Regular readers will know that I’m not happy with the state of affairs in D.C. (not Wor-Shing-Tun, but actual D.C.) regarding COVID-19. The short version is that, after delaying too long in shutting things down, D.C. got really close to crushing the curve, and then reopened too early. Over the last couple of weeks, the prevalence has been climbing, and, as of yesterday’s data, Wards 1, 3, 4, 5, 6, 7, and 8, as well as the city as a whole exceeded the German emergency brake threshold of 50 new infections per 100,000 inhabitants over a week (0.05% of the total population).
At the same time, it’s clear that contact tracing and testing has failed: only 2.6% of positive cases in D.C. are from those who are already in quarantine or a close contact of someone who is. This failure–and that is the appropriate word–likely stems from two sources. First, it’s taking far too long to receive ‘non-emergency’ testing results: if you need to establish a link from person A to person B to person C, but it takes too long to get results for person B (or for that matter, person A), there’s no way you can make the link to person C. Second, I’m not convinced the tracing is going deep enough; close contacts aren’t enough.
Since all the lights are blinking red, what should D.C. do? (we’ll ignore the typical New Democrat penchant for doing nothing). Until yesterday, the city seemed paralyzed. Before we get to what the Bowser administration is doing, let’s go through several options the city has, given the constraints created the murderous federal response.
One option would be to expand D.C.’s own testing and tracing capacity. As best as I can tell, DC Health actually has good turn around time. If there’s a way to expand their capacity, then do so. However, experience to date in D.C. suggests testing and tracing as a solution is a can opener–right now, it doesn’t seem realistic to do this.
Another option, which I think is the best option, if rather blunt, is to roll back to phase 1. You don’t have to worry about testing backlogs at commercial labs. As some asshole with a blog has noted, the best way to prevent infection is to not be around infected people.
The third option is to go all in on mask wearing. That’s what D.C. has decided to do as of Wednesday, according to an executive order. It’s pretty good as these things go. It requires masks in all businesses and other public areas, as well as in the common areas of apartments, condominiums and cooperatives. It is a little vague with “Persons leaving their residences shall wear a mask when they are likely to come into contact with another person, such as being within six feet of another person for more than a fleeting time”–and I would like to see people exercising on sidewalks (i.e., runners) required to wear a mask. Still, it’s good.
The question though is, will this be enough? D.C.’s mask compliance is pretty good, so I don’t know how much additional protection we’ll get. One problem with the emphasis many people have placed on masks–and masks are unusually effective against SARS-CoV-2, is that it deemphasizes the role physical distancing plays. We can either have ‘concierge’ physical distancing, quarantining and isolating people based on testing and tracing, or we can do it broadly through rollbacks. Given the lack of success with testing and tracing, I would like to see a rollback, since I just don’t know how much more advantage there is to wring out of mask wearing in D.C. (other states, there’s a lot of room for improvement).
But at least it’s a plan. Though if we had waited longer before reopening, we might not have needed this plan–we could have crushed the curve. Instead, we had a failure of governance.