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States Are Forced To Face Surge In New Coronavirus Cases

STEVE INSKEEP, HOST:

State by state by state, Americans are adapting to the pandemic. Some states are changing course, even reversing themselves, as cases soar. The governor of Texas once prevented local governments from ordering mask use. Now he's giving that order. And in the absence of consistent national direction, much depends on what states do. In this part of the program, we'll hear from two places going in two directions.

Manhattan Beach, Calif., is in Los Angeles County, one of 19 California counties the governor shut down after cases surged. We last heard from Manhattan Beach Mayor Richard Montgomery in May just after he opened the beach for which his town is named. We called him back after the governor ordered it closed again.

Mayor, thanks for taking the time - on short notice, too, as I understand it.

RICHARD MONTGOMERY: Anytime. Today's a great day.

INSKEEP: Excellent. Well, it's not like you're going to the beach or anything.

MONTGOMERY: (Laughter) No, I'm not going to the beach, Steve. Thank you.

INSKEEP: Last time we spoke, you were talking to us about reopening the beaches where you are. Now we're talking about closing the beaches. What's changed?

MONTGOMERY: The biggest change, Steve, so far in Southern California - as you know, Los Angeles County is the leader. We jumped 56% in the last two weeks of COVID cases. That is the biggest change.

INSKEEP: What else is closing in your area besides the beaches?

MONTGOMERY: The governor has closed, along with LA County Health Department, bars, restaurants for indoor dining, movie theaters, museums, our aquarium and then of our pier, state piers, beach parking lots. They're all closed.

INSKEEP: Is it dispiriting to have to back up a few steps?

MONTGOMERY: The timing is coincidental. Here we are celebrating American Independence Day, July 4. And yet we're going backwards. So it's disheartening. And my own number - just to give you an eye what each numbers are like, Steve. We started this all - this shutdown March 25. We had 17 confirmed cases. As of June 30 - 135. And in that number, Steve, we had three deaths. Any death is a concern. But we are blessed and fortunate that it's only three. It's because we took proactive action by shutting our parks down and doing some steps that weren't required by the county or the state - why that number is still lower than most surrounding communities.

INSKEEP: As best you can determine or your local health officials can determine, are these closures getting at the problem, getting at the place that the disease was spreading? For example, is there evidence of community spread on the beaches?

MONTGOMERY: That's the issue because the beaches are outside. You're separated 6 feet or more, especially if you're surfing or on the beach itself. The pushback has been, we're not contracting the disease at the beach. We're all 6 feet apart. We're exercising in the sunlight. We do know that the bars and restaurants, you know, have a much more difficult time keeping that spacing, having people wear their face coverings. But the move was a move to keep us all safe and protected. If it does what it's supposed to do - numbers drop down - then we're all better for it.

INSKEEP: Do you feel that this is the pattern you're going to have to maintain for the next year? Sometimes, things will be open. Sometimes, you have to shut them back down.

INSKEEP: In talking to Governor Newsom's office, along with LA County Health Department Dr. Barbara Ferrer, no, we think that we can get past this and see this mini surge and see where we are in three weeks. Hopefully, we can get back to a near-normal summertime outside experience. If not, we'll get through how long it takes. And, hopefully, this'll knock it down before we expect the fall to get here.

INSKEEP: Have you been a little frustrated looking across at the European Union and seeing how they've gotten their cases down for the continent to a few thousand a day - and here we are in the United States at tens of thousands a day with a warning of 100,000 a day?

MONTGOMERY: Yes, it is frustrating to see it. And I'm disappointed when I see people walking outside in public with others around them not wearing face coverings. And that's just a microcosm of what we see all across the country.

INSKEEP: Richard Montgomery is the mayor of Manhattan Beach, Calif.

Let's bring another voice into the conversation, Dr. Ali Khan. He is dean of the College of Public Health at the University of Nebraska Medical Center. Dr. Khan, good morning.

ALI KHAN: Good morning, Steve.

INSKEEP: I just want to note California beat down their number of cases. They were a success story. Mayor Montgomery told us he thought they had a good number of months before a second wave and was surprised to be shut down so quickly. Are you surprised?

KHAN: Not at all. And I would not characterize what happened in California, what happened in the United States as a success story. Clearly, after our initial peak of about 35,000 cases, we started to come down a little bit. But our response was stalled and stagnant for four to six weeks. And it never - we failed to ever contain the outbreak. So it's very predictable that we would continue to see increases in cases.

INSKEEP: So even the states that got on this early, relatively speaking, did not get on it early enough. That's what you're telling me?

KHAN: Oh, absolutely. We never contained this outbreak in the United States. So we continued to have 20,000 cases the day for four to six weeks through May and June. And if you fail to contain the outbreak - I characterized it like embers of a fire. There's a little ember left that can restart your forest fire. And that's exactly what we're seeing happening now throughout the United States. I mean, you just heard the experience in California - I believe 23 states currently that are backing up their reopening plans and 38 states that have an increased number of cases.

INSKEEP: Well, Dr. Khan, stay with us because we now turn to a state that seems at the moment to be doing better. As California is reclosing beaches, Illinois is preparing to open some of the beaches along Lake Michigan because their case numbers seem to have gone considerably down. We called Dr. Emily Landon, who advises the Illinois government.

So what seems to be working in Illinois?

EMILY LANDON: Well, Illinois took a lot of steps early on to try and control the spread of this virus, maybe before it was an emergency to do so. And that's really the right time. I'm convinced that if we hadn't had our stay-at-home order on March 21, that even a week or two weeks delay would've put us in the same situation as what we've seen in the Northeast and in New York City.

INSKEEP: Do you find mask use to be pretty widespread if you go out on the streets of Chicago, say?

LANDON: Well, I think it's not bad here. I think most of the buildings and most of the shops that are open here in Chicago are requiring masks for entry. And I think that's been really important. We were one of the earliest places to require masks back before it became really so much of a political issue. And I think that's really helped Illinois to come along and kind of buy into the masks, at least in Chicago. Now, you'll still see lots of people not wearing masks on the street. But that's because you don't need to wear a mask unless you're really within 6 feet of another person. So if you're out running on the lakefront path or you're taking a walk with your quarantined family, you know, it's not necessary to wear your mask. But you do need to have one if you want to be close to other people.

INSKEEP: So what else besides some beaches will be opening in Illinois in the next few days?

LANDON: Well, Illinois went into phase four last week. And that means that restaurants - indoor parts of restaurants are now able to operate at 25% occupancy. Public pools are now allowed to open in some places. And the lakefront path, which had been closed since a very nice day in March, where too many people were out and about gathering - and the mayor very smartly shut that down. Now that's open. And beaches may open soon. Gyms began to open last week. Certainly, these are still risky activities. There's still more infection than we want to be having. But if people are following the rules, keeping distance, wearing their mask - if we can keep doing those things, then it should be safe enough for us to go back to doing some of these things that we used to enjoy before the pandemic.

INSKEEP: Now, when I listen to you saying what you think you did right, I hear some similarities between Illinois and California because California, as you know, also said, hey, we were on this early. We shut down early. We're in a better situation now. We can begin to open up. And now they're having to shut back down again. It turns out that the virus has been there all along and is emerging again.

LANDON: Yeah.

INSKEEP: Is that a cautionary tale for you?

LANDON: It is. In fact, I've been talking to my friends and colleagues and saying we need to understand better what's happened in California. But with respiratory viruses and with infection in general, there's kind of a tipping point that happens where every case is able to spread to one or more other people on average. Then you have to do some very drastic things, like a stay-at-home order or really closing down a lot of public buildings and activities. So I don't know exactly what's putting California back into this situation. But I do know that if they do the same things that they did before, that it should be successful in curbing the spread of the virus.

INSKEEP: Dr. Emily Landon is chief infectious disease epidemiologist at the University of Chicago Medical School and has been advising the governor of Illinois.

Now, Dr. Ali Khan is still with us at the University of Nebraska Medical Center. And, Dr. Khan, do you sense that state and local officials are learning and even learning from each other as some suffer setbacks?

KHAN: Not at all. And with due respect to Dr. Landon, I don't believe the data supports that Illinois is doing better. Mid-June, I think there were 550 cases. And I believe yesterday, there were 800 cases. So another cautionary tale, which is that unless you get your outbreak under control, you will see an increase in cases when you open up. So we'll see the exact same thing probably happen here.

But let me talk about what we're seeing here - is this is now being shifted. And I've seen this now - multiple places are shifting the blame to individuals not doing what they're supposed to be doing. I've not heard one person talk about test and trace. And so if you're going to reopen, what are you doing to get cases down to zero? So no metrics. How much - you know, how soon does it take to isolate somebody? How many contacts are people following? How many cases are from contact list. So no, we cannot go back to what we did before successfully because we were not a success before because we had failed to do test and trace.

So there's four elements of getting this disease under control. So yes, one is the community component which, is, where you mask. Social distance. And wash your hands. That's just one component. And it's not the primary component. The primary component is the state and the localities and the national responsibility to get cases down. Test and trace. Add that to leadership. And then add that to dropping deaths with dexamethasone. Those are the four things we need to do to become a success, just like Europe and countries like New Zealand that have eliminated the disease. So they have zero cases. And China has two cases in 1.4 billion people. We can do this in America.

INSKEEP: Dr. Ali Khan, thanks for the insights, really appreciate it.

KHAN: Thank you very much, Steve. Mask on.

INSKEEP: Thank you. He is the dean of the College of Public Health at the University of Nebraska Medical Center. Transcript provided by NPR, Copyright NPR.

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