As Wisconsin sees a steady slowing of new COVID-19 cases, Medical College of Wisconsin president and chief executive officer Dr. John Raymond said the state still has several benchmarks to meet before it can begin reopening business.Raymond has reported updates on the number of new COVID-19 cases in the state and Milwaukee during daily briefings hosted by the Metropolitan Milwaukee Area of Commerce.In order to have a “smart restart” of the economy, Raymond said on Monday, the state needs to see a “sustained reduction in cases” for 14 days, more testing and a greater capacity to trace and monitor COVID-19 cases. On those measures, the state and city have seen improvement over the past three weeks. On Monday, the state posted a 9% growth rate in new COVID-19 cases, while Milwaukee reported an 8.8% growth rate, according to MCW. That’s compared to growth rates of about 30% three weeks ago, when MCW first began tracking the data. The state’s doubling time — the number of days it takes for the number of cases to double — is 7.7 days, while Milwaukee’s is 7.9 days. Those rates have improved since three weeks ago, when the number of cases were doubling less than every three days, according to MCW.Raymond said the improvement on both of those fronts indicates the effectiveness of social distancing, but it isn’t time to relax those practices yet. Data won’t reflect the possible effect of last week’s in-person election and possible loosened physical distancing over the holiday weekend until later this week, he said. “We cannot yet declare victory,” Raymond said. “On the contrary, we dodged a bullet but we must understand that the gun is still pointed at us and that there are more bullets in the chamber.” He warned that when social distancing restrictions are relaxed, there will likely be an increase in new COVID-19 cases and “possibly an overwhelming surge” if the state doesn’t “get the balance right” when reopening the economy. “We can’t relax our vigilance even as we begin to anticipate how we’ll reopen our economy,” he said. Raymond said the state should meet these indicators to safely restart the economy:
Sustained reduction in cases for 14 days (beginning April 12).
Testing availability for all people with COVID-19 symptoms.
Hospitals have the ability to treat all patients requiring hospitalization without resorting to crisis standards.
Adequate PPE available for workers exposed to the public.
Ability to count, trace and monitor COVID-19 cases and outbreaks in real time.
Raymond also said restart of the economy should be done in phases, beginning with “low-risk” sectors of the economy. Once social distancing restrictions are relaxed, businesses and individuals will also likely have to adopt new behaviors, including continuing to use cloth face coverings, adopting alternative greetings, limitations on gatherings over 10, continuing to work from home in some cases and hand washing upon entry of buildings, Raymond told Greater Milwaukee Committee members during a virtual meeting Monday. Gov. Tony Evers also addressed the timing of the reopening of the economy with GMC members.“Many of you are asking when that will happen,” Evers said. “The answer is we just don’t know yet.” Evers said he spoke Monday morning with governors from neighboring states — including Minnesota, Michigan and Illinois — to plan for the reopening of business. “The good news is we have already started planning to get people back to work safely,” he said. But he and public health officials are cautious to assign any dates to when that might happen. Last week, the Wisconsin Manufacturers & Commerce, 18 other statewide business associations and 33 local chambers of commerce called on the Evers administration to create a plan that allows the state’s economy to begin to restart on April 24, when the governor’s “Safer at Home” order is set to expire. Evers has not said yet whether he will extend the order. The chambers noted the significant economic cost of the order, including nearly 300,000 new unemployment claims in March, a more than 50% decrease in retail business foot traffic and a 75% decrease at restaurants. The letter said employers need lead time to get their businesses up and running again. “Utilizing the April 24 expiration of the Safer at Home order as the target date will allow businesses and workers to engage in the planning necessary to relieve the current economic hardship, and importantly, demonstrate to Wisconsin citizens who are struggling that there is light at the end of the tunnel.” During the GMC meeting, Evers stressed that, before reopening, the state needs to substantially increase its testing to identify who has the virus and who potentially has immunity. “We’re going to need lots of testing and we're going to need it soon,” he said. Currently, there are 23 labs in the state running COVID-19 tests, with a collective daily capacity of 3,886 tests, Wisconsin Department of Health Services secretary-designee Andrea Palm said Monday. Health care providers have begun testing more widely, including some people with mild symptoms, as capacity grows. Up until recently, testing has been largely focused on health care workers, hospitalized patients, nursing home residents and first responders. Evers said the state also needs more contact tracers who can identify every confirmed COVID-19 patent and the people they have come into contact with. In recent weeks, DHS has added more than 120 contact tracers to help local health departments. “We’re going to need, frankly, an army of contact ... investigators,” he said. Increased testing and tracing capacity will allow public health officials to respond more quickly to prevent secondary waves or spikes of the virus moving forward, Evers said. David Lubar, chair of the GMC, said the group is committed to finding the “right balance” between mitigating future flare-ups while also being able to reopen the state to minimize the impact on the economy. Several projections indicated Wisconsin would see its peak of hospitalizations and deaths this week. One model suggested it would have been Sunday. Dr. Ryan Westergaard, chief medical office for DHS, said officials won’t know for a while when the peak has occurred. “It would be wonderful if that was true, we very much hope that it was, but the truth is we don't know,” Westergaard said when asked if the peak had already passed. Even if has already occurred, Westergaard said, the state needs to be vigilant about social distancing.“It doesn’t mean that we’ve eradicated or eliminated (the virus)” he said. “We’ve flattened the curve, but we haven’t smashed the curve down to nothing.”According to Wisconsin Hospital Association data, there are 1,400 ICU beds throughout the state, 501 of which are immediately available. In southeastern Wisconsin, there are 632 beds, 222 of which are immediately available. “We have a number of acutely ill patients that have COVID-19 that at this moment is not straining our hospital capacity,” Westergaard said. “But … there is a sustained transmission in the community that means there is a large number of people potentially who are infectious … When we relax Safer at Home, we’re really going to need to zero in and contain those individuals.”Work continues on the alternate care facility at the Wisconsin State Fair Park to provide beds, if needed, for COVID-19 patients in an effort to ease demand on local health care systems caring for high-acuity patients. When built out, the makeshift hospital will have capacity to care for 750 patients. It will be ready to receive patients next week and organizers are recruiting health care worker volunteers to staff it. “This facility is an ‘insurance policy’ to ensure sufficient beds will be available for COVID-19 patients, should the need arise,” said Debra Standridge, the facility’s CEO. Get more news and insights in the March 30 issue of BizTimes Milwaukee:
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