The State Of California: From 'Miracle' To Surging Cases

Doug Sovern
July 01, 2020 - 6:37 pm

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    Another day, another set of alarming numbers about the worsening spread of the coronavirus in California.

    As the pandemic intensifies, Gov. Gavin Newsom is imposing new restrictions on the 19 counties where COVID-19 is surging the most.

    Just a month or two ago, California was being hailed as a "miracle," a model for the nation of how to keep the virus in check, remarkably spared the terrible toll the pandemic was taking in places like New York.

    Now, it’s a completely different story.

    The rate of spread, the positivity rate, the caseload all continue to climb here. Hospitalizations have hit a record high for 11 days in a row, ICU cases are up, and now the death toll is catching up with the other metrics, 110 dead Tuesday, that’s the second most ever and the most since April 22.

    For more on what’s gone wrong and whether the measures announced Wednesday by the governor will make a difference, we were joined on KCBS Radio’s "The State Of California" by Dr. Bob Wachter, chair of the Department of Medicine at the University of California, San Francisco.

    How in the world did California go so wrong?

    I think we got a little bit complacent. There was some logic to begin to open up, you know, it’s hard to be locked down that long for people as individuals, families and the economy. It wasn’t unreasonable to begin opening up, but I think that we got a little bit cocky. People came to believe that we dodged the bullet for the first three or four months. As we began opening up, many people weren’t wearing masks and people were getting too close to each other. Our luck ran out. The first three months, we were good, but we were also lucky. We didn’t have outbreaks or any big super spreader events. The combination of things began taking off and getting out of hand, so it’s important for us to pull things back, which is what the governor did today.

    Was it a mistake to let the counties take control of the reopening process instead of a unified approach from Sacramento?

    I think that is the benefit of hindsight. If we go back to early May, California was doing extraordinarily well and it was not unreasonable to say that we’re now entering a phase where counties can open up, they may have their own ways of doing it, but it’s all within a certain set of guidelines. You know, watch carefully and see what happens. We’re now seeing the results of that and it turns out we did go too far too fast. I don’t think what was done at the time was unreasonable. California, we have 40 million people, we’re the size of many countries. To have a uniform set of rules and policies across the entire state was not entirely appropriate and we’re seeing that now. The governor is closing back down many counties, but not all of them, because certain counties including San Francisco are still seeing little bit of an increase but not the same kind of surge. So, some ability to customize is reasonable within an overall framework.

    Does the state-by-state approach work?

    Well, it’s imperfect because people do travel. As we’ve seen in California, cases that began in Southern California can end up in Northern California. If you look at San Francisco today, half of their hospitalizations are patients transferred to us from other hospitals that didn’t have capacity. The outbreak at San Quentin State Prison began with prisoners being transferred up there. So, we’re all interconnected, and the states are all interconnected. The country is a federation. It’s a very individualistic country. There was always going to be some patchwork of central rules, but also some flexibility. Where I think it’s appropriate to be critical is the mixed and often incorrect messaging that’s come out of the federal government, which has really been unhelpful. I think if there had been a clear message about how serious this was and why uniform masking and uniform distancing was the right policy, maybe different states are going to roll it out in different ways. We might have had a different course of things. But it has allowed certain people to not wear masks, the president said it wasn’t a big deal. It’s allowed certain states to do that. I think that’s gotten us in more trouble that we should have been.

    How big an impact will the governor’s new order make?

    It’s an important start and I think it’s going to be very important to watch over the next week or two to see if the case rates stabilize. One of things we’ve learned is the inputs into how we do are partly what the rules are and what’s open, but also the sum total of 20, 30, 40 decisions a day that 20 to 40 million people are making. The question is not just what’s open and what’s closed, but are people wearing their masks are people gathering together or not, are people keeping distance? What we see over the next few weeks is going to be crucial and it’s not just related to what the governor did, but also the message the governor was trying to send which is that this is a very big deal, it’s very scary. It’s going off the rails and if we don’t get our act back together, things are going to get worse. We will all find ourselves back in lockdown in the next several weeks if we don’t turn this thing around pretty quickly.

    How concerned are you about California’s hospitalizations?

    We are much better prepared than we were three and a half months ago. I’ve had people ask me if we wasted that effort, no we didn’t. Three months ago, I can tell you at UCSF, our hair was on fire. We didn’t have enough PPE, we had no testing, we had to worry if we had enough ICU beds. We didn’t really know how the virus spread. We had no treatments that were effective. All of that is different now. We’ve built extra hospital rooms at our place and other places. We have more ventilators. We have enough PPE, at least for now. We have a lot of testing, we have contact tracing, we have a couple of treatments that are moderately effective. We’re in much, much better shape than we were three months ago. I don’t think, certainly in the Bay Area, hospitals will become overwhelmed anytime soon. But there’s a limit to that. If it spikes up the way it has spiked in the last two weeks, we will find ourselves overwhelmed. Already in certain parts of California, as I’ve mentioned, there are patients at UCSF and other Bay Area hospitals today that are from Imperial County. They ran out of ICU beds, they ran out of hospital beds. We’re all in this together. We’re okay going into this, but I think if we don’t turn this around quickly, we will not be okay.