2020 | Coronavirus

Montgomery County starts publishing reopening benchmarks

Officials say partial reopening phase could begin in ‘a week or two’

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A chart from Montgomery County's data dashboard shows the trend of COVID-19 related hospitalizations. The data dashboard includes charts that track reopening conditions for the county. All of the data can be found at https://montgomerycountymd.gov/HHS/RightNav/Coronavirus-data.html.

Chart from Montgomery County

Montgomery County on Wednesday started publishing its progress on conditions for reopening after several weeks of widespread closures to stop the spread of the coronavirus.

Maryland Gov. Larry Hogan last week said the state has made enough progress on handling the pandemic that some businesses and community amenities can reopen, as along as social distancing guidelines are used. That limited reopening took effect at 5 p.m. on Friday.

Some jurisdictions in Maryland, including Montgomery County, have been hit harder and are not reopening yet.

Although Montgomery County is not ready to reopen, possibly for at least another week, officials are already considering what reopening would look like as data for cases and other metrics continue to show that the county is moving in a positive direction.

During a media briefing Wednesday, Dr. Travis Gayles, the county’s health officer, said the county is getting closer to meeting some benchmarks it has set as conditions to begin reopening.

“We are making positive strides,” he said. “We’re moving in the right direction. … We’re hoping to be able to open some aspects of phase one within the next week or so.”

A data dashboard with the metrics will be updated daily at noon.

On Tuesday, the county added 533 new COVID-19 cases, a gain of 6%. On Wednesday morning, 102 cases were added, an increase of 1%.

Before Tuesday, the county had 10 days in which the daily increase was 2%, 3% or 4%.

Because of some “outliers” in the data, Gayles said the county is looking at three-day averages to determine trends. The metrics also include the number of days out of the last 14 days that had improvement. The county is saying the criteria “must be met or show substantial progress.”

The county’s data page lists a three-day average for each category. The second part of each line is the number of declining days for that category. The criteria are:
● Number of new confirmed positive cases each day: 282 (three-day average); nine declining days so far
● Number of COVID-19 new deaths each day: 12 (three-day average); nine declining days
● COVID-19 related hospitalizations: 383 (three-day average); 11 declining days
● Number of COVID-19 related emergency room patients: 18 (three-day average); 9 declining days
● COVID-19 related intensive-care unit hospitalizations: 127 (three-day average); nine declining days
● Acute care bed utilizations rate: 75% (three-day average); zero days of adequate capacity
● Percentage of ventilators in use: 54% (three-day average); 14 days of adequate capacity

The county is meeting its goal or showing substantial progress for COVID-19 related hospitalizations and percentage of ventilators in use.

The county has also met its conditions for:
● leveraging health care networks to provide testing to symptomatic and asymptomatic patients
● creating accessible testing options available across the county by using a diverse network of options, including health care providers, alternative test sites, mobile testing units, and others.

The county is making progress in:
● putting networks in place to achieve a testing capacity of 5% of the population per month
● sustained flattening or decrease in test positivity
● continuing current efforts and partnering with the state on state-drive n, large-scale contact contracting efforts that will allow for contacting cases within 24 hours upon receipt of results and identified contacts within 48 hours
● compiling and using data by race, gender, age and geographic location to inform policy decisions related to health outcomes
● ability to disseminate information, programming, and policies that address the impact of social determinants of health on COVID-19 outcomes

Gayles said one measure that the county has not seen as much of a decrease in as it would like is intensive-care unit bed capacity in hospitals.

Four of the six hospitals in the county have had no room for new ICU patients over the last week.

“We want to see that number come down and continue to come down,” Gayles said.

County Executive Marc Elrich said that only 19 ICU beds in the hospitals were available on Tuesday.

“It tells you that if we were to reopen and see a serious uptick in cases … we would swamp hospital capacity and we can’t afford to do that,” he said.

The test positivity rate — the percentage of people who are tested and have a positive result — is 22%. Of the people who are tested, the county’s goal is to have less than 15% of people test positive. The state average is 19%.

An experimental drug called remdesivir is being investigated as a potential treatment for COVID-19. Some of it has started to filter into the county’s hospitals through state and national shipments, Gayles said.

But Elrich said he spoke with one local hospital that reported only receiving enough doses for three coronavirus patients.

“This is where people’s promises don’t match reality,” he said.

Partial reopening

When the county starts to lift restrictions, potentially in the next week, Elrich said, a partial reopening could potentially include allowing curbside retail service, but did not provide additional details.

County officials have not set a reopening date.

“If everybody is focused on a day instead of thinking about what it’s going to take to get to that day, I think it creates more problems than it’s worth,” he said.

Elrich said Hogan asked businesses to take a pledge as a condition of reopening. The pledge includes requirements for surface cleaning, social spacing and mask wearing, he said.

“I think if we can get agreements that these are going to be the conditions … until we get further down the road with this virus, then opening is going to become more possible,” he said. “It’s all dependent on people following the rules. The numbers continue to trouble me a little bit.”

Testing capacity

Gayles told the County Council on May 7 that the county is finalizing a contract with a company to “significantly” expand testing capacity. He said Wednesday that he expects that the testing will be available in the “next day or so.”

The county’s goal is to test 5% of its population every month. It has currently tested 3.4% of its population — close to 40,000 people — and is providing nearly 1,000 tests a week.

The first priority for the expanded testing will be for essential employees and front-line staff members, as well as employees and residents in nursing homes and assisted living facilities.

State teams have scheduled visits to provide testing to 25 of the 33 nursing homes in the county, Gayles said.

Briana Adhikusuma can be reached at briana.adhikusuma@bethesdamagazine.com.