Respectfully, I beg to differ with Lex Burkett’s letter criticizing our elected officials for promptly imposing more stringent measures to control the spread of coronavirus infection than neighboring states [“We Deserve Better Political Leadership,” May 27, Xpress].
Our local leaders took action on March 15, two days before Gov. Cooper pulled the plug at 5 p.m. on St. Patrick’s Day, averting superspreader events in crowded bars. In public health, we have a word for these kinds of decisions: conservative.
A classic nightmare in public health, made famous by Ibsen’s play “An Enemy of the People,” is elected officials balking at control of microbial hazards out of fear of upsetting the local tourism industry.
Total case counts heard on the news allow the health care system to plan to not get overwhelmed. But rates in the population and in space provide more insight into disease transmission, I believe. Using data from the websites of state health departments on May 2, I compared incidence rates for Buncombe with two counties in adjacent states whose residents frequently travel to Asheville. To tease out social distancing from the built environment, which can’t be readily altered, I normalized the rates to each county’s population density. Buncombe’s rate was just four cases per 100,000 population per 100 square miles. In Washington County, Tenn., (Johnson City) it was 13, and in Greenville County, S.C., it was 17. This struck me as early evidence that our more stringent local and state measures were working.
As of May 29, however, my calculations show Buncombe’s rate now matches that of Washington County, Tenn. (18 per 100,000 people per 100 square miles), while Greenville’s is 33. Johnson City’s larger student population leaving town, some to be diagnosed at home, and Buncombe’s outbreaks in long-term care facilities have probably skewed these numbers to Buncombe’s detriment. Either way, a logical inference is that things would have been a lot worse, sooner without the prompt action taken by our local leaders.
I miss the convivial atmosphere of my favorite places downtown, too. I look forward to seeing all my buddies, vertical and not under a mountain of medical debt. Perhaps we’ll raise a glass to the decision-makers who had the brains and guts to protect public health, along with our long-range economic future.
Tip big, folks.
— Ken Silver
Editor’s note: Silver reports that he is an associate professor of environmental health at East Tennessee State University in Johnson City.