By Matthew Wellington and Maura R. McLaughlin
Wellington is Public Health Campaigns Director for the U.S. Public Interest Research Groups. McLaughlin is a family physician and founder of Blue Ridge Family Practice in Crozet.
Virginia just passed the grim milestone of 100,000 COVID-19 cases, with more than 2,000 deaths from COVID-19 recorded in our state.
Robert Redfield, the director of the Centers for Disease Control and Prevention (CDC), warns that unless we get the novel coronavirus under control now, we could face “the worst fall, from a public health perspective, we’ve ever had” in the United States.
We can avoid more needless suffering and death, and get our economy back on track more quickly, if Gov. Ralph Northam orders the state to shut down, start over, and do it right this time.
Gov. Northam has said, “We’ll never recover economically unless we get the health crisis under control and behind us.” Economists have reinforced the message that there’s no trade-off between saving lives and saving the economy.
Since states began their shutdowns in March, health experts have said to reopen safely, we need to both dramatically reduce cases and implement a robust testing and contact tracing program designed to contain new outbreaks.
Virginia did well with its initial stay-at-home order and public health measures. By June, we brought the R0 of SARS-CoV-2 below 1, meaning each infected person, on average, spread the virus to less than one other person. However, we relaxed too quickly. Our new daily cases now are on par with our May peak. As students return to schools and colleges, and cooler weather drives people indoors, daily case numbers, hospitalizations, and deaths are expected to increase.
Health experts cite two important metrics for determining if it’s safe to start reopening — the rate of new daily cases should be less than 1 per 100,000 people, and less than 3 percent of people tested should test positive.
In Virginia, our average case rate during the last week was more than 10 per 100,000 people, and the positive test rate was more than 5 percent.
It’s time to hit the reset button.
First, we need to thwart the virus’ spread. We should enforce and comply with Gov. Northam’s executive order requiring public mask-wearing. But that’s not enough. Gov. Northam needs to reinstate a proven strategy: stay-at-home orders.
Restaurants should only offer take-out and delivery. Non-essential businesses should operate limited pick-up or delivery options, and should close temporarily if they cannot. Then, we need to financially support businesses and individuals who struggle under these restrictions. They’re doing society a service by staying at home.
No one should go out except for essential work, to get groceries or medicine, go to the doctor, or exercise outdoors. This will be difficult. But this is not about what we want; it is about what we need. If a less-painful intervention would help the long-term health of our people and economy, we could do that instead. But there isn’t one right now. Every day we delay this decision leads to more unnecessary deaths and further slows our recovery.
A national stay at home order would be best, but we know by now that is unlikely to happen. This must be done state by state, and would be most effective if several governors acted together. We need Gov. Northam to lead right now.
While shutdown measures slow viral transmission, we need to provide appropriate personal protective equipment (PPE) to all essential workers, from health care professionals to grocery store clerks to poultry processors, so they can safely keep saving lives and keep critical services running. Right now, we have inadequate PPE across the country and state.
We also need to rapidly expand testing, contact tracing, and isolation/quarantine efforts. Currently, Virginia has just over half of the testing capacity recommended for containing outbreaks and less than half of the estimated contact tracers required. If we get our total cases down significantly, our testing and tracing capabilities will be more effective.
Once the rate of people testing positive drops below 3 percent and we have less than 1 new daily case per 100,000, we can gradually lift public health measures, while limiting the spread of the virus through robust testing and tracing protocols.
This will be neither easy, nor smooth. But if we have the courage and strength to do this, we will save both lives and the economy. In the years to come, we will be able to look back proudly on how we responded in this unparalleled, challenging time.
We have a second chance, right now, to get this right. We may not get a third.