his notion, which defies evidence, that the virus would simply fade away.

“I think we’re going to be very good with the coronavirus,” Trump said. “I think that at some point, that’s going to sort of just disappear, I hope.”

Similar confidence seemed to animate the approach of some leaders even in regions buffeted by the virus. In Texas, the Republican lieutenant governor, Dan Patrick, assailed Fauci for suggesting that some states “skipped over” key benchmarks for reopening.

“The only thing I’m skipping over is listening to him,” Patrick told Fox anchor Laura Ingraham, referring to the nation’s top infectious diseases expert.

The inconsistent messaging is causing Americans to throw up their hands, said Umair A. Shah, the medical director in hard-hit Harris County, which includes Houston and is leading Texas in confirmed cases. Some people, he said, are concluding, “Well, gosh, I’m just going to risk it.”

“This is where the federal government, and the [Centers for Disease Control and Prevention] in particular, comes in,” Shah said. “In the past it’s been a convener, bringing communities and health departments together, saying, ‘Here’s what we’re doing across the system.’ I have not seen that as much now.”

The CDC had 47 teams activated as of this week to assist local health officials, including 36 working directly in the field. A number were tackling outbreaks in communities of color and among younger age groups, according to a spreadsheet obtained by The Post.

While new infections have been most prevalent among young people, and while deaths have not risen as sharply as caseloads, the death toll is only just coming into view. Arizona on Wednesday reported 88 deaths, a one-day high, and CDC analysis of incidence and mortality — collected in a slide deck obtained by The Post — also shows sharp increases in daily deaths from covid-19 in Texas and Florida.

Meanwhile, scenes of besieged intensive care units that shocked the country when they emerged from New York in the spring are now being envisioned across the Sun Belt. Don Williamson, president of the Alabama Hospital Association, said he worries some hospitals could run out of ICU beds by the end of July — the entire state by the end of August.

The holiday weekend, he said, “is probably our last chance to avoid at least some of our hospitals simply being overwhelmed.”

But health officials across the country are drained, and some are using the holiday weekend as the first opportunity to take time off since the pandemic’s onset. Testing sites administered by the public health district that covers 13 counties in central Georgia are closed Friday and Saturday. “We have been working six to seven days a week since March,” said the health district’s spokesman, Michael Hokanson.

Others preparing to work over the holiday weekend wondered if they would come to regret it. Geoconda Argüello-Kline, secretary-treasurer of the Culinary Workers Union in Las Vegas, welcomed a new statewide mask mandate but noted it came 24 days after casinos opened. The union is suing three casino companies, alleging they failed to adequately protect workers from exposure to the virus among unmasked crowds, while the companies say they followed proper procedure.

Elsewhere, there was hope a silver lining might emerge from an increasingly visible crisis. Arizona health officials this week authorized hospitals to implement “crisis care” standards dictating how to ration medical resources, a move that public health experts said may finally make clear to residents the consequences of unchecked viral spread.

Some were skeptical.

“People are just in denial,” said Joanna Bivens, a hairstylist in Gilbert, Ariz.

Cara Christ, director of the Arizona Department of Health Services, said new guidelines issued by the governor, combined with “public messaging and education,” would help stem the tide.

Others said the emphasis on coaxing the public to behave was misplaced. In Miami-Dade, a county commissioner who disseminated Marty’s proposal for more robust testing and contact tracing, said the government’s response must go beyond beseeching people to be safe.

“To blame it on people not wearing masks is to mask the truth,” said the commissioner, Daniella Levine Cava, a Democrat running to be the county’s mayor.

She said contact tracing, which is overseen by the state, is perfunctory and highly limited, despite plans to contract with a third-party call center, Maximus, to bolster Florida’s workforce.

Neither the state health department nor the county mayor, Giménez, responded to requests for comment. And it remained unclear how the plan laid out by Marty, though it met a positive reception among county officials, would be put into practice.

At a commission meeting this week convened to address the county’s rising caseload, Giménez, a Republican running for Congress, stressed the importance of social distancing and wearing masks. “Unfortunately, we think — we know — that a number of our citizens did not do the things that we asked them to do,” he said

The mayor made the right call by closing the beaches for the Fourth of July, Marty said. Now, there needs to be a broader reset, said the infectious diseases expert.

“We have to give this piece of genetic material its due, or it’s going to continue to wreak havoc,” she said.

Jacqueline Dupree in Washington, Jeremy Duda in Phoenix and Lori Rozsa in Palm Beach and West Palm Beach contributed to this report.

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