After a brutal summer of increased infection and overburdened hospitals, California is having a moment of respite in coronavirus transmission as much of the nation and the world experiences yet another rise in cases.
But experts and public health officials warned Californians to practice caution.
California saw just eight new cases per 100,000 people on Tuesday, while the US as a whole reported more than double that at 18 cases per 100,000. Disneyland is on a path to reopening, albeit not for a few weeks at the earliest and at a very limited capacity. Hospitalization rates have declined. The test positivity rate is down to 2.6% over a 14-day period, “some of the lowest test positivity that we’ve seen across the state”, said Dr Mark Ghaly, California’s secretary of health and human services.
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“Many states across the nation, and frankly nations across the globe, are facing new waves of cases,” Ghaly said at his Tuesday briefing. “We’re seeing testing impacts, hospitalizations and challenges in some of the hospitals around the nation, things that during that summer that we certainly faced here in California, but because of our working together, came down nicely. So far, we have not been facing those increases.”
California was the first state to order residents to shelter in place when the pandemic emerged in the country in early spring. The state avoided a surge in cases like the one New York experienced, and its death rate remained relatively low. Its government, led by Gavin Newsom, was touted across the country for its forceful leadership.
But restrictions started easing in May, and as the weather warmed, residents in some counties flooded back to beaches, bars, restaurants, fitness rooms and salons. By 4 July, the state registered an average of about 6,000 to 7,000 new cases each day.
“We made a terrible mistake like so many other places in the United States did when we opened up too quickly in May and continued to let them be open in June and that led to the horrific time we had in July and August,” said John Swartzberg, a professor emeritus of infectious diseases at the University of California, Berkeley. “I think California learned from that mistake.”
California moved away from its “watch list” system that prevented counties from reopening certain sectors of the economy if they had too many cases or too high a test positivity rate. The state instead adopted a tiered system for reopening. Based on rate per population and positivity rates, a county can decide to reopen more the lower and longer its rates remain.
Ghaly, the secretary for health and human services, has said hospitalizations have declined in part because the state is testing more people and is doing a better job at contact tracing.
Some large cities in the state became coronavirus success stories. The San Francisco Bay Area was among the first in the US to register coronavirus cases, but the city avoided an explosion of infections. Even as it met state criteria for reopening time and time again, city officials have practiced caution. The efforts have paid off. San Francisco, a more populous city than all of North Dakota, has almost three times fewer coronavirus cases than that entire state.
“If the national-level leadership had followed California and several other states on how they conducted things, there’s no question that there would have been quite a lot fewer deaths and a lot less morbidity,” Swartzberg said.
Governor Newsom this week welcomed the reassuring numbers, but cautioned he wanted to be realistic as much as optimistic.
Experts predict a fall surge will come, he warned, and that Californians cannot allow themselves to become lax in their efforts. “This is what all the epidemiologists, scientists, anyone who followed our history or data from the Spanish flu pandemic anticipated moving into the colder season,” Newsom said. “That’s why we are being very sober and, forgive me, stubborn, about some industries in the state that I know are eager to get guidelines [on reopening].”
Officials are particularly monitoring infection rates among young people, who often have more social contacts. In Los Angeles, people aged 18 to 29 now account for about 10% of all coronavirus-related hospitalizations compared with 5% in mid-May. Barbara Ferrer, the Los Angeles county public health director, told the Associated Press it was one of the troubling trends in the county.
The state last week lifted its most severe restrictions on most counties, and officials now say it is OK for up to three households to gather outdoors if people keep a distance.
But the effects of the pandemic remain. Teaching for millions of school-age children remains remote. Large public gatherings are still not allowed. Many bars and restaurants are not yet operating indoors.
“I hope one recognizes our stubbornness on a health-first, data-driven decision-making process is done with our eyes wide open on what’s happening now around the world,” Newsom said on Monday. “We have to maintain that vigilance so we can avoid any further increase in transmission.”
“We had to be tough. We had to be vigilant. We had to be mindful of the changing dynamics of this pandemic.”