Elections & COVID-19: A Virtual Town Hall

On Tuesday April 28, at 6pm, please join me, State Representative Beth Moore, and Gwinnett County Commissioner Ben Ku, for a public online program entitled “Elections & COVID-19: A Gwinnett Virtual Town Hall.”

Coronavirus has changed a lot of things, including the ways we safely and securely conduct our elections. We’ll  provide you with important updates and recommendations for best practices in the 2020 election cycle. This is a non-partisan event, and all district residents are invited to watch and submit questions.

You can tune in one of two ways:
(1) Watch the Facebook Live broadcast from my Facebook page; or
(2) Listen in by calling (301) 715-8592 and entering Meeting ID 926 3171 1369.

You can submit questions in advance by clicking on this Google Form link.

We’ve Only Just Begun

Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.
–Winston Churchill

The Governor’s About-Face

Almost two weeks ago, a beleaguered Governor Kemp, just back from visiting tornado-ravaged north Georgia, stood in front of the press to address Georgia’s response to the COVID pandemic. He was asked when he thought the economy could open back up. With an overwhelmed expression he said, “On the back side of this we can focus on opening up, but not yet.”

Seven days later, standing in front of the same press, he announced the reopening of businesses including gyms, salons, dine-in restaurants, tattoo parlors, and massage spas — all before the end of his April 30th Shelter-in-Place and May 13th Declaration of Emergency Orders.

Why this About-Face? Was it his phone call with Vice President Mike Pence? Was it his conference call with other southern, Republican governors? Was it the threat of a “Reopen GA Protest” at Georgia’s Capitol? Or was he following his heart and thinking this is the right thing to do?

During times of crisis we need the steady hand of reliable leaders. Instead, Gov. Kemp’s About-Face leaves us feeling like we don’t know what’s around the corner. His premature decision to say “yes” to non-essential massages, tattoos and haircuts, while still telling most of us to stay home except for necessities, makes no sense and does not inspire the kind of trust we need in a leader right now.

Orders for Re-Opening

This week the Whitehouse released “Opening Up America Again,” a very reasonable roadmap for balancing the opening of the economy and the health of Americans, as we wait for a treatment or vaccine to be developed. Even before activating the first of three phases, the report advises certain “gateway” criteria including 14-day declines in flu-like and COVID-19 symptoms and cases, adequate hospital beds, as well as PPE and testing for health workers. Has Georgia met these? No. This question was asked during this week’s legislative conference call with the Governor’s office:

What numbers changed to support the re-opening of Georgia businesses that was announced on Monday? The President’s reopening guidelines include a 14-day drop in cases before re-opening. What is the reasoning in re-opening before this has taken place?

Answer: “As the Governor said in his press conference on Monday, the state is on its way to meeting the gating criteria into Phase 1 of the “Opening up America” plan. We are beginning to see a plateau and slight decline in new case notifications and a decline in total death notifications.

“On its way” doesn’t cut it. Georgia does not meet the guidelines. And don’t be surprised if you see published graphs of declining cases to justify the Governor’s decision. According to the Atlanta Journal Constitution, new COVID-19 cases are now being recorded differently — instead of recording a new case when a test result comes back positive, the case is being recorded according to the date symptoms first appeared. This new way of documenting cases will result in a well-timed and misleading, temporary drop in case numbers. Many of us are relying on data to evaluate potential risks in venturing out — almost like looking at the weather forecast when planning trips. These changes in the numbers leave us feeling vulnerable and confused.

A Salute to Georgia’s Hospitals

Just a few weeks ago, we feared the United States would be “the next Italy” — that people would die because of a shortage of ventilators, and that a medical triage process would choose who lives and who dies. This did not happen in Georgia, due to the hard work of Georgia’s hospitals. Right now, possibly at the peak of our first COVID wave, we have over 900 available ICU units across Georgia. The cancellation of regularly scheduled procedures provided the necessary personnel, equipment and physical space so in-patient beds could be converted to ICU beds. Private healthcare systems worked cooperatively across healthcare systems to share resources, and a system of counting ER, ICU and in-patient beds was developed so the state could plan for the coming surge of patients. It all worked because of the sacrifices of so many people, from doctors who closed their businesses, to the healthcare workers who risked their own health to take care of others, to those of us who were staying home to slow down the spread, allowing our healthcare system the breathing room it needed. These numbers show that as long as there is not a resurgence of COVID-19 cases, hospitals can begin meeting pent up demand for elective procedures and surgeries. “Elective” in some cases means cancer treatments and people who are in disabling pain needing surgery.

April 24 Capacity In Use Available
ICU Beds 3,246 2,329 917
ER Beds 3,430 843 2,587
General Beds 14,727 9,169 5,558

source- Georgia Hospital Association

A Salute to Georgia’s National Guard

Forty percent of Georgia’s COVID-19 deaths are residents of long term care facilities. Over the course of the last three weeks, almost 3,000 soldiers, airmen, and State Defense Force personnel  have been deployed across Georgia to assist in the COVID-19 response. Most of these soldiers make up Infection Control Teams, who have visited 80% of the hundreds of nursing homes and long term care facilities in Georgia, doing deep cleaning, and training local staff on proper disinfection and infection control. General Tom Carden says that Georgia’s use of the National Guard in addressing the state’s COVID crisis is a model now being replicated in other states. Georgia’s National Guard is also assisting hospitals, food banks, school lunch delivery programs, and public health departments.

Does Georgia’s Testing Pass the Test?

Several constituents have been telling me from the beginning that it’s all about testing. Yet Georgia has been slow to get adequate testing rolled out. We’ve been told repetitively that testing will be “ramping” up, yet we continue to test less than 1% of Georgia’s population. In the last few weeks, we’ve slowly climbed from 45th to 43rd in the nation for people tested, as our daily testing numbers increased from around 3,000 to almost 7,000. Questions about testing came up in this week’s Governor’s conference call:

Will the testing the state is doing have both antibody testing and positive/negative test results? More information that we could share with constituents on this topic would be helpful.

Dr. Toomey responded: Initially, the tests that the state is administering are live virus tests run through PCR machines (positive/negative test). At this time, DPH is not administering antibody tests. This test shows exposure to COVID19 and may paint a better picture of the breadth of the virus at a time when access to adequate testing was limited. However, at this time we don’t know if the presence of antibodies necessarily shows immunity. The science isn’t there yet, so we wouldn’t rely on the presence of antibodies as firm evidence that a person is no longer at risk of being infected with COVID.

Dr. Toomey also referred to the CDC’s recent statement regarding the use of antibody testing: “The test is not currently designed to test individuals who want to know if they have been previously infected with COVID-19.”  (FDA letter to healthcare providers, and CDC Serology Testing)

During Monday’s press conference, Gen. Tom Carden was asked about the goals of Georgia’s testing program.

Gen. Carden responded: If you look at the rate of acceleration of our testing program during the last week (how much it has “ramped up”), Georgia is 28th out of 54 states and territories.  We are only limited by the supply of test kits and lab capacity. Our goal is to have enough testing to be able to make data driven decisions. We’re going to test what we can source for. “Trying to test almost 11 million people in the state of Georgia is about like trying to boil the ocean.”

When the press asked about measurable goals, Carden continuedThe top two testing states in the country, Rhode Island and NY, have both been able to test a little over 3% of their populations. Georgia is at 0.71%. I’d love to say Georgia could test 10%, but that’s not realistic. “My goal is to drive it until the system breaks.” 

Wherever the Virus Goes, We Go

Dr. Kathleen Toomey has said repetitively that contact tracing is how we are going to keep this virus under control. Yet she admits that the logistics of setting up a tracing system for a disease that is spreading so quickly through the population is not something that anyone in our current public health system has experience with. One constituent told me recently that he was exposed to the virus in early March through the wife of one of the early COVID patients. He was never contacted by public health, even though a contact tracing program was supposedly up and running.

What is the state’s plan for getting contact tracing up and running?

Here is Toomey’s response: The DPH is finalizing its plans for substantially increasing their capacity for contact tracing by significantly increasing staffing through partnerships with our higher education institutions and leveraging technology through a partnership with Google – more details will be shared in the coming days. It will take a village. Every public health epidemiology team will serve as incident commanders. We will have videos to train staff in the districts, to train volunteers. Other states built teams using Master of Public Health students, and medical students who are not currently in classes. When a person is newly infected, we will reach out, talk to them, find out with whom they were in contact and where did they go? We will address the exposures. In the past, we have done this manually with staff. Now with the wonder of Google technology, a computer based app is being finalized. It will be customized to our own needs. This is the priority in months ahead. This is how we keep spread from occurring even as we open up the economy. 

Four Week Chunks

So if we are just now approaching the end of the beginning, what’s next? I think we continue to protect ourselves and our healthcare system while we evaluate the impact of the Governor’s decisions the best we can. I’m carefully tracking hospitalization data because I feel it’s a pretty good measure of virus activity, and it’s not easy to manipulate. This data indicates we may have reached a plateau, and conference calls with major hospital systems support this data. For the most part, hospitals are reporting that they are discharging the same number of people they admit each day.

I told my kids, who are wondering if they will have in-person college classes in the fall or not, “you need to plan, then make contingency plans.” My friend Michael Murphy-McCarthy said, “I do well with four-week chunks.” Let’s see where we are in a few weeks, then we’ll ask “what’s next?” once again. In the meantime, check on your neighbors, donate to your local food bank if you can, and do whatever makes you feel good, within limits, of course!