As Alaska Gov. Mike Dunleavy and Anchorage Mayor Ethan Berkowitz move to reopen the state and city economy, both say that their actions will be guided by data.
But both officials and experts caution that the decision-making around the reopening can be complicated and hard for the public to follow. There’s no single measurement that reflects the state’s overall progress in fighting the coronavirus, nor is there specific, centralized guidance from the federal government.
Dunleavy’s “Reopen Alaska Responsibly Plan” says the administration is watching 18 different pieces of data. They include the number of new COVID-19 hospitalizations and hospital bed capacity, the number of tests and the average turnaround time, and the number of people exposed to each confirmed case.
Berkowitz’s “Roadmap to Reopening” says eight different metrics must be met. They include the “ability and capacity to screen and test widely,” case counts trending downward, enough protective gear for health-care workers and the monitoring of all contacts of confirmed cases.
“There’s a lot of variables to this calculation, and I don’t think any single variable is going to determine what the course of action is going to be,” Berkowitz said in a phone interview. “If we saw something that was out of the norm, that was a deviation from the way things have been, that would give us cause to do further inquiry. And if we did further inquiry and had reason to be more concerned, we would change our course.”
While each administration has released specific measures it will watch, neither has published detailed benchmarks that, if reached, would cause the reopening process to move forward or backward — like a certain number of deaths, hospitalizations or confirmed cases.
Officials with both administrations have been hesitant to say that crossing one particular threshold would prompt them to resurrect stricter health mandates. Even the tally of new cases — which, on the surface, appears to be a straightforward metric — can be misleading, Dr. Anne Zink, Alaska’s chief medical officer, said at a news conference earlier in the week.
Infections associated with travel, she said, have different implications than those that stem from unexplained transmission within a community. And new cases in a small town might require a different response than if they’re in a large city.
“The type of cases matters,” Zink said. “Five cases, or 30 cases, or 100 cases in Anchorage would be very different than 100 cases in Juneau.”
As policymakers decide how to move forward, there are broad categories that they should be watching, said Janet Baseman, an epidemiology professor and associate dean at University of Washington’s School of Public Health.
Those categories, she said, include testing numbers, hospital space and the capacity of public health agencies to track the contacts of people — which are the same types of data that Dunleavy and Berkowitz say they’re following.
The Trump administration has released its own list of general criteria that states or regions should meet before moving to the next phase of their reopenings. But Baseman said there’s been no list of specific benchmarks handed down by the federal government — which leaves local leaders to develop them themselves.
“Everybody is trying to figure this out right now,” she said. “Absent that centralized set of specific recommendations, this is just taking time for people.”
One thing to keep in mind, Baseman said, is that if policymakers want to make informed decisions about how each phase of the reopening changes the data, they need to wait at least two weeks between them.
That’s because it can take that long for an infected person to start showing symptoms, and even longer to be hospitalized or die.
Dunleavy waited exactly 14 days between the second and third phases in his reopening. He said at a news conference Tuesday that he’s comfortable with that timing because not all businesses are reopening at once.
“We’re all feeling pretty good, we’ll watch it. And we’ll continue to report,” he said. “But we think it’s going to work out.”
A spokesman for Dunleavy, Jeff Turner, referred requests for an interview about the governor’s decision making criteria to the Department of Health and Social Services. A department spokesman, Clinton Bennett, responded to interview requests by sending a link to the state’s two-page Reopen Alaska Responsibly Plan.
That document lists the 18 criteria that the state is tracking, within four broad categories: disease activity, and testing, public health and health care capacity.
For reopening phases to move forward, disease activity, for example, must be “consistently declining or stable,” as assessed by metrics like the number of new cases and new hospitalizations, and their geographic distribution, the document says.
Anchorage’s system is similar, and the city maintains an online “dashboard” that currently shows each of its eight reopening criteria as a green light or yellow light. But it doesn’t show any of the numbers or specific thresholds that, if reached, would cause the colors to change.
Asked how the city is measuring its criteria and deciding what colors to show on its dashboard, a Berkowitz spokeswoman, Carolyn Hall, emailed a copy of a “risk assessment” that the municipal health department sends the mayor weekly.
The four-page memo, sent May 15 by the director of the Anchorage Health Department, breaks down the city’s performance against each of the eight criteria laid out in Berkowitz’s reopening plan. It includes daily COVID-19 case count trends — an average of .9 new ones in the previous week — daily testing rates, an assessment of health-care providers’ stocks of protective equipment and data on positive tests among people without symptoms.
Berkowitz said he reviews the numbers on a daily basis, working with experts to make sure he understands any variables that could be attached to the data. And he said that the public has access to “virtually all” of the same information.
“We’re making real-time decisions based on the best information that’s available to us, as well as the best understanding that currently exists about the disease,” Berkowitz said. He added: “The lack of comprehensive and coherent information at a national and international level is a factor in the decisions that we make. And so, there are unknowns that we have to account for.”