San Francisco Chronicle - (Sunday)
Small gatherings wrong culprit
The first wave of the pandemic brought horror stories of hotspot nursing homes, cruise ships and corrections institutions, pointing to public officials and private companies that failed to protect lives. Now, in the midst of the third and worst wave, we’re being told a different and more questionable tale: that the virus is metastasizing through countless small household gatherings, leaving everyone collectively at fault and our leaders powerless to do more than plead with us to behave better. The superspreader has supposedly given way to millions of microspreaders.
“Cases are spiking, in part because we’re letting our guard (and masks) down with family & friends,” San Jose Mayor Sam Liccardo warned on Twitter days before he was forced to acknowledge gathering with people from four other households for Thanksgiving. The latest surge is “because of these family gatherings,” Solano County Health Officer Bela Matyas told The Chronicle, where people are “letting their guard down.”
Back in July, months before Gov. Gavin Newsom and San Francisco Mayor London Breed were caught dropping their guard for separate gatherings at a fancy Wine Country restaurant, Newsom used similar language, blaming the second wave of infections on family gatherings at which people “let down their guard,” adding that “individual decisionmaking” would “determine the fate and future of the spread of this disease.” Likewise, as cases nationwide were surging in October, U.S. Health and Human Services Secretary Alex Azar pointed a finger at “household gatherings” in an interview with CNN: “This is being driven by individual behaviors at this point.”
Don’t blame the government, in other words; blame yourselves.
The idea that small family gatherings are driving the spread of the virus is intuitively persuasive, especially as the pandemic lingers, the holidays arrive and more of us feel the pull of traditional celebrations with relatives. Particularly as the pathogen’s prevalence increases, any gathering across households heightens the risk of transmission.
What’s misleading about the focus on family gettogethers, however, is that there is little compelling evidence to suggest that they are the primary engine of the contagion to date. On the contrary, study after study has pointed to larger gatherings and superspreading events as its disproportionate drivers.
Research led by Stanford computer scientists and published in the journal Nature last month, for example, used cell phone mobility data to attribute “a large majority of infections” in San Francisco and other populous American cities to “a small minority of ‘superspreader’ ” places. They included restaurants, gyms, hotels and houses of worship, underscoring the efficacy of closing or limiting occupancy of such highrisk locations. A study of cases in Hong Kong, published in Nature in September, found that 80% of transmission could be linked to 19% of cases, with social settings such as bars and temples accounting for far more transmission than households.
Seattlearea public health officials reported last week that about 41% of local infections over the past two months followed a household exposure, a slight increase over the earlier months of the pandemic, but more than twice as many cases followed other potential exposures, led by workplaces, social events, restaurant visits and health care settings. Santa Clara County’s contact tracing data shows no consistent increase in average reported close contacts per case since the summer. And surveys by the University of Southern California’s Dornsife Center and Gallup show only slight changes in the shares of Californians and their fellow Americans who reported visiting other households or attending small gatherings.
While California’s summer and fall swells have coincided with holidays, they have also followed official decisions to allow restaurants and other gathering places to reopen. And while experts have widely viewed Thanksgiving and Christmas with trepidation, the season arrived with the third wave of infections already well under way.
Even now, the worst outbreaks are taking place in states that have imposed the least restrictions. Public officials who have consistently limited highrisk activities have had more success than those who vaguely urge the public to abide by a strict regime of isolation that they themselves can’t seem to follow. Individual decisions matter, but the decisions of the individuals elected to lead us matter more.