The one tool that could have the greatest impact in convincing Gov. Jay Inslee and other governors in the United States to relax the most stringent of social-distancing practices to fight the coronavirus pandemic and open up local and state economies is long, thin and topped with cotton or other fibers; in other words, a simple swab.
Public health and elected officials nationally and locally have repeated the message often that what would be most effective in allowing the lifting of social-distancing restrictions would be a coordinated effort of testing, tracing and identification of an infected person’s recent contacts and isolation of those infected or exposed.
Those three steps — in combination with continued vigilance by individuals to reduce the potential for exposure to the virus — would allow most to begin to return to jobs and many of the activities that have been curtailed now for more than a month. Getting anywhere near back to “normal” will require an even higher bar, ample supplies of a vaccine, which is likely still a year to 18 months away.
Yet, several states already have begun loosening those restrictions; the most concerning of which is Georgia, whose governor has allowed restaurants — albeit with precautions — to reopen dining rooms and given the go-ahead for bowling alleys, hair salons and tattoo parlors to again welcome customers.
Inslee, as well, in constant contact with health and economic advisers, is more carefully preparing to lift some of the restrictions under the month-old “Stay Home, Stay Healthy” order. Last week the governor announced that following discussions with building and development groups, unions and others, he would permit more construction projects to resume, with provisions for continued social distancing, use of protective equipment and plans to mitigate any outbreaks.
Monday, Inslee announced many recreational activities can resume as of May 5. Next on the list are elective surgeries, which will depend on an adequate supply of personal protective equipment.
Inslee and his advisers are reviewing several points of data as these decisions are made, he told The Herald Editorial Board last week. Included in the reviews are the day’s number of infections, of positive COVID-19 tests, of hospitalizations for COVID, admissions to emergency rooms for coronavirus symptoms, fatalities and the weekly trends of those numbers. Also consulted among economic figures, the governor said, are numbers for jobless claims in the state, which last week were expected to reach 1 million.
There’s been pressure — ranging from constructive discussions with business leaders to less-than-so rants from Capitol-steps protesters — to hasten the pace of loosening restrictions, but there’s also caution among the state’s residents and a willingness to stay the course of social distancing.
Nationally, polls have generally found as much as 80 percent support for stay-at-home orders, and concern between 66 percent and 71 percent of Americans polled that restrictions might be lifted too soon. Those national numbers are similar to a new statewide Crosscut/Elway Poll, that found that 76 percent believed Inslee’s “Stay Home, Stay Healthy” mandate had worked to control the virus’ spread; 61 percent told the statewide poll that lifting the restrictions too soon was a greater risk to public health than to the economy; 31 percent were concerned that not lifting restrictions soon posed a greater threat of harm to the economy than to public health.
Inslee cited those numbers, but also found support from what some might consider an unlikely ally: “The person who agrees with me most, at least officially, is the Trump administration,” the governor said. “Donald Trump’s guidance to the state of Washington was not to reopen.”
Still, when restrictions could begin to be lifted remains the question on everyone’s mind. Recent modeling from the Institute for Health Metrics and Evaluation has now provided those dates on a state-by-state basis. The schedule, which is based on each state reaching a conservative measurement of one new daily COVID-19 infection per 1 million residents — about eight each day for Washington state — would allow Washington to safely ease social distancing measures by May 28. That’s not as soon as Hawaii or Montana (April 6), but far earlier than, say, Georgia (June 22).
What gets us to the point where restrictions can be relaxed and can remain so until a vaccine is ready, Inslee reiterated, is testing, tracing and isolation. The state, in concert with local health districts already is working to build a team of as many of 1,500 people to handle the task of contact tracing, including some 700 members of the state’s National Guard. Isolation facilities also are being prepared.
What’s still lagging is the testing, specifically testing supplies and materials needed to administer the tests and process the kits.
Just obtaining something as basic as a swab has prevented Washington and other states from increasing the availability of testing. Inslee said the state recently received a shipment of swabs from overseas, but it had to be rejected because of bacterial contamination.
In conversations among Inslee and other governors with Vice President Mike Pence, the federal government has promised more swabs and testing materials. But even if Washington gets its fair share of that allotment, Inslee said, it still would count for only a third of what is needed here. At the same time, Congress has increased funding for testing nationwide in the latest round of the CARES Act. The funding is appreciated, the governor said, but does nothing to increase the available supply of testing materials.
What the United States lacks, the governor said, is a reliable domestic supply of testing materials.
That could be substantially provided through effective use of the federal Defense Production Act, which President Trump has yet to use to its full effect. Even after saying weeks ago he would use the act to compel General Motors to manufacture ventilators through a partnership with the Bothell medical-equipment maker Ventech Life Systems, the Trump administration has yet to place an order for the ventilators, even as that work continues, USAToday reported at the start of the month.
Nor has the act, adopted by Congress in 1950, been effectively used to increase the supply of testing materials. The act authorizes the president to compel businesses to give priority to federal contracts, and as spelled out in a recent Atlantic article, allows the government to induce, coordinate and facilitate manufacture of the materials the country needs.
Trump, a week ago said he would use the Defense Production Act to require an unidentified company to produce 20 million swabs a month. Nothing further has been announced.
As Benjamin Franklin might observe: For want of a cotton swab, the economy was lost.