Should reopen effort be slowed?

Newsom hedges on reinstituting movement, economic restrictions amid rising COVID-19 cases

With COVID-19 cases surging to record levels, is it time for California to push pause on reopening?

The question crystallized Friday as confirmed cases in the state passed 200,000 and hospitalizations continued a three-week-long upward march. Two Bay Area counties — San Francisco and Marin — said they would slow schedules that would have seen a new round of businesses open next week, and Contra Costa may also pump the brakes.

For his part, Gov. Gavin Newsom called on Imperial County, the state’s hardest hit with intensive care units dangerously close to capacity, to shut down tight or he would force the issue. But Newsom resisted suggestions in his daily news briefing that he should take more extensive steps that would impact other regions.

Yet as governors in Florida, Texas and elsewhere pulled back on their reopening plans, several prominent medical experts called on this state to do the same.

“If we don’t act now, it doesn’t make sense to wait until we’re a lot worse off,” said John Swartzberg, an infectious disease expert and professor emeritus at UC Berkeley.

Dr. Shashank Ravi, assistant medical director in the emergency department at Stanford Health Care, said his hospital has been preparing for both a second wave of COVID-19 and the upcoming flu season, and he is concerned by the way Californians have been venturing out in recent weeks, promoting viral spread.

“I think we do need to pause and see where we’re at,” Ravi said. “I think, people are moving

across counties more and more, Southern to Northern California, Northern to Southern California, and so we’re seeing more intermingling.”

Most troubling to experts such as Swartzberg and Ravi are the sharp upward trends in newly confirmed COVID-19 cases — approaching double the daily rate from the beginning of June — and hospitalizations, which have increased by more than 30% over the past two weeks.

Alarmed by the numbers in her city, San Francisco Mayor London Breed on Friday announced the suspension of a plan to enter into the third stage of Newsom’s four-phase reopening, which would have allowed salons, barbershops, tattoo parlors and other select businesses to resume activity. The decision was made after 103 test results came back positive for the virus over the previous 24 hours.

“At our current rate, the number could double rapidly,” Breed said. “If that continues and we don’t intervene, we’ll be at such a high number that our only option would be to shut down.”

Marin County said late Friday it would pause reopenings of gyms, hotels and body art professionals, propelled by an outbreak at San Quentin State Prison.

And Contra Costa County health officials — who had planned to reopen indoor dining, bars, gyms and hotels July 1 — also said they were “evaluating whether the county should continue its current reopening timeline.” It was in response to COVID-19 hospitalizations surging 42% over the previous seven days, the average daily number of new cases soaring from 39 to 68, and the proportion of infected people under 40 increasing from 38% to 55%.

Santa Clara County signaled its intent to overhaul its reopening strategy, which has been perhaps the slowest in the state, next week as well. But officials were vague about what that would mean.

“What’s been learned over the last four months is that it’s not about the business you’re participating in, but it’s the activities you’re doing,” County Executive Jeff Smith said. “It’s like driving a car on the freeway. It doesn’t matter whether it’s a truck or a sports car, if you’re speeding, you put people at risk. The focus had been on what you were driving, or the business.”

In his news briefing Friday, Newsom put a particular focus on Imperial County, home to the state’s highest per-capita case rate with 3,000 cases per 100,000 residents. The Southern California county borders Mexico, which is thought to have contributed to the problem.

Imperial County’s test positivity rate meanwhile hit 23% over the last two weeks — drastically higher than the state’s rate of 5.3%.

“We’re now in a position where we are working with county officials and advising them to pull back and once again reinstitute their stay-athome orders,” Newsom said. “If they’re not able to come to some consensus, I am committed to intervening.”

But Newsom dismissed questions about whether he would do the same for more populated counties that have increased activities and seen significant infection surges as a result.

“California is not one-sizefits-all. … When you look at the prism of California, the only responsible way to look at it is through a bottom-up lens,” Newsom said. The governor insisted he is striking the proper balance, urging people to continue to wear masks and avoid unnecessary activities, but others were not so sure.

“Our governor said we were going to follow the data. The idea of following the data is that if we start to liberalize things and see cases not going up, we can continue to liberalize things,” Swartzberg said. “But if the percentage starts going up, we need to at least pause and reevaluate where we are. He’s not following that plan right now.”

Dean Winslow, a professor of medicine at Stanford specializing in infectious diseases, believes that counties will soon need to return to heavier restrictions.

“I think at this point, probably (a) very strict shelter in place is not going to fly,” Winslow said. “But I think all of the other measures, we should really strongly consider maintaining at least for the foreseeable future potentially, until we have an effective vaccine.”