Author Archives: James A. Bacon

Twin Tragedies: COVID-19 and the Northam Administration

Posted on April 1, 2020 | 12 comments

by James C. Sherlock

Communication in this time of crisis has not been a notable strength of either Governor Ralph Northam or his cabinet. I discovered the reason why in the Governor’s press conference today: They are clueless.

The Northam administration’s online communications

The state’s official website as of today has no information about the real time activities of emergency management, about testing availability, about personal protective equipment, or about anything else that matters.

  • As for the Virginia Department of Health (VDH), the last entry on the Health Commissioner’s Blog is dated October 15, 2018.
  • Not a single entry in the media room discusses what the state is actually doing, only what they see happening.
  • Not a word about the functioning of Virginia’s six Health Care Coalitions (HCCs).

No word either about the actions of Virginia’s Emergency Operations Center (VEOC), just that the center is conducting response operations. The situation report tells us nothing about what state officials are doing, how they are doing it or what success they may or may not be having.

The Governor’s April 1 Press Conference

Now for today’s Governor’s press conference. I must report that I am literally stunned. Continue reading →

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Posted in Health Care

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Localities Are Re-Writing Budgets. So Should the State.

Posted on April 1, 2020 | 7 comments

by James A. Bacon

It is obvious to some people that COVID-19’s body blow to the economy will have a devastating impact on state/local government finances. Old Dominion University professors Ron Carlee and Robert McNab have estimated that local governments in Hampton Roads are losing at least $16 million a month in local taxes, while local governments across the state are losing $60 million monthly or more. And the blood-letting is getting worse.

Hotel occupancy and revenues were only 80% of normal levels in early March. By the end of the month, the estimate, revenues were running only 20%. Sales, business-license, hotel & motel, restaurant & food taxes comprise a “vulnerable” category of local government revenue amounting to $637 million in Hampton Roads and $2.9 billion statewide.

Unlike the federal government, the professors write, state and local governments must balance their budgets (unless, I might add, they engage in hidden deficit spending like running up unfunded pension liabilities and falling behind in building and infrastructure maintenance). “It’s not time to panic,” they write in the Richmond Times-Dispatch, “it’s time to prepare.”

Some local governments are acting proactively. Fairfax County and Chesterfield County are among those slashing budgets — including next year’s — in anticipation of declining revenues. Remarkably, Chesterfield is anticipating a decline in revenue sources funneled through the state even though Governor Northam and General Assembly budget writers have yet to re-work the budget passed earlier this year before the full dimensions of the COVID-19 crisis were apparent. Continue reading →

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Posted in Budgets, Health Care, Taxes

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Bacon Bits: Mobilizing Against COVID-19

Posted on April 1, 2020 | 12 comments

NoVa field hospital sites identified. State officials have begun identifying sites to use for field hospitals in the event that an influx of COVID-19 patients overwhelm the capacity of Northern Virginia’s hospitals. The first phases of plans call for adding beds in existing hospitals or on hospital campuses. A third phase would establish new treatment facilities at the National Conference Center in Loudoun County, the Dulles Expo Center in Fairfax County, and the Goerge Mason University campus in the City of Fairfax, according to a briefing given yesterday to the Prince William County Board of Supervisors, as reported by WTOP News. The Northam administration has said it was examining sites with the Army Corps of Engineers, but had not publicly identified specific locations.

Thousands volunteer for medical reserve corps. Virginians can erect emergency field hospitals, but who will staff them? Health providers will be stretched to the breaking point just dealing with COVID-19 patients in regular hospitals. Perhaps members of the Virginia Medical Reserve Corps can helo. As of Tuesday morning, reports the Richmond Times-Dispatch, more than 12,300 volunteers across a variety of health professions had signed up. Of those about 8,200 are deployable, meaning they have had their credentials confirmed. Virginia’s Medical Reserve Corps, established in 2002 after 9/11, operates 27 units across the state.

Making more hand sanitizer. The Appalachian College of Pharmacy, located in Buchanan County, is using its compounding lab to produce hand sanitizer. The college delivered its first shipment last week to Food City for distribution to Food City pharmacies, reports the Bluefield Daily Telegraph. “We told them we’ll take all you can make,” said Food City CEO Steve Smith. “We’ve been out of hand sanitizer for days and have tried different avenues to get it without success.” (Hat tip: Mary Trigiani.)

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Posted in Health Care

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Federal and State Responses to COVID-19

Posted on April 1, 2020 | 10 comments

Duck and cover!

by James C. Sherlock

The federal government’s relationships with state and local governments is defined by the U.S. Constitution. Presidential management of internal national crises is constrained by lack of command authority over the states. No governor works for the President. He cannot order them to do anything, even in wartime. He can take control of industries, but not state governments. If the President nationalizes the National Guard, the Guard loses its ability to enforce state laws or respond to the Governor. And no, I don’t think we need to change our constitution.

The most complete restructuring of the federal government in my lifetime was the creation of the Department of Homeland Security after 9/11 and a complete rewrite of the National Response Plan. Giving birth to that full-grown mastodon was as noisy and bloody as you can imagine. After its birth, it was very awkward for a time. FEMA, now an element of DHS, existed at 9/11 exclusively as an agency that wrote checks upon the Presidential implementation of the Stafford Act. Although all of the plans and programs were restructured in 2002 and 2003, FEMA had that same role when Katrina happened in 2005.

After Katrina, the National Response Plan (NRP) was re-written again. The lessons learned from that tragedy resulted in a major restructuring of FEMA to support a national emergency command center and greatly improve its logistics capabilities, but those logistics capabilities still largely lie with check writing to implement contracts negotiated both before and during crises. Virtually every other major federal agency has a role in federal response coordinated by FEMA with participation of other federal agencies defined in plans specific to the type of emergency. The White House has its own staff to support the president and direct the federal agencies. Continue reading →

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Posted in Disaster planning, Health Care

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COVID-19 Update: Hospitalizations Surge

Posted on April 1, 2020 | 22 comments

Wrong reaction, lady, your hands should not be touching your face!

The Virginia Department of Health has updated its statistics to reflect yesterday’s numbers. The big movers: hospitalizations and deaths, both of which surged 26%.

Total confirmed COVID-19 cases: 1,484, up 234
Total hospitalizations: 208, up 43
Total deaths: 34, up 7
Total tests: 15,344, up 1,943

Here are John Butcher’s latest calculations for the “doubling” rate for key metrics:

Confirmed cases: 3.2 days
Hospitalizations: 3.7 days
Deaths; 2.9 days

The hopeful news is that the doubling rate for hospitalizations shows signs of stretching out. It makes a substantial difference if it takes 3.7 days for hospitalizations to double compared to 3.0 days. A top public health challenge is to “flatten the curve” — to prevent Virginia hospitals from getting overwhelmed with COVID-19 patients at one time.

I question, however, how well the VDH data reflects the reality in hospital wards and emergency rooms. Bon Secours Mercy Health, which operates 11 hospitals in the Richmond and Hampton Roads regions, announced yesterday that it has furloughed 700 full-time employees across seven states and 12 markets, reports Virginia Business. Continue reading →

22 Comments

Posted in Health Care, Uncategorized

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Wanted: Government Informants

Posted on April 1, 2020 | 21 comments

by Kerry Daugherty

Nosy neighbors and tattletales.

They’ve been with us always. And they’ve always been despicable.

When I was a kid a reclusive neighbor – we’ll call her Mrs. Murphy – spent all of her time peering out of her windows. If a kid so much as planted a bare toe on the Murphy lawn her front door swung open and she threatened to call your mother.

Once, when a stray cat had been run over by a car, we kids decided to stage a funeral and bury it in an overgrown vacant lot next to her house.

Old Lady Murphy saw us and called the cops.

Er, cop. We had only one officer in our small town.

Barney Fife arrived in minutes and demanded to know what we were doing.

Once we explained he seemed inclined to let us proceed until Mrs. Murphy roared out, red-faced, with rollers in her hair, hollering that she could smell the dead animal and it was a health hazard. Continue reading →

21 Comments

Posted in Health Care, Individual rights

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Another Call for Face Masks

Posted on April 1, 2020 | 19 comments

Photo credit: AP/Chiang Ying-ying

Should people don face masks when they go out in public? The question has caromed around the Internet with many conflicting opinions. A previous contributor to Bacon’s Rebellion has argued that Virginians should wear them. Contributor Hans Bader agrees. — JAB  

by Hans Bader

You should wear a mask when you leave the house. In East Asia and the Czech Republic, huge numbers of people now wear masks, and that has greatly reduced the spread of coronavirus. Mask-wearing isF a key reason why the virus spread less in East Asia than in Western countries like Italy, Spain, and the United States.

“More Americans should probably wear masks for protection,” notes the New York Times. “Places like Hong Kong and Taiwan that jumped to action early with social distancing and universal mask wearing have gotten their cases under much greater control.” The Times quotes Dr. Neil Fishman, the chief medical officer of the University of Pennsylvania hospital, explaining that “if everyone in the community wears a mask, it could decrease transmission.” Continue reading →

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Posted in Health Care

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Backgrounder: Virginia’s Healthcare Emergency Management Program

Posted on March 31, 2020 | 10 comments

by James C. Sherlock

State emergency operations are personally meaningful to me. Preparation is key. Decisions have consequences. I want this one to go as well as possible.

I spent about a year while under contract to the Defense Advanced Research Projects Agency (DARPA) as director of operations for a program that offered advanced Department of Defense capabilities to the state of Louisiana to improve its real-time emergency voice and data exchange and GPS-enabled visualization capabilities with response agencies across the state. We operated out to the state Emergency Operations Center and performed several successful statewide multi-participant live demonstrations. The people were great. The post-action reviews were very favorable. We finished the demonstration series about eleven months before Katrina. DoD’s offer was never accepted.

So, any words I offer are informed by that tragedy and are well meant.

Virginia Healthcare Emergency Management Program

In an earlier column, we reviewed Virginia’s training and exercise program funded by the Federal Emergency Management Agency. There is a second one. The Virginia Healthcare Emergency Management Program is funded through an annual Hospital Preparedness Program (HPP) grant from the U.S. Department of Health & Human Services (HHS). Continue reading →

10 Comments

Posted in Disaster planning, Health Care

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Note to Readers

Posted on March 31, 2020 | 6 comments

Bacon’s Rebellion is experiencing technical difficulties — or, to be more accurate, our web server is experiencing technical difficulties. The website was down about three hours this morning, and some of the functionality has yet to be restored. The Cloud is far from perfect!

We are aware of the problem, and we’re working on it. Thanks for your patience.

— JAB

6 Comments

Posted in Blogs and blog administration

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Yes, Virginia Does Have a Plan to Fight the Pandemic

Posted on March 31, 2020 | 5 comments

by James C. Sherlock

I have reviewed the Commonwealth of Virginia Emergency Operations Plan, HAZARD-SPECIFIC ANNEX #4 PANDEMIC INFLUENZA RESPONSE[1], August 2012. Such plans are required by FEMA as a predicate for federal funding, so every state and territory has one. Virginia’s operations plan, which follows the FEMA template, is excellent. The lead agency for execution is the Virginia Department of Emergency Management (VDEM).

 The question, as always in emergency response, is pre-emergency training and exercises. FEMA offers every level of both training and exercises and pays the bills, but the states must opt to use them, make sure that the right people participate and correct any readiness deficiencies exposed. Assessments of how and how often Virginia exercised, who participated, the level of rigor and post-exercise corrective actions will wait for post-operation analyses Here follows highlights of that plan. (Text in italics are my editorial insertions.)

Purpose

The Commonwealth of Virginia Pandemic Influenza Response Annex …has been developed to provide a sound basis for pandemic influenza preparedness and to establish the organizational framework and operational concepts and procedures designed to minimize the loss of life and property and to expedite the restoration of essential services following an influenza pandemic. Continue reading →

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Posted in Disaster planning, Health Care

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Ralph Northam’s Power Play: Part Two

Posted on March 31, 2020 | 44 comments

by Kerry Dougherty

This is getting to be a bad habit.

For the second Monday in a row Governor Ralph Northam kicked off the week with a heavy-handed executive order. This one was a body blow to the Virginia Beach economy.

Last week the governor prematurely closed all schools – public and private –  for the remainder of the academic year.

This Monday Northam issued a stay-at-home order for the entire commonwealth and closed Virginia’s spectacular beaches to swimmers and sunbathers until June 10.

(Note: At 10 Wednesday morning, the city issued a correction, that said swimming was not prohibited.)

An absurd 10 weeks from now.

Northam decided to keep his order in place past Memorial Day – a potentially catastrophic move for the Virginia Beach tourism industry – without even warning Virginia Beach officials of the timeline. Continue reading →

44 Comments

Posted in Health Care, Individual rights

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COVID-19 Update: Edvard Munch Edition

Posted on March 31, 2020 | Leave a comment

The latest data from the Virginia Department of Health indicates that Monday saw the biggest single-day increase in the number of new confirmed COVID-19 cases yet in Virginia – 239 cases, bringing the total to 1,250.

The 29 new hospitalizations were the biggest one-day increase yet, bringing the total to 165.

Total deaths increased by two to 27. The number of new tests increased by 1,263 to 13,401 total.

The number of reported new tests has declined three days running from when it peaked at 1,929. Far from administering more tests, Virginia’s hospitals, doctors, and public health authorities appear to be administering fewer. Hopefully, this apparent decline is an artifact of the statistical reporting system, not reflective of real-world shortages in testing equipment or bottlenecks in administering the tests.

Here are John Butcher’s latest calculations of doubling times:

Case count: 3.21 days
Hospitalizations: 3.72 days
Deaths: 2.77 days Continue reading →

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Posted in Health Care

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Don’t Blame Northam for Virginia Medicine’s Structural Flaws

Posted on March 30, 2020 | 20 comments

Governor Northam when announcing stay-at-home order this morning.

by James C. Sherlock

I have to give Governor Ralph Northam a partial pass on a key issue. Much of the criticism directed at him is for actions or inactions that are based on incomplete data and, as a a consequence, incompletely informed staff assessments concerning the business of healthcare in this state. That is a structural problem in state government, not a leadership problem.

The Department of Health is not designed as a crisis action agency and has no authority to oversee Virginia’s healthcare system as an industry. It administers Certificate of Public Need regulations and oversees the practice of medicine, not the business of medicine. No agency regulates that business except in the narrowly focused and demonstrably failed COPN system. There is no such regulation because Virginia’s integrated health systems don’t want their businesses to be regulated, and not any other reason.

Virginia’s Board of Health is not designed or populated to function in a crisis and it hasn’t in this one (See this post from Feb. 22). The public health issues addressed by the Virginia State Board of Health include the prevention and control of chronic disease, not pandemics. Continue reading →

20 Comments

Posted in Health Care, Regulation

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Some Perspective

Posted on March 30, 2020 | 19 comments

I have appended the number of COVID-19-related deaths to a ranking of the leading causes of mortality in Virginia, based on 2017 data, the most recently available from the Centers for Disease Control.

The number of COVID-19 deaths will increase, of course. For purposes of comparison, the Institute for Health Metrics and Evaluation forecasts that Virginia could experience 1,543 deaths — roughly equivalent to the number of drug overdoses.

(Hat tip: Sheila Gunst)

— JAB

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Posted in Health Care

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Neighborhood Narcs

Posted on March 30, 2020 | 26 comments

Getting fresh air is all we have left. Looks like the neighborhood busybodies want to shut that down, too.

by Kerry Dougherty

I always liked the idea of Neighborhood Watch. You know, loosely organized groups of residents who keep an eye on things.

Sort of like homeland security for your street.

We don’t have an organized watch in my neighborhood, but we do look out for each other.

Here’s an example: I remember walking my dogs late one night when I saw a man I didn’t recognize trying to open a neighbor’s front door. It was locked and I saw him duck around the back.

Despite the fact it was after midnight, McKerry the Crime Dog went home, grabbed her phone, woke the neighbors only to learn that the “intruder” was the husband’s brother, visiting from out of town. They’d left the back door open for him. Continue reading →

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