BOSTON — Last week, as Dr. Emily Wroe left her home in Boston and drove west to see her parents in Idaho, she watched as signs of the pandemic became fewer and farther between.
After she left Ohio, customers at gas stations no longer wore masks. In Nebraska, when she needed a repair to her truck, the mechanic seemed to look at her strangely because she was wearing one. In Montana, there were no masks in sight, and motorcyclists clustered in groups of 20.
The farther she was from the East Coast, the more she found Americans treating the threat of the virus as “faraway, and not important.”
“I wasn’t surprised, but it is striking,” said Dr. Wroe, who spent the spring preparing contact tracers for Massachusetts. “We’re in the middle of a global pandemic, and there are a lot of towns and businesses along the way where nothing has changed.”
Six months since the coronavirus crisis was first detected in the United States, the Northeast stands in sharp contrast with the rest of the nation.
Along the East Coast, from Delaware through Maine, new case reports remain at a low level, a small fraction of their April peak. Six of the country’s 11 states with flat or falling case levels are in that Northeastern corridor.
New York State announced on Wednesday that just over 700 people were hospitalized because of the virus, the fewest since mid-March and a huge drop from a peak of over 18,000 people. Deaths have also slowed significantly, hovering around 20 for the past six days, compared with the nearly 800 fatalities in a single day at its peak.
“It’s acting like Europe,” Dr. Ashish Jha, the director of the Harvard Global Health Institute, said of the Northeastern United States.
Like Europe, the Northeast suffered a devastating wave of illnesses and deaths in March and April, and state leaders responded, after some hesitation, with aggressive lockdowns and big investments in testing and tracing efforts. Residents have largely followed rules and been surprisingly supportive of tough measures, even at the cost of economic pain.
Dr. Jha said the difference in regional trajectories was so pronounced that, by the time flu season rolls around in the late fall, “I would not be surprised if what we have is two countries, one which is neck-deep in coronavirus, its hospitals overwhelmed, and another part of the country that is struggling a little, but largely doing OK with their economy.”
It is also true that the Northeast remains the corner of America that has suffered most from the virus. New Jersey, New York, Connecticut, Massachusetts and Rhode Island have reported the country’s most deaths per capita over the course of the pandemic, with more than 61,000 combined. And the economic wounds from prolonged shutdowns are deep: Massachusetts’s unemployment rate in June climbed to 17.4 percent, the worst in the country, according to federal data released on Friday.
But polls, so far, suggest that voters in the Northeast are prepared to tolerate prolonged economic pain in order to stop the spread of the virus. Governors from the states that were hit early in the pandemic have sustained the highest approval ratings in the country.
And in May, when a poll by Suffolk University Political Research Center asked Massachusetts residents how long they could endure the hardships of a shutdown, 38 percent of those surveyed answered “indefinitely.”
“This isn’t an economic policy, this is life or death,” said David Paleologos, the center’s director. “That is at the core of why people are saying, ‘I’ll do whatever it takes.’”
The crisis has drawn out key regional differences in how Americans view the role of government in their lives, said Wendy J. Schiller, chair of the political science department at Brown University in Providence, R.I. The Northeast, she said, with its 400-year tradition of localized, participatory government, has been less affected by decades of antigovernment rhetoric.
“In New England and the Northeast, it is easier to say, ‘Let’s put on a mask and lock down, we’re all in this together, we know each other,’” she said. “It’s this reservoir of belief that the government exists to be good.”
Four months ago, all of the New England governors were scrambling to contain the spread of the virus. They had hesitated to impose shutdowns in early March, when many in the public health community were urging immediate action, Dr. Jha said.
“It took longer than it should,” he said.
But the responses that followed were aggressive. Charlie Baker, the Republican governor of Massachusetts, decided after a late-night phone call with Jim Yong Kim, co-founder of the nonprofit Partners in Health, to budget $55 million for contact-tracing programs that would recruit and train a corps of 1,900 newly minted public health workers. The program was up and running within weeks.
“I certainly felt under the gun — and I know many of my colleagues did — to make decisions with less than perfect information,” Mr. Baker said.
By this month, tracers were able to reach 90 percent of contacts within 24 hours. New cases had fallen so steeply that the corps was reduced to 500.
There was a similar scramble to acquire personal protective equipment, which included chartering six flights from China to carry shipments of masks. In early April, Robert K. Kraft, the owner of the New England Patriots, transported a million N95 masks from China to Boston Logan International Airport on a team plane.
The Coronavirus Outbreak ›
Frequently Asked Questions
Updated July 22, 2020
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Why do masks work?
- The coronavirus clings to wetness and enters and exits the body through any wet tissue (your mouth, your eyes, the inside of your nose). That’s why people are wearing masks and eyeshields: they’re like an umbrella for your body: They keep your droplets in and other people’s droplets out. But masks only work if you are wearing them properly. The mask should cover your face from the bridge of your nose to under your chin, and should stretch almost to your ears. Be sure there are no gaps — that sort of defeats the purpose, no?
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Is the coronavirus airborne?
- The coronavirus can stay aloft for hours in tiny droplets in stagnant air, infecting people as they inhale, mounting scientific evidence suggests. This risk is highest in crowded indoor spaces with poor ventilation, and may help explain super-spreading events reported in meatpacking plants, churches and restaurants. It’s unclear how often the virus is spread via these tiny droplets, or aerosols, compared with larger droplets that are expelled when a sick person coughs or sneezes, or transmitted through contact with contaminated surfaces, said Linsey Marr, an aerosol expert at Virginia Tech. Aerosols are released even when a person without symptoms exhales, talks or sings, according to Dr. Marr and more than 200 other experts, who have outlined the evidence in an open letter to the World Health Organization.
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What are the symptoms of coronavirus?
- Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
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What’s the best material for a mask?
- Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
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Does asymptomatic transmission of Covid-19 happen?
- So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
“There’s all kinds of things that happened over this period of time that were unusual decisions and risky ones, but for most of us, we felt we were doing what we had to do,” said Mr. Baker, whose job approval ratings rose to 81 percent in late June, according to a Suffolk University poll.
In Rhode Island, Gov. Gina Raimondo, a Democrat, took a stern approach beginning in late March, at one point ordering State Police to stop cars entering the state from New York to enforce quarantine requirements. She regularly warns that expanding freedoms will be curtailed if residents fail to observe social distancing rules.
It has been a transformational political moment for Ms. Raimondo, lifting her approval ratings to 81 percent in late April, at the height of the pandemic, from 35 percent in January. Her signature admonition — “knock it off” — became so popular that a gift shop in Providence printed it on T-shirts.
Mr. Baker said the high level of compliance with quarantine measures was natural, given how badly the region was battered in the spring.
“Like everybody else, I know people who have been directly affected by this thing,” he said. “I’ve had very close friends almost die. I’ve had good friends who have lost family members because of it. I went 100-odd days without seeing my father because he’s 92 years old and in an assisted living facility.”
It is not certain what the months ahead will hold for the Northeast. A new surge of cases in the South and the West has spread across other states, and as of this week, cases were rising in 41 states. The number of people hospitalized for the coronavirus across the country was nearing an earlier peak in the spring, according to the Covid Tracking Project. Among states where cases were slightly rising in recent days were Rhode Island and Massachusetts.
In New York, the drop in cases has held even as the state has gone through a gradual reopening process, one that began with officials warning that they would not hesitate to restore restrictions if the virus showed signs of returning. Nearly two months after the state began reopening, New York has seen about 1 percent of Covid-19 tests return positive.
Dr. Jha said he was optimistic that Northeastern states could maintain control over the virus’s spread through the summer, reopening gradually while closely monitoring shifts in the data.
“I think they’re watching what’s happening in the South and they’re horrified,” he said.
Gov. Janet Mills of Maine, a Democrat, sounded cautious. She said officials in her state were “exhaling, but safely, with masks.”
“The last few weeks, in particular, have felt good, but we’re not out of the woods,” she said.
The coming months will bring new waves of difficulty as well, as the economic impact of the spring shutdowns ripples outward, unemployment benefits expire and an expected wave of evictions begins.
Of all the difficult decisions that she faced this year, Ms. Mills said, none has been more “gut-wrenching” than her first stay-at-home order.
“Nobody wants to be the governor who puts the kibosh on graduations, weddings, beach parties, bars,” she said. “Nobody wants to be the governor the tourist industry rails against. Nobody wants to be that governor.”
Mitch Smith contributed reporting from Chicago, and Michael Gold from New York.
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