A few weeks before Gov. Gavin Newsom’s announcement Monday that California would radically cancel its reopening, a new COVID-19 crisis arose 2,500 miles away.
It was before Memorial Day, when groups broke out in the deserts of Imperial County, along the Mexican border. Driving north with expanding advertising activity and seasonal travel, when the state reopened and began the summer, the disease devastated retirement homes in Tulare, Modesto and Fresno counties, while it would possibly bleed in June.
Los Angeles, meanwhile, had its own impulse that never calmed down.
For a time, the Bay Area and the northern district of the state would be immune to resurgence, perhaps through extensive use of masks and cool temperatures that prevented others from snuggling up indoors with air conditioning. But eventually, the epidemics on their edges, probably fueled by relaxed attitudes around social gatherings, also hit them and carried their curves upwards.
“California is the epimicide,” said Dr. David Rubin, who analyzed the knowledge from his position as director of PolicyLab, a center at the Children’s Hospital in Philadelphia that fuels knowledge to the White House Crownvirus Working Group. “I’d put them on the list with Texas, Arizona and Florida.”
But unlike those other states, California is famed for its progressive and technocratic policies, and in particular for its first-in-the-nation shutdown. Newsom’s order on Monday again ended indoor dining, closed bars, shuttered zoos and museums, and obligated most counties to revert to the earliest stages of the reopening process.
What went wrong?
According to Rubin, many state leaders have noticed only the capacity they have in their emergency rooms and extensive care units, and have overlooked one underlying factor: the rising rate of transmission of the virus. Often referred to by experts as its reproductive value, or R0, it reflects the ease and frequency with which a disease spreads. That number has fluctuated up or down daily in California counties. But the trend – “the signal,” as Rubin says – was unequivocal.
Prior to Newsom’s order, PolicyLab predicted a new outbreak in San Francisco, according to models shared with The Daily Beast. The graphs come with transmission rate projections and expected case count models for the reopening stages, 3 in total, as well as an on-site shelter situation and the last actual trajectory. Last week, Dr. Rubin and his colleagues shared their findings, as well as data and models for the country’s counties, with the Working Group, which incorporates knowledge into its personalized recommendations for governors.
“I think [California] pushed through their reopening even as they had evidence that their transmission rate was increasing,” Rubin said, arguing that the sporadic outbreaks across the state illustrated the growing threat. “People look for that visual cue that says, ‘Hey, we better do something.’ But it’s already too late. It’s like waiting for the stock market to crash before selling your stock.”
“We’ve noticed a trajectory of spread that has reassured California’s leaders with reopening,” he said. “I am very convinced that California has a plan that includes the description used by the governor, the attenuator. We knew we were going up and down with our interventions.
But while Golden State epidemiologists differed from Rubin’s analysis, they shared confidence that the state’s workload had deviated horribly from its trajectory and that it would take a lot of effort to solve it.
Researchers from the University of Southern California’s Keck School of Medicine have been tracking and modeling for months the spread of COVID-19 in Los Angeles, a city that Mayor Eric Garcetti warned this week that he would possibly have to shut down altogether.
A month and a part ago, Garcetti announced that the expanding city would enter the third point of its reopening, allowing restaurants, salons and places of worship to return to a safe point of general functioning and offices to resume operations where teleworking impossible. . The result, as noted through the USC team, was an accumulation of instances and transmission rates, which only increased.
In an interview, DR. Abigail Horn of USC noted that Los Angeles entered its initial closure around the same time as New York, California City was at a much earlier level of the pandemic. This, combined with decreased density and other factors, probably explained that the City of Angels suffered a much lower death toll than New York in the early months of the epidemic.
He also noted that the city had controlled to flatten its curve, had never controlled to bring it down.
“What concerns us most is that we have not yet reduced our instances. Infections in total never subsided. We opened up in that context,” Horn said, adding that USC scientists had detected increased mobility and contact among Los Angeles residents. “We predicted that the instances would increase. It’s inevitable. The queryArray” How much? “”
“From a public fitness perspective, I think it’s smart to reopen. The challenge is how other people react,” said Conti, who asked for higher government messages to achieve more consistent compliance. “Whenever there are cases, there is the possibility of a peak. The consultation is how other people behave.”
Four hundred miles away, at the University of California, San Francisco, Dr. George Rutherford saw a very different problem.
He admitted the recent upswing in cases in the Bay Area likely owed to celebrations before and during the Fourth of July weekend. Nonetheless, he argued the COVID-19 surge was less a consequence of personal choices, and more of the personal obligations imposed on essential workers—particularly those in the state’s Hispanic communities.
“Everyone’s got a guy in a swim shorts and a T-shirt in Huntington Beach. That’s where the infection is,” he said, and he mentioned a recent paper published by his school’s researchers about the tests in San Francisco’s Mission District. . “This is an endemic disease in The Latin American network of California.”
This goes beyond COVID-19’s national tendency to affect communities of color much stronger than their percentage of the population and, according to Rutherford, has to do with the over-representation of California Latinos between a must-have staff and their overcrowding. living conditions.
For example, he believes that the inability to involve the disease is due to the unhookful or inability of leaders to launch a major social intervention that would allow infallible staff to isolate themselves outdoors from their homes while offering their families. .
The California Department of Corrections’ ruling to move 121 unesteered inmates from the Chinese Men’s Institute to San Quentin State Prison has worsened the entire state and region, Rutherford said. More than a thousand people in this last installation now have the virus.
“Obviously, some put moved too soon, and the pin put this procedure in position to return,” he said.
For his part, Ghaly, the Secretary of State for Health and Human Services, noted that, despite all the exemptions granted throughout the state, he never extended one to Imperial County, the site of some of the worst outbreaks. He added that the fitness formula of the state’s criminal formula was in the hands of a federal trustee appointed through the court, and insisted that the quality of care in San Quentin has improved.
“This is all a component of our continuous and evolving response,” Ghaly said. “Surely it’s about things we keep building on in California. We’ve already done a lot of things, but there’s still a lot to do.”
Independent epidemiologists consulted through The Daily Beast agreed that the trajectory of the epidemic would vary greatly from region to region. And Rubin and Rutherford argued that with The Order of Newsom and the continuation of standards of masking and social estrangement, the Bay Area could possibly temporarily oppose its last wave. However, the scenario in Southern California is more intractable.
All doctors agreed that the state wants a consistent and concerted awareness in all degrees of government, its visions of this intervention may differ.
As for what California’s unfortunate example might teach the nation, Rubin noted that transmission rates have recently increased in some of the hardest-hit areas in the United States: New York, New Jersey, and Pennsylvania. To avoid a total relapse like the West Coast, the states act temporarily and slow down their reopening procedure before the fall.
“I see the same patterns emerge,” he warned. “If you expect an apparent signal in two or three weeks, it’s too late.”