Just How Old Is COVID-19 Really?

Along with Zsa Zsa Gabor and the universe itself, there are several things whose real age have long been a mystery.   We can now add COVID-19 to this list as well.  The now-pandemic viral disease was first thought to have originated in December 2019 in a "wet market" (live animal market) in Wuhan, China.  Then, it was found that there were older cases not linked to that infamous "wet market" cluster, implying a different origin from that, and November 17 was then given as the date for the first known case.

But now there is increasing (albeit circumstantial) evidence that it may be even older still.  Satellite data from China, particularly Wuhan, suggest that hospitals saw unusually high traffic and unusually full parking lots in the fall of 2019, as far back as mid-September.  Internet search trends in Wuhan also show a spike for searches for "cough" and "diarrhea", two now-known key symptoms of COVID-19, the latter of which is generally not found in seasonal flu.  And those upward trends actually began in late summer.

Thus, it was very likely that travelers had brought it to the USA and Europe far earlier than originally believed.  Take this YouTube video from 10 months ago (August)--it discusses outbreaks of a mysterious respiratory illness in nursing homes in Fairfax County, Virginia.  While some antibody survey testing results were a bit underwhelming in several countries, we should keep in mind that, as Oxford Professor Sunetra Gupta notes, other facets of the immune system (such as T-cells) may have fought off the infection before the body had a chance to make antibodies to the virus, and indeed mild infections may not generate detectable levels of antibodies right away if at all.  There seems to be at least partial cross-immunity with exposure to related coronaviruses (i.e. common cold viruses).  So the percentage of positive antibody test results should really be seen as a lower bound for the percentage of the population that was already infected at some point. 

Thus, herd immunity is closer than you think, if we are not already there yet.  And it is that, and not the (belated) lockdowns, that is what really caused COVID-19 peak and then decline in so many places.

JULY UPDATE:  The plot thickens even more, it seems.  An analysis of old, frozen sewage samples from Spain finds that the virus was already circulating since at least as far back as January 15, 2020.  For the virus to be detectable in sewage, it must have been quite prevalent indeed!  That dovetails nicely with the positive test result of the reanalyzed old blood sample from a patient in France back in December 2019.  Moreover, the Spanish researchers subsequent analyzed old sewage samples from January 2018 through December 2019, finding all were negative except for March 12, 2019 (i.e. more than a year ago!), which was found to be weakly positive for the virus.  This means that either the test is more prone to false positives than we thought, or the virus is in fact a LOT older than anyone imagined, more than a full year old.  And just like its cousin SARS, it does not seem to be aging very well either in terms of its genetic material, and may very well be losing its "mojo".

AUGUST UPDATE:  There seems to be a growing scientific consensus lately that the COVID-19 virus likely originated in a lab (the Wuhan Institute of Virology) rather than in nature.  Basically, researchers would do reckless "gain of function" experiments (which is illegal on most countries) on various bat coronavirusues to make them more contagious, more deadly, and/or more likely to jump species barriers, in order to study such phenomena. And perhaps one of these novel genetically modified (GMO) viruses "accidentally" escaped the lab and got into the population, and the rest is history.  If so, the institute and the government of China (and also the Trump regime who lifted Obama's moratorium on such research) really have a LOT of blood on their hands!  And the very best way to avenge the deaths of COVID-19 victims is to permanently ban such reckless experiments worldwide, no exceptions.

The latest theory is that that the virus actually originated in 2012 (leading some to call it COVID-12 instead) when a group of six miners in southwest China contracted pneumonia from it, which they likely got from exposure to bat guano in the mine shaft.  The Wuhan Institute of Virology then kept samples of this virus, which they perhaps tweaked even further using their so-called "gain of function" research.  The virus then escaped from the lab sometime in 2019, and as they say, the rest is history.

Another possible route is a genetically modified bat coronavirus from 2015, one deliberately engineered to make use of the human ACE2 receptor to enter our cells, which we now know that SARS-CoV-2 (aka COVID-19) does as well.  This "gain-of-function" research was apparently done in a collaboration between the University of North Carolina at Chapel Hill and the Wuhan Institute of Virology.  Again, all it would taken was for it to "accidentally" escape from the lab in order to easily cause a pandemic.

And now the plot thickens even further as a Chinese virologist turned whistleblower finally gets the chance to tell her story....

JANUARY 2021 UPDATE:  A genetic investigation into the origins of COVID-19 in China apparently puts it at October 2019 (if not earlier), which means the virus had been spreading months before Chinese authorities belatedly alerted the world.  Also, a new Bayesian analysis finds that, statistically speaking, the probability that the virus originated in a lab is practically certain.

Maybe even earlier than that, who knows? 

And while it turns out that only some pockets of herd immunity prevailed after the first wave in Europe and the USA, hence the second wave in several countries and states, the fact that the virus is now in retreat despite it being the middle of winter strongly suggests that we are at or very close to full herd immunity nearly everywhere now.  This is evident even before the vaccine would have had any effect, by the way.  The first wave, even in Sweden, apparently produced just enough immunity for seasonality to naturally suppress the virus temporarily in the summer, only to be followed by a fall/winter wave.  But Sweden's second wave was still not as bad as either their own first wave or the second waves of most other European countries.  And future major surges are unlikely in nearly every county going forward, even with new strains of the virus emerging.

How Japan Beat COVID-19

One country that the lockdown enthusiasts seem to conspicuously avoid talking about is Japan.  Sweden is their favorite punching bag, as is Florida, but Japan?  It's as if they don't even exist.  And yet, they managed to beat the COVID-19 virus by doing everything "wrong".  And by "wrong", we actually mean RIGHT for the most part.

Despite being in the original geographical danger zone for the pandemic, and being one of the earliest countries to be infected that was not named China, their per capita death rate (the most important indicator) remains so low that it barely even gets on the chart relative to the rest of the world.  So how did they do it?

They did not impose a compulsory lockdown, opting instead for what they called a "soft lockdown" that did not even have the force of law (as their constitution, that they actually take seriously, strictly forbids doing such a thing), and even that was fairly brief and quite belated.  Nor did they close their borders either, opting instead for health checks at ports of entry and fairly modest visa restrictions early on.

What they did do, rather famously, is habitually wear face masks in public, as they did even before the pandemic began during flu season as well as allergy season.  Not everyone, but apparently enough to make a difference. And they are generally very good about hygiene overall there as well.  But less famously, and yet likely contributed even more to their success, was their virtually unique strategy of contact tracing despite doing relatively few tests for the virus.  Instead of going high-volume, labor-intensive, and prospectively, they quietly went after the larger clusters and traced contacts retrospectively, working backwards.  And that strategy really seemed to out-ninja this rather stealthy virus, since the spread pattern is highly skewed and heterogeneous, overwhelmingly driven by a fairly small number of "superspreaders" (10-20% of infected people), while about 70% of infected people statistically don't pass the virus on at all to anyone.  So this pattern lends itself more to that kind of contact tracing paradigm.  And best of all, they did it with excellent timing, unlike so many other countries that squandered and missed their chances to do so before it was too late.

Some cynics may think that Japan deliberately did as few tests as possible so as to make their numbers look good to the outside world, in the hopes of hosting the 2020 Olympics in Tokyo (which nevertheless got postponed to July 2021), thus sweeping it under the rug.  While that may or may not have been part of the motivation for running a low number of tests, their death numbers don't lie, and they seemed to have outsmarted the virus in any case.

And last but not least, despite having the oldest population in the world, they apparently protected the elderly quite well, and apparently did NOT screw up with their nursing homes like so many other countries (especially the UK and New York) unfortunately did royally.  That alone is worth its weight in gold, and the proof is in the numbers.

Now THAT is a shining city on a hill!

(The Wall Street Journal has another great article about Japan's success story here.)

OCTOBER UPDATE: While Japan still seems to have quite a lot of "cases" (positive tests), their per capita death rates are still very low and barely even get on the chart. Another good article can be found here.

2021 UPDATE:  We now basically take back anything we said about Japan "beating" the virus, especially anything about masks which turned out to be largely a red herring all along.  Japan had lots and lots of cases, even with low testing, but very few deaths and essentially no excess deaths, most likely due to low obesity and prior immunity from related coronaviruses common in East Asia.  That is a far better explanation than masks or ingenuity.  Their two worst waves so far both occurred in 2021, and they also had quite the surge in RSV in 2021 as well, despite a whopping 98% mask compliance.  Otherwise though, we still praise Japan for avoiding a hard lockdown, or even any serious mandates prior to 2021.  The virus was always destined to become endemic, and on some level they seem to be accepting that despite their initial elimination strategy.

The Nuanced Truth About Sweden

Sweden is one of those countries that, in our polarized world, you either love them or hate them.  Being the most famous of the non-lockdown countries, the anti-lockdown side loves them while the pro-lockdown side just loves to hate them.

In truth, however, they are neither a shining city on a hill, nor are they an unmitigated disaster in terms of how they handled the COVID-19 pandemic.  They are in fact...about average by European standards, at least in terms of per capita death rates for now.  Worse than their Nordic neighbors and Germany and Austria, but better than the UK, Belgium, Spain and Italy.  Worse than the USA as a whole, but better than the seven worst US states, especially New York.  Which is nothing to brag about, of course, but hardly a ringing endorsement for lockdowns either.  Especially since they avoided completely annihilating their economy (albeit still suffering) and inflicting other collateral damage that the lockdowns in other countries (especially the UK) did, while still being able to "flatten the curve" and thus keep hospitals from being overwhelmed and collapsing Lombardy-style.

The architect of the Swedish mitigation strategy of moderate social distancing, Anders Tegnell, admits that Sweden could and should have done more.  And yes, they did screw up in several major ways, at least in the beginning.  But he still does not endorse a full lockdown.  So what could they have done differently, short of a lockdown?  Here are the things that come to mind that they should have done but didn't, or should have done earlier but did too late:

• They kept their borders wide open with no hard restrictions on international travel or even any health screenings at ports of entry.  Even Japan and Belarus didn't make that mistake.  In hindsight, that was really quite foolish.
• They did not declare a state of emergency.  Even the Donald did that, albeit belatedly.
• Their gatherings limit of 500 people, first imposed on March 11, should have been cut down to 50 people or some other double-digit threshold much sooner, ideally on that same day or the very next day, rather than waiting until early April to finally do so.
• They should have made virus testing available much sooner.  Instead, until very recently, you literally had to be sick enough to go to the hospital in order to get a test as per their test rationing policy that began in March.  Their testing is basically a national joke.
• Contact tracing?  What's that?  (Though even with very little testing, they could still have done it the Japanese way.)
• Like most countries, they should have done a better job protecting nursing homes. In Sweden's case, they should have banned or severely restricted visits to nursing homes much, much sooner, instead of being loosey-goosey about it until finally doing so on March 31.  And they should have made sure early on that the staff had (and used) adequate masks and PPE, which they failed to do.  Even Florida did better than they did, though New York was far worse.
• Their triage protocols for nursing home patients being (not) sent to the hospital turned out to be wholly unnecessary and counterproductive.
• And like most countries also failed at, they should have kept colleges open even if they canceled classes temporarily.  Sending students home to infect their parents and grandparents was probably not the wisest idea in the world.
• And last but not least, they generally eschewed masks on the mistaken belief that they create a false sense of security.  Spoiler alert:  Um, NOPE!

Aside from those flaws, there is still much to admire about Sweden.  But ultimately they are paying a rather heavy price for their errors, even after belatedly correcting such mistakes.  They likely will reach the holy grail of "herd immunity" sooner or later, if they are not already there, but unfortunately due their missteps, the journey turned out to be much more dangerous than the destination.  Thus, we hereby give them a gentleman's C for effort.

In other words, we can certainly learn a lot from Sweden--both what to do as well as what not to do.

JULY UPDATE:   It looks like not only is Sweden's COVID epidemic all but oven now as per Worldometer death rates, and their death curve did turn out to be much more bell-shaped after all, but that Sweden is now quite vindicated indeed compared to even some of their neighbors in terms of cumulative all-cause mortality through the first 24 weeks (roughly the first half) of 2020.  Though worse than Norway, Sweden nevertheless fell very close to and just between Denmark and Finland, and fared far better than Scotland.  So it looks like the lockdown zealot vultures will need to find a new punching bag now.

Additionally, it looks like the Swedish city of Malmo is in fact doing a particularly good job overall.  They followed the Swedish strategy minus the screwups, basically, and as we can see now, it's really paying off. 

A Report Card For The Pandemic

It is June now, and we at the TSAP think it is time to issue tentative grades for each country on how they handled the pandemic.  These will be updated over time.  Grades are based on a mixture of per-capita death rates, economic damage, and policy measures.  All grades are on a curve, normalized with the European average set at C.  Here is the current list:

Taiwan:  A+
Hong Kong:  A
Iceland:  A
Belarus:  A
Norway:  A
Finland: A
Denmark: A
Japan:  A-
New Zealand:  A-
Germany:  A-
Austria: A-
Russian Federation:  B+
Portugal:  B+
Australia:  B+
Canada:  B
Singapore:  B-
Switzerland:  C+
Netherlands:  C
Sweden: C
USA: C (overall, varies by state)
Brazil:  D
France:  D
Italy:  F
Spain: F
UK:  F
Belgium:  F
China:  F (though they really deserve a Z, for infecting the whole world!)

Countries that avoided a full lockdown and still got good results automatically get higher grades than those who achieved the same results with a full lockdown.

For US states, a partial list of states' grades:

Washington State:  A
Iowa:  A
Wyoming:  A
Hawaii:  A-
South Dakota:  A-
Arkansas:  A-
North Dakota:  A-
Oregon:  A-
California:  B+
Florida:  B+
Georgia:  B+
South Carolina:  B
North Carolina:  B
Texas:  B-
Arizona:  C+
DC:  C
Maryland:  C
Virginia:  C
Wisconsin:  C
Connecticut:  C-
Massachusetts:  C-
Louisiana:  D
Illinois: D
Michigan:  D-
Pennsylvania:  D-
New Jersey:  F
New York:  F

If you remove the seven worst states, the USA has one of the mildest outbreaks in the world.  Only a very few states are worse than the European average as far as per capita death rates.  And non-lockdown states outperform most non-lockdown states.

All of these grades are of course subject to change in the coming weeks and months.

America Is Literally Burning. Stop Fighting Fire With Gasoline!

In the wake of the state-sanctioned murder of George Floyd by three cops while a fourth cowardly bystander did nothing, protests have fully understandably erupted across the nation.  Racism (especially structural racism) and widespread police brutality are nothing new in America, and remain persistent problems that are clearly not going away on their own, so the protestors' anger is fully justified.  The murderers and all of their accomplices must be brought to justice, and structural reforms absolutely must be made, yesterday.

(The problem is actually twofold, involving an intersection of both 1) institutional racism and the resulting gross racial disparities at all levels of the criminal "justice" system, as well as 2) a more general overcriminalization of people for victimless "crimes" and gross overmilitarization of police, along with a general lack of accountability for rogue cops.  And both need to be tackled simultaneously.  Yesterday.)

But when protestors foolishly play into the hands of outside agents provocateur (everyone from extremists to recreational troublemakers to false flags and even undercover cops) infiltrating the otherwise peaceful protests to turn them violent and destructive, then it becomes something far different and highly toxic, and counterproductive to the cause.  And by taking the bait of Trump and his buddies--the ultimate master baiters (pun intended)--who are also pouring gasoline on the fire, that is like cutting off one's nose to spite one's face.  So please don't fall for it.

The last thing America needs right now is a full-blown civil war.  Which is where we are unfortunately heading if this continues to escalate much longer.  And it is what the "alt-right", white supremacists, and other right-wing extremists like the Boogaloo movement seem to really want to happen, hence their sending outside agitators to infiltrate protests.

(Hear that?  That's the sound of Putin having a good belly laugh at America's expense.)

And while we really hate to be a wet blanket, please remember that while the right to peacefully protest is sacrosanct in what is supposed to be free society, the COVID-19 pandemic is still going on, and you still need to take precautions nonetheless since the virus doesn't care about your or anyone's politics.  Wear a mask, carry hand sanitizer, stick to smaller groups, and try to keep as much physical distance as possible out there.  Don't deliberately get in anyone's face either.  And if you have any sort of questionable symptoms at all in the least, please sit this one out and stay home protesting virtually.  In other words, please use common sense.  That advice applies to both the George Floyd / Black Lives Matter protestors as well as any anti-lockdown protestors, by the way.

To quote Rodney King himself during the 1992 LA riots:  "Can we all just get along?"

The Progressive Case For Reopening America (And Never Shutting Down Again)

Recently there was an article titled "The Left-Wing Case Against Lockdowns" that explains in detail why genuine leftists and progressives should oppose extending these coronavirus lockdown policies.  It basically echoes what we at the TSAP has been saying for weeks now, namely that these policies have not aged very well and are doing more harm than good in the long run. And the empirical evidence actually bears this out:  non-lockdown countries are generally outperforming lockdown countries on average, and within the USA, non-lockdown states have also been outperforming lockdown states in terms of coronavirus case and death rates per capita.

The supposed effectiveness of lockdowns (compared to far less extreme restrictions) in terms of slowing or stopping the spread of coronavirus has been called into serious question lately by more recent studies.
Such studies have found there is at best no correlation, and perhaps a perverse effect between the two defining features of hard lockdowns (stay-home orders and closures of all non-essential businesses) and COVID-19 cases and deaths per capita after other factors such as less-extreme policies are accounted for.  The benefits are thus nothing more than a statistical mirage that does not stand up to scrutiny--much like the supposed benefits of the 21 drinking age vis-a-vis DUI deaths in the long run.

Meanwhile, the collateral damage (economic depression, inequality, poverty, alcohol and other drug abuse, domestic violence, child abuse, loneliness, poor mental health, delayed medical treatment, etc.), which also kills people too by the way, continues to mount with each passing week of lockdown, making an utter mockery of practically all progressive and even basic humanitarian priorities.  And that's to say nothing of the civil rights and liberties, as well as community cohesion, that progressives generally support.  It seems that the "cure" is quickly becoming far worse than the disease as time goes on.

(And that's just for the affluent countries.  For poorer countries, the collateral damage will most likely be at least an order of magnitude worse and deadlier.)

As for the disease itself, here is what we already know:  The horse has already bolted long ago, the train has left the station, the genie is out of the bottle, and herd immunity is ultimately inevitable at some point (if we're not already there in some places).   That is the only way the pandemic will finally end for good, since any effective vaccine or miracle cure will most likely come far too late.  Fortunately though, the true infection fatality rate is revealed to be far lower than was originally believed, and most likely somewhere between seasonal flu and pandemic flu (though still nothing to, um, sneeze at of course).

Thus, whatever the original merits of these sweeping, medieval-style quarantines (unprecedented on such a large scale and for such an extended period of time), there is really nothing "woke" or progressive about extending them any further than yesterday.  It is no longer "merely" about lives versus livelihoods anymore, but increasingly about lives versus lives.

So what would a progressive reopening plan look like?  At the TSAP, we believe that the following schedule should be the case:

Phase 1:  End of stay-home orders and "bubbles", and gatherings of up to 10 people permitted.  Construction, manufacturing, and select retail reopened with restrictions, with priority given to small businesses. Masks required in all public places where six feet of distance cannot be maintained.  Parks and beaches reopened with restrictions.

Phase 2:  Gatherings of up to 20 people permitted.  All retail stores reopened with social distancing and 50% occupancy restrictions.  Restaurants, but not bars, reopened with 25% occupancy restrictions.  Masks required for all employees and customers of reopened businesses whenever practical.  Select places of amusement reopened with restrictions.

(Somewhere around this point, reduce the six-foot rule to three feet, in line with the World Health Organization's recommendation of one meter distance.)

Phase 3:  Gatherings of up to 50 people permitted.  All retail stores reopened with social distancing and some occupancy restrictions.  Salons, barber shops, and other "hands-on" businesses along with gyms and fitness centers reopened with strict hygiene standards and occupancy restrictions.  Restaurants reopened with 50% occupancy restrictions, select bars reopened with 50% occupancy restrictions and table service only.  Nightclubs and casinos remain closed.  Places of amusement reopened with restrictions.  All schools and educational facilities reopened, and all daycares and camps reopened as well regardless.  Some professional sports leagues at least partially resume, without the fans of course.

Phase Out:  Gatherings of up to 100, then 500 people permitted.  Everything including nightclubs and casinos reopened, albeit with some occupancy restrictions.  Bar service now permitted.  Mask wearing is now voluntary, except on public transit and for employees of higher-risk businesses, where it will remain mandatory at least at first.   Six-foot rule is now just a common-sense and non-absolute guideline rather than a hard and fast rule.   Hand and respiratory hygiene still taken as seriously as ever.  All schools and educational facilities reopened, period.  Professional sports leagues fully resume, without fans until at least Labor Day, then fans very gradually reintroduced to stadiums/arenas.

Each of the first three phases will last two weeks (or one week each for both Phases 1 and 2, if the onset of Phase 1 happens to be delayed until June 15 or later), while Phase Out is indeterminate but will likely last for 90 days or more.  Ideally, Phase 1 would not have begun until a state is at least two weeks post-peak, but after June 1st states may not have the luxury of waiting any longer to begin reopening (if they wish to avoid irreversible economic damage and a long-term depression).  If during any phase there is any resurgence in disease there should be a further pause between moving to the next phase, but otherwise full steam ahead with no backtracking after June 1st.

(Any reimposition of tighter restrictions after June 1st should be limited to the local level only, not statewide or nationally.)

Indoor gatherings, which are riskier than outdoor gatherings, should probably have a tighter limit.  For example, thet could have a cap of 10 people indoors vs. 50 people outdoors for Phase 3, or 50 people indoors vs. 500 people outdoors in Phase Out.

At all phases, mask and sanitizer kiosks should be available everywhere, and/or there should be a Taiwan-style free mask rationing app available for everyone.  And Taiwan-style temperature checks to enter most places should prevail through the first three phases and much of Phase Out as well.  (Hey, they must be doing something right over there, and with no lockdown or shutdown either.)

And while we clearly need to scale up testing and contact tracing, quite frankly the time to do that was weeks if not months ago, and we can no longer afford the luxury of time at this point.  We will simply need to make do with what capacity we have right now and in the immediate future, even if we have to do it the Japanese way of focusing mainly on the larger clusters instead of every single case out there, which is far less resource- and labor-intensive.

As for vulnerable populations (elderly, immunocompromised, and/or those with underlying health conditions), the lockdowns have utterly failed to protect them, so extending the lockdowns will not benefit them at all.  Rather, they should be encouraged (but not forced) to stay home as much as possible and avoid crowds during Phase 1 and 2 (and possibly 3), and nursing homes should continue to ban visitors or allow only one designated visitor per family during at least the first three phases of reopening.  And for the love of all that is good, immediately stop discharging still-contagious hospital patients into nursing homes!  Shame on any policymakers (New York, I'm looking mainly at you) who thought that was somehow a good idea!

The TSAP also supports a far more robust stimulus that includes Universal Basic Income and Medicare For All, and the rest of Rodger Malcolm Mitchell's Ten Steps to Prosperity.  We also support expanded unemployment benefits, expanded Social Security, and a Green New Deal.  And of course the HEROES Act.  It is not too late to prevent the greatest depression the world has ever seen--but only if we both reopen reasonably soon and implement such programs sooner.  It is NOT an either-or.

Also, it should really go without saying of course, but we at the TSAP do NOT support any sort of reckless behavior, rioting, violence, or death threats against Governor Gretchen Whitmer of Michigan or any other governor or government official regardless of how much we dislike their policies.  We hereby denounce and condemn such behavior, period.  Peaceful protests which follow proper health and safety precautions, fine, but anything else has no place in our movement or any other movement worth its salt.

UPDATE:  The TSAP does NOT support Trump's Fourth of July military parade or any other parade, campaign rally, or mass gathering of similar size at this time, as it is really far too soon and thus very, very ill-advised.  We believe that even the best-performing states and localities who appear to be almost out of the proverbial woods in terms of the pandemic should still do their darnedest to avoid gatherings of more than 50 people before July 4, and more than 500 people after that until at least Labor Day at the earliest.  The deadly lessons of the 1918 flu pandemic loom large.  But if we must have a second wave, which Dr. Fauci himself claims is somehow (but hopefully not) inevitable, frankly better it should happen in the summer when the virus is less virulent than in the fall or winter, and as a bonus, those Trump supporters who will be earning Darwin Awards will thus "thin the herd before" they can vote in November.  Unfortunately, these fools also put others at risk as well--they should at least be wearing masks to protect others even if they don't care one iota about themselves.  (At least it won't fall on the conscience of progressives this time.)

JUNE UPDATE:  It looks like several states are seeing spikes in COVID-19 in recent weeks following reopening.  While some of it is due to increased testing, the very large spikes in Texas, Arizona, Florida, California, and some other states also show increases in hospitalization rates*, so at least some states are seeing real increases.  And those are generally the ones who reopened before even reaching their peaks, while California's early flattening of their curve seems to have merely delayed the bulk of their infection burden.  And interestingly, Georgia had not seen any real spikes until very recently, despite being the first state to reopen.  Meanwhile many states, most notably New York and New Jersey, have not seen any spikes at all despite increased testing and massive protest rallies in recent weeks.  Both were among the first states to have mandatory mask requirements, and were also the earliest and hardest-hit states.

(*Even the increase in hospitalization numbers may be less than meets the eye.)

Thus, it may not even be due to the timing and pace of reopening at all, but rather due to how many people are wearing masks, and simply that states that were hit harder earlier, the epidemic has largely run its course, while the states that started with milder outbreaks simply still have a ways to go yet.  And overcrowded bars and nightclubs seems to be the biggest culprits in the new hotspots lately.

It is notable that death rates are still dropping nationwide despite the apparent surge in daily cases to new record highs.  Even in the new hotspot states, deaths are generally low and flat or declining, and even Arizona's death rates are still following the same old slow-burn pattern they had before reopening despite being the fastest-growing state in terms of positive test results lately.  Most new cases are coming from younger people (under age 35), a possible reason for the apparent decoupling of infection rates from death rates, and suggesting herd immunity likely occurring sooner rather than later.  Or perhaps we have learned (often the hard way) better ways to treat the disease, thus saving more lives.  Or the virus itself could simply be getting tired and losing its "mojo" after circulating so much for so long.

Also, here is another good article for any anti-lockdown leftist or progressive.  And another.