We know a lot more now than we did in March when we started dealing with the COVID-19 pandemic. We also know that it has always been “easier to criticize than it is to create” and many people have used this opportunity to criticize the steps taken by Gov. Ralph Northam (D). It’s also very difficult to “prove a negative.” Had we not taken the proactive steps we did in mid-March and early-April, and there had been deaths on the scale of what we saw in New York, then someone would be saying, “You failed! You should’ve done more.”
But, since we took the steps we did and we didn’t have the deaths that were projected, the detractors and “second guessers” are instead saying, “See, it wasn’t as bad as you said it was going to be.”
Now, as we appear to have weathered the first wave – testing is close to 10,000 tests per day, finally; the percent positivity is declining, even though the number of tests are increasing; statewide ventilator use appears to be holding steady at about 20 percent; the Rt (rate of transmission) has been below the all-important 1.00 threshold for the past six weeks; and the daily death toll is now routinely in single digits. All of these metrics undeniably show we made the right decisions. Our health care system was not overwhelmed, and we did not have body bags piling up in spare rooms as they did in New York City.
But now we need to begin planning for the second wave. We know the virus is still in the community and as we start to reopen, the virus will begin to spread again. All you have to do is look at the Rt for the various states that have started to reopen. As of June 15, there were 18 states with a Rt greater than 1.0, which means the virus is spreading again, including Arizona, where the reports are that their ventilator usage is above 70 percent.
The approach we took in the first wave – a complete shutdown of the state – is not going to be the right answer for the second wave. The lessons learned from this show that while the virus can and does strike all ages, hotspots are created in vulnerable communities, such as senior communities, minority communities, factories, poultry processing and densely populated areas. Based upon this knowledge, and here I’m going to borrow a couple of Cold War terms, we need to move away from the “mutually assured destruction (MAD)” approach, where we shut down everything to eliminate the virus, to a “containment strategy.” This should probably have been the approach that was taken at the national level, but since we’re getting no leadership from the federal executive, we can and should apply this approach within the borders of the commonwealth.
A containment strategy applies the appropriate force and resources to contain and eliminate the virus in the smallest possible, least disruptive geography by marshaling forces from across the state and getting local political and logistical support, because everyone will know that if we don’t contain it here, we’ll have to expand the reach of the containment. In an ideal implementation, we’ll be able to identify when a hotspot is beginning to take hold in a nursing home, factory, college, poultry processing center, et cetera and bring resources to contain and eliminate the virus. If the testing and contact tracing indicates that the virus has spread beyond the initial area of containment, then we will need to expand our area of containment to the next level, which could be a local community, city, county, health district, contiguous health districts and then perhaps the entire state again.
After we move past Phase Three of the Virginia Forward Plan, we must maintain thorough testing in vulnerable communities. This will be the key indicator for identifying where we need to deploy statewide resources for future containment. If an outbreak occurs, the state will need to initiate an immediate lockdown on that affected entity, increase testing, isolate infected individuals and implement thorough contact tracing. If sufficient ventilators, doctors, testing capability and contact tracing are not available in this area, this is where the governor must use the executive branch to rally and direct resources from across the state to the area of most need. This can be done using the National Guard and Volunteer Medical Corps to target and eliminate the outbreak.
Virginia needs to develop a post-Phase Three plan to simultaneously fight COVID-19 outbreaks spread out across the commonwealth. By developing and articulating such a plan, the governor can acknowledge the success of what we’ve done in the first wave and that we’re learning from those lessons in a way to more surgically combat and contain the virus in the second wave.
David Reid, a Democrat, represents the 32nd District in the Virginia House of Delegates. His district spans across Lansdowne, Ashburn and Broadlands.