Wise or Unwise?

COVID-19 Cases Spiraling in Reopening

The discovery of new coronavirus cases is spiraling and more virus-related deaths are reported in Oklahoma even as the governor goes forward with his plan for reopening businesses.

Gov. Kevin Stitt has referred to his plans as a phased reopening, but it is a plan that goes beyond what the federal Centers for Disease Control has recommended.

The governor has said if his plan results in the overburdening of hospitals with new coronavirus cases, he will order a roll back of the plan.

But the CDC plan calls for states to begin reopening once they have begun to show a marked decline in new cases.

Hospitalizations, meanwhile, are still in line with models that predicted the state has already reached its peak. 

And a key official said last week that the main focus as the state reopens will be testing and tracing potential cases.

“The key to reopening Oklahoma is going to be the state’s plan underway to continue to expand testing and to ramp up contact tracing,” Aaron Wendelboe, interim state epidemiologist, told The Oklahoman.

“These efforts allow us to rapidly communicate with Oklahomans who have a positive test and their contacts to either isolate those with symptoms or quarantine those with a known exposure to a positive-COVID case.”

The Oklahoma Department of Health reported last week that there were 127 new confirmed cases of COVID-19.  That was the largest one-day increase since April 9, when cases rose by 160.

Deaths rose by 21, the largest single-day increase, but only five were within 24 hours of the report.

Total hospitalizations rose from 307 on Friday to 346 on Monday but dropped to 298 on Tuesday of last week.

Day-to-day totals related to the pandemic have varied considerably over the past few weeks, and some data is affected by reporting lags, particularly during the weekend, meaning there are sometimes spikes early in a week.

“The total number of people hospitalized with confirmed COVID-19, as well as persons under investigation with COVID-like symptoms peaked at 560 on March 30 and the overall trend has continued to decline since then,” a spokesman for the governor said last week.

“The governor is continuing to watch the data, but the trend has been positive over the past three weeks.”

Hospitalizations were at 370 on April 15, which, according to the Institute for Health Metrics and Evaluation was Oklahoma’s peak day for the utilization of hospital beds and personal protective equipment.

A state model developed earlier this month by Mr. Wendelboe, with help from the University of Oklahoma and Oklahoma State University, predicted the state would reach its peak hospitalization on Tuesday of last week.

Whether the state has peaked in any category is unknown.

Gov. Stitt announced two weeks ago that he is planning for a phased reopening in early May of businesses deemed non-essential, which are supposed to be closed statewide. 

He and his task force have also planned for weeks for an expected surge in hospitalizations.

A spokesperson for the state health department said Tuesday that the state “has been performing much lower on hospitalizations than IHME has been forecasting. 

The state’s goal has been to be prepared for any scenario, and the state is adjusting its plans as we acquire new data points every day.”

Mr. Wendelboe said, according to The Oklahoman, that the health department is developing a new model.

“Currently, my team of expert modelers and I are working to update and adapt the state’s COVID model according to our access to real-time data on Oklahoma residents,” he said.

“No modeling is going to be the silver bullet as we are in uncharted waters with this global pandemic, but the state is confident in the data we have in hand and how we are continuing to look and adjust our forecasting.”

The White House issued guidelines last week for states to reopen businesses with benchmarks for establishing readiness. 

Included are downward trajectories over a 14-day period in confirmed cases or in positive tests as a percentage of overall tests.  Robust testing of health care workers is also a benchmark.

Dr. Dale Bratzler, a professor at the University of Oklahoma Colleges of Medicine and Public Health, said.

“If you look at the president’s guidelines, they say a steady reduction for at least two weeks in the number of cases–and that’s part of what compelled me to look at the data through Saturday [of last week], which showed we were flat, but we weren’t going down.”

“I think over the next week,” he said, “we’re going to know pretty clearly if this trend continues and if it is really going down.”

Linda Thompson, an immunology researcher at the Oklahoma Medical Research Foundation, noted that the increase in confirmed cases could reflect the increase in testing.  The White House guidelines allow for that by pointing to positive tests as a percentage of overall tests.

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