Fauci: I don’t understand why every state hasn’t shut down yet

Is the problem that some states haven’t issued stay-at-home orders yet? Or is the problem people ignoring orders in states that have issued them? Good lord:

Fauci was asked last night about a national shutdown order. Trump doesn’t have the authority to do that, as Fauci seems to realize, but of course governors in the holdout states could do it.

The 12 states without the orders in place are enjoying freedom, sweet freedom, before their activity inevitably seeds their own local outbreaks:

“We’re doing what we would do for the flu, with older people sheltering in place and the rest of us taking the best care we can,” says Brian Joens, whose Iowa City eatery, Joensy’s, is doing a brisk take-out business of its fabled pork tenderloin.

“But let’s be honest, what country do we live in?” says Joens. “It’s the USA, which is freedom, freedom to choose. When we get notes from the government saying do this or do that, it feels like that’s not what this country is built on. People should be smart, and you live with your choices.”…

“I’m looking out the window of my dealership, and people are everywhere, it’s unbelievable,” says Chris Mayes, who owns Big Red Kia and Oklahoma Motorcars along the Mile of Cars commercial strip in Norman. “We’re not on lockdown here.”…

“When I see images from other U.S. cities, where there’s just no one in the streets, very few cars out, that is the total opposite of what we’re seeing here,” he says, adding that he rarely strays from his showroom. “And I’m absolutely worried about it.”

On the one hand, people clearly are practicing social distancing in states like Iowa and Oklahoma despite the lack of stay-at-home orders. Check the Kinsa “health weather” map and you’ll find dramatic declines in fevers in both states. Exhortations from experts like Fauci and the spiraling death toll in New York are clearly having an effect on behavior across the country. On the other hand, a lesson from the data according to Kinsa itself is that formal orders by the state do measurably affect behavior. Notice the reversal of fortunes between Santa Clara, California and Miami-Dade, Florida in this graphic published by the Miami Herald:

Governors who’ve refused to issue orders thus far are looking at the limited *known* spread of the disease in their states and wagering that keeping their local economies going won’t result in a larger, less manageable outbreak for whatever reason. Maybe the virus will burn itself out before it reaches the heartland; maybe effective therapeutics will arrive before the virus does in full force. Maybe lower density in rural states will limit the contagion. That’s a high-risk wager. A different wager, which would be less explicable, is that they understand and accept that sustained economic activity now will mean a wider, deadlier outbreak when the virus finally descends on them. They’re under no illusions that they can dodge the pain. They’re just putting it off, knowing that doing so will allow it to spread further, because it’s important to keep people on the job to whatever degree they can.

I don’t know about that:

The national strategy is to put out the fire everywhere all at once so that we don’t have new blazes breaking out in one region just as they’re being semi-extinguished elsewhere. If the northeast and west coast are getting through their first wave just as the first wave is raging in the heartland, heartlanders traveling around the country could seed new outbreaks. If we don’t have a national strategy, states will need to seriously consider interstate travel bans — assuming they’re even legal. The economic pain will last longer too: Doubtless the economies in states like Iowa and Oklahoma are suffering already due to the freefall elsewhere in the country. If they start getting hit by COVID-19 just as other regions are beginning to do business again, that’s another month or two of local recession while they strain to cope.

A piecemeal strategy is also leading to inefficient distribution of medical supplies, say experts:

“This is a problem that we should be dealing with over the entire nation,” said William Haseltine, a biologist famed for his work on HIV and AIDS. “This is a national problem — it needs a national response.”…

“This is not a partisan issue,” said Kenneth Bernard, a retired Navy rear admiral and biosecurity expert who served in the administrations of Presidents Bill Clinton and George W. Bush. “There needs to be a central command presence on this. There needs to be a person who can act as a focal point for tests, personal protective equipment and countermeasures — acquisition and distribution. Right now, it’s too fragmented and fractured, and that’s counterproductive, because the states are competing against the federal government for the same sources of materials.”

South Korea, the world’s shining success story against coronavirus, implemented an aggressive national program early to make sure that areas that needed tests and equipment received them expeditiously.

I’ll leave you with this, from a guy who pronounced the virus “relatively contained” on March 6 and now appears to agree with health experts that there’ll be no economic recovery until it’s really contained:

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