If the Chesapeake Bay were a hospital patient, it would need major surgery, not just a tweak to the medicine it’s been getting. After 25 years of cleanup efforts, the bay is barely holding its own against the tide of people who have moved into the region – drawn to the very body of water they’re fouling.

The prognosis is not encouraging, with Maryland’s population expected to grow by another million-plus people in the next 20 years.

The Chesapeake is so large, its ultimate recovery depends on actions by all the states whose waters drain into it. But scientists and advocates say there are steps Maryland could take on its own to revive its rivers – and thus the bay Most experts agree, for instance, that there must be a sharp reduction in polluted runoff from farms.

Tough limits on suburban sprawl also are needed, they say, to preserve the forests, meadows and wetlands that naturally filter out pollutants before they can reach the bay. And as part of that, the proliferation of household septic systems that leak pollution into creeks and rivers has to stop. It’s unclear whether those measures will get much consideration in the State House next year, even though no one disputes that they would help the bay. State and local officials have flinched in the past at ordering such steps because of what they would cost. Not just in dollars, but in the restrictions on farmers, builders and homeowners. Farmers don’t want to be told what to do with their land, saying tough regulations will drive them out of business. Builders say restrictions will put housing prices out of reach of working families.

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