But so far, neither Hogan nor Bowser appears to be following Virginia’s lead.
The region’s tally of up to 52,695 cases reported as of Tuesday isn’t the most telling measurement, local officials say, because testing is still limited.
Instead, what Hogan calls the “Roadmap to Recovery” requires this milestone: sustained declines over 14 days in key indicators, such as the number of new hospitalizations and new intensive care unit patients. Hogan, Northam and Bowser have all laid out plans for lifting the stay-at-home orders and restrictions.
Where on the road map are we? There appears to be light ahead, especially in Virginia. Ocean City, Md., too, said it will reopen its beach and boardwalk to the public starting this weekend.
But the metrics for the District, Maryland and Virginia remain mixed.
The average daily increase in reported coronavirus cases in the three jurisdictions was 2,231 during the five-day period ending Monday, compared with 1,626 during the previous five-day period that ended April 29. The average daily death toll was 91 for the five-day period ending Monday — three more than the previous five-day average.
New hospitalizations have mostly declined in Maryland in recent days, and been roughly flat in Virginia. New cases and deaths have largely plateaued over the past two weeks, despite day-to-day fluctuations. Efforts to ramp up testing, contact tracing and the provision of protective equipment are underway.
“Each state has their own situation, their own challenges,” Northam said Monday, when he announced that he hopes to begin lifting some restrictions on May 15. “We’re probably not going to do everything on the exact day, but we’re working as close as we can.”
Below is a breakdown of the key metrics, and where Maryland, the District and Virginia stand on each.
How many people are hospitalized?
The District does not publicize data on day-to-day admissions, though officials said last week that there were 435 covid-19 patients hospitalized in the city, up from 402 the previous week. Of those patients, 124 were in intensive care (four more than the previous week) and 84 were on ventilators (25 more than the previous week).
In Maryland, an additional 138 covid-19 patients were hospitalized Tuesday, with 1,693 hospital beds in use as of Tuesday. Average daily admissions for the five-day period ending Monday was 70, down from 151 during the previous five-day period.
The state health department’s website showed that 573 intensive care beds were in use Tuesday, compared with 563 on Monday and 565 on Sunday.
In Virginia, 1,496 people with confirmed or probable cases of covid-19 were hospitalized Tuesday, after 73 more were admitted since Monday. (Seventy-three also were admitted Monday.) Average daily admissions during the five-day period that ended Monday was 90, compared with 85 during the previous five-day period. The state health department does not share data on ICU admissions.
What about hospital beds?
Hogan says Maryland has added 6,000 hospital beds, including at a building inside the state prison in Hagerstown, at the former Washington Adventist Hospital in Takoma Park and in a tent at Adventist’s Fort Washington Medical Center in hard-hit Prince George’s County.
State health officials say they have enough hospital beds to handle new admissions through mid-June, with 5,017 beds open. So far, 20 percent of the state’s 2,938 hospital ventilators are being used, officials said.
District officials say the city wants up to an additional 1,000 hospital beds by May 15, with local hospitals 70 to 75 percent full. The city is converting a portion of the Washington Convention Center into a field hospital to deal with any surge in patients.
Are we getting more personal protective equipment?
All three regional leaders have complained about a shortage of respirator masks and other protective gear that would help stop infections among health-care workers, emergency workers and police who are in daily contact with covid-19 patients. Last month, the region got a fraction of what it asked for from the Federal Emergency Management Agency’s national stockpile.
Hogan has launched a multiagency task force to boost the state’s supply of equipment. On Tuesday, he announced that the state had acquired 600,000 N95 masks, 47,000 gallons of hand sanitizer, 3.5 million gowns and 5,000 infrared thermometers since March. But he did not say how much of that equipment had been used and how much remained on hand.
Last month, Virginia officials said the state had ordered 17.4 million respirator masks, 1 million face shields and 17 million pairs of gloves. Northam said Monday that hospitals are reporting less-urgent needs for PPE.
In the District, Bowser said last month that the city needed about 600,000 N95 masks, 5.6 million surgical masks, 1.4 million gowns, 350,000 face shields and 40 million gloves to get through August.
Is there enough coronavirus testing?
The Centers for Disease Control and Prevention announced Thursday that it was sending $631 million to state and local health departments to increase their capacity to do contact tracing and testing, a reversal of President Trump’s earlier stance against using federal funds to increase testing.
D.C.-area leaders say there aren’t enough test kits and supplies available to show how many people are infected and which areas the virus has hit the hardest.
In particular, they say, there is a shortage of cotton swabs to collect samples and the chemical reagents used to determine whether a sample contains the virus.
The national shortage has led to a focus on testing people who appear to have symptoms of covid-19. That leaves out the thousands of area residents who may be infected but show no symptoms. Public health experts say up to 25 percent of the coronavirus infections could fall into that category.
If local health officials know more about those “asymptomatic” cases, they can better isolate the virus and better understand pockets of transmission, said Amanda Castel, an epidemiologist specializing in infectious diseases at George Washington University.
Additionally, blood antibody tests could determine who already has had the virus and developed some level of immunity. That testing capacity also could guide plans for lifting restrictions.
“If we’re going to reopen, we’ve got to scale up that testing,” Castel said.
In Maryland, 140,103 tests had been conducted as of Tuesday, with 19 percent of those people found to be infected. Hogan said he wants to conduct as many as 20,000 tests per day, or nearly six times the state’s current capacity. His administration recently got a big boost toward that goal, buying 500,000 tests from South Korea at a cost of $9 million, though a Washington Post report showed that very few those tests had been used. Last week, Hogan ordered that residents and employees of nursing homes be tested, regardless of whether they show symptoms of covid-19.
In Virginia, 127,938 people had been tested as of Tuesday, with just below 16 percent of them positive. Northam has appointed a task force to boost the state’s testing capacity, which had averaged about 2,600 a day but rose to 6,000 per day over the weekend. The state hopes to get to 10,000 tests per day before restrictions are lifted.
The state initially prioritized specific groups, such as those older than 65, first responders and those who are already showing flu-like symptoms. Facing criticism over Virginia’s low rate of testing, state officials recently began taking samples from residents in low-income areas and plan to test people with chronic diseases, expectant mothers, babies born to mothers with covid-19, and uninsured and underinsured residents, Virginia Health Commissioner Karen Remley said.
The District did not report new test numbers Tuesday. As of Monday, 24,329 people had been tested, with nearly 22 percent of that group showing infection. City health officials say they want that rate to drop to 10 percent by the time restrictions are lifted. The city has started deploying rapid-coronavirus-testing equipment at institutions serving the vulnerable. D.C. officials say their public health lab plans to double its testing capacity to 1,000 a day but does not get more than 500 requests per day. They are encouraging anyone with symptoms — not just those in high-risk groups — to seek testing. District officials said they will be ready to launch a phased reopening when the city has achieved benchmarks including having enough tests for everyone who is symptomatic, and for all essential workers and the close contacts of those with confirmed infections.
What about contact tracing?
Finding people who may have been infected so they can be tested — and then treated and isolated if they have been infected — is another crucial factor in deciding when to ease restrictions, officials said.
Last week, Maryland signed a contract with the National Opinion Research Center at the University of Chicago to hire 1,000 contact tracers, which will bring its workforce for that effort to 1,250 such workers.
Virginia says it plans to hire 1,000 contact tracers over the next two weeks. The District said it hopes to expand its army of 65 contact tracers to 900 before restrictions are lifted.
“When we loosen those restrictions, we have to be able to test widely, we have to be able to contact-trace quickly and immediately,” D.C. City Administrator Rashad M. Young told the D.C. Council. “We are developing and working on strategies to be able to massively increase our ability to contact-trace and scale up quite significantly our ability to test.”
Erin Cox, Fenit Nirappil, Gregory S. Schneider, Laura Vozzella and Ovetta Wiggins contributed to this report.