States Want to Reopen but Few Have Met the Criteria

One of the requirements that the President set on April 16^th for reopening the country is that the state or region must  show.14 consecutive days of declining daily case counts  No state has met this criterion in the strict sense.  For some of the states that have reopened or announced reopening soon such as Minnesota, Tennessee, Arkansas, Arizona, Indiana, Iowa, and Colorado the latest 14-day  trend in their case counts is actually upward and they should definitely not ease any of the restrictions they have in place.  For some of the reopening states such as Texas, Ohio, Kentucky, Alabama, and Mississippi the trend is mostly flat and not downward.  Only for Florida, Georgia, Louisiana, Oklahoma, Alaska, Idaho, and Montana, are the most recent two-week trend edging downward.  The alternate gating criterion of a downward trajectory of positive tests as a percentage of total tests has also not been met by most states.  This criterion makes more sense in those situations where a state broadens testing protocol significantly to cover both asymptomatic and mildly symptomatic cases such that case counts may even rise temporarily.  

Florida cities and counties responded early and forcefully to tackle the COVID-19 pandemic as soon as the first confirmed case appeared on March 1^st.  So even though the governor only declared a state-wide stay-at-home policy on April 4^th, Florida is one of the few states that passed both versions of the President’s gating criteria on case count for reopening the state.  The figure below shows that a week after the governor’s state-wide order, the confirmed case count (brown squares against left axis) peaked around 1200 cases per day near April 9^th.  Fatality count (blue diamonds against right axis) began to flatten out a week later near 45 per day but still has yet to peak. 

The figure below shows the number of COVID-19 tests performed in Florida each day over the last 5 weeks.  Florida has tested about 1.78% of its population to date – comparable to the US total of 1.88%.  While the number of daily tests (brown squares against left axis) has increased by roughly 50%, the more significant metric is the percentage of tests that returned positive results (blue diamonds against right axis) dropped steadily from near 12% to near 6% -  roughly half of that of the US as a whole recently at 12%.  This means that FL has begun to test more of their uninfected and less obviously infected cases.  It is important to continue to broaden the test administration so that Florida can gain a better understanding of where the disease remains so that effective isolation and contact tracing can be conducted to cut the transmission further.  Antibody serology tests which are easier to do could provide complementary information on what portion of the currently uninfected population has already been infected and may have gained immunity.  

Florida is reopening May 4^th with a conservative phased approach to minimize reinfection. Most of the state will reopen certain businesses like restaurants and retailers at 25% capacity and with strict adherence to the social distancing guidelines of the CDC.  Movie theatres, bars, fitness centers, and places that offer personal services will open later.  Miami-Dade, Broward and Palm Beach Counties that are the most infected will not reopen until additional data can be collected to show that they are sufficiently safe.