For quite a while, it seemed like California had dodged the calamity. It was the first U.S. state to order residents to take refuge on the spot in March, and its initial and aggressive actions paid off. Despite being the most populous state and an international hub with the highest number of direct flights to China, where the coronavirus first appeared, California’s death rate remained relatively low.
In May, Disneyland announced plans to reopen. The country’s top health official, Dr. Anthony Fauci, praised Governor Gavin Newsom’s leadership. And as the weather warmed, Californians returned to the beaches and bars.
“We had reason to feel safe,” said Dr. Bob Wachter, who chairs the department of medicine at the University of California, San Francisco. “And so, we got into some trouble. “
Some outbreaks caused an explosion, averaging approximately 6,000 to 7,000 new cases each day in the past week. Los Angeles County began counting more sick residents with Covid-19 cases elsewhere in the nation, and Disneyland postponed its reopening. As hospitalizations increased, the death toll surpassed 6,000, and ICU beds in some regions began to fill, California Governor Gavin Newsom ordered bars, restaurants, movie theaters, and other closed places in the more counties affected to close again. .
Now, health officials and epidemiologists examining the rubble are wondering how the golden state lost its status as a golden boy of public health.
‘People began to obsess over individual liberties.
“Looking back, the decision to reopen when we did so seemed perfectly reasonable,” Wachter said. “We were doing quite well, we had the resources to face a rebound in cases.” Despite some setbacks, Newsom had set and ultimately met fairly ambitious goals to screen 60,000 to 80,000 Californians each day, and stock up on protective gear for healthcare workers.
The Los Angeles Times editorial board wrote that California was fortunate to have Newsom as its leader. “People are alive today because of Newsom’s expeditious action,” he said. The state’s death rate was similar to that of Germany, a country widely regarded as a public health success story.
The Newsom administration’s four-phase plan to slowly reopen, while encouraging Californians to remain vigilant about the use of facial covers and keep their distance to stop the spread of the disease seemed “perfectly good and smart,” Watchter said. .
“But what I think we did not understand well was the national political scene,” he said. California, despite its reputation as a progressive state, was not immune to a growing conservative movement that rejects facial masks as muzzles about independence and vilifies public health officials as enemies of the people.
In Orange County, where more than 15,000 people have been infected, Health Director Nichole Quick resigned in mid-June after being confronted with a banner depicting her as a Nazi, protests outside her home and personal threats. Quick had issued an order requiring residents to wear masks in public, which the county sheriff insisted he would not enforce. After becoming the third senior health officer in Orange County to resign, the county quickly reversed Quick’s order, recommending, but not insisting, that residents wear masks.
On Memorial Day, Californians “thought it was safe to just have parties, go to overcrowded beaches, get close to other people, and remove their masks,” said Lee Riley, an epidemiologist at the University of California, Berkeley. “People began to obsess over individual liberties without realizing that one of the most fundamental civil liberties in the United States is the right to health, the right to stay alive.”
‘This is not a political problem’
As restaurants, bars, zoos, and movie theaters reopened across the state, outbreaks in Southern California have been the most concerning, with Bay Area counties seeing more modest increases. Overall, despite their enormous workload, approximately 6.9% of those tested for coronaviruses statewide have tested positive for the past week. That’s higher than the 5% that the World Health Organization recommended as the top bar for reopening, and much lower than the positive test rate of 25.2% in Florida and 17.7% in Arizona.
Scientists are still working in what context the majority of cases are spreading: early follow-up data in Los Angeles County suggests that outbreaks in nursing homes added to cases traced to restaurants, workplaces, warehouses, and retailers they represent approximately 15-20% of all cases. While the disease may also have spread amid massive protests against police brutality, epidemiologists are not connecting large outbreaks with the protests. “We still don’t know where the majority of cases are spreading, but my suspicion is individual households,” Lee said.
Demographic data suggests that younger people, between the ages of 18 and 50, are fueling the current wave of infections, accounting for almost 60% of cases statewide. “Maybe they feel invincible, so they go out to bars, they get together in big groups,” Riley said. “But then they can pass the virus on to their grandmothers and grandparents, their parents, their friends with asthma or diabetes, who are more vulnerable.”
Among the worst affected regions are rural counties in the south and the Central Valley, where farmworkers have been working hard at every stage of this pandemic. California is known as “the breadbasket of the world” for good reason: it is the world’s fifth largest provider of food and agricultural products.
As more Californians emerged from their homes, crammed with restaurants and public spaces, “it really put our essential workers at greater risk,” said Ninez Ponce, director of the UCLA Center for Health Policy Research. The vast majority, over 90%, of farmworkers in California are Latino, working in precariously populated settings. More than 60% of the workers involved in food preparation are also Latinx. And it’s those workers, many of whom lack access to health care and can’t afford to stay home, who have the most to lose as the virus travels through the state, Ponce said.
Latinx, Black and other minority groups are infected and die disproportionately with Covid-19, according to a monitoring tool designed by UCLA, and initial metrics suggest that the reopening of the state has exacerbated the disparities. The devastating outbreaks in California prisons and homeless shelters have further fueled inequalities.
The many complicated factors that fueled the increase in the coronavirus in California have collided in Imperial County, a rural community along California’s southern border with Mexico and Arizona. Out of every 100,000 people in the country, more than 3,700 have been infected with the coronavirus, which is several times higher than the state average of 600 infections per 100,000.
As the only two hospitals in the region ran out of beds, concerned residents wrote to Newsom, asking him to intervene as local leaders allowed the companies to continue reopening. The community, which had already been besieged by toxic dust storms, suffering one of the highest poverty rates in the state, “was ill-prepared to respond to even a small outbreak of cases, let alone what we are seeing now, ”Said Luis Olmedo, a community advocate who heads a local advocacy group called the Civic Committee of the Valley. And while the local council finally managed to curb its optimistic reopening plan, officials remained more concerned with appeasing the few rowdy and privileged people pressing for a hasty return to normalcy than with protecting minority workers, Olmedo said. “I want all of our leaders to step forward and take care of the entire community,” he said, “because now they are ending up in the emergency room and ending up in body bags.”
Looking back, Richard Pan, a doctor and a state senator, said the state hastened his reopening plan. Officials had initially established a two-week decline as a benchmark to move through each phase of reopening. “We wanted to not only flatten the curve, but see a recession,” he said. “Then we started to see the protests against the blockade, basically with a wink and a wink from Donald Trump, and the governor faced increasing pressure to move faster.”
As the number of cases increases, the governor’s recent orders to pause the reopening of California, and his state mandate requiring residents to wear masks, are laudable, he said. “Still, we are only successful if people follow the order, and right now, they are not.”
Pan, who recently introduced legislation to protect health officials from attacks, said the governor’s presence at the top of every health briefing, as the response to the pandemic may have been counterproductive. Governors and mayors across the country likely left the need to step up and combat Trump’s dramatic, bombing, and counterproductive daily missives with their own daily press conferences. “But they should have let their public health officials get on the podium.” He said: “They should have been allowed to lead the conversation, to show that this is not a political problem.”
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