When ‘green’ means ‘stop’
The color-coded, phased reopening was developed by Pennsylvania to gauge two indicators: the amount of virus circulating in the community, and also the degree to which the economy was open.
“In the beginning, we had a plan where there was pretty tight linkage between level of viral transmission and reopening activities,” said Susan Coffin, a pediatric infectious disease specialist who is working on Children’s Hospital of Philadelphia’s response to the pandemic. Over time, she said, though the color-coding system remained a good indicator for which businesses were opening up, it stopped reflecting the viral risk as closely as the number of new cases ebbed and flowed. And that, she said, has resulted in confusion.
“Now, we are seeing what might sound like a contradictory message: Yes, we are reopening, but, no, we don’t want you to stop behaving as though there is virus in our community.”
In neighboring New Jersey, by contrast, the phased reopening is incremental. Each phase offers a broad sense of what will change, and, industry by industry, individual restrictions are loosened one at a time.
For his part, Philadelphia Health Commissioner Thomas Farley said he wished people could ignore the color coding altogether.
“The governor came up with this high-level plan with these three different colors, but clearly Philadelphia is unique,” Farley told reporters at a press conference at which he announced the city would pause before entering the full green phase. “So we’re calling it green, but I would rather have people focus less on the color and more on what activities are allowed and not allowed.”
Part of the issue is that the science is evolving and what we know about the novel coronavirus changes each day. Masks, for example, were initially explicitly discouraged because of short supply. Once they became more available, and research emerged demonstrating asymptomatic spread of the airborne virus, masks were back in full force.
The messaging around asymptomatic spread also lagged behind the research confirming its existence. “Stay home if you’re sick” doesn’t help contain the virus if you can infect people without knowing you’re ill.
Though health departments do their best to keep up with the research as it emerges — and to explain why their recommendations change, when they do — it can be hard to keep track of. And it doesn’t help when politicians don’t follow orders.
“We can’t be out there as the secretary of health [is] telling you to wear a mask and your local elected official is telling you, ‘Don’t wear a mask, you’ll be fine, they’re making it up,’” said April Hutcheson, communications director for Pennsylvania Department of Health. “It makes the job more challenging.”
But there is some messaging health departments can control. Pennsylvania laid out what many interpreted as specific metrics for testing capacity, contact tracing, congregate care outbreaks, and the number of new cases that counties would have to hit to move to less restrictive phases by a certain date. Many counties in the southeastern part of the state didn’t meet those benchmarks, but transitioned anyway. The governor later said the metrics were not hard marks, but would be considered in concert with other factors to determine overall risk.
Setting aside whether Pennsylvania’s transition to yellow led to an increase in coronavirus cases, it was likely to contribute to distrust in government, said Ellen Peters, who runs the Center for Science Communication at the University of Oregon.
“It gives people inconsistent information, so you’re being told, ‘Eh, that didn’t happen, but we’re going to go ahead and do it anyway,’” said Peters, whose Oregon county similarly failed to meet its benchmarks but moved into a new phase anyway. “And so people are left with, ‘Well, the guidelines don’t matter then. If they don’t matter, what else can I not trust that this city or state entity is telling me?’”
Research has shown that when people are stuck at an impasse, they are more likely to just opt for doing what they want to do in the first place. After months of staying at home, you can guess what that might look like.