Unsanitized: The Building of the Second Wave

Plus, an inaccurate mailer from the Postal Service. This is The COVID-19 Daily Report for September 14, 2020.

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First Response

Even though in aggregate, the United States appears to be the only country in the developed world that had a second wave of the coronavirus in the summer, that’s a slightly misleading quirk of this being a sprawling country. For the most part, the initial wave happened on different timelines at the state or even the city level. There were maybe some modest outbreaks initially and then a large one later, or there was a large outbreak at first that grew mild. The Dakotas, for example, are experiencing a significant outbreak now after mostly avoiding the pandemic previously.

That’s not to say that there weren’t measures to take to avoid an outbreak; it wasn’t destined for the virus to spread throughout the country. Just keeping indoor restaurant patronage down would have significantly reduced spread, according to CDC statistics. But for the most part, we’ve seen the virus rip through states and regions once, on different timelines.

That’s why the presence of a few states on this list where COVID-19 cases are growing over the past week jumped out. It includes Connecticut, Maine, New Hampshire, New Jersey, and Rhode Island: states in regions (New England and the Mid-Atlantic) that have already experienced the worst of the virus. With Connecticut and New Jersey, this is a rise off a very low level and could just be a blip. In New Hampshire and Maine, the rise looks more pronounced but they never had that big an outbreak. Rhode Island’s been stalled at a modest level for a few weeks.

Read all of our Unsanitized reports

The reason this provokes concern is what we’re starting to learn from around the world, including places where the spike in cases occurred earlier than in the U.S. Countries in Europe are seeing a legitimate second wave, at least at the case level. Spain in particular is back up to pretty high levels, particularly around Madrid.

This should give pause to the louder devotees of “herd immunity,” the idea that once a certain segment of the population has been infected, then the virus has nowhere to spread. Successful interventions against the virus have given rise to the claim that you need lower and lower levels of immunity to stop the spread. But Madrid in particular had a high seroprevalence, months of low case counts, and then an outbreak. In England cases are rising as well, in what also looks like a true second wave.

There’s one major positive here: the extra sophistication of the medical response has led to far lower death rates on the second wave. That means that suppressing the virus at the outset, rather than letting it rip through an area with little resistance, makes the most sense, because saving medical cases for later offers a better chance at survival. Hospitalizations are also down, which reflects the younger profile of the average infected individual, but as we saw in the U.S., that can filter upward quickly.

This also could mean that the timeframe of immunity might be limited. More likely, it means that you need a much higher degree of immunity within a region to give enough protection to let people out in the world again. If you relax restrictions too soon, the virus will find hosts and spread around. We don’t have a case study of everyone in an isolated area getting the virus, and there would be too much mortality at risk to allow that. So the best practice remains suppression until a vaccine. There’s no natural process of letting the virus rip through a community that will yield enough success.

Maybe if you can lower death rates through treatments and masking to a small enough level, you can return to normal before vaccinating everyone. But I doubt you will get there among the immunosuppressed and the elderly. Israel instituted a second lockdown, the first relatively developed country to do so, to get the virus to stop spreading. That’s still a tool for countries, and in the event of a true second wave you’ll see it pulled out.

Factcheck’s in the Mail

The idea that there’s going to be a partisan split on who uses absentee ballots in a pandemic has always struck me as fairly odd. People are going to want to protect themselves and their families regardless of political party. Sure enough, there are more absentee ballot requests in key battleground states like Ohio and Michigan than in any other election in history. That’s not all coming from one political party (though maybe more Democrats at the margins). Loud and ignorant people get attention, but large numbers of people will vote by mail.

Which is what makes the postal slowdown so critical. And it’s why you have to view even the most potentially innocuous actions from that agency with skepticism right now. I got a postcard in the mail, scheduled to go to everyone in the country, which includes a checklist to prepare to vote by mail. Because states handle the vote by mail process in different ways, it’s impossible to send a single checklist to everyone in the country with perfectly accurate information everywhere. So sure enough, Colorado’s Secretary of State has sued to block the mailing.

Colorado is an all-mail state, and you don’t need to request a mail-in ballot to get one. But the postal mailer, while it notes that “rules and dates vary by state” and offers a link to where to find your local election boards, advises voters to “request your mail-in ballot (often called “absentee” ballot) at least 15 days before Election Day.” That’s not true in Colorado and eight other states (plus the District of Columbia), some of which have changed their rules because of the pandemic. In those states, the mailer will cause plenty of confusion. A federal district court judge granted a temporary bar on sending the mailer in Colorado.

In addition, the mailer requests that ballots should be mailed “at least 7 days before Election Day.” Some Secretaries of State were recommending even longer times in advance, and this now presents a mixed message.

Confusion is the friend of those who want to suppress the vote, of course. You can take the Postal Service at their word, and believe they were issuing this mailer as a public service, to give people a sense of how far in advance they would need to pre-plan to ensure their vote was counted. But our elections are local affairs, and it’s impossible to put a one-size fits-all gloss on them. And supplying incorrect information does interfere with the right to vote.

Days Without a Bailout Oversight Chair

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Today I Learned

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