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California’s pandemic pain increases sharply

Photo illustration of the coronavirus in California. (Photo: Maridav, via Shutterstock)

COVID-19 cases in California are spiking dramatically — more than 6,600 new cases on Tuesday alone — and scientists predict California will double its transmission rate every four to five weeks.

The state has reached Gov. Newsom’s goal of testing 60,000 people a day and wearing a mask in public is obligatory for the general population. On Wednesday, the death toll spiked to 98, bringing to 5,725 the total number of deaths so far.

But the record increase in new cases — a daily average of 63 deaths and 4,600 new cases statewide —  is the highest level since shelter-in-place began in March, according to the L.A. Times’ comprehensive data tracker. That has prompted state officials to reconsider the planned reopening of public gathering places. 

On Wednesday, the death toll spiked to 98, bringing to 5,725 the total number of deaths so far.

 “Those that suggest we are out of the woods, those that suggest this is somehow going to disappear … these numbers tell a very, very different and sobering story,” Newsom said at a pandemic briefing. He said a stay-at-home order was possible: “We don’t intend to do that, we don’t want to do that, but I want to make this clear: we are prepared to do that if we must.”

The increase in COVID-19 cases nationwide has sparked controversy over the numbers.

Some politicians, including  President Trump and Arizona Gov. Anthony Ducey, attribute the new increase in cases solely to expanded testing. Scientists say their data shows the increase in cases is higher than reflected by the expanded testing initiatives alone.

But they note that the overall number of cases is spiking partially because of increased testing. Trump was correct when he said, “when you have more tests, you have more cases.”

But testing isn’t the only reason case numbers are going up, and experts point to daily hospitalizations per capita and positivity rates as better data sources for evaluating COVID-19’s pervasiveness.

Hospitalization rates aren’t affected by additional testing — rather, they increase when more people become infected. And according to the California Department of Public Health, the positivity rate is “a key indicator of community spread.”

Hospitalizations increased by more than 10% in five counties since Sunday, June 14, though most counties’ rates are stable.

Hospitalization rates vary by county, and some counties haven’t seen hospitalizations rise in over six weeks — even with an increase in the total number of cases. But that is starting to change.

Los Angeles County, for example, makes up 41% of new cases in California, but its hospitalization rates are stagnant — indicating that testing accounts for the increase in cases. That isn’t the situation everywhere, however.

Hospitalizations increased by more than 10% in five counties since Sunday, June 14, though most counties’ rates are stable (which isn’t necessarily good), and five are declining.

Ventura County’s hospitalization rate has increased by 75% in the last two weeks. The statistics emphasize that numbers are ominous in several parts of the state. 

The threat of another wave has hospital administrators shaking in their boots. Hospitals are already under immense stress in California — an additional influx of patients this summer would be arguably impossible to handle for near-insolvent hospitals. Facing another spike in the fall would prove grim for the preservation of the health care system.

The economy could reopen without increased cases if people continue to act responsibly.

An additional spike would be detrimental not only to hospitals — the economy could be put in harm’s way again, and a particularly high surge could force another, widespread closure of “unnecessary” businesses.

Some believe that the cause of the the new spike is the ending of stay at home orders, noting that it’s the only thing that has changed policy-wise since the state saw a decline in cases in April.

That’s not the whole story, however.

With the reopening of the economy comes a necessity to comply with social distancing and mask-wearing measures. Because mask-wearing is the “most effective means to prevent interhuman transmission,” according to the Proceedings of the National Academy of Sciences, it’s increasingly important that Californians wear them to prevent further transmission. The economy could reopen without increased cases if people continue to act responsibly.

However, a solid portion of the public has taken the end of stay-at-home orders to mean that the worst of the crisis may be over.  Mask-wearing and social distancing practices have declined, both between individuals and within business establishments.

By law, Californians can be charged with a misdemeanor for not wearing a mask. However, officials say enforcement will most likely be lax.

Some groups see the mask-wearing requirement as an infringement of their personal liberties. The health officer of Orange County received weeks of attacks and even a death threat for attempting to enact mandatory mask rules.

Newsom made an effort to target personal responsibility with the sweeping decision to require masks in public last week. But enforcing the policy is tricky, particularly during a time of civil unrest and hostility toward the police. 

By law, Californians can be charged with a misdemeanor for not wearing a mask. However, officials say enforcement will most likely be lax. 

Those concerned about future spikes assert that completely eradicating a lack of individual responsibility is impossible. Hosting events in the privacy of one’s own home is not preventable through policy, for example.

“People don’t seem to be able to draw the line between what’s OK and what is not.” — Apoorva Mandavilli

Another concern regards interstate travel.

Imperial County, for example, is located at California’s southeast corner and its residents often travel through Mexico and Arizona — both of which have higher rates of COVID-19 than California. The county now has some of the highest infection rates in the state.

Interstate travel and events at one’s own home are not controllable (unless the state were to impose war-time restrictions).

But until there is a vaccine, encouraging responsibility through policy is the best officials can do.

“There are ways to be responsible and socialize, but people don’t seem to be able to draw the line between what’s OK and what is not. For too many people, it seems to be binary — they are either on lockdown or taking no precautions,” wrote New York Times science reporter Apoorva Mandavilli.


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