The bar is too high

The governor has entered into a a compact with several other states, regarding how to move toward fewer economic and social restrictions. I have not seen many details yet, but to me, any strategy at this point that relies on widespread testing is one that is not going to be implemented anytime soon, for sheer lack of tests and test processing supplies. Controlling infection and hospitalization rates basically requires continuing the present shutdowns, which is even so only containing the spread to linear growth in Minnesota. Health care systems being prepared for a surge in cases after some restrictions are lifted can only happen if the restrictions are eased very gradually; there has been a lot of back and forth lately on how many people have actually already had the coronavirus, but in general it is clear that the pandemic will go back to spreading exponentially as soon as it is possible for it to do so.  Even with rates of severe illness that are much lower than initially thought, the potential for hospitals to be swamped is very real.

The federal government’s ’sOpening Up America Again plan also takes a slow approach. Before even entering Phase 1, the recommendation is for a declining number of cases, and for the ability to do lots of testing of health care workers. In Minnesota, the former is not going to happen anytime soon. The number of “congregate care settings” with known positives is up over eighty now; I would put that as something like “the brush pile has caught on fire, we have no water, and we’re just going to have to wait for it to burn itself out”. I think it will take at least a month for that to happen, and probably longer.

The next step is readiness for “test and trace”, for hospital capacity to respond—including adequate supplies of protective equipment, and for adequate protection for other workers, mass transit users, and the general public, along with infection monitoring programs. I expect supply issues to persist in these areas for weeks, at a minimum.

Phase 1 tells vulnerable individuals to continue to shelter in place, limits group gatherings to 10 or less, opens most businesses and entertainment venues with restrictions, and (finally) allows elective surgeries to resume. If there is too much of a rebound in cases, it is back to Phase 0.

To enter Phase 2 requires continuing declines in case numbers. Vulnerable people are still isolated. Group number increases to fifty; schools and youth activities and bars can reopen.

With further declines in cases, Phase 3 opens things up most of the way, but with continuing precautions recommended for vulnerable people.