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What More Can California Do to Stop the Coronavirus?


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California Today

Thursday: A conversation about navigating risk today. Also: Teachers push for limits, and Los Angeles basketball is almost back.

Jill Cowan

  • July 30, 2020

ImageThe North Central neighborhood of San Mateo, Calif.  The North Central neighborhood of San Mateo, Calif. Credit…Jim McAuley for The New York Times

Good morning. The rising coronavirus case count in California is maddening, in part because the effects of our sacrifices feel unclear, diffuse: We are not going into bars, most of us are wearing masks and a vast majority of us are taking the threat seriously. So why are thousands of people still getting sick every day? Where are they getting sick? And why are dozens dying?

These questions came up again and again when we asked what you wanted to know about how the pandemic is reshaping life in California, and speak to the anxieties many of us are feeling.

[Track coronavirus cases by California county.]

Finding the answers to where the virus is spreading and why can be tough, especially given the limited state of California’s contact tracing efforts.

So I spoke with Dr. Kirsten Bibbins-Domingo, the vice dean for population health and health equity at the School of Medicine at U.C. San Francisco, to get her insights on why the virus continues to ravage California, and what can be done to slow its spread.

First, I wanted to ask what you thought about Gov. Gavin Newsom’s new focus on the Central Valley.

If you look at transmission rates in the Central Valley, they’re super high.

One of the biggest challenges, especially among our front-line workers is that they need both personal resources to be able to figure out how to effectively isolate and to make sure their wages are protected if they need to take time off work.

But also, there needs to be investment in the sectors that employ these low-wage workers to make sure that this is possible.

And we need additional investments, including making sure there’s testing availability when departments of public health are really hard hit because of the higher burden of transmission.

It’s a little late, frankly, which is the unfortunate thing. But the Central Valley needs attention.

Right — I know from talking with you and other experts that it’s not news that these communities were vulnerable.

I think what’s challenging for the pandemic in general and for California in particular is we cannot, as a state and/or as a county, continue to just look at average effects. We have to basically shift our resources.

That’s what’s frustrating. You see that within the county of San Francisco — we focused on the Latinx community, because our average rates were low. But in all of our cities, it’s been late to even shift testing to where stuff is happening.

One of the things that’s striking in the Central Valley, also, is how much our rhetoric betrayed our very urban biases — like, “Close the beaches, close the bars.”

We should have said, “Being in indoor environments, even when you’re with your family, is bad news.” You could look at the congregate settings that our farmworkers are living in and just know they were vulnerable.

But something about this pandemic — it seems to be hard for us to be proactive.

Last time we talked, you mentioned being cautiously optimistic that this pandemic will show people how much communities’ health is interconnected. Do you still feel that way?

The thing that makes me optimistic is that the people who are trying to address the pandemic are realizing we can’t just put out nice public health announcements. There are big structural factors that make it challenging to control, and when things are challenging in one part of our community, the entire community can’t really do the things it wants to do and open up.

What makes me pessimistic over time is that there is fatigue with this pandemic, which can make people lapse into a narrative of “It’s those communities. I can get it under control, so what’s the problem?”

The reality is that we when our rural counties get overloaded, they airlift the patients to the other counties. We’re all taking care of patients from these counties. And the agricultural sector is an important part of our economy. If it falls through, it’s going to be something we all pay for.

How would you talk to someone who’s trying to navigate risk in their own life?

One of the things that I hear from epidemiology colleagues is one of the best things that departments of public health can do is just really go deep. Like in the last hundred cases — how did people get it?

The Coronavirus Outbreak ›

Frequently Asked Questions

Updated July 27, 2020

  • Should I refinance my mortgage?

    • It could be a good idea, because mortgage rates have never been lower. Refinancing requests have pushed mortgage applications to some of the highest levels since 2008, so be prepared to get in line. But defaults are also up, so if you’re thinking about buying a home, be aware that some lenders have tightened their standards.
  • What is school going to look like in September?

    • It is unlikely that many schools will return to a normal schedule this fall, requiring the grind of online learning, makeshift child care and stunted workdays to continue. California’s two largest public school districts — Los Angeles and San Diego — said on July 13, that instruction will be remote-only in the fall, citing concerns that surging coronavirus infections in their areas pose too dire a risk for students and teachers. Together, the two districts enroll some 825,000 students. They are the largest in the country so far to abandon plans for even a partial physical return to classrooms when they reopen in August. For other districts, the solution won’t be an all-or-nothing approach. Many systems, including the nation’s largest, New York City, are devising hybrid plans that involve spending some days in classrooms and other days online. There’s no national policy on this yet, so check with your municipal school system regularly to see what is happening in your community.
  • Is the coronavirus airborne?

  • What are the symptoms of coronavirus?

  • 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.

I think we should be communicating to people so they can start to make decisions themselves, as opposed to just closing big sectors of life — that’s the mind-set we have to be in rather than, “All bars and dining are bad,” or “I can’t get together with anyone.”

The way I think about it is those enclosed, close-contact environments, and especially when you’re with many other people, are always riskier environments. And if you’re doing an activity that requires you to take that mask off, that is a thing that raises the risk.

Do you think some of these essential sectors have the potential to get it right — to be models for how to keep people safe inside?

I think that’s exactly right. You’re going to need some enforcement, because there are clearly bad actors.

What I would also hope is that the state pouring resources into our low-wage sectors really could allow businesses and community leaders to say, “How can we redesign this? How can we get people into humane housing?”

If we have creative and committed community leaders with resources, hopefully they’ll be able to think about sustainability.

(This article is part of the California Today newsletter. Sign up here to get it delivered to your inbox.)

The cafeteria area of an elementary school in Los Angeles.Credit…Jae C. Hong/Associated Press

  • Teachers’ unions, including powerful ones in California, are fighting for longer school closures, as well as limits on how much teachers can do remotely. [The New York Times]

  • The governor said the state’s backlog of almost a million unemployment claims could take two months to clear. [The Sacramento Bee]

  • A former Vallejo SWAT team commander said he was forced out of the city’s troubled Police Department after he raised concerns that officers were commemorating fatal shootings by bending the points of their badges. [Open Vallejo]

  • The July Complex fire in far Northern California has gotten bigger than last year’s largest blaze. It’s 127 square miles. [The Mercury News]

  • Tonight, the Lakers and the Clippers will finally share a court again. [The New York Times]

  • If you missed the, ahem, not-at-all funny faces that got Joe Kelly, the Dodgers reliever, suspended for eight games, see the clip here. [The New York Times]

California Today goes live at 6:30 a.m. Pacific time weekdays. Tell us what you want to see: [email protected] Were you forwarded this email? Sign up for California Today here and read every edition online here.

Jill Cowan grew up in Orange County, went to school at U.C. Berkeley and has reported all over the state, including the Bay Area, Bakersfield and Los Angeles — but she always wants to see more. Follow along here or on Twitter.

California Today is edited by Julie Bloom, who grew up in Los Angeles and graduated from U.C. Berkeley.

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