Coronavirus Data: What We Still Need to Know to Reopen Safely

A server disinfects an outdoor table, June 2020.

President Donald Trump’s first rally since the coronavirus crisis began in March underscores how irresponsible his approach to the crisis has been. For months, he has been pushing for states to roll back critical public health measures in place to slow the spread of the novel coronavirus, but the data simply doesn’t back him up.

The problem isn’t just that death tolls remain high, having surpassed 110,000 with no end in sight—new case counts have also spiked around the country, meaning that most states don’t meet the Trump administration’s own guidelines for reopening (or, for that matter, those suggested by the Center for American Progress). In addition, testing and supplies of personal protective equipment (PPE) are still sorely lacking in many areas of the country.

Below are some of the major issues related to the coronavirus and our understanding of it—issues that could have massive ramifications for understanding how and where it is safe to reopen—that the administration seems to be simply ignoring.

  • Spread in jails and prisons. Jails and prisons are perfect settings for a disease like COVID-19 that spreads particularly quickly and easily in indoor places where people are in close physical contact. Moreover, prisoners often lack the kinds of sanitation and hygiene products necessary for combating the spread of infectious diseases, many of which are considered contraband. Unsurprisingly, there is clear evidence that correctional facilities have seen unusually high rates of coronavirus infection as well as large spikes in deaths since the beginning of the outbreak. But, as Reuters has reported, the fact that most prisons “typically limit testing to inmates with obvious symptoms,” rather than conducting mass testing, and a dearth of public reporting from local jails has left massive gaps in what we know about the numbers of people who have been infected and potentially killed by the deadly virus. The problem persists despite confirmation of coronavirus cases in all jails and prisons the Centers for Disease Control and Prevention (CDC) has studied and infection rates of up to 65 percent in some state prisons as well as a 73 percent rise in coronavirus-related deaths in jails and prisons since mid-May. As a result, “figures compiled by the U.S. government appear to undercount the number of infections dramatically in correctional settings,” to the point that, in May, Reuters was able to document “well over three times the CDC’s tally of COVID-19 infections—about 17,300—in its far more modest survey of local, state and federal corrections facilities” than the CDC found in a much larger study. More recently, The New York Times put the figure even higher, reporting that 68,000 prison inmates are known to have been infected with the virus. The problem is not limited to prisoners themselves: Staff and contractors working in the facilities could also easily bring the disease home with them, exacerbating the outbreak elsewhere and undermining efforts to reopen safely.
  • Deaths among U.S. health care workers. Health care workers face major risks during the coronavirus crisis, especially due to shortages in PPE and the Trump administration’s reluctance to invoke the Defense Production Act to alleviate the shortages. Already, data shows that significant numbers of health care workers have become infected with or died from the coronavirus in the months since it arrived in the United States. According to the CDC, as of June 16, more than 77,000 health care personnel have tested positive, and 417 have died. However, as NBC News has noted, the CDC’s data suggests that the numbers could be significantly higher. Less than one-quarter of respondents in the CDC’s data reported working in the health care industry, and, according to the CDC’s website, “death status was only available for” 63 percent of health care respondents.
  • Meatpacking plants. Like jails and prisons, meatpacking plants make for perfect hotspots for a disease such as COVID-19, with large amounts of workers working in close proximity to each other. They have also been deemed essential businesses, meaning that they have continued operation, even as many other physical workplaces have largely shut down. Available data appears to largely confirm that meatpacking plants have seen significant outbreaks: According to The Washington Post, as of May 12, “Of the 30 counties in the United States with the highest per capita prevalence of the coronavirus … 10 are home to major meatpacking plants.” That may explain why there also appears to be an active effort to cover up the data. Nebraska Gov. Pete Ricketts (R), whose state is home to plants with more than 1,000 infected employees, announced in early May that the state would stop reporting information on infection rates at individual facilities.
  • Racial data. From the beginning of the outbreak, the coronavirus has exposed systemic inequities between communities of color—specifically Black and Native Americans—and white Americans. As the Center for American Progress has previously documented, people of color face multiple sources of disproportionate risk from the pandemic. They are more likely than their white counterparts to lack health insurance; they disproportionately work in industries that increase their risk of contracting the disease; they are more likely to lack the financial resources necessary to go without a paycheck for months; and, due to structural racism, they also face the kinds of chronic health conditions and environmental factors, including poor housing, lack of access to health care providers, and air pollution, that often exacerbate respiratory illnesses. Unsurprisingly, racial data so far confirms that Black, Native, and Latinx Americans comprise a disproportionate share of coronavirus deaths and infections. However, that racial data remains woefully incomplete: According to Johns Hopkins University’s Coronavirus Resource Center, only four states—Delaware, Illinois, Kansas, and Nevada—have released COVID–19 data for testing, deaths, and confirmed cases. Meanwhile, Nebraska and North Dakota have not released racial breakdowns for any of the three categories.
  • Antibody tests versus infection tests. As the United States finally moves toward a threshold of testing necessary to safely consider reopening, a new problem has emerged. At least half a dozen states, including Virginia and Texas, have at some point published testing numbers that include not only tests performed for current infections but also tests performed for the presence of antibodies, which indicate whether a person has previously infected with the virus. As the Texas Observer explained, conflating the two types of tests without specifying how many of each test is being performed risks significantly overstating the amount of testing being done and artificially lowering the positive test rate, which could have massive consequences as states begin to reopen. According to The Atlantic, the CDC had also begun mixing the two types of tests in its data, “making, at best, a debilitating mistake” and “overstating the country’s ability to test people who are sick” in a way that systematically skews data states are expected to use to determine whether it is safe to reopen. Moreover, the antibody test themselves are widely considered unreliable, providing false results as much as half of the time, leading the CDC to recommend that they “should not be used to make decisions about returning persons to the workplace” or other setting like schools or dormitories. Finally, it remains unclear whether the presence of antibodies, which typically indicates past exposure to an illness, actually confers immunity, further reducing the tests’ usefulness in making public-health decisions.
  • Risks for children. Trump has championed reopening schools, contradicting advice from top administration public health officials such as Dr. Anthony Fauci, who warned that expecting sufficient testing and vaccines to even open schools in the fall may be “a bridge too far.” Trump has argued that reopening schools would be safe because the coronavirus “had very little impact on young people.” Not only does Trump’s statement ignore the adults who work in schools, it also ignores a growing body of evidence that the risks to children may be significantly higher than previously known. Despite low initial mortality rates among children, they may be susceptible to developing rare and potentially fatal inflammatory diseases after contracting the virus. In addition, there are risks to children with respiratory conditions such as asthma and risks that children can transmit the virus to adults.

The data so far on reopening looks grim. At least 10 states have seen record high case numbers since June 11, including Alabama, which reported record numbers of new cases for four straight days from June 11 to June 14. In Arizona, where the caseload has spiked since reopening began in late May, hospital ICUs have nearly reached their capacity—the precise problem social distancing was designed to prevent.

Already, Dr. Fauci and data collected by the CDC have suggested that the death toll from the coronavirus may be higher than has so far been publicly confirmed—not, as Trump has suggested, lower than official totals. As Trump pushes states to continue recklessly rolling back public health measures to protect people from COVID-19 and caseloads spike nationwide, it is more important than ever that we act deliberately and based on evidence in order to mitigate the dangers of the pandemic.

Jeremy Venook is a research associate at the Center for American Progress Action Fund.