With COVID-19 Cases Surging Again, States Are Taking Action, Though Current Efforts May Not Be Enough to Stop the Spread

Coronavirus cases are once again surging in the United States, fueled by colder weather driving people indoors and relaxing of social distancing restrictions over the summer by state and local officials. Cumulative cases have topped 11 million and daily cases are escalating at levels not seen before. Currently, nearly all states and DC meet hotspot status—Hawaii is the only state where cases appear to have stabilized. Nearly 80,000 people are hospitalized nationally, more than at any point since the pandemic first hit. As hospitals fill up, the strain on the health care system is evident. Facing shortages of beds, staff, and supplies, hospitals and the entire health care system risk being overwhelmed unless action is taken to curtail the spread of the virus.

Without clear federal guidance and mixed message at times, critical decisions about imposing measures to slow the increase in cases, which have been mired in partisan politics, continue to fall to the states. Moreover, much has changed since state lockdowns were first imposed in the early days of the pandemic. On the one hand, we know more about how the coronavirus spreads and can target interventions more effectively. On the other hand, growing fatigue with social distancing measures and outright resistance from certain segments of the population, economic concerns related to even short-term business closures without federal financial relief, and limits placed on executive branch authority by some state legislatures and courts all pose new challenges for Governors.

Yet, despite these challenges and the politicization of COVID-19 related actions, 31 states have imposed new restrictions since the beginning of November.  The states span the ideological divide—13 are led by Republican governors while 18 are headed by Democrats.

While these recent actions are important and an acknowledgement of how dire the current situation is, state responses vary widely and, in many cases, may not be enough to stop the virus’ spread. In lieu of stay at home orders similar to what were adopted in March and April, states are focusing on a few key areas—face mask requirements, limits on large gatherings, and limits on restaurants and bars.

• Universal face masking is recommended for preventing SARS-COV-2 transmission, yet decisions about mask mandates have been fraught with political and legal challenges. Still, after significant resistance among many states to implement such mandates, 38 states have done so, including Iowa, North Dakota and Utah in just the past two weeks (Table 1). Still, there are 13 states, several of which—Nebraska, South Dakota, and Wyoming—are at the epicenter of the current outbreak, that do not mandate mask wearing in public.
• States are tightening limits on social gatherings in line with CDC recommendations on holiday gatherings. With the new restrictions, 17 states limit indoor gatherings to no more than 10 people and six effectively prohibit them altogether. Another eight states allow gatherings of up to 25 people. But that means 20 states either do not limit the size of gatherings or allow gatherings of up to 50 people.
• Restaurants and bars are another source of COVID-19 spread. Here again, states are taking different approaches to limiting the public’s exposure. Seven states have recently closed restaurants to indoor or all in-person dining while 20 allow indoor dining but impose capacity limits. States have been more willing to close bars—16 states have closed bars to indoor service. However, 15 states continue to have no restrictions on restaurants and 13 do not restrict service at bars.
• Several states have also adopted “curfews,” closing restaurants and bars, and in some cases, other businesses, at certain hours in the hopes of curtailing exposure by limiting socializing, especially with alcohol. So far, 17 states require restaurants to close or stop serving alcohol at a certain time and 12 states require the same for bars. Two states are imposing broader curfews from 10 pm to 5 am, statewide in Ohio and in “purple” counties in California (currently 41 of 58 counties). However, it is not clear that these measures will have any significant effect on limiting the spread of the virus.

Recent state actions, even in the midst of an election season and the political polarization of COVID-19 that has occurred, signal how urgent the situation is becoming. Just in the last two weeks, 31 states have issued new restrictions, and more are expected to do so soon.  With the holiday season just ahead and winter upon us, it remains to be seen whether these measures will be enough, particularly if some states, including those with surges, choose not to issue social distancing measures.