San Francisco Chronicle - (Sunday)
Cities strive to balance economy, public health
Officials must walk fine line, weighing commerce and safety against virus’ spread
When Gov. Gavin Newsom announced last week that he was shutting down bars and other indoor venues to subdue California’s swelling coronavirus outbreak, much of the Bay Area wondered: “Wait, bars were open?”
In most of the region, they actually weren’t. And in the counties where bars had resumed business, they hadn’t been open long enough to determine whether these establishments contributed to increased spread of the disease.
But bars, more than just about any other business, expose customers to the highestrisk activities in a pandemic. They bring people together in crowds, inside and with little room for social distancing. No one wears a mask when they’re downing a draft or a craft cocktail. And cautious behavior often declines as alcohol consumption increases.
Open, closed or somewhere in between — yes, curbside margaritas have become a thing — the plight of the corner tavern has come to symbolize the state’s confusing
patchwork of reopening policies. While some counties forged a trail they thought would lead toward economic recovery, others lagged behind, wary of the virus still lurking. Bars and clubs opened from Los Angeles to San Mateo County. But in Oakland, even the beer gardens were closed.
Finding consistent and effective coronavirus policy has proved difficult for the Bay Area and California, and that goes for bars, barbershops, elementary schools and beyond. So far, the path between open and closed, danger and safety, has eluded public health officials. But living with the coronavirus depends on finding that equilibrium: striking a balance between economic recovery and preventing widespread disease. Newsom has paused everything now, as it’s become apparent that Californians have to coexist with this deadly new virus, and life may not get back to normal for a very long time — many more months, if not a year or even two.
Public health experts believe there is a fine line that exists. But the spiraling case and hospitalizations counts, and the dizzying adjustments to county and state sheltering orders over the past eight weeks, underscore how challenging it is to find that equilibrium.
“People wanted to hear, ‘OK, we’re through the worst of it,’ ” said Nicholas Moss, the Alameda County health officer. “But now they are realizing that it’s going to be slower and it’s going to take more work and sacrifice on all sides to get through this together.”
California was successful at sheltering in place when the pandemic first struck. But the state appears to have lost the next round. It tried to reopen too fast, and the virus surged and forced a retreat. As counties halt or roll back their reopening and everyone hunkers down again, one question looms over all others: How does California control this pandemic?
Reopening backfires: In the past week, California reported more than 10,000 cases in a day for the first time, and averaged nearly 9,000 new cases a day. Hospitalizations hit new peaks — nearly 7,000 people were in the hospital with COVID19 by the end of the week, more than at any other time in the pandemic. Deaths have begun to increase, too.
Cases started to pick up in the second and third weeks of June, but public health authorities now trace the surge to the state’s economic reopening, which began in midMay. Over Memorial Day weekend, with the promise of summer luring people outside, millions of Californians began to emerge from home isolation.
The message hadn’t been made clear that it wasn’t safe to return to normal — that it may not be for a long time. People had lost jobs; they were scared and anxious. They missed their friends and their grandchildren. High school seniors who’d endured virtual graduations wanted to celebrate.
On a much bigger, more visible scale, tens of thousands of people took to the streets in crowds to demand social justice in Black Lives Matter protests.
“There was a change in the psychology,” said Matthew Willis, the Marin County health officer. “There’s a lot more casual approach, and that’s linked to more social interactions and more transmission.”
At first, the state, under the authority of Newsom, moved slowly toward reopening. But when case counts remained fairly steady, and much of the rest of the country threw open its doors, pressure mounted to pick up the pace.
In early May, Newsom said that certain counties, which met strict criteria proving their outbreaks were small and contained, could open faster. But few counties hit the targets, and complaints flew from business and political leaders.
A week later, Newsom responded with more relaxed criteria, and by the end of May, almost every county had permission to reopen ahead of the statewide schedule. Even Los Angeles, by then the center of the state’s outbreak, was granted a fastpaced reopening.
By midJune, it was clear that reopening was leading to a surge in the number of virus cases. The state made a watch list to hold counties accountable if they weren’t meeting data targets. On July 1, Newsom forced the 19 counties then on the list to close bars and some other business.
Case counts kept climbing in most of those counties anyway, and by Monday more than half the state — accounting for 80% of the total population — was on the watch list, and a few counties were running dangerously low on hospital beds, particularly in intensive care units.
The state had lost control, and Newsom finally signaled a retreat.
Flattening the curve, Take 2: Ben DeVault, general manager of Rosie McCann’s Irish Pub and Restaurant in San Jose’s Santana Row, said that his industry is used to economic turmoil. “You have to be quick on your feet,” he said. “You have to roll with the punches.”
“But this was the mother of stress tests,” he said, of the sudden shutdown in March and the slow path to reopening.
The restaurant was forced to close on what would have been one of its biggest days of the year: St. Patrick’s Day, March 17. It later was able to open for takeout, and now it has patio seating. The staff had talked about a “St. Patrick’s revival” in September or October, but that seems increasingly unlikely — DeVault doesn’t know when the restaurant will be able to reopen for indoor dining, or when crowds of customers can come back and celebrate with friends and strangers alike.
“I know things are not going to be as they were,” DeVault said. “But this is the new norm now, and we have no choice but to accept and respect it.”
Bay Area counties have not said what metrics they need to see before they will be comfortable pushing forward with reopening again. It will be a couple of weeks at least — enough time for the case counts and hospitalizations to stop climbing and turn the other direction.
Mark Ghaly, secretary of the California Health and Human Services Agency, said the state is looking for the number of new cases and hospitalizations to trend down for at least 14 days, and then potentially stabilize beyond that, before it reverses the widespread business closures recently ordered.
His vision for a safe reopening includes people still staying home as much as possible — a shift that he suggested would require the public to adopt lifestyle changes that could last a year or two.
“I’m going to be the last one