Tag Archives: California

Coronavirus curve for California compared to New York, Florida – dramatic contrast

New York versus California: A tale of two pandemics

San Francisco Chronicle, by Erin Allday, July 27, 2020
People practice social distancing in white circles in Domino Park New York in May. Photo: Noam Galai / Getty Images

Their journeys began at about the same time, but California and New York immediately diverged down two very different paths during the coronavirus pandemic.

California started in January, with travelers from China carrying a new virus into the Bay Area. New York was probably only a few weeks behind, its virus arriving from Europe.

From there, California’s trajectory was a gentle upward bend in case counts, a long plateau, and then — the surge. New York’s was the classic curve: a sharp climb in cases followed by a long and bumpy descent.

Last week, six months into this pandemic, their paths crossed. California passed New York with the most coronavirus cases in the United States.

That grim convergence occurred as the nation reached its own dark milestone: 4 million reported cases. California, as of Sunday, has about 452,000 cases, to New York’s 412,000. Florida passed New York over the weekend and now has about 425,000 cases.

California and New York have gone through a role reversal of sorts, now that New York’s terrifying outbreak from the spring appears to be over, while California’s summer surge is still swelling. In March and April, New York consistently reported 10 times as many cases a day as California. By the end of June, California was outpacing New York by about the same rate. Last week, California reported about 65,000 new cases to New York’s 4,900.

But the numbers are more complicated than case counts. California has twice the population of New York, and its infection rate is half that of the Empire State — about 1,100 cases per 100,000 residents compared to 2,100 per 100,000. And New York has more than three times as many deaths — 32,600 to California’s 8,400, an indicator of how hard-hit the East Coast’s hospitals were early in the outbreak and how many more people died as a result.

The numbers are even more nuanced when California and New York are parsed into regions. The Bay Area, for example, has experienced a different epidemic, and is in far better shape, than Southern California. Some rural northern parts of the state have barely been touched by the virus. In New York, it has been Manhattan, along with the other four boroughs and their suburbs, that make up the vast majority of the cases statewide.

The two states ended up in roughly the same place — 400,000 known infections — at this moment in time. How they got there says as much about the nature of this new virus as it does about the culture of the East and West coast states and how they responded to the threat.

“The relationship between behavior and virus spread is mathematical, and we see it in those curves,” said Steven Goodman, a Stanford epidemiologist.

In the beginning. The initial trajectory of their curves are fairly well understood. California, the first state in the U.S. to enact widespread shelter-in-place orders in mid-March, shut down ahead of its outbreak. New York acted a little too late.

By the time New York shut down, a large portion of the population in New York City was already infected, public health experts now believe. In the two weeks after Gov. Andrew Cuomo’s statewide shelter-in-place order, confirmed cases doubled every three or four days, and the hospitals were overwhelmed. When the outbreak peaked in the second week of April, more than 10,000 cases were being reported a day and about 1,000 people were dying.

California successfully quashed its burgeoning outbreak. After a gentle uptick in March, daily cases seemed to settle at about 1,000 to 1,500 for a while. They climbed a bit more in May, hitting more like 2,000 cases a day, but still looked stable.

The hospitals were never overrun. The state generally saw fewer than 100 deaths a day. Residents celebrated their “California miracle.” Early, aggressive action had saved the state from the fate of New York and countries like Italy that experienced disastrous outbreaks.

“New York never had the chance to be data-driven and to build up their health care infrastructure and at least mitigate mortality,” said Shannon Bennett, chief of science with the California Academy of Sciences. “Even though we’ve flip-flopped in terms of the endpoint and daily new cases, it’s very different here. We were hearing in New York reports of bodies piling up, the social fabric was kind of crumbling. And I haven’t seen that here in California.

“We’re way better off than New York because we kind of saw it coming,” she added. “But wouldn’t it have been nice if seeing it coming could have prevented where we are now?”

New York: the bell curve. An advantage of having a sharp trajectory up is it’s fairly clear when the peak has arrived. In New York, it was in mid April, when the state reported 11,434 cases on what would have been Tax Day. California saw 1,197 cases that day.

From there, the cases fell far and fast in New York. The state reported a daily average of 7,600 cases in April, and 2,100 in May. The average dropped to about 750 cases a day in June and 700 this month.

New York’s curve, now six months into this pandemic, is an elegant bell with a well-defined peak and a long, steady tail.

There’s no one reason why New York’s case count fell so dramatically, but infectious disease experts point to a few most likely explanations. There were probably very few gaps in New York’s shutdown, which primarily affected New York City, the driver of infections. Residents were scared — a few weeks into the outbreak almost everyone knew someone who’d been infected — and therefore obediently quarantined.

Another possible explanation for the drop-off is immunity. By the end of May, one-fifth to one-quarter of people in New York City are believe to have been infected, according to antibody studies. That’s not enough for herd immunity, in which a large enough portion of the population is immune that a virus can no longer find traction to spread.

But if groups of people prone to infection had higher rates of immunity, that could have dampened the outbreak, infectious disease experts said.

“That may have produced some blunting,” said George Rutherford, an infectious disease expert with UCSF. “And they may have just learned their lessons better than the rest of the country.”

California: flattening the curve. California has never come close to that level of community disease. In the Bay Area, only about 1% of people were infected by the end of April, according to a recent Centers for Disease Control and Prevention study. That was the result of flattening the curve.

The state averaged about 600 cases a day in March, then 1,400 in April and 2,000 in May. That’s an obvious increase with the benefit of hindsight, but at the time the numbers appeared flat, day after day. They were even steadier in the Bay Area. There is no doubt, public health experts said, that sheltering in place prevented the massive spike that New York had experienced.

But when it looked like the numbers had plateaued, and as the rest of the country began to reopen the economy, Californians grew complacent and impatient. People in many parts of the state begged for a loosening of stay-at-home restrictions. They also began to socialize again — visiting friends and family they hadn’t seen since March.

Cases began a notable uptick around Memorial Day, and then picked up speed. Californians thought they’d peaked in April, like New York — but it turned out the worst was still to come. The state reported an average of 4,000 cases a day in June — twice as many as May. And 8,500 a day so far in July.

“We never really allowed the epidemic to reach a peak,” said Lee Riley, an infectious disease expert at UC Berkeley. “When they started seeing a slight flattening of the curve and what they thought was the peak, that’s when they reopened. And then it kept going up. In New York, they waited well after the peak period of the epidemic to begin to reopen.”

But California’s curve is deceptive, infectious disease experts say, because it’s taken different shapes in different regions. Los Angeles’s trajectory, which has been driving the state curve in recent weeks, was on a slow but steady ascent before a sudden spike in June. In the Bay Area, the curve was notably flat for a long stretch in April and May before trending up.

New York’s pandemic may have been deadlier and more destructive, but it was also more easily contained because it was centralized, Rutherford said. “When you talk about New York State, what you’re really talking about is New York City and the suburbs,” he said. “That makes it simpler.”

California held down its initial outbreak with a blanket shutdown on all 58 counties, but that wasn’t going to be appropriate for the entire state in the long haul, public health experts said. The reopening was blundered, in part, because there was no one approach. “Here, it’s like herding cats,” said Riley.

Both states can learn lessons from the other, infectious disease experts said. California looked to New York’s spike in March and April and knew to bulk up its hospital capacity while its case counts stayed manageable. That knowledge is paying off now as hospitalizations climb to new records.

“Certainly we have learned from the New York situation how bad the pandemic can get and how rapidly it can get bad,” said Grant Colfax, director of San Francisco public health, in a news briefing last week.

And New York, perhaps, looked to California’s reopening and saw that a more conservative approach would be best.

“The lessons that Gov. Cuomo talks about are the lessons of Memorial Day weekend,” Rutherford said. “That’s when it got away. And you don’t want that to happen to New York.”

Forecasting this pandemic has been notoriously difficult, so no one can yet say where the New York and California trajectories will go from here. The hope, of course, is that New York stays its course, and California manages to tamp down its current surge and wrestle back some control of its outbreak.

These curves represent only the first chapter of what’s bound to be a very long story, infectious disease experts say. These months may end up being the worst of the United States’ epidemic, or simply the first rise in a dizzying roller coaster with many more swells to come.

“We happen to be crossing these milestones, but we’re still very much in the early phases of this pandemic,” said Nicholas Jewell, a biostatistician with UC Berkeley. “This is a long haul. Let’s try to be strategic, and learn what works and what doesn’t. We need to be in better shape to live with this virus while we wait for a vaccine.”

San Francisco Chronicle staff writer Mike Massa contributed to this report.  Erin Allday is a San Francisco Chronicle staff writer.

COVID-19 “test positivity rates” in California, U.S.

Coronavirus: California continues troubling trend upward in COVID-19 metrics

With the weekend delays accounted for, the 7-day average of new cases climbed to its highest point of the pandemic
Vallejo Times-Herald, by Evan Webeck, July 7, 2020

The seven-day average of new coronavirus cases in California soared as Los Angeles County reported three days’ worth of test results Monday.

The raw number of cases reported around the state Monday obliterated the previous record but comes with an enormous caveat: a number of counties, including L.A., which itself accounts for nearly half the state’s confirmed cases, had backlogs of test results of up to three days because of the long holiday weekend. In total, the statewide case count grew by 16,637, including 8,903 in Los Angeles, to 271,889, according to data compiled by this news organization. Another 109 Californians succumbed to the virus — 81 in Los Angeles — raising the death toll to 6,446.

With the weekend delays accounted for, the average number of new cases reported around the state each day for the past week climbed to its highest point of the pandemic. For the first time, California is adding more 7,000 new cases per day — 7,041, 28.6% more than a week ago — while the average daily death count reached its highest level in more than a month: 67 lives taken by the virus each day over the past week.

Hospitalizations and test-positivity rate, two metrics frequently cited by Gov. Gavin Newsom and local health officials, also continued to slope upward. There were 5,790 patients hospitalized statewide Sunday, including 504 in the Bay Area. In the past two weeks, the number of COVID-19 patients in hospital beds has doubled in the Bay Area while rising 56% statewide.

Even as some counties near capacity, there remain plenty of open hospital and ICU beds around the state. Riverside County’s ICUs were 94% full Sunday — down from 99% last week, though more were COVID-19 patients (9.5% of ICU beds on June 27; 13.9% on July 5) — while hospitals in the Bay Area are accepting transfers from other counties. Statewide, COVID-19 patients continue to take up about 8% of the state’s hospital beds.

The percentage of tests to come back positive over the past seven days also crossed the 7% threshold for the first time since the end of April. In two weeks, it has risen from 4.9% to 7.5% even as the state conducts more tests. Labs around the state reported 25% more positive tests in the past week than the one before (6,826 per day vs. 5,499), despite conducting 12.5% more tests (104,523 per day vs. 92,848).

Newsom has previously said “each decimal point is profoundly impactful” when it comes to positivity rate. But California’s still lags many other states, despite recording among the most cases. Its 7.5% rate ranks 18th among all 50 states, well behind Arizona (25.3%) and Florida (18.7%). The country’s rate has seen a similar spike: below the 5% threshold three weeks ago, to 7.8% now.

The World Health Organization has said positivity rates should remain at 5% or below for 14 days before beginning to reopen. Currently, only 23 states meet that metric, according to Johns Hopkins University and the COVID Tracking Project.

As cases and hospitalizations climb, California scrambles to tamp down the surge

San Francisco Chronicle, Catherine Ho, Alexei Koseff, July 6, 2020
People at Dolores Park on Saturday, July 4, 2020, in San Francisco, Calif.
People at Dolores Park on Saturday, July 4, 2020, in San Francisco, Calif. Photo: Santiago Mejia / The Chronicle

Coronavirus infections and hospitalizations continued to climb in California and many parts of the Bay Area over the weekend, as the state that found early success in containing the virus is now scrambling to tamp down outbreaks in prisons and spiking new cases among young people.

Statewide, the average number of new cases per day doubled from just under 2,000 in May to 4,000 in June. That number jumped to a daily average of 6,700 new cases the first four days of July alone, according to Chronicle data.

“The damage that COVID-19 can do — this pandemic — is still in front of us,” Gov. Gavin Newsom said Monday. “It continues to spread at rates we have not experienced here in the state of California since the beginning of this pandemic.”

The number of people hospitalized with COVID-19 in California hit a record high, 5,690, for the 17th consecutive day. As of July 5, according to Chronicle data, the Bay Area had 494 patients hospitalized, down from its all-time high of 508 on July 3. Prior to the recent spike in cases, the Bay Area had reached a high of 471 hospitalizations on April 7.

The rate of positive tests has also climbed to 6.8% — up from 5.6% last week. It had been holding steady at 4.9% the previous several weeks, and its steady climb indicates the infection is spreading more quickly now than before.

Deaths, however, are declining statewide and in the Bay Area — from an average of 69 per day in May to 64 per day in June in California. The average number of deaths went from 4.8 to 4.5 in the Bay Area during the same period. That may be because more young people are getting diagnosed and hospitalized, but the severity of disease among younger patients is not as acute as it is in older patients, Newsom said.

People line up to buy fireworks from a stand in San Bruno on Friday, July 3, 2020.
People line up to buy fireworks from a stand in San Bruno on Friday, July 3, 2020. Photo: Nick Otto / Special to The Chronicle

People line up to buy fireworks from a stand in San Bruno on Friday, July 3, 2020.Photo: Nick Otto / Special to The Chronicle
In the Bay Area, the average number of new cases per day spiked 114%, from 182 in May to 390 in June, and 800 the first four days of July. The Bay Area reported a record-high 1,010 new cases Thursday — the first time the region has surpassed 1,000 new cases a day since the pandemic began.

As of Monday evening, there were 2.9 million confirmed cases in the United States, including 130,284 deaths. California reported 273,303 cases, including 6,450 deaths.

Much of the recent increase has come from large clusters of infections at prisons and nursing homes, as well as community transmission among members of the public as counties have reopened restaurants and businesses over the last several weeks.

Marin County on Sunday said it will suspend indoor dining for at least three weeks, after previously allowing it. Marin is one of 23 counties on a state watch list of counties that are showing warning signs of coronavirus spreading at concerning rates.

The outbreak at San Quentin State Prison in Marin County, where nearly 1,400 inmates have tested positive for the coronavirus, is putting new strain on hospitals that are admitting the patients — in particular at nearby Marin General, Newsom said. The prison is now also sending inmates to Saint Francis Memorial Hospital in San Francisco and Seton Medical Center in Daly City so those hospitals can help share the responsibility of caring for the patients, Newsom said.

The San Quentin outbreak accounts for more than half of the 2,445 cases that have emerged inside state prisons.

The state over the weekend rejected Santa Clara County’s application to move faster toward reopening. A July 2 county order that allows some activities to resume — including outdoor gatherings of up to 60 people and indoor gatherings of up to 20 people, with some restrictions — is scheduled to take effect on July 13 or when the county gets state approval, whichever date comes later.

Over the holiday weekend, state regulators visited nearly 6,000 bars and restaurants and issued just 52 citations for violations of coronavirus safety guidelines. Newsom said it was an encouraging sign that most Californians are doing the right thing as the state struggles to reopen amid a surging caseload.

After ordering bars and indoor dining closed in most of the state last week, Newsom said that agents with the Department of Alcohol Beverage Control stepped up their enforcement during the Fourth of July weekend out of concern that more people would be out celebrating and visited 5,986 businesses between Thursday and Sunday.

The governor said his administration sent enforcement teams to six key regions across the state with known violators or high-risk workplaces, though he did not specify where those were. He said the effort was more about educating business owners, and state regulators cited only those who were unwilling or unable to make changes to their operations.

“There were only a handful of citations because the overwhelming majority of people were doing the right thing,” Newsom said at a news conference. “I was very encouraged by the team that came back and said that even if people were out of compliance, the engagement got people back into compliance very quickly.”

California is trying to control a coronavirus outbreak that has taken a turn for the worse in recent weeks, following a loosening of restrictions on businesses and public life.

The state is closely monitoring 23 of California’s 58 counties, including Contra Costa, Marin and  Solano in the Bay Area, because of their high rate of new infections, positive tests or increasing hospitalizations. Of the 20 most populous counties in the state, all but five — Alameda, San Francisco, San Mateo, Santa Clara and Sonoma — are on the watch list. Napa County is also not being monitored.

Santa Clara County, which was previously flagged for an accelerating rise in hospitalizations, fell off the list over the weekend. After being removed late last week, Contra Costa County was added back.

Counties that have been on the list for three consecutive days must close bars and indoor dining, wineries, tasting rooms, family entertainment centers, movie theaters, museums, zoos and card rooms for at least three weeks.

Solano County wake up! Gov. Newsom threatens counties that don’t order mandatory masks

Newsom threatens California counties that defy coronavirus rules as cases spike

San Francisco Chronicle, by Alexei Koseff June 24, 2020 
Gov. Gavin Newsom at a news conference in Sacramento on June 5.
Gov. Gavin Newsom at a news conference in Sacramento on June 5. Photo: Rich Pedroncelli / Associated Press

SACRAMENTO — Gov. Gavin Newsom could withhold financial relief from local governments in the upcoming state budget if they do not follow guidelines that he says are necessary to tamp down the spike in coronavirus cases in California.

The budget deal with legislative leaders announced this week ties $750 million in funding to replace lost tax revenue for county services, as well as $1.3 billion for counties and $500 million for cities from the federal bailout package, to local governments’ compliance with the stay-at-home order and other state requirements on the coronavirus response.

Newsom, through his Department of Finance, could order state officials not to send local governments their portion of the money if they do not certify they are following the rules, which include a new mandate for Californians to wear masks nearly everywhere outside the home.

At a news conference Wednesday, the governor said that authority would give him leverage over those who “simply thumb their nose” at state guidelines. He did not specify how cities and counties would be expected to prove their compliance, though he added that he was trying to encourage good behavior rather than punish bad behavior.

“We give an enormous amount of power, control and authority to local government, but what we’re now looking for is accountability,” Newsom said.

Since the state rolled out its requirement for face coverings last week, county sheriffs and local police chiefs from Orange County to Sacramento have announced that they do not plan to enforce the order. The mayor of Nevada City, in Nevada County, encouraged residents to defy the mandate to “prevent all of us from slipping down the nasty slope of tyranny.”

Newsom, who has previously used state regulatory agencies to pressure businesses and local governments that defied his lockdown measures, said Wednesday that the “power of the purse” would give him another tool.

“If counties that have submitted that they need more state money to address this pandemic but are unwilling to enforce the rules and laws related to mitigate that pandemic, it seems not only counterintuitive that you would continue to provide those resources, but actually harmful to the broader effort,” he said.

California reported a record 7,149 new cases of the coronavirus Tuesday, Newsom said, which he attributed not only to an increase in testing but also a rising rate of positive tests. The state has recorded more than 12,000 cases in the past two days.

Hospitalizations of coronavirus patients have grown by 29% over the past two weeks, to 4,095, though the governor noted that is only a fraction of the state’s capacity.

Newsom blamed the spread on more Californians venturing out of their homes to visit family and friends, which he suggested was threatening the ability of the state to continue reopening its economy.

“Many of us, understandably, developed a little cabin fever. Some, I would argue, have developed a little amnesia. Others have just, frankly, taken down their guard,” he said. “It is our behaviors that are leading to these numbers, and we are putting people’s lives at risk.”

Earlier this week, Newsom acknowledged that he might have to shut down businesses again if the state loses control of its coronavirus outbreak. He released a video with former governors Jerry Brown, Arnold Schwarzenegger, Gray Davis and Pete Wilson encouraging the public to wear masks.

On Wednesday, Newsom pleaded with the public to continue washing their hands, wearing face coverings and avoiding large crowds and intimate gatherings.

“Consider others in your life and strangers. Love thy neighbors like yourself,” he said. “If you cannot practice physical distancing, then are you practicing love?”