The trend lines are as strong as they are puzzling: Daily COVID-19 infections in New York have been down more than 90% since their April high, while California’s new cases have gone up ten times in that time.
New York, a horror of coronavirus in the spring, has since been praised for correlating the infection. California, a model for its first-in-the-nation statewide stay-at-home order to slow the spread of the virus, is now a cautious story, as it turns reopening into a fight to contain outbreaks. The state’s director of public health resigned last weekend without explanation, and New York is pledging to visit a California calantin for two weeks.
What in the world happened?
There are no easy answers. Experts of infectious disease cite a number of issues that affect the trajectories of states, from the way state leaders re-manage to public compliance with health commands, different immunity levels and viral penalties and even just luck.
But many point out that the virus was so apocalyptic to New Yorkers – with the nightly sirens of ambulances driving the infamous to overcrowded hospitals, where lobbies were transformed into ERs and cooler trucks in sidewalks for sidewalks – they remain numerous more vigilant.
“The cases just came out, and the deaths – I’m still freaked out about it,” said Maureen Miller, an epidemiologist of infectious disease at Columbia University’s Mailman School of Public Health in New York. “The in-your-face-ness it was really scary.”
That was not the case in California, where easy-to-recover hospitals and ERs were mostly empty during the early months of the pandemic – but by Friday, the state had a total of more than 600,000 cases and 11,000 deaths. Miller notes that a family member in San Diego only recently began wearing a face mask regularly, something she and other New Yorkers have been doing since April.
Unlike Texas and Florida-led by Republicans, who have also seen falls this summer, California and New York are controlled by Democrats. But although Govin Newsom of New York Andrew Cuomo and Govin Newsom of California share similar policies, they differ in style.
David Vlahov, an infection epidemiologist at Yale University in New York, found Cuomo, 62, to be more effective at communicating what was needed to tame the virus than Newsom, 52.
“Cuomo was able to take very complex information and make it accessible,” Vlahov said. ‘When he had his daily briefings, the world would stop, people would stop and see it. He oasis really empathy, people who were connected in it. I saw Gavin once and thought, this guy is really gabbing. It is not inspiring, not informative. ”
A closer look at how each state reacted as its outbreaks grew showed that they took broadly similar approaches with a few notable exceptions, suggesting that there are more to the results than their policies.
“Policy is just one part of it,” said Dr. Amesh A. Adalja, a former scientist at the Johns Hopkins Center for Health Security in Baltimore. “Policy compliance is another factor.”
California saw its first COVID-19 case in January. Mid-March, counties of Bay Area and Southern California ordered residents to seek shelter, followed by Stateom’s March 19 Statewide stay at home.
Meanwhile in New York, which did not see its first case until March, Cuomo and New York City Mayor Bill de Blasio were still discussing the need for such drastic measures. Cuomo’s equivalent New York State on break order took effect March 22. Epidemiologists have even said that a few days of delay could have spread the virus exponentially in New York.
But when New York leaders were initially slow to respond, the exposed nightmare accelerated their pulse. On April 15, when daily cases peaked in New York, Cuomo became the first U.S. governor to require residents to wear masks. Los Angeles and San Francisco came out with similar mandates around the same time, but Newsom made it mandatory statewide until June 18, more than two months later.
Amid protests from reopening residents, both states began laying ground rules in May for regions to relax in phase-in phases as they met criteria for lowering hospitalizations and deaths and increasing tests and capacity of case investigations. In mid-May, Newsom lost some demands after criticism that some of California’s reopening criteria – such as no deaths in the last 14 days – would be impossible for most counties to meet.
Rural and suburban communities in both states began to reopen in the coming weeks, but the picture was very different in their largest and hardest hit cities. For example, in Los Angeles, bars, restaurants, gyms, wineries and nail salons have welcomed customers inside, even as new cases and hospitalizations have gone up. In New York City, even restaurants and bars can not yet serve customers inside.
By July 7, California’s new daily cases had more than doubled in a month, while New York remained stable at about one-tenth or as many cases. That was when Newsom ordered a second shutdown on indoor dining and other businesses in Los Angeles and other urban counties where cases skyrocketed.
And, then it happened: On July 22, California followed New York in reporting the most total COVID-19 cases in the country during the course of the pandemic: 413,576. The day before, California registered its most new daily case ever, 12,807, according to San Francisco Director of Public Health Dr. Grant Colfax, Dark Warns that ‘it is plausible that we could get into late summer as a start to the summer in a New York-like situation. ”
New York’s highest daily new business on April 15 was 11,571 – on July 21 it had just 855.
To be clear, with half the population of California and more than double the death toll so far, New York has suffered less. But if you want to choose a place today to be safer from the coronavirus, there is no question that it would not be California. Dr. Bob Wachter, who chairs the medical department of the University of San Francisco, said when it comes to the virus, New York is “probably the safest place in the country to be.”
But the question here remains: has California invited disaster by opening too hard?
Experts like Adalja said New York did a better job of having a solid case research system in place before reopening to track down the newly infected contacts and warn them to test and isolate them – a standard practice for public health in containing outbreaks.
California Secretary of Health and Human Services Mark Ghaly, defended California’s response to the pandemic.
“This idea that we did something completely wrong is something I strongly oppose,” Ghaly said in an interview with the Bay Area News Group.
Ghaly added that although the state provided leads for reopening, it was not always followed.
“In Los Angeles, the county where I live, they had a lot of restaurants, for example, that didn’t follow the guidelines as well as we would like,” Ghaly said. “They saw masks in restaurants that were empty, and bars full.”
That would not surprise Mindy Yuen, 34, a digital designer, after recovering from the virus, leaving New York City in June with her husband and son to stay with her parents in Vacaville before having her second child. berne. She was puzzled by how cavalier Californians look about the pandemic.
“In New York, it was just as serious the way people talk about the virus,” said Yuen, who is preparing for her return trip to the Big Apple, where the spring nightmare will remain a memory. “You heard sirens every night, you would drive around and see those freezers outside hospitals – it was very real.”
Yuen understands that things were not nearly as bad in California, where temporary hospitals like the one set up in the Santa Clara Convention Center in anticipation of a patient crash did not see much use. But she laments that California’s more relaxed attitude rubs her off and makes her uneasy.
“Here it’s like no big deal,” Yuen said. ‘It’s kind of not taken seriously. I felt like it was so weird. ”
However, experts are not convinced if the pace of opening up as a social observation of public health measures fully explains the different outcomes. Miller points to a preliminary study by the Scripps Research Institute that suggests the strain of the new coronavirus that emerged in Europe and then spread New York much more easily than the early penalties in California from China. That European tribe has made its way through the country since its inception and may be behind summer gains in the South and West.
Wachter is not convinced by that theory, but points to other studies that indicate that one in five New Yorkers now has antibodies from exposure to the virus compared to one in 33 Californians, a level of immunity that spreads it. East back can tamp. And he notes that California was lucky enough to avoid a ‘superspreader’ event earlier this year like the ones that hit New York.
“We were good in the beginning,” said Wachter, “and we were lucky.”
Ghaly said experiences in different states at different times did not lend themselves to easy comparison, noting that knowledge of the virus has evolved. It’s becoming increasingly clear, for example, that the virus spread more easily inside than outside, something California learned when it reopened and that he said New York City could learn from the Golden State. California re-learned better treatment methods from New York’s early experience, and helped reduce the death toll.
And he says it’s too early to look back on a pandemic that is still missing – there are indications that California’s summer currents are already peaking.
“We are in a moment in time in this whole response in COVID-19,” Ghaly said. “To critics who are now trying to draw conclusions, I would say … we are still writing our story.”
