Tighter rules slow virus in U.S., but victory remains far away

The coronavirus pandemic is reaching a plateau in some of the hardest-hit U.S. states after public officials imposed unpopular public health measures, like closing bars and requiring masks.

Now, those officials wonder whether they can force infection rates down again, as they did in the spring — and this time, make them stick until a vaccine arrives.

Florida on Monday reported 8,892 new coronavirus cases, the fewest since July 7. Texas recorded 5,810 on Sunday, its lowest tally in two weeks. And case counts are falling in Arizona after an alarming spike in June.

“We’ve weathered the big surge,” said Carlos Gimenez, mayor of Miami-Dade County. “We’re now at the crest of this surge, and it looks like maybe — maybe, and I’m saying maybe — that it has topped off and that it’s starting to level off and starting to go down.”

Americans are still falling ill in much greater numbers than residents of other developed nations and relative stability doesn’t mean a return to life as usual. The point was driven home Monday when the new season of Major League Baseball — the nation’s bellwether pastime — was thrown into jeopardy by a raging outbreak among Miami Marlins players. And the mercurial U.S. President Donald Trump, who for days had toed a new and sober line on virus safety, once again encouraged governors to reopen their economies.

“My concern is that we will stay in this muddled place,” said Joshua M. Sharfstein, a vice dean at Johns Hopkins Bloomberg School of Public Health. “The absence of a national strategy is a big problem, because we are a connected country. It is very hard to have 50 different approaches to a single pandemic.”

No surrender

Trump has refused to formulate a national strategy for fighting the pandemic, instead letting each state chart its own course. But he has made no secret of his desire for a swift economic recovery as the November election looms, a point he repeated Monday. “I really do believe a lot of the governors should be opening up states that they are not opening,” he said during a briefing.

For months, many governors had followed Trump’s lead, resisting stringent public health rules to fight the disease that has killed more than 147,000 Americans. Now, where case counts are leveling off or decreasing, many of those officials credit some of the steps that were so contentious — wearing masks, maintaining a safe distance from each other, and keeping many kinds of businesses closed.

“We have been in the unhappy but necessary business of breaking up large adult gatherings,” Arizona Gov. Doug Ducey, a Republican, said late last week as he extended closure orders on bars and gyms. “That’s where we’re going to be for some time.”

Ducey imposed those restrictions in late June as the pandemic was raging in his state. It’s no accident, he said, that new cases are declining a month later. The number of COVID-19 patients admitted to the hospital each day in Arizona peaked at 129 on June 29 and has now stayed below 50 for nearly a week.

“We’re going to continue to press on with the strategies that are working in Arizona,” he said. “There’s no victory lap today, there’s no celebration. We cannot let up.”

Waiting game

On Monday, coronavirus cases in the U.S. increased 1.3 percent compared with the same time Sunday to 4.27 million, according to data collected by Johns Hopkins University and Bloomberg News. The increase was below the average 1.7 percent daily gain over the past week.

Cases are still rising sharply in many states, including California and most of the southern part of the country. And even in states where infections appear to be leveling off, the numbers remain high enough to strain hospitals and their staff.

Many public officials say that the newfound commitment to masks and distancing won’t be enough to keep Americans safe until the advent of a vaccine. There are multiple companies in the race to develop a shot, but one may not be available until next year — if at all.

Improved testing — and faster turnaround times for test results — are crucial to containing the virus until then, said Helen Boucher, chief of infectious diseases at the Tufts Medical Center in Boston.”We need to have tests that are reliable, and that give us results in what I would call an actionable time frame,” she said. This means getting results in a day. She described waiting a week or longer as a “disaster,” because by the time people get the outcome back, the opportunity to isolate and do contact tracing has been missed.

“I’m frankly really perplexed that it’s July and we’re having the same conversation about testing that we were having in March,” she said.

You’re out

The outbreak in Major League Baseball, after only a few days of the truncated 60-game season, showed how difficult it is to contain the disease. It came despite carefully controlled conditions and in a population that is young and by definition athletic and fit.

The league in June hammered out safety protocols that run more than 100 pages. Players are to be tested every other day, and their conduct both on the field and in the dugout faces restrictions that fly in the face of tradition. High-fives are out, as is spitting or getting within 6 feet of an umpire in an argument.

Cases still popped up around the league. Then came news that 12 players and two coaches of the Miami Marlins had tested positive. The league postponed games between the Marlins and the Baltimore Orioles and between the New York Yankees and the Philadelphia Phillies, who had just completed a three-day series with Miami.

The outbreak threw into doubt a sport whose return was a treasured reminder of normality, and raised questions about how schools and colleges — which have much fewer resources — would manage to convene in mere weeks.

The Marlins transmission was inevitable, said Roger Shapiro, associate professor of immunology and infectious diseases at the Harvard T.H. Chan School of Public Health. “If you have a lot of interaction back and forth between the players and their surrounding community, it’s really just a matter of time before it gets from the community into the team,” he said.

Florida measures

Florida, whose Republican Gov. Ron DeSantis has resisted instituting most public health measures, was among the first states to see a spike of COVID-19 in June and July. Although Florida suspended bar drinking, the governor has allowed mayors, including Miami-Dade’s Gimenez, to order masks and restrict businesses.

The percentage of first-time positive tests has been declining, with the seven-day average falling to the month’s lowest level in the most recent report. Speaking alongside DeSantis at an event Monday at the University of Miami medical school, Vice President Mike Pence said the administration was encouraged by the “favorable trends here in Florida.”

They may not be enough, in Florida or elsewhere. Still, Tom Steyer, a former Democratic presidential candidate who is co-chairing California’s task force on economic recovery, said social distancing and masks are the least we can do.

“I’m not sitting here holding my breath for a vaccine,” Steyer, a hedge fund billionaire, said Monday in an interview. “There are a number of things that can change this that are not a vaccine.”