May 22, 2020
Dear County Executive Elrich, Members of the County Council and Dr. Travis Gayles:
Balancing the impacts from a highly contagious virus and the shutdown is a difficult task and we appreciate your efforts to do so. While I understand the council’s primary goal is to save lives from covid unfortunately the decision to prolong the shutdown will put other lives at risk. While a letter could be devoted entirely to the negative impacts of the shutdowns (one of which is attached for your reference) suffice it to say that many people and businesses are seriously suffering. The data suggests that a balanced, targeted approach is possible.
During the press conference Wednesday, Mr. Elrich said his top two metrics for lifting the stay at home orders were total case numbers and ICU utilization rates. Mr. Elrich suggested that death rates are not going to be changed much by testing and contact tracing. He also stated that death rates are the hardest numbers to change. How can any metric have a higher priority than who dies from the disease? Does this suggest Mr. Elrich believes that regardless of what we do, the vulnerable will die from covid? Eventually we will all die of something, but a targeted approach can help protect the vulnerable from dying of covid and allow the rest of us to get back to work.
Who is at the greatest risk of dying from covid and might benefit the most from an effort to lower death rates? Nursing home patients. This group comprises 74% of the 465 total deaths in the county. But please also note that 85% of all deaths are folks over 65. Who has a low risk of dying from the disease? People under 65 especially those without underlying health conditions. Only 0.007% of county citizens under 65 have died from covid with or without underlying health conditions. What other name does this low risk group go by? The workforce.
Only total case and death numbers are provided in the dashboard which is not helpful for understanding risk or evaluating a targeted strategy. Deaths of nursing home patients and those over 65 with serious underlying conditions should be eliminated from any trends that will impact the decision to reopen. While the lives of nursing home patients are as important as any other life, these folks are not the ones who are shopping and operating businesses. Plus nursing homes are highly specialized environments that are not found in general office and retail. If it is not possible to segregate the data this way, please add charts to the dashboard for under and over 65 daily fatality rates and you will find as I did with Maryland data that the trend has been flat for over a month.
Data charts that only include nursing home stats should also be created to guide decisions and strategies to protect patients and staff. This segregated information will also allow the citizens and county to monitor results.
Hospitalizations are a key metric. The dashboard states that in order to reopen we must achieve 14 days of acute bed utilization rate of 70% or less of the total number of acute beds. We have had 0 days under 70% for acute beds. Are we to assume that if nothing changes we will have at least 14 more days before we can reopen? Please note that the top utilization rate for both covid and noncovid patients was 83% and only 6 days since April 30 have been over 80%. In other words, we have been able to accommodate all patients since the beginning of the pandemic with beds to spare.
Only a notable spike would cause a shortage of acute care and ICU beds. If a spike were to occur, when would that be? Well after reopening. Therefore waiting another 14 days to reopen achieves nothing but negative health, emotional and financial impacts to the citizens. Rather than passively watching the numbers, is there an approach that balances the needs of all of the citizens utilizing advance planning? For example, is it possible to transfer patients between hospitals to balance the load or develop a plan to increase beds immediately in the event of a spike?
Antibody testing and other situations such as the aircraft carrier Roosevelt suggest as many as 50% of covid positive people could be asymptomatic and far more of the population has been infected than indicated by current testing. This suggests that increased testing will result in increased cases for some undetermined period of time. While I completely support the County’s new programs to increase testing, even if 5% of the population is tested monthly, many folks could still be walking around unaware they have covid. The only way to manage that is through physical distance, good hygiene and masks when within 6’ of another. Why should small businesses be held hostage while testing ramps up when the same avoidance practices must be instituted regardless? Considering that county essential workers are not required to quarantine when they have been exposed to covid, the health department must have high confidence that these practices will stop the spread. Let’s extend this confidence to the entire workforce and reignite demand in the county.
The statement in the meeting Wednesday that when stay at home orders are lifted, the county might only allow stores to do curbside pickup was extremely troubling. Certainly all the members of the council have noticed that people are not staying home. They are out shopping in big box stores. Does science dictate that we are only safe in big corporate retail and at greater risk in small independent stores? No. Science does tell us how to stop the spread and small business owners are very capable of maintaining physical distance and instituting appropriate hygiene standards. Therefore, why should government officials decide which businesses live and which die? The County should stop giving big box retailers a crushing advantage over our small businesses and open fully.
Every day matters. Each minute we remain closed, the consequences will pile up exponentially from deferred medical treatments, unemployment and financial devastation. Suicide rates have increased as has substance abuse, physical abuse and depression. The fact that we now have food lines in the county speaks volumes. Small businesses are genuinely suffering which will have its own long term health impacts. Many businesses will not survive. Has the county examined what will happen to its tax base if small business is decimated?
Regardless of the council’s good intentions, continued stay at home orders will not deliver us from covid. We implore the council to proactively balance the needs of all the citizens and implement a targeted approach that protects the vulnerable and allows the healthy to assume personal responsibility and get back to work. Any business that can maintain physical distance guidelines should be allowed to open fully. The data supports that action and the new guidance from the CDC regarding the transmission of the virus should give all of us more confidence to move forward. And finally, please obtain input from the people of the community who will explain how both covid and the shutdown have impacted their lives and livelihood.
Sincerely,
Sue Seboda
The numbers are fascinating. And I quote you here, “Only 0.007% of county citizens under 65 have died from covid with or without underlying health conditions. What other name does this low risk group go by? The workforce.”
Today in my neighborhood, an urgent care clinic that had been open for about ten years announced closure due to the pandemic. Healthcare workers now unemployed.
The numbers are very interesting. I wish everyone would study them.