Plan to reopen faces hurdles
Gov. Gavin Newsom made a bold declaration on Tuesday: By June 15, California will be able to almost fully reopen after a year and three months of pandemic restrictions.
The clock has started, and California now has a little under 10 weeks to stabilize its vaccine supply and ward off another deadly wave of the coronavirus to meet its selfappointed target. On the whole, the state is in good shape, public health experts say, and that date seems reasonable for reopening.
But 10 weeks is still plenty of time to get knocked off the path to recovery, they warned. Especially when it comes to a pandemic defined by its twists and turns, and as the U.S. faces down a fourth surge.
“It’s a pretty bold leap to try and predict that far out, in
COVID times,” said Dr. Matt Willis, Marin County’s health officer. “I hope that we’ll be able to move forward. But there’s a lot that can happen between now and then.”
California’s reopening plan involves ditching the complicated, colorcoded tier structure that’s guided the state response since August. Instead, almost all sectors of the economy will be able to fully resume normal operations, with some precautions still in place. California’s mask mandate will remain indefinitely, state officials said.
Opening the state on June 15 is largely reliant on vaccine supply: California expects it will have enough by then so that every person 16 and older who wants to be vaccinated either already is or can easily make an appointment. The second criterion is keeping hospitalizations for COVID19 very low. The state is using that metric as its main marker of whether a fourth wave is building and potentially threatening lives.
With those goals in mind, there are several hurdles that could hobble the state’s plans, or even make a June 15 reopening impossible, public health experts said. In short, those hurdles are: vaccine supply, variants and human behavior.
Vaccine supply
Newsom has said he feels confident that the state will have plenty of vaccines from the three manufacturers to offer shots to everyone on demand. And supply has indeed improved dramatically since the rough start of the state rollout. On Tuesday California hit 20 million doses administered, and Newsom said he’s aiming for 30 million total by the end of this month.
But county public health officials aren’t all quite as confident. Willis said he learned Wednesday afternoon that county vaccine allocations “across the state” would be lower next week than this week or the week before. “This could be a one time thing, but does raise additional concerns about setting a fixed (reopening) date,” he wrote in a text message. “We haven’t seen the increase in doses promised yet.”
In a statement, Dr. Grant Colfax, director of San Francisco public health, said Wednesday that having a target date for reopening is “exciting news because of its implication that we will soon have enough vaccines for all eligible San Franciscans.” But he added that the city still has far more capacity to administer shots than actual doses.
State and federal leaders have repeatedly made promises to improve vaccination efforts,
“and to a certain extent those promises have been fulfilled, but some of them have not,” said Dr. Yvonne Maldonado, an infectious disease expert at Stanford. “Granted, this is a difficult process. It’s not often you build out vaccine manufacturing for a whole world all at one time. But you need to keep vaccination levels up to reopen.”
Maldonado noted that supply is just one aspect of reaching herd immunity and stomping out spread of the virus. Over the next two months, she said, it may become clearer how many people don’t want the vaccine, and how much that will impact the state’s reopening progress.
Variants
Coronavirus variants may be the real wild card barrier to reopening. California already has identified all of the most concerning variants circulating around the globe, but so far none seem to be causing significant damage, and notably the vaccines should provide strong protection against all of them.
The B.1.1.7 variant first detected in the United Kingdom is now dominant in the U.S., the Centers for Disease Control and Prevention said Wednesday. That variant is up to 90% more infectious, and also causes more serious disease. And it may be what’s driving surges in Michigan and a few other states.
California has identified
about 900 cases of the U.K. variant but it’s not dominating here yet. Instead, two Californiabred variants — known as B.1.427 and B.1.429 — are predominant, and though they’re also more infectious they’re not nearly as concerning as the U.K. variant.
“It’s really the variants that threaten to undo all the progress we’ve made,” Dr. Sara Cody, Santa Clara County’s health officer, told the Board of Supervisors. Like many of her public health peers, she said she’s mindful of surges in other parts of the world and how tenuous California’s recovery could be if a dangerous variant gets a foothold.
Dr. John Swartzberg, a UC
Berkeley infectious disease expert, said there’s no clear reason that places like Michigan should be experiencing new surges in cases and hospitalizations when they’re also vaccinating at a quick pace. He and others suspect the B.1.1.7 variant is playing a significant role.
“That’s a headwind that very much worries me. What’s protecting the West, and what’s protecting specifically California from the same thing happening in Michigan?” Swartzberg asked. “What will these variants do and will they throw off the governor’s plans? Unknown.”
Human behavior
Pinning a date on reopening
could be an interesting study in psychology, some public health experts said. Will Californians use that June 15 date as a morale booster to get them through these last couple of months of restrictions? Or will they use it as an excuse to get a little sloppy and give up some stillnecessary precautions like maskwearing?
“Some people may think it’s party time already. But it’s not,” said Dr. Curtis Chan, deputy health officer for San Mateo County.
The Bay Area is still reporting several hundred new coronavirus cases every day, and about a dozen deaths due to COVID19. No counties are yet in the least restrictive yellow tier of the state’s stilloperational blueprint for reopening. In short: The coronavirus remains a deadly threat, and people need to behave appropriately even as the situation improves and the public health messages become more hopeful than dire.
“We want people to start thinking about what comes next, but balancing that with where we are today,” said Dr. Nicholas Moss, Alameda County’s health officer. “This is not the finish line.”