by James A. Bacon
As Governor Ralph Northam ponders the details of a statewide order mandating Virginians to wear face masks, he might do well to consider the latest COVID-19 data in his deliberations.
A record number of test results, 11,609, were incorporated into the Virginia Department of Health COVID-19 database yesterday and published on the VDH dashboard this morning. (Only one day, May 1, saw a higher number, and that reflected a major change in reporting methodology.) This is the first time that Virginia has met Northam’s professed goal of a minimum of 10,000 tests daily.
Only 495 new COVID-19 cases were confirmed, the lowest number in more than a month. The percentage of positive tests fell to 4.3%. That was the lowest since March 18, before COVID-19 had reached epidemic proportions. Northam has cited evidence of declining positive-test ratios as an indicator for loosening his Vulcan Death Grip on Virginia’s economy.
But Northam appears to be committed to issuing a mask-wearing edict “especially for individuals going into businesses.” The only thing holding him back is that some issues remain unresolved. One is the “equity” implications of a mandate. Said he: “We want to make sure everyone has access to a mask.” In other words, he wants to ensure that members of poor and minority communities are not prevented by their inability to obtain masks from entering places of business. Another issue, he said, “We also want to talk about how we enforce that.”
One might legitimately as whether the Governor personally sees any efficacy in face masks, given his recent maskless appearance on a Virginia Beach boardwalk in close proximity to other beach goers. (See Steve Haner’s commentary here.)
More to the point, using the Governor’s own criteria and the latest VDH data, there appears to be less justification for a statewide mask mandate than ever before. The virus in Virginia continues to recede.
Let’s review the key metrics:
The number of new confirmed COVID-19 cases: 495, lowest since April 20.
Percentage of new confirmed cases: 4.3%, lowest since March 18.
The number of new hospitalizations: 33, the lowest since April 27.
Total COVID-19 patients in hospitals: 1,351, the lowest number since April 21.
The number of deaths: 12, the third lowest since April 14. Of those deaths, ten occurred in long-term care settings. That means only two deaths occurred from the general population. As I have said repeatedly, using the most important of all metrics, mortality, COVID-19 is mainly a nursing home epidemic.
In the context of requiring masks in business settings, consider these data points.
Total outbreak cases originating in “congregate” settings: 1,328, or 3.7% of all COVID-19 cases.
Total outbreak deaths originating in “congregate” settings: 19, or 1.6% of all COVID-related deaths in Virginia.
“Outbreaks” refer to incidents in which 10 or more people in the same setting contract the virus. “Congregate settings” refers settings where large numbers of people congregate in the same venue. The category excludes long-term care facilities, jails and prisons, healthcare facilities, and educational facilities, which VDH tracks separately. It includes everything from business conventions to musical performances, places of worship to places of work. Places of employment and commerce sub-sets of this larger category. These data points do not include smaller-scale spreading incidents and, therefore, cannot be regarded as a complete accounting of virus transmission in these settings. This is a far-from-perfect indicator of the prevalence of viral spread in places of business but it’s the best we’ve got.
I can find no data published in the Virginia Department of Health dashboard to single out places of commerce and work as locations where the virus spreads. Perhaps the Governor has access to data that the public does not. Hopefully, he will share it when he announces his mask mandate.
What we do know for certain is that long-term care facilities are associated with 59% of all COVID-related deaths in Virginia. (The percentage has been even higher in recent days.) If the public health goal is to save lives, then the Northam administration should focus on containing the disease in nursing homes. To paraphrase Willie Sutton, who said he robbed banks because that’s where the money was, nursing homes are where the deaths are. Getting tangled up with the mandating of masks, fretting over the equity implications, and devoting brainpower to figure out how to enforce an unenforceable public health mandate will yield incremental benefits at best and distracts from the much larger problem.
Whatever the Governor decides, I plan to continue wearing a mask. At 67 years of age I have no co-morbidities that would elevate my personal risk, but I don’t want to become an unwitting, asymptomatic carrier of the virus. I interact with two individuals older than 90 who, by virtue of their age, are at elevated risk. Wearing a mask is my personal choice based upon my personal circumstances. However, I am leery of a statewide mandate that would ignore local conditions and personal circumstances. I look forward to seeing the details of the Governor’s mandate and the reasoning behind it.
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