San Francisco Chronicle - (Sunday)
Death totals remaining stable despite increases in infections and hospitalizations.
The number of new coronavirus cases exploded in California last week while the death toll held steady, prompting predictions that the low body count, instead of a bright spot, might represent the calm before an evergrowing storm. A record number of new coronavirus cases were recorded in the Bay Area, with 491 people hospitalized on Thursday, surpassing the previous peak of 471 on April 7.
There were 5,595 COVID19 patients in the hospital in California on Friday, the highest number since Gov. Gavin Newsom relaxed the shutdown order in June, and more people began going out in public. That’s a 60% increase in patients over the past two weeks.
But even as cases increased, the average number of deaths per day from COVID19 dropped in the Bay Area by 14% from May to June. Statewide, average daily deaths fell by about 8%. There were 100 deaths statewide on July 2 and 50 on July 3 — both well below California’s peak of 115 deaths on April 22.
Infectiousdisease specialists say the low death rate is partly because of drugs that control COVID19 better than before. But mainly, they say, it’s because most recent COVID19 victims have been young people who are less likely to develop serious complications.
“It’s very likely that most, if not all, of the difference has to do with who is getting infected at the moment,” said Art Reingold, professor of epidemiology at the School of Public Health at UC Berkeley. “If the people getting infected by COVID19 are younger and healthier, which appears to be the case, you would expect the death rate would be smaller.”
Of all the new cases in the state on July 3, 65% were people between the ages of 18 and 49. That was more than three times the rate of the secondhighest group, ages 50 to 64, which made up 17% of the new cases. People over age 65 made up 78% of the COVID19 deaths in California.
The sharp increase in new cases started after the reopening in the past month of restaurants, bars, salons and gyms and a general relaxation of shelteringinplace and socialdistancing protocols. Large Black Lives Matter demonstrations, prompted by the May 25 killing of George Floyd after a Minneapolis police officer knelt on his neck, probably spread the disease too, health officials said.
California and the Bay Area each reported nearly 75% increases in daily cases in June compared to May. The number of cases has also been rising in 37 other states, prompting Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, to warn Thursday that the U.S. is in danger of losing control of the epidemic.
Nineteen states, including California, have now halted or reversed their decisions to loosen restrictions on businesses and public gathering spaces.
And the steady rise in infections won’t stop any time soon, even if most of the current victims are young and healthy, said John Swartzberg, an infectiousdisease specialist at UC Berkeley.
Based on the history of the coronavirus since it was discovered in China in December, new COVID19 infections are typically followed two weeks later by a large increase in hospitalizations. A rise in deaths, in turn, usually doesn’t start until about two weeks after hospitalization, he said.
“I would expect that in two weeks we can expect the death rates to go up,” said Swartzberg, admitting that the increase could be less sharp than earlier in the pandemic because of the comparatively young age of the new patients. “The case fatality rates are an elusive number because they lag so far behind the actual number of people getting infected.”
Fatality rates are also skewed, he said, because there are still many victims of the disease who are dying at home. Those people don’t get recorded as a coronavirus case, despite the fact that the underlying cause was COVID19, because they never got tested for the disease.
Most experts agree that the lower death rate California is seeing now also probably has something to do with the introduction of more effective treatments for the coronavirus over the past five months and the fact that hospitals are better prepared to handle patients.
Many doctors now use the steroid dexamethasone, which reduced the number of deaths in seriously ill patients during testing in the United Kingdom. And various antiinflammatories have helped control the killer lung condition known as acute respiratory distress syndrome, or ARDS.
The Bay Area and the state are also doing more testing, so infections get treated faster. The quick responses have helped level off the deadly nursing home outbreaks that have plagued the state.
“I think a lot of it is because the health care providers are getting better at handling these new patients,” said Lee Riley, the head of the division of infectious disease and vaccinology at the UC Berkeley school of public health.
Today’s rising caseloads, he said, happen because many of the young people contracting the virus are not wearing masks. They may also be inadvertently spreading the virus to their friends and relatives during its fiveday incubation period.
“Young people do die, not as much as old people, but it is not them we are worried about. It is their grandparents, their older relatives and all the other people who are at high risk of dying that we are worried about,” Riley said. “This is exactly what happened at the beginning. It was the young people who were traveling and getting infected and they were spreading the infection to older people.”
Los Angeles County is much worse off than the Bay Area, with 1,933 coronavirusrelated hospitalizations on July 2. In the Bay Area, Alameda County topped the hospitalization list with 141 on that date.
The total number of positive cases in California since the pandemic started is 253,090, according to county data compiled by The Chronicle. Statewide, 6,331 people have died of COVID19.
In the end, halting the steady progression of the disease is paramount, according to public health officials and epidemiologists. Doing that, they say, will not be up to the doctors and their new treatments. It will, as always, come down to wearing masks and taking personal responsibility.
“This is not about your personal liberty or freedom. It’s about society,” Riley said. “The right to integrity of the body is one of the fundamental civil liberties we have in the United States. Without public health you don’t have civil liberty.”
Peter Fimrite is a San Francisco Chronicle staff writer. Email: pfimrite@sfchronicle.com Twitter: @pfimrite