What Aggressive Coronavirus Lockdown Might Look Like in the U.S.

From limiting movement in or out of large apartments or dormitories to an Italy-style emergency, experts break down what seems to be coming.

As residents of Washington and New York battled the two largest clusters of the 2019 novel coronavirus in the United States, new restrictions on public assembly meant to ease the deadly crisis raised the question: Just how aggressive might authorities get?

U.S. cases of the new coronavirus had, as of Wednesday, topped 1,000, while Republicans in Congress have been briefed on the likelihood that most Americans will eventually be exposed to the infection, and the World Health Organization finally declared the outbreak a global pandemic. President Trump on Wednesday also used a 9 p.m. Oval Office address to announce a confused, partial travel ban between the United States and Europe, along with a variety of measures geared at steadying the economy.

But on Thursday, specifically in the Seattle area and in a suburb of New York City, life was about to get considerably more eerie.

Gov. Jay Inslee announced Wednesday that he would use emergency powers to prohibit large-scale public gatherings of 250 people or more in three counties through March in Washington state, where at least 29 people have died from the disease. Such events include social, spiritual, recreational, and work activities. Seattle’s public schools will also close.

King County Executive Dow Constantine added that for his jurisdiction, authorities have ordered that even gatherings of fewer than 250 people “should not happen unless very clear public health steps are taken” beforehand.

New York Gov. Andrew Cuomo said the coronavirus had infected at least 121 people in suburban New Rochelle alone by Wednesday evening, putting the nation’s second-largest cluster of the virus about 20 miles north of New York, America’s largest city. Cuomo called in National Guard troops to enact a one-mile containment zone in New Rochelle, which was set to go into effect on Thursday and remain in place for two weeks, through March 25. Troops would assist in distributing food and cleaning public spaces, Cuomo explained. 

Experts told The Daily Beast that it was too early to consider an Italy-style lockdown in the United States. New York and Washington haven’t imposed restrictions on movement so much as assembly, and the federal government has publicly and controversially struggled to even test enough Americans for the virus. But given the current trajectory, officials may end up pushing people close to their limit.

“The U.S. is not China, and our people would not tolerate the kind of social control and intrusive surveillance that we saw in China,” said Lawrence Gostin, who directs the O’Neill Institute for National and Global Health Law at Georgetown University and the World Health Organization’s Collaborating Center on National and Global Health Law. He called such a plan on American soil “both legally flawed and unethical.”

Gostin added that he believed a mass quarantine wouldn’t even be constitutional in the United States. But he said he could envision the U.S. limiting movement in or out of, say, large apartments or dormitories.

“We certainly did do that with the cruise ship, which was a debacle, so we would have to be far more prepared to protect the people that were quarantined,” said Gostin, referring to the Diamond Princess, where hundreds were infected in Japan last month, ultimately leading to at least six deaths. “I would hate to see that repeated in a university dormitory or public housing. It would be very, very troubling.”

Dr. William Haseltine, president of the global health think tank ACCESS Health International who recently chaired the U.S.-China Health Summit in Wuhan, China, where the outbreak originated, said he believed the United States was “close to” authorities implementing such lockdowns.

“Once you do something like in New Rochelle and stop people attending gatherings, I think it’s a real possibility,” he told The Daily Beast. “If the infection really gets out of control, and, if they’re accompanied by rigorous testing, I think China proved that it works. Everyone who moves at all in China has to report where they’ve been and where they’re going and then gets tested when they arrive.”

The outbreak in New Rochelle ostensibly began when a Manhattan lawyer who lives in Westchester County contracted the coronavirus on a trip and brought it home, where his wife, son, daughter, rabbi, and several neighbors became infected, too. The lawyer, Lawrence Garbuz, has since been hospitalized at the New York-Presbyterian/Columbia University Irving Medical Center in Manhattan, according to health officials.

Ken Ovitz, a longtime friend and cousin of Garbuz, told The Daily Beast that Lawrence is “the best, finest person you would ever know” and that he was told by the patient’s wife that his condition was “improving slightly.” Ovitz declined to provide more details about his cousin’s condition, except to say that he was “wise, kind, a gentleman, [has a] great heart,” and is “very smart.”

The one-mile “containment zone” was set to be structured around the Young Israel of New Rochelle synagogue, the temple attended by Garbuz before he was diagnosed. But Cuomo has stressed that the zone was not a travel lockdown and that anyone not quarantined was free to leave their homes, and local businesses could remain open. But all schools, houses of worship, and other large gathering spots in the area were to be shut down for two weeks.

“New Rochelle is the hottest spot in the country, the most dense cluster,” Cuomo said on Wednesday. “Our action in New Rochelle is just no large gatherings. People can come, people can go. There’s no limitation on movement, but no large gatherings because the large gatherings are where it spreads.”

“It sounds more dramatic than it is,” he added.

Still, those trying to live their lives in New Rochelle told Gothamist this week, before the order even took effect, that “it feels like there’s a toxic haze over us,” while others questioned how helpful the National Guard could even be during an epidemic.

“What are they going to do? Shoot the virus?” Raj Shaikhar, the owner of Jessica Newsstand, asked in an interview with the outlet.

The precedent set by Italy, which has seen hundreds of deaths caused by the virus, also loomed.

Italian Prime Minister Giuseppe Conte this weekend signed an unprecedented coronavirus containment decree, to disastrous effect, as Italians jumped in cars and on trains to flee an impending travel lockdown, and authorities sent and received mixed signals about whether they should even stop anyone. While movie theaters, museums, gyms, schools, and beauty parlors have been closed in the south, officials across the country instituted a “one meter rule,” requiring three feet of personal space everywhere from sidewalks to coffee bars. All 60 million people in the country are now affected by either the expanded lockdown or other travel and social-distancing restrictions. Anyone defying a ban on “unnecessary movement”—into and out of the virus-battered northern region, which includes the cities of Venice, Milan, Parma, and Modena—could be subject to criminal charges.

The country’s worst cluster emerged in northern Italy on Feb. 21. As of Wednesday, there were 12,462 cases and 827 deaths nationwide.

Meanwhile, in China, the outbreak was largely confined to the Hubei province, where it first originated. The lockdown in Wuhan, the epicenter of the virus, is still in effect, though the rate of new cases has come way down, and President Xi Jinping even visited the city this week.

But Gostin said he did not buy the Chinese precedent as the only—or best—way forward.

“There’s very little evidence that these large lockdowns worked,” he said. “Japan and South Korea have not used them—and used traditional public health measures—and had dramatic drops in cases.”

Social separation, on the other hand, may not stop an epidemic, “but it flattens the curve and slows it down, which buys us time,” said Gostin, who noted that he expects Americans will likely see increased self-isolation at home in the coming of weeks, possibly into the millions.

“Quarantine and isolation is a social contract where citizens agree to stay separated from the community for the common good, and, in exchange, the government promises them that they will keep them safe with good healthcare and humane conditions,” he said. “I think citizens will comply, but I’m not sure if the government can hold up its end of the bargain.”

“If you’re unemployed, uninsured, elderly, disabled, in a rural area, you’re not going to have the ability to take care of yourself and you may be very vulnerable,” said Gostin.

Those concerns have already been discussed by city leaders in affected areas, at least in Seattle, where City Councilmember Teresa Mosqueda on Wednesday called on her state’s elected officials to act “with one purpose: to protect the health of the community and front line workers.”

“That includes maintaining protections for civil liberties, housing and care for our most vulnerable and acting swiftly to implement public health prevention and containment strategies,” she told The Seattle Times

But Gostin cautioned: “Lockdowns without testing are minimally effective. To be effective, you have to know who is infected and who is not. You have to know who to treat and how to contact-trace.”

“What’s happening in New Rochelle is a joke” compared to the rigorous tracking and testing in China, Haseltine argued. “It isn’t a joke for those people, but in terms of what’s effective—it’s not effective. They need tests, and they need to make sure that there’s really effective containment.”

“Our testing is so far behind the reality that there probably is no connection between the two,” Cuomo said on MSNBC Wednesday. “I have no doubt that people have coronavirus and are walking around.”

To that end, Gov. Cuomo on Wednesday joined several other local and state leaders who have pointed fingers at the Centers for Disease Control and Prevention over its troubled rollout of working diagnostic kits, which experts and elected officials have said deflated the number of confirmed infections in the United States. Only about 5,000 tests had been conducted in the U.S. by Wednesday, compared to the tens of thousands in other developed countries.