4-26-2020-2-15-38-PM-1384942

Rich Miller: Finally, feds give states a recovery road map

While short on details, the state and regional guidance finally issued by

the White House last week gives us a set of pretty reasonable, if

difficult-to-achieve goals.

We all know why we need to contain and reduce our risk to the COVID-19

virus: Save lives, preserve health and get people back to work.

We now know what states are supposed to do to get to the finish line: 1) A

measurable and sustained reduction in new positive tests over three sets of

two-week periods, or the same downward trajectory of positive tests as a

percentage of total tests; 2) The ability to treat all patients without crisis

care (like the tent hospitals in New York City); 3) Robust testing, contact

tracing, syndromic surveillance that can catch an outbreak before it actually

happens, as well as surveillance testing of asymptomatic members of vulnerable

populations; and 4) An ample supply of personal protective equipment (PPE) and

the ability to deploy it along with an ability to surge ICU capacity.

Again, details are lacking. The White House says states must be able to do

things like “Protect employees and users of mass transit,” without

explaining what that means.

When all that and more is done, states can then move to the first, quite

limited phase of reopening their economies. But if they cannot sustain all four

points mentioned above (and more) during that phase, they have to start over

again.

Then it’s on to phase two of the reopening, but with the same mandate to

meet all the requirements listed above. Then comes phase three, which looks

something like pre-pandemic life.

So, where is Illinois right now? The state seems to be generally OK with

its hospital system; and the governor claims it’s improving its PPE supply

system.

But after weeks of promises, the state’s testing program still lags the

nation. The governor claimed yet again last week that they’ve fixed the latest

glitch, but he’s made similar promises before about other things (like the

state’s unemployment insurance application process), so we’ll see. State

leaders have been saying for weeks that testing is very important, but we have

yet to see significant progress on that front. You cannot walk until you can

crawl and we’re still crawling here.

Illinois appears to have a long way to go on contact tracing,

surveillance, etc.

But the really hard part will be meeting the requirement for a measurable

and sustained downward trajectory in newly positive tests.

Decline doesn’t appear to just happen on its own. The upward climb in

positive results is relatively swift, but the peak’s other side looks more like

a plateau. Illinois Department of Public Health Director Ngozi Ezeki said on

Friday, April 17, that she didn’t think Illinois had even reached its peak.

Illinois, like some other states, has slowed the upward curve of newly

positive tests, except for the 17th, when it spiked up hard. Slowing is good,

but it’s not enough to comply with the White House guidance. I asked the

governor on the 17th what scientists were telling him about how to reduce the

number of newly positive tests. and he said there wasn’t much that can be done

except to continue doing what they have been doing.

Pritzker shied away from requiring masks in public, even though some say

it could help bend that curve downward. I happen to think it’s a good idea, but

the governor said, “We don’t live in a dictatorial society.” To me,

if the government can force restaurant cooks to wear a hair net, it can and

should require them to wear masks.

We know the “why” and we now know the outline of

“what” states have to do. But when it comes to the sustained

reduction of positive tests, the nation really has no plan for “how”

that will be accomplished.

But at least we finally have a road map, which should give the nation and

our state a bit of predictability.

By the way, the White House guidance also says schools can reopen during

phase two, even though crowd sizes of 50 people or more “should be

avoided.” That seems unwise, but if by some absolute miracle Illinois

fixed all of its testing and monitoring issues within two weeks and new

positive test results began to drop immediately and then continued to

consistently drop for four more weeks, the school year would almost be over

anyway. That miracle is not going to happen. The governor was right to cancel

the rest of the school year.

Rich Miller publishes

Capitol Fax, a daily political newsletter, and CapitolFax.com.

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