Our View: Time for tough questions

Our View: Time for tough questions
Inova Alexandria (Photo Credit: Alexa Epitropoulos)

The data on COVID-19 is terrifying. The federal government said on Tuesday the death toll in the United States could approach a quarter of a million people, or approximately the population of Arlington County.

The Institute for Health Metrics and Evaluation, along with others, is doing estimates on when COVID will peak nationwide and in each state. IHME also estimates the number of overall hospital beds, ICU beds and ventilators that will be needed at that peak and calculates whether there’s a shortage state-by-state.

For Virginia, IHME estimates that our peak will come on May 20, that we have enough hospital beds statewide to meet peak capacity, but that we have a significant deficiency statewide in ICU beds. Specifically, IHME estimates that 918 ICU beds will be need- ed, but notes that only 329 are available – a whopping deficit of 589 ICU beds.

At peak, Virginia is going to need an estimated 734 invasive ventilators. It is not clear whether Virginia has a ventilator deficit, though based on the ICU numbers, that seems likely. It’s also worth noting that ventilators require a specialist to be properly used, and it’s unlikely that Virginia has enough trained respiratory therapists to meet peak demand.

Given Alexandria’s proximity to D.C. and Maryland, it’s reasonable to assume that our COVID-19 peak will be much closer to theirs in late April than Virginia’s statewide projection of late May.

We don’t think Alexandria is ready for this pending surge.

We base this conviction on a number of factors. Conversations with city leaders make it clear they believe responsibility for COVID-19 testing and hospital bed provision lie with the private sector, non-profit sector and the state government.

Other localities, from neighboring Arlington to counties in rural Indiana, have drive-through testing sites. Alexandria does not. City leaders’ mantra that “Everyone who needs a test can get a test” sounds like a political talking point, not sound health policy.

According to the New York Times, Virginia lags far behind most of the country in per capita COVID-19 testing. Recent articles in the Wall Street Journal posit that widespread testing – not just of those with severe symptoms – is the key to containing COVID-19. New data estimates as many as 25 percent of those infected with COVID-19 are asymptomatic, according to the New York Times.

This means that without significantly increased testing, it’s going to be impossible to contain this virus. Widespread testing and strictly enforced quarantines are what enabled South Korea to minimize the damage from COVID-19.

Unfortunately, decentralization – the very element that makes the United States so politically and economically dynamic – is a great hindrance to our country’s efforts to control the virus. Controls on social interaction vary from state to state, as does pro-activeness at the state and local level in procuring tests, ventilators and hospital beds.

Two governors in particular, Andrew Cuomo (D-NY) and Larry Hogan (R-MD), have set fine examples of leadership in crisis. Field hospitals are being set up in New York City’s Central Park and in Baltimore’s Convention Center. Cuomo just announced yesterday that a private company is providing New York with 500,000 additional COVID-19 tests, and the first shipment is already en route.

The contrast between that proactiveness and the administration of Gov. Ralph Northam (D-VA) in Richmond and Alexandria’s city government is stark. Northam, himself a medical doctor, has been slow off the dime at seemingly every turn.

Alexandria’s city government continues to operate within its business-as-usual mode of silos of responsibility. Leaders seem to not grasp that this is a special case requiring extraordinary action. We need results, not slogans or excuses. Specifically, we would like to hear City Manager Mark Jinks and Mayor Justin Wilson brief the city on how they plan to:

*Work with INOVA Alexandria Hospital to procure a vastly increased supply of rapid response COVID-19 tests. They’re now available from various private labs. This isn’t normally the role of our city government, but that’s not an acceptable excuse. Find the money; make the purchase; get the tests.

*Set up a drive-through COVID-19 testing site on Inova Alexandria’s campus. Along with this set-up and an increased number of test kits, relax the criteria and thus greatly expand testing. Make this the only approved site in Alexandria for COVI-19 testing, if the city legally can do so. This will protect health care workers throughout the city, protect those getting tested and protect the greater population.

*Get a handle on how many COVID-19 tests are being done daily in Alexandria and calculate a percentage of infected to tests. Dr. Stephen Haering, director of Alexandria’s Health Department, told the Times this information isn’t easily obtainable. Jinks needs to divert staff from other functions, develop processes and find this out.

*Based on available projections, estimate how many hospital beds Alexandria will need in a month, and whether we expect deficits in regular beds, ICU beds, ventilators and ventilator technicians. What steps are being taken to procure what’s lacking? Do we have plans for an auxiliary hospital in Alexandria? If not, tell us the city’s plan for regional or state hospital bed sharing.

At this point, we know to stay distant from neighbors and to wash our hands. While we are grateful that our Netflix isn’t going to be cut off nor our cars ticketed for parking four days, what we really need are answers to crucial questions – answers that show Alexandria is ready for the upcoming tsunami.

Break down the business-as-usual silos and get it done.