It's Now up to Governors to Slow the Spread

11/19/2020 It’s Now Up to Governors to Slow the Spread - WSJ

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OPINION | COMMENTARY It’s Now Up to Governors to Slow the Spread States should work together to close bars and nightclubs—or risk expensive lockdowns later.

By Scott Gottlieb and Mark McClellan Nov. 15, 2020 434 pm ET

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A bartender wears a mask in Milwaukee, Oct. 19. PHOTO: BING GUANREUTERS

The latest U.S. Covid surge isn’t conﬁned to certain regions like the ones in the spring and summer. It’s hitting the whole nation hard. Hospitalizations reached 70,000 this week, with more than 13,000 patients in intensive-care units. Health systems in communities like Minot, N.D., and El Paso, Texas, are overburdened, and others may be in the same position soon if governors don’t work quickly and across state lines to slow the spread.

In previous waves, health-care workers from less-aﬀected areas were deployed to New York and the South. It isn’t possible to send an army of health-care personnel into hot zones when the entire country is a hot zone. Another 15% of the U.S. population could be https://www.wsj.com/articles/its-now-up-to-governors-to-slow-the-spread-11605476054?campaign_id=9&emc=edit_nn_20201117&instance_id=24179… 1/3 11/19/2020 It’s Now Up to Governors to Slow the Spread - WSJ infected by the end of January, on top of the 15% that has already been infected. The genetic epidemiologist Trevor Bedford estimates that such a course could result in about 200,000 more deaths, assuming an improved infection fatality rate of about 0.45%.

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The Covid response has been a joint eﬀort, with the federal government working to support states overseeing their own local mitigation eﬀorts. But the White House is changing hands during the most critical point of the pandemic, and it’s a particularly important time for leadership from governors, mayors and county administrators. State and local actions, supported by improved treatments, can help build a bridge to vaccinations and more widespread immunity in 2021. Americans are understandably tired of Covid, but accepting temporary restrictions now will help prevent even more painful personal and economic disruptions.

A patchwork of local policies won’t be potent enough. People move across borders and bring the virus. Governors and local leaders should first reinforce steps known to be effective: wearing a quality mask, avoiding gatherings and maintaining social distance, especially indoors. Halloween gatherings contributed to the current spread, and Thanksgiving will be no different without more vigilance. At least while infections are widespread and surging, governors and local leaders should mandate the use of masks and impose clear and consistent plans to restrict gatherings. They should remind people to avoid large groups at Thanksgiving and stay home if possible.

This doesn’t mean broad lockdowns. State and local leaders can tie restrictions to expected hospital strain, tailored to hot spots and not necessarily the entire state. Restrictions can focus on known sources of spread, such as bars and nightclubs.

https://www.wsj.com/articles/its-now-up-to-governors-to-slow-the-spread-11605476054?campaign_id=9&emc=edit_nn_20201117&instance_id=24179… 2/3 11/19/2020 It’s Now Up to Governors to Slow the Spread - WSJ Congress should help by supporting aﬀected businesses with another round of paycheck protection. A priority should be helping schools that are open, especially elementary schools, where the risk of infection is lower and the beneﬁts of in-class instruction are considerable.

Governors should also work with local leaders to use new countermeasures that have only recently become available. This includes a valuable new treatment: monoclonal antibodies, man-made versions of naturally occurring ones that neutralize the virus. But these drugs are challenging to administer, requiring special sites for infusions and public education. People in high-risk groups with symptoms should get tested and treated before their condition deteriorates. Governors need to get the message out that Covid is now a treatable condition at the early stages, and work with local leaders to ensure that access to antibodies is available, especially in underserved communities.

Rapid testing is also more widely available, which allows for better detection of outbreaks in settings where people must be together, such as assisted-living facilities, essential workplaces and schools. With so much coronavirus spread through people without symptoms, especially younger people, it’s now possible to consider using these tests routinely as one more tool. Governors can work together to develop a consistent national screening protocol for containing outbreaks.

Winter was always going to be the hardest time with the virus, but coordinated state and local leadership can make it more manageable. Many governors have taken aggressive steps to slow the spread, but states that don’t act quickly put the entire nation at risk.

Dr. Gottlieb is a resident fellow at the American Enterprise Institute and was commissioner of the Food and Drug Administration, 2017-19. Dr. McClellan is the director of the Duke-Margolis Center for Health Policy at Duke University and was FDA commissioner, 2002-04. Dr. Gottlieb serves on the boards of Pﬁzer and Illumina and Dr. McClellan on the boards of Johnson and Johnson and Cigna ; each company is involved in aspects of the Covid response.

Appeared in the November 16, 2020, print edition.

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