Decline in new cases a key to reopening - Albuquerque Journal

Decline in new cases a key to reopening

Most shops in the Laramie Square mall, at San Mateo and Candelaria NE, have been closed since Gov. Michelle Lujan Grisham ordered restrictions on nonessential businesses. (Jim Thompson/Albuquerque Journal)

Copyright © 2020 Albuquerque Journal

SANTA FE – Gov. Michelle Lujan Grisham hasn’t set a target date for when she believes it will be safe to reopen more of New Mexico’s economy.

But guidelines issued by the White House and Johns Hopkins University offer a few clues about what to watch for.

One of the standards, for example, suggests phasing in a reopening of businesses after a decline in new cases over a two-week period – a standard New Mexico doesn’t appear to meet yet.

The number of new cases announced Wednesday, in fact, represents the biggest single-day surge so far.

The federal and university guidelines, however, don’t answer a key question – whether to allow certain counties or regions of New Mexico to open earlier than others. Instead, the White House and Johns Hopkins each leave that decision to a governor’s discretion.

About 20 of New Mexico’s 33 counties either haven’t reported a virus case in the past two weeks or have so few cases that it’s difficult to discern a trend. Most are sparsely populated, but they also include Los Alamos, Lincoln and Taos counties.

Lujan Grisham, a Democrat and former state health secretary, has repeatedly rejected the idea of opening some counties but not others.

Transmission of the virus doesn’t heed county lines, she has said, and the rapid growth in McKinley and San Juan counties demonstrates how easily the virus can spread in areas far from the state’s most populous cities.

“The fight against (COVID-19) is the same in every part of the state, whether there are 3 positive cases in a certain community or 300,” Lujan Grisham said in a tweet Wednesday. “Three cases becomes 300 very quickly.”

Republican state legislators and others critical of the governor’s public health orders, meanwhile, say the state shouldn’t impose a “one-size-fits-all” restriction for New Mexico, especially when some counties haven’t reported even one case over the past two weeks.

“We ought to follow the data,” House Minority Leader James Townsend, R-Artesia, told reporters in a conference call this week. “That’s what everyone wants – to be treated fairly.”

Comic book store Astro Zombies, 3100 Central SE, has been closed for weeks amid public health orders implemented to slow the spread of COVID-19. (Jim Thompson/Albuquerque Journal)

Other criteria

Case counts are just one standard outlined by the White House and Johns Hopkins’ Center for Health Security.

Adequate supplies of personal protective equipment for health care workers, robust testing to monitor the spread of the disease and the capacity to carry out contact-tracing investigations are also suggested criteria.

Human Services Secretary David Scrase suggested Wednesday that New Mexico could reach its targeted conditions for relaxing some restrictions within the next two to three weeks.

“We believe that if New Mexicans continue to practice the same level of social distancing that they have been, that we will reach our proposed gating criteria for disease spread, testing, contact tracing and isolation, and hospital capacity and PPE within the next 2-3 weeks,” he said in a written statement.

Neither the White House nor Johns Hopkins offers a black-and-white formula for when it would be safe to reopen a state or region.

The Johns Hopkins’ guidelines – authored by professors, scientists and Dr. Scott Gottlieb, a former head of the Food and Drug Administration under President Trump – suggest that governors work with public health professionals, hospital leaders and mayors to assess when to proceed to a phased-in reopening.

“Recognize that the desire to get back to normal as quickly as possible is a common reaction in the catastrophic context, and it is an impulse worth restraining,” the authors urged in a 23-page document outlining their guidance to states.

The White House-issued Guidelines for Opening Up America Again also grant discretion to governors. They suggest “where appropriate” that governors work on a regional basis to satisfy the opening criteria.

The federal guidelines say they can be carried out statewide or county by county, at a governor’s discretion.

“State and local officials may need to tailor the application of these criteria to local circumstances (e.g., metropolitan areas that have suffered severe COVID outbreaks, rural and suburban areas where outbreaks have not occurred or have been mild),” the federal guidelines say.

No decline in new cases

New Mexico hasn’t yet had a decline in new daily cases.

One of the White House standards calls for a “downward trajectory” of documented cases or percentage of positive tests over a 14-day period. The Johns Hopkins criteria is similar but slightly more strict, with a suggestion to wait until the “number of new cases has declined for at least 14 days.”

A statistical model crafted by a team at Los Alamos National Laboratory estimated a 51% chance earlier this week that New Mexico was already past the peak in daily new cases.

The daily case counts reported by New Mexico health officials are still bouncing around, fluctuating based on how many tests are administered and whether laboratories report full results each day. But six of the highest single-day case totals have come since April 22.

The state announced 239 new positive tests Wednesday, the largest number in a day so far. About 7% of the new test results announced Wednesday were positive, 2 percentage points higher than the day before.

Lujan Grisham and state health officials have described the trend as a flattened curve, meaning New Mexicans have succeeded overall in slowing the growth in new cases. But the governor hasn’t characterized it as a decline.

Tracking individual counties is difficult, because the state often adjusts the numbers afterward to remove duplicate totals or make other changes.

But about 20 counties have had no or a minimal number of cases over the past 14 days.

On the other hand, the totals can climb quickly. Socorro County had no reported cases for three consecutive days earlier this month, for example, and then jumped to 11 in a single day. The number declined again after that.

Patience urged

Rep. Deborah Armstrong, an Albuquerque Democrat and chairwoman of the House Health and Human Services Committee, said she hopes the public will remain patient. She is sheltering at home with her 91-year-old mother and her daughter with advanced cancer.

New Mexico is making progress on testing and health care equipment, Armstrong said, but it’s best to proceed cautiously.

“I don’t think any of us really want our parents, our siblings, our kids – those who are vulnerable – to be given a death sentence,” Armstrong said.

Republican lawmakers, in turn, continue to push for a limited reopening in parts of the state. Four GOP legislators from Roswell delivered a resolution to the Governor’s Office on Wednesday making their case.

Rep. Greg Nibert, R-Roswell, told reporters this week that many small businesses won’t survive if the closure of nonessential businesses remains in place, pushing the state to the brink of a depression.

But business owners and customers are willing to abide by social distancing instructions, he said, to get the economy moving again. It’s clear that some parts of the state haven’t been hit as hard, Nibert said, making it reasonable to craft locally tailored solutions.

“We’re on the precipice of a real economic collapse in our state if this goes on longer,” Nibert said.

Lujan Grisham’s plans for reopening should become clearer Thursday. She has scheduled a public briefing to explain her decision to extend the state’s public health orders through May 15.

But she hasn’t ruled out modifying the orders.

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