PROVIDENCE -- Governor Gina M. Raimondo is starting a phased reopening of the Rhode Island economy Saturday, giving rise to the question: Does the state meet the suggested guidelines the White House coronavirus task force says should be met before easing restrictions?
Pretty much. The Globe looked at the state’s coronavirus statistics as well as the standards established by Raimondo’s health experts, which they say are tailored to the state’s needs. That team reviewed their stats with Dr. Deborah Birx, the task force coordinator, who was complimentary of the state’s efforts, Raimondo said, but did not offer an opinion as to whether Rhode Island should start to relax its restrictions.
Here’s a look at those nonbinding federal guidelines and how Rhode Island stacks up:
Federal health officials want to see the number of confirmed cases on a downward trajectory for 14 days in a row (that would be since April 24)
Have the number of positive tests as a percentage of all tests show a steady drop over two weeks.
The feds give states the option of meeting one or the other of these criteria because a state like Rhode Island, which is doing a lot of testing, is going to see a jump in the number of positive cases, and may have a harder time showing a decline in cases than a state that isn’t testing nearly as much. In other words, more testing is going to uncover more infections.
So does Rhode Island meet the first criteria? Depends on how you define “downward trajectory.”
Rhode Island’s cases have not dropped every day in the past two weeks. There have been sporadic daily drops: For example, from April 24 to April 27, cases slid from 430 to 219 per day. But they popped back up again to more than 300 a day from April 28 to May 1, before taking another three-day drop. Yesterday, the state reported 325 new cases; today there are 249.
Raimondo’s team is looking at the overall decline of new cases over the past two weeks. It appears the state may have hit a peak April 23 when it recorded 437 cases. Since then, even though the chart looks like a roller coaster, cases have been on a downward trend, dropping by more than 40 percent.
How about the second criteria, the ratio of positive cases to tests administered? That’s a far different story: On April 24, the state had tested 50,891 people and uncovered 7,129 positive cases, or about 14 percent of those tested.
By yesterday, the number of Rhode Islanders tested had soared in just two weeks to 82,318, while the number of positive results had risen more slowly, to 10,530 -- 12.9 percent. In fact, the spread between those tested and those who are infected has been growing since mid-March.
Apart from the task force guidelines, many infectious disease experts want to see states achieve an infection rate of less than 10 percent of those tested before relaxing restrictions. Their view is that a higher rate of positive results, regardless of the number of tests administered, indicates that the virus is still widespread in a population.
Despite its high level of testing, Rhode Island has dropped below a 10 percent infection rate only four times in the past 10 weeks. However, all of those days were this week, indicating that the infection rate may be on the decline.
The bottom line: Rhode Island does meet the criteria in the government’s Cases category.
The task force guidelines in this category call for hospitals to be able to treat all patients without crisis care
Have a robust testing program as well as antibody testing in place for all at-risk health care workers.
According to federal health officials, “crisis care” is when health care systems are so overwhelmed by a pervasive or catastrophic public health event -- like the coronavirus outbreak -- that it is impossible for them to provide the normal, or standard, level of care to all patients.
On this score, Rhode Island is in good shape, according to Raimondo. Hospitals are not overwhelmed; in fact, 35 percent of ICU beds are empty, she said, surpassing the goal of 30 percent that her administration had set.
However, the testing of health care workers is a mixed bag.
Yes, all at-risk health care workers -- including nursing home staff -- are being tested, according to health department spokesman Joseph Wendelken. But the state is not giving those workers antibody tests. Instead, Wendelken said, there was an antibody test pilot program for employees at four Stop & Shop supermarkets, and now will choose 5,000 residents at random for more tests.
State health director Dr. Nicole Alexander-Scott said there is no data to support using antibody tests on individuals and health officials are focusing on diagnostic tests. Once fully implemented, antibody tests will be used to track the general spread of the disease, she said.
The bottom line: Rhode Island hospitals are not in crisis, and all at-risk health care workers are being tested. However, those workers are NOT getting antibody tests.
The task force guidelines call for a 14-day decline in the number of people with flu-like illnesses
A two-week decline in the number of people exhibiting symptoms similar to those associated with COVID-19.
Rhode Island has had sporadic cases of the seasonal flu in the past two weeks, but Wendelken said data from February through April 3 shows a drop in illnesses, doctor visits, and positive flu tests.
The state does not know if there has been a decline in the number of people exhibiting COVID-19-like symptoms because health officials don’t track that, Wendelken said, because everyone who has symptoms are urged to be tested.
The bottom line: The state seems to be past the worst of flu season, which will help hospitals if reopening the economy causes another surge of coronavirus cases. And hopefully, with widespread testing, everybody with symptoms they think could be COVID-19 can get tested.