COVID-19 cases could explode after Labor Day: It’s up to us to stop it

Memorial Day came. We celebrated. We burst out of our suffocating homes with a damn-the-torpedoes surge, eager to see the places, family and friends we’d been yearning for during those smothering weeks of isolation.

Then we paid the price. Two or so weeks later, after the virus had incubated, cases of Covid-19 spiked, with 4 million more cumulative cases since Memorial Day. The surge ignited an upward trend we’ve been battling ever since.

The Fourth of July holiday didn’t help — that was another excuse to launch caution to the skies. By then, cities and states were also lifting restrictions. One mistake fed upon another, with tragic consequences.

As of Tuesday, September 1, there were at least 6,073,840 total cases and over 184,664 deaths in the US overall.

“Americans love to travel, and people had pandemic fatigue,” said pediatrician Dr. David Rubin, who directs PolicyLab, a research and public policy center at Children’s Hospital of Philadelphia that’s tracking Covid-19 cases in communities across the country.

“There were lax restrictions around the use of masks,” Rubin said. “All of it created a very hospitable environment for this virus to transmit.”

Will Labor Day be any different? That, experts say, depends entirely on us.

“I’m worried about Labor Day because people may have the impression that cases are coming down,” said epidemiologist Ali Mokdad, a professor of health metrics sciences at the Institute for Health Metrics and Evaluation at the University of Washington.

“Despite the fact that Covid-19 is now the third leading cause of death, people still doubt that we have a problem. They may think they are out of danger and behave as they did around Memorial Day,” said Mokdad, who manages a database tracking Covid-19 deaths, mask use and social distancing.

“We use Labor Day as a way to take the day off, but unfortunately the virus doesn’t,” said epidemiologist Jennifer Nuzzo, a senior scholar at the Johns Hopkins Center for Health Security.

“The more we travel, the more we interact with people, the more opportunities there are for exposure,” said Nuzzo, who is the lead epidemiologist on the Covid-19 transmission tracker at Hopkins’s Coronavirus Resource Center.

“It’s really best that we try to limit our movement as much as possible.”

Beware of family gatherings

“We’re seeing a lot of evidence that transmission is happening in smaller, family-driven parties,” said Beth Blauer, executive director at Johns Hopkins University Centers for Civic Impact. She’s part of the team that tracks US Covid-19 transmission data at the institution’s Coronavirus Resource Center.

Yes, it’s those birthday and graduation parties, weekend get-togethers, backyard barbecues, family reunions and weddings we thought were safe. The repercussions can be widespread and deadly.

A wedding and reception in Millinocket, Maine, on August 7 infected 134 people within the past three and a half weeks. Only 56 of the cases were from people who attended the event, yet the virus spread 100 miles to a nursing home and 220 miles to a county jail.

“What we are dealing with is a giant tube of glitter. You open a tube of glitter in your basement then two weeks later you are in the attic and all you find is glitter and have no idea how it got there,” said Maine Center for Disease Control & Prevention Director, Dr. Nirav Shah, in a news briefing.

“That’s what Covid-19 is like. You open up glitter in Millinocket and next thing you know you are finding traces of it at a jail complex in York County. It’s just emblematic of how quickly, silently and efficiently it can spread.”

The outbreak has already claimed a life.

“A woman who never even attended the wedding or the reception but simply interacted with someone else who did attend … lost her life to this virus,” said Maine Governor Janet Mills.

“One person, one contact can light a match and spark a fire that we may be unable to put out.”

College and school reopenings

“This virus transmits well in crowded indoor locations,” Rubin said. “And if you think about where this virus really hasn’t had its opportunity yet, it’s on college campuses and in school buildings.

“July 4th and Memorial Day would tell you that we should be worried about Labor Day and with schools opening, to me, it’s a one, two punch,” Rubin added.

Plans to keep schools that opened in early August running smoothly have been KO’d by the virus in numerous districts. In Cherokee County, Georgia, for example, some 260 elementary, middle and high school students and eight teachers were quarantined during the first week of school alone.

So far, colleges have been especially hard hit. The University of Alabama reported over 500 cases of Covid-19 just six days after classes began; another 224 occurred at the University of Kentucky. A similar spike caused both the University of North Carolina at Chapel Hill and the University of Notre Dame to halt in-person classes within days of the start of the school year.

Much of the increase has been driven by off-campus parties and a lack of safety measures by students, officials have said. Ohio State University temporarily suspended 228 students when they violated the university’s Covid-19 regulations around socializing.

“The 20-year-olds may not particularly fear this virus — they see the death numbers and they know who is typically affected by it,” Nuzzo said.

“We have to understand what it’s like to be that age,” she added. “At that point in life, the most important thing to you is probably your friends and social interactions. So we have to accept that. That’s how it’s going to be.”

Iowa State University senior Ryan Jenkins captured that attitude on video during “8:01” parties across the ISU campus. An Iowa tradition, students begin drinking at 8:01 a.m. on the Saturday before classes start.

“It’s essentially just a campus wide party and it is without a doubt, the biggest social event all year,” said Jenkins, adding that he has attended it in the past.

“I just had to record it because we’re living in history right now and I wanted to make sure people saw what was going on.”

The video shows large numbers of students gathered in tightly packed crowds across the campus. Few wore masks.

“F**k coronavirus,” one group of students told Jenkins. “I personally think it’s a hoax,” another student said. “I think when Trump gets reelected, it’s done.”

“Yeah,” his friend agreed, adding: “If I were to get it, I’d survive.”

Jenkins posted his video on his personal website; so far it’s gotten over 32,000 views, along with some infuriating comments from fellow students.

“It drives me crazy,” Jenkins said. “People are saying like only 150 kids our age, from the 18 to 24 demographic, have died from it.

“And you know, 150 people is a lot. I don’t know why people don’t get that,” he added, voice rising. “Those are lives that have memories, family, aspirations, dreams … they’re gone, you know, they’re never coming back.”

Jenkins is hoping ISU officials will see the behavior he captured on video and take further action to preserve lives. In just the first week of classes, 130 students, faculty and staff tested positive — that’s an extremely high positivity rate of 13.6%. The rate climbed to 28.8% in the second week of classes.

To put that into perspective, in May the World Health Organization recommended an area maintain below a 5% positivity rate for at least two weeks before considering reopening.

“All it takes is one unlucky loved one, one grandparent, one parent to get it and the odds not to be in their favor and they die from it,” Jenkins said.

“Then as soon as they catch it, it’s your fault, you know? So was it worth it to go out that day and possibly risk catching it?”

Reconsider bringing students home

The explosion of Covid-19 on campuses should make parents think twice about allowing their child to return home from college over Labor Day — or any other day they test positive, experts say.

“One option is just not to come home,” Rubin said, adding that PolicyLab is advising colleges with new cases of Covid-19 to quarantine students on campus rather than at home.

“Putting them on airplanes and sending them home to their parents doesn’t make sense,” Rubin said. “I think people need to be careful.”

Dr. Deborah Birx, the White House coronavirus task force coordinator, sent a message directly to college students in a recent media briefing.

“To the college and university students, please isolate at your college,” Birx said. “Do not return if you’re positive and spread the virus to your family, your aunts, your uncles, your grandparents.”

Rubin is especially concerned about other, more family-focused holidays, such as Thanksgiving and Christmas.

“It’s not about whether you’re going to keep your kids at school,” he said. “They’re definitely going home for Thanksgiving. And it might be right at a moment where we’re seeing a fair amount of transmission (that can) seed infections across generations.”

Colleges and parents trying to change youthful misbehavior should take into account their need for social activities and togetherness and avoid being harsh or critical in the message, experts say.

“Simply shaming that age group is not going to get us where we need to be. That will just drive the partying underground where we can’t see it,” Nuzzo said.

“And we’ll still have the case surge that we don’t want, but contact tracing and other interventions will be much more difficult to execute if we don’t know what’s going on,” Blauer added.

If we can target the message at things that are important to college students, that helps, said IHME’s Mokdad.

“When I talk to young people, I say, ‘If you want your football games, you have to do social distance. If you want to see college football, you have to wear a mask. Those are the sorts of things that they are interested in,” Mokdad said.

And parents should be role models, experts say, by adhering to social distancing guidelines — masks at all times, 6 feet or more of distance, washing hands frequently and avoiding groups not in a small quarantine “bubble.”

But the data in many parts of the country show that’s not happening at the levels needed to drive down the virus, experts say.

“It’s really difficult for us to think about being with our moms and dads or our grandparents, wearing a mask and maintaining that distance and not getting that hug in,” Nuzzo said. “That could be one of the reasons why we’re seeing some of this driven in the data.”

Avoiding any family or social gatherings outside the people in your “bubble” of trust over Labor Day is the best course of action.

But if you must gather, here are some of the safest ways to do so, according to Mokdad and other experts:

  • First, get a test for Covid-19 to make sure you are negative.
  • Then isolate yourself for two weeks, to make sure you stay free of the virus.
  • Gather with other families or family members outside, not inside.
  • Make plans to remain outside if there is bad weather — “or get in your car and go home,” Mokdad said.
  • Wear masks at all times when not eating.
  • Keep the family units separated by at least 6 feet or more.
  • Make sure tables, food, condiments, eating utensils and trash containers are also separated.
  • Have each family bring their own food.
  • If food is shared, separate it in advance into small containers for individual servings.

Of course the dangerous times are when people go inside to the bathroom, or to the kitchen to prep or replenish food or drinks. Families must plan for those events in advance, Mokdad said, and communicate the safety protocols to all guests.

“If you’re bringing food, make sure you bring it in separately,” he said “Tell your friend or family member, ‘When you come, you wait in the car, I will unload and put it in the pot or on the table. Then you can come into the yard.’

“We can grill, but only one of us is grilling the meat,” Mokdad said, adding these tips:

  • Put the meat in a place where one person can grab it and grill it.
  • Don’t socialize at the grill.
  • Put the grilled meat on separate plates, then move away
  • Ask people to come and get a plate one at a time.

“We have to be very careful,” Mokdad said. “Until we get a vaccine we have to change our way of life, create a new way of doing business, a new way of socializing.

“The only way I can recommend for you to behave is to assume you are in fact infected, he added. “Doing it this way sends a clear message to our children, our teenagers. We have to be role models ourselves in order to survive this virus with less damage and keep our economy going.”

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