KOJO NNAMDIYou're tuned in to The Kojo Nnamdi Show on WAMU 88.5, welcome. Later in the broadcast we'll talk with Kim Roberts editor of a new anthology featuring local poets both well-known and obscure from D.C.'s founding until 1930. But first, the United States has now surpassed 11 million COVID-19 cases, and our region isn't spared from the spike in cases. We're facing a record breaking number of infections each day. So what are the latest local measures to prevent the spread and to keep people safe? Joining us now to discuss this is Dr. Travis Gayles. He is Montgomery County's Health Officer and Chief of Public Health Services. Dr. Gayles, thank you very much for joining us.

DR. TRAVIS GAYLESGood afternoon. Thank you for having me.

NNAMDIDr. Gayles, what are your biggest concerns right now as we see this spike in cases including in Montgomery County?

GAYLESWell, the big concern is that we're seeing more cases. We're starting to see a significant increase in hospitalization rate and utilization. And what we're also seeing is we're seeing a high number of cases spread across all age groups. So we used to think that, you know, COVID fatalities and severity of illness was only tied to those who were older, but we're starting to see that across age groups. And the other thing that is really concerning is this is all happening at a time were the holidays are upcoming and there's lots of potential for travel and lots of potential for family gatherings that could further spread and transmit the disease.

NNAMDIDr. Gayles, what do the latest restrictions look like in Montgomery County?

GAYLESSo right now our restrictions are tied to capacity restrictions to try to limit the number of folks in different venues both indoor and outdoor to minimize the risk of coming into contact with someone who's positive. We know that from an epidemiologic standpoint the most effective policies are limiting high contact situations where those, who are positive are coming into contact with those who are negative. And so our restrictions are related to 25 percent capacity and our social gatherings at this time are limited to 25 people at a time.

NNAMDIDr. Gayles, for nearly two weeks Maryland has reported more than 1,000 cases each day. Are current restrictions enough to stop this second wave? Can we expect a drop in cases any time soon?

GAYLESI think it's going to take more efforts and actions in terms of restrictions to be implemented to really effectively drive down the number of cases to get us back to where we were even a month ago. And I think that the governor has a press conference today to talk about potential further restrictions and I know that is something that we are looking at very closely and we'll continue to look at our data and trends as well as our contact tracing data to suggest key areas where we can implement tighter restrictions to have a greater effect.

NNAMDIIn the spring and even into the first phase of reopening in June, things like gyms, museums, retail stores and nail salons remained closed. Do public health officials really think it's safe to allow them to continue operating now?

GAYLESWell, that's part of the challenge. You're correct. What's different about where we stand now in terms of seeing these high numbers of cases is when we saw them in the spring everything was closed. And so in terms of navigating that, we didn't have to, you know, think about what's open and what provisions and how we have to put things in place. From a health perspective we can strictly, you know, provide that guidance to say that the more things that are open the more points of contact and potential risk of transmission happens.

GAYLESWe recognize that, you know, elected officials do have a host of other things to think through when making those determinations, you know, related to economic realities and those kind of things. But strictly from a health perspective, you're correct. The more things that remain open particularly in a setting of high levels of community transmission it is concerning and it is a setup for increased transmission of new cases.

NNAMDIJoining us now is Dominique Maria Bonessi, WAMU's Maryland Reporter. Dominique, thank you for joining us.

DOMINIQUE MARIA BONESSIThanks, Kojo.

NNAMDIDominique, we've already been talking with Dr. Travis Gayles. But I want to backtrack for a second to talk in general terms about what local leaders are doing to address the current spike in cases, Dominique.

BONESSIRight. There hasn't been a ton of change in D.C., but there has been some tightening of restrictions in Maryland and Virginia. D.C. Mayor Muriel Bowser said yesterday that she wouldn't make any rollbacks on phase two and that she would rely on the science to make any further decisions about restrictions. In Virginia on Sunday, Governor Ralph Northam announced the state is limiting all in-person gathers to 25 people instead of the current cap of 250. And their onsite alcohol sales and consumption is prohibited after 10:00 p.m.

BONESSINortham has also expanded the mask mandate. Before it said that 10 years and older had to wear a mask. Now it's 5 years and older must wear a mask in public spaces. In Maryland, Governor Larry Hogan scaled back capacity at restaurants from 75 percent to 50 percent. Health Department warns that indoor gatherings should also be limited in Maryland to 25 people and avoid traveling to states with high spread especially with the Thanksgiving holiday coming up next week.

BONESSINow Prince George's, Montgomery and Anne Arundel counties all have sort of a bit different regulation. And their restrictions are a bit tighter than Hogan had announced. Hogan is expected to make an announcement today at 2:00 p.m. about additional action to combat the surge. And Montgomery County Executive Marc Elrich is also expected to make an announcement within the next week about additional restrictions.

NNAMDIDominique, what counties are being hardest hit by this spike in Maryland?

BONESSISo really it's the most populous counties that have been adversely affected by this pandemic. Prince George's, of course, 36,700 cases as of today, more than 875 deaths. At the beginning of this month the county saw 6.4 percent positivity rate and that's well above the 5 percent that the World Health Organization recommends. Montgomery County as well, 29,200 -- more than 29,200 deaths -- pardon me, 29,200 cases and 860 deaths. It's also seeing a high transmission rate like those that we saw in May. Baltimore City also seeing 20,900 cases and Anne Arundel County more than 14,400 cases, and those are really the counties that are seeing high surges right now and high transition rates.

NNAMDIYou mentioned one county, but how in general does this compare to spikes we saw earlier this year?

BONESSISo we're up in positive cases and surpassing what we saw in the spring. Now there was 1782 cases in Maryland at the highest point on May 19th. Maryland hit over 2300 positive cases just three days ago on November 14th. Hospitalizations increasing in the state and in ICU and acute beds are also filling up. Prince George's County in particular, the ICU bed capacity for COVID-19 patients is more than 57 percent as of last week. And then I will note that deaths in the state are remaining the same -- or not the same, but just pretty stagnant.

BONESSIWe're not seeing deaths like we saw in the spring. In Prince George's County per week they have remained below 10 deaths per week since the end of September. But at their height in late April and early May there were 81 deaths in a week. But, you know, one death is still too many.

NNAMDILet's go to Adam in Takoma Park. Adam, you're on the air. Go ahead, please.

ADAMHey, Kojo. How are you doing today?

NNAMDIDoing well.

ADAMThank you. So, you know, I think that these measures are great. But I think that there's a disconnect between what we ought to be doing and what we are doing in practice. My wife and I were out in the Middleburg area this weekend for a little country day and we thought it would be quiet and we'd be the only folks out there. We'd check out some wineries and sit outside. And everywhere we went was packed to the gills with people. We didn't end up going into any of them, because we didn't feel safe. But it was just shocking to us to see how many people are out there like nothing is going on.

NNAMDIYes. A lot of people have been complaining about that. Thank you very much for sharing that with us. Dr. Gayles, you are scheduled to brief the county council today on latest COVID-19 conditions. What precautions will you recommend and do you think a stay-at-home order is needed?

GAYLESWell, we actually had our briefing before this session. And we talked about, again, being able to look at the data and our contact tracing data that will show us -- continue to show us which types of activities or which types of venues are contributing or coming up more frequently when we interview cases who've turned up positive. And we'll continue to use that guidance to put forward our next set of recommendations. But you do raise an interesting point. We are at a point now where the level of community transmission is so significant and it's so widespread across different activities and across different venues that there has to be a serious conversation about taking significant action such as an across the board lockdown.

NNAMDIHere now is Bill in Gaithersburg. Bill, you're on the air. Go ahead, please.

BILLHi, Kojo. I have a question for Dr. Gayles. I worked during the election at a crowded precinct. And I was wondering how long after that can I feel safe about not having picked up anything at that election site?

GAYLESWell, thank you for your service on helping make sure that the elections run smoothly. And in terms of exposure period, we typically tell people, you know, the window is 14 days after, you know, your potential concerning exposure to monitor for the development of any type of symptoms. And certainly given the widespread availability of different testing options across the region and in particular Montgomery County, I would recommend that you utilize one of those spaces to get a test so that you could know your status for sure.

NNAMDIAnd, Bill, thank you very much for your call, and as the doctor said, thank you for serving during the election. Dr. Gayles, how will any upcoming safety regulations -- COVID safety regulations compare to those we've seen so far this year? Will restrictions get stricter from here on in?

GAYLESWell, I think the challenge in moving forward with restrictions is, I think there's a couple of phenomena happening. I think there is the sense of COVID fatigue, which has been talked about a lot. I think there's another interesting issue that's happening. It's the sense of COVID risk perception. I think there are a lot of folks who are willing to take, you know, more risks in terms of the types of activities that they participate in based upon their perceived notion that, you know, I maybe in a healthier class or I maybe in a younger population, and so even if I get it it won't be that bad.

GAYLESAnd what we're trying to get people to understand is that there's no guarantee if you contract COVID that you're going to have a smooth asymptomatic course. So, you know, we're concerned about how all of those factors influence how things move forward and those types of behaviors will certainly also impact the types of restrictions or the types of guidance that we would put forward to curve the increase in cases.

NNAMDIWe're talking with Dr. Travis Gayles. He is Montgomery County's Health Officer and Chief of Public Health Services. And Dominique Maria Bonessi, WAMU's Maryland Reporter. I'm Kojo Nnamdi.

NNAMDIWelcome back. Dominique Maria Bonessi, Montgomery and Prince George's counties have remained in phase two of reopening even though Governor Hogan moved the state into phase three in September. What do any upcoming restrictions mean for local businesses?

BONESSISo local business owners in Montgomery County spoke at a hearing last week, when the Council voted to tighten restrictions, and a lot of them were saying that they were comfortable with the 50 percent capacity and that, you know, it helps them stay open. It helps them produce some sort of profit. And many expressed concerns that the 25 percent capacity at restaurants and retail will probably be problematic for their turning a profit. Another thing to keep in mind is that a lot of small business owners say restrictions in Montgomery County and other places don't just distinguish between the big box stores and small retail businesses.

BONESSIIt was brought up at the meeting last week that many of the big box stores were not complying with face two regulations and that many small business owners were. For example, Tom Rooter -- I'm sorry if I'm pronouncing that name wrong. He's the owner of Symmetry Salon Studios in Rockville, Gaithersburg and Bethesda. He told the Council that his business has been taking COVID-19 precautions since January. He said quote, "I'm here to encourage you to take a balance in nuance approach going forward as our COVID cases increase," and then he says, "One size does not fit all." So definitely some hesitancy and worry about those restrictions being put on small businesses.

NNAMDIHere now is Teresa in Hyattsville, Maryland. Teresa, you're on the air. Go ahead, please.

TERESAHi, Kojo. My concern is this. I felt very jubilant when I heard that PG County and Maryland were imposing a wear mask if you go outside rule, but then it's always qualified, which throws the whole thing out the window. For example, except if you're social distancing. And the problem with that is that you cannot social distance adequately on two and a half feet wide sidewalks. You don't know who's going to come down.

TERESALast week a person over 60 fell, because she had to cross the street to avoid people not wearing masks, who claim they were social distancing. The other part of that is it needs to be you go outside, you wear a mask, because I can't tell you how many people have told me that they're outside. They don't need a mask. They're exercising so they don't need a mask. It's summertime so they don't need a mask.

TERESAAll these misinformation pieces that have been put out there, and why would a person who is respirating more than I am walking, running and exerting himself not need to protect other people from his respiratory droplets? I mean, it just doesn't make ...

NNAMDIWell, most of the regulations indicate that if people are outside exercising like running, they're not required to wear a mask. And Dr. Leana Wen, who has appeared on this broadcast said, you are not likely to contract the coronavirus from someone passing by, from someone you walk by. That is one of the very rare circumstances in which that happens. Of course, if you happen to be gathered with people who are not wearing masks, it's infinitely more dangerous. But we have Dr. Travis Gayles back with us. Dr. Gayles, our caller was just talking about people crossing the street, because they see people not wearing masks coming from the opposite direction. What would you say to those people?

GAYLESI think the key thing is in terms of we get concerned about coming into contact with folks, you know, for extended period of times. And so, you know, in terms of crossing people's paths as long as you're not congregating standing next to them within that smaller distance for an extended period of time, those are the kinds of things that will put you at increased risk of contracting it should they be positive and you're standing within, you know, an intimate space for an extended period of time.

NNAMDIThank you very much for your call, Teresa. And here is Kendall in Kensington. Kendall, you're on the air. Go ahead, please.

KENDALLYes, I just wanted to simply say thank you to our public health professionals like Dr. Gayles. They play a vital role especially in this time, the pandemic. And I did have a question. I just wanted to make sure I understood correctly. MCPS, our school system here -- I have a son who is in enrolled in an elementary school. My understanding is that the hybrid plans that were put forward do not involve testing. And I listened to the call that the school district put on and that concerns me greatly. It doesn't seem like a reopening of any kind without testing would succeed. And I'll take my answer off the air. Thanks.

NNAMDIDr. Gayles.

GAYLESWell, it's a great question. And testing is a crucial component of lots of reopenings. I know that in our conversation with them that is something that they have thought and they're continuing to think through. I know that they are soliciting feedback from parents across the county to talk about what types of models that they would prefer to utilize. And so in the absence of it coming out definitely so far doesn't mean that it's not something that won't be continued to be considered and won't necessarily not be a part of the ultimate reopening plan that they put forward.

NNAMDIThank you very much for your call. Dr. Gayles, how are you collaborating with health departments in other Maryland counties and in D.C. and Virginia?

GAYLESWell, we actually -- the health officers from across the State of Maryland, we meet at least three times a week collectively amongst ourselves as well with staff from the Maryland Department of Health including the secretary and the deputy secretary of public health. In addition to those formal conversations, the national capital region health officers, including Frederick and Montgomery, Prince George's, Charles counties, D.C., Loudoun, Alexandria, Arlington, Prince William and Fairfax, we meet on a bi-monthly basis as well to talk about the regional perspectives in the national capital region.

GAYLESSo we're constantly talking and working with each other to identify best practices to share best practices and to share information so that we can develop strategies recognizing that our residents, even though, they may live in our jurisdiction, they cross borders frequently to work, to play, to go to school and utilize other resources. So it's important that we're all on the same page.

NNAMDIDominique, this past week have been filled with promising news on a COVID-19 vaccine. First with last week's news that Pfizer's vaccine could be 90 percent effective and yesterday's news that early data from Moderna's vaccine says it's 94.5 percent effective. You recently did a comparison of immunization plans in our region. Tells us what you found.

BONESSIRight. So the plan for immunization in the region is based on recommendations from the Centers for Disease Control and Prevention. It lays out this three phase plan on which the vaccine would be distributed. And it's based on the supply and the availability of the vaccine. The first phase would have limited doses of the vaccine. And the first people to get that vaccine in each state would vary. Maryland's plan states that the first people to get it in phase 1A of the plan would be paid persons serving in healthcare settings, those who are direct or indirect to exposure to patients or infectious materials and unable to work from home.

BONESSIAnd then phase 1B of the plan would be for essential workers and people at high risk of severe COVID-19 illness. Now Maryland state officials have acknowledged they don't know how much of the vaccine will be available in the first phase. But the first phase right now has 14 percent of Marylanders needing the vaccine. That's more than 770,000 residents following the phase one.

BONESSINow Virginia is planning to leave it up to each individual county to determine, which sectors of the workforce are most essential and which ones need to get vaccinated first or can get vaccinated first. And just to note, D.C. has not publically released their vaccination plan. Even with a journalist asking for a Freedom of Information Act request, but last month Health Director LaQuandra Nesbitt told members of the D.C. Council the plan is to get the vaccine to healthcare workers first regardless of whether or not they live in the District.

NNAMDIDr. Gayles, we only have about a minute left, but looking forward, when might we expect a vaccine rollout in our area? And do you have any idea of when we have some semblance of normalcy?

GAYLESThat's a million dollar question. I think in terms of the vaccine, I think best case scenario, an optimistic view for those in that first priority group as just was mentioned is potentially by the winter holidays and late December. And I think that process in terms of based upon how the priority groups are setup is it could take probably about a six month window at least to be able to get the vaccine disseminated widespread to all the different categories. And so that puts us most likely sometime next summer where hopefully by then we will have achieved widespread distribution of the vaccine. And to your question maybe some sense of normalcy by then.

NNAMDIDr. Travis Gayles is Montgomery County's Health Officer and Chief of Public Health Services. Thank you for joining us.

GAYLESThank you, sir, always a pleasure.

NNAMDIDominique Maria Bonessi is WAMU's Maryland Reporter. Dominique, thank you.

BONESSIThank you, Kojo.

NNAMDIGoing to take a short break. When we come back we'll be talking with Kim Roberts editor of a new anthology featuring local poets both well-known and obscure from D.C.'s founding until 1930. I'm Kojo Nnamdi.