‘Our Luck May Have Run Out’: California’s Case Count Explodes - The New York Times

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SACRAMENTO — Only a few weeks ago, thousands of Southern Californians were flocking to beaches, Disneyland was announcing it would soon reopen and Whoopi Goldberg was lauding Gov. Gavin Newsom on “The View” for the state’s progress in combating the coronavirus. The worst, many in California thought, was behind them.

In fact, an alarming surge in cases up and down the state was only just beginning.

Over the past week California’s case count has exploded, surpassing 200,000 known infections, and forcing Mr. Newsom to roll back the state’s reopening in some counties. On Monday, he said the number of people hospitalized in California had risen 43 percent over the past two weeks.

Los Angeles County, which has been averaging more than 2,000 new cases each day, surpassed 100,000 total cases on Monday, with the virus actively infecting one in every 140 people, according to local health officials. More than 2,800 cases were announced in the county on Monday, the most of any day during the pandemic.

On Sunday, Mr. Newsom shut down the bars in a half-dozen counties, including Los Angeles County and in the Central Valley, and recommended that another eight counties voluntarily close their nightspots and gathering places. On Friday, Imperial County, along the Mexican border, was told to return to a stay-at-home order. And Disneyland has since rescinded its decision to open its gates.

California was the first state to shut down and one of the most aggressive in fighting the virus. But the state that was so proactive in combating the spread of the coronavirus is now being forced to ask itself what went wrong.

“To some extent I think our luck may have run out,” said Dr. Bob Wachter, a professor and chair of the department of medicine at the University of California, San Francisco. “This is faster and worse than I expected. You have to have a ton of respect for this thing. It is nasty and it just lurks and waits to stomp on you if you let your guard down for a second.”

On Monday, the governors of New York and New Jersey said they were reconsidering plans to allow indoor dining in the coming days because they were so alarmed by the rise in coronavirus cases in the South and the West.

The head start that California appeared to enjoy — the companies that allowed employees to work from home as early as February, the governor who warned residents in daily briefings to stay home and appeared to be listened to — was not protective enough in the long run.

Younger people appear to account for the large surge in new cases, as they have in many other states. Latinos, who make up a large swath of the state’s essential work force, have also recently seen consistently high case counts.

And just as in Texas and Florida, the state’s reopening appears to have triggered a large resurgence. Pressured in part by businesses, church groups and conservatives, Mr. Newsom ceded control of much of the timing of reopening to local officials who were eager to regain a sense of normalcy and stem economic losses. The result was a decentralized, haphazard process that sowed confusion and gave residents a false sense that they were in the clear.

Unlike people in the Northeast, many Californians did not have a sense of urgency or immediacy toward the virus because infection rates had been so low for months. There were no overflowing morgues or ambulance sirens at all hours.

In a state with 40 million people, outbreaks have been heterogeneous: San Quentin State Prison on the San Francisco Bay, food-processing plants in the Central Valley, nursing homes, dense urban neighborhoods filled with essential workers and family gatherings in remote rural communities have all accounted for clusters of cases.

But health experts and state officials say the ultimate reasons for the surge lie in the millions of individual decisions made across the vast state.

Mayor Eric Garcetti of Los Angeles blamed “irrational exuberance.”

“A lot of people didn’t stick with the plan,” the mayor said in an interview on Friday. “The idea was, we would do a move, wait three weeks, check the impact, take the next move.”

Instead, Mr. Garcetti said, the reopening “was like a tidal wave — one move led to the next, led to the next, led to the next. And then we had the protest on top of that, and other things. And we have yet to be able to identify where spread is happening and what we can do to crank it down.”

Patrons outside Figaro Bistrot in the Los Feliz neighborhood of Los Angeles on Sunday.Credit...Jenna Schoenefeld for The New York Times

State Senator Richard Pan, a Sacramento physician who led the state’s push to tighten immunization requirements, said that the state might have flattened its curve at first, but that it never bent it down toward zero.

“How this disease spreads is all about the margins,” Dr. Pan said. “All it takes is, like, 5 percent more people doing more high-risk behavior to change its direction.”

Dr. Pan blames partisanship and misinformation spread by President Trump. On the weekend after June 20, when bars reopened in Los Angeles County, an estimated 500,000 people visited nightspots. Additionally, half of the restaurants visited by county inspectors are not complying with new public health rules, according to health officials.

“I’m frustrated because it’s not that we don’t know what to do,” Dr. Pan said. “We know what to do. We’re just not doing it.”

California was one of the earliest states to get hit by the virus. Soon after it first appeared on American shores, Silicon Valley, south of San Francisco, was considered a major hot spot, seeded by travelers arriving from China.

Counties across the Bay Area banded together to announce the nation’s first stay-at-home order on March 16, followed by a statewide order three days later. Cellphone data showed that Californians moved around less than people in other states, and infection rates stabilized at a plateau well below the levels experts had projected, making military field hospitals and sports arenas and auditoriums — all mobilized in case of a shortage of beds — unnecessary.

The Coronavirus Outbreak

• Frequently Asked Questions and Advice

  Updated June 24, 2020

  • What’s the best material for a mask?

    Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.

  • Is it harder to exercise while wearing a mask?

    A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.

  • I’ve heard about a treatment called dexamethasone. Does it work?

    The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.

  • What is pandemic paid leave?

    The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.

  • Does asymptomatic transmission of Covid-19 happen?

    So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.

  • What’s the risk of catching coronavirus from a surface?

    Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

  • How does blood type influence coronavirus?

    A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

  • How many people have lost their jobs due to coronavirus in the U.S.?

    The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

  • What are the symptoms of coronavirus?

    Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

  • How can I protect myself while flying?

    If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

  • What should I do if I feel sick?

    If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

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By May, with low case counts remaining steady, Mr. Newsom was coming under increasing pressure to reopen. Harmeet K. Dhillon, a civil rights attorney and member of the Republican National Committee, filed more than a dozen lawsuits related to the reopening. If residents could congregate at Costco, they should be able to go to church, she argued. Elon Musk, the head of Tesla, railed that his Bay Area car factory was forced to shut and threatened to move the company’s headquarters out of California.

Mr. Newsom localized the reopening process, allowing counties to move at different speeds, repeatedly declaring that “localism is determinative,” and vowing to collaborate with county governments, not issue orders. Church congregations were allowed to meet with restrictions.

Advocates for reopening like Ms. Dhillon felt vindicated.

“I feel that our lawsuits were responsible for large sectors of California’s economy opening up much sooner than the governor originally intended,” she said, adding that she fielded countless calls from business owners. “People are absolutely devastated.”

But Mr. Newsom was also criticized by those who worried the state was reopening too quickly.

Dr. Sara Cody, the chief health officer of Santa Clara County and the architect of the Bay Area’s stay-at-home orders, said the system was bewildering to residents who cross county lines regularly.

“For the public it’s incredibly confusing,” Dr. Cody said in an interview. “What’s the message? How can it be that something is OK here and in the adjoining county it’s not?”

The measures have become even more disparate in the past few weeks. In Napa and Sonoma Counties, wine tastings and restaurant meals are permitted both indoors and outside. In San Francisco, restaurant dining is only available outdoors. Mayor London Breed of San Francisco announced last week that the city would postpone the reopening, scheduled for Monday, of hair and nail salons, massage shops, museums, tattoo parlors and outdoor bars.

Diana Dooley, a former state secretary of Health and Human Services who dealt with the Ebola and Zika pandemics during her tenure, said she had watched “with great empathy” as the crisis gripped California. Initially, she said, “it looked like the Bay Area was driving the decisions.” And as the virus spread, Californians were generally compliant.

“But after several months, the impatient people have made top-down orders very hard to enforce,” she said.

The result, she said, is a sense in some parts of the state of “a kind of liberty gone rampant.”

“People want to go to bars, they want to go to picnics,” she said. “These protest rallies have heightened that sense of ‘I want to be in a crowd.’ We’re coming up on the Fourth of July and people want to be in connection with each other.”

“You can only lead if people follow,” Ms. Dooley said. “Newsom has done a pretty good job of creating awareness, and people in California are more inclined to believe this is serious. But what they can do about it, we’re still getting to.”

David Townsend, a veteran Democratic political consultant in the state, said California’s size and political complexity pose a considerable challenge. Although the Legislature is overwhelmingly Democratic, more than a fifth of the electorate is Republican.

“You have the Inland Empire doing one thing, Los Angeles doing another, Orange County — it’s pretty hard to corral everybody in California and get them to do the right thing. It’s just so big.”

Mr. Townsend said the pressure would be tough for any governor.

“How do you put the genie back into the bottle?” Mr. Townsend added. “I’m not sure there’s much more he can do.”

Shawn Hubler reported from Sacramento and Thomas Fuller from Moraga, Calif. Mitch Smith contributed reporting from Chicago.

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