Washington Wednesday - Ready to reopen?

NICK EICHER, HOST: It’s Wednesday, the 22nd of April, 2020. Glad to have you along for today’s edition of The World and Everything in It. Good morning, I’m Nick Eicher.

MARY REICHARD, HOST: And I’m Mary Reichard. First up, lifting coronavirus restrictions.

Most Americans have been hunkered down in their homes since the middle of March. That’s when schools closed. Restaurants, movie theaters, and retail outlets soon followed. Companies started laying off workers. Jobless claims soared. And Congress approved the biggest stimulus package in U.S. history.

EICHER: Despite the hardships, most people endured the stay-at-home orders as a public health necessity. But that endurance is wearing thin.

AUDIO: [Sounds of horns honking]

These are protesters in Harrisburg, Pennsylvania. 

That was just one of several rallies held across the country over the last few days urging state leaders to ease restrictions.

Plans for a gradual reopening are already underway in many places. So, what can we expect in the next few weeks and months?

Well, it’s Washington Wednesday, and we are going to try to answer that question. Because it involves so many different factors, we decided to bring in experts from two different fields. Zach Jenkins is a pharmacist and infectious disease expert. Mark Caleb Smith is a political scientist. They’re both professors at Cedarville University in Ohio.

Zach, I’d like to start with you.

The three-word catchphrase we keep hearing is: test, trace, isolate. So testing is the foundation. Explain for us why that’s the key to reopening.

JENKINS: Sure, so testing is going to be a really critical component for us moving forward. One reason that it will be important is that with antibody testing, we should be able to gain some insight as to whether people have been exposed to the virus and, theoretically, have developed some sort of immunity to it. Another element that’s going to be important with testing is to the comment about tracing, we’re going to be doing something called contract tracing where we actually will identify individuals who are positive for the virus. Then what we’ll do is we’ll trace who they’ve been in contact with and then recommend quarantine for those individuals. Now, under some circumstances, that would mean a 10 or 14 day quarantine period. But what testing does for us is it allows us to actually speed up their re-entry into their normal lives. And then we can further identify other individuals to test, isolate, trace.

EICHER: So I can understand why test is the easiest pill to swallow, so to speak. Everyone wants to know if they have this virus.

Trace and isolate, that’s completely different.

America isn’t China, in the sense of command and control of the population. And thank God for that. We don’t have the surveillance, we don’t systematically force people into mass quarantine sites.

So, how do we handle trace and isolate in a free society? What options does the U.S. health system have, Zach?

JENKINS: So, as far as tracing goes and isolation goes, what we would recommend for individuals that aren’t hospitalized that are positive for the virus is that they self-quarantine. And that would be the same recommendation for other individuals who have tested positive. And the burden is on the public health department and other health authorities to try to trace their contacts as much as possible. Now, quite honestly, that’s a huge resource cost. It would take, I think, there’s an estimation of about 300,000 people to adequately trace all these different contacts for the virus and right now our public health departments across this country I think have roughly 3,000 employees. So, you can imagine the burden that that would create. But, really, it’s strong recommendations and not necessarily forced isolation.

EICHER: What about from a constitutional perspective, Mark? The federal government has broad powers during a public-health crisis. So let’s talk about how far the feds could it go to enforce the “trace and isolate” measures.

And maybe, really, it’s more of a state-by-state matter, because that’s our system, and the president—even though he went back and forth on the question—has landed on empowering governors. How would this work constitutionally?

SMITH: When you look at Article II of the Constitution, which is what sets up executive power, the president really does not have any direct power to deal with this kind of a crisis with the sort of heavy handed approach that you might find in other countries. So, in order for that to happen, he would have to have legislation from Congress authorizing him to carry out some sort of a significant testing and tracing campaign. Even then, you could argue that it could be unconstitutional, frankly, because the federal government just is not endowed with that sort of authority. The Supreme Court, though, has kind of looked at certain situations like a war, like a civil war—for example—and they’ve allowed governments to do a little bit more during those crises than they would in a normal peace time environment. And so it could be the judicial system would give some flexibility because of the situation, but that’s an assumption. There’s no guarantee of that.

I think the second part of your question is actually closer to the truth. State and local governments have significant powers over this. Our government reserves powers, the states that include power over safety, health, and welfare kinds of issues. And this certainly falls into that. And so I think a governor, for example, could pretty easily under constitutional guidelines enforce this kind of regime that Zach’s talking about. And so if states would enter into it, I think you would see it more likely to take place, or maybe some sort of cooperation between the state and federal authorities together would provide the best constitutional shield.

EICHER: Well, as we’ve noted, people are growing weary of the lockdown. We humans are made to work, made to produce, and a lot of people are out of work. But we’re just guessing at the economic damage, because we’ve never experienced anything like this.

At first, it was all public health, no questions asked, everybody’s on board with the shutdown. But now we’re starting to count the economic cost. And so elected officials are starting to feel some pressure to reopen.

Would you say that the politics have changed, Mark?

SMITH: I think that they are starting to see some pressure in certain places. But I think you have to be careful to define what that pressure actually is. If it’s a demonstration, well, that could be a fairly small representation of your population. Public opinion polling that we’ve seen—at least at the national level—is that most Americans are pretty comfortable with the stay-at-home orders that we’ve seen. Whereas I think some Americans are frustrated. We’re all frustrated economically. I’m not sure that necessarily spills into something resembling a majority or a large group of people who would be willing to sort of engage in a kind of civil unrest. And so I think governors in particular should be careful to assume that the presence of a protest actually reflects a widespread displeasure at what’s happening.

EICHER: Well, set the protests aside: Surely they can read the economic figures that are coming out. They can see the applications for unemployment benefits. They can see retail sales cratering. They can see all of these things. That’s pressure, too, is it not? 

SMITH: No question about it. I think across the country, authorities feel that kind of economic reality that’s hitting them as well. But they have to be careful. If they open up too soon and you see a resurgence in cases and in hospitalizations and even in deaths, you’re going to have a further economic problem on top of a further health problem. And so the goal now, I think, is to minimize the health problem with the goal of opening the economy as soon as possible—whenever that is. There’s real pressure. There’s no doubt there’s real pressure. It’s also very possible that some of these folks will lose their seats, depending on how they handle this over the next several months or even year.

EICHER: Zach, I’ll close with you, and I got word that we’ve lost the studio connection, so we’ll use the Skype line as we wrap up. Obviously we have a lot to learn about this virus. But researchers are now discovering that many, many more people have caught the novel coronavirus without knowing about it because they didn’t have any symptoms. We heard that from Dr. Birx of the federal task force. 

How do you think that changes, or does it change, the response from a public health perspective?

JENKINS: So, I think invariably when we do discover exactly how prevalent the virus is, it will change our response in a few ways. One of which is we’ll be able to do more targeted social distance efforts. By and large what we’ve done so far is kind of the equivalent of using a club. It’s very blunt and it hits a lot of things at once but not necessarily a very precise target. So when we have some more information about those communities, that will actually make things a little bit easier moving forward. Another important thing to also consider is we’re still trying to figure out what the case fatality rate is, and that actually describes how severe this virus may be for individuals. And so as we start to discover how prevalent it is in the population, the more prevalent it is, the more likely that fatality rate is lower. The other element I’d say, too, on top of all these considerations is it helps us to recognize how significant those asymptomatic cases are by number. And so if you think about some of these recommendations that we’ve had lately as far as wearing masks, avoiding contact with individuals in such a close proximity, a lot of that is just designed to limit spread from people who don’t realize they have it. So, those things could potentially be lifted if we recognize that maybe the asymptomatic distribution is not quite as significant as we once thought.

EICHER: Zach Jenkins is an infectious disease expert and pharmacy professor. And Mark Caleb Smith is a professor of political science. They both teach at Cedarville University in Ohio. Gentlemen, thank you!

(AP Photo/Keith Srakocic) A woman holds a sign out the sunroof of a car as she is driven down Grant Street during a demonstration, Monday, April 20, 2020, in Pittsburgh. 

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