Wisconsin is losing ground in the fight against COVID-19, and residents’ adherence to physical distancing and masking today will determine the state’s ability to contain the coronavirus’ spread through 2020, public health officials say.
But as warm weather draws people out of their homes and into their typical summertime activities, the communal commitment to COVID-19 precautions is waning, according to Dr. John Raymond Sr., president and chief executive officer of the Medical College of Wisconsin.
“Absolutely there should be more concern,” Raymond said. “People have relaxed their diligence very significantly over the last month. And I think we need to take a look at what’s happening in states that had the beginning of their surge of new cases a month ago. I would say look at some of the states like Texas, Florida and Arizona and their major municipalities, in particular Houston, Miami and Phoenix. All were doing pretty well back in May and are not doing well now.”
While many may be bracing themselves for a “second wave” of COVID-19 in the fall or winter, Raymond noted Wisconsin hasn’t yet cleared the first wave of the coronavirus.
“We haven’t controlled the first wave,” he said. “So the waves, so to speak, are going to blend together. … I would say we actually need to worry more about controlling the first wave than we need to worry about a second wave.”
As of early July, Wisconsin had one of the highest COVID-19 reproductive numbers in the country (1.28) – a key indicator of the transmissibility of the coronavirus. At press time, Wisconsin’s reproductive number had been over 1 – meaning each existing infection causes more than one new infection – for 19 consecutive days. The state previously saw a 16-day stretch during which the rate was under 1.
“Cases are rising faster than the numbers of tests reported. In fact, we’ve had almost 17,000 new cases in Wisconsin since Memorial Day,” Raymond said. “And our reproductive number, which is a measure of the contagiousness of the disease … has risen.”
A combination of factors – including summer holidays, warm weather, the overturning of state and ending of municipal stay-at-home orders, the opening of bars, and protests – has likely contributed to the uptick, Raymond said.
[caption id="attachment_508766" align="alignnone" width="1280"] Dr. John Raymond Sr.[/caption]
Following the state Supreme Court decision to throw out Gov. Tony Evers’ “Safer at Home” order on May 13, municipalities and counties have begun reopening – with some lifting restrictions more incrementally than others. At press time, the city of Milwaukee is in phase 4 of its reopening plan, which allows retail stores, bars and restaurants to operate at 50% capacity and grocery stores to operate at 75% capacity. The city’s progression to the next phase is based on the number of COVID-19 cases in the city, testing and contact tracing capacity, hospitalizations and hospital capacity, and PPE availability.
Meanwhile, following the overturning of “Safer at Home,” the Evers administration’s ability to institute statewide coronavirus-related restrictions is curtailed.
“Unfortunately, the reality is that the Supreme Court ruling and the Republican lawsuit really hamstrung our ability to respond to this pandemic,” Evers said during a recent call with reporters. “That’s why we continue to ask for your help. Public health is everyone’s issue and overcoming COVID-19 is on every community, on every age group and on every Wisconsinite.”
While younger people – a group that is less likely to experience severe symptoms or require hospitalization – are driving many of the new cases in recent weeks, asymptomatic or less symptomatic patients still could cause spread to their more vulnerable co-workers, friends and family members, Raymond said.
If people continue to relax their physical distancing and masking practices, the state can expect to see its hospitals begin filling up in four to six weeks, as they have in other states, he said.
“We might not see that increase until early to late August,” he said.
While the number of COVID-19 patients has not exceeded hospital bed and ICU bed capacity in Wisconsin to date, the onset of seasonal influenza in the fall will put an additional burden on area health systems.
“The seasonal flu starts in the fall and goes through the early winter,” Raymond said. “And we often fill up hospital beds with people who are sick with the flu. So it may complicate matters for us, first and foremost, by straining our hospital capacity. And secondarily by making it more difficult to diagnose or discern between the flu and COVID-19.”
But in many ways the state is in a better position to handle COVID-19 than three months ago. Daily statewide COVID-19 testing capacity is up to more than 19,000, with 80 labs running diagnostic tests. That is expected to grow in the coming weeks, Raymond said.
Hospitals have learned how to create internal surge capacity for COVID-19 patients, if it’s needed, and how to better triage and treat COVID-19 positive patients.
Also by the fall, a validated saliva diagnostic test for COVID-19 could be available, which is a less uncomfortable alternative to the current nasal swab option.
Several “relatively well-validated” vaccines could be available as soon as the end of the year, but there will likely be challenges in deploying them, Raymond said.
Under ordinary circumstances, it takes an average of about 12 years to develop a vaccine and bring it to market in the United States, he noted. Developing and deploying a vaccine within 12 to 18 months of the release of COVID-19’s genetic sequence in January 2020 – as is currently projected – would be a “remarkable achievement,” he said. But it also requires an acceleration of vaccine candidates’ pre-clinical studies, clinical studies, safety testing and manufacturing process.
“If we do get a vaccine, I think that there will be some legitimate concerns about safety and many people who normally would agree to take, say, an influenza vaccine won’t agree to take it,” Raymond said. “There will be ethical issues about whether we can make the vaccine available for children or not, at least for the first phase. And you’re already seeing a very significant ramp-up of the anti-vaccination organizations. That will also come into play.”
While people are experiencing “lockdown fatigue,” physical distancing, wearing a mask outside the home and hand washing remain the best lines of defense against COVID-19, he said.
“Masking works,” Raymond said. “We should all be doing it, whether it’s voluntary or mandatory. It’s just the right thing to do. If we care about our neighbors, if we care about our family and our loved ones and our communities, everybody should be wearing masks when they leave home.”
To reach herd immunity for COVID-19, about 70% of the population would need to be immune. That would take years to achieve without a vaccine, Raymond said.
As planning amid the uncertainty of the coronavirus creates challenges, business leaders might be better served by making shorter-term plans.
“If the outlook is 12 to 18 months (for a vaccine), there are certain things when you adapt, you’re going to take and capture and use hopefully forever, and there are some things you’ll only do in the short-term,” said Jerry Jenessa, co-founder and partner of Stuck LLC. “... It might be better to have a shorter-term view, where you may only be looking out 12 months to 18 months, versus doing 3- to 5-year planning.”
Whether working off a long- or short-term plan, Jendusa recommends executing on them in 30-, 60- and 90-day increments, and continually monitoring progress on those goals.
While businesses may want to mitigate risk and tread cautiously through the end of the year, it could be an opportune time to make smart hires, he said.
“There’s a lot of talent that’s available,” Jendusa said. “It seems almost counterintuitive because if you’re looking only at financials and trying to do things to risk mitigate and preserve cash, one might not necessarily be in a hiring mode. But people make all the difference in the world, and if you can find some talent that will allow you to innovate and grow and pivot, you can leverage that talent to navigate through challenges.”
Now’s the time to add team members in the area of business development, innovation, engineering and technology-driven solutions, he said.