The Coronavirus Six Weeks Later - When to Reopen?

The numbers. As of late yesterday/early this morning, the US had 975,798 cases, with 54,941 deaths. New York is still the worst by far, with 293,354 cases and 22,275 deaths. Then New Jersey with 109,038 cases and 5,938 deaths, Massachusetts with 53,348 and 2,730 respectively, then Illinois with 41,777 and 1,874, California 42,688 and 1,695, Pennsylvania 41,697 and 1,804, and Michigan with 37,203 cases and 3,274 deaths. The number of deaths to date is approaching the number of deaths in the worst flu season of the past ten years - 2017 to 2018, when an estimated 61,000 people died in the US. And LA County, which has had 19,107 cases and 895 deaths reported this statistic late Saturday: out of the last 48 deaths, 37 of those people (77%) were over the age of 65. It is fairly clear which age group is at the most risk.

The 4/24/20 New York Times had an interesting chart on page 11 of that day's paper. It showed the death rate from the virus by state. Perhaps not surprisingly, the more densely populated states of the Northeast, which are generally smaller in size, have the highest death rates. Again, New York leads the way with 79 deaths per 100,000 people, New Jersey with 57, Connecticut with 43 and Massachusetts with 32. The worst of the Western states - all large in size but not necessarily population - was Washington with a low 9 deaths per 100,000 people. California, large in size and also the most populated of all the states, had 4 deaths per 100,000 people. Clearly, the large states make it easier for people to practice social distancing. Leading the Midwest was Michigan with 28 deaths per 100,000 people. In the South, Louisiana had 32 deaths per 100,000 people.

In the latest week's unemployment numbers, another 4.4 million people filed new claims. That brings the 5 week total to an astronomically high total of 26.4 million people. This is simply unprecedented. One reporter asked NY Governor Andrew Cuomo at one of his daily press briefings: "Is there a fundamental right to work if the government can't get me money when I need it?" Cuomo's reply: "You want to go to work? Go take a job as an essential worker. Do it tomorrow." That was an unfair and callous reply. Clearly, people are not going to qualify overnight to become a doctor or nurse or paramedic or firefighter or police officer. And I do not believe enough retail jobs are opening to employ 26.4 million people.

So, when will it be time to reopen the country? Five days ago, The Hill reported on a Reuters/Ipsos poll, taken from 4/15-4/21, with a margin of error of 6%. 72% of Americans were said to support keeping the stay at home orders until "doctors and public health officials say it's safe." Broken down by party, 88% of Democrats agreed, 70% of Independents and 55% of Republicans. An AP/NORC poll had similar numbers for Democrats, with 63% strongly agreeing to keep stay at home orders (except for essential workers), and 28% somewhat agreeing - for a total of 91%. For Republicans, 36% strongly agree and 35% somewhat agree - for a total of 71%.

The flu of 1957-58 was a particularly devastating year. It is estimated that 25% of the population was infected, and that 116,000 people died. Yet, nothing was shut down. The country remained open for business - the people's business, whatever that was. But the question remains, when we do reopen - and some states are starting to do so - what will it look like? Will there be a new normal? Will greeting someone with a handshake ever return? What about dining out? Some restaurants say they will check people for a fever before admitting them. Tables may be fewer. Those with booths may have plexiglass between the booths. A company that designs airplane interiors is already working on a redesign of the seating layout, which may also include plexiglass between the seats.

The hospitality industry, hit hard by the coronavirus, already has new policies in place. Fox News reported that anyone entering the 4 Seasons Hotel in New York City will have a temperature check. Check-in and check-out will be done virtually. Each guest will be provided with 3 large bags for dirty linen. Room service - gone. The restaurant, bar and coffee shop - closed. Those policies certainly do not entice me to think about a trip or hotel stay. The 4 Seasons will have pre-made box meals. And rooms will be deep cleaned between guests. Hilton apparently will keep rooms vacant for 3 days after a guest checks out. What about concerts and sporting events? Will most seats remain empty in order to allow for 6 feet of social distancing between people?

Will retail outlets, supermarkets and big box stores limit the number of people allowed to be inside at the same time. So, will we now wait in line to shop, as has already happened in many places. One woman who has a work-out business said she was inclined to continue to run her business virtually. Many white collar jobs can be done as well remotely as in an office. Will an increasing number of businesses see an advantage to allowing their employees to work at home? It can certainly save on office overhead. On the other hand, my daughter has been working at home for 5 weeks now, and her company and customers seem to have some difficulty in distinguishing between work hours and non-work hours. When we venture out into the world, will a mask be the newest mandatory apparel item in everyone's wardrobe? And will we ever step closer than 6 feet to another person in public again?

According to Fox, there was a study of 5700 patients hospitalized at a Northwell Health System hospital. The study, as reported in the Journal of the American Medical Association, found that of the Covid 19 patients, 94% had at least one other disease or illness. The median age of the patients was 63 years old. 53% had hypertension, 42% were obese, and 32% had diabetes. So, when we reopen, will there be actual orders compelling people in the high risk groups to remain at home? Absent such orders, will those in the high risk groups who get sick and infect others, then be legally responsible?

To end on a hopeful note, we have a story out of UMass Memorial Health Care. It was reported that a gravely ill patient with the coronavirus, improved within a few hours of getting a blood plasma transfusion from a patient who recovered from Covid 19. Let's hope for more of that, and for less cases overall.