The Dance

West Virginia is beginning the steps of reopening. The engineer and entrepreneur Tomas Pueyo has called this phase of the coronavirus response “the dance."

Learning to live with COVID-19 will be like dancing. Some steps forward, some backward, and sometimes, it may be necessary to leave the dance and stay home.  

Many people in our state, and others, are trying to figure out how best to reopen their state’s economies, while also protecting their citizens.

Some common questions emerge.

Are we ready to open?

How do we measure against guidelines for reopening, like the White House Coronavirus Task Force?

How do we determine when to keep going, when to stop or when to reverse? 

What is the new normal? 

I will take a shot at answering these questions and a few others. 

Are we ready to open?

I believe yes. 

How do we measure against guidelines for reopening, like the White House Coronavirus Task Force?

The real goal of all guidelines is to wait until the spread of the virus has quieted before reopening the state. In states with a high number of cases, reducing cases for a number of consecutive days is suggested. We have reduced a cumulative rate of positive testing below 3%. That is important for many reasons, including a national average of almost 20% positive, and another that I will explore later. 

However, a different measure of spread is the R0 (R naught), or the reproductivity rate of the virus. The average R0 level of COVID-19 is thought to be ~2.5. That is a single infected person with the virus will infect on average 2.5 new people. Because of the compounding effect of viral infection, if the R0 was 2, then by two months, the single infected person would have infected 1024 new people; by four months, the single person would have infected 1 million new people; and by six months, the single infected person would have infected 1 billion new people. 

How do we determine when to keep going, when to stop or when to reverse? 

International leaders like German chancellor Angela Merkel, a physicist by training, is following this closely. She is focused on having the R0<1. In other words, an infected person infects less than one person. This stops the spread of the virus. 

West Virginia's most recent R0 is 0.74. 

On Monday, Germany’s R0 went up from the low of 0.7 in April to 0.96 after reopening some businesses, and Merkel urged citizens to stay at home. 

This is the dance. Stepping forward, and when necessary, stepping back. Germany is doing this, as will West Virginia, as will the United States.

What is the new normal and how do we plan to keep stepping forward? 

The new normal is coming back out, but carefully. The vulnerable should stay at home. Those that can work from home should. For those who need to venture out again, it should be with masks or face coverings. 

Tomas Pueyo points out that if 60% of people wear masks or face coverings that are 60% effective, we can likely control the spread of the virus. If 90% of us wear coverings or masks, we will do even better and add to the growing legend of our state in this pandemic. 

We should continue to physically distance 6 feet (even with face coverings), wash our hands frequently with soap and water for 20 seconds (or sanitizer with at least 62% alcohol content), and avoid touching our mouth, nose or eyes.

The virus is still with us, and although West Virginia has done a great job flattening the curve, what we really did is bought more time and saved lives. Most of our people are still not immune to COVID-19 (as evidenced by our <3% positive rate), and we still have the most vulnerable state in the country with population health.

We still have to protect ourselves and each other. 

Is there hope? 

Of course!

A new study suggests that an anti-viral drug, Remdesivir, which blocks a critical step in viral reproduction, reduced the time people with COVID-19 needed to stay in the hospital and is promising. 

A new vaccine targets the spike proteins found on COVID-19, which can block the virus from getting into our cells. After 28 days of exposure, the vaccine protected primates against the virus. That is promising as well. 

Can we manage to be more precise to control COVID-19 as we reopen? 

Yes, I believe we can. 

Pueyo again suggests the most successful countries managing COVID-19 have case positive rates <3%. This is because at this rate of new cases, public health experts that identify these people and trace their contacts are not so overwhelmed and can do their work quickly. 

We are <3%. 

Not only have we done a great job controlling our rate of new cases, but we have an excellent group of county and state public health experts. We have also aggressively done the suppression work earlier than other states.

Finder.com rated West Virginia as the best state in the country in our response to COVID-19.

But the main reason I am confident that we can do what others can’t is because of our citizens.

It’s clear that the more the state remains committed to protecting themselves and their neighbors, their healthcare system and their state is protected.

It is because of each of you. It is because of us.

It is because we are together. 

It is because we are West Virginia strong.

In this new dance for West Virginia. For our country. For our world.

Let’s lead. 

Almost Heaven.