Coronavirus And Thanksgiving: Fauci Says Family Gatherings Are A Risk : Consider This from NPR As cases spike around the country, Utah is one state changing the way it's approaching the coronavirus. Republican Gov. Gary Herbert has a "new game plan" to beat back record-high cases that threaten to overwhelm the state's hospital system.

New York Gov. Andrew Cuomo says "halftime adjustments" like that are necessary for states to slow the spread of the virus this fall, as more Americans prepare to spend more time indoors. An exclusive NPR survey of contact tracing efforts reveals many states are not prepared to handle the coming surge in cases. NPR's Selena Simmons-Duffin explains.

And Dr. Anthony Fauci warns Thanksgiving gatherings may accelerate spread even more.

In participating regions, you'll also hear a local news segment that will help you make sense of what's going on in your community.

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Pandemic 'Halftime': U.S. Looks At Lessons Learned As Fall & Holidays Near

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Pandemic 'Halftime': U.S. Looks At Lessons Learned As Fall & Holidays Near

Pandemic 'Halftime': U.S. Looks At Lessons Learned As Fall & Holidays Near

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This week, the governor of Utah announced it was time for a new game plan.


GARY HERBERT: I, like you, am tired of 2020. I'm tired of emergencies and social distancing. And frankly, it doesn't matter how tired we are. We must, in fact, win this fight.

CORNISH: Republican Gary Herbert said with infections at an all-time high, the state's health care system is nearly overwhelmed.


HERBERT: We've worked to create a new game plan for Utah's second half of this contest, so today I'm announcing a new system.

CORNISH: Utah replaced its old color-coded system with a new streamlined method for imposing restrictions on businesses and gatherings based on county-by-county data - per capita case rates, test positivity rates and the state's ICU capacity. And the state implemented more widespread mask mandates.


HERBERT: It's really time for a new game plan. We have to make some adjustments.

CORNISH: At a time when a lot of Americans may have tuned out the pandemic, Herbert is not the only governor trying to remind people where things stand.


ANDREW CUOMO: We're at halftime. We went through the first half.

CORNISH: New York Gov. Andrew Cuomo.


CUOMO: Now we're looking at the fall. We see 36 states increasing. Let's look back at the first half of the game, and then let's adjust for the reentry onto the field because this is not going away.

CORNISH: CONSIDER THIS - states learned a lot of hard lessons this past spring about how to beat back the pandemic. So which lessons will stick? New York Gov. Andrew Cuomo on his regrets and what to do about COVID fatigue. From NPR, I'm Audie Cornish. It's Thursday, Oct. 15.

It's CONSIDER THIS FROM NPR. First things first, halftime might be a little optimistic.


ANTHONY FAUCI: When are we going to get back to something that closely resembles or is, in fact, normal as we knew it?

CORNISH: Dr. Anthony Fauci said this month, based on even the most optimistic vaccine timelines...


FAUCI: It likely will not be until the third or even the beginning of the fourth quarter of 2021.

CORNISH: That means based on the time it will take to vaccinate as many people as possible, next fall is when things could feel normal again. As for this fall...


NORAH O'DONNELL: So your Thanksgiving will look different this year?

FAUCI: My Thanksgiving is going to look very different this year.

CORNISH: Fauci told CBS News this week that Thanksgiving gatherings could cause cases to rise even faster than they already are.


FAUCI: It is unfortunate, of course. That's such a sacred part of American tradition, the family gathering around Thanksgiving. But that is a risk.

CORNISH: Fauci said here's what we know based on everything public health officials have learned these past months. Gathering indoors with people who have been working or traveling a lot outside the home is especially risky. Fauci said some Americans may need to, quote, "bite the bullet" and avoid getting together. That's what his own kids are doing.


FAUCI: They would all have to go to an airport, get on a plane, travel with public transportation. They themselves, because of their concern for me and my age, have decided they're not going to come home for Thanksgiving even though all three of them want very much to come home for Thanksgiving.


CORNISH: Halftime or not, Gov. Andrew Cuomo is right about one thing. New York is doing a lot better than it was earlier this year. But there are now small outbreaks in the state that are nudging its numbers up again, which might make it a questionable time to put out a book with a title like his - "American Crisis: Leadership Lessons From The COVID-19 Pandemic." In it, Cuomo slams the Trump administration but also local leaders he accuses of being, quote, "too incompetent" or "too politically frightened" to enforce quarantine rules. And it's no wonder he and Mayor Bill de Blasio have clashed over shutdown orders and reopening orders over the last few months. I asked Gov. Cuomo about that when we spoke this week.


CUOMO: It is confusing if a local politician says, I think we should close down the parks, but they don't have that authority. It is confusing. Politics is often not a neat process.

CORNISH: But your criticism is that the federal government did not enable a coordinated response. Aren't you, in effect, doing kind of the same thing just on a state level? Why not show a united front to the public? - because it's not a village; it's New York City.

CUOMO: Well, look. I have 62 counties, 700 school districts. I can't get 62 local officials to agree with everything I do. And I can't stop, nor should I stop, the 62 officials from giving their own opinion. Your point is nice. In a textbook, the governor should work with all 62 officials, and they should all agree on everything. Yeah, if life was so simple and neat, yes, it would be a nice thing. But you have politics, and you have egos, and you have different political parties and different philosophies. And that's called reality.

CORNISH: Does that apply to President Trump?

CUOMO: My point on federal jurisdiction was different. I didn't say the president should have sought consensus with all 50 states. I said the federal government should have exercised more federal control. I think there should have been a national testing policy. How can you leave it to all 50 states to put together testing? I think there should have been a national PPE procurement policy. Why did you make all 50 states compete for masks and gowns, et cetera?

CORNISH: One of your suggestions in your blueprint going forward - you say citizen action is essential. And this sort of follows this question around the backlash from the Orthodox Jewish community in New York because there's been sustained political backlash to state issue mandates in other areas of the country. This is an area of struggle for governors. What is your suggestion for countering it, given what you're going through right now?

CUOMO: There is no answer. If you think that you can govern only by doing things that people like, I would question the premise. That's not what government is. It's not what government in the midst of a pandemic is.

Very few people enjoy wearing a mask. Very few people enjoy having to do the social distancing all the time, not having parties, not going to large gatherings. This is all inconvenient. And, yes, some governors, frankly, I think, have decided to do fewer restrictions because they don't want the political backlash. If you don't do the restrictions, the virus grows. More people get sick. More people get hospitalized. More people die. And then you wind up doing more damage not just to people's lives, but also to the economy.

So it's - I don't want to say damned if you do, damned if you don't. I think the responsible course will be borne out in the history books.

CORNISH: You look at the progress New York has made from when it was essentially the epicenter for months of this pandemic. Do you have worry that it could return to that point - you know, for people who look at this and say, how does he have a book out about this now when New York is still in the crisis?

CUOMO: Well, that's exactly why I have the book out.

CORNISH: Like, is it a victory lap?

CUOMO: No, it's the exact opposite. This is halftime in the game, to use that analogy.

CORNISH: Is there one single thing you're going to be doing differently?

CUOMO: I think if I could've replayed the first half - we were the first state to do a mask ordinance - I would've done the masks sooner. The federal government was in charge of testing when we first started. I wish the state could've just done its own testing and not waited for the federal government. I wish we knew the virus came from Europe. I wish we knew that asymptomatic spread was real because a lot of people lost their lives from that. Going forward, we're going to be more diligent on the calibration of the virus, more testing and, frankly, quicker to make adjustments when we see the virus starting to increase.


CORNISH: Andrew Cuomo, governor of New York.

One thing public health officials did know back in the spring is that the U.S. would need a lot more contact tracers to deal with the expected surge of cases in the fall. Contact tracers do the work of contacting people who test positive, finding out who else they might have infected and encouraging those people to isolate and get tested. Officials predicted the U.S. may need as many as a hundred thousand of them. But now that the fall surge appears to be here, the U.S. is nowhere close to that goal. That assessment comes from an exclusive contact tracing survey by NPR in collaboration with the Johns Hopkins Center for Health Security. NPR's Selena Simmons-Duffin has the results.


SELENA SIMMONS-DUFFIN: Our survey found that the United States has more than 50,000 contact tracers for the first time since the coronavirus pandemic hit. That's an increase from the last survey, which found around 40,000 contact tracers, but...

CRYSTAL WATSON: It feels stagnant.

SIMMONS-DUFFIN: That's Crystal Watson, a senior scholar at the Johns Hopkins Center for Health Security, who oversaw this survey.

WATSON: I don't see a lot of evidence that we have a new push or renewed interest in trying to get us there to prepare for what we might see this winter.

SIMMONS-DUFFIN: Public health experts think the country is likely to see new surges as the weather gets colder. And contact tracing is the kind of program that's hard to scale up quickly when transmission starts escalating out of control.

WATSON: We're already seeing cases tick up across the U.S. and in Europe, and it is concerning.

SIMMONS-DUFFIN: Currently, case numbers are climbing in North and South Dakota, Montana and Wisconsin, which was one of many states that indicated it's planning to hire more contact tracers. Elizabeth Goodsitt from the Wisconsin Department of Health Services wrote in response to the survey that they are, quote, "maximizing limited resources in attending to the surge in number, as well as the increased complexity of cases." Another state, Minnesota, responded that it had the resources to run its program for now, Watson says, but added...

WATSON: There are questions related to sustainability and ongoing funding.

SIMMONS-DUFFIN: There has yet to be significant federal investment in contact tracing despite some proposals in Congress. That lack of investment has meant the country's efforts fall far short of the workforces deployed to contact trace in some East Asian countries, says Danielle Allen. She directs the Edmond J. Safra Center for Ethics at Harvard University. And early in the pandemic, she was part of a group that advocated for 300,000 contact tracers nationwide.

DANIELLE ALLEN: We just - as a country, we have not been able to transition in that kind of rapid way to build out on that scale.

SIMMONS-DUFFIN: Our survey shows, instead, the country continues to inch up its contact tracing workforce while financial resources are stretched to the limit. Going forward, we'll likely keep inching up, she says. Allen and other experts note that contact tracing isn't a silver bullet. When transmission is high, it becomes much more difficult for the process to keep the spread of the virus in check. But it's still valuable, she says, in part because of the data that can come from tracking how the virus is spreading through a community.

ALLEN: If you can work out that you have a whole cluster coming from one specific kind of activity, well, then you know, like, that's what you shut down. You don't have to shut down everything.

SIMMONS-DUFFIN: In our survey, the vast majority of states say they're gathering this data, but fewer than half are making the data public on a government website. Watson of Johns Hopkins hopes that more states will follow suit so that data from contact tracing can be used not just for allocating resources and informing policy decisions, but for helping regular people make decisions about their lives, like whether to go to a restaurant or the gym or whether it's safe to send kids back to school.


CORNISH: NPR's Selena Simmons-Duffin.

It's CONSIDER THIS FROM NPR. I'm Audie Cornish.

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