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States Start Taking Significant Steps To Fight Pandemic As Cases Surge


As the U.S. enters the worst stage of the coronavirus pandemic to date, more states are reimposing different kinds of mitigation measures. But with an unthinkable 1 million new cases each week and no sign of letting up, will anything short of another massive multistate lockdown be enough? Joining us now is NPR global health correspondent Nurith Aizenman.

Hi, Nurith.


SHAPIRO: When the numbers are this high and climbing, is there just a certain amount of new infections and deaths that are now inevitable?

AIZENMAN: Well, one of the experts I talked to - he said in the most optimistic scenario that he's modeled - which is that starting today, practically everyone starts wearing a mask, and in any state where the death toll gets really high, as in eight deaths a day per million people in that state, which is already the case now in the Dakotas, for instance - at that point, the state goes back to April-style stay-at-home mandates. He says even in that scenario, the U.S. would not be able to push cases down. Cases would just plateau.

This researcher's name is Ali Mokdad. He's on a team at the University of Washington's Institute for Health Metrics and Evaluation. He projects the U.S. would remain stuck at that plateau all through winter.

ALI MOKDAD: Why it will be leveling - because the seasonality of COVID-19 is working against us.

SHAPIRO: OK, because the evidence suggests that the virus transmits more effectively in cold weather. But Nurith, explain why even if everybody shut down, put on a mask and stayed home that would be too late to push cases down.

AIZENMAN: Well, that would be if people waited to shut down, you know, until things got really, really bad, even worse than now. I pressed Mokdad on this, and he conceded that if states imposed much more stringent stay-at-home measures now, that would do it. But Mokdad says his team isn't really modeling that because the reality is they think people and leaders in the U.S. just won't go for it. There's too much pandemic fatigue.

SHAPIRO: Well, some states have started taking major steps, requiring nonessential businesses to stop indoor in-person services - I mean, California, New Mexico, Oregon. What kind of a difference would that make?

AIZENMAN: Right. The issue is not very many states are going that far. For the most part around the country, the new mandates that states are turning to are not barring people from gathering indoors in groups of, say, six, eight, even 10 people. And there are indications that a fair amount of the spread right now is coming from those kinds of family-and-friends interactions. That's making a lot of the researchers who model how this disease spreads really worried about the potential fallout from Thanksgiving.

Jeffrey Shaman is at Columbia. He says he wishes a national leader like the president would just say this.

JEFFREY SHAMAN: Maybe we should be thinking about Thanksgiving on July 4 of next year. As ridiculous and painful as that sound, I'm asking people, for the sake of their loved ones, for the sake of their neighbors, for the sake of their country, to forego getting together in person.

SHAPIRO: And is he talking about more than Thanksgiving - like the entire holiday season - Christmas, Hanukkah, New Year's, et cetera?

AIZENMAN: Yes. Yes. Yeah. And it's a big ask, but I want to stress that none of the researchers I spoke with said the situation is hopeless. They said that what leaders are doing now does still slow infections and save lives.

And I also spoke with Jennifer Nuzzo with the Johns Hopkins Center for Health Security, and she emphasized another possible strategy. She says, given how hard it could be to get enough people to stop the get-togethers, officials should make that much more of an effort to pinpoint all the other places in a given area people are getting infected - find the specific bars, the restaurants, the unsafe workplaces. Here's Nuzzo.

JENNIFER NUZZO: If you can prevent people from getting it out in the community, then you can prevent them from spreading it to their loved ones at a family gathering.

AIZENMAN: Of course, that takes resources.

SHAPIRO: That is NPR's Nurith Aizenman.

Thank you.

AIZENMAN: You're welcome. Transcript provided by NPR, Copyright NPR.

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