Looking at the skyrocketing number of COVID-19 cases in Georgia is like staring down the barrel of a gun.
No, make that a rocket-propelled grenade. Things are getting so much worse so quickly that it is apparent that the state’s approach to controlling the epidemic is not working. Yet, what did the governor do? As we reach 3,000 deaths, he extended the current guidelines for another 5 weeks and even loosened them by allowing live performance venues to reopen and conventions to occur. Cases have risen by 245 percent. This reminds us of the definition of insanity: when you keep doing the same thing and expect a different result.
Doing what we have been doing brought us to an all-time high number of new cases — 2,886 in one day. These new cases are not due to increased testing. We see higher percentages of positive cases among those being tested, and testing is still quite limited. Testing does not produce new cases, and testing does not produce hospitalizations. The surge is the direct result of continuing transmission. It began after the state “reopened.” It is insane and profoundly irresponsible to think that continuing on the same path is going to stop this pandemic or preserve our state’s economy. We know more now about the science of the disease, we have more clarity around what it will take to reduce transmission, and we know that taking action just one week earlier in March could have saved 36,000 U.S. lives. yet our fellow Georgians are falling ill at higher rates than ever before. And we don’t require even the most basic measures of prevention, masks.
The problem is not individual behavior; it is the governor’s failure to align economic opening with protection of Georgia’s citizens from getting COVID-19. The approach is not working. The balance is off. The current strategy is costing lives, especially those of minority groups and the elderly; and it may well backfire as we lose more lives. It may give us a third wave, and a fourth, and more.
Ideally our governor would quickly collect the data that would show the results of the state’s reopening efforts so far and he would quickly modify policies accordingly. The data about what exactly has led to the surge are incomplete, however. We have a system whose parts are not working well together. Paul Batalden, a pioneer in healthcare improvement, told us that “Every system is perfectly designed to get the results it gets.” Our current policies and our practices are working to produce this COVID-19 surge. But we can do much better. There is no shortage of scientific expertise that the governor could tap into. Other states are doing better.
The issue of school openings highlights the urgency of a more coherent strategy. We have 6 weeks to get this surge under control if we want our kids to be able to go back to school safely. Because everything we do affects the system, our failure to wear masks and stay at home today means our children will not be able to go back to school a month from now. Not being able to open schools, again, hurts those who are already the most vulnerable, whose parents aren’t home to help and who don’t have access to the internet or technology for learning. With our current approach to COVID-19, we are failing the next generation of Georgians and creating a challenging path ahead.
So what to do? First, in the absence of clear leadership from the national and state levels, we need counties and local government to step up and supply the leadership, information and direction that is lacking — to step up their work on testing, isolation and contact tracing as well as policies requiring face coverings in public. One very serious complication in Georgia is that the heads of county health departments are not county employees — they are state employees appointed by and reporting to the state public health commissioner. They may be reluctant to step up and be distinct from their state counterparts or supervisor. In many places, the failure of our state public health officials to do their job is forcing school leaders and others to do their job for them. These times call for bold action and leadership. Atlanta’s mayor Keisha Lance Bottoms and leaders of several other cities and counties in Georgia have stepped up and made the wearing of masks mandatory. The lives and livelihoods of their communities depend on it. This is also their opportunity to show they are hearing the message of recent Black Lives Matter protests and to do better addressing an issue so closely tied to the legacy Black people carry.
Second, we need leaders of all types to step up. We need leaders from the business community to acknowledge we need evidence-based policies so that they can reopen safely and sustain a stable workforce. Georgia is also rich with performance artists and celebrities. We have faith, non-profit and academic leaders. Let’s mobilize them to get the message out, loud and clear through every means possible about the importance of wearing masks, compulsively washing hands and the absolute importance of social distancing. This kind of community- and business-based leadership can help us address the pandemic in a way that leaves politics out and empowers people as vital members of their communities. Who knows, maybe the governor will even get the message and make masks and social distancing mandatory. Maybe he will even get the message that doing the same old thing and expecting a different result, well, that’s just plain crazy.
Mark L. Rosenberg, M.D. is an epidemiologist, infectious disease physician, and psychiatrist. He is president emeritus of The Task Force for Global Health and a former assistant surgeon general. Julie Rosenberg is deputy director of the Global Health Delivery Project at Harvard and an Assistant Director at Ariadne Labs in Boston. She is Mark Rosenberg’s daughter.
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