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Data Driven

Number-cruncher says Memphis opened too soon, may need to shut again.

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One month into Safer at Home, James Aycock was grasping to "figure out what was going on" with the local COVID-19 situation here but found little information and "even less thoughtful analysis."

Though he says he's no epidemiologist, he did what someone with a background in biomedical ethics would do. He took matters into his own hands, or spreadsheets. He crafted the daily virus information from the Shelby County Health Department into a series of visualizations. The data came to life in easy-to-read charts that show where we've been and where we're (probably) heading.

James Aycock maps virus trends on his First Responses blog. - JAMES AYCOCK
  • James Aycock
  • James Aycock maps virus trends on his First Responses blog.

His First Responses blog and his Twitter feed have become a go-to for data-hungry Memphians. His first update had over 2,000 impressions and nearly 600 engagements, about 200 times higher than his normal tweets. Those numbers grew to 15,000 and 3,000 for the last update.

"The reason I think it's needed — the real reason you should care about what I have to say — is because the public is not getting the full story from our local officials," Aycock says. "Analyzing the data, I've noticed the ways our elected officials have not always been honest with us and have not always made public health a priority. So, it is my hope that my analysis can inform the public discussion so that we can hold our elected officials accountable."

We caught up with Aycock to talk data (natch), trends, and projections. Catch the full interview with him this week at memphisflyer.com. — Toby Sells

Memphis Flyer: Why did you begin?

JA: I recently wrote a piece (which you can find here) about this, so I would just point you there. If you need me to try to summarize, let me know.

MF: What does it show you?

JA: The data show me that, first of all, we reopened too soon. We had actually made some real progress. We had effectively flattened the curve, but we did not meet the criteria for reopening. That's the big thing. Plus, the reproductive rate was still over 1. And then Phase 2 has been a disaster. It just makes me wonder, how much safer would we be right now had we waited a little longer, until we actually met the criteria, to move to Phase 1?

The second thing I'm seeing is how we're starting to effectively lose control of the spread of the virus. The reproductive rate continues to climb, new cases continue to climb much faster than testing, and the positivity rate is spiking.

We're averaging 278 new cases per day so far this week, which is up 260 percent over the 77 new cases per day we averaged the week we moved to Phase 2. Testing is up, but not nearly at the same pace. Since the week we moved into Phase 2, testing is only up 40 percent, while new cases have exploded at over six times that rate. And this is why the positivity rate has spiked, from 4.7 percent to 12.2 percent so far this week. At this rate, we know that a significant number of cases are likely not being captured. And that means people with the virus, probably without symptoms, are unknowingly infecting their friends and family and colleagues.

MF: What might lie ahead for us?

JA: If we don't take aggressive action, and soon, we will have no other choice than shutting things down again. We are looking at exponential growth. Remember, that's what "flattening the curve" was all about. And we did that...until we didn't. The curve is back again. And that is incredibly dangerous.

Right now, we're doubling roughly every 30 days. Case 2,500 occurred on May 1st, then Case 5,000 occurred on May 31st, and then Case 10,000 occurred this week, on July 1st. If this trend continues, we're looking at 20,000 total cases by August 1st. To frame that, it took us four months to see the first 10,000 cases, but at this rate the second 10,000 cases will come in just 30 days.

So, let's play that out. Let's say we continue to double every 30 days. Then we're talking about 40,000 total cases by September 1st and 80,000 by October 1st, all the way to 640,000 cases by January 1st. At this rate, all of Shelby County will have been infected before the end of January.

Obviously, that would overwhelm the medical system, but it also means a lot of preventable deaths. We have to focus on more than hospitalizations. We have to focus on lives. This is a Black Lives Matter issue. African Americans represent 52 percent of Shelby County, but 61 percent of covid fatalities. Our Latinx community is also significantly overrepresented. We have to protect life.

MF: How have you seen data drive policy here?

JA: Unfortunately, I'm not seeing policy being driven by data. According to the data, we reopened too soon. Not only did we not meet our own criteria, but the reproductive rate was above one when we reopened, even though we know it has to be under 1 to stop the spread.

And we reopened without a mask ordinance in place, although all the data say that wearing masks significantly reduces spread. I am proud that Tami Sawyer on the county commission, as well as Michalyn Easter-Thomas and Jeff Warren on the city council, were able to get mask policies passed. But four commissioners and four council members opposed this. And our mayors reopened without it.

They also reopened before building out our contact tracing capacity, which the data say is essential to stopping the spread. We just onboarded 141 new tracers this week, but that should have been a precondition to reopening.

Also, the data right now is alarming. But I'm not hearing any alarms being sounded by our mayors. Tami Sawyer has been a strong voice for letting the data guide our policy, but so far she's the only one calling for a reexamination of our "Back to Business" plan.

MF: What do we do now?

JA: I realize that our local leaders are in a tough spot. Congress refuses to act to provide real financial security for workers, for businesses, and for state and local government. And that is why there's such pressure to open as much as we can, regardless of whether it's really safe. So the first thing we need to do is contact our representatives in Congress.

Secondly, we know that people are tired of being at home, so we need to create ways for them to go out safely. Being indoors, with air conditioning circulating the virus, is a big problem. We need to do something about this. But we know it's much safer outdoors.

So, let's find ways to push activities outdoors. For example, we could close down streets to allow restaurants to space out tables. Imagine if we turned Madison and Cooper into outdoor seating for Overton Square. Imagine if you did the same with South Main, Broad Ave, Cooper-Young, etc. We could also turn parks and parking lots into open-air markets and cafes. These are things other cities have done. The point is, we've got to get creative. Going back to "normal" will not work.

MF: Anything else?

JA: Two things.

First, we need a real testing plan. My friends who are front-line medical workers are tested at least once per week. That has to be the standard for everyone going to work. The only way to contain the virus is to seek out and find every case so that we can isolate and trace contacts to stop the spread. We have to do far more testing than we're doing currently.

Secondly, we have to decide if we want schools to reopen in the fall. If we don't act, and act now, then it won't be safe. The data are worse than ever, far worse than the spring, when we kept kids home.

If schools are not able to open in the fall, that will create a nightmare scenario for parents, especially working parents who are not able to work from home. And that, in turn, will create a huge problem for businesses. Without going back to school, there is no "Back to Business." So we have to do everything we can to turn things around and create the conditions for safely opening schools.

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