The Atlanta Journal-Constitution
Georgia health workers’ plea to state leadership
Dear Gov. Kemp:
Last week, Georgia set records for new COVID-19 diagnoses and current hospitalizations, and deaths are climbing. Georgia health care workers are increasingly concerned about the direction of the pandemic in our state. Earlier this month, over 1,400 of us wrote you to express our concerns, and today some 2,150 of us write to ask again that you revisit your strategy for combating the virus.
We appreciate that managing the state of Georgia is an enormous task and that you are trying to balance controlling the virus against damage to the economy and the livelihoods of workers. We share your concerns, as economic well-being directly impacts the health of our patients. We firmly believe that if policy decisions are made based on science, economic benefits will follow. Likewise, this pandemic began with a new virus about which we knew very little, and we understand that keeping policies in line with the rapid accumulation of scientific knowledge continues to be a challenge. Now
■ We reached a new peak of 4,813 COVID-19 cases on July 24, and a peak 7-day average of 3,745 on July 24. Prior to your shelter in place order on April 3, the highest number of cases reported per day was 1,085 on March
31. Also, compared to March-April when most cases were in few counties, now cases are occurring in urban, suburban and rural Georgia.
■ Our current hospitalizations have increased substantially since June 13, reaching a new record of 3,188 on July 29 and more than 3,000 patients hospitalized with COVID-19 every day since July 19. Hospitals are increasingly on total or ICU/CCU diversion across the state.
■ Our ICU capacity statewide is strained, with only 12-16% of beds available statewide, and half of hospital regions having 15 or fewer ICU beds available on July 20.
■ Deaths also are moving upward, with 82 reported on July 24, the second-highest daily report ever. We know that deaths lag behind cases and hospitalizations by weeks, and that a strained hospital system also will increase deaths.
■ Our percent positivity for tests has risen as high as 17.1% on July 23, when the ideal is below 5% and a level above 10% raises a red flag. This increasing positivity rate underscores that new cases are a result of worsening community transmission, not simply more testing, and that cases are being missed and their contacts never traced.
■ Due to the sheer size of the outbreak encompassing multiple states, our testing infrastructure is strained and wait time has increased substantially with many individuals reporting that it takes up to two weeks to receive results, effectively eliminating the benefit of contact tracing.
According to the July 14 White House Coronavirus Task Force report that is provided to governors weekly, Georgia is now in the “Red Zone” of states for which more stringent steps are recommended. “Disease trends are moving in the wrong direction in Georgia,” according to the Task Force. Georgia qualifies for “Red Zone” status by having over 100 cases per 100,000 population as well as test positivity above 10%. The Task Force made the following recommendations for Georgia:
1. Mandate statewide wearing of cloth face coverings outside the home.
2. Allow local jurisdictions to implement more restrictive measures.
3. In all counties with 7-day average test positivity greater than 10%, close bars and gyms, require strict social distancing within restaurants, and limit gatherings to 10 or fewer persons.
In addition, the Task Force recommends specific actions aimed at increasing testing access, decreasing turnaround time for tests, intensifying contact tracing, protecting seniors in long-term care facilities, and improving public health messaging about risk of serious disease in all age groups.
JULY 31, 2020
is the time to update policies to align with current science.
Although our current strategy is falling short, the good news is that there are concrete steps that you can take to dramatically curtail the surge without completely shutting down the state. Your actions in April were effective in flattening the curve of cases and preserving our fragile hospital infrastructure. The recent surge of cases associated with decreased social distancing is placing our hospitals at risk again, and aggressive actions are urgently needed.
Here are the troubling facts we now must confront:
with local experts on mechanisms for expanding the capacity of academic and hospital labs around the state, and to collaborate with academic, hospital and public health labs that have capacity out of state. Testing sites must be rapidly expanded throughout the state, and contact tracing must be expanded in collaboration with local communities and reported with transparency, as is done by states such as Oregon.