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.

Table 1: State Policy Actions on Social Distancing Measures
State New Restrictions Imposed Since Beginning of November Face Covering Requirement Limits on Indoor Gatherings Limits on Restaurants Limits on Bars Limits on Retail and Other Businesses
Alabama No Required for General Public None Open–No Limits Open–No Limits Open–No Limits
Alaska No Required for Certain Employees None Open–No Limits Open–No Limits Open–No Limits
Arizona No Required for Certain Employees; Allows Local Officials to Require for General Public 50 People Open at 50% Capacity; Closed in Counties with Substantial COVID-19 Spread Open at 50% Capacity, Closed in Counties with Substantial COVID-19 Spread Retail and personal care open; gyms open at 25% capacity
Arkansas Yes Required for General Public None Open; Cannot serve alcohol after 11 pm Open; Cannot serve alcohol after 11 pm Open–No Limits
California Automatic based on metrics Required for General Public All Gatherings Prohibited in Most Counties Closed to Indoor Service in Most Counties Closed in Most Counties Retail open at 25% capacity for counties in Tier 1; personal care open with limits
Colorado Automatic based on metrics Required for General Public 10 People in Most Counties Open at 50% Capacity; Closed in Counties with Substantial COVID-19 Spread Closed in All but One County Retail open at 50% capacity; personal care and gyms open at 25% capacity in most counties
Connecticut Yes Required for General Public 10 People in Homes/Up to 25 People in Venues Outside of Homes Open at 50% Capacity; Must close dine-in service from 10 pm to 5 am Closed Retail and gyms open at 50% capacity; personal care services open at 75% capacity
Delaware Yes Required for General Public 10 People in Homes/Up to 50 People in Venues Outside of Homes Open at 30% Capacity Open at 30% Capacity Retail open at 60% capacity; gyms and personal care services open at 30% capacity
District of Columbia No Required for General Public 50 People Open at 50% Capacity Closed Retail open at 50% capacity; gyms open with 5 people per 1,000 square feet; personal care open by appointment only
Florida No Required for Certain Employees None Open–No Limits Open–No Limits Open–No Limits
Georgia No Required for Certain Employees; Allows Local Officials to Require for General Public 50 People Open–No Limits Open at 35% Capacity Open–No Limits
Hawaii No Required for General Public 10 People Open at 50% Capacity; Cannot serve alcohol after 10 pm Open at 50% Capacity, Cannot serve alcohol after 10 pm Reatil and personal care open at 50% capacity; gyms open at 25% capacity
Idaho Yes Required for Certain Employees 10 People Open–No Limits Open–No Limits Open–No Limits
Illinois Yes Required for General Public 10 People Closed to Indoor Service Closed to Indoor Service Retail, gyms, and personal care open at 25% capacity
Indiana Yes Required for General Public 25 People Open at 75% Capacity Open at 75% Capacity Open–No Limits
Iowa Yes Required for General Public 15 People Open; No service after 10 pm Open; No service after 10 pm Open–No Limits
Kansas No Required for General Public None Open–No Limits Open–No Limits Open–No Limits
Kentucky Yes Required for General Public 8 People Closed to Indoor Service Closed to Indoor Service Retail and personal care open at 50% capacity; gyms open at 33% capacity
Louisiana No Required for General Public 50% of Venue Capacity up to 250 People Open at 50% Capacity Open at 25% Capacity; Outdoor service only Retail, gyms, and personal care open at 75% capacity
Maine Yes Required for General Public 50 People Open at 50% Capacity; Must close at 9 pm Closed Retail 5 people per 1000 sq. ft; gyms 50 people; personal care open at 50% capacity
Maryland Yes Required for General Public None Open at 50% Capacity; Must close from 10 pm to 6 am Open at 50% Capacity; Must close from 10 pm to 6 am Retail, gyms, and personal care open at 50% capacity
Massachusetts Yes Required for General Public 10 People Open; Must close indoor dining at 9 pm Closed All non-essential businesses must close from 9:30 pm to 5 am; gyms open at 40% capacity
Michigan Yes Required for General Public 10 People Closed to Indoor Service Closed to Indoor Service Retail open at 30% capacity; gyms open at 25% capacity; personal care open by appointment only
Minnesota Yes Required for General Public All Gatherings Prohbited Open at 50% Capacity; Must close from 10 pm to 4 am Open at 50% Capacity; Must close from 10 pm to 4 am Retail, personal care open; gyms closed
Mississippi No Required for Certain Employees 20 People Open; Cannot serve alcohol after 11 pm Open; Cannot serve alcohol after 11 pm Open–No Limits
Missouri No None Open–No Limits Open–No Limits Open–No Limits
Montana Yes Required for General Public 25 People Open at 50% Capacity; Must close dine-in service at 10 pm Open at 50% Capacity; Must close dine-in service at 10 pm Retail and personal care open; gyms open at 75% capacity
Nebraska Yes Required for Certain Employees 25% of Venue Capacity Open–No Limits Open–No Limits Open–No Limits
Nevada No Required for General Public 10 People Open at 50% Capacity Open at 50% Capacity Retail and gyms open at 50% capacity; personal care services open
New Hampshire No Required for General Public None Open–No Limits Open–No Limits Retail and gyms open at 50% capacity; personal care services open by appointment only
New Jersey Yes Required for General Public 10 People Open at 25% Capacity Closed Retail open at 50% capacity; gyms open at 25% capacity; personal care  open by appointment only
New Mexico Yes Required for General Public 5 People Closed, except  Takeout/Delivery Closed Closed except for curbside services and delivery*
New York Yes Required for General Public 10 People Open at 50% Capacity; Must close dine-in service from 10 pm to 5 am Open at 50% Capacity; Must close at 10 pm Retail open; Personal care services open at 50% capacity; gyms open at 33% capacity, must close at 10 pm
North Carolina Yes Required for General Public 10 People Open at 50% Capacity Open at 30% Capacity; Outdoor service only Retail and personal care open at 50% capacity; gyms open at 30% capacity
North Dakota Yes Required for General Public 50 People Open at 50% Capacity; Must close dine-in service from 10 pm to 4 am Open at 50% Capacity; Must close dine-in service at 10 pm All open at 25% capacity
Ohio Yes Required for General Public 10 People; All Gatherings Prohibited After 10 pm Open; Must close to dine-in service from 10 pm to 5 am Open; Must close to dine-in service from 10 pm to 5 am Open–No Limits
Oklahoma Yes None Open; Must close dine-in service from 11 pm to 5 am Open; Must close to dine-in service from 11 pm to 8 am Open–No Limits
Oregon Yes Required for General Public 6 People Closed, except  Takeout/Delivery Closed Retail open at 75% capacity; personal care services open by appointment only; gyms closed
Pennsylvania No Required for General Public 25 People Open at 25% Capacity Open at 25% Capacity Retail open at 75% capacity; gyms and personal care services open at 50% capacity
Rhode Island Yes Required for General Public Limited to one household in Homes/Up to 25 People in Venues Outside of Homes Open at 33% Capacity; Must close dine-in service at 10 pm weekdays/10:30 pm weekends Closed Retail and personal care limited to 1 patron per 100 square feet; Must close at 10 pm weekdays/10:30 pm weekends; gyms closed
South Carolina No Allows Local Officials to Require for General Public None Open–No Limits Open–No Limits Open–No Limits
South Dakota No None Open–No Limits Open–No Limits Open–No Limits
Tennessee No Allows Local Officials to Require for General Public None Open–No Limits Open–No Limits Open–No Limits
Texas No Required for General Public 10 People Open–No Limits Open at 50% Capacity All open at 75% capacity in areas with low hospitalizations. Limited to 50% capacity in areas with high hospitalizations
Utah Yes Required for General Public All Gatherings Prohibited Unless Held at a Business or Has an Event Host Open; Cannot serve alcohol after 10 pm Open; Cannot serve alcohol after 10 pm Open–No Limits
Vermont Yes Required for General Public All Gatherings Are Prohibited Open; Must close dine-in service at 10 pm Closed Retail open at 50% capacity; gyms and personal care services open at 25% capacity
Virginia Yes Required for General Public 25 People Open; Cannot serve alcohol after 10 pm and must close by 12am Closed Non-essential retail limited to 10 people per establishment; personal care services open; gyms open at 75% capacity or 25 people
Washington Yes Required for General Public All Gatherings Are Prohibited Closed to Indoor Service Closed Retail and personal care services open at 25% capacity; gyms open outdoors only to 5 participants or fewer
West Virginia No Required for General Public 25 People Open at 50% Capacity Open at 50% Capacity Retail open; gyms open at 40% capacity; personal care services limited to 10 person capacity
Wisconsin No Required for General Public None Open–No Limits Open–No Limits Open–No Limits
Wyoming Yes Allows Local Officials to Require for General Public 25 People Open–No Limits Open–No Limits Open–No Limits
NOTE: All states require physical distancing and other safety measures in businesses, including restaurants and bars.  * New Mexico has closed in-person services for all non-essential activities and issued a stay at home order.
SOURCE: KFF review of state executive orders, guidance documents, policy bulletins, and news releases

The Henry J. Kaiser Family Foundation Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400
Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270

www.kff.org | Email Alerts: kff.org/email | facebook.com/KaiserFamilyFoundation | twitter.com/kff

Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California.