By Adam Pagnucco.

Montgomery County’s COVID-19 dashboard is a great resource for judging the county’s progress in its efforts to control the coronavirus. Unfortunately, it’s not so great at enabling comparison with other jurisdictions, most of whom don’t release data at that level of detail. Inter-jurisdictional comparison is relevant because both public health and economic competitiveness cross state and county lines. Also, if local leaders facing similar circumstances make different decisions, that’s important for voters to know.

Johns Hopkins University hosts data on COVID cases and deaths relative to population by county on its website. On those two measures, here is how MoCo compares to other large jurisdictions in the region as of 9/6/20.

MoCo is about average for the region in terms of cases per capita. It is above average on deaths per capita. Prince George’s County has been hardest hit in terms of cases and, along with D.C., on deaths.

The data above illustrates the historical impact of COVID-19 but it’s less helpful in understanding recent trends. The table below shows cases in the two most-recent 7 day periods (8/24-8/30 and 8/31-9/6) relative to population.

During the 8/24-8/30 period, MoCo had the lowest cases per capita of any large jurisdiction in the region. During the following week (8/31-9/6), MoCo was below the regional average and about equal to Baltimore City, Howard, Fairfax and Loudoun. It’s worth noting that MoCo’s cases per capita increased over the two weeks.

MoCo is one of just four jurisdictions in Maryland (along with Baltimore City and Anne Arundel and Prince George’s counties) that is not reopening in line with the state’s phase 3. MoCo’s cases per capita in the most recent week are roughly equal to or lower than Howard, which is proceeding to stage 3, and most of Northern Virginia, which has been operating under Virginia’s phase 3 (which is less restrictive than Maryland’s) since July 1.

Here’s the bottom line, folks: if reopening is a data driven decision, then the facts do not point exclusively in one direction. As seen here and in Part One, supporters and opponents of reopening can each point to data that reinforces their respective points of view. Anyone who says that the data is completely with them is mistaken.

That said, each side bears a burden in making their argument.

County Executive Marc Elrich must explain why he continues to resist reopening despite improvement in the majority of the county’s tracked measures. He must also explain why some jurisdictions with similar or higher recent COVID case rates have proceeded to greater economic liberalization than MoCo, especially in Virginia.

The critics have a different problem. Elrich has been very consistent in saying that public health is his top priority. In making that judgment, he is far from alone among MoCo residents. Critics have to acknowledge that further reopening creates greater risk. They must also explain why public health should not be considered the county’s sole top priority, or at the very least why concessions on that issue are justified by economic recovery.

By Adam Pagnucco.

Last week, Governor Larry Hogan announced that Maryland would enter phase 3 of its reopening, which included a partial lifting of restrictions on indoor theaters, outdoor venues, retail stores and religious institutions. County Executive Marc Elrich said he was a “bit disappointed” with the decision and said the governor “has again taken us by surprise.” Declaring “this is not party time,” Elrich declined to follow the state’s reopening plan, which he is allowed to do under the governor’s executive orders.

Jurisdictions around the state are split. Anne Arundel, Montgomery and Prince George’s Counties are not proceeding to phase 3. Baltimore City is not either, although it is relaxing some restrictions. Most of the rest of the state, including large jurisdictions like Baltimore County, Frederick and Howard, are moving into phase 3 with a handful of small counties not making announcements yet.

Elrich has said time and again that his reopening decisions are made based on data and science. Elrich’s critics say he is not balancing economic needs with public health and that county restrictions are driving MoCo residents to spend money in neighboring jurisdictions.

Who is right?

First, let’s look at MoCo’s COVID-19 dashboard, which tabulates 10 quantitative data points and 7 qualitative data points identified by the county as relevant to its progress. At this writing (Sunday, September 6), 4 data points (intensive care unit bed utilization, percentage of ventilators in use, test positivity and hospitalizations) have been rated adequate on at least 80% of the days since the county went into phase 2. No data points have been rated inadequate on a majority of those days, although one (acute care bed utilization rate) was close. This is not a perfect record, but it’s a decent one.

The record looks stronger when these numbers are compared to the worst days in May. Let’s look at the county’s weakest measure: acute care bed utilization rate. This measure has averaged just above 70% in the last couple weeks. It topped out at 82% in early May. Bear in mind that this is the county’s weakest measure and it has shown improvement.

Now here is one of the county’s strongest measures: the percentage of the county’s ventilators in use. In the second week of May, this measure peaked at just over 60%. It has now been under 30% since mid-August.

The qualitative criteria are even better. As of September 6, 4 criteria were judged to be met and 3 were making progress.

Elrich and his critics can each find support for their arguments in this data. Elrich can say that not every measure is where it should be and that the trend of improvement is not as robust as it was in June or July. Those who disagree can say that most measures have been improving, and if that is not enough to justify further reopening, then what is?

All of the above is just one dimension of the issue. In Part Two, we shall see how MoCo compares to its neighbors.

By Adam Pagnucco.

Stories in Bethesda Beat and the Washington Post have confirmed a disturbing aspect of the dispute between Montgomery County and Rockville lab AdvaGenix, with which the county had a contract to provide COVID tests that was later terminated. Specifically, the county’s contract with AdvaGenix prohibits it from disclosing to the public how much it is obligated to pay the company.

Bethesda Beat filed a Maryland Public Information Act (MPIA) request with the county to obtain its contracts with AdvaGenix and Bio-Reference Laboratories, another testing lab. According to Bethesda Beat, the county took 53 days to answer the request despite plainly having the contracts in its possession, a violation of the 30-day requirement in state law. Both contracts had pricing terms redacted.

The images below are from the AdvaGenix contract as posted online by the Washington Post. Note how pricing references are redacted and the parties agreed to keep “all information and matters regarding pricing” confidential.

The county’s public information officer cites provisions in the MPIA preventing disclosure of trade secrets as the reason for redacting pricing data in the contract. He has a point: according to the state’s Attorney General, the MPIA indeed “prevents disclosure of trade secrets, confidential commercial or financial information, and confidential geological or geophysical information, if that information is furnished by or obtained from any person or governmental unit.” However, that doesn’t mean that the county had to agree to specific contract provisions keeping pricing confidential. In fact, the county’s MPIA response database is full of requests for and disclosures of county contract information, including pricing schedules.

A contractor’s pricing schedule for inmate phone calls released in response to an MPIA request.

Pricing secrecy benefits a county contractor in two ways. First, if the company’s pricing is protected from disclosure, that makes it harder for a potential competitor to undercut it in the future. Second, secrecy makes it easier for a contractor to charge higher prices to other customers. For example, if another county knows that the company is charging MoCo X dollars per unit, why would it agree to pay more? This is all very helpful to contractors but not so helpful to taxpayers.

MoCo’s secrecy agreement occurs in a context of widespread variation of COVID test prices. The New York Times reported that COVID test charges in Texas vary from $27 to $2,315 per test. That range is facilitated by the common practice of hospitals and insurers to keep COVID test prices secret, as MoCo does. Last year, President Donald Trump issued an executive order requiring hospitals “to publicly post standard charge information, including charges and information based on negotiated rates and for common or shoppable items and services, in an easy-to-understand, consumer-friendly, and machine-readable format using consensus-based data standards that will meaningfully inform patients’ decision making and allow patients to compare prices across hospitals.” When the American Hospital Association sued to keep prices secret, it lost in U.S. District Court. (It will no doubt appeal.)

Montgomery County Government is actually more anti-transparency in the case of COVID test pricing than Donald Trump. Think about that.

Unlike out-of-pocket costs paid by hospital patients, MoCo’s testing costs don’t directly hit the wallets of those being tested. But they do hit residents’ wallets through their tax bills. On top of that, possible litigation with AdvaGenix looms. The fact that MoCo taxpayers do not know how their tax dollars are being spent is highly problematic. And that is the case because their county government wants it that way.