With encouraging signs that the US is nearing the peak of its coronavirus outbreak, at least 10 states have created coalitions to work together toward reopening their economies. But as they do, several other state leaders are taking a more measured approach, …

(CNN)Withencouraging signs that the US is nearing the peak of its coronavirus outbreak, at least 10 states have createdcoalitions to worktogether toward reopening their economies. But as they do, several other state leaders are taking a more measured approach,saying they fear the worst is yet to come for their parts of the country.
The contrasting responses reflect one of the challenges the country will face as talks turn to lifting social distancing measures and states find themselves in vastly different circumstances.
Robert R. Redfield, the director of the US Centers for Disease Control and Prevention, said Monday that while the country is nearing its peak in the coronavirus pandemic, different parts of the country were affected differently and should be viewed as “separate situations.” By Tuesday, there were 582,607 cases of the virus in the US. At least 23,628 people have died.
In Pennsylvania, Secretary of Health Dr. Rachel Levine said that while social distancing measures have had a positive impact in slowing the number of new cases, it would be a “very big mistake” to think about reopening the state before it hits its peak — which she said hasn’t happened yet.
North Dakota Gov. Doug Burgum said Monday that governors across the Upper Great Plains region don’t think they are anywhere close to opening.
“We have said all along there are going to be different curves for different parts of the country, and so we are not there yet,” he said.
He said that while other states have begun showing signs of a flattening curve, in North Dakota, the numbers of cases and deaths are still on the rise.
“That is going to be confusing for people. If … New York had all these deaths and they are opening up, why aren’t we opening? That will be a communication challenge for us, but we have to just keep monitoring and see where we are going on this,” Burgum said.
New York Gov. Andrew Cuomo said his state was coordinating with other Northeastern states, including New Jersey and Connecticut, and on Tuesday would begin discussions around reopening.
“Now it is time to start opening the valve slowly and carefully while watching the infection rate meter so we don’t trigger a second wave of new infections,” he said. “This is not a light switch that we can just flick on and everything goes back to normal — we have to come up with a smart, consistent strategy to restart the systems we shut down and get people back to work.”
On the West Coast, the governors of California, Oregon and Washington said they’d also be working together with similar goals.
As those announcements began rolling in, President Donald Trump said the White House plans to unveila committee — or multiple ones — Tuesday focused on reopening the country in the coming weeks.
“We will soon finalize new and very important guidelines to give governors the information they need to start safely opening their states,” Trump said. “My administration’s plan and corresponding guidelines will give the American people the confidence they need to begin returning to normal life.”
What May will look like still uncertain
An influential model cited by the White House predicts the coronavirus pandemic will “peter out” in May and the expert who built the model, Dr. Christopher Murray, says it’s possible to get transmission of the virus down to zero by this summer.
The model, which makes predictions until August, projects zero deaths after June 21.
“The one thing we absolutely know for sure is that social distancing measures work,” said Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington. “It leads to a situation where every case is infecting less than one other case, and that means if you keep the course, you’ll get transmission essentially down to zero.”
But a timeline toward normalcy is something most governors seem hesitant to draw.
In Tennessee, the beginning of May will mark a “phased reboot of our economy” after the state’s stay-at-home order ends on April 30, Gov. Bill Lee said Monday.
Lee announced the formation of an Economic Recovery Group that will work in coordination with local leaders, healthcare professionals, and representatives of impacted industries to determine what is best.
The steps the group will take in reopening the economy have not yet been determined, Lee said.
In Georgia, one of the last states to issue a sweeping stay-at-home order, Gov. Brian Kemp said plans beyondthe end of the month were not the priority.
“Our focus is on the hospital surge capacity, the ability to test more because we are going to need that when we go back to work,” the governor said when asked about the reopening of the state economy.
“We are a little behind the curve from when our peak is going to be to other states around the country,” he added.
Louisiana Gov. John Bel Edwards announced Monday that schools would be closed through the end of the academic year but said it was too soon to know when the state could loosen social distancing guidelines.
“I cannot tell you exactly what that’s going to look like yet, but we will be working really hard with all the experts to get that figured out,” he said.
Four key cities are listening to stay-at-home orders
In some of thecountry’s hotspots — New York, New Jersey, Detroit and New Orleans — cases havebegun leveling off or going down, US Surgeon General Dr. Jerome Adams said in a tweet Monday.
“In the midst of tragedy, there IS hope,” he tweeted. “Social distancing and mitigation IS working. There is a light at the end of this dark tunnel.”
A report from the CDC shared a similar message. CDC researchers studied data from New York City, Seattle, New Orleans and San Francisco — four cities that had large outbreaks and implemented mitigationmeasures early on.
The report found that, in all four areas, the percentage of people leaving their home was close to 80% on February 26. By April 1, that declined between 20 percentage points and 40 percentage points in each city.
“They didn’t leave their home at any point for any reason. They didn’t go outside. That’s significant,” said study coauthor Kathleen Ethier, leader of the CDC’s community mitigation task force for the coronavirus response.
“When you put in these social distancing measures, they do seem to work,” she said.
For now, Florida Surgeon General Scott Rivkees said social distancing will remain the new normal until a vaccine is developed.
“I cannot emphasize enough that we cannot let our guard down at this present time,” he said. “Until we get a vaccine, which is a while off, this is going to be the new normal and we need to adapt and protect ourselves.”
First statewide hydroxychloroquine trial
South Dakota Gov. Kristi Noem announced Monday the state was working with Sanford Health to conduct the nation’s first statewide hydroxychloroquine trial, which will include both patients who have tested positive for the virus and residents who have been exposed.
Patients who have been exposed to the virus will receive either hydroxychloroquine or a placebo, Sanford Health’s Chief Medical Officer Allison Suttle said.
“We’re going on offense to help every single person deal with this virus and be willing to fight it and get better and go home to their families,” the governor said.
The news comes as researchers in New York are expected to announce next week preliminary results of a study on hydroxychloroquine — offering one of the first scientific hints as to whether the drugs are helpful against coroanvirus.
The study will review hundreds of medical records from hospital patients across New York state with coronavirus to see if the drugs are helping them or hurting them.
“We wanted to get an immediate sense of this,” said David Holtgrave, dean of the University at Albany School of Public Health, who is running the study. “Time is so much of the essence here.”
CNN’s Arman Azad, Chandler Thornton, Elizabeth Cohen and Sarah Jorgensen contributed to this report.