Story at a glance
- As multiple states experience coronavirus case outbreaks, several are seeing consistent plateaus or declines.
- State residents following health protocols are extremely important to continued success.
Rising new COVID-19 infections and hospitalization rates across some of the most populous and warmest U.S. states — California, Texas and Florida are the latest hot spots — have turned public attention to which states are finally seeing substantial declines in new infections and how they got there.
In an analysis compiled by The New York Times, current state health data is aggregated to show the daily fluctuations in confirmed coronavirus cases across the 50 states, as well as in Puerto Rico, Guam and Washington, D.C.
While 35 states are seeing documented increases in COVID-19 infections, a consistent few oscillate between seeing outright declines and steady plateaus. Among the states consistently faring the best during the pandemic are Maryland, Rhode Island, Vermont and Connecticut, as well as Washington, D.C.
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A large part of these success stories has to do with complying with public health mandates, especially wearing masks.
Erin Sorrell, an assistant professor at Georgetown University’s Department of Microbiology and Immunology, specifically regards masks as a vital part of getting new cases down.
“I think the local governments, state governments requiring face masks in public is huge. That, to me, is one of the main reasons why we’ve been successful in decreasing cases or seeing a plateau compared to other states beginning to reopen,” Sorrell said, referring to both Maryland and Washington, D.C., as well as parts of Virginia.
Calling the use of facial coverings “paramount,” Sorrell also noted that washing hands, avoiding highly trafficked areas and having hand sanitizer in public are all ways to practice infection prevention control, or to reduce more coronavirus transmission.
These public health measures appear to be working when applied, especially when considering Washington, D.C., is the most densely populated territory in the U.S., and Rhode Island, Connecticut and Maryland trail closely behind at numbers three, six, and seven respectively. The District and these three states beat other areas like New York and California for population density.
On the other end of the population density spectrum, states like Vermont are also showing a steady plateau and relatively low case count. Sorrell notes that less densely populated areas can give governments a better chance to effectively social distance and enforce home quarantines for people who are ill.
For Jan Carney, the associate dean for public health at the University of Vermont Larner College of Medicine, successfully reducing coronavirus cases isn’t guaranteed with a less densely populated state.
“Population density is a piece of it, but not the total story, in my opinion,” Carney said.
Carney credits Vermont’s success in reducing the virus spread to strong relationships between public health officials, the health care sector and state government departments.
“There's excellent communication and working relationships between the department of health and the Vermont state government,” Carney said. This communication includes consistently sharing data and other relevant information back and forth.
“Those relationships are not something that happened as a result of COVID-19. Those relationships are there all the time,” Carney said. The state’s ability to respond in a unified way was very important to its success, she added.
Carney also noted that 89.5 percent agreed with the steps the state government was taking to fight the virus, according to a research survey she worked on. Researchers also saw evidence from the survey that respondents were practicing social distancing.
Sorrell saidthat residents of the DMV have followed state mandates and public health protocols diligently: “I think D.C., Maryland, and Virginia have done that very, very well and I think the public have bought into it.”
Additionally, Carney noted that Vermont’s department of health was quick to implement some of the Centers for Disease Control and Prevention’s recommended protocols, including wearing masks, social distancing and washing hands frequently. State public health experts also looked to the 1918 influenza epidemic to better understand how to fight the coronavirus.
“We followed the science,” Carney said. “I think all those factors are very important in our management to date and as well as going forward.”
She noted that the current health messaging Vermont state officials are aiming to keep in the forefront is positive, namely to wear masks and wash hands frequently.
The contrast in responses to the pandemic by state governments and residents is evident in current reopenings; Vermont, Maryland, D.C. and Rhode Island are gradually opening their economies to more in-person activities, while states like Arizona, Texas and California have recently backslid into more strict regulations.
Both Arizona and California began reopening at the start of May, and Texas reopened on April 27. Rhode Island also began steps to end its lockdown on May 9, but Washington, D.C., Virginia and Connecticut started reopening in mid-to-late May. Virginia didn’t officially lift its stay-at-home order until June 10.
When states reopened is certainly playing a large role in how they are faring now in containing the coronavirus, but it is not the entire picture.
"In some places it may be because they did in fact reopen too early," Surgeon General Jerome Adams told Business Insider. "In other cases it may be that they reopened right on time and that the governmental institutions and public health institutions did everything right, but that the citizens did not have the will or desire or the follow through to do the social distancing that we have recommended, and to wear coverings as we have recommended."
Both Sorrell and Carney agreed that reopenings have to be slow transitions. Sorrell in particular notes that progress is observed in retrospect, and that there is a lag time to see the impacts of current public health mandates as well as for new cases to be reported.
“The virus has not gone away. It is still here we are still in the first wave … a lot of people are talking about impacts and concerns for the second weave. We’re still in the first and we need to make sure we get out of it,” Sorrell said.
Johns Hopkins data notes that there are more than 2.6 million confirmed cases across the U.S.
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