America could learn a lot from the state hit hardest by COVID-19 — if only Republicans would listen

The pandemic has created an almost infinite number of questions. One of the biggest faced by our country, our states, and our localities is how to start “reopening.” Most states mandated widespread closures of businesses and other public institutions in order to mitigate the damage caused by COVID-19, but even with those measures, and social distancing, we’ve already lost over 100,000 Americans—disproportionately Americans of color.

The crucial decisions on the reopening process have fallen largely to the states. The wrong strategy can result in a second wave of the virus far more deadly than many may expect. The 1918 Spanish flu killed 675,000 Americans—and our population then was only one-third of today’s; almost 200,000 of those deaths occurred in the second wave, after social distancing and other public health measures were relaxed prematurely. Could we be setting ourselves up for something equally disastrous? It may boil down to which state you call home.

New York is one of the states hit hardest by COVID-19. But finally, in recent days, the Empire State has begun to reopen, region-by-region, utilizing a very careful and transparent process. Eight weeks ago, 800 New Yorkers were dying each day from the coronavirus, but this Friday that number hit a new low of 42. Still far too many, but clearly the actions the state has taken are helping a great deal. New York Gov. Andrew Cuomo, a Democrat, has also been quite vocal in the debates over the federal government’s responsibilities when it comes to helping states recover in financial terms. On this, as well as the reopening, he has displayed much wisdom.

First of all, New York’s elected leaders, working with health experts, recognized that each region of the state was impacted by the virus in a different way. New York City witnessed suffering like few other places in the world, while parts of upstate experienced a relatively mild outbreak. With this in mind, Cuomo and his team created a regional, multiphase approach that centers each zone’s realities, independent of the others.

Next, New York’s reopening relies on clearly defined metrics:

• declines in numbers of people hospitalized
• deaths
• new hospitalizations
• hospital bed capacity
• bed capacity in intensive care units (ICU)
• testing capacity
• contact tracing capacity

The first five numbers relate directly to how much the illness exists in any given geographic area. The last two are equally important. Without proper testing and contact tracing, it is impossible to identify new outbreaks and quickly isolate both sick people and those with whom they’ve come in contact. That’s how communities cultivate every chance of mitigating whatever second (or third, etc.) waves that might break out.

Hitting all the metrics means a region can enter Phase One, in which the following businesses can reopen: construction, agriculture, forestry, hunting and fishing, manufacturing, wholesale trade, and retail—the latter open only for curbside or in-store pickup and drop-off. Phase Two allows full reopening for retail, as well as “all office-based jobs, real estate services,” and “limited barber shop and hair salon services.” Phase Three reopens restaurants, and Phase Four includes arts, entertainment, recreation, and education. Two weeks after a region enters each phase, its leaders, along with state officials, will assess whether to move on to the next phase. After a bit of initial confusion, five regions entered the second phase on May 29, with two others getting there this past week.

Beyond the numbers, this is also about values. New York is not going to reopen simply because wealthy corporate interests demand it do so NOW. On the other hand, no state can afford to wait to reopen until the virus is gone completely, or until there is a vaccine or treatment, none of which will happen in all likelihood anytime this year. Thus New York is acting in ways that minimize the risk for the maximum number of people.

Unfortunately, many parts of the country have not followed a similar approach; the impeached president bears a significant share of the blame.

50 governors are charting their own paths. The White House and the CDC have released bare-bones guidance for reopening, but neither entity can dictate what states do; they can only hope that governors choose the right course.

As of early May, that wasn’t happening. More than a dozen governors’ reopening plans appeared to either outright ignore, or interpret very loosely, the Trump Administration’s nonbinding reopening guidelines, according to an Associated Press analysis. [...]

Much of the blame for that disarray falls on Trump himself. The President has repeatedly undermined the guidance of his own public-health officials, fomented antiquarantine protests on Twitter and politicized cautious positions taken by some governors. On May 7, the AP reported that the Administration had “buried” more detailed CDC advice to states on how to safely reopen.

Finally, after leaks and significant outside pressure, the White House allowed the Centers for Disease Control and Prevention (CDC) to issue some revised guidelines with more details—but that took place after a number of states, starting with Georgia on April 24, had already begun their reopenings. A competent government would have devised a more logical sequence. Although there are many adjectives with which to associate this administration, those are not two of them.

As for the results? They are starting to look more than a bit scary, as the number of new COVID-19 cases is increasing in a large number of states—most of which reopened a few weeks ago. Even more concerning is that, while 13 states saw case numbers rise the week ending May 17, 20 states saw increases the following week. That’s not a promising trend.

Widespread nationwide protests—which are unquestionably righteous and obviously necessary in order to create the change our country must undertake on police violence and white supremacy—might well have the tragic side-effect of further spreading the virus. If that happens, there would presumably be a ripple effect on reopening as well, further delaying the process—at least in states that actually pay attention to health metrics.

Writing for The New York Times, Georgia physician Keren Landman detailed her state’s poor choices, and put the blame on Republican Gov. Brian Kemp.

Someone had to go first, and Mr. Kemp isn’t the only political leader eager to reopen the country. But the ham-handed way he went about it makes Georgians of all stripes afraid of what comes next, and it leaves us wondering whether he is setting us up for a punishing new wave of infections. He has clashed with city and county leaders and left business owners — the people he was trying to help — in the dark.

From my vantage point as a doctor, an epidemiologist, a journalist and a native Georgian, it’s clear that if there’s anything to be gained from this moment’s anguish, it is the opportunity to help others avoid our mistakes.[...]

Some of our confusion and fears were inevitable — but the governor exacerbated those with his poor planning, and he may have set us up for a relapse. Inevitably, other governors will make other mistakes, even if they learn from Georgia’s mistakes.

Wisconsin reopened not because of any metric at all, but because hyper-partisan Republicans—both in the state legislature and on the state Supreme Court—acted to overturn the stay-at-home order issued by Democratic Gov. Tony Evers.

Two weeks after the state abruptly reopened, it reached new highs in coronavirus cases, hospitalizations, and deaths. Republicans bear the blame. They say they care about “freedom,” but when a state reopens prematurely, workers are forced to either risk their lives for a paycheck because they’ll lose unemployment benefits if they don’t or, for too many, stay home and not be able to pay the bills or eat. That’s not much of a choice; clearly Republicans aren’t concerned about preserving freedom for those workers.

Back to New York. Gov. Cuomo has not done everything perfectly on the coronavirus, of course. Far from it. He, along with New York City Mayor Bill de Blasio, were a solid week behind West Coast officials—particularly those in the Bay Area—who responded about as quickly as anyone had a right to expect, potentially saving thousands of lives. Additionally, the petty rivalry between the two New Yorkers, which often involved Cuomo bigfooting the mayor in various ways, hasn’t been good for their constituents either.

Cuomo also rightfully faces criticism over the heavy toll suffered during the pandemic by residents of nursing homes, a complicated issue to be sure. The governor initially said that asymptomatic, COVID-19 positive nursing home employees could continue working. He also told nursing homes that they had to care for residents who tested positive, rather than send them to a hospital.

Gov. Cuomo ultimately reversed both decisions. New York nursing home residents have died in large numbers, and he certainly bears some responsibility for that. On the other hand, at least he hasn’t been flat-out lying about the number of coronavirus deaths in his state, like Florida Republican Gov. Ron DeSantis and his administration, or taking other measures to mislead the public about COVID data as has been done by Georgia’s and Iowa’s Republican state governments.

In fact, New York has done a lot right, even beyond the rigorous reopening process it’s established for itself. For example, Cuomo and de Blasio are making sure that the families of front-line workers who pay the ultimate price—those in any area of public health, law enforcement, transit employees, and firefighters—receive death benefits. “We will continue to show respect to our frontline heroes not just with words, but with action,” the governor announced May 25.

Cuomo has also spoken eloquently about New Yorkers coming together and taking responsibility for one another—in ways that directly contradict the words and actions of Trump—when it comes to issues like mask-wearing. Encouraging everyone to wear a mask, the governor declared on May 28: “We’re one family in [New York]. Do it for the good of the family.” President Obama also often spoke of America being a family, whereas Trump only tries to keep us divided. Going beyond words on responsibility, Gov. Cuomo also issued on May 28 an executive order giving businesses the right to tell anyone not wearing a mask that they will not be served.

As a New Yorker, I appreciate the fact that Cuomo has taken the time to understand the issues at hand, as opposed to operating under the delusion that he knows more than the scientific experts who work for him (hydroxycloroquine, anyone?). However, states, even one like New York, can only do so much on their own. In order to truly recover, states need help from the federal government.

Although the federal COVID-19 relief packages have, to date, authorized $150 billion aimed at making states whole after pandemic expenditures, the ones that have suffered most have received far less than they should have. Although testing levels are certainly different in each state, Alaska received $3.4 million per positive case of coronavirus, while New York got $24,000 and New Jersey got $27,000. Wyoming, which got just over $2 million per case, received the equivalent of 80% of its entire general budget for the year.

Understandably, Cuomo and other governors have pushed for more federal money to help the states hardest hit.

The HEROES Act, recently passed by the House of Representatives, included $1 trillion for territories, localities, and states. Unfortunately, Republicans in Washington, in particular Senate Majority Leader Mitch McConnell, have thus far not acted. McConnell in particular has been dismissive of what his office, in an official statement in late April, disgustingly called “blue state bailouts.” Even last week he continued to pour cold water on the idea of providing states the level of relief necessary to do the job.

Trump, in a remark that is almost too stupid to behold—not to mention completely contradictory to the way the president of the United States should be talking—said that helping those hard-hit states was “not fair to the Republicans because all the states that need help—they’re run by Democrats in every case.”

Cuomo did not like what McConnell had to say. Correctly, the governor called the majority leader’s words “un-American” and “uncharitable.” Then he got really mad: “Bail out New York? You’re not bailing out New York—New York has bailed you out. Every year, it’s bailed you out. Mitch McConnell is a taker, not a giver.” Cuomo then pointed out that New York is “the number one state in donating to the federal pot,” whereas “Kentucky is the number three state in taking from the federal pot.”

The governor of New York is right, as the above graphic demonstrates. Additionally, what the chart doesn’t mention is that the top two “receiving” states—Virginia and Maryland—are the top two because so many federal agencies and defense contractors are located in the D.C. suburbs, so in those cases it makes some sense that they would receive so much more in federal spending than they send in. Kentucky’s status as the next one on the list—and it’s actually second on a per resident basis—well, that’s a lot harder to swallow given Moscow Mitch’s bullshit about a blue state bailout.

On May 27, Cuomo went to Washington to meet with Trump, and again reiterated the need for a national relief effort. Afterward, the governor spoke with the media at the National Press Club. Referencing what McConnell, along with other Republicans like Florida Sen. Rick Scott, had been saying about providing more help to states like New York, Cuomo didn’t hold back: “This is really an ugly, ugly sentiment. It is an un-American response. We’re still the United States. Those words meant something.”

The governor was just warming up: “Previous bills have helped large businesses, small businesses, all kinds of businesses. Hotels. Airlines. That’s great.” But what about making sure there’s money for schools, fire departments, law enforcement, public hospitals, for crying out loud? Only state and local governments fund those, he noted.

So my point, to our friends in the Congress: Stop abusing New York. Stop abusing New Jersey. Stop abusing Connecticut, Stop abusing Illinois and Michigan and Pennsylvania. Stop abusing the states who bore the brunt of the COVID virus.

It’s because the COVID virus came from Europe, and no one in this nation told us. We were told, ‘The virus is coming from China’…They missed it…It was not New York’s job. We don’t do international/global health. And now you want to hold that against us? Because we bore the brunt of a national mistake?

You want to now double the insult (and) the injury by saying, ‘Why should we help those states?'

Cuomo’s meeting with Trump was focused on getting federal money specifically to jumpstart three vitally important, major infrastructure projects in the New York City metro area. As the governor noted, reopening the economy is one thing, but it’s not going to snap back to life overnight. Cuomo stated that we need significant upgrades in our infrastructure, and asked “When is there going to be a better moment in history to do it?” Interest rates being near zero makes it an even smarter time to initiate such a major jobs program. Finally, the governor added “You’re spending billions and trillions of dollars to handle COVID-19 and bring back the economy – at least build things that we can leave our children.”

At the aforementioned press conference, Cuomo emphasized key questions he had raised in the Oval Office meeting: “How do we supercharge the reopening—especially in New York, which has been hard hit? How do we take some of these big infrastructure projects which have been sitting around for a long time—which if we were all smarter and better we would have done 30 years ago—and because we need the jobs now more than ever?” He reports that he left the meeting optimistic, and made clear that he’ll make sure New York is ready to move forward immediately: “If [Trump] gives us the green light, this is not going to be years of discussion. I have a shovel in the trunk of my car, we’ll start this afternoon, right?” he joked. The governor hopes to hear something from the White House in a matter of days. We’ll see what happens.

Nothing about this pandemic is easy. Unfortunately, it’s been made much harder by those—from The Man Who Lost The Popular Vote on down—who have politicized just about every element of our collective and individual response, even something that should be noncontroversial, such as wearing a mask. And that was BEFORE the Black Lives Matter protests all but promised a second wave sooner.

Our response should rely on data and science. Almost everyone says that, even Trump—on occasion. But while, at one point, he did talk about reopening the economy based on concrete metrics and benchmarks drawn from actual science, by May he had shifted to simply demanding that states remove restrictions right away—and attacking those that didn’t.

If we want to reopen safely, what we need from our leaders is relatively straightforward: Don’t lie to us, don’t put politics over public health, and make decisions based on facts. States like New York, along with California, Washington, and others, are showing how it’s done, while that guy in the Oval Office—hopefully for only another few months, if we voters do our jobs—keeps on showing how unfit he is to be there in the first place.

Ian Reifowitz is the author of The Tribalization of Politics: How Rush Limbaugh's Race-Baiting Rhetoric on the Obama Presidency Paved the Way for Trump (Foreword by Markos Moulitsas)