RI Emergency Doctor Explains Possible Causes of Coronavirus Surge

PROVIDENCE, RI — Rhode Island is experiencing its worst coronavirus surge to date, surpassing cases and hospitalizations from the spring. While there are many reasons that could be blamed for the spike, one emergency doctor explained some possible culprits.

Dr. Megan Ranney is an emergency doctor with Brown Emergency Medicine and director of the Brown University's Center for Digital Health. In a thread on Twitter, she explained how Rhode Island is uniquely positioned to be so hard hit by the latest wave of the pandemic.

"OK, I keep getting asked why our COVID-19 rates are so high [in Rhode Island]," she wrote. "Here are my best guesses."

Firstly, Rhode Island is conducting a lot of testing per capita, Ranney said, and as Gov. Gina Raimondo has repeatedly said, more testing leads to more cases.

From a public health perspective, Rhode Island has the unfortunate combination of being small and densely populated, so minor increases in case numbers have an outsize effect, Ranney explained. It's also the second-most densely populated state in the country, "with lots of multi-family and multi-generational homes," she said.

Which leads into another potential cause for the spike: Rhode Island is tight-knit. The old joke that everyone knows everyone in the state makes the chances of large family gatherings with a lack of social distancing and mask-wearing a real concern.

"Two-thirds of Rhode Islanders never move out of the state," Ranney said. "And we know that our much-treasured family gatherings are often superspreader events."

On top of that, Rhode Island has many college students. Early in the semester, students were on campus and routine tested for the virus, adding to negative test total and keeping the positive test rate low. After Thanksgiving, colleges moved to distance learning and students went home or are no longer getting tested frequently.

Race and income status play a large role in public health, according to Ranney. Rhode Island has many essential workers and low-income populations, contributing to the spread of the virus as certain residents are forced to work or don't have access to proper health care, she said.

Finally, Ranney reminded Rhode Islanders that the state's indoor recreation facilities only closed at the start of the two-week pause, meaning any decreases associated with their closure won't show up for least two weeks. She criticized the decision to keep indoor dining open at restaurants.

"At the end of the day, regardless of the reason, our hospitals are overwhelmed & everyone knows someone who is sick," she said. "We are calling for retired health care workers to volunteer, while allowing people to eat in-person at Denny's. We are, frankly, in a very bad spot. With no sign of slowing."

The one factor Ranney said likely isn't contributing to the spike? Schools.

"We are far from the only state with in-person schooling," she explained. "Our infection rates at schools — like elsewhere in the country — remain low and are not unique to RI. We may need to close in-person simply bc of staffing issues, but I do not blame our rate on our schools."

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