State moving to reopen as virus surges elsewhere
More than two months past the peak of the deadly winter surge, coronavirus cases are still dropping in California even as the state unfurls from an extended lockdown, but the picture is starting to look grim again in other parts of the United States.
Daily cases are stubbornly holding in the 50,000 range nationwide, remaining higher than the lull between surges last fall. Cases are trending up in more than half of all states. And several hot spots have emerged in pockets around the country, fueled by the spread of a more infectious variant of the virus and people tossing aside their masks and abandoning social distancing protocols.
“I continue to be worried about the latest data, and the apparent stall we are seeing in the trajectory of the pandemic,” Dr. Rochelle Walensky, director of the U.S. Centers for Disease Control and Prevention, said during a White House briefing on Wednesday. She noted that the sevenday average for new cases is up this week from last, and hospitalizations and deaths are flat after a long period of declines.
In the past, California has trailed a few weeks behind national trends. Before the winter surge, California was a standout along with one or two
other states for keeping its case rates low while the rest of the country blew up. But it only took a few weeks for California to be overrun and in worse shape than almost every other state.
So it’s concerning, Bay Area public health experts say, to see reports of outbreaks around the country alongside images of people clearly giving up on social distancing efforts. Michigan has seen a particularly alarming spike in cases recently. In Florida, Miami Beach issued an emergency curfew this week when spring break revelers got out of control, gathering in packed crowds on beaches and in bars with very few masks in sight.
At the moment, metrics in California and the Bay Area are improving, and both the state and region are at or near presurge levels in daily cases and other data points like hospitalizations and patients in intensive care. The state’s vaccination rollout continues, with about 26% of residents having received at least one dose and the governor planning to open vaccines to all comers at the end of April.
There are other signs that California is betterpositioned now than at earlier points in the pandemic to avoid being swept up in a national surge. The dangerous B.1.1.7 variant from the United Kingdom hasn’t taken off here the way experts had feared it might, even as it gets footholds in other states. In fact, two Californiabred variants — B.1.427 and B.1.429, which are worrisome but don’t appear to be as infectious as B.1.1.7 — may be holding the U.K. virus at bay.
California, too, remains attached to its aggressive public health protocols. Though much of the state is relaxing some restrictions and reopening at a brisk pace, many basic rules — such as a statewide mask mandate and social distancing regulations — are firmly intact. California is still much more shut down than most other states.
“I don’t worry a whole lot about what’s happening in other states in terms of California, as long as we are careful,” said Dr. Stephen Shortell, former dean of the School of Public Health at UC Berkeley.
He noted that if California is simply trending behind the rest of the country, that could be a key advantage this time around, giving the state a critical two to three extra weeks to vaccinate more people and buffer the effects of another wave if it does arrive.
Though California’s metrics are still favorable, there are plenty of red flags — globally and locally — that should compel people to remain cautious, infectious disease and public health experts said. Several parts of Europe are reporting large outbreaks due to a combination of the B.1.1.7 variant taking hold and people giving up on social distancing behaviors; Germany issued new lockdown orders this week.
Brazil also is under siege, with hospitals overwhelmed across much of the country as the P.1 variant drives a fresh surge. That variant is more infectious and also seems to be a source of reinfection among people who were thought to be immune to the coronavirus.
Four cases of the P.1 variant have been identified in California, including three reported this week. Three of the cases are in Southern California and one is in El Dorado County near Sacramento.
“These cases are a warning. It happens because there’s so much transmission occurring in those communities,” said Dr. Lee Riley, an infectious disease expert at UC Berkeley. He noted that outbreaks in other parts of the country, in particular in Michigan and Minnesota, appear to be fueled by the B.1.1.7 variant.
“These mutants do well in communities where people are not maintaining social distancing,” Riley said. “It’s kind of a perfect storm of variants and then people relaxing, and without a good vaccination rollout. Those three forces are contributing to the surge in Europe, and they could be happening in pockets of the U.S.”
California public health officials have repeatedly said they’re concerned by the national numbers and they don’t expect the state to be fully immune to the effects of its neighbors, or even states on the other side of the country.
Dr. Matt Willis, the Marin County health officer, told the Board of Supervisors on Tuesday that cases have picked up slightly this week. Though it’s too early to consider that a trend, he said, “in the context of increase in cases we’re seeing in other parts of the country, it’s something we’ll be keeping a very close eye on.”
In Southern California, the Los Angeles County health officer echoed that sentiment to her Board of Supervisors.
“This past year indicates that often the East Coast experiences increases in cases before the West Coast and, typically, L.A. County is a few weeks behind New York,” said Dr. Barbara Ferrer. She added that the county has not yet vaccinated enough people to ward off a new wave of cases, and therefore residents must stick with social distancing behaviors.