Florida, Texas, Arizona face hurdles in getting outbreaks under control

Some states with spiking COVID-19 cases are losing control of their outbreaks, warn public health experts who say the states must take strong actions now to slow the virus’s spread.

“It’s going to be difficult now to get this under control,” Scott Gottlieb, the former Food and Drug Administration (FDA) commissioner, said Thursday on CNBC.

He warned that states like Texas, Florida and Arizona all have a relatively short period of time to act, and recommended that they close bars to limit the spread of the disease and also take steps to ensure they have enough hospital capacity.

“Whatever these states do right now is really going to help them in about two weeks,” he said.

Cases have been increasing in dozens of states since Memorial Day when governors began lifting stay-at-home orders and allowing businesses to reopen.

The U.S. on Wednesday recorded the largest single-day increase of new COVID cases since the pandemic began, bringing the total number of confirmed cases to 2.4 million.  

The South has seen the worst of the outbreaks, with Texas, Arizona and Florida leading in the number of new cases confirmed every day. Experts say the states reopened too quickly without having proper safeguards in place, mask mandates, and increased testing and contact tracing of new cases. 

Texas on Thursday paused the reopening of its economy, but Gov. Greg Abbott (R) has resisted calls to mandate masks or close or reduce capacity at restaurants and bars that are already open. GOP governors in Florida and Arizona have also resisted such measures.

“The speed of which this is happening in a number of these places is really quite alarming,” said Jennifer Nuzzo, an epidemiologist and senior scholar at the Johns Hopkins Center for Health Security. “We’re clearly headed in the wrong direction in many places.”

Public health experts say the steps taken by governors in states with new outbreaks have been too little and may be too late.

“The signs were there at Memorial Day but there were not policy interventions until less than a week ago,” said Will Humble, executive director of the Arizona Public Health Association and former director of the state’s health department. He noted pictures and video of young people over the Memorial Day weekend congregating at nightclubs and bars with no restrictions. 

“We’re now faced with the situation where policy changes will be far less effective now than they would have been a month or even three weeks ago.” 

Arizona recorded another 3,000 cases Wednesday, bringing the states total confirmed number of infections to 63,000. The percent of tests coming back positive is about 20 percent, which indicates that there is not enough testing and the virus is spreading widely. 

If Humble were still in his old job as the director of the Arizona Department of Health Services, he said he would issue a statewide mask wearing order and put substantial penalties on businesses that don’t enforce it. 

Arizona Gov. Doug Ducey (R) had until last week barred localities from wearing masks in public. There is still no statewide requirement, but several localities have since taken action. 

However, Humble said, the virus appears to be past the point of containment in Arizona, and said he would focus most of his energy on preparing for a surge in hospitalizations. Arizona intensive care units were at 88 percent capacity Wednesday. 

“The surge is coming to the hospitals. I just see it as inevitable at this point,” he said. 

In Texas, bars are now operating at 50 percent capacity and restaurants are at 75 percent capacity. Those rules would not change under the pause announced Thursday, but some experts said the state may need to close or reduce capacity at indoor venues as the outbreak spirals out of control. 

Texas was one of the last states to issue a stay-at-home order and one of the first states to allow businesses to reopen, prohibiting localities from taking stronger actions to contain the virus.

“The last thing we want to do as a state is go backwards and close down businesses,” Abbott said in a statement Friday.

Texas has added more than 5,000 new cases on each of the last two days, and the number of overall cases has doubled since the end of May. 

“I do think those states need a public mask law that says you cannot go out into public you can’t go into restaurants or public spaces without a mask. That’s the minimum,” said Ashish Jha, director of the Harvard Global Health Institute, on the “Today” show Thursday.

“Nightclubs are still open in places. Restaurants are open. I really think the state has [to[ look at whether it can sustain having indoor restaurants at all,” Jha added.  

Abbott issued an executive order Thursday pausing elective surgeries at hospitals in four counties to prepare for a surge in patients.

Nahid Bhadelia, an infectious disease doctor and associate professor at the Boston University School of Medicine posted on Twitter: “Texas is stopping medical care before they stop happy hours.” 

Florida reported more than 5,000 new COVID-19 cases Thursday, its highest single-day increase, bringing the state’s total to more than 114,000. Florida Gov. Ron DeSantis (R) has also resisted calls to require mask use statewide, but several localities have passed their own mandates.

He has blamed the surge in cases on young people who aren’t following social distancing guidelines. Bars, movie theaters, bowling alleys and concern venues are allowed to reopen in most of the state at 50 percent capacity, and DeSantis has not shown any indication of moving backward. 

The explosion of COVID-19 in the South could also trigger more cases in other states as people travel and potentially seed new outbreaks. New York, Connecticut and New Jersey issued a 14-day quarantine requirement Wednesday for travelers coming from Texas, Arizona, Florida and other states experiencing surges in cases.

Cases, hospitalizations and the percentage of positive tests, which are signs of growing outbreaks, are also increasing in Mississippi, Oklahoma, Georgia, South Carolina and Nevada. Cases are also increasing in Alabama, Arkansas, California and Utah, but the percentage of tests coming back positive are not increasing significantly or there are fewer COVID-19 hospitalizations, Jha said. 

States need to continue building up necessary case-based interventions, like testing and contact tracing, to stop transmission of the virus, Nuzzo said. 

“The more we are able to do that successfully, the more impact we will have on slowing the virus,” she said.