Meet a real American hero, Sarah Cody. She is Santa Clara County’s (San Jose) Public Health Officer, and she was the individual who convinced seven San Francisco Bay Area counties to shut down March 16. Those counties were the areas around San Francisco, Silicon Valley, San Jose, and Oakland/Berkeley, with a population of around 7 million.
”She had just gotten off the phone with health officers Tomas Aragon from San Francisco and Morrow from San Mateo County. They debated the race-against-time decision, the consequences for faltering — the kinds of stuff of Hollywood scripts,” reported the San Jose Mercury News. “They compared the trend lines of COVID-19 cases in the Bay Area with Italy’s a week and a half earlier, just before the situation there turned dire. If they didn’t take bold action, the Bay Area could be next. ‘It was clear to me already how quickly it was moving, and that’s what gave me a sense of urgency,’ Cody said. ‘We just needed to embrace the risk and do it.’”
Because of her actions, the San Francisco region appears to have its COVID-19 problem under control (furiously knocking on wood), while parts of the country burn. Meanwhile, places like Texas and Florida refuse to learn the lessons.
This chart, from a week ago, pretty much says it all. The San Francisco Bay Area had more confirmed cases than New York City on March 10, 14 to 7. But look what happened in the days afterward:
Of course, the number of confirmed cases doesn’t reflect the number of actual afflicted. I have a close friend nearby who clearly has COVID-19, but her symptoms are too mild to get tested. So how do we know that the chart just doesn’t reflect more robust testing in NYC? Well, you can see the disparity just as clearly, and far more painfully, in the death toll. While New York has suffered 1,139 deaths as I write this, the number in the SF Bay Area is 65.
What can account for this disparity? The biggest difference is Sarah Cody’s heroism—not just in realizing the danger and acting it, but being so incredibly well-respected and persuasive that she got six other surrounding counties to go along. Competence matters. And part of competence is recognizing a problem and moving quickly to address it. No one was faster than Cody and the SF Bay region in shutting things down.
|
Date of Shelter in Place order |
SF Bay Area |
March 16 |
California |
March 20 |
New York |
March 20 |
Illinois |
March 21
|
New Jersey |
March 21 |
Louisiana |
March 22 |
Michigan |
March 23 |
Oregon |
March 23 |
It seems crazy that a four-day head-start on the rest of the state and country could make such a difference, but for a disease that spreads exponentially, every single day matters. Here’s how the SF Bay Area compares to the rest of the state:
From a vast majority of California cases, to a shrinking percentage, those four days were a big part in mitigating the local effects of the pandemic. And again, just to ensure that these numbers aren’t skewed by access to testing, here’s deaths:
Again, the Bay Area has steadily decreased as a statewide percentage of new deaths.
There’s another factor, one that would be hard to quantify, but … the Bay Area took this thing seriously from Day 1. A week before the March 16 shutdown order, my kids’ piano recital was cancelled. Too dangerous, already. On March 8 I attended a BBQ birthday party for my closest friend, and we were already keeping our distance, keeping the hugging and touching to a bare minimum.
Meanwhile, here was New York City Mayor Bill de Blasio on March 9, “It’s not people in the stadium, it’s not people in the big open area or a conference and all. It’s people close up to each other, deeply engaging each other to the point that the inadvertent spitting that comes with a conversation sometimes, or a sneeze or a cough, directly goes at the other person in close proximity.”
On March 11, he said, “[the city is] telling people to not avoid restaurants, not avoid normal things that people do. If you’re not sick, you should be going about your life.” Then, the day after he finally shut down the city’s schools on March 15, he commuted across town to go to the gym, setting a poor example for anyone watching. Gov. Andrew Cuomo wasn’t much better, slamming de Blasio for wanting to issue a shelter in place order on March 19, just a day before he shut down the whole state anyway.
The words of our leaders matter, helping shape behavior.
Now of course, New York is dense than the Bay Area, about 35% denser than San Francisco. So perhaps it was inevitable that New York would face a tougher task. But California’s early action has dramatically slowed the virus’ death toll compared to much of the country. Remember, California has about 12% of the US population:
|
New Deaths 3/31 |
Total Deaths |
New York |
372 |
1,714 |
Michigan |
75 |
259 |
New jersey |
69 |
267 |
Louisiana |
54 |
239 |
California |
35 |
180 |
Massachusetts |
33 |
89 |
Connecticut |
33 |
69 |
Illinois |
26 |
99 |
Georgia |
23 |
125 |
Colorado |
18 |
69 |
Washington State, the first epicenter of the disease in the country, isn’t even in the top 10 anymore, with 15 new deaths yesterday. Curve-flattening methods work, even if it’ll be a couple more weeks before we see numbers in New York and New Jersey begin to come down. That’s the terrible trajectory of this disease, we’re always several weeks behind the curve. But if you do the right thing today, you save lives.
And that’s why it’s so distressing to see so many states still refuse to take things seriously. Florida didn’t shut down until today. Texas still hasn’t shut down. And both states face staggering loss of life. The CovidActNow.org model had Florida losing potentially over 300,000 without a stay in place order. It’s great that one is now in place, but the delay will cost lives, as we saw with that 4-day head start the Bay Area had on everyone else.
Texas is looking at a death toll of over 400,000 if it continues on its current trajectory. But maybe now that Florida has finally fallen in line, Texas’ Republican Governor Greg Abbott might finally do the right thing.
And those are just the big-ticket states, with huge populations, neither of which are as young and healthy as that of New York City, with a top-class health care system, highly active population, and low obesity and smoking rates. (New Yorkers, in fact, live longer than anyone else in this country.) Missouri is facing around 90,000 dead if it doesn’t lock down. 46,000 for Iowa. 158,000 for Georgia. 44,000 in Mississippi. Those are incomprehensible numbers, yet even now it’s not too late to mitigate the damage.
Now, shutting down is just part of the equation. States and local municipalities have to zealously enforce the restrictions. You may have seen people at the beach down in LA a couple of weekends ago, being so stupid. Chicago Mayor Lori Lightfoot has become a meme queen, as she relentlessly chides Chicagoans to stay home. Look at these Italian mayors take the task seriously:
So even a stay-at-home order is inadequate unless it’s strictly enforced and followed. That becomes particularly challenging in some of our nation’s reddest areas, where people have spent a month hearing that everything is a hoax and just like the flu from Fox News, and are already predisposed to distrust both the media and science. It may take another month of nagging from Trump to get them to take this seriously, and who knows if Trump even has the fortitude to keep this up before he goes back to saying it’s time open everything back up?
Then, of course, we have to contend with the stress on our health care system—the lack of ventilators, the lack of protective equipment, the shortage of doctors and nurses—exacerbated by those getting sick from the lack of protective equipment. We’ve got a long way to go, and it will only effective action by the states that keeps the national death toll below the 240,000 mark that Trump would consider “a good job.”
To be clear, clear, clear—I don’t write this to bash New York City or the state, which are currently fighting a desperate battle against time and pestilence. The point isn’t to say that they suck, they don’t. New Yorkers and their neighbors in New Jersey are heroic people.
The point is that every day that people dismiss the seriousness of the disease is a day that will, down the road, cost lives. The SF Bay Area took it seriously, from the very beginning, and it has thus far been able to mitigate the damage. That should be a lesson to all the holdouts, like Texas, as well as to individuals who still don’t take this seriously enough—more than a quarter of the population:
That 27% of Americans are just a little or not at all concerned is dismaying. There shouldn’t be a single person who isn’t “extremely concerned,” but here we are.
There are lessons to be learned. From the SF Bay Area. From Korea. From China. From Italy. Trump’s inability to assimilate those lessons and apply them nationally is a curse. He can’t see past the immediate moment, and it’s getting people killed. So it’s up to the rest of us to do what we can to apply the lessons within our power and try to limit the damage.
Most of us can’t help increase the supply of ventilators or protective equipment or tests or get Texas Gov. Greg Abbott to get his head out of his ass. But we can urge everyone around us to stay the hell home for non-essential activities. It’s not just the “stay in place” orders that help save lives, it’s our ability to take them seriously and help enforce them.
We need everyone to be like Sarah Cody.