
Cartoon – See You Soon!



The state’s struggle to combat the coronavirus reflects just what a tenacious adversary it really is. Even for a place that has a lot going for it, the toll has been severe — and it is growing by the day.
As of Friday, Massachusetts had more than 64,000 cases — behind only New York and New Jersey, its larger northeastern neighbors. New cases totaled 2,106, continuing a dismal streak lasting more than two weeks of at least 1,500 additional cases per day. Deaths hit 3,716, behind only New York, New Jersey and Michigan.
Even as many states began opening up their economies Friday — allowing restaurants, shopping malls and hair salons to do business — that remained a distant prospect in Massachusetts. Instead, Gov. Charlie Baker (R) on Friday was announcing new restrictions, including a requirement that people wear masks while in public.
“This is going to be a way of life,” Baker said. “No ifs, no ands, no buts, no doubts.”
The persistence with which people keep getting sick in Massachusetts has been matched in other hard-hit states. Rather than a precipitous decline, the number of new cases in places such as Illinois, California and the D.C. metro area has instead been leveling off slowly.
Experts say that is to be expected, even if it means a long road ahead.
“If social distancing is done well — and Massachusetts has done it pretty well — the effect is going to be to flatten the curve and spread it out over more time,” said David Hamer, professor of global health at Boston University and an infectious-disease physician at Boston Medical Center. “Instead of a peak, it’s a prolonged plateau. It’s going to be a gradual decline.”
Like other states, Massachusetts has avoided some of the most dire projections about how many people would fall ill. Its social distancing measures also have prevented hospitals from becoming overwhelmed.
But actually pushing down the rate — rather than treading water — will be tricky to pull off, because of the nature of who is getting sick.
More than half the state’s deaths have been people in long-term-care facilities, such as nursing homes. The elderly make up a slightly higher share of the Massachusetts population than the national average.
Essential workers — who have to commute to their jobs each day and often are in close quarters with others — also have been hit hard.
“Some people have been able to completely shelter at home. Their risk of getting anything is very low indeed,” said Jeffrey K. Griffiths, who teaches public health at Tufts University. “But there are other groups of people that man the gas stations, the grocery stores, the hospitals. They’re police and firefighters. They still have to go to work.”
And then there are the poor, for whom social distancing at home is particularly challenging.
Geralde Gabeau, an advocate for the state’s Haitian community, said she knows of immigrant families that are living 10 to a two-bedroom apartment and sharing a single bathroom.
“If one person gets infected, the likelihood of everyone being infected is very high,” she said. “There is no room for people to isolate.”
Gabeau said the immigrant assistance group she runs, Immigrants Family Services Institute-USA, has gone from helping 60 families to more than 300. “Our phone never stops,” she said.
And she hesitates before opening Facebook: “All you see is RIP,” she said. “Every single day, people are losing their grandparents. Yesterday we lost a young man, 34 years old. A family in Boston lost four people. The Haitian community is mourning like crazy.”
Immigrant groups say Massachusetts needs to do a better job circulating information about the coronavirus in multiple languages. Though much of the literature is translated into Spanish, that accounts for only about 40 percent of the state’s population that is not proficient in English. Gabeau said she has taken it upon herself to produce videos in Creole to help spread the truth about the virus for the Haitian community, which makes up a significant share of the state’s 1 million-plus foreign-born residents.
Massachusetts was among the earliest states to reckon with a coronavirus outbreak, recording its first case on Feb. 1. But Hamer said the virus was probably present far earlier, and it was far more widespread than anyone knew when Baker declared a state of emergency on March 10. With everyone cooped up indoors for the New England winter but without official mandates to socially distance, the virus had ample opportunity to spread.
Many of the cases from early March were traced back to a late-February conference hosted by a biotech company, Biogen.
Experts say that on the whole, the state has done well with its response. Baker is a Republican, while Democrats dominate the legislature. The two sides have worked cooperatively, with little partisan rancor.
“I would say that as a state we are doing this right,” said Maryanne Bombaugh, president of the Massachusetts Medical Society. “It’s a very positive example of how you can work together and make a difference for your people.”
Bombaugh cited in particular the prevalence of testing in Massachusetts, including of the asymptomatic, which she said accounts at least in part for the state’s relatively high infection levels. The state also is tracing those who come into close contact with people who have tested positive, a vital step in containing future outbreaks.
Unlike states that have been besieged by protests, there has been comparatively little pressure in Massachusetts to reopen before public health experts give the all clear. The state is among a coalition, led by New York, that is trying to coordinate reopenings across the Northeast rather than acting individually, as many states have done.
The state’s nonessential-business closure extends until at least May 18, with an advisory group due to report back to Baker by then on the best way to gradually reopen.
The governor on Friday said he was encouraged by a slight decrease in the percentage of coronavirus-positive patients requiring hospitalization. “Overall, this is a very good sign,” he said.
Yet testing is still below what epidemiologists would like to see before stay-at-home restrictions can be lifted. A sustained drop in positive results is another prerequisite. And although experts say it is probably coming, it will take some time to get there.
“The plateau is telling us that we’re getting there,” Griffiths said. “But if we were to open up again while we’re at that plateau, we would just see another sharp spike up.”

As Faust describes it, the issue boils down to this: The annual flu mortality figures published by the Centers for Disease Control and Prevention are estimates produced by plugging laboratory-confirmed deaths into a mathematical model that attempts to correct for undercounting. Covid-19 death figures represent a literal count of people who have either tested positive for the virus or whose diagnosis was based on meeting certain clinical and epidemiological criteria.
Such a comparison is of the apples to oranges variety, Faust writes, as the former are “inflated statistical estimates” and the latter are “actual numbers.”
To get a more accurate comparison, one must start with the number of directly confirmed flu deaths, which the CDC tracks on an annual basis. In the past seven flu seasons, going back to 2013, that tally fluctuated between 3,448 and 15,620 deaths.
Note that these numbers are very different from the CDC’s final official flu death estimates. For 2018-2019, for instance, the 7,172 confirmed flu deaths translated to a final estimate of between 26,339 and 52,664 deaths. Again, that’s because the CDC plugs the confirmed deaths into a model that attempts to adjust for what many epidemiologists believe is a severe undercount.
Now, let’s add a bar for this season’s covid-19 deaths, which as of this writing stands at 63,259, and which will be even higher by the time you read this. Note the drastic change in the y-axis to accommodate the scale of covid-19 mortality.
This year’s data are necessarily incomplete, as 22 weeks remain in the flu season. There are not likely to be many more flu deaths, as we are well past the worst of the season. But covid-19 mortality has plateaued at around 2,000 deaths per day. Where it will head next is anyone’s guess.
Using an apples-to-apples comparison, we can say that the coronavirus has already killed eight times as many people as the flu. By the time we get data for the entire season, the difference appears likely to be at least tenfold, or a full order of magnitude.
The coronavirus, Faust writes, “is not anything like the flu: It is much, much worse.”
One of the most challenging things about this pandemic is making sense of the profound uncertainty surrounding the many quantities that might appear, at first glance, to be rock solid. On the surface, comparing flu and coronavirus deaths seems like a simple proposition: dig up the official numbers of both and see which is greater.
But that effort gets complicated as soon as you realize that flu mortality is not reported as a tally but as an estimated range, which is far different from the individual counts, based on testing and diagnoses, used for covid-19. And because we can’t test and diagnose everyone, those covid-19 deaths are probably undercounted as well. Soon, what once appeared to be a simple mathematical exercise turns into a mess of algorithms, estimates and uncertainty.
People encountering that uncertainty for the first time, as many of us are during this pandemic, are likely to react in one of two ways. Some cherry-pick a single number that comports with their biases, creating an artificial certainty to score political points or avoid upsetting their preconceptions. That’s what the politicians and talking heads using faulty flu data to downplay the outbreak are doing. Others throw their hands up and declare the truth to be unknowable, indulging in the cynicism that believes you can “make statistics say whatever you want.”
But rather than try to make sense of this uncertainty ourselves, there’s a third option: turning to the experts who’ve devoted their entire careers to these questions. We can listen to the epidemiologists and physicians, people like Faust and his colleagues, who are trained to draw the best possible conclusions out of uncertain data, understanding that those conclusions may have to be updated as new information comes in.
And while the experts might not all agree on some points, something like a critical consensus emerges if we listen to enough of them. Then, that consensus can be used to inform policy that helps save lives and protect the economy.




Fauci, who has repeatedly cautioned against prematurely easing restrictions, said he already noticed that some states and cities are not adhering to the steps laid out in the White House’s recently issued guidance on reopening — a plan that administration officials say will now replace the expired federal social distancing measures.
“If you follow the guidelines, there’s a continuity that’s safe, that’s prudent and that’s careful,” he said.
But if governors rush to reopen when they aren’t ready, Fauci cautioned that the move would likely only set back the progress their states have made.
“There’s no doubt in my mind that when you pull back mitigation, you’re going to start seeing cases crop up here and there,” he said. “If you’re not able to handle them, you’re going to see another peak, a spike, and then you almost have to turn the clock back to go back to mitigation.”
Fauci’s comments come as dozens of states have unveiled plans to begin easing stay-at-home orders, with some changes already taking effect despite the number of coronavirus cases and related deaths continuing to rise nationwide. Georgia Gov. Brian Kemp (R), for example, weathered intense criticism, including from President Trump, after announcing that he would lift restrictions on a wide array of businesses, allowing them to open a week ago.
The patchwork effort to return to some semblance of normalcy coupled with the absence of stringent social distancing recommendations has left health experts worried, The Washington Post’s Yasmeen Abutaleb and Rachel Weiner reported. Attempts to reopen states too soon at a time when social distancing remains the most effective way to stem the spread of the virus could increase the risk of new outbreaks, experts say. According to most recent figures, the United States has more than 1 million cases of the coronavirus and nearly 63,000 deaths.
On Thursday, Fauci appeared to echo those concerns, but stressed that major problems could be avoided so long as states adhere to the federal government’s reopening guidelines, which he described as “very well thought out and very well delineated.”
“I keep trying to articulate to the public and to the leaders, ‘Take a look at the guidelines,’ ” Fauci said on CNN. “They don’t tell you because you’ve reached the end of the 30-day mitigation period that, all of a sudden, you switch a light on and you just go for it. That’s not the way to do it. Each state, each city, each region is going to be a little different.”
Citing the guidelines, Fauci reiterated that states need to report a steady decrease in coronavirus cases within a 14-day period in addition to meeting other requirements before even thinking about moving on to the first phase of reopening.
“The discretion is given to the governors, they know their states. The mayors know their cities, so you want to give them a little wiggle room,” he said. “But my recommendation is don’t wiggle too much.”
While Fauci acknowledged that some local leaders are following the guidance, he said “others are taking a bit of a chance.”
“I hope they can actually handle any rebound that they see,” he added.
Later in the segment, Fauci was asked by CNN’s chief medical correspondent Sanjay Gupta about whether the rise in cases in states that are reopening would be incremental or exponential. In response, Fauci said that though he doesn’t know for sure, he doubted that any area would see “something as explosive as we saw in New York.” New York, which has yet to lift restrictions, is the epicenter of the U.S. outbreak with more than 300,000 confirmed cases and roughly 23,600 deaths.
But he warned that states could really find themselves in trouble if infections managed to “spill over into the general community,” similar to the way the virus spread in New York.
“If you can’t stop that from happening, then I think you’re really going to see the sharp peak,” Fauci said. “That is going to be very disturbing when that happens because it’s really going to take a while to get it back down.”

“This is a proposal which I think is fiscally responsible but also recognizes the additional risk that people are taking,” Romney said in a phone interview with The Washington Post on Friday.
He noted that an essential worker who earns less than $22 per hour may ultimately be paid less than someone earning unemployment benefits that were bolstered by Congress in recent virus rescue packages.
“That’s not fair, number one,” Romney said. “And number two, it would create an anomaly, of course, for people to be taking additional risk of their health and have someone else not working making more than they are.”
The idea of hazard pay — additional compensation for those on the front lines of the pandemic — has broad conceptual support in Washington, yet neither lawmakers nor the Trump administration addressed the issue in the economic and health relief bill, totaling nearly $3 trillion, passed thus far.
President Trump has spoken in general terms about providing additional pay to critical medical personnel, and the White House has indicated that the administration is working with Congress on doing so. Senate Democrats have released a plan, dubbed the “Heroes Fund,” that provides up to $25,000 per person for a broad category of essential personnel including not just health-care employees but also food workers and delivery drivers.
Romney’s proposal covers a similarly broad swath of workers. The Labor Department and Congress would determine what industries would be deemed “essential,” but they would include at a minimum hospitals, food distributors and manufacturers. Employers would have to prove that workers would be in conditions that increased their exposure to the coronavirus to qualify for the bonus.
Three-quarters of that additional money would be paid for by the federal government in the form of a refundable payroll tax credit, and the rest would be picked up by their employer. That pay boost would last from May 1 through July 31 under Romney’s plan.
Someone earning $50,000 or less per year would receive an additional $12 per hour, with the hourly increase gradually phased out as salaries increase. The maximum qualifying salary would be $90,000.
Romney, a former Massachusetts governor with a lengthy business background, has spoken to other GOP senators and said that while opinions may differ, the concept of hazard pay could be gaining traction among Republicans.
“It strikes me that we’re open to considering a wide array of opportunities to help people that are serving the public,” Romney said. “And a number of individuals have expressed an openness to considering different ideas.”
https://www.vox.com/2020/4/29/21231906/coronavirus-pandemic-summer-weather-heat-humidity-uv-light
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Summer weather could help slow the coronavirus. But it’s likely not enough.
Some Americans are hoping for a natural reprieve to social distancing as the coronavirus pandemic drags on: that sunnier, warmer, and more humid weather in the summer will destroy the Covid-19 virus — as it does with other viruses, like the flu — and let everyone go back to normal.
There is some evidence that heat, humidity, and ultraviolet light could hurt the coronavirus — an idea that President Donald Trump bizarrely leaned into when he suggested the use of “ultraviolet or just very powerful light … inside the body” to treat people sickened by Covid-19 (an idea with no scientific merit, as experts have repeatedly stated).
But even if heat, humidity, and light help slow the virus’s spread, sunny, hot, and humid weather alone won’t be enough to end the epidemic. Experts point to the examples of Singapore, Ecuador, and Louisiana, all of which have recently had growing numbers of Covid-19 cases despite temperatures hitting 80-plus degrees Fahrenheit and humidity levels reaching more than 60, 70, or even 80 percent.
High levels of heat, UV light, and humidity can help prevent more widespread infections of the flu or colds in the summer, along with medical treatments and vaccines (when available). But the Covid-19 coronavirus is still new to humans, so we don’t have as much immune protection built up against it — so the virus seems able to overcome summer-like weather and still cause big outbreaks.
“For the novel coronavirus SARS-CoV-2, we have reason to expect that like other betacoronaviruses, it may transmit somewhat more efficiently in winter than summer, though we don’t know the mechanism(s) responsible,” Marc Lipsitch, an epidemiologist at Harvard, wrote. “The size of the change is expected to be modest, and not enough to stop transmission on its own.”
Still, the studies on heat, light, and humidity, plus the fact coronavirus has a harder time spreading in open-air areas, suggest that the outdoors may be a safe target for a slow reopening as transmission of the virus slows, as long as precautions like physical distancing and mask-wearing are followed. So outdoor activities could offer a respite to lockdowns and quarantines — one that’s also, potentially, good for physical and mental health.
It also means that if Covid-19 becomes endemic (a disease that regularly comes back, like the flu or common cold), then heat, sunlight, and humidity could restrict bigger outbreaks to fall and winter. But that possibility is likely still years away, experts say.
So summer weather may make the outdoors a little safer, but it won’t be enough to quash coronavirus on its own. That means we’ll likely need to continue social distancing to some degree in the coming months, and continue working on getting more testing, aggressive contact tracing, and medical treatments up to scale before places can safely reopen their economies.
There are a few ways that summer weather could have an effect on SARS-CoV-2. Higher temperatures can help weaken the novel coronavirus’s outer lipid layer, similar to how fat melts in greater heat. Humidity in the air can effectively catch virus-containing droplets that people breathe out, causing these droplets to fall to the ground instead of reaching another human host — making humidity a shield against infection. UV light, which there’s a lot more of during sunny summer days, is a well-known disinfectant that effectively fries cells and viruses.
“There are multiple coronaviruses out there that affect our population, and many of them, if not most of them, exhibit a seasonal influence,” Mauricio Santillana, the director of the Machine Intelligence Lab at Boston Children’s Hospital and a researcher on the effects of the weather on coronavirus, told me. “The hypothesis postulated for Covid-19 is that it will have a similar behavior.”
But that’s hypothetical. How does it play out in reality?
So far, the coronavirus has largely spread in the Northern Hemisphere, where it’s been winter and early spring. It’s not clear if the weather is a reason for that, because data on its spread in the Southern Hemisphere — particularly poorer countries in Africa and South America — is largely lacking due to weak public health infrastructure.
Still, we have some evidence. The National Academies of Sciences, Engineering, and Medicine — one of America’s top scientific evidence reviewers — summarized the research earlier in April. It looked at two kinds of studies: those that tested the effects of summer-like temperatures in a laboratory, and those that attempted to tease out the effects of heat, UV light, and humidity in the real world.
In the lab, researchers use sophisticated tools to see how the virus fares in different conditions. Generally, they’ve found more heat, UV light, and humidity seem to weaken the coronavirus — although one preliminary study suggested that coronavirus may fare better in the more summer-like conditions than the flu, SARS, and monkeypox viruses.
This is the kind of study Bill Bryan, the undersecretary for science and technology at the Department of Homeland Security, presented at the April 23 White House press briefing. That study found that coronavirus seemed to die off much more quickly in hotter, more humid environments with a lot of UV light.
As the National Academies noted, however, this evidence comes with big caveats. Perhaps most importantly, these studies haven’t yet been peer reviewed. So they could have big methodological errors that we just don’t know about yet. (This Wired article does a good job breaking down the concerns with such early research.)
But even if these studies are well-conducted, the real world is simply a lot messier than a laboratory setting. For example, the lab-grown virus used in these studies may act at least somewhat differently than the natural virus in the real world.
People can also act differently in summer than they do in winter, and the lab studies don’t account for how those behaviors affect coronavirus’s spread. People are more likely to stay indoors during the winter to avoid the cold — but indoor spaces are generally more poorly ventilated and cramped, both of which make it easier for the coronavirus to spread. Warmth and sunshine also could impact the immune system, though that relationship is still unclear.
We’ll get more evidence on real-life seasonal effects as the months go by — especially if more places take potentially dangerous risks. “In Georgia, where they are opening back up without really any concrete measures to encourage distancing, we might be able to better evaluate how [the coronavirus] spreads in the summer months,” Angela Rasmussen, a virologist at Columbia, told me.
But there is some early real-world research already, which the National Academies also reviewed. These studies looked at whether the SARS-CoV-2 virus was affected by different climates in real-world settings, and if it spread more easily in places where it was colder and less humid and there was less UV light. Some researchers also developed models based on data from different outbreaks in different parts of the world.
One upcoming study from a group of researchers at the University of Nebraska Medical Center tried to model the effects of heat, humidity, and UV light, finding that they mitigated the spread of the virus. UV light seemed to play a bigger role, although the researchers cautioned that their findings will need to be replicated and verified with, ideally, years of data. “This is a very new virus, and there are lots of things we don’t know about it,” Azar Abadi, one of the researchers, told me.
But this aligns with the evidence that the National Academies reviewed.
“There is some evidence to suggest that SARS-CoV-2 may transmit less efficiently in environments with higher ambient temperature and humidity,” Harvey Fineberg, author of the National Academies report, wrote. “[H]owever, given the lack of host immunity globally, this reduction in transmission efficiency may not lead to a significant reduction in disease spread without the concomitant adoption of major public health interventions.”
This is the point experts emphasized again and again: It’s one thing for the weather to have some sort of effect on coronavirus; it’s another thing for that effect to be enough to actually halt the virus’s widespread transmission. We have early evidence the weather has an effect, but we also have early evidence that it won’t be enough.
The problem: Other factors, besides the weather, play a role in the spread of diseases. In the case of coronavirus, these other factors seem to play a much bigger role than weather.
The mayor of Guayaquil, Ecuador, where it’s regularly 80-plus degrees Fahrenheit, described her city’s experience with Covid-19 “like the horror of war” and “an unexpected bomb falling on a peaceful town.” Ecuador now has one of the worst coronavirus death tolls in the world — a sign that warm, sunny, and humid weather can’t make up for struggling public health infrastructure in a still-developing country.
Singapore, which is nearly on the equator, managed to contain coronavirus at first, but it has seen a growing outbreak recently. The problem, it seems, is the government neglected migrant workers in its initial response — letting Covid-19 spread in the cramped and sometimes unsanitary conditions many migrants live in. Warm, humid weather alone wasn’t enough to overcome preexisting issues and an overly narrow public policy response.
Meanwhile, Louisiana is suffering a significant coronavirus outbreak, with the fifth-most deaths per 100,000 people out of all the states. According to experts, Mardi Gras — held on February 25 — may have accelerated that. The massive celebration seemed to cause a lot of transmission, even as New Orleans saw temperatures up to the 70s, and cases continued to climb even as temperatures reached the 80s. Maybe the weather made things better than they would be otherwise, but it was, again, no match for human behavior’s effects on the spread of Covid-19.
The bigger problem is too many people in the US are still vulnerable to the virus. “While we see some influence [of the weather], the effect that we’re seeing — if there’s any effect — is eclipsed by the high levels of susceptibility in the population,” Santillana said. “Most people are still highly susceptible. So even if temperature or humidity could play a role, there’s not enough immunity.”
That made it extremely easy for the virus to spread, regardless of the weather, especially since SARS-CoV-2 appears to be so contagious relative to other pathogens. In contrast, if you think about the viruses that are more affected by the seasons — the flu and colds — humans have been dealing with them for hundreds if not thousands of years. That’s let us build some population-level protection that we just don’t have for Covid-19, making other factors besides our actions, like the weather, a bit more important for the seasonal viruses.
So down the line, if Covid-19 becomes endemic — a possibility if, for example, immunity to it isn’t as permanent as we’d like — it’s possible that seasons will have a much stronger sway over when it pops up again.
Even then, it’s worth acknowledging that seasons don’t fully determine when the flu and colds hit. As the National Academies pointed out, some flu pandemics have started in the summer: “There have been 10 influenza pandemics in the past 250-plus years — two started in the northern hemisphere winter, three in the spring, two in the summer and three in the fall.”
In fact, some of this research could be taken to mean that coronavirus will be even more dangerous eventually: If the colder, dryer weather this fall and winter empowers the virus, that could lead to a bigger outbreak. The National Academies noted, as an example, that a second spike is typical for flu pandemics: “All had a peak second wave approximately six months after emergence of the virus in the human population, regardless of when the initial introduction occurred.”
But, as is true in the reverse, other factors besides the weather likely play a bigger role in the spread. So if governments and the public do the right thing through the fall and winter, there’s still a good chance that there won’t be a big spike.
The upshot of all of this: The changing weather likely won’t be enough on its own to relax social distancing. Given that there’s still a lot about Covid-19 we still need to learn, experts don’t know this for certain. But it’s what they suspect, based on the data that we’ve seen in the research and real world so far.
“If the only concern is the health of people, it’s irresponsible to go back to relaxing social distancing anytime soon,” Santillana said. “We’re not done, even if summer starts.”
So as the plans to end social distancing indicate, the world will likely need at least some level of social distancing until a vaccine or a similarly effective medical treatment is developed, which is possibly a year or more away. That may not require the full lockdown that several states are seeing today, but it will mean restrictions on larger gatherings and some travel, while perhaps continuing remote learning and work.
Weather could help determine how safe it is to go outside, even as social distancing continues. Some states, for example, are considering opening parks and beaches during the earlier phases of reopening their economies. Experts warn that summer weather won’t allow large gatherings — 50 people or more is often cited as way too many — but it could give people some assurance that they can go outdoors as long as they keep 6 feet or more of distance from others they don’t live with, avoid touching surfaces and their faces, and wear masks.
Otherwise, however, how much social distancing will be relaxed in the coming months won’t come down to the weather but likely how much the US improves its testing and surveillance capacity. Testing gives officials the means to isolate sick people, track and quarantine the people whom those verified to be sick came into close contact with (a.k.a. contact tracing), and deploy community-wide efforts if a new cluster of cases is too large and uncontrolled otherwise.
While the US has seen some gains in testing, the number of new tests a day still fall below estimates of what’s needed (500,000 on the low end and tens of millions on the high end) to safely ease social distancing.
Along with testing, America will need aggressive contact tracing, as countries like South Korea and Germany have done, to control its outbreak. A report from the Johns Hopkins Center for Health Security and Association of State and Territorial Health estimated the US will need to hire 100,000 contact tracers — far above what states and federal officials have so far said they’re hiring. A phone app could help mitigate the need for quite as many tracers, but it’s unclear if Americans have the appetite for an app that will effectively track their every move.
These are, really, the things everyone has been hearing about the entire time during this pandemic. It’s just worth emphasizing that the summer weather likely won’t be enough on its own to mitigate the need for these other public health strategies.
“The best-case scenario is if we’re doing that [social distancing] and there’s a dampening [in the summer], maybe there is a possibility of limiting this virus here in the United States and other places,” Jesse Bell, one of the University of Nebraska Medical Center researchers, told me. “But then again we just don’t know.”
So we’re very likely going to need social distancing, testing, and contact tracing for the foreseeable future, regardless of how warm, sunny, and humid it is outside.

The divide between rural and urban America was highlighted during the first several weeks of the COVID-19 pandemic in the U.S., as major metropolitan areas were hit much harder than their rural counterparts, suggesting lower population density could spare rural America the brunt of the outbreak.
However, this week’s KFF analysis suggests COVID-19 is now spreading in rural America, whose older population and smaller, often sparsely equipped hospitals may be ill-prepared to bear up against the coronavirus. That rural hospitals have been in dire financial straits for years suggests that they may not be able to marshal the resources to properly respond if they become inundated with coronavirus patients.
A recent letter from the Medicaid and CHIP Payment and Access Commission to Health and Human Services Secretary Alex Azar also suggests that hospitals with a high proportion of Medicaid and low-income patients are not getting enough emergency federal funding in response to COVID-19, a trend that could also hurt some rural hospitals.
According to the KFF analysis, there was a 45% uptick in COVID-19 cases in non-metro counties over the past week, versus 26% in metro counties. Over two weeks, cases increased 125% in non-metro counties versus 68% among their urban counterparts. And deaths are up 169% over the past two weeks in non-metro counties, versus a 113% increase in metro counties.
Meanwhile, the easing of lockdowns in states with large rural areas foretells more problems in the near-term. “Georgia has started to reopen certain businesses and allow limited dine-in at restaurants, despite some of its counties rising toward the top of this list of U.S. metro and non-metro counties with the highest numbers of COVID-19 deaths per capita,” the KFF analysis observed.
The county with the most deaths per capita in the U.S. is Randolph County, with 278 deaths per 100,000 people. Randolph is a rural county in Georgia.