October 16, 2021

As the U.S. reopens, more virus outbreaks are likely

Todd R. McAdam/managing editor

Adam Mendies, left, walks with his roommate, who declined to be identified, on Thursday on North Main Street in Cortland. They take COVID-19 protection seriously, and plan to continue social distancing until a vaccine for the virus is available.

Cortland County is just starting to open up again for the first time in nearly two months. The transition is slow — not everything is back to normal, not by any means.

But as we begin to move in the direction of normality, uncertainty lingers. The novel coronavirus is still out there, and as reopening proceeds, the chance of infection numbers going up also increases.

The possibility of future outbreaks also increases. According to the state executive order governing the reopening process, regions of New York must meet — and continue to meet — seven criteria, which include keeping infection numbers and rates of increase low. In a worst-case scenario, a big bump in positive cases could put us right back to where we are right now.

But after weeks of being cooped up at home, people are anxious to get back to normal. At the same time, people are also concerned about contracting a virus for which there is no vaccine and no effective treatment, and for which a vast majority of greater Cortland area residents have not been tested.

Without a vaccine, effective treatment or widespread testing, public health experts expect the novel coronavirus to be a feature of daily life for the foreseeable future. In fact, on Wednesday, Michael Ryan, executive director for the World Health Organization’s Health Emergency Program, said in a news conference that the coronavirus could become endemic and “may never go away.”

Social distancing

Adam Mendies and his roommate strolled Thursday along North Main Street in Cortland, wearing matching brown masks with polka dots. They live together, and avoid getting within 6 feet of people, but the masks remain on.

“I think people need to take it more seriously,” Mendies said, as the pair glanced as a bicyclist passed by. Not quite 6 feet.

The two have grown comfortable during the pandemic-inspired shutdown and discuss whether it was simply to allow health providers to stock up on supplies — ventilators, masks and protective gear — or whether it was to give time to people like them to learn new, safer, ways of behaving to slow the spread of the virus.

“People are going out like it’s another day. They’re on the road,” Mendies said. “On the first day, the streets were empty. Now they’re full.”

‘Taking a risk’

Dr. Isaac Weisfuse, a medical epidemiologist with Cornell University Public Health, sees the current patchwork re-opening of the country, in which states are in charge of decision-making, as a big gamble.

“There really isn’t a great precedent for this. It’s not really clear what to do, and I think we should probably take it very cautiously,” he said. “We’re sort of conducting in the United States this big national experiment where some places are opening up quite a bit and other places are not.”

This decentralized experiment, Weisfuse said, will also be hard to learn from, because it makes an already confusing situation more complex. It will be harder to obtain and compare data.

“We have to really keep track of what the results are,” he said.

Moreover, infection outbreaks are likely, but we don’t know yet how significant they will be, he said, but he thinks areas of the country that have been doing well so far could be in for an unpleasant surprise.

The Cortland area, for instance, has so far been spared any serious consequences from the pandemic, but this could change, he said. By Friday, the county had seen only 39 confirmed cases and no deaths, fewer than any other county in the Central New York Region.

Only five counties in New York have fewer cases, the state Department of Health reports. Also, only five — Lewis, Jefferson, Oswego, Schuyler and Chatauqua — have a lower rate of infection, adds the Johns Hopkins Coronavirus Tracker.

“I think the impact on locations could be profound if there is a resurgence of cases, especially if they are places that haven’t seen many cases beforehand,” he said. “You may not have as dense housing, but the resources that you have there are also proportionally smaller.”

Outbreaks, depending on how severe, could require moving back into lockdown.

“I think that could be difficult both mentally and economically for many people,” Weisfuse said.

One tool on the belt

An outbreak that overloaded local hospitals “creates a whole other dynamic,” he said — one in which nonsymptomatic people who need other urgent medical treatment stay away from hospitals for fear of contracting the virus, which in turn can lead to worse outcomes for those people, on top of what would already be a crisis.

“So there’s a whole cascade of results that may occur,” he said.

Weisfuse said that we don’t know the true numbers of fatalities COVID-19 has caused so far, just that the numbers available so far are an undercount.

Without a vaccine or effective treatments, “the only thing we have in our tool belt is social distancing,” he said.

New York’s approach to reopening is “probably a good approximation of what’s needed,” he said.

But other areas of the country that are being less cautious — such as ones with rising infection numbers “are definitely taking a risk,” Weisfuse said. “From my perspective, there’s no amount of economic activity that can replace a person who is infected and passes away from it.”

Varied vulnerability

Even if there is a resurgence of cases in Central New York and the Southern Tier, including, Cortland and Tompkins counties, those residents are less likely than many other New York counties to incur serious consequences, according to an analysis published in April of demographic data by Cornell Population Center in the Cornell Program on Applied Demographics.

The analysis ranks New York counties according to two types of vulnerability — demographic and health. Demographic vulnerability is measured by the percentage of the population:

  • 80 years or older.
  • With a disability.
  • Living in group facilities.
  • Living in households that span three generations.

In this category, Cortland does well, with a negative vulnerability index, and ranking 41 out of 62 counties, with No. 62, Saratoga County, the least vulnerable.

Cayuga County, however, doesn’t do so great, ranking 18th out of 62, and having a positive vulnerability index.

Health vulnerability is determined by the percentage of residents with known health risks such as asthma, cardiovascular disease, diabetes, high blood pressure, adult obesity and smoking.

Cortland again does OK in this category — with a negative vulnerability index and a rank of 49 out of 62 counties.

Cayuga, again, does poorly, with a positive vulnerability index and a rank of 29 out of 62 counties.

Tompkins County, on the other hand, does quite well according to both metrics, ranking in the lowest quartile on both measures — 58th for demographic vulnerability and 57th for health vulnerability.

Economic resilience

But a rebound of infections would affect not only physical and psychological health. The economic damage would also be severe — and, in the case of many small businesses, devastating.

The area has not yet seen the full extent of the economic damage of the past two months, said Daniel Alpert, a senior fellow in financial macroeconomics at the Cornell University Law School.

“We still don’t know how many small businesses won’t be able to reopen,” Alpert said. “Most small businesses are not running on a cushion of enormous capital. They’re running hand to mouth. So any spike in the disease is only going to exacerbate that. That condition already prevails, and a spike (in infections) just makes it worse.”

But the original projections on the number of hospitalizations over the past few months didn’t pan out, and the crisis, so far, has not been as catastrophic as was initially feared. This, Alpert said, gives policymakers greater flexibility, and allows for the reopening process.

However, unemployment has reached highs not seen since the Great Depression; more than 36 million Americans have so far filed for unemployment.

“That’s a number we haven’t seen before,” he said. “That’s an enormous number of people who are out of work.”

The rate at which unemployment has grown is also unprecedented.

“We’ve never seen employment build at this rate,” Alpert said.

Certain sectors of the economy have been hurt a lot more than others.

Hotels, motels, restaurants and bars, for instance, have been hit hard by the economic shutdown.

But manufacturing workers and white collar workers are, for the most part, still working, and they are generally paid more, though they may feel more risk from working in close proximity.

“Even if they’re worried to go back to work, at least they’re being compensated to take the risk,” Alpert said.

Drawn-out recovery

Alpert specializes in studying low-quality jobs, or those with low wages and low hours, which have become increasingly prevalent in American society — 63% of the jobs created since the 2007-08 economic crisis are in this category, he said.

People with low quality jobs are the most likely to be out of work due to the pandemic, he said.

The question is what their employers will do now that the economy is starting to reopen, because re-opening does not guarantee that customers will come flocking back.

If they don’t, business owners especially small-business owners won’t be able to afford to keep employees on the payroll.

“If customers don’t show up, then those businesses are going to shut down,” Alpert said. The longer these trends continue, the more likely these businesses are to fail.

Future outbreaks threaten business further, partly by the lockdowns that would follow, but also because of increasing fear in customers, who would become even more reluctant to patronize businesses they used to frequent.

“Any increase in the disease is going to keep customers away,” he said.

But given these caveats, and based on the current data, Alpert thinks reopening the economy will be slow but largely steady.

“This is not going to be a smooth process and it’s not one size fits all,” he said. “But my feeling at this point is that we’re going to have a relatively stable experience.”

The damage, however, will be serious and lasting, and will require sustained government effort to mitigate.

“So this isn’t just turn the key, reopen and we’re done,” he said. “This is going to be a long drawn-out process.”