Gov. Jim Justice and his advisers tried to explain additional aspects of the “West Virginia Strong” plan to gradually reopen the state’s economy while monitoring the effects of coronavirus.
Why 3 percent instead of two weeks?
Over the past few weeks, coronavirus response coordinator Clay Marsh has described wanting to see a downward trend of confirmed tests over 14 consecutive days before loosening response guidelines.
The guidelines for Opening Up America Again, distributed by the White House, call for the same 14-day standard, which lines up with the incubation period for the virus.
But when Justice announced his administration’s guidelines on Monday, the standard was different.
Justice wants to see three consecutive days of West Virginia’s cumulative positive tests below 3 percent.
That’s the number of positives divided by the total number of tests.
West Virginia hit that mark on Monday afternoon when the cumulative rate was 2.49 percent.
That cumulative rate is one that West Virginia health leaders have been watching weeks, but Monday was the first day anyone expressed 3 percent as the key figure to hit.
Justice said the 3 percent number is better than just reopening with no data standard.
“I’ve just been searching for something that is simple for our people to get behind and something for them to be able to see every day and follow,” the governor said Tuesday morning on MetroNews’ “Talkline.”
Justice said maintaining an infection rate below 3 “can really trigger some scientific math to be able to tell us that it’s safe and it’s good to move forward. So, I think it gives us some science, it gives us some math and it give us some clarity. With our experts and all the stuff we’re doing, I think it’s just a good methodology to use.”
.@WVGovernor speaks with @HoppyKercheval about his reopening plan for West Virginia and taking steps to move back towards normalcy. WATCH: https://t.co/wkudfIAoe1 pic.twitter.com/dumgejVcYm
— MetroNews (@WVMetroNews) April 28, 2020
Marsh, speaking at a Tuesday afternoon news conference, said the nature of the pandemic means the ways of measuring its effects must be flexible.
West Virginia’s rate of confirmed cases has been stable, he said. And he said the infectious rate of the virus has also been kept at a minimum.
Of the White House guidelines and others, Marsh said, “These sorts of instructions are not rigid, linear requirements. They are advisements and guidelines for us to decide to open.”
“Ultimately, I felt that was a sign that we had this good window,” Marsh said.
Senate President Mitch Carmichael, R-Jackson, speaking on MetroNews’ “Talkline,” said he is pleased the governor is taking steps to reopen the economy.
But Carmichael acknowledged there are questions about the testing standard identified by the governor.
“Three percent. Where does that number come from?” Carmichael asked. “Who is being tested? If we’re only testing people with symptoms then 3 percent could be a high number. But if you’re testing the entire population or people who are asymptomatic then that could have an impact as well.”
.@SenCarmichaelWV talks with @HoppyKercheval about the reopening plan for West Virginia. WATCH: https://t.co/wkudfIRZCB pic.twitter.com/R6re4MiwFe
— MetroNews (@WVMetroNews) April 28, 2020
What happens if the number goes above 3 percent?
The West Virginia guidelines say the steps of the reopening process could slow, stop or reverse if the cumulative percent of positive test results surges above 3 percent.
Justice was asked about this possibility during Tuesday afternoon’s briefing.
“There’s no methodology that’s perfect. But if we spike to a 3.5, we’ve got a big problem. And we’ll know where the spike is,” he said.
Marsh described “The Hammer and the Dance” approach, which describes the broad shutdown orders of the past few weeks as a hammer but the adjustments likely to be necessary over the coming weeks and months as a dance.
“We’re leaving the hammer phase and getting to the dance phase where we are trying to identify much more precisely where the virus is rearing its head,” Marsh said.
West Virginia’s percent changed on Tuesday when the state removed duplicate test results.
As hospitals and other health care providers caught up to speed on providing results electronically to the state, there was duplication of what had already been reported via fax.
“Those duplicates have been removed from the totals,” the Department of Health and Human Resources stated Tuesday.
So DHHR reported 40,489* laboratory results on Tuesday morning.
But at 5 p.m. the prior afternoon, DHHR had reported a higher 43,227 results.
The result was a spike in the percentage.
On Tuesday, West Virginia’s cumulative rate was 2.66 percent.
On Monday, it had been 2.49 percent.
Contact tracing and protective equipment must ramp up, but how much?
The roadmap for reopening says West Virginia must ramp up its supply of personal protective equipment and its contact tracing capability.
But it doesn’t specify what West Virginia has or how much it needs.
State officials on Tuesday addressed a couple of questions about that, essentially saying it depends.
“It depends on the demand for resources. How many cases we have,” Marsh said.
State Health Officer Cathy Slemp said West Virginia needs needs 270 or 300 people for contact tracing — but it also depends on the phase of the virus spread.
“As we expand more testing and identify more cases, we will need to have more and more people with that,” Slemp said.
Contact tracing is tracking the spread of the virus by identifying someone with a positive test and then going over their recent contacts. The patient and the contacts are asked to quarantine.
“As far as the contact tracing, every state in the union is suffering from the same problem,” Justice said. “We don’t have enough. We just plain don’t have enough. We’re catching up. We’re catching up just as fast as we possibly can.”
Justice noted that DHHR is partnering with West Virginia University’s School of Public Health to recruit participants to help with contact tracing. The effort launches this week.
On personal protective equipment, state officials have described continued efforts to identify, secure, make or reuse items such as masks, gloves and gowns.
But it hasn’t always been easy to identify what the state needs.
Modeling being used by the West Virginia National Guard indicates most needs for the front-line responders are being met for the near term, said Major Holli Nelson, a spokeswoman for the Guard.
“That’s 100 percent correct. We are working with multiple entities to get an accurate picture of what the need is, not just at a hospital but at long-term care facilities, those nursing homes,” Nelson said in a telephone interview.
But a need for gloves continues, Nelson said.
And estimates must be adjusted as time goes by and the situation changes.
“We think we’re good right now. We think we’re going to be able to meet through the peak as it was forecast. As we open back up, we need to make sure we’re prepared,” she said.
Week 1 starts right away, Week 2 starts Monday
Justice said the state has met the standard to begin its first phase of opening — elective medical procedures.
He first described opening this sector of the economy last week and expressed confidence that the state is ready.
Such medical procedures include a variety of outpatient services. Justice said most have state approval to go forward but could be delayed if the licensing boards that oversee their activities aren’t yet ready.
Week 1 also includes testing of day care personnel to begin to open those facilities to children.
Week 2, Justice said, starts right away — May 4.
“We’ll be starting Week 2 on Monday,” he said.
That includes reopenings for small businesses of less than 10 employees, professional services such as hair and nail salons or barbershops by appointment only, outdoor dining at restaurants and the resumption of church services with limited gathering sizes.
Weeks 3 through 6, if the numbers indicate moving ahead, open up broader segments of the economy.
“This disease is still with us. It’s a pandemic. West Virginians, you have done fantastic. That’s all there is to it,” Justice said to conclude today’s briefing.
“If we use a metric — instead of just a wild guess — we’ll know when we have a problem. And if we have a problem, we’ll run to the fire.”