COLUMBUS, Ohio — Republican leaders are promising Ohioans there will be no second shutdown, while Democrats say a surge in COVID-19 transmission this winter should be met with tailored restrictions if the public health community recommends them.

The Trump campaign says there is little daylight between its record and former Vice President Joe Biden’s COVID-19 plan, which also promises testing, PPE production, and vaccine development. But beyond those goals, the parties are more clearly divided in their visions for how to return to normalcy amid continued spread of the virus – an issue at the forefront for Ohio voters.

The state is reporting record new case numbers, as are many states in the Midwest, raising concern that tightened restrictions could be on the horizon.

Cases have climbed during mild weather that still affords pleasant opportunities for dining and socializing outdoors. Officials fear the coming winter season could produce increased transmission of COVID-19.

In the spring, the Department of Homeland Security’s Head of Science and Technology William Bryan said there was emerging evidence the virus dies more rapidly in higher temperatures and humidity. The research was touted by the White House and offered the country hope that COVID-19 cases would plummet in the hot summer weather.

But predictions the virus would wane in the summer did not materialize for the United States.

“We were hoping for that but we actually saw continued community spread throughout the entire summer,” said Dr. Maureen Ahmann, the health commissioner for Stark County in northeast Ohio. “The heat in and of itself didn't really help decrease the transmission.”

But even though the virus may not be as responsive to heat as once suggested, at least not from a purely biological standpoint, Ahmann says the turn to winter brings fresh concern of a COVID-19 surge for behavioral reasons.

If Ohioans continue to congregate, but instead of barbequing and patronizing outdoor bars they move those activities inside, that shift could increase transmission of the virus. Officials are particularly concerned about family gatherings in the holiday season that will bring residents together with their older relatives for shared meals and celebrations indoors.

These new challenges are potentially around the corner for Ohio at a time when the current trajectory of the virus in the state offers little in the way of optimism as the state’s new case numbers continue to rise. As of Tuesday, Ohio reported an average of 1,475 new cases over the last seven days, a significant increase from the average two weeks ago of slightly more than 1,000 cases per day, and the state’s highest seven-day average so far during the pandemic.

Some of that rise can be accounted for due to testing being at its highest point, but the state’s positivity rate is trending up as are hospital admissions. According to the Ohio Department of Health, as of the latest update Tuesday 1,016 COVID-19 patients were hospitalized, with 270 in intensive care units and 134 on ventilators.

On Tuesday, Gov. Mike DeWine said “things will get worse before they get better” and added “it would appear that we could have a tough winter ahead of us.” Weddings, funerals, and other family gatherings that are taking place without distancing or masks are of particular concern to DeWine.

Meanwhile, officials fear the onset of flu season could cause strain and lead to uncertainty of who has the virus and who has the flu.

President Donald Trump, recovering from the virus himself, is more convinced than ever it is time to reopen the economy beyond a level where Democrats are comfortable. Upon his discharge from Walter Reed National Military Medical Center, he tweeted about responding to COVID-19 like the flu, which he pointed out does not upend our day-to-day lives.

“We have learned to live with it, just like we are learning to live with Covid,” he tweeted on Oct. 6.

Shortly thereafter, DeWine spoke about learning to live with the virus in remarks during a press briefing that drew the attention of the public health community as the governor seemed to be ruling out a second round of restrictions this winter.

“We’re not going to shut down this economy again. We’re not going to shut everything down. So the question is how do we live with it in as safe a way as we can,” DeWine said on Oct. 8.

During the pandemic, the governor has developed an unlikely alliance with Democrats in the state who largely support his response to the coronavirus pandemic. While he campaigns for Trump, DeWine remains popular among Democrats and, according to polls, faces more opposition to his coronavirus response from members of his own party than from the other side of the aisle.

Ahmann said she thought DeWine’s shutdown comments were the governor sharing his optimism that Ohioans can act responsibly heading into the winter and prevent the need for a second round of restrictions. If a significant wave were to materialize with the change of seasons, DeWine would act, she said.

“I think if it came to it to where DeWine believed that Ohioans lives were at risk he would have targeted closures,” she said. “DeWine has done an excellent job helping Ohioans keep safe, and I believe he will continue to do that. I think he said that out of pure optimism, and he truly believes that Ohioans are going to do the right thing, so that we don't have to think about another round of closures.”

If there is a severe surge in the virus and the governor opts to continue with the current state of statewide protocols, one mayor says he would consider taking matters into his own hands.

“I'm not going to rely on politicians to make my decisions. I'm going to rely on the medical experts,” Lorain Mayor Jack Bradley said. “And if the medical experts indicate that we may need to take some extreme measures then I'm certainly going to take that into account making decisions regarding the city of Lorain.”

Bradley supports DeWine’s handling of the virus so far, and believes DeWine would respond to a severe wave despite his comments that closures are off the table.

According to recent Gallup research, 64 percent of Republican men and 54 percent of Republican women say they are “ready to return to normal activities right now,” while just 5 percent of Democratic men and 3 percent of Democratic women say the same. Less than a month from the election, many Republicans are looking for assurance from their elected officials that the restrictions the country saw in the spring are long in the past. DeWine’s latest comments, as well as the president’s calls for further reopening, including calls to open all the schools, speak to these voters.

In Vice President Mike Pence’s assessment, Biden’s coronavirus plan looks like “plagiarism” of the president’s COVID-19 response, he said during the vice presidential debate. But Republicans' pledge to keep the economy open stands in contrast with Democrats’ calls to respond to outbreaks when the arise.

In August, Biden said he would do whatever it takes to contain the spread of the virus, including enacting a second shutdown if scientists recommended it, later adding that in his view such a shutdown will not be necessary if people wear masks and follow safe practices. During the Sept. 29 presidential debate, he said, “You can’t fix the economy until you fix the COVID crisis.”

A second shutdown could be devastating for business if it looked anything like the first wave of restrictions in the spring. In Hamilton in Butler County, businesses could survive closures for a couple weeks, but another months-long shutdown would lead to a wave of permanent closures, said Dan Bates, the president of the city’s chamber of chamber of commerce.

“Our businesses can survive a reduction. They will not survive a shutdown,” he said. “If cases got drastically worse and they had to do a total shutdown, I think that we see a double digit percentage of businesses close that may not reopen again.”

A second round of restrictions could be very different than the broad closures that were enacted around the country in the spring. Some of the restrictions that were last to be lifted could be among the first to be reenacted. In the case of a severe worsening of the outbreak, changes to dining and bars, reductions or reversals of visitation for nursing homes and prisons, and pauses of in-person K-12 learning locally are more imaginable than another more universal shutdown.

While some industries are booming in Hamilton, Bates said the arts and hotels continue to be killed by the pandemic. Those industries are unlikely to be affected by a surge in cases – they remain largely unable to operate and their hopes of reopening on a meaningful scale look bleak until vaccines are administered widely. Most vulnerable to a case surge are bars and restaurants that have recovered somewhat from their losses in the spring, but many of which are still on the edge due to capacity restrictions and the state’s 10 p.m. alcohol sales cutoff, Bates said.

“Because the weather has been so nice, a lot of them have begun to catch up with what they lost in the spring. But if we have a tough winner, they don't have a safety cushion. They are trying to catch up. If the weather turns terrible fast, it's going to be detrimental to some of our restaurants and bars,” he said.

Bates is more concerned about the loss of outdoor dining capacity and a lack of consumer confidence in dining indoors than he is of a second round of closures or restrictions, which still feels like a distant possibility. His organization is offering grants for heaters and outdoor tents to help businesses make it through the cold season.

The economic toll of a second round of restrictions would hit small businesses the hardest, he said. Those small businesses would be most likely to permanently close.

“The devastation would be really in the smaller businesses that don't have the resources to survive,” Bates said. They're the fabric of all these communities. The feel of the community, what people enjoy as consumers, that largely comes from small business.”

In Lorain, Bradley said he would respond to a surge by focusing on preventing anything that could be a superspreader event. He said the main source of spread in the city, in his understanding from his conversations with the local health commissioner, has been family gatherings where people let their guard down. He also cited bars and restaurants as areas of concern.

“In the beginning, I would say we erred on the side of caution and maybe some of the precautions that we took were an overreaction,” Bradley said. “So I think if it comes to the point where we have to make some restrictions, we can do it with a little bit more intelligence and knowledge of the virus.”

For families wondering if they can celebrate the holidays, he urged masks and distancing when possible, and said it is important to make sure that those who are more susceptible to severe cases are not exposed to the virus during such gatherings.

Even in a worst case scenario during a surge of cases, retail would be unlikely to shutter for a second time. Retail capacity might be limited, Bradley said, but masked shopping is not seen by officials as a major source of spread.

Ahmann agreed. With masks, plexiglass barriers, and capacity restrictions, shoppers are not particularly likely to contract the virus at the store, which means retail can likely withstand a surge. She said officials are better tooled to make targeted approaches to shutdowns with more precise data regarding which parts of a county or even specific locations are seeing spread.

“We now have more information to make targeted approaches to a shut down, in terms of what shuts down, versus shutting down the entire state like we did before,” she said.

While cases are climbing in Ohio, a widespread second wave of restrictions would take a surge that leads to a real strain on the hospitals, Ahmann said.

“When we really have to shut down is if we can't respond, like New York got to in the spring,” she said. “That would be when we would have to consider another shut down."

Commissioner Duane Stansbury of the Warren County Health District in southwestern Ohio said officials continue to closely monitor hospitalizations. Should the situation dramatically worsen, the state will respond, he said.

To businesses concerned about a second round of restrictions, Stansbury’s message was to focus on doing their part to stay vigilant and continue to adhere to the precautions implemented in the spring. It is a good time for owners and managers to remind employees of the measures in place and to stress this would be the worst moment to relax protocols. 

The public health community is thinking about a second shutdown because even in non-pandemic times the public health community’s job is to prepare for worst-case scenarios.

“It's always better to assume the worst-case scenario so you can be prepared and protected against it, and then hope that it isn't as bad as the predictions,” Stansbury said. “Our response should all be based on what we see happening and what the reality is. We need to be prepared to institute changes quickly, whether that's changes to restrict things or changes to allow things to open up more."

Despite the worsening spread in Ohio, case numbers would still have to skyrocket for hospitals to become strained in the way Stansbury and Ahmann said would prompt a second shutdown. While there is concern transmission will increase this winter, with mask compliance and adherence to social distancing, officials say the state can avoid a new round of restrictions.