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As Pandemic Widens, How Did We Get To This Point?


The coronavirus outbreak has entered a new phase in this country. That's what Dr. Deborah Birx of the White House Coronavirus Task Force is saying now.


DEBORAH BIRX: I want to be very clear. What we're seeing today is different from March and April. It is extraordinarily widespread. It's into the rural as equal urban areas.

MARTIN: Birx was on CNN yesterday and stressed the need for everybody - no matter where they live - to wear a mask and to socially distance. We're going to take a step back over the next few minutes and talk about where the virus is spiking now, how we got here and what it's going to take to turn it around. And we are joined by NPR science correspondents Nurith Aizenman and Rob Stein. Thanks to both of you for being with us this morning.


ROB STEIN, BYLINE: Good morning.

MARTIN: I'm going to start with you, Nurith. Dr. Birx talked about how widespread this outbreak has become, moving to new parts of the country. How did we get to this point?

AIZENMAN: Yeah. Remember - back in February, the outbreak was small and mainly in Washington state, California, and pretty soon the locus shifted to New York and New Jersey, where cases really blew up in early spring. But those states then went all in with strict lockdowns, such that by Memorial Day their cases had declined to on par with the caseloads of some big Southern and Western states like Texas, Florida and Arizona. And in the following weeks, New York for instance, kept up its social distancing to push its caseload down even lower.

Meanwhile, in a lot of the Southern and Western states like Texas, Florida, Arizona, the lockdowns weren't as robust, so cases had been sort of bubbling along at a steady rate, rather than declining. And then around Memorial Day, a lot of those Southern and Western states started easing up on their social distancing very fast, and that's what's given rise to this current situation.

MARTIN: So this is really - when we talk about the virus being so widespread now, as Dr. Birx said, we're really looking at the Southern and Western part of the country.

AIZENMAN: Correct. When you look at the daily new infections as a percentage of the population, right now 14 states are in the red zone, according to this rating system that a team from Harvard has come up with to flag - you know, when a state's transmission rates get so high, probably the only way to control it is to revert to some amount of stay-at-home mode. And all but one of these 14 red zone states are in the South and the West. The top five are Florida, Mississippi, Tennessee, Louisiana and Arizona.

That said, there are also now an additional 19 states just one notch below the red zone. And these orange zone states are all over the country - Iowa, Ohio, Wisconsin, North Dakota, Nebraska. By the way, for the last two, the daily case count isn't just high; it's rising.

Ashish Jha is on the Harvard team that came up with this red zone rating tool. He notes that some other wealthy countries coming out of the spring lockdown are seeing flare-ups, but Jha says the U.S. situation is totally different.

ASHISH JHA: What we have is not little flare-ups. We have a raging forest fire - large parts of our country where the outbreak is just out of control.

AIZENMAN: And even in some of the states that are in pretty good shape overall - Colorado, Washington, Oregon - there are a few individual counties where transmission is in the red zone.

MARTIN: So I know a lot of states, though - I mean, they've been late to the mask game.

AIZENMAN: (Laughter) Yeah.

MARTIN: Like, it took them a long time to get on board with requiring people or asking them to wear masks. But now they are. Is that helping at all?

AIZENMAN: Yeah, and in states where it isn't statewide, some cities and counties have gone ahead with that, along with other measures like closing bars; people are adjusting behavior on their own. Likely due to that, some states like Arizona have managed to slightly bend the curve. But cases and deaths there are still high. Meanwhile, in some of the hardest-hit states where the masking requirements are a patchwork, cases are still on an upswing - Mississippi, Tennessee.

One prominent forecasting team is, meanwhile, warning about rising case counts in areas of the mid-Atlantic and the Northeast like Baltimore or Philadelphia, the New Jersey Shore. That alert comes from the policy lab at Children's Hospital of Philadelphia. They say it's largely driven by summer travel.


AIZENMAN: Also, forecasters are warning the transmission could pick up further in autumn once the weather cools.

MARTIN: So what do you take away from that?

AIZENMAN: You know, scientists say it just illustrates that until there's a vaccine and that vaccine is widely deployed, this virus will remain a constant threat. It's going to take a sustained national strategy.

MARTIN: All right. NPR's Rob Stein has been listening in. I want to bring you into this conversation, Rob. Nurith just outlined where we're at. What needs to happen?

STEIN: You know, there's no question that things look pretty bleak right now, and it comes at a time when a lot of people are just kind of exhausted and fed up with the past five months, so it may make things seem kind of hopeless. But, you know, I spent all day talking with public health experts, infectious disease specialists, epidemiologists - they, too, can't quite believe what a mess the country's in. But they also say, look - all hope is not lost; quite the opposite. We know what to do. We can beat this virus. We just all have to get on the same page and do it. Here's Jeffrey Shaman at Columbia.

JEFFREY SHAMAN: We're all tired of it. I'm tired of it. I'm sure you're tired of it. We would much rather go back to our own lives, when we don't have people telling us that you have to socially distance and wear a face mask, and you can't go to restaurants, can't have sporting events, and you can't go to concerts, and you can't go to church. People are tired of that. That's totally understandable. But, unfortunately, this is a moment of collective national sacrifice, where we need to do that for the greater good.

MARTIN: But that same message, Rob, I mean, we've been hearing that for many months, and people are not getting it...

STEIN: Yeah.

MARTIN: ...Or enough people aren't getting it. So what's the next step here?

STEIN: Yeah. Yeah. So, you know, first of all, people do have to finally get it. They do have to really start wearing those masks and keeping their distance from other people as much as possible, especially indoors. But beyond that - and here is the tough part - we have to shut some things back down again in a lot of places. No one wants to hear that, but unfortunately that's the bitter pill that, a lot of places, they do need to swallow, especially in the hot spots Nurith mentioned and maybe places that look like they're about to become the next hot spots.

But, you know, it doesn't mean that has to go on forever - maybe six, eight weeks if it's done right. And that could slow the spread of the virus enough to get the pandemic under control. That won't mean game over - far from it - but at least the virus would be beaten back enough to let the country try to reopen more strategically and carefully this time, without the pandemic surging out of control again.

MARTIN: So would a lockdown like that, akin to what we saw in the spring - I mean, would it be as strict as we did back then?

STEIN: Well, you know, this is the little bit of good news - it doesn't necessarily have to be as strict. We've learned a lot about the virus. We can probably leave some things open this time, like parks and, you know, beaches and playgrounds, and go after the places and situations where the virus seems to be spreading the most. The virus is spreading too fast right now in too many places, and there still aren't nearly enough tests...

MARTIN: Right.

STEIN: ...For testing and contact tracing to stamp it down. But if you do that as much as you can, you could learn what to do to basically beat it back in the places where it's spreading the most, like crowded bars, maybe indoor restaurants, retail shops, certain factories, house parties and family gatherings. And if the nation does all that and finally gets enough tests and trains enough contact tracers, it won't be like our old lives, but it'll be a lot better than the lives that a lot of us are living right now and could get kids back to school and safely let people get back to work.

MARTIN: Testing, contact tracing, social distancing, masks - we have heard it before. We all just have to get on board. Science correspondent Nurith Aizenman and Rob Stein. Thanks to you both.

AIZENMAN: You're welcome.

STEIN: You bet.

(SOUNDBITE OF THE AMERICAN DOLLAR'S "SHADOWS") Transcript provided by NPR, Copyright NPR.

Rob Stein is a correspondent and senior editor on NPR's science desk.