I’ve been leafing through the results of a new Imperial College study on the current status of the pandemic in the United States, and I am not encouraged. The study is self-admittedly pessimistic in its assumptions, primarily because it doesn’t assume that we’ll do an effective job of mitigation through increased testing, contact tracing, and behavioral modification. So, for example, an increase in mobility to the pre-crisis baseline looks extremely bad, but if we’re not completely careless the rate of infection shouldn’t look quite so devastating.

Having said that, the study estimates that about half the states do not have the pandemic under control, meaning that the average initial reproduction number (Rt=0) is greater than one. Here’s their bottom line:

We predict that increased mobility following relaxation of social distancing will lead to resurgence of transmission, keeping all else constant. We predict that deaths over the next two-month period could exceed current cumulative deaths by greater than two-fold, if the relationship between mobility and transmission remains unchanged. Our results suggest that factors modulating transmission such as rapid testing, contact tracing and behavioural precautions are crucial to offset the rise of transmission associated with loosening of social distancing.

Overall, we show that while all US states have substantially reduced their reproduction numbers, we find no evidence that any state is approaching herd immunity or that its epidemic is close to over.

And here are the states that are in the worst shape:

In 24 states, however, the model shows a reproduction number over 1. Texas tops the list, followed by Arizona, Illinois, Colorado, Ohio, Minnesota, Indiana, Iowa, Alabama, Wisconsin, Mississippi, Tennessee, Florida, Virginia, New Mexico, Missouri, Delaware, South Carolina, Massachusetts, North Carolina, California, Pennsylvania, Louisiana and Maryland.

A simple way of looking at this is that none of the above states should be relaxing social distancing rules or encouraging businesses to operate if they involve the clustering of people in confined spaces.  This is because the rate of infection is growing as things stand, so letting their guard down is almost guaranteed to result in a massive flare-up of cases and deaths.

Some states are seeing an upsurge in cases after initially being little effected by the outbreak, and most of these are states with low population density. Large church congregations may be their primary risk factor, which is a good reason for them to keep those services virtual for the time being. Unfortunately, Trump has decided to make church reopenings one of the central themes of his campaign message. This is dangerous.

Trump’s drive to re-open churches comes despite a growing body of evidence tying church services to serious outbreaks of coronavirus. Just Tuesday, the Centers for Disease Control released a warning about Arkansas church meetings in March where more than a third of 92 attendees wound up infected. Another 26 members of the community wound up hit by the virus. Four people died.

Similar church-focused outbreaks have been reported in Washington state, South Korea and France. Experts theorize that hand-holding, singing and the fellowship typical of church services create robust vectors to transmit the virus, particularly through airborne droplets.

Pretty much everything Trump is pushing will make it harder to contain the virus, so I don’t really look at his choices for how they play politically in the moment. He’ll be judged above all by whether or not the virus is still raging or seems to be a crisis of the past. The economy is going to be bad either way, but will look far worse if we’ve made no headway on the virus.

I wish there was a way for Trump to do this badly politically without it costing hundreds of thousands of people their lives, but for now the two seem intertwined. He will not do the right thing either for the country or for his political future.