Tag Archives: COVID-19

Virginians Hit the Sauce

By Peter Galuszka

Virginians are stocking up on spirits, fearing that the ABC store system might shut down because of the coronavirus pandemic.

Last week saw sales of $30.1 million up from $4.5 million the previous week. While big, the volume has not surpassed the holiday seasons last year.

For days, there have been rumors that ABC stores would shut down.

Not so, says the ABC system. They are changing store hours to open at noon and close at 7 p.m., seven days a week

So far, one store in downtown Richmond has been temporarily shut down because an employee tested positive for the virus.

Governor Ralph Northam, hoping to ease the financial pain of restaurants now closed to dining inside, has urged them to ramp up their takeout and delivery sales by letting them include wine and beer.

There had been talk that cocktails might be included, but the ABC says no.

A local ABC store employee told me that there are big runs on large bottles and there are some shortages but generally, the delivery system seems to be working. ABC also offers online sales.

Among the best- selling brands are Jack Daniel’s Tennessee Whiskey and Tito’s vodka.

Bottoms up!

COVID-19: More Everyday Heroes…

Beech Tree Elementary to the rescue! When Beech Tree mother Van Nguyen heard about the shortage of medical face masks, she put her sewing skills into action and produced 20 masks. Local medical professional pleaded for more. Then Beech Tree 5th grader Caroline joined the effort. Learning how to sew from her mother and YouTube tutorials, she has completed three face masks and has 30 more in production, reports the Fairfax County Public School community relations staff.

Scanning for fevers, donating masks. Based on its experiences dealing with the COVID-19 situation in China and Singapore, Micron Technology, which operates a semiconductor manufacturing plant in Manassas, is using noninvasive thermal scanners to determine if entering employees have a fever.  Sick employees can be told to return home. The company responded early to the epidemic, increasing site-cleaning rotations, making changes to cafeteria serving, and restricting large gatherings. The company is sharing its experience with other major employers across Virginia — and joining other firms, such as Huntington Ingalls, the Newport News shipbuilder, in donating personal protective gear to healthcare workers, reports Stephen Moret, CEO of the Virginia Economic Development in a recent communication to economic development partners.

Another $1 million for tests. The Charlottesville-based Quantitative Foundation has donated $1 million to UVA Health to accelerate the number of tests performed by the health system from 200 daily to more than 500. The grant provides for putting aside a portion for inpatients at other Virginia hospitals and for clinical providers and first responders with symptoms. Prior to the deployment of UVA Health’s in-house testing, patients were waiting five to nine days for results. Thanks to the UVA Health’s ability to produce its own tests, local turnaround time has been cut to 24 hours.

A limited number of trained personnel has constrained the ability of UVA Health to administer tests. The hospital system’s lab is using the grant to add a new lab tech position. That, in addition to the current cross-training of existing laboratory personnel, reports UVAToday, will allow testing in a second shift. The funds will also be used to order a second robotic instrument which, when installed, will further increase capacity.

— JAB

COPN’s Deadly Quid Pro Quo

The Arlington hospital referral region had the highest ICU capacity gap in the country in this 2018 American Hospital Association survey.

by James C. Sherlock

The Northern Virginia Community Hospital in Arlington was bought by HCA in 2002.  The Arlington facility was closed in 2006 to comply with a 2005 Certificate of Public Need (COPN) decision that required HCA provide “trade-in” beds in the same health region to gain state permission to build a hospital in Loudoun County. (See this Washington Business Journal story. You will see that the business press knew the deal back in 2002.)

Regular Virginians have to ask why in the world HCA was required to buy and close the Arlington facility to build 30 miles away in Loudon County. And why in the world was the state involved in such a business decision in the first place?

In approving that application, the Health Commissioner reversed the recommendation of the DCOPN staff. We don’t know the reasoning for either the staff recommendation or the Commissioner’s reversal. Was some formula used? Why did Arlington, with its population far higher than when Arlington Hospital Center (now the only hospital in Arlington) was built, suddenly need fewer hospital and ICU beds? We know only the outcome.

The Commissioner was presented with a Hobson’s choice as a result of esoteric COPN rules devised by the VDH itself. A hospital in Arlington or a hospital in Loudon?  “Both” was not historically an available decision. After 47 years of COPN, that is what has evolved.

Continue reading

COVID-19 Update: The Epidemic Intensifies

The Virginia Department of Health has published yesterday’s COVID-19 numbers, and they continue to show a rapidly spreading epidemic.

Total confirmed cases (the tip of the iceberg) have risen to 460, an increase of 69 from the previous day.

The number of hospitalizations has risen to 65, an increase of six from the day before.

The number of deaths has leaped to 13, up from nine.

The number of tests has surged to 6,189, up 819.

— JAB

NoVa Healthcare Adapts to the Epidemic

Alex Krist

by James A. Bacon

The Washington region, including Northern Virginia, is a looming epicenter of the COVID-19 epidemic. Known coronavirus cases in the metropolitan area now exceed 1,000, according to the Washington Post. And it will surprise no one to know that the number of cases confirmed by medical tests represents the proverbial tip of the iceberg.

Of the 25 patients he has seen so far this week, says Dr. Alex Krist, a Fairfax County primary care physician, he would say that five of them carried the COVID-19 virus. They had coughs, shortness of breath, chest pains, and fever — and a week-and-a-half ago they’d been to New York. Given the shortage of test kits, however, they didn’t qualify to be tested. In Northern Virginia, he says, tests are being used not for epidemiological purposes (to track the spread of the disease) but as a screening device to determine if patients are appropriate candidates for ICUs and respirators.

Things will get much worse in Virginia before they get better, says Krist, a Virginia Commonwealth University research professor who chairs the U.S Preventive Service Task Force.

Spurred by emergency conditions, Northern Virginia hospitals and doctors are changing the way they practice medicine, Krist tells Bacon’s Rebellion. “We’re going to run out of hospital beds. We’re going to start trying to treat people at home.” Continue reading

Wartime Governor

by Chris Braunlich

If Donald Trump is a “wartime president”, Ralph Northam is now a “wartime governor.”

Unless one has been isolated on a Pacific isle (or wears tinfoil hats to block evil radio waves), Virginians understand that the pandemic we are in is deadly serious, growing exponentially, and requires radical steps to reduce its disastrous effects on our health and our economy. Unlike Nazis during World War II, COVID-19 has already landed on our shores.

But like World War II, mobilizing to fight our new enemy requires redirecting large numbers of resources. And winning will take “not playing by the rules.”

In the last 75 years, government has done what Thomas Jefferson, in the Declaration of Independence, accused King George of doing:  “… erected a multitude of New Offices, and sent hither swarms of Officers…” in the form of a regulatory regime designed to protect Americans from abuses and from each other.

In fighting a common enemy, those rules and regulations serve mostly to hinder. The answer is better found by freeing up those regulations, permitting flexibility, and waiving requirements in key areas needed to win. And, by all accounts, Virginia’s Governor – when emergency powers are invoked – can cut through those regulations. Continue reading

Who’s Got ICU Beds?

ICU beds per 100,000 people aged 60 and older, by hospital referral region

As Virginians try to formulate rational COVID-19 policy, it would be helpful to know how many ICU beds there are in Virginia hospitals. We’ve got a handle on the count of acute-care beds, but the number of ICU beds, reserved for the most critically ill patients, is perhaps an even more critical. Virginia public health authorities have not released that number, as far as I can tell, and I can’t find the data on the Internet. However, the Wall Street Journal did obtain data for ICU beds in Virginia’s hospital referral regions and published the map above showing ICU beds per 100,000 people aged 60 and older.

Here’s a close-up of Virginia:

The Washington Post breaks it down a little differently: ICU beds per 10,000 Americans aged 16 and over. The WaPo provides the following numbers for Virginia HRRs:

Arlington — 2.3
Lynchburg — 2.5
Winchester 2.5
Charlottesville — 3.2
Norfolk — 3.3
Richmond — 3.5
United States average — 3.6
Newport News — 3.6
Roanoke — 4.7

How to Optimize the Lives/Jobs Tradeoff in the COVID-19 Epidemic

by James. B. Murray, Jr.

The debate now raging over the tradeoffs between saving lives and economic disruption is clouded by oversimplification. The solutions we ultimately adopt will not be some groundless elimination of protective measures on Easter Sunday, any more than they will call for quarantining everyone, everywhere until some arbitrary date in July or September. The answer must be much more nuanced.

America has three strategic goals to address, in this order: First, buy time until we can get our health care system capacity upgraded to handle the flood of cases that epidemiologists can predict are coming to each city and region of the country. Second, get our testing capacity and the infrastructure needed to deploy it, distributed across America so we can tell who is infected and begin the random testing needed to model mathematically where and when the virus will spread. Third, quickly develop a set of protocols that can be used to identify those who can go back to work and who may circulate publicly without risk to the most vulnerable.

We need only look at New York City, Italy and Spain to see what happens when the virus peaks in a community before the health care system is prepared. Everywhere across America, including here in Virginia, our hospitals are running low on personal protective equipment (“PPE” – like N-95 face masks, gowns, and gloves). Our doctors and nurses can’t care for the critically ill if they themselves are infected. Continue reading

COVID-19 Update: Ignore What I Said Yesterday, the Virus Is Going Exponential

John Butcher was right, and I was wrong. I was hoping, based on the previous two days’ worth of data and a heap of wishful thinking, that Virginia was heading up a less steep slope in the growth in the number of COVID-19 infections than widely feared. John maintained, however, that the data was consistent with an exponential growth curve. Today’s data update by the Virginia Department of Health shows that John, better known as Cranky, as in publisher of Cranky’s Blog, was right.

The number of total cases, new cases, hospitalizations, and fatalities all surged. Total cases in Virginia reached 391 yesterday, a single-day increase of 101. More ominously, hospital admissions rose to a total of 59, a one-day increase of 14. Tragically, the number of deaths leaped from six to nine.

The commonly cited rule of thumb is that the virus doubles in the early stages of the localized spread every three days. The numbers suggest that Virginia is no exception to the rule. Fasten your seatbelts, ladies and gentlemen, it’s going to be a bumpy ride!

Click on “Leave a Comment” below to view John’s updated graphs.

— JAB

Plan Now for COVID-19 De-Mobilization

by James A. Bacon

Everyone wants to put people back to work as soon as the COVID-19 virus recedes, whether that’s month or two or three from now. In video discussion above with Dr. Alan Dow, Richmond creativity consultant Scott Wayne (at right) argues that we need to begin thinking now about how to do that. The process could be trickier than we realize.

Essentially, the question is this: Do we let some people re-enter the workforce earlier than others?

It’s fine to let young, healthy people back in the workplace, but how about older workers or those who have medical conditions that might put them at risk? Would delaying the return of older workers constitute a form of age discrimination? What obligation do employees have to disclose private health information about medical conditions that put them at greater risk? Employers must balance competing priorities of public health vs. individual rights.

Writing in the Wall Street Journal, John H. Cochrane discusses the same issues. “Governors must … use this time to work with businesses on a plan for reopening the economy in a way that mitigates health risks.” Continue reading

Governor Northam, Don’t Destroy the Future

by James C. Sherlock

The President has just demonstrated strategic command of two ideas, combating the virus and preventing economic disaster, and is pursuing them in parallel.

His background as a successful leader of a large business gives him understanding of the complexity, interdependence and fragility of the economy. He knows that already some businesses will remain shuttered forever. More the longer we wait. Those businesses provide livelihoods not only to their owners, but also to their employees. Not all of them we see. While some are consumer-facing, others supply goods and services without which downstream production and retail can be brought to a halt and the food supply can suffer.

He described wide swaths of the country — the farm belt and many western states — far less impacted by the virus than the great international cities, media centers all, on the coasts.

The President wants the governors, including Virginia’s, to begin to open the economy in their states or parts of their states as soon medical data suggest it is relatively safe to do so. To wait for a declaration of absolute safety by scientists is to misunderstand the standards of scientists. Continue reading

Keep Cash Flowing

by Chris Braunlich

The government actions taken to flatten the coronavirus pandemic will most effect the smallest of businesses, as well as part-time and lower income workers such as restaurant wait staff, and ‘gig’ economy workers without benefits

For small businesses, an SBA loan (even at discounted interest) is no substitute for customers and cash flow. For workers, $1,200 checks from the feds (and unemployment checks) will be no substitute for a job.

When the St. Louis Federal Reserve Board president predicts unemployment will hit 30% and GDP will be cut 50%, it’s appropriate to assume that many of those small businesses may be gone when this is over. And if the businesses are gone, the workers they hire will be out of work even longer.

Steve Haner, the Thomas Jefferson Institute’s Senior Fellow for State and Local Tax correctly notes the best way to moderate the economic drop is to keep cash flowing through the economy. That is a role many of us can play. Continue reading

Cabin Fever? Red Cross Has the Cure

Kerry donates blood.

by Kerry Dougherty

During these long and lonely shut-in days, I spend a lot of time talking to myself.

For instance, I got up yesterday morning, poured a cup of coffee, took a deep breath and turned on my computer.

What fresh hell awaits us today, I whispered as it flickered on.

Instead of another load of catastrophe porn, though, I found this: A message from the American Red Cross.

“Through March 18, nearly 4,500 blood drives have been canceled due to coronavirus to concerns, resulting in over 150,000 fewer blood donations. Yesterday, the Surgeon General stressed the importance of giving blood. Make an appointment.”

Geez, that’s terrible, I murmured, as I started to delete the message. I hope people donate.

Then I thought about a special guy I know who has blood cancer. He gets transfusions regularly. Without them, his prognosis would be grim.

Wait a minute, I thought. I’m people. I should donate. Continue reading

COVID-19 Economic Impact Estimates

by James A. Bacon

Thanks to its high share of federal government employment and a high percentage of jobs that can be performed remotely, Virginia is somewhat less vulnerable to job losses from COVID-19-related shutdowns of large sectors of the economy than other states, said Stephen Moret, CEO of the Virginia Economic Development Partnership (VED) in a Monday update to economic development partners.

“We expect a large increase in unemployment to happen quickly, led by the hospitality sector, with substantial job losses in retail as well,” he wrote. The short-term impact will vary substantially by industry sector:

  • Minor impacts for ~48% of total employment in Virginia (federal government, healthcare, K12 education, utilities, data centers, and agriculture);
  • Moderate impacts for sectors representing ~35% of total employment (professional services firms, IT firms, manufacturers, higher ed, real estate, construction);
  • Severe impacts for sectors representing ~17% of total employment (hospitality, retail (with a few exceptions, e.g., grocers), and small businesses generally (especially those in the non-traded sector), and movie production.

Any prognostication must be tempered by big unknowns, he said: (1) the size and speed of federal stimulus to offset social distancing impacts, and (2) the timeline for social-distancing measures to remain in place. Continue reading

Leadership in the Time of COVID-19

We comment endlessly on the performance of our federal, state and local leaders in the time of COVID-19. It is perhaps time to discuss what successful wartime leadership at the top levels looks like without discussing individual personalities so that we have a common standards with which to measure them.  I offer the following:

The characteristics of success at the highest level leadership in times of crisis include:

  • Remain calm in the face of the enemy.
  • Possess training and experience at lower levels of command to understand the characteristics and implications of leadership success and failure or, less often, find oneself to be naturally gifted without such preparation.
  • Have a strong belief in oneself.
  • Be able to inspire or command the support of enough skilled people to achieve victory.
  • Be able to sort through strategic options offered by staff to choose the right ones in roughly the right order.
  • Be more concerned about strategic results than tactical ones.
  • Maintain the strategic picture in the face of sequential narrow advice by specialists/
  • Be a master of messaging and presence to inspire one’s own forces and create fear in adversaries.
  • Harness personal ambition to deal with an existential threat

All of that adds up to being a supremely skilled patriot. A great leader must not be a master of all of these, but certainly most. Badly implemented, these characteristics can existentially threaten. Appropriately harnessed, they produce greatness.

— James C. Sherlock