Unless, of course, Mayor Bowser decides to ignore one of the key metrics, but I’m getting ahead of myself. Every ward in D.C., other than Ward 2, saw massive increases, and the city as a whole had a 52% increase in prevalence. Every ward, other than Ward 2, exceeded the German rollback threshold of 50 new cases per 100,000 per week (0.05% in the second column below):
|Ward||one-week prevalence||one-week % pos.||two-week prevalence||two-week % pos.|
This is a catastrophe. If we have another fifty percent increase, we will blow by the phase 1 re-opening metric of more than fifteen positives per 100,000 people per day. In fact, if we ‘only’ have an increase in new daily positives of twenty-five percent we will exceed that threshold. While the city gives itself wiggle room, there’s every reason to rollback if that happens. Given that there are no policy initiatives to lower spread, we have to hope for bad weather and similar things that will keep people away from each other. That is, there is no response plan.
I realize people in D.C., like everywhere else, are preoccupied with stymieing the threat of authoritarianism on Tuesday, but this massive spike, while covered in local news, doesn’t seem to be penetrating our so-called city leaders’ noggins. There’s a really good chance–and I hope I’m wrong–that we’ll breach the 15 new daily positives per 100,000 people in the next week.
And there’s no plan. Meanwhile, we still don’t understand how spread occurs:
Despite being months into the pandemic, we still don’t understand how spread is happening in D.C. We can repeat certain generalizations and bromides about particular activities, but what we need are cases that have been examined in detail, followed by communication of those cases to the public. Unless we believe–with absolutely no evidence to do so–that the transmission of SARS-CoV2 is fundamentally different in D.C., we are missing superspreading events. It’s tempting to joke about the White House Covidpalooza, but, were it not for leaks to the press, it’s doubtful our current system would have identified those cases either, other than (possibly) as another unknown rise in cases.
What the city must do is refocus some of its contact tracers and rapid testing capability to dive in deep into a case. Find out where this person shops for groceries and other supplies–and test everyone there. Do they take the bus? Find everyone who was on the bus with them. Are there other stores, restaurants, and other indoor activities where this patient has spent time? Trace and test people there. Are people supposedly in quarantine actually in quarantine? Run one of these cases down until there are no more threads. Some will be busts, but it’s likely you’ll eventually stumble across a superspreading event.
Without details of the natural history of transmission, we simply do not know which restrictions can be loosened and which should be tightened.
On top of that, we still could be four to six weeks away from returning to normal-ish, but we intentionally remain four to six weeks away from safely returning to normal-ish because we’re unwilling to do what it takes to make that happen.
At this point, anger isn’t the appropriate emotion, rage is.