US enters risky new phase of coronavirus fight

Reopening is entering a risky new phase as some states open up even as coronavirus cases continue to rise. 

At the same time, public health experts are acknowledging that stay-at-home orders cannot last forever amid rising fears of economic devastation and are instead urging a slow and measured approach to reopening as the country moves forward.

“I don’t want people to think that any of us feel that staying locked down for a prolonged period of time is the way to go,” Anthony FauciAnthony FauciWhite House sued over lack of sign language interpreters at coronavirus briefings Fauci warns of 'really bad situation' if daily coronavirus cases don't drop to 10K by September Overnight Health Care: Trump criticizes Birx over Pelosi, COVID-19 remarks: 'Pathetic' | Democratic leaders report 'some progress' in talks with White House | WHO chief: There may never be 'silver bullet' for coronavirus MORE, the government’s top infectious disease expert, said on CNBC on Friday. “We had to do that when we had the explosion of cases, but now is the time, depending upon where you are and what your situation is, to begin seriously looking at reopening the economy, reopening the country, to try and get back to some degree of normal.”

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As most of the country moves to reopen in some way, there is a wide variation in how states are faring. Some sparsely populated states, such as Montana and Vermont, have been doing relatively well throughout the crisis, and some larger states, such as Washington, have gotten high marks for tamping down the virus.

Other states that had large outbreaks, such as New York and Massachusetts, are now seeing declines in new cases but are proceeding slowly and cautiously in reopening. Some reopening states, such as Georgia and Missouri, have so far avoided spikes in cases.   

On the other hand, there are warning signs in states such as Alabama, Arkansas and North Carolina, which are reopening even amid a rise in new cases.

“I have concerns if cases are continuing to go up and you're actually jumping over some of the benchmarks that we put in the recommendations,” Fauci said in the CNBC interview. The White House guidelines for reopening call for a 14-day decline in new cases. 

Alabama has sparked particular concern in recent days after the mayor of Montgomery warned that the city had only one intensive care unit bed available. 

Gov. Kay Ivey (R), though, is proceeding with a plan to have movie theaters and bowling alleys reopen this weekend with precautions. Restaurants and bars are already open in the state. 

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Ivey said at a press conference Thursday that “our numbers are not as good as we would hope” but that it is time to reopen. 

“Just as we've had to learn to live with the flu and other viruses for which there is no known cure, it's not realistic to think we are going to be able to keep everyone totally isolated from each other forever,” she said.

Arkansas on Wednesday had its highest one-day jump in new cases yet, of 455. About half were in correctional facilities, and half were in the broader community.  

North Carolina has also seen rising cases even as it announced it was entering phase two of its reopening plan this weekend, allowing businesses such as restaurants and hair salons to open with limited capacity. 

These states note that one reason for the increases could be that testing is ramping up, and therefore more cases are being identified. 

Still, North Carolina Health Secretary Mandy Cohen said at a new conference Thursday, “I would have liked to see this trend starting to level, but it has not yet done that.”

On the other hand, Georgia, which drew national attention and concern over its early reopening, has not seen a spike in cases yet, though it is possible one could still come. 

The divergent scenarios have left experts unclear to some degree as to why some reopening states are seeing resurgences but others are not. 

“There are places I worry,” Ashish Jha, director of the Harvard Global Health Institute, said Thursday on a live chat hosted by PBS. 

“I've been very worried about Georgia. They opened early with a lot of cases, and it seems at least two-plus weeks in that they haven't seen a surge, and that's great,” he said. “Texas has opened, and they are seeing a rising number of cases. So what I expect is going to happen is over the next couple of weeks the picture will become clearer.”

Experts say the country is more prepared to deal with the virus now than it was when the stay at home orders began in March. Testing still needs to be ramped up significantly, but it has also improved markedly from when the country was mostly blind to the outbreak in February and March. 

States have also been working to hire contact tracers, who together with testing can help hunt down outbreaks and stamp them out, allowing the virus to be fought without blunt stay-at-home orders when there are relatively low numbers of cases.

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“Now states are better informed. States have better capabilities to do contact tracing, to take care of sick patients,” Tom Inglesby, Director of the Center for Health Security at Johns Hopkins University said during a forum on Thursday. “So we're in a different place than we were two months ago, but it's still important for people to recognize things can change quickly with this virus.”

Nationally, cases have declined somewhat from their peak in April but are still high and are not declining substantially. 

The virus could also quickly get out of control. Experts say even as businesses reopen, people should continue staying six feet apart, wearing masks in stores and washing their hands. 

“A little more than two months, ago we had 100 cases in this country, 100 cases recognized, and now have more than 1.5 million,” Inglesby said. “So things change quickly, and people need to pay attention to that. While this virus may be down in a given place, it's not out necessarily and could come back.”