Newsom: Don’t let up on sheltering in place
Strict measures may be working, but experts urge vigilance
Thursday marks two weeks since Gov. Gavin Newsom ordered the state to shelter in place to suppress spread of the coronavirus. But despite early signs that the plan is working, the governor — with Bay Area health officers who have expanded regional stayhome directives — says that California is not yet safe.
Newsom reported Wednesday an alarming increase in demand for hospital beds and, in particular, intensivecare beds: The number of people infected with the virus who were in ICUs jumped fivefold in less than a week, and hospitalizations more than doubled.
Though the outbreak in
California and the Bay Area has not been nearly as dramatic as the events unfolding on the East Coast, and especially New York, state and local leaders emphasized this week that they continue to see troubling increases in the number of cases. Without proper preparation, they said, hospitals could still be pushed past capacity.
“We must redouble our commitment to slowing down this virus in our community,” said Dr. Grant Colfax, director of the San Francisco Department of Public Health, at a news briefing Wednesday. “At this stage in the game, there are still very plausible scenarios where our health care system could be brought to the brink and even overwhelmed.”
Cases of COVID19, the disease caused by the coronavirus, have doubled in California since Friday, and they’ve increased nearly tenfold since the statewide shelter in place took effect on
March 19. That’s still slower growth than New York, which saw cases increase 20fold to nearly 85,000 over the same twoweek period. California reported about 9,937 cases and 212 deaths as of Wednesday.
Nationwide, cases continue to blow up in pockets around the country. More than 215,000 cases have been reported in the U.S., and more than 5,100 people have died. This week, federal public health officials estimated that 100,000 to 240,000 Americans could die even with social distancing measures in place. President Trump extended national guidance for people to isolate as much as they can through the end of April.
Infectiousdisease and public health experts believe that the benefits of early, and much stricter, directives to keep Californians at home and away from one another are already apparent in the case counts and other measures used to track the outbreak. And it’s telling, they say, that California’s hospitals are not yet overrun with patients.
But cases statewide and in the Bay Area have continued to climb 10% to 15% a day since Californians began sheltering. And on Wednesday, the state reported 1,277 new cases — the highest singleday number since the outbreak began more than a month ago.
Clusters of infections popping up around the state are also worrying public health authorities. San Francisco’s cityoperated Laguna Honda nursing home has reported 12 cases, including 10 staff members and two patients, in an outbreak that could be disastrous among the hospital’s vulnerable patient population. Experts with the Centers for Disease Control and Prevention and the California Department of Public Health arrived at Laguna Honda to help curb the outbreak, city officials said Wednesday.
In Sacramento County, 90 new cases were reported on Wednesday, bringing the total to 314 — and public health officials said they were especially concerned to learn that about a third of all cases can be linked to church gatherings. The information prompted authorities to issue a special advisory against attending church services, even though such gatherings already are not allowed under state shelterinplace orders.
At his daily briefing Wednesday, Newsom implored Californians to continue adhering to stayhome orders, noting that even though the state is still well below capacity on hospital beds and ventilators, he expects case counts to keep climbing and become dangerously high.
According to his advisers’ latest projections, Newsom said the state will need 50,000 extra hospital beds by midMay, and another 16,000 by the end of May. The state is aggressively trying to add those beds now — in the form of leasing former hospital facilities and converting convention centers and fairgrounds into temporary medical units — but authorities need more time, he said.
“The good news is we have time,” Newsom said. “That’s why it’s incumbent on all of us to utilize this time to continue to practice safe physical distancing.”
The goal of social distancing is to reduce the caseload just enough that the outbreak is spread out over a long period of time, instead of spiking all at once and overwhelming health care systems. Such a spike could lead to preventable deaths if people are not able to get appropriate care.
Newsom’s statewide shelterinplace orders were put in place indefinitely, and he has not said when they might be lifted. On Tuesday, seven Bay Area counties — Alameda, Contra Costa, Marin, San Francisco, San Mateo, Santa
Clara and Sonoma — extended regional stayhome orders to May 3, and added further restrictions to prevent people from gathering in groups. San Francisco city officials said Wednesday that there’s a good chance the orders could be extended again.
Infectious disease experts said the repeated pleas for people to stay away from one another and to respect sheltering orders make sense, even as California appears to be weathering the coronavirus storm better than most other parts of the country.
Though current projections — including those put out by the governor’s office and others from academic institutions — suggest California may emerge from its outbreak relatively unscathed medically, they depend on strict adherence to social distancing, and not letting up too early.
Plus, projections are based on data such as case counts that are inherently imprecise, and the estimates can change day to day, infectious disease experts said.
Sometimes the projections change for the better: A model put out by University of Washington scientists already predicts 1,000 fewer deaths for California as of Wednesday than it did last Sunday, when it was predicting 6,000 would die.
But projections also can be overly optimistic. Newsom said Wednesday that his team’s models suggest California will be able to meet health care demands, but he can’t count on that.
“New York was hit hard, and I think it’s good that Gavin Newsom is preparing for the worst,” said Shannon Bennett, chief of science at the California Academy of Sciences. “But I think we’re going to be better off than that.”
Bennett added that her “worst fear” is that people will grow tired of social distancing and start recongregating before the statewide outbreak is fully under control, which could be well into May or even June. So far, people seem to be keeping their distance, from what she’s seen anecdotally. But it’s not easy on anyone.
“I am a very cuphalffull eternal optimist person. In my own personal observations, I feel like people are being very respectful of social distancing,” she said. “But we’re worried about people who maybe aren’t compliant because they don’t feel at risk.”