Virus escapees’ dilemma: Borders without doctors
In “The Decameron,” seven women and three men leave plague-tormented Florence for a villa in the hills, where they tell one another bawdy stories. Written nearly 700 years ago, the tale remains fresh, as affluent New Yorkers try to escape the coronavirus outbreak by moving into their second homes at the beach or in the woods.
But there are two big differences. In Renaissance Italy, people living outside the city didn’t patrol their borders. By contrast, Florida and Rhode Island have tried to deter visitors from New York by demanding that they undergo two weeks of self-isolation. After New Orleans became a coronavirus hotspot, Texas started checking cars at the Louisiana state line, ordering their passengers to do likewise. Texas was already imposing self-quarantines on airline passengers flying from Miami, Atlanta, Detroit and elsewhere.
Another big difference is that in the distant past, the only thing people could do about the plague was avoid getting it. They did that by staying away from others. That’s still essential, but today there are medical interventions to help most of the afflicted survive. The big-city health systems have the hospitals, the doctors and the equipment to provide them.
True, many of these urban hospitals are being overwhelmed by the crush of patients, but the caseloads are now growing at a faster pace in rural areas that generally have vulnerable older populations. Health officials everywhere now worry about shortages of ventilators, masks and tests.
Over half the U.S. counties don’t have a single hospital intensive care unit bed. By contrast, health officials in large metropolitan areas have the option of moving patients from overcrowded hospitals to other facilities in the region. That was done in the Seattle area, one of the worst-hit parts of the country.
And there’s a spark of good news from Seattle. Its early and stringent social distancing policies may be slowing rates of infection and mortality — even as Washington state sees infections rise in rural areas.
Whether one state can legally restrict travel or commerce from another remains questionable. Most constitutional lawyers hold that only the federal government can do this. For example, the U.S. Department of Agriculture forbids many Hawaiian farm products from entering the U.S. mainland because they may harbor invasive pests or disease. If the USDA can stop Hawaiians from shipping berries and cactus plants to other states (flower leis and pineapples are OK), why couldn’t the federal government stop Americans from crossing state lines to slow the spread of disease?
On Saturday morning, President Donald Trump talked about quarantining travelers from the New York City metropolitan area but dropped the idea by evening. Instead, an advisory was issued asking them to avoid nonessential travel — a policy already in place.
The recent infection rate in New York City was one in 1,000 people. That’s a high number of cases (though partly a reflection of New York’s more aggressive testing for the virus). But — and not to sugarcoat this — it also means that 999 out of 1,000 were not found to be infected. New Yorkers who follow the rules for hand-washing and keeping a distance from others would seem to have a very good chance of avoiding the virus.
Obviously, Americans who contemplate bolting from a coronavirus hot spot have more calculations to make than did the gentry of plague-ridden Florence. On one hand, Americans could go to lower-populated areas where they are less confined and the virus has not spread as widely. On the other, medical facilities are scarcer there and perhaps not as state-of-the-art as the ones in town. Put simply, are there ventilators, hospital beds and doctors on the other side of the border?