On Saturday afternoon, two games of pickup basketball shared a single court on the northwest side of Painter Park in South Minneapolis. Twelve men wearing black and white T-shirts moved in tight clumps, keeping far less than 6 feet apart. The temperature hovered around 70 degrees, drawing people out of their homes and into public spaces as the first month of the state's stay-at-home order came to an end.
The scene might have been unthinkable weeks earlier, as states ramped up lockdowns to stop the spread of the coronavirus. But as quarantine orders drag on, people are becoming more likely to ease up on some of the many precautions they've adopted.
Indeed, although each state has its own guidelines, people across the country appear to be bending the rules of stay-at-home orders. That's evident in research the University of Maryland released last week, which looked at anonymous cellphone location data and suggested a decrease in compliance nationwide.
"Aside from quarantine fatigue, in many places people are getting messages saying that they are successfully flattening the curve and that cases have peaked in their area, so they might question the value of continuing to stay locked down and avoiding seeing other people," said Tara Smith, a professor of epidemiology at Kent State University in Ohio.
In this way, the early success in some parts of the country could bring a false sense of security, said Kumi Smith, an assistant professor of epidemiology and community health at the University of Minnesota School of Public Health.
It's the people who we know that we talk to the most and that we are more likely to break that 6-foot rule with.
"There is a strange side effect when most people in some places are untouched by this epidemic, meaning they don't know anyone who has had COVID-19 or who has died of the virus. That threat is no longer top of mind," Kumi Smith said.
While people seem to continue to prioritize avoiding getting too close to strangers on the street, sanitizing groceries and washing their hands, they may be getting a bit more relaxed about hanging out with friends and family, which actually poses a bigger risk, Kumi Smith told NBC News.
"It's the people who we know that we talk to the most and that we are more likely to break that 6-foot rule with," she said. "That's where the virus has a better chance of making that leap."
People may also develop a false sense of security from assessments that their states are over the worst of the pandemic.
But according to Kumi Smith, the models used to predict local pandemic curves assume everyone fully adheres to stay-at-home orders. If that doesn't play out in real life, the models are inaccurate.
"We haven't modeled a situation in which guidelines are relaxed, so we don't know what that looks like," she said. "If the information from these models is at all behind or inaccurate, if that group lets their guard down, we'll only find out that was a problem after it's too late."
Nationwide statistics are also skewed by states like New York, New Jersey and Massachusetts — all of which have huge numbers of cases but have managed to flatten their curves, said Jennifer Nuzzo, a senior scholar at the Johns Hopkins Center for Health Security. Plateauing in those states is reflected in nationwide counts, but it obscures the fact that cases in some parts of the country are still growing exponentially.
"The one real worry I have is that the case numbers are only as good as the testing, and testing has been very constrained," Nuzzo said.
Testing, testing, testing
As of Tuesday, less than 2 percent of the U.S. population had been tested, according to the COVID Tracking Project. Any relaxation of social distancing would have to be paired with a very robust testing strategy, Kumi Smith said. Experts predict that coronavirus testing will need to double or triple what it was in mid-April before the country can safely reopen.
Nuzzo said that as people start expanding their social circles, their risk of exposure to these mild cases increases.
"The cases we're missing are probably the mild ones, but these cases are just as capable of spreading the virus to other people," she said. "We may find ourselves with this seemingly sudden overnight growth in cases, which has really been spreading silently for weeks."
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Case-based interventions, which would identify everyone who has come into contact with a person who tested positive for COVID-19, allowing them to be isolated, is another key strategy that must be in place before people can safely ease up on distancing.
"If we just ease social distancing but don't snap into place with those actions, we are going to be back where we started," said Nuzzo, who is concerned about the nation's ability to put such costly case-based interventions in place before states begin to reopen.
"We acted when we were concerned that cases were spiraling out of control, and it's appeared to have an impact in most places, but as soon as we reverse course, unless we have case-based and testing measures in place, we will fall back to where we started or even worse," she said.
Playing the long game
According to Kumi Smith, people everywhere should continue to wear cloth masks when they expect to have face-to-face conversations or are in closed spaces like stores. While cloth masks won't prevent a person from getting sick, they can help prevent people who are sick from spreading the virus to others.
Tara Smith said: "Even if we relax precautions, we still have a chance for another wave and more lockdowns. Antibody tests suggest even that in New York City, only 20 percent of people have immunity, meaning we are experiencing nothing close to herd immunity."
In addition, people should always practice good hand hygiene, in a pandemic or otherwise. "And we probably shouldn't go back to shaking hands any time soon," Nuzzo said. "You cannot go to a pre-COVID-19 state. The virus is still out there, and people will still die."
Limiting the number of people you come into contact with is important, so people should also avoid groups for the foreseeable future. However, Nuzzo's advice is to go ahead and take a walk outside with a friend, with a few caveats.
"Is it zero risk? No. Every time you introduce a new person into your network, you are at risk of being exposed to everyone that they have been exposed to," she said. "But if going on a walk with this person is the thing you need to do to maintain sanity or health, then go for it. Just be sure to minimize risk by keeping a distance while walking and washing your hands when you get home."