When will Memphis reopen and how will that happen? The answers involve the sometimes conflicting perspectives of health, business and political leaders. It will ultimately involve discussions between local and state leaders, with potential input from one significant wild card: President Donald Trump.
Nearly three weeks into lockdown, coronavirus-plagued Memphis might face another eight weeks or more of restrictive social distancing and safer-at-home measures, computer modeling suggests.
But even when Memphis does reopen don’t expect it to all happen overnight.
“You probably will see a phased-in approach,’’ said Shelby County Mayor Lee Harris, who heads the local COVID-19 Task Force with Memphis Mayor Jim Strickland.
What will that look like?
Will schools open first? How about restaurants? Or bars?
When will the Redbirds play baseball again? Will the postponed Memphis in May International Festival still happen this year?
Will the University of Memphis Tigers play football in the fall?
“No one has the right, best answer’’ on what might happen or exactly when and how we get back to normal, said Dr. Manoj Jain, an infectious disease expert hired to help guide the task force.
But if local leaders follow the playbook laid out by experts, the eventual reopening will come in stages with some continued but less-restrictive limits on public gatherings along with occasional social distancing and the wearing of masks in public.
There also will be intensive “community surveillance’’ with targeted testing, extended seclusion for vulnerable groups like seniors, and adaptations by the hard-hit business community to ensure COVID-19 doesn’t reignite.
“Not every business may (survive), but maybe new businesses will spring up,’’ said Greater Memphis Chamber President Beverly Robertson, who is drafting a business recovery plan.
But before we get to recovery, first we must get through the surge. Moving on will require great resolve and enormous resources. The task force’s medical advisers say to reopen, Memphis will need ample hospital beds to handle any reignited outbreak and enhanced testing abilities and robust contact tracing to detect and eradicate it.
Reopening prematurely could push Memphis back into the pandemic.
“That would kill our economy and everything we do,’’ said Dr. Jeff Warren, a Memphis City Councilman, physician and member of the COVID-19 Task Force. “So, what we have to do is keep it shut down until we have the infrastructure in place to monitor it so it doesn’t blossom again.’’
Some fear resolve could fracture if disillusionment grows over prolonged social distancing.
“I think if it goes on long enough, you are going to see some of that stir craziness and maybe some civil disobedience and things,’’ said Dr. Jon McCullers, an infectious disease specialist at the University of Tennessee Health Science Center, who says he’s thankful no one is protesting yet.
But there is a wild card in this conversation: President Trump.
President Trump has repeatedly said he’d like to reopen the country, possibly in May. Gov. Bill Lee – like Trump, a Republican – was among the last to sign a stay-at-home order on April 2. Lee has not said whether he will extend that order after it expires Tuesday, April 14.
“What if President Trump gets at the podium one day and tells all the governors, open up your states?’’ asked County Mayor Harris, a Democrat. “Well, for sure, some governors are not going to listen. But a whole lot of governors are going to listen. And then they’ll be off to the races.’’
On Friday, April 10, the same day Vanderbilt University came out with new COVID modeling projections, President Trump was discussing another aspect of the novel coronavirus.
“This week, in only four days, we had the biggest Stock Market increase since 1974. We have a great chance for the really big bounce when the Invisible Enemy is gone!’’ he tweeted, using his pet term for the pandemic.
The President has been pushing for weeks to reopen the country. The Washington Post reported Thursday he is quietly pursuing a strategy to resume business activity by May 1.
“Hopefully, we’re going to be opening up – you can call it ‘opening’ – very, very, very, very soon, I hope,’’ he said at his Thursday press briefing.
The New York Times reported Trump is torn between private phone calls he receives from business associates and TV images of overwhelmed hospitals as communities battle the pandemic that’s killed more than 20,000 Americans to date – more deaths than any other country.
If Harris is right – if Trump pressures state governors to ease restrictions – there could be direct implications for Memphis.
Lee’s press secretary indicated last week the governor is already thinking about recovery.
“Not able to offer you an interview at the time but the governor will be talking about these plans in the coming days,’’ Gillum Ferguson said in an email to The Institute for Public Service Reporting.
The Vanderbilt study said lifting the stay-at-home order now could trigger catastrophic consequences: a steep upward climb in infections that would overwhelm hospitals.
Still, the question on some people’s minds this weekend wasn’t disease but freedom: When will restrictions be lifted?
“We understand what a hardship that is on everyone,’’ Doug McGowen said at a Saturday, April 11 news conference in answer to a reporter’s question possible growing dissent.
The chief operating officer for Mayor Strickland, McGowen said restrictions may be in place for another 30 to 60 days.
“This is a very difficult situation to manage. We are trying to preserve life. We are trying at the same time to balance the ability of everyone to live their lives and to have the ability to prosper,’’ he said.
“But we understand that that has an impact on the economy, has an impact on small businesses and has an impact on citizens. It is a very difficult challenge to manage.’’
When to reopen?
Shelby County Health Department Director Alisa Haushalter said at the news briefing she expects the COVID surge to hit “in late May to early June.’’ That’s based on a local team of “physicians, biostatisticians, epidemiologists and other public health professionals’’ who are monitoring four modeling programs and “assessing their strengths and weaknesses’’ in consideration of “our very specific context here in Shelby County,’’ she said.
But a surge in late May or early June doesn’t mean everything suddenly reopens afterward.
Experts say a city can start easing restrictions and begin the journey back toward normal about two weeks after a peak depending on a variety of factors including a sustained downward trend in new cases over 14 days.
“So, (you’ve got to get) hospitals out of any crisis mode,’’ said Jain, a hired adviser who helps guide the Memphis and Shelby COVID Task Force. “We (have to be) able to sufficiently test all our symptomatics. And we (must be) able to do contact tracing on all cases. So, if you can begin to do that, that means then we can be talking about how to sort of ease the pedal on the social distancing part.’’
With a minimum of about 14 days added to the end of a peak, the timetable for reopening Memphis roughly begins to look something like this:
- The Vanderbilt study anticipates a statewide peak between mid-May and mid-June depending on the degree of social distancing restrictions. That could place the start of reopening around June 1 or July 1.
- Haushalter’s placement of the surge between late May and early June conceivably translates to an initial reopening between early and late June.
- McGowen’s estimate of maintaining restrictions for another 30 to 60 days appears to translate to reopening between mid-May and mid-June.
But none of that is as simple as it seems. McCullers said a peak can look more like a plateau that lasts for some time.
“How long or how short, I think are just up in the air right now, because we really don’t know the effectiveness of our social distancing and safer at home, which are kind of the main factors that would say that’s going to cut off transmission early or that you’re just going to spread it out over a much longer time,’’ he said. “So, it’s an inexact science.’’
Road to recovery
Once a surge passes and testing and contact tracing capabilities are optimized, a community can safely move to the next step, says Scott Gottlieb.
“During this phase, schools and businesses can reopen, and much of normal life can begin to resume in a phased approach,’’ writes Gottlieb and other researchers at the American Enterprise Institute, a right-tilting public policy think tank in Washington.
Trump’s former Food and Drug Administration commissioner, Gottlieb takes a much tougher stance than his former boss when it comes to committing resources to eradicate COVID-19. His influence is broad and extends to disease control specialists like Jain, the Memphis consultant.
“You should have widespread screening in place,’’ Gottlieb recently told CNN. “…And right now, screening is largely confined to hospitals. We don’t have the capacity to broaden it…. I think that’s going to be the big variable. I think we’re going to be taking a step toward opening aspects of the economy before we have the optimal level of screening in place. And that’s the risk that we’re going to take.’’
Asked if Trump was listening to him or his position papers, Gottlieb, a physician, said, “Well, I’ve certainly made them available to the White House.’’
In his AEI paper, “National Coronavirus Response: A Road Map to Reopening,’’ Gottlieb argues that even after reopening “some physical distancing measures and limitations on gatherings will still need to be in place to prevent transmission from accelerating again.’’ Shared surfaces like those in gyms and workplaces should receive more frequent sanitation. And “the public will initially be asked to limit gatherings’’ and should be asked to wear “fabric nonmedical face masks while in the community to reduce their risk of asymptomatic spread,’’ Gottlieb said.
Limiting the time of vulnerable seniors out in the community also will be vital, he said.
County Mayor Harris said Saturday he’s amended his COVID orders to help protect vulnerable, isolated seniors by creating protected grocery shopping hours for seniors to reduce contact with individuals who might be infected.
“When we look at the number of deaths in Shelby County, the median age so far is 65 years old. That’s why seniors-only shopping is important,’’ Harris said. “Every day we are working on this as we identify groups that are at higher risk.’’
Health policy expert Ezekiel J. Emanuel sees a slowly reopened economy in which restrictions are lifted first for the young and the strong, possibly with schools and universities holding summer sessions.
“Parents should be allowed to assess the risk that their children could become infected with the coronavirus and bring it home,’’ Emanuel, vice president of global initiatives at the University of Pennsylvania wrote in an opinion piece for The New York Times.
As restrictions are lifted, “sentinel surveillance’’ of segments of the workforce such as retail clerks or customer service agents will be needed to prevent a reignition of the disease, Jain said. This involves focused investigation and testing that he likened to “search and destroy’’ missions.
“So, it really is an epidemiological process of trying to, search and destroy: search (out) and isolate the (positive) person and then allow that virus to then be destroyed by the patient’s immune system.’
Jain is supportive of a cell phone app developed by researchers at the MD2K Center of Excellence at the University of Memphis that he says will help in sentinel surveillance efforts. The free app, mContain, alert a user when he or she is within six feet of another long enough for transmission of COVID-19 and also tracks the number of interactions a person has, Jain said.
The app may help reduce contact in offices and warehouses as well as general places where people gather.
“It can help you in your workplace, in church and places like that,’’ Jain said.
The virus is triggering a reconfiguration of all aspects of culture and society – even sports.
The University of Memphis postponed spring football practice. And though coach Ryan Silverfield told The Commercial Appeal recently he’s optimistic college football will happen in the fall, no one is really sure.
“Industry executives are already creating contingency plans for a nuclear fall of no football,’’ Sports Illustrated reported last week, citing plans that include possibly shortening the season.
The exact look of reopening is still just a faint image. The task force has had only a few “scattered’’ discussions about it, Harris said.
But already, some initial recovery measures are under way. One initiative funded by the Community Foundation of Greater Memphis has employed 50 people laid off from the restaurant and tourism industries to provide testing and outreach information to vulnerable Memphis Housing Authority tenants.
The Greater Memphis Chamber has started a recovery task force that’s been meeting for a couple weeks now, collecting data and studying past disaster recoveries from other cities.
“What we’re going to be doing in the next couple of weeks is taking a look at how we move businesses back,’’ Chamber President Robertson said. “I do think it will probably have to be in phases in some way, phasing in businesses and letting business begin to sort of try moving back slowly and see how that sits, and how it works, and making sure that it doesn’t reignite this COVID virus.’’
In Memphis, for now, support for social distancing and safer at home appear solid even in the hard-hit business sector.
“We’re very much in line, and we are encouraging our membership to abide by the CDC (Centers for Disease Control) and the mayor and the state’s mandate to do so,’’ Robertson said. “And we haven’t had any pushback from any of our members.’’
No pushback – but there’s been plenty of sacrifice particularly among small business.
“Due to the virus, so many are suffering, downsizing or closing,’’ Robertson said.
Already sharing the pain of furloughs and layoffs that’ve triggered a massive surge in joblessness – 246,026 Tennesseans have filed unemployment claims over the past three weeks including 32,355 in the Memphis area – local small business owners also are having trouble tapping funds from the Small Business Administration’s Economic Injury Disaster Loan pool, part of the $2.2 trillion stimulus package passed by Congress.
“The SBA is building the plane while they’re flying it,’’ said Robertson.
The pressure on small business also puts a pinch on the Chamber, which is largely funded by membership fees – a large portion coming from small business. About a third of small businesses recently scheduled to renew their memberships have not been able to do so, Robertson said.
As the coronavirus crisis surges forward, her staff is working closely with businessmen and women try to cut through SBA red tape and also connect unemployed workers with businesses that are hiring.
Providing such resources and assistance will be critical in holding constituencies together through the long haul of social distancing.
“Somebody asked me in an interview earlier this week what was I most surprised by? And I was most surprised by that we’re really accepting this pretty well,’’ said McCullers, the infectious disease specialist. “I mean, people are being pretty cooperative and polite about it for the most part and accepting…. I think that’s a good tribute to the citizens of the city and the county and the region. But also, I think the leadership’s been clear in saying why we need to be doing this.’’
“I think we’re resilient,’’ she said. “We’re learning how to be patient. You can’t rush (the development of a vaccine), you cannot rush a drug. What you can do is stay at home so that you don’t have to engage and come down with the virus so that you don’t end up being a statistic.’’
This story first appeared at dailymemphian.com under an exclusive use agreement with The Institute. Photos reprinted with permission of The Daily Memphian.