Health experts caution Pa. lawmakers against easing COVID-19 rules too fast

"I just worry that there’s a pressure to go just a bit too fast."

• By Katie Meyer/WHYY

(Philadelphia) — Partisan tensions are growing in Harrisburg over the appropriate way to respond to the coronavirus pandemic — with many Republicans hoping to scale back business closures and get the economy back up and running, and Democrats largely urging a more cautious approach.

“We recognize the severity of the disease and what the immediate quarantine did in terms of buying us time,” said House Majority Leader Bryan Cutler, a Republican. “Our concerns looking to the future though, and really what has driven some of the discussion this week, is what will the next steps be?”

Medical experts are also wrestling with the question of when it will be appropriate to start returning to normal life. But asked to weigh in on several bills moving through Pennsylvania’s GOP-controlled legislature, two doctors — one from Pittsburgh, one from San Francisco — had similar responses: it isn’t time yet to start relaxing restrictions.

Cutler, who plays a key role in setting the House’s legislative agenda, said his caucus has several priorities, most of which will expand the list of businesses that are allowed to operate while under emergency coronavirus rules.

First, Republicans are trying to create a task force between the state’s legislative, executive and judicial branches to coordinate various coronavirus responses.

Next, he said, he wants to think about measures that would allow a gradual return to normalcy — like one that would allow businesses to reopen if they allow only one worker and one customer inside at a time.

“Look, for a lot of those small mom-and-pop shops, it is their livelihood,” he said. “And if they can do it safely and get slowly back to normal, I think we should give those individuals that responsibility who, one, choose to do so, and two, can safely do so.”

Neil Clancy, a Pittsburgh-based infectious disease physician, said he understands the impulse to get things back to normal — but it makes him nervous.

“These are legitimate aspirations,” he said of what he called a “well-founded desire people have to get things moving again.” But he added, “I just worry that there’s a pressure to go just a bit too fast.”

What is “too fast,” in Clancy’s eyes?

He cites former Food and Drug Administration head Scott Gottlieb, who has estimated the country would have to be able to perform three to five million coronavirus tests per day in order to safely monitor disease spread if people go back to work.

“I’m not sure, as a country, we’re close to that right now,” Clancy said. “I think what they’re putting together in terms of picking out certain types of businesses and then rolling them out in a hierarchical approach is the way to go … but I don’t know if you can do anything until you’re absolutely rock solid that you can do the testing.”

Leo Nissola, a San Francisco doctor who specializes in immunology and is working as an advisor to the project COVID Act Now, had similar thoughts.

Despite the “sea of unknowns” about COVID-19, he said, one thing has been pretty clear: states that implemented early shelter-in-place orders, like his home of California, saw fewer cases.

“You see Gavin Newsom actually flew ventilators out of California,” Nissola said. “We are very confident that the sheltering in place and the stay-at-home orders actually did the trick in states like California, and we were hoping that other states would follow suit.”

But Nissola added, he’ll only feel comfortable with states lifting those orders if a few specific things happen.

First, he said, the country needs to perform more random tests on asymptomatic people to study how broadly the disease has actually spread. The National Institutes of Health recently announced the start of such a study, which will test volunteers’ blood for antibodies indicating they’ve been infected with COVID-19.

“That result would actually tell us if sheltering in place will need to be extended or not,” Nissola said. “But until we know that number, we are flying blind.”

He also said people need better protective equipment if they’re going to venture out more frequently — specifically N95 masks, which remain difficult to get. Federal and state officials have advised people to make or buy cloth masks instead, in hopes of limiting transmission to others. But Nissola said the growing prevalence of those masks makes him worried that people overestimate their effectiveness.

“When people ask, well what should you do? My only advice is that you should be outraged, you should be upset that you’ve been told to wear something that is not going to protect you,” he said.

Despite Republicans’ eagerness to even out and eventually ease business closure provisions in Pennsylvania, they would have to get Democratic Gov. Tom Wolf on board to do so.

So far, he has expressed support for a version of one of the GOP’s proposals — the task force. But instead of a Pennsylvania-wide collaboration, Wolf announced Monday that he was adding the commonwealth to an interstate coalition with New York, New Jersey, Connecticut, Delaware, Rhode Island and Massachusetts.

That group, he said, would “work together to develop a fully integrated regional framework to gradually lift the states’ stay-at-home orders while minimizing the risk of increased spread of the virus.”

At least one GOP lawmaker was unhappy with the decision. State Sen. Ryan Aument, a high-ranking Republican, said on Twitter that he was “extremely disappointed.”

“We need a Pennsylvania-focused, bipartisan inter-branch task force,” he wrote. “The COVID-19 Cost and Recovery Task Force provides the best opportunity to develop a data-informed plan to protect public health and restore our economy.”

When it comes to eventually easing up on coronavirus-related business closures, Wolf and officials in his administration have said they’re generally unwilling to entertain the possibility yet.

“While the Governor and I are as eager as anyone to begin getting people back to work, doing so prematurely will only increase the spread of the virus, further lengthening associated economic challenges, while also placing more lives at risk,” Health Secretary Rachel Levine wrote in a recent letter to the legislature.

Legislative Democrats — despite having limited power to impact proposals with broad GOP support — said they’re on the same page.

House Democratic Spokesman Bill Patton said his caucus isn’t focused on reopening businesses, but on helping people who will be out of work indefinitely.

“Supporting workers and small businesses in any way we can, including increased unemployment help, help with insurance,” Patton said when asked about legislative priorities. “We need to take care of those people at ground level and help them get through this immediate crisis.”

The rise in COVID-19 cases appears to be slowing in Pennsylvania, with new cases no longer rising exponentially. Monday saw the commonwealth confirm an additional 1,366 positive cases, bringing the statewide total to 24,202.

Levine said it was good news, and that it shows social distancing measures should continue.

“It really could be much, much worse,” she said.

WHYY is the leading public media station serving the Philadelphia region, including Delaware, South Jersey and Pennsylvania. This story originally appeared on WHYY.org.