California's COVID-19 Dream Has Devolved Into A Nightmare. Now What?
“We all pretty much knew better, but we rolled the dice.”
For a while there in late spring, it seemed as though California, with its bold first-in-the-nation decision on March 19 to order residents to shelter in place, had spared itself the worst of the coronavirus. “The California miracle,” some public health experts called it.
But, as mounting case numbers and dire hospitalization figures have starkly illustrated, talk of a miracle was premature, to say the least. On Wednesday, California’s official case count surpassed New York’s — a number driven in part by the state’s massive population but also by its steady and alarming increase in new cases. Last week, Gov. Gavin Newsom shuttered the state back up, ordering bars, movie theaters, and indoor service at restaurants and wineries to shut down across the state. Testing is delayed again. Some hospitals are out of ICU beds. Schools in more than 30 of the state’s 58 counties will be online-only in the fall. Los Angeles Mayor Eric Garcetti has repeatedly raised the possibility of a new stay-at-home order for the city’s 4 million residents if conditions don’t improve.
Now, many Californians, yearning for a return to normal life and feeling like it’s further and further away, are wondering: Now what?
“When is this all going to end?” asked Ariel Dela Cruz, 27, who lives in the Los Angeles suburb of Carson and works part time at an aquarium. She added that she had been “really looking forward to going out.” Now, she said, she feels “a little sad and a little depressed.”
As of Thursday, California, the nation’s most populous state, had confirmed more than 420,000 cases of COVID-19, according to the Coronavirus Resource Center at Johns Hopkins University. Deaths, too, have begun to rise, although they are nowhere near the 1,000 deaths a day seen at the peak of the outbreak in New York.
The situation has left many grappling with where the state had gone wrong when it began to allow large swaths of the economy, including shops, restaurants, hair salons, gyms, and bars, to reopen starting May 8.
“I think people just took advantage of the openings too quickly,” said Ivan Rees, 38, as he waited for takeout at a plant-based burger joint in the Echo Park neighborhood of Los Angeles. “There wasn’t, like, clear-cut ‘we should do this and this and this’ — it was just like, ‘OK, bars are open now.’”
Rees, who is a dentist, said he was one of the many people who went to an outdoor gathering at someone else’s home last month — despite a nagging feeling that it was probably too soon.
“We all pretty much knew better, but we rolled the dice,” he said.
Public health experts say reopening itself wasn’t the problem; rather, California just didn’t go about it the right way. Officials moved too fast through reopening phases and didn’t provide strong enough messaging about how people should behave once they had more freedom. As a result, too many people went to social gatherings without proper social distancing and face masks.
“What we’re learning now is what we did starting in mid-May and on did not work — [it] wasn’t unreasonable to try it, but it didn’t work,” said Dr. Robert Wachter, chair of the Department of Medicine at the University of California, San Francisco. “We’ve got to do it differently. We've got to do it more slowly and more carefully.”
Regardless of whether Californians understood that gatherings were still largely prohibited, the act of reopening restaurants, gyms, bars, and other meeting spaces certainly made some feel it was safe to see other people again.
“That was the whole reason my uncle thought it was OK to go out,” said Briana Lopez, whose uncle Thomas Macias died from COVID-19 last month after attending a barbecue.
The day before he died, Macias urged his friends in a Facebook post to socially distance and wear a mask, writing, “Don’t be a fucking idiot like me.”
“We don't want to go out anymore. It's just scary,” Lopez told BuzzFeed News, adding that she expects her family to be cooped up at home through early 2021. “If a doctor doesn't say, ‘OK, we got this under control, it’s OK to go back out,’ then I’m not going out.”
It’s unclear whether the reopening of more high-risk venues, like restaurants, bars, churches, and gyms, is driving the rapid increase in infections in California. However, outbreaks of COVID-19 have previously been linked to restaurants, choir practices, and nightclubs where air circulation is poor.
“We need to be extremely concerned about indoor eating in restaurants where people are rebreathing air,” said Dr. Stefano Bertozzi, professor and dean emeritus at the UC Berkeley School of Public Health. “All of the evidence that I’ve seen suggests that anything you do outside is much less likely to result in transmission than doing the same thing inside.”
In addition to bars and indoor operations at restaurants, movie theaters, and wineries, more than 30 counties — including Los Angeles, Orange, San Diego, Sacramento, and Contra Costa — have been ordered to close indoor fitness centers, worship services, personal care services, hair salons, and malls due to spikes in cases.
Newsom said he was shutting those specific businesses down because they encourage the mixing of different households, which state and local health officials have pointed to as the major reason for the surge.
Los Angeles County Health Officer Dr. Muntu Davis told BuzzFeed News he couldn’t say to what degree restaurants or bars may be contributing to the increase in cases because those who are getting sick have reported participating in multiple high-risk activities.
“If someone just said, ‘Oh, I stayed at home and all I did was go to a restaurant,’ then you could say ‘Well, probably it was the restaurant, they have no other likely exposure,’ but if you have someone who is working ... and they went out to a restaurant and they worked out at the gym, it's hard ... to tease out exactly which one of those would have been the cause of exposure,” Davis said.
Still, some experts felt it was a bad call to open places like restaurants and bars, given the evidence that the virus can spread in poorly ventilated rooms and buildings.
“People didn't look at the evidence,” said Dr. Rick Peters, an assistant professor of population health at the University of Texas at Austin. “We’ve had enough experience around the world to understand what the disease is and how it's transmitted, but we haven't done the things to look at it and say ‘Oh, how would we stop that from happening? How would we get control of this and manage it effectively?’”
While not nearly as bad as the spikes in Texas, Arizona, and Florida, the COVID-19 resurgence in California has complicated the narrative that the states where officials didn’t take the pandemic seriously are the ones experiencing an increase in infections and death.
“It raises the question: Is the American attention span such that you can manage a fairly strict adherence to a set of rules that are unpleasant for about three months and then people lose interest or lose their ability to stick with it?” Wachter said. “If that's true, then New York … will be due to get walloped again in the fall as they begin to forget to be afraid and let down their guard.”
On March 16, as it was becoming increasingly clear that the coronavirus was spreading in communities all over the US, seven health officers from across the Bay Area gathered in San Jose to announce the nation’s first shelter-in-place order, forcing businesses to close and requiring residents to stay in their homes except for essential needs. Three days later, Newsom issued a statewide order, directing nearly 40 million people to do the same.
Many other states followed the state’s lead. For New York, which has recorded more than 32,000 deaths — the highest in the nation — it was too late to stop the disease from cutting a deadly swath. Even as California’s case numbers climb, the number of deaths from the coronavirus — currently at about 8,000 — is far lower than New York’s.
As it has across the country, the disease has impacted communities of color at much higher rates than it has white communities. In California, Latinx people, who represent 40% of the state’s population, account for about 56% of its cases and 45% of deaths.
At the time of Newsom’s stay-at-home order, California officials had confirmed just 1,006 cases of COVID-19 across the state and 19 deaths, but studies later showed that scores more had likely been infected by then.
“We got really lucky,” Wachter said. “There is no really great reason that we couldn’t have been New York.”
Wachter, who recently wrote about “the end of California’s coronavirus miracle” for the Atlantic, told BuzzFeed News the reason for the Golden State’s early success in the fight against COVID-19 was a combination of chance and a lot of good decisions by government officials, corporate leaders, and regular Californians.
In early March, Facebook, Google, Twitter, and other major companies encouraged their Bay Area employees to work from home. Smartphone data showed that early on most Californians complied with officials’ orders to stay home.
While some Californians protested the orders as the shutdowns dragged on, they seemed to be more accepting of the measures than Americans in other parts of the country.
“There was a general feeling that the threat is real, that we should take it seriously, we should believe the scientists, we should believe the politicians,” Wachter said. “I think we were pretty unified in doing the right thing, and it worked.”
While Californians hunkered down in their homes, officials worked to increase hospital capacity, procure personal protective equipment (PPE) for workers in healthcare and other essential sectors, and build up the state’s testing capacity and contact tracing workforce.
In early May, the numbers of new cases, hospitalizations, and deaths had plateaued statewide, prompting officials to begin easing stay-at-home orders. At first, officials allowed bookstores, florists, and other retail businesses to reopen only for curbside pickup and gave counties an opportunity to reopen even further on a case-by-case basis if they met certain criteria on hospitalizations, deaths, testing capacity, contact tracing, and PPE supplies.
The state later weakened the metrics, citing a “need” to give local governments more control. By the end of May, 49 of the state’s 58 counties had received approval to further modify their stay-at-home orders to open hair salons and barbershops, restaurants, and in-person church services, even though, according to an analysis by the Desert Sun, nearly half of those counties had failed to meet at least one of the criteria.
As reopening accelerated, Californians' fear of the virus dissipated, according to a University of Southern California survey, which saw respondents' average perceived chance of getting COVID-19 drop from around 30% in April to 20% in June.
Californians started to leave their homes more, not only to patronize businesses that had reopened but to visit friends and families outside of their own households.
But doing the right things early left many Californians still at risk of getting sick when people tried to get back to normal life.
“The numbers that we have show that the reason for the spike — it's pretty clear in what we’re seeing — is that people are no longer at home,” Jill Darling, survey director at the USC Dornsife Center for Economic and Social Research, told BuzzFeed News.
While state and local officials released detailed, industry-specific guidelines for how businesses could reopen with proper social distancing, masking, and other safety measures in place, the messaging for the general public wasn’t clear or robust enough and left many people unsure about what to do, according to some public health experts.
On top of that, despite a recent New York Times analysis that showed mask use is relatively high in California, the ongoing political fight over face coverings has made it difficult for health officials to mandate universal masking, something other countries who have contained the disease have done.
“People are confused. They’re defiant. They're pissed off because they've been at home. They’re pissed off because they don’t have their jobs. They’re pissed off because their kids aren’t getting taught,” Peters said. “That combined with this political animosity that we have and justification to say, ‘Well, it's my right not to do this’ — it all adds up together to make people have a lack of clear understanding of what they should do.”
In early June, Orange County’s health officer resigned after receiving threats of violence over her mandatory mask order. Two days later, the new officer rescinded the mandate, saying instead that though it was no longer a requirement, he strongly recommended wearing masks.
A week after the Orange County health officer’s resignation and more than a month after the state began reopening, Newsom mandated all Californians wear face coverings while in public — a move that some felt was too late.
“We should have had a statewide mask order earlier — way earlier,” said Stephanie Roberson, director for government relations for the California Nurses Association. “We opened up the floodgates, and we did not have a mandate to protect the people who went out in the streets to enjoy freedom.”
In the days and weeks since issuing the mask mandate, Newsom and his office have shared photos of celebrities wearing face coverings.
“It’s really not that big an ask. Wear a fucking mask when you go outside,” comedian Sarah Silverman said in one video posted to the governor’s social media accounts.
The goal of California’s stay-at-home orders was never to get the number of new infections back down to zero, state officials have said. Rather, the intent was to buy time to prepare the public and the state’s healthcare system to handle the disease going forward and protect older Californians in nursing facilities and those with underlying health conditions, who are more likely to die from the disease.
“We began and always knew that we weren't waiting for us to have no cases in California as much as that’s a wish in a dream,” Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, told BuzzFeed News. “We knew that this virus was virulent; it would move around our communities, and we had to do what we can to reduce transmission.”
Still, some public health experts, including Wachter of UCSF, said state officials should have been more thoughtful and communicated more clearly about what it meant to come out of the shelter-in-place order to make sure people understood how to protect themselves and others.
“How are you going to change the behavior of 40 million people?” Wachter noted. “I think we need to put more energy and more resources into doing that now if we’re going to get it right.”
The second round of closures has been heartbreaking for small business owners who put a lot of time and money into making their establishments safe to reopen.
“If this keeps going on, a lot of restaurants are not going to reopen,” said Patrick Mulvaney, chef and co-owner of Mulvaney’s B&L, a landmark restaurant in Sacramento.
Mulvaney, who owns the restaurant and a catering business with his wife, told BuzzFeed News he believes the new shutdowns have made people fearful about eating out, making it hard for restaurants to bring in enough revenue to stay afloat.
“We can close, but how do we reopen? And are we going to get to reopen again?” he said. “We don’t know.”
Vanessa Workman, owner of the Pure Barre studio in Hollywood, said she “bought a bunch of stuff with money I don’t really have” to reopen for in-person classes on July 8. Five days later, she had to shut down because of Newsom’s orders.
Like many in the fitness industry, Workman shifted her business to offer livestream classes when the stay-at-home order was issued in March, but many clients have chosen to freeze or cancel their memberships.
“The studio’s just kind of, like, hemorrhaging money,” Workman told BuzzFeed News. “Honestly, I’m like trying to get in a headspace where I’m, like, prepared emotionally if we do need to shut down.”
Public health experts are hopeful that California will get this surge under control as officials move to shore up pitfalls in messaging as they roll back reopening and work on better strategies for testing moving forward.
In addition to prioritizing test processing for those in high-risk environments, including people who live and work in nursing homes and prisons, healthcare workers, and patients in hospitals, the state is also continuing to build up its testing capacity and evaluate other methods, like “pool testing,” to make it more efficient and less costly.
The state is still in a much better position to handle the virus now than it was in the spring, not just because of the work that state and local governments have done but also because scientists have learned much more about the disease and how to treat it.
“California’s not Texas or New York ... and if we’re still careful and diligent, it’s not going to get there,” Peters said. ●