Reopening America: a conundrum

Bob Sheak – April 25, 2020

wordpress.com/posts/vitalissues-bobsheak

This post focuses on the White House proposal to reopen America. It is a proposal pushed by President Trump and his economic advisers but only reluctantly supported, if not opposed, by his scientific advisers. Trump is anxious for the economy to come back from its current decline as quickly as possible, because he believes his chance to be reelected hinge significantly on having a good economy. So far, the polls indicate that a majority of Americans choose to stay on the path encouraged by the scientists.

Extraordinary dual crises

There are two systemic trajectories stemming from the onset and spread of the Coronavirus in the United States. One is health related. The Covid-19 virus is causing a massive health crisis, spreading rapidly across the country and the world, transmitted between people and carried across communities, cities, regions, states, and countries. The World Health Organization (WHO) declared COVID-19 a pandemic on March 11, 2020 (https://time.com/5791661/who-coronavirus-pandemic-declaration). At that time, WHO pointed to over 118,000 cases of the disease in over 110 countries and territories with an ongoing risk of further global spread. Dr. Tedros Adhanom Ghebreyesus, WHO director general said at the time that “it is a crisis that will touch every sector.” A pandemic, he said, often applies to new influenza strains that are “able to infect people easily and spread from person to person in an efficient and sustained way” in multiple regions. By April 22, according to The Washington Post, “[m]ore than 800,000 coronavirus cases have been confirmed in the United States, with nearly 45,000 reported deaths. Worldwide, more than 2.5 million infections and 175,000 deaths have been reported” in 182 countries (https://washingtonpost.com/world/2020/04/22/cornonavirus-latest-news). Note the virus spread across the world by 2.4 million cases in just 42 days. And these numbers represent only those with symptoms who have sought medical treatment and/or been tested for Covid-19. The great majority of people abroad and in the US have yet to be tested or traced.

The other trajectory reflects the vast economic effects of the pandemic, causing in the United States extreme and widespread economic dislocations, with widespread business closures, rising job losses at depression-levels, and severe deprivation of all sorts among already economically challenged and vulnerable populations. Many state and local governments are experiencing growing fiscal deficits, as sales and income taxes generate less and less money. Consider just the employment impact. Patricia Cohen and her colleagues at The New York Times report the latest government figures on April 23 as follows: “The grim economic toll from the coronavirus pandemic jumped on Thursday when the government reported another 4.4 million people filed new unemployment claims last week, bringing the five-week total to more than 26 million” (https://nytimes.com/2020/04/23/business/stock-market-today-coronavirus.html). With respect to the administration’s proposal for the states to begin planning for the reopening of economies, they point out that it is “understandable when epidemiological and medical experts tell us that there are grave risks in reopening the returning to normal economic activities before the pandemic is well on the way to eliminating the virus. If businesses re-open and workers return to work too soon, then there is a risk that the virus will begin spreading again.”

Trump says wants to reopen the economy soon, despite expressions of caution from scientific adviser

 Chris Walker considers  the reasons for why Trump is pushing to reopen the economy, “even as a number of prominent health experts…are expressing alarm that a premature return to normalcy could create serious setbacks in the nation’s attempts to contain the virus” (https://truthout.org/articles/trumps-push-to-reopen-economy-on-may-1-puts-his-reelection-above-public-health). In an article published in Truthout  on April 10, Walker cites a Washington Post article on Trump’s thinking on the issue, namely, that the president has suggested in phone calls to advisers outside the White House that “he has a strong desire to reopen the nation’s businesses by May 1 or sooner.” He is worried about how “the bad economic news” of rising unemployment rates and a looming recession or worse could damage his reelection chances in November. The president has often spoken publicly about “his wishes for a fast reopening of the nation’s economy.” Walker quotes what Trump said at a press beefing on April 9:

“Hopefully we’re going to be opening up — you can call it ‘opening’ — very, very, very, very soon, I hope. We’re at the top of the hill, pretty sure we’re at the top of the hill.”

In the televised Coronavirus Task Force “briefing” aired on MSNBC on April 22, Trump kept insisting that the pandemic will be all but vanquished by the fall, when there will only be scattered “embers” of the virus existing here and there. In his exuberance, he sometimes says that he and his administration have created the conditions for a reopening of much of the economy in the latter part of April or in May. If the economy is largely reopened in the fall, it will be recorded as a political plus for Trump’s obsessive presidential aspirations and could well be the decisive factor leading to his reelection.

On April 16, the President’s Coronavirus Task Force  put forth a set of nonbinding guidelines, “Opening Up America Again,” designating the criteria and the conditions that should inform when and how fast governors decide to move toward reopening their respective state economies (https://whitehouse.gov/openingamerica). Trump now emphasizes that the final decisions lie with the states, not the President. Peter Baker and Michael D. Shear report as much, writing: “President Trump told the nation’s governors on Thursday [April 16] that they could begin reopening businesses, restaurants and other elements of daily life by May 1 or earlier if they wanted to, but abandoned his threat to use what he had claimed was his absolute authority to impose his will on them.” They report as well that the President “has previously said that as many as 29 states could reopen soon” (https://nytimes.come/2020/04/16/us/politics/coronavirus-trump-guidelines.html).

White House guidance for reopening the economy

The Opening Up America document, 18 pages long, outlines a “phased approach.” First, however, there are a list of criteria for governors to satisfy before taking any steps to reopen their state economies, and what they should be prepared to undertake, including “testing and contact tracing,” an adequate “healthcare system capacity,” plans to facilitate the reopening of their economies, and guidelines for continued good individual practices.” Even then, governors should proceed only when there is a “downward trajectory of influenza-like illnesses (LIL) reported with a 14 day-period” and a “downward trajectory of Covid-like symptoms” reported over 14 days. It goes on.

There a few lines on what employers should have in place before they open their businesses. Employers should have “social distancing and protective equipment” for their employees, be able to carry out “temperature checks” on workers and customers, have sanitized their workplaces, disinfected common and high-traffic areas, and limited business travel. They should also be able to monitor the workforce for “indicative symptoms” and “not allow symptomatic people to physically return to work until cleared by a medical provider.” Furthermore, they should “develop and implement policies and procedures for workforce contact tracing following employee COVID-19 test.” These requirements are scientifically reasonable given the lethality of the Covid-19 virus. However, it stretches the imagination to think that most employers have the capacity or willingness to institute such a broad range of protections. And it’s not at all clear how the government would enforce the guidelines. Perhaps it will be the customers who will make the difference.

The guidelines are not legally obligatory but voluntary – and generalized with little instructive detail. Baker and Shear point out the Opening Up America document does not confront , for example, some difficult questions: “how to finance the billions of dollars necessary for expanded testing; whether travel should be restricted between states; when the ban on international travel from Europe and elsewhere would be lifted; and how the states should deal with future shortages of protective equipment if the virus resurged in the fall.”
The guidelines

If the preconditions for the Opening Up America guidelines are met, then the document advises that the reopening of businesses should proceed through three phases. States may enter this phased process only if they have satisfied the preconditions previously reviewed, particularly a 14-day decline in reported Covid-19 infections and a well-provisioned health care system. Dr. Deborah Birx, one the principal science experts on the President’s Coronavirus Task Force, identifies the conditions and practices that should exist in a given state or county as they initiate phase one and then at some unspecified time move onto the subsequent phases (https://nypost.com/2020/04/16/trump-unveils-opening-up-american-plan-aims-for-may-1).

Phase 1, which recommends continued social distancing, closure of schools, teleworking and sheltering in place for vulnerable individuals. Non-essential travel would be discouraged, bars should remain closed and visits to nursing homes and hospitals should remain prohibited, the guidelines warn. “If a vulnerable population needs to return to work, there should be special accommodations for all vulnerable populations. If the schools are already closed, they should remain closed,” Birx said. “All visits to senior living facilities should continue to be prohibited. Large venues can only be operated under strict physical distancing protocols. Gyms could open if they adhere to strict physical distancing.” The concept of “strict physical distancing” has become defined as having persons remain at least six feet apart. (And all employees and customers should wear masks, be screened to ensure they do not have the disease, practice social distancing, and have access to well sanitized environments.)

Phase 2 follows when there is a further decline in Covid-19 cases. Then states and local governments can allow schools, restaurants, and bars to reopen with diminished occupancy. Non-essential travel can resume, and people can gather in groups no larger than 50, but teleworking is still encouraged. “This is for the employers. We still would like to encourage telework, and the common areas should remain closed or be physically distant,” Birx said. “This should be a relief to many households that have small children: schools, day cares and camps can reopen in Phase 2. Visits to senior living facilities however should remain and hospitals prohibited.”

Phase 3 occurs when there are virtually no new cases of the virus, in which case states and local governments may allow workplaces to reopen with no restrictions, and visits to senior care centers and hospitals can resume. “It is essentially returning to our new normal. Good hygiene practices and continuing the respect for spaces between individuals continues, because we know that we still have an issue with asymptomatic spread,” Birx said. At this point, the guidelines are framed as follows: “Vulnerable individual can resume public interactions, but should practice physical distancing, minimizing exposure to social settings where distancing may not be practical, unless precautionary measures are observed.” Employers may “resume unrestricted staffing of worksites.” People can visit senior care facilities and hospitals. Large venues (“e.g., sit-down dining, movie theaters, sporting venues, places of worship) can operate under limited physical distancing protocols,” “gyms can remain open if they adhere to standard sanitation protocols,” and “bars may operate with increased standing room occupancy.”

It remains to be seen whether many counties and locales within the various states will be able to satisfy the conditions that precede with the phased opening of their economies. There is no doubt that the federal government will have to provide substantial support in many cases, but even then the proposed guidelines allowing for a safe reopening of businesses, workplaces, sports events, concerts, supermarkets, and public spaces, nursing home and long-term care facilities, will require behavior that wasn’t normative prior to the outbreak, it will be costly, and many people and families will require public assistance in what may well be a long transition to the new normalcy.

How Trump is playing it

The Opening Up America document provides political cover for the president in the event that the actual reopening of the economy should lead to an increase in infections, hospitalizations, and deaths. If high rates continue through May and in the following months, the president is will be in position where he can disclaim responsibility for any setbacks in the struggle against Covid-19 by claiming, one, that the Opening Up America guidelines were created the experts on his task force and therefore they, not he, are to blame. And, two, he can cast blame on the governors who under the coronavirus task force plan have the independent authority to follow the guidelines or not.

Bear in mind two other factors. All of this unfolds in a context in which, to reiterate, there has so far been too little testing to identify the infected population, little contact tracing, and shortages of protective personal equipment and other medical supplies for hospitals, medical personnel as well as for businesses, most workers, or the public at large. And, bear in mind also, the neoliberal policies that have been pushed by Republicans in the White House and Congress for forty years, including most of Trump’s presidency, have overall weakened the public health system in the US and left it sorely unprepared for this pandemic. Trump, his administration, his task force, state governments, the medical community, businesses have all been playing catchup due to how belated and confusingly the Trump administration came to acknowledge the crisis.

For one elucidation of the neoliberal scuttling of the US safety net, see the article by Candice Amich and Uimanthi Perera-Rajasingham, “Declaring War on a Virus Ignores the Neoliberal Policies that Put Us Here” (https://truthout.org/articles/declaring-war-on-a-virus-ignores-the-neoliberal-policies-that-put-us-here).

Cautionary views

Fauci

 Chris Walker (cited above) quotes Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and a coronavirus task force member, who believes “the approach proposed by Trump could result in serious repercussions for the nation.” And, quoting from an earlier CNN interview, Fauci said he wants to see “a clear indication” that the infection rate in the U.S. is “very clearly and strongly going in the right direction” before the economy is reopened.” And then on Friday, April 10, Fauci pointed out: “The virus kind of decides whether or not it’s going to be appropriate to open or not. He added that “prematurely” opening businesses and other places that have shuttered due to social distancing could result in the country winding up “back in the same situation” that we presently find ourselves in. That is, if the economy is opened prematurely and without the introduction of a detailed plan, the number of infections and deaths from the virus will rebound. Then on April 22, according to a report sent out by Yahoo, “Dr. Anthony Fauci said he was convinced the coronavirus would be around in the United States until at least the fall but that the scope of those cases depended on the American people abiding by social distancing measures and lawmakers listening to public health advice before reopening segments of the country” (https://yahoo.com/huffpost/fauci-coronavirus-fall-021009936.html).

Redfield

In an article published in Washington Post, Lena H. Sun reports about concerns of the CDC Director Robert Redfield about how next fall and winter the Covid-19 pandemic will still be with us and will coincide with the flu season (https://washingtonpost.com/health/2020/04/21/coronavirus-secondwave-cdcdirector). She quotes Redfield: “There’s a possibility that the assault of the virus on our nation next winter will actually be even more difficult than the one we just went through. And when I have said this to others, they kind of put their head back, they don’t understand what I mean.” He said that we must be careful in any actions undertaken or planned to reopen the economy. According to Sun, “Redfield said federal and state officials need to use the coming months to prepare for what lies ahead.” She continues her quote of Redfield: “As stay-at-home orders are lifted, officials need to stress the continued importance of social distancing. Officials also need to massively scale up their ability to identify the infected through testing and find everyone they interact with through contact tracing. Doing so prevents new cases from becoming larger outbreaks.”

The CDC is in the process of drafting “detailed guidance for state and local governments on how they can ease mitigation efforts, moving from drastic restrictions such as stay-at-home orders in a phased way to support a safe reopening.” While the CDC “has about 500 staff in the states working on a variety of public health issues,” many now working on the covid-19 response, Redfield said “CDC also plans to hire at least another 650 personnel as experts to ‘substantially augment’ public health personnel in the states and assist with contact tracing, among other tasks.” He acknowledged that “a much larger workforce is needed,” and was “talking with state officials about the possibility of using Census Bureau workers and Peace Corps and AmeriCorps volunteers to build an ‘alternative workforce.’” Former CDC director Tom Frieden estimates that “as many as 300,000 contact tracers will be needed. And:

“The Johns Hopkins Center for Health Security and the Association of State and Territorial Health Officials — which represents state health departments — estimate 100,000 additional contact tracers are needed and call for $3.6 billion in emergency funding from Congress.”

The thrust of Redfield’s statements is that preparations to mitigate the pandemic must grow and continue for the foreseeable future.

The testing gap

 Chris Walker notes that health experts are concerned about a reopening “because there aren’t enough testing kits across the nation to determine which states are able to move in that direction.” Asked to respond to the protests on the Good Morning America show hosted by George Stephanopoulos on Monday, April 20, “Fauci tried to show sympathy for their cause while also noting how their goals couldn’t be achieved without controlling the virus first.” And, he also said “The message is that clearly this is something that is hurting, from the standpoint of economics and the standpoint of things that have nothing to do with the virus. But unless we get the virus under control, the real recovery economically is not going to happen,” Fauci said.

In an opinion piece, The New York Times editorial board addresses the challenge of marshalling resources to support the massive testing that is required for mitigation efforts and to provide necessary information to guide governors who are planning to open up some parts of their economies that have been shut down due to the pandemic (https://www.nyt.com/2020/04/21/opinion/coronavirus-test.html). The editors argue that there is a need for far more tests than have thus far been done. In the week ending on April 16, “about 150,000 Americans per day were tested for the coronavirus, according to the Covid Tracking Project. This total number of testing had remained the same over the previous two weeks.

The NYT editorial board asks, “How much more is needed?” To enable a safe resumption of economic activity even in phase one of the White House plan, it would take “from 500,000 tests per day to five million per day, and beyond.” They refer to a Rockefeller Foundation report published on Tuesday, April 14, that lays out “a useful road map for the United States to reach three million tests per week by late June.” According to the report, 3 million tests per week “would be sufficient to test people with coronavirus symptoms, people identified as coming into contact with those who have the virus and people at high risk if they get the virus.’ The foundation assumes that 3 million tests per week “would allow for a limited return to normal activity [at phase one level] across much of the country.” In order to achieve this level of testing, laboratory facilities that “currently perform other kinds of tests, including university labs and small private labs” would have to be conscripted to focus on tests relevant for the Covid-19 virus. The foundation’s report “estimates that two-thirds of the nation’s molecular testing capacity is used for other purposes and could easily be redirected.” The report calls for the creation of a nonprofit, a central hub, “to place bulk orders for needed supplies, that is, to ensure that there are no shortage of critical supplies to carry out the testing in any location. At a fixed $100 fee for each completed test, the estimated cost is around $100 billion. But this plan would require that Trump uses his authority under the Production Control Act to compel labs to participate, something he has been reluctant to do.

But the goal of doing 3 million tests a week is only the start. The Rockefeller report says that it will be necessary “to aim for the capacity to perform 30 million tests every week by the fall,” if the economy is to move toward expanded – and safe – economic activity.

Many governors say they don’t yet have adequate testing capability

J.M. Rieger reports on this predicament in an article published in The Washington Post on April 22 (https://washingtonpost.com/politics/2020/04/22/trump-administration-says-states-have-testing-capacity-they-need-governors-says-they-lack-testing-supplies). He writes: “Nearly one-third of governors over the past week have said they lack sufficient coronavirus testing supplies to reopen their states, according to a Fix analysis of public statements….Many of the 16 governors who have said they lack testing supplies have not disputed they have ample testing capacity to start to reopen, but that doesn’t mean there aren’t other hindrances. Some, like New York Gov. Andrew M. Cuomo (D), have said his state needs to double existing testing, while others like Washington Gov. Jay Inslee (D) have said his state needs to quintuple existing testing.” Rieger continues: “Among the testing supplies governors have said they are lacking are swabs and reagents. Some governors have called for the federal government to acquire and distribute testing supplies to the states amid a global shortage.” In any case, they think that some centralized and unified supply source needs to be created.

Trump and his supporters further politicizes the issue

In an article for Truthout on April 20, Chris Walker reports on the protects that have occurred across the country on April 18-19, “in which participants argued against stay-in-place orders meant to slow the spread of the coronavirus, and in favor of ‘reopening the economy’ now without conditions, as sometimes pushed by President Donald Trump” (https://truthout.org/articles/lifting-stay-in-place-rules-wont-fix-economy-if-virus-still-rages-fauci-says).

Heather Digby Parton digs into other forces that are generating the protests against the stay-at-home rules (https://truthout.org/articles/trumps-praise-for-astroturf-protests-is-a-divisive-relection-strategy). She refers to a report by Salon’s Sophia Tesfaye that the protests are organized, at least in part, by Freedom Works, one of the instrumental forces behind the Tea Party. Freedom Works is “holding weekly virtual town halls with members of Congress [and] igniting an activist base of thousands of supporters.” It is financed by Charles Koch and other big money contributors.

Parton continues: “Other right-wing groups vocally opposing shutdowns include Americans for Prosperity, an organization [also] funded by the Koch brothers, and the conservative Heritage Foundation. There is even a connection to the family of Trump’s Secretary of Education, Betsy DeVos. As Michigan’s governor noted, the DeVos family foundation helped fund Facebook ads for this week’s protest.” Pro-gun activists have also joined the activities. Both Trump and Vice President Pence have praised the protestors, despite “common sense and all legitimate scientific advice…  that prematurely letting our guard down will likely lead to a resurgence of the epidemic.” If that should happen, it would mean “shutting down the economy all over again, with even worse consequences.” They – and the Republican Party – are willing to take this risk because they give greater weight to their political futures than to the health of the population. They “are, Parton explains, still convinced that a highly divisive strategy focused entirely on their base voters is the way to go, even in the midst of an unprecedented public health crisis.

The billionaire backers are not alone. “Republicans in Congress are doing their part as well,” Parton points out. “The bill coming up for a vote this week to supplement the small-business bailout fund [now passed by the US Congress, April 24] is missing something vital that Democrats and governors of both parties have been begging for, that is,  “help for state and local governments, many of which are in dire economic trouble and hamstrung by balanced-budget requirements.” Why? Parton refers to research by Axios that finds

“Republicans will use this prospect as a cudgel to force states to reopen: ‘The thinking among some Trump administration officials is that many states should be reopening their governments [and economies] soon and that additional funding could deter them from doing so.’”

The polls go with the experts, not Trump

Parton considers how the pro-protestor backers may underestimate the fear and suffering of the American public. She writes: “The real effects of the virus may upset their plans. Maybe it’s the growing pile of dead bodies — more than 40,000 of them as of Sunday night [April 19; and over 50,000 by April 24]— or Trump’s increasingly unhinged behavior at these coronavirus briefings, but recent polling shows that Trump’s rally-round-the-flag bump in support has already dissipated. Gallup has Trump’s approval rating down to 43%, from 49% last month, while his disapproval rating is up nine points, to 54%. The latest NBC-Wall Street Journal poll reports that 60% of respondents say that Trump did not take ‘the threat seriously at the beginning,’ with a similar number in the Pew poll saying that Trump was ‘too slow’ to recognize the threat. His overall approval average is headed back down to the low 40s, where it’s been throughout his entire term.”

More bad news for Trump and his right-wing supporters. The Kaiser Family Foundation conducts ongoing polls of the public on health care issues and, recently, on attitudes regarding various aspects of the Covid-19 pandemic. In their most recent poll KFF finds: “most Americans (80%) say strict shelter-in-place measures are worth it in order to protect people and limit the spread of coronavirus. Fewer (19%) say the strict shelter-in-place measures are placing unnecessary burdens on people and the economy and causing more harm than good. Majorities also say they can continue following strict social distancing and shelter-in-place guidelines for more than another month while less than one in five say they either cannot follow the guidelines at all (3%) or say they can follow the guidelines for less than a month (14%). While a majority of Republicans say they can follow social distancing guidelines for a month or longer, three in ten Republicans say they can either follow them “less than one month” or ‘not at all.’”

Concluding thoughts

 Amidst the double whammy of the pandemic and an increasingly depressed economy, the road ahead remains ambiguous. What is clear, though, is that the federal government must play a leading role in providing a significant part of the resources, financial and otherwise, to assist states, medical providers, displaced workers, business of all sorts, and vulnerable and low-income segments of the population with a safe and healthy environment and a unprecedented assistance in rebooting the economy. And it seems that a growing majority of the population has come to recognize that all workers are essential, that our societies are more fragile than many previously believed,  that unity is better than division, and that government has an important role to play in it all.

If we were operating in the spirit of the 1930s New Deal, the country would also prepare to do extraordinary things. Here are some examples: rebuild the social safety net; introduce a universal, single-payer health care system; strengthen the public health systems at all levels of the society; increase support for scientific research; support public education and accessible educational opportunities at higher levels; create employment-generating programs; enact a robust progressive tax system; advance reforms to transform or replace the mega-corporations that dominate the economy; build affordable housing; support alternatives to industrial agriculture; replace fossil fuels with renewable energy and efficiency; and build an energy-efficient infrastructure. The revenues for such projects would come from a revived economy, equitable taxes, and a healthier population. The Covid-19 virus would still exist but would be controlled, eventually, with vaccines. One other thing. A progressive government would support global institutions to assist the poor nations of the world, and to supplant militarism with diplomacy and cooperation, acknowledging that we live in a highly interconnected place we call earth.

If Trump, the Republican Party and their allies continue to hold the power they do, then there will likely be vaccines that will eventually control the virus, but also a society riven by enormous and increasing inequalities, a rigged political system, a system that is accelerating the degradation of the environment, the continued shattering of the social safety nets, an infrastructure in disrepair, a bias against policies that address the common good, and a foreign policy based on “America first” principles.

There are also middling possibilities. But we do not have a wealth of time to figure it all out. Even if there are eventually vaccines that control Covid-19, humanity continues to confront  an accelerating and increasingly destructive “climate change,” civil strife and war, the growing threat of nuclear war, the ongoing degradation of habitats on the seas and land, unsustainable industrial-type agriculture, massive numbers of migrants fleeing violence and poverty, the fight for increasingly scarce and vital resources, and the rise of autocratic, if not fascistic, governments. And all this takes place while the earth’s human population grows to 9 or 10 billion by mid-century.