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Lack of coordination in reopenings could lead to more coronavirus spread, spillover between states

On Saturday afternoon, the line of people waiting to get into a Methuen Home Depot was very long.
On Saturday afternoon, the line of people waiting to get into a Methuen Home Depot was very long.Jim Davis/Globe Staff

Shaggy, quarantine-weary residents in New Hampshire were free to visit a hair salon nearly two weeks ago. In Massachusetts, that long-awaited luxury will be allowed next week. But in New York, some residents could be waiting quite a while longer.

Absent a clear, cohesive federal blueprint for reopening, governors across the country have been decision-makers in their own high-stakes gambit, choosing how to reopen and when. What’s emerged is a dizzying, sometimes discordant patchwork of plans that scientists and public health experts say may come at a great cost.

New research released Thursday from MIT found that, during the lockdown, people networking through mobile phones, video conferencing, and social media appeared to influence the travel behaviors and adherence to government restrictions of those in other states, even places far away.

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A person in Florida chatting over Facebook with someone in New York about the Southern state’s more lax rules, for instance, could affect the New York resident’s adherence to their local mandates, said Sinan Aral, a coauthor of the research and Director of the MIT Initiative on the Digital Economy.

The researchers also found that if one county enacted stricter shutdown rules compared to another, travel increased to the less restricted country from the one under more stringent lockdown.

The researchers said this cross-state influence is likely to remain so as states reopen, and those with stricter rules may be undermined by spillover travel from neighboring states with looser plans.

“Obviously we don’t advocate a one-size-fits-all policy. We recognize different localities with different circumstances may need different policy responses,” Aral said. “But our work suggests that they should coordinate with each other.”

The research — based on data from millions of mobile phones and social network connections — has not been published or peer-reviewed.

Most states are relying on a mix of various health measures to gauge the pace of their reopening — a 14-day or perhaps 7-day downward trajectory of new cases, hospitalizations or deaths, a robust level of hospital and testing capacity, and the ability to trace infected contacts. But no two state plans seem to match up. Even neighboring states differ on these all-important metrics.

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“I do think it’s reasonable for different areas of the country to make different decisions,” said Dr. Ashish K. Jha, director of the Harvard Globe Health Institute. “Where it gets a bit more complicated is when states right next to each other start doing things very differently.”

Montana, for example, has had relatively few cases. “It’s probably not a big deal in many parts of Montana to open restaurants," Jha said.

Massachusetts, on the other hand, has among the highest infection rates in the nation. And neighboring states could pay the price as house-bound residents clamor for haircuts, beach outings, and more.

“Any discoordination across states is costly to other states,” Jha said. “That does not mean every state should be doing the exact same thing.”

In New England, Maine was one of the first states to reopen, with hair salons and certain other businesses allowed to resume May 1. Massachusetts has been the most cautious, taking its first steps weeks later.

Another approach is Rhode Island, which started opening construction and manufacturing earlier this month. Although Rhode Island and Massachusetts have taken slightly different approaches, Jha doesn’t think the plans are discordant enough to cause problems. “My sense is both states are being pretty data-driven, pretty reasonable,” he said. “Neither state is rushing very fast.”

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Connecticut put the brakes on a plan to reopen hair salons May 20 after concerns were raised by businesses next-door in Rhode Island. Two days before Connecticut’s salons were slated to fling open their doors, the states jointly announced that they’ll align the reopening of those shops in their respective states in early June.

The level of other coordination between states in the Northeast corridor remains unclear.

In mid-April, New York Governor Andrew Cuomo announced a pact to collaborate with Democratic governors from Connecticut, Delaware, New Jersey, New York, Pennsylvania, and Rhode Island. Governor Charlie Baker also indicated he was participating. But few details on their discussions have emerged.

Baker’s administration released a statement Thursday that suggested the governors are still talking.

“The Administration continues to meet weekly with other members of the multi-state coalition to share information to ensure regional cooperation in the fight against COVID-19," the statement said. "The Administration is thankful for the efforts of other members of the council, and will continue to take all steps necessary to protect the people of Massachusetts as we work to return to a new normal as safely as possible.”

The federal government has offered only modest guidance on reopening. The White House released criteria for states to reopen based on a “downward trajectory” of cases over the last 14 days, though it did not define how to measure the trajectory.

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It’s been up to state leaders to balance public health, economic, and political considerations. Some will do fine, but some are bound to make policy mistakes, said Dr. Sarah Fortune, chair of the Department of Immunology and Infectious Diseases at Harvard T.H. Chan School of Public Health.

“How well people do at a community level is going to determine the success of the reopening plans,” she said. “That puts a lot of burden on individual people.”

Complicating the states’ decisions is the lack of knowledge about precisely which aspects of the shutdown were most effective.

“Viral transmission always depends on people coming together,” Fortune said. And any measure that keeps people apart is going to help. Sure, crowded bars, sporting events, and concerts should be avoided for now. But as for whether getting your hair cut is more or less dangerous than dining out — no one knows. “We are left with very blunt tools,” Fortune said.

Nationally, some of the states early to reopen, such as Tennessee and Texas, have since reported spikes in cases, whereas others that reopened later are on a downward trend.

Wendy E. Parmet, a professor of public policy and urban affairs at Northeastern University, said its critical for states to work together and share their latest data on infections and related trends, especially since a second wave of infection is likely.

“The danger is, it’s a race to the bottom as more and more states reopen,” Parmet said. "It will be harder and harder for governors to maintain stricter measures in their state. People are tired of the lockdowns and there is a pressure in opening up, but also a lot of risk.”

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Edward Fitzpatrick of the Globe staff contributed to this report.


Kay Lazar can be reached at kay.lazar@globe.com Follow her on Twitter @GlobeKayLazar. Felice J. Freyer can be reached at felice.freyer@globe.com. Follow her on Twitter @felicejfreyer