A few weeks ago, D.C. Health Director Dr. LaQuandra Nesbitt said something very interesting (boldface mine):
“Although we are experiencing downward trends, unless we get to a level of a daily case rate where we have demonstrated containment, which in the District would be 10 cases per day or lower, we would be at risk for an acceleration again,” says Nesbitt.
That’s very close to what I call on the Twitterz, ‘the good place’ of one daily new case per 100,000 people. I’ll spot Nesbitt the three daily cases, since people like base ten numbers.
But Nesbitt’s comment didn’t get enough play–and it strikes me as a subtle dig at Mayor Bowser and the D.C. Council. To get to a place where we can really keep COVID-19 under control, we need to be at around 50 cases per week; D.C. is around 20-25 fold higher than that. We never did that. In D.C. we did reach about four new cases per 100,000 people–and then we just…stopped trying. And once we had a little travel and some bad habits, the prevalence just kept slowly, but inexorably, kept rising until it got bad. Really bad.
Obviously, this isn’t just a local D.C. phenomenon. We still haven’t wrapped our heads around the importance of prevalence, and are still too focused on the trend (the trend does matter, just not for what you decide to do that day). I have yet to hear prominent politicians or other figures lay out prevalence-based goals*, as a path to containment.
A broad failure of governance.
*As best as I can tell, the ‘metrics’ exist only to justify loosening restrictions, otherwise political leaders are just using any good news, no matter how trivial or irrelevant, to loosen the restrictions they want to loosen.