The Other McCain

"One should either write ruthlessly what one believes to be the truth, or else shut up." — Arthur Koestler

A ‘Granular’ Re-Opening Plan

Posted on | April 17, 2020 | Comments Off on A ‘Granular’ Re-Opening Plan


During the past couple of weeks of daily briefings, Dr. Deborah Birx has popularized the word “granular” to describe how the COVID-19 task force is tracking the spread of the disease. While the news media remain focused on the Big Numbers — the cumulative total of cases and the death toll — those whose job it is to try and control this contagion must pay attention to a series of small-scale pictures: What is causing the increase in cases in one particular county? Are local health officials able to do complete contact tracing on new patients? Does the task force need to move more resources into this region?

During the discussion of when and how to “re-open the economy” (a misleading phrase, because large segments of economic activity have not been restricted by “stay-at-home” orders), the anti-Trump media seemed to be under the impression that a one-size-fits-all approach would be imposed by the White House, which never made sense. There are many parts of the country where rates of COVID-19 infection are still very low, and there is no reason why these communities cannot be permitted to ease restrictions, while at the same time keeping the viral “hot spots” under lockdown orders. For example, in Florida, no one is suggesting that the Miami area should just “go back to business” anytime soon, but it doesn’t make sense to maintain indefinitely the same restrictions in Lakeland and Kissimmee.

If the level of infection, on a per-capita basis, is comparatively low in a community, and if the number of new cases is small enough that each individual case can be contained via quarantine and contact tracing, then a return to something like “normal” life is possible. Of course, there must be measures to protect the elderly and other high-risk individuals, but let me quote something from an Associated Press article:

For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia and death.

That’s from an article about Brazil, whose president fired the health minister this week, but it is a fair summary of what we know: Most people who become infected with COVID-19 are never hospitalized; some are asymptomatic, or nearly so, while a relatively small percentage of those infected develop serious problems which may be fatal. Thursday’s report from Florida, for example, shows 23,340 known coronavirus cases since March 1, of which 3,458 (14.8%) have ever been hospitalized, and 668 (2.9%) have died. Keep in mind, of course, that some unknown percentage of Floridians have actually been infected already, but experienced few or no symptoms, and recovered without ever being tested or treated by any medical professional. So the actual death rate is probably lower than what has been reported, and Florida’s 668 deaths in a population of more than 21 million are but a fraction of the per-capita death rate in New York, New Jersey or Michigan. Letting states and local communities manage their outbreaks, under guidance based on “granular” metrics, is what the Trump plan is about:

President Donald Trump gave governors a road map Thursday for recovering from the economic pain of the coronavirus pandemic, laying out “a phased and deliberate approach” to restoring normal activity in places that have strong testing and are seeing a decrease in COVID-19 cases.
“We’re starting our life again,” Trump said during his daily press briefing. “We’re starting rejuvenation of our economy again.”
He added, “This is a gradual process.”
The new guidelines are aimed at easing restrictions in areas with low transmission of the coronavirus, while holding the line in harder-hit locations. They make clear that the return to normalcy will be a far longer process than Trump initially envisioned, with federal officials warning that some social distancing measures may need to remain in place through the end of the year to prevent a new outbreak. And they largely reinforce plans already in the works by governors, who have primary responsibility for public health in their states.
“You’re going to call your own shots,” Trump told the governors Thursday afternoon in a conference call, according to an audio recording obtained by The Associated Press. “We’re going to be standing alongside of you.”

My guess is that we’ll see a resumption of spring training games in Florida in a matter of weeks. Just keep watching the numbers.



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