OAKLAND — Florida is shutting down all bars. Texas is doing the same — and imposing a host of new restrictions. Arizona is in a state of crisis as the coronavirus spreads at a new and alarming rate.
But in California, which is shattering single-day records for new Covid-19 cases and watching hospitalizations climb higher by the day, Gov. Gavin Newsom isn’t touching the state’s dimmer switch. At least for now.
“As long as we’re attacking these issues together and as long as we start to see more and more compliance with our mask mandate, then I think we can move forward more safely and work our way through this without having to toggle back,” Newsom said this week.
The governor, a high-profile Democrat, has avoided specifying what would cause him to shut down certain economic sectors again. But he appears focused on the state’s hospital capacity and has pointed to plenty of bed space as a defense of keeping sectors open.
Texas Gov. Greg Abbott on Friday closed bars and scaled back restaurant capacity after already halting elective surgeries to preserve hospital bed space. Also on Friday, Florida Gov. Ron DeSantis ordered bars to be shuttered statewide. Both governors are Republicans who had resisted imposing tough restrictions early in the pandemic.
Newsom on Friday urged hard-hit Imperial County on the southern border, which has the highest prevalence of the disease in the state, to reinstate a full stay-at-home order. But the governor didn’t suggest rolling back any statewide reopening rules.
While California won national praise for its swift lockdown orders early in the pandemic, the state’s progress is evaporating each day. The latest sign: a week of soaring cases would seemingly qualify California for the 14-day quarantine set by New York, New Jersey and Connecticut for travelers coming from states where the disease is rapidly spreading.
With Wednesday’s record-breaking report of 7,149 new cases — a 69 percent increase from two days earlier — and another 10,239 cases over the next two days, that brings the total case count to 200,461. Meanwhile, the governor reported Thursday that hospitalizations increased 32 percent over the last 14 days, with ICU admissions up 19 percent in that same time period.
“We’ve said all along this is the price we’re going to pay for reopening,” said George Rutherford, an epidemiologist and infectious disease expert at the University of California, San Francisco.
California’s reopening began in May and kicked into high gear earlier this month with a vast array of sector openings including bars, gyms, summer camps, movie theaters, bowling alleys and nail salons. While not all counties have allowed such establishments to open, more sectors are open than closed in most of the state. Newsom has drawn a line against activities that involve congregations in the hundreds, from fan-attended sporting events to conventions.
Newsom has repeatedly cited the state’s preparedness as reason to forge ahead. With just 8 percent of California’s hospital beds occupied, the governor on Wednesday expressed confidence in the state’s “capacity in the short run to meet the needs of those most in need.”
He’s also touted the state’s supply of ventilators and personal protective gear, along with the growing force of workers throughout the state charged with tracking down people who may have been exposed to the virus. As numbers worsened, Newsom this week struck a new tone by appealing to both individual responsibility and a sense of togetherness, all while imploring Californians to “do the right thing” — wear a mask, wash their hands and keep their distance.
Public health experts say it appears California is shifting from high alarm to “harm reduction,” a health strategy that focuses on reducing rather than eliminating the negative consequences typically associated with drug and alcohol use disorder. In this case, it’s increased mobility in the time of a pandemic.
“Now we’re in the land of tradeoffs. Lessening the lockdown is an economic and political necessity, but it’s going to result in more cases,” said Andrew Noymer, associate professor of population health and disease prevention at UC Irvine.
As for what metrics should be used to trigger closures, Newsom relies heavily on what’s called the “positivity rate,” or the percentage of positive cases, which accounts for the state’s increasing tests. California on Wednesday surpassed the World Health Organization’s recommended positivity threshold of less than 5 percent for reopening, logging positive cases of 5.1 percent over two weeks and 5.6 percent over the last week.
Some counties are reporting alarming positivity rates, with Los Angeles County nearing 9 percent, San Bernardino County moving toward 11 percent and Imperial County nearing 23 percent.
But Noymer said he’s still wary of being quick on the trigger to lock back now this summer. He wants to keep that weapon in the arsenal.
“If things get really crazytown in the winter with K-12 starting up again and perhaps galvanizing a resurgent wave of transmission, another lockdown is something we need to keep up our sleeve,” he said.
To Noymer, “things aren’t really bad right now; they’re just not where we want them to be.” Locking down again would be hard, he said, but locking down yet again “is going to be like Chicken Little, ‘the sky is falling.’ People aren’t going to believe it.”
Despite the risks, Noymer acknowledges the status quo can’t persist. “I don’t think we’re better off if we save people from the pandemic, but crush them in other ways,” he said.
UCSF’s Rutherford is worried about certain California counties running out of bed space. The border county of Imperial has already started to exceed hospital capacity, and has sent patients as far north as Stanford University in the Bay Area for care.
The saving grace so far is that death rates statewide haven’t kept pace with skyrocketing case counts, Rutherford said. He attributed that to increased cases among younger people, who are at a lower risk of dying. “But give it two to three weeks to see if the deaths keep up with the cases,” said Rutherford, who says the best thing people can do is wear a mask and avoid mass gatherings.
The state has launched a “watch list” of counties struggling to maintain their Covid-19 outbreaks. The list — now at 15 — includes Santa Clara and Sacramento counties, which had been dropped from the list but are back on due to increased hospitalizations. Stanislaus County is fairly new to the list, and Contra Costa County was just added.
“It seems once business began to reopen and activities began to resume, many people in our county began acting as if everything is going back to normal,” Stanislaus County Supervisor Kristin Olsen said. “Instead of going to a restaurant with their family, they cater a party in their backyard. That has led to our increased numbers.”
Olsen is worried about running out of hospital beds this summer if the case count continues to increase on the current trend. She said 600 of the county’s 1,200 hospital beds can be made available for Covid-19 patients. Capacity remains, but is going fast.
“Within three or four weeks, we could be hitting that 600 figure if those rates continue to increase,” Olsen said.
Being on the state’s watch list means the county has two weeks to try to resolve the issues, Olsen explained. If the county fails to do so, the state could suggest the county consider reinstating some limitations.
While it’s not planning to close any sectors, Stanislaus has delayed the reopening of nail salons, as well as massage, tattoo and piercing services to July 1 even though the state allowed them to open a week ago. The county is also working on the hospital bed capacity and increasing contact tracers.
Newsom has emphasized that counties control their reopening plans and shifted power to local officials, which more closely mirrors the federalism approach taken by President Donald Trump as well as the local control efforts of red-state governors. That stands in contrast to the earliest months of the pandemic when Newsom was calling most of the shots for California’s nearly 40 million residents — which initially won him plaudits for early actions but later drew criticism from weary residents, especially in counties that had few Covid-19 cases.
The decentralization has played out in different ways.
Lassen County halted its reopening plans last month after a surge of cases hit the small, northern county, but resumed after a couple of days. Sonoma County leaders last month kept certain sectors closed and met vocal opposition from the county sheriff, who initially vowed not to enforce the orders until he backed off.
San Francisco on Friday delayed the city’s planned reopening of hair salons, museums and outdoor bars, which was slated for Monday, amid rising case counts.
Grant Colfax, director of San Francisco’s Department of Public Health, couldn’t say when the city would move forward again, but that the next few days and weeks will be crucial. He said hospital capacity in San Francisco remains strong, but was concerned that Thursday’s spike of 103 cases in the city would develop into increased hospitalizations.
"We’re taking a pause here. We’re not reversing. We’re going to have to watch the data," Colfax said during a press conference Friday.
Some recreational entities have been more cautious around reopening. Yosemite National Park this week reversed course after reopening two weeks ago, extending its campground closures through July 31 due to concerns of increased disease spread. And Disneyland, which hoped to reopen the park by its July 17 anniversary date, has now decided to wait after the state apparently intervened, Newsom suggested Thursday.
Business groups are encouraging Newsom to continue deferring to local governments — and to continue melding public health and economic concerns. They also hope the state will step in to protect them from being held liable under local regulations, and to give them a grace period to implement local rules without fear of being sued.
"We strongly believe our governor and state leaders need to continue to defer to counties and their public health officials for the best and most accurate local health and safety guidelines," said John Kabateck, state director of the National Federation of Independent Business. "We have been stressing to the governor’s team a strategy that involves a process based on empirical data from the best health and safety experts, combined with sound information from economic development and job creation leaders."
Carl Guardino, head of the Silicon Valley Leadership Group, a nonpartisan public policy organization representing more than 350 companies in the capital of the innovation economy, said the effects of a second shutdown on the state and regional economy would be unfathomable — and devastating.
The costs of a second shutdown in the Silicon Valley — and statewide — would not only be “crippling in different ways on people’s economic health as well as their health in other ways,’’ he said, but would manifest in spousal abuse, child abuse, stress, calls to suicide hotlines and more.
The real message to California at this point must be “we cannot afford to let our guards down,’’ Guardino said.
Carla Marinucci and Debra Kahn contributed to this report.
Source: politico.com
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