More than a month has passed since municipal facilities were closed to the general public and most community events were cancelled. Similarly, it’s been more than 20 days since the Governor issued a Stay at Home Order. With great sacrifice for many, the efforts at physical distancing, avoidance of gatherings, and a focus on essential services have helped avoid a catastrophic peak in COVID-19 cases. With progress being made and recognition of the economic toll combatting the virus has taken, talk has more recently turned to when and how local economies can be safely reopened. This urge is natural—we all want to return to something resembling normal and stem the economic losses. However, it must be done smartly and strategically, lest all the sacrifices will be for nothing.
Steps for Reopening
A consensus seems to be growing, from the White House to public health advisors to Governors, that a number of requirements must be met to safely reopen our communities and avoid an abrupt return to shutdown orders.
Reduction in New Cases
A sustained reduction in new cases is a pre-requisite. Most public health officials advise that reopening should not be considered until there has been a decline in new cases for a continuous period of 14 days. Virginia has yet to see a decline in cases—in the past 30 days, cases reported have gone from 114 to over 8,500. In our region, during that same time period, we have gone from essentially no cases to over 1,700. It is clear to see, we are not yet there. Recent models actually indicate it may be late June or July before we reach this benchmark.
Available Space in Hospitals
A key reason for desiring sustained reduction in cases includes a more manageable caseload for hospitals and for public health agencies. Unless there is to be a rapid increase in the availability of hospital beds, especially ICU space, then caseloads must remain at or, preferably, below the capacity of area hospitals. This was the very basis for extreme physical distancing in the first place. We are fortunate here in the Roanoke region to have multiple hospitals, which has allowed the region to retain capacity to accommodate any spikes in cases. For the most part, this has not been an issue in Virginia as it has elsewhere such as New York or Detroit, but warrants continued vigilance.
Test and Trace
Robust testing and contact tracing is essential. These are the techniques that will be used to identify and quickly contain new cases or outbreaks, should they occur. In this regard, Virginia like most of the nation is behind where it needs to be. Current estimates are that there needs to be at least 500,000 tests performed every day in the United States. Currently those numbers are more like 150,000 per day and they are not well distributed. As Dr. O’Dell, the official responsible for the public health response in our area states, “to be an effective tool we must move our testing and tracing protocol from a population basis to a case basis—meaning every individual case is investigated and contacts traced and isolated.”
Prepare for Recovery
Even though cases continue to increase, more are hospitalized and many will still unfortunately succumb to COVID-related illnesses. Even though we likely will not meet the requisite thresholds until later this summer, it is the right time to prepare for our reopening. The Governor will decide when the Stay At Home order is lifted and when non-essential activities are permitted once again. Locally, we must decide when it is safe to reopen municipal facilities, issue permits for gatherings and events, conduct public meetings in person, and how best to help our local businesses, nonprofits, and arts and cultural institutions recover. We must determine how to continue to deliver the services needed in our community with millions less dollars than we had just a few months ago.
We have made great progress in our struggle with COVID-19. We have sacrificed much. Our work is not yet done and many more challenges lie ahead. But if we are thoughtful, prudent, and plan accordingly we can begin to prepare for what comes next and act accordingly. Now is not the time for hasty decisions. Now is not the time to forget we are a Commonwealth, acting together for the common good. Now is the time for resolve and steadfastness. Stay strong, Roanoke!
-- Bob Cowell