New restrictions likely to last longer
Infectious disease experts say it’s unrealistic that latest stay-home order will end in early January
“We know this isn’t a permanent state of affairs — and I fervently hope three weeks are sufficient — but it’s too soon to speculate.” — Dr. Mark Ghaly, California Health and Human Services Secretary
Gov. Gavin Newsom grasped for an encouraging tone last week as he leveled a new round of restrictions on coronaviruswear y Califor nia ns in hope of tamping down an alarming surge in cases: Hunker down one last time for a few weeks to bend the curve. Vaccines are coming.
But in the week since Newsom announced his new stayhome order with tighter restrictions on travel and shopping and a ban on outdoor restaurant dining, infections have spiked to record highs, intensive-care wards have filled faster than expected in many areas and some of the state’s rules have met open defiance. Amid signs that Thanksgiving gatherings fueled new infections, Christmas and New Year holidays now loom with the specter of more cases.
While the new stay-home order comes with a tentative sunset after three weeks, depending on results, epidemiologists say the early January lifting Newsom forecast is unrealistic.
“It’s going to get worse before it gets better,” said Dr. John Swartzberg, an infectious disease expert and professor emeritus at UC Berkeley. “Unless something remarkable is going to happen and people meticulously follow the orders, we’re going to see things continue to get worse through probably the third week of January.”
Andrew Noymer, an epidemiologist and population health scientist at UC Irvine, said that while the vaccines expected to be distributed in coming days are “the best thing to happen in a long time,” they are “coming a little too late to have a major influence over the dynamics of the current wave” of infections.
“I would characterize the recent vaccine developments as the light at the end of the tunnel,” Noymer said. “I’d also say it’s not clear to me that given all the realworld practicalities of getting vaccines to all Californians when they need it, that a vaccine is going to hit like a ton of bricks over a short time frame” and stamp out the virus.
Thursday marked another day of grim records in
the Golden State. The past week has been California’s deadliest of the pandemic and as the state logged more than 30,000 new infections for a fourth consecutive day Thursday, Santa Clara County had intensive care units at three hospitals fill to capacity.
County health authorities have cautioned that as they prepare to administer the first rounds of vaccine to prioritized front line doctors and nurses and the staff and residents at nursing homes, the rollout to most everyone else is months away.
The San Francisco Department of Public Health said Thursday “the general population will not likely have access until the vaccine supply is no longer limited,” which it said likely would be next summer or early fall.
Santa Clara Count y Health Officer Dr. Sara Cody told a health com
mittee this week that the county will initially receive “a very limited number of vaccines.” She said “it is going to take quite some time” before vaccinations and natural infections combine to produce “herd immunity” with about 70% of the population protected from infection.
For Newsom, the ongoing slog of social distancing and shutdowns has posed a mounting challenge. The governor enjoyed broad support and cooperation for his first-in-the-nation stay-home order in March. After a spring letup on restrictions led to a summer case surge, he retooled the state’s reopening metrics with a color-coded scheme. That seemed to work for a while, but then came the fall infection spike.
With each cycle of reopenings a nd ne w restrictions, public compliance has come harder. It didn’t help that the gov
ernor was caught disregarding his administration’s guidance on large gatherings w ith friends and family for a dinner last month at an exclusive Napa Valley restaurant.
Announcing the new st ay- home order, Newsom appea led to Californians to give quarantine one more go and as they did in March, “take that same spirit and that same capacity and make sure that we meet this moment.” As vaccines arrive “in the next few weeks, you’ll be hearing good news on top of other good news.”
“There is light at the end of the tunnel,” Newsom said. “We are a few months away from truly seeing real progress with a vaccine, real distribution, real accessibility, real availability. We do not anticipate having to do this once again.”
But with epidemiologists talking about public “quar-
antine fatigue,” many restaurants have vowed to continue serving customers at outdoor tables in spite of the new restrictions. And protests prompted the state to drop outdoor playground closures from the order.
“People are sick of it,” Noymer said.
The stay- home order, which begins when a region drops to less than 15% of its hospitals’ intensive care capacity and is already implemented in the Bay Area’s largest counties and the southern and central part of the state, remains in effect for at least three weeks. Swartzberg and Noymer said it’s unlikely any region will improve enough in that time to come out of it.
California Health and Human Services Secretary Dr. Mark Ghaly, however, said it’s up to residents how long the restrictions last.
“If we all truly stay home except for essential
work and needs, California should start seeing case rates flattening or even decreasing in three weeks,” Ghaly said in a statement. “If we all continue our normal lives and holiday plans, cases will keep spiking upward and hospitals will continue to be overwhelmed. We know this isn’t a permanent state of affairs — and I fervently hope three weeks are sufficient — but it’s too soon to speculate.”
It will be at least March, Swartzberg said, before vaccinations begin to produce a measurable effect. But he and Noymer said things will look a lot better this summer.
“I fully expect summer 2021 to be much more like a normal summer than the summer we just had,” Noymer said. “This is not going to go on forever and ever, I guarantee that.”