To shut down or not to shut down? Officials must contend with backlash.

With the coronavirus raging out of control and hospitals nearing capacity, state and local leaders across the country are facing once more the gut-wrenching decision of whether to order shutdowns.

But many are finding the call much harder to make this time—eight months after cities and states last implemented weeks-long shutdowns—amid angry backlashes, deeply polarized constituents and dire economic consequences.

Chicago was the first major city to announce, on Thursday, a reinstatement of stay-at-home orders. On Friday, New Mexico followed suit with the country’s most restrictive statewide measures since the fall surge began. Oregon also announced a partial shutdown Friday, closing gyms and dine-in restaurants and mandating a six-person limit on all social gatherings.

The moves come as United States reported more than 177,000 new coronavirus cases Friday, a record high for the third straight day.

Other states are trying to avoid full-blown lockdowns by enacting almost every other kind of restriction: nighttime curfews, bar closures, stricter mask mandates, 10-person gathering limits. California, Oregon and Washington urged residents this week to cancel nonessential travel. Vermont restricted nonessential travel into the state. New York City said its public schools could close as soon as Monday.

New Mexico Gov. Michelle Lujan Grisham, a Democrat, said the state is at a “breaking point” and reinstated the most heightened public health restrictions, including prohibiting on-site dining and requiring nonessential businesses to close their physical locations. The state recorded 1,742 coronavirus cases Thursday, a record.

Officials say they are making such decisions under considerable pressure.

Chicago Mayor Lori Lightfoot, a Democrat, said she called for lockdowns only after experts showed her projections that at least 1,000 people could die by year’s end unless the city took immediate action.

“If the possibility of 1,000 more people dying doesn’t grab you by the throat as it did me when I started to see that model, there’s very little we can do to move you,” she said. “People are dying. We’re seeing a daily uptick. This is literally a matter of life and death. ”

That did not deter Republicans from immediately attacking Lightfoot, posting pictures of the mayor, who was not wearing a mask, celebrating Joe Biden’s presidential victory with a crowd days earlier. “Democratic Hypocrisy,” one conservative commentator tweeted.

Restaurant and other business owners in Illinois—who have already filed lawsuits against officials over earlier restrictions—decried Chicago’s lockdown.

The city’s top health official said Chicago’s outbreak now is at its worst point since the pandemic began. A month ago, Chicago had a daily average of 500 new cases, and the rate of people testing positive was roughly 5%. Today, the city is averaging 2,000 new cases a day and has a test positivity rate in some areas of more than 25%.

“It takes very little time for these numbers to get to the point where we start to overwhelm hospitals and talk about deaths in ways that I hope never to talk about,” said Chicago Public Health Commissioner Allison Arwady.

Ram Villivalam, a state senator who represents Chicago, pleaded for federal aid for local businesses and workers who could lose their livelihoods under the new restrictions.

“Measure after measure, we’ve tried to do our best,” he said. “But the reality is, there is so much we can do in the state of Illinois. The federal government is able to print money. ”

Chicago is limiting all indoor and outdoor gatherings to 10 people, but the new restrictions don’t affect the 50-person maximum set for gyms, retail stores and movie theaters.

Illinois reported a record number of cases Friday for the fourth day in a row, with 15,415 residents testing positive.

Governors in Illinois, Maryland and Washington say they are now weighing similar lockdowns.

But leaders in more conservative states have made clear that stay-at-home orders are out of the question. Despite mounting deaths and packed hospital wards, some continue to balk at even less-intrusive measures such as mask requirements.

Mississippi Gov. Tate Reeves, a Republican, ruled out any shutdown, calling closing businesses “totally and completely unreasonable.” His statement came just days after the governor’s 8-year-old daughter was infected and his entire family forced to isolate. The state recorded 1,305 cases Friday, the most since July, and five deaths.

Public health experts, however, are divided on the question of lockdowns. Many agree that lockdowns may be the most effective—and perhaps only—way to get control of the virus. Because of how badly U.S. leaders and some individual Americans have handled the pandemic response, the virus has now entered a stage of exponential growth that will be hard to halt with minor actions, experts said.

The widespread nature of this fall’s surge also makes it much harder to contain – with cases rising in almost every state, instead of simply one area like in New York last spring and the Sun Belt states over the summer.

But many health officials acknowledge the financial and emotional devastation that shutdown orders would bring, especially in the absence of any economic aid because of Congress’s months-long stalemate. It is unclear, experts say, if some people would even follow such orders given the fatigue, anger and disbelief in the virus in some parts of America.

“It’s becoming clear that we need to close parts of society to control covid,” Tom Frieden, a former director of the Centers for Disease Control and Prevention, wrote in a tweet. “Unfortunately, the spring’s initial widespread closure poisoned the well – many places shut down too soon and for too long. ”

He and others have called for the latest round of closures to be more targeted, using real-time data to pinpoint communities that have surging cases, and prioritized – choosing to close bars, for instance, so schools can stay open.

The heated debate has affected even the new coronavirus task force convened by President-elect Joe Biden.

Michael Osterholm, a member of the task force, suggested this week that paying people to stay home during a four- to six-week national lockdown could get the pandemic under control. He later clarified that such a sweeping plan is obviously not feasible, given the lack of economic aid from Congress.

But conservatives seized his comments to accuse Biden of planning to enact a national lockdown.

“Lockdowns. Mask police. Curfews. What about freedom?” crowed Rep. Jim Jordan, R-Ohio, in a tweet.

South Dakota Gov. Kristi Noem, a Republican, who has taken a lassiez-faire approach to the virus and enacted few restrictions even as cases and hospitalizations in her state have surged, tweeted, “Just like we said, Biden’s team wants lockdowns.”

Vivek Murthy, a co-chair of Biden’s task force, clarified Friday that the Biden team is not calling for national lockdown.

“We’re not in a place where we’re saying, ‘Shut the whole country down,’ ” said Murthy, a former U.S. surgeon general. “We got to be more targeted. If we don’t do that, what you’re going to find is that people will become even more fatigued, schools won’t be open to children, and the economy will be hit harder. ”

Biden met privately Friday with leaders of his coronavirus task force and demanded in a statement a “robust and immediate federal response, which has been woefully lacking,” from the outgoing administration. Biden did not mention lockdowns.

Lockdowns are blunt instruments best used to buy time to put in place more nuanced strategies, epidemiologists say. But each time state leaders have put such restrictions in place, the federal government has failed to use that time to rally the country’s resources and issue a national coordinated plan to fight the virus.

“We as a country desperately need to somehow reset our pandemic response,” said Columbia University virologist Angela Rasmussen. “There’s a lot of hope Biden will do just that, but there’s also no way we as country can wait until inauguration to get control of this virus. ”

By that time, the number of daily infections could double, some disease models show. America’s current death toll of 243,000 could reach 360,000 or higher.

That means state leaders will probably be left again—in the absence of federal leadership—to make the biggest decisions during this lame-duck period.

“I try not to be too depressing. But my outlook right now is pretty pessimistic,” Rasmussen said. Missing, she said, is economic support to help businesses. A coordinated plan on what such lockdowns would accomplish. And the federal and political leadership needed to get people’s buy-in.

“We should be doing lockdowns, but the reality is I don’t know if we as a country can.”

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