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California Set the Tone on Coronavirus Shutdowns. What’s Its Next Move? California Set the Tone on Coronavirus Shutdowns. What’s Its Next Move?
(about 1 hour later)
SAN FRANCISCO — California has been ahead of the rest of America in confronting the coronavirus pandemic, locking down its citizens early and avoiding, so far, the worst-case scenarios predicted for infections and deaths.SAN FRANCISCO — California has been ahead of the rest of America in confronting the coronavirus pandemic, locking down its citizens early and avoiding, so far, the worst-case scenarios predicted for infections and deaths.
But as the national conversation begins to shift to reopening and President Trump beats the drum of economic revival, California’s extremely cautious approach toward the virus is a measure of how complicated it will be to restart the country.But as the national conversation begins to shift to reopening and President Trump beats the drum of economic revival, California’s extremely cautious approach toward the virus is a measure of how complicated it will be to restart the country.
“We’re not going to flip the switch and suddenly have the economy return to what it was and everyone come out of their homes simultaneously,” Mayor Eric Garcetti of Los Angeles said in an interview. “People’s physical interactions, people’s spatial understandings, people’s risk-taking will come slowly.”“We’re not going to flip the switch and suddenly have the economy return to what it was and everyone come out of their homes simultaneously,” Mayor Eric Garcetti of Los Angeles said in an interview. “People’s physical interactions, people’s spatial understandings, people’s risk-taking will come slowly.”
As America’s premier gateway to China, California was, early in the pandemic, seen as one of the most vulnerable states to the spread of the virus. In January, close to 600 direct flights from China carrying around 150,000 people landed in the state, more than twice as many as landed in New York.As America’s premier gateway to China, California was, early in the pandemic, seen as one of the most vulnerable states to the spread of the virus. In January, close to 600 direct flights from China carrying around 150,000 people landed in the state, more than twice as many as landed in New York.
But two and a half months after the first cases were detected in Southern California, scientists are scrambling to explain the California conundrum: The state, despite its large, globe-traveling population, ranks 30th in the nation in coronavirus deaths per capita and has a fraction of the mortality rate that New York and New Jersey have suffered. As of Monday, San Francisco had recorded 15 deaths.But two and a half months after the first cases were detected in Southern California, scientists are scrambling to explain the California conundrum: The state, despite its large, globe-traveling population, ranks 30th in the nation in coronavirus deaths per capita and has a fraction of the mortality rate that New York and New Jersey have suffered. As of Monday, San Francisco had recorded 15 deaths.
Much remains unknown about the coronavirus, and experts are still trying to understand why it is affecting some areas more than others. But figuring out why it has spread much less intensely in America’s most populous state than initially feared will be important in planning next steps, experts say.Much remains unknown about the coronavirus, and experts are still trying to understand why it is affecting some areas more than others. But figuring out why it has spread much less intensely in America’s most populous state than initially feared will be important in planning next steps, experts say.
As it has with so many other policies, California went its own way on confronting the virus. In moving toward recovery its leaders are inching forward, having repeatedly said that success can quickly turn to failure.As it has with so many other policies, California went its own way on confronting the virus. In moving toward recovery its leaders are inching forward, having repeatedly said that success can quickly turn to failure.
How the nation’s largest economy calibrates the reopening will have huge ramifications for the rest of the country, providing examples of what works, and what does not, especially given limits on testing capacity.How the nation’s largest economy calibrates the reopening will have huge ramifications for the rest of the country, providing examples of what works, and what does not, especially given limits on testing capacity.
Gov. Gavin Newsom said on Tuesday that the state would eventually replace its broad-based stay-at-home orders with more localized and less restrictive measures. But he did not give a time frame, saying he would revisit the question in two weeks.Gov. Gavin Newsom said on Tuesday that the state would eventually replace its broad-based stay-at-home orders with more localized and less restrictive measures. But he did not give a time frame, saying he would revisit the question in two weeks.
“Ask me the question then. I know you want the timeline but we can’t get ahead of ourselves,” Mr. Newsom said. “Let’s not make the mistake of pulling the plug too early.”“Ask me the question then. I know you want the timeline but we can’t get ahead of ourselves,” Mr. Newsom said. “Let’s not make the mistake of pulling the plug too early.”
“We want to see hospitalization numbers flatten and start to decline,” the governor said, adding that the state would also have to build up its testing capacity, better protect older and more vulnerable people and ensure that hospitals have enough supplies.“We want to see hospitalization numbers flatten and start to decline,” the governor said, adding that the state would also have to build up its testing capacity, better protect older and more vulnerable people and ensure that hospitals have enough supplies.
Face coverings will likely remain a feature of public life, at least for a time, he said. Patrons of restaurants will likely have their temperature taken before being seated, and servers will wear masks and gloves. Large gatherings over the summer were “not in the cards,” he said, and in the fall, students may attend school in shifts to avoid crowded classrooms.Face coverings will likely remain a feature of public life, at least for a time, he said. Patrons of restaurants will likely have their temperature taken before being seated, and servers will wear masks and gloves. Large gatherings over the summer were “not in the cards,” he said, and in the fall, students may attend school in shifts to avoid crowded classrooms.
“Normal it will not be,” he said.“Normal it will not be,” he said.
The reasons for the early promising signs in California are numerous, experts say. The state was the first to issue stay-at-home measures, and even before the orders came down, Californians were beginning to keep their distance from one another, while New Yorkers were still packing bars and restaurants.The reasons for the early promising signs in California are numerous, experts say. The state was the first to issue stay-at-home measures, and even before the orders came down, Californians were beginning to keep their distance from one another, while New Yorkers were still packing bars and restaurants.
Other factors include a work-from-home culture at many companies, spurred by the tech industry; a dry and sunny February that brought people away from crowded spaces and into the outdoors; and even the fact that the San Francisco 49ers lost the Super Bowl, avoiding a crowded victory parade.Other factors include a work-from-home culture at many companies, spurred by the tech industry; a dry and sunny February that brought people away from crowded spaces and into the outdoors; and even the fact that the San Francisco 49ers lost the Super Bowl, avoiding a crowded victory parade.
California’s deep experience confronting natural disasters has also helped it address the pandemic. Not only does the state have a vast government machinery in place to handle disasters, but its populace has experience following orders at a time of calamity.California’s deep experience confronting natural disasters has also helped it address the pandemic. Not only does the state have a vast government machinery in place to handle disasters, but its populace has experience following orders at a time of calamity.
Several experts are advancing another explanation, too: Features that have long been viewed as liabilities — the state’s solitary car culture and traffic-jammed freeways, a dearth of public transportation and sprawling suburban neighborhoods — may have been protective.Several experts are advancing another explanation, too: Features that have long been viewed as liabilities — the state’s solitary car culture and traffic-jammed freeways, a dearth of public transportation and sprawling suburban neighborhoods — may have been protective.
“Life in California is much more spread out,” said Eleazar Eskin, chair of the department of computational medicine at the University of California, Los Angeles. “Single-family homes compared with apartment buildings, work spaces that are less packed and even seating in restaurants that is more spacious.”“Life in California is much more spread out,” said Eleazar Eskin, chair of the department of computational medicine at the University of California, Los Angeles. “Single-family homes compared with apartment buildings, work spaces that are less packed and even seating in restaurants that is more spacious.”
Many scientific studies have found a correlation between population density and the spread of flu and other infectious diseases, something that may exist for the coronavirus as well.Many scientific studies have found a correlation between population density and the spread of flu and other infectious diseases, something that may exist for the coronavirus as well.
Moritz Kraemer, a scholar at Oxford University, conducted a study with 12 other scientists across the world that relies on data from China. The study, which has not yet completed peer review, shows that more crowded areas had both higher coronavirus infections per capita and more prolonged epidemics.Moritz Kraemer, a scholar at Oxford University, conducted a study with 12 other scientists across the world that relies on data from China. The study, which has not yet completed peer review, shows that more crowded areas had both higher coronavirus infections per capita and more prolonged epidemics.
“The more space you have, the less probability there is for transmission,” said Dr. Kraemer, who is also leading a team of researchers in mapping the global spread of the virus.“The more space you have, the less probability there is for transmission,” said Dr. Kraemer, who is also leading a team of researchers in mapping the global spread of the virus.
But California still has numerous weak points, and experts stress that density is only one of many factors in the spread of a disease that is still poorly understood.But California still has numerous weak points, and experts stress that density is only one of many factors in the spread of a disease that is still poorly understood.
Nursing homes and other settings where people congregate have been hit hard. The authorities discovered 102 cases at a single homeless shelter in San Francisco.Nursing homes and other settings where people congregate have been hit hard. The authorities discovered 102 cases at a single homeless shelter in San Francisco.
Jeffrey Shaman, a professor of environmental health sciences at Columbia University, where he has been deeply involved in modeling the spread of the disease, said it was likely that some aspects of West Coast culture helped dampen the early spread of the virus. But that does not argue, he said, for car congestion as a cure-all.Jeffrey Shaman, a professor of environmental health sciences at Columbia University, where he has been deeply involved in modeling the spread of the disease, said it was likely that some aspects of West Coast culture helped dampen the early spread of the virus. But that does not argue, he said, for car congestion as a cure-all.
Updated June 12, 2020Updated June 12, 2020
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Some experts like George Rutherford, a professor of epidemiology at the University of California, San Francisco, put more emphasis on early government action in mitigating the spread of the virus. Dr. Rutherford said the nation’s first stay-at-home orders by officials in the San Francisco Bay Area, led by the Santa Clara chief health officer, Dr. Sara Cody, were crucial.Some experts like George Rutherford, a professor of epidemiology at the University of California, San Francisco, put more emphasis on early government action in mitigating the spread of the virus. Dr. Rutherford said the nation’s first stay-at-home orders by officials in the San Francisco Bay Area, led by the Santa Clara chief health officer, Dr. Sara Cody, were crucial.
“That’s where the credit belongs,” Dr. Rutherford said.“That’s where the credit belongs,” Dr. Rutherford said.
Dr. Rutherford pointed out that his commute on mass transit in the Bay Area resembled one in New York City more than in Los Angeles.Dr. Rutherford pointed out that his commute on mass transit in the Bay Area resembled one in New York City more than in Los Angeles.
“I easily come within six feet of 200 people a day,” he said.“I easily come within six feet of 200 people a day,” he said.
Yet even in San Francisco, the nation’s second-densest major city, cars are much more common than in New York. San Francisco has one vehicle for every two people while the ratio in New York is one to four, according to data from the Department of Motor Vehicles.Yet even in San Francisco, the nation’s second-densest major city, cars are much more common than in New York. San Francisco has one vehicle for every two people while the ratio in New York is one to four, according to data from the Department of Motor Vehicles.
Experts say understanding the dynamics of spread will be crucial for the next phases of the pandemic, as the authorities look for ways to open up the economy while avoiding a wide-scale and deadly second wave of the disease.Experts say understanding the dynamics of spread will be crucial for the next phases of the pandemic, as the authorities look for ways to open up the economy while avoiding a wide-scale and deadly second wave of the disease.
Mr. Garcetti, the Los Angeles mayor, has been guided by history, spending his nights and weekends studying how California cities responded to the 1918 flu pandemic. One of his key takeaways is that acting too soon to reopen could be disastrous, citing a second wave of infections in 1918 that proved more deadly than the first.Mr. Garcetti, the Los Angeles mayor, has been guided by history, spending his nights and weekends studying how California cities responded to the 1918 flu pandemic. One of his key takeaways is that acting too soon to reopen could be disastrous, citing a second wave of infections in 1918 that proved more deadly than the first.
In 1918, “L.A. acted quickly and kept with it,” he said. In contrast, San Francisco, he said, “had also done really well but then came out of it too quick, and had a second spike in the short term, which killed a lot of people.”In 1918, “L.A. acted quickly and kept with it,” he said. In contrast, San Francisco, he said, “had also done really well but then came out of it too quick, and had a second spike in the short term, which killed a lot of people.”
Epidemiologists say transmission dynamics will differ by state, city and neighborhood.Epidemiologists say transmission dynamics will differ by state, city and neighborhood.
In a push to better understand the scope of people’s interactions, Dr. Eskin is leading a survey effort in California and beyond. The survey asks what symptoms the participant has experienced, if any, and the locations of the supermarkets and pharmacies where he or she goes.In a push to better understand the scope of people’s interactions, Dr. Eskin is leading a survey effort in California and beyond. The survey asks what symptoms the participant has experienced, if any, and the locations of the supermarkets and pharmacies where he or she goes.
“We want to give the public health authorities the data that they need for them to make decisions on when they should let people go back to work or the kids go back to school,” Dr. Eskin said.“We want to give the public health authorities the data that they need for them to make decisions on when they should let people go back to work or the kids go back to school,” Dr. Eskin said.
But even as California officials consider data that shows the outbreak here is far less intense than initially feared, they are being cautious in predicting a loosening of restrictions anytime soon.But even as California officials consider data that shows the outbreak here is far less intense than initially feared, they are being cautious in predicting a loosening of restrictions anytime soon.
Mr. Garcetti, for instance, has been touting the idea of using wide-scale testing to determine who is immune, and then allowing those people to resume some measure of normal life.Mr. Garcetti, for instance, has been touting the idea of using wide-scale testing to determine who is immune, and then allowing those people to resume some measure of normal life.
“The idea of folks having an immunity passport, or something that allows them to be able to work, certainly would accelerate for me our economic recovery and my ability as mayor to lift the orders for some people,” he said recently.“The idea of folks having an immunity passport, or something that allows them to be able to work, certainly would accelerate for me our economic recovery and my ability as mayor to lift the orders for some people,” he said recently.
But that plan would require wide-scale testing, which California does not have.But that plan would require wide-scale testing, which California does not have.
An immunity passport, Mr. Garcetti said, is “still a while off.”An immunity passport, Mr. Garcetti said, is “still a while off.”
Thomas Fuller reported from San Francisco and Tim Arango from Los Angeles. Adam Nagourney contributed reporting from Los Angeles and Matt Richtel from San Francisco. Susan C. Beachy contributed research.Thomas Fuller reported from San Francisco and Tim Arango from Los Angeles. Adam Nagourney contributed reporting from Los Angeles and Matt Richtel from San Francisco. Susan C. Beachy contributed research.