Hello My Fellow Californians:
There were 3 deadly waves of the 1918 pandemic. The first was short-lived and died back in the summer of 1918. The second wave pulverized the nation in October just when everyone thought the virus had vanished. Then the country opened up again, only to be hit by a third wave in February. The question that keeps public health people up at night is whether California — and the nation — is going to suffer that same fate. I took a look at this question in light of California’s alarming increase in case numbers.
It turns out that there are mighty differences between the 1918 pandemic and this one. The 1918
pandemic was caused by the H1N1 flu virus, part of a notoriously mutation-prone family that essentially mutated itself out of existence at the time. It was a predictably seasonal flu that waned in the summer. The deadly second wave in October coincided with troops returning home from Europe. The pandemic spread along rail and sea routes, then radiated outwards to wreak havoc on previously unexposed populations.
The virus eventually died out, probably due to its own internal mutations and the development of herd immunity. The US death toll was 675,000, and probably even more than that — that would be equivalent to around 2.5 million deaths in our current population.
Covid is a coronavirus; it’s not the flu. Coronaviruses evidently don’t mutate much. We don’t know if it is seasonal. For that reason, some experts do not think that the oscillations in the outbreak will follow the “second wave” pattern that hit in the fall of 1918. Rather, we will have an up-and-down pattern, like the ones we are seeing right now, which will reflect how effective our measures are in checking the virus’ spread in the non-immune population. If you don’t close your meat packing plant and clean it up, your cases will skyrocket, for example.
In other words, our fate is in our own hands. Social distancing, mask-wearing, testing and tracing will keep the spread in check and keep infection and death rates steady. At least this is the current thinking. The 1918 flu hit hard in October because it was a seasonal flu, and because the soldiers were bringing it home. Covid-19 may hit hard in October, but for different reasons: school goes back in session with its potential for super-spreading, people spend more time indoors where the virus is more easily spread, people get less Vitamin D for being indoors, and the regular flu season starts, making the population more susceptible to respiratory illnesses.
It is wonderful to think that Covid will mutate itself out of existence, but so far there is no evidence that this is happening, and it would be a bit out of character for this particular family of viruses.
There are worrying signs that California is catching a second wave already. Cases continue to rocket upwards. On Monday the state broke its record for new daily cases with 3,131, the second time in a week that new cases broke the 3,000 mark. Not to pile on, but now we have the additional worry that the statewide protests over George Floyd’s murder are potential super-spreader events that could push the state into a second lockdown.
Is this a true, second, upward curve, or is it an artifact of increased testing? or is it both? We don’t know yet. Cases are up even though many testing sites are currently shuttered because of the protests.
The good news is that hospitalizations are down. Deaths are slowly trending downwards as well. We have reason to believe we are on the right side of these trends. Will it last? We will know much more in a month. Stay tuned.
BY THE NUMBERS
As per the above, California cases are up, hospitalization rates and mortality trends are down. Testing is not where it needs to be.
Total Cases: 122,935 (+3,191 on Thursday. Yikes)
Total Deaths: 4,454 (+69)
Hospitalizations: Declining or stable except in Norcal: Upticks in Marin, Sonoma, Placer, San Mateo, Sacramento, Contra Costa, Stanislaus, and San Joaquin. Overall, though, hospitalizations in the Bay are declining, with a 10.2% decrease over the last 3 days.
COVID’S IMPACT AND POOR AND MINORITY COMMUNITIES
Covid is delivering a devastating 1-2 punch to poor and non-white communities in California: The disease itself is surging along with the economic devastation left in its wake. Here are the results of a recent Public Policy Institute of California survey:
Latinos have been hit particularly hard in California, even harder in some places than the Black community. I have noticed this trend in the data.. so I checked with Public Health in the county I live in, Marin County, to see if this trend is reflected here. This is an overwhelmingly White, affluent, and suburban community .. look at the numbers. Hispanics are 16% of the population and 60% of the cases.
The data also confirms: that the young are the ones getting sick, and the old are the ones who are dying. In Marin, 79% of the infections are in people younger than 65. But the 65+ cohort accounts for 100% of the deaths. You find similar patterns everywhere. Statewide, 79% of the deaths are in the 65-and-over cohort.
Are the Bay Area and SoCal hitting their re-opening benchmarks? The Chronicle has an excellent analysis.
What are the Benchmarks?
- Cases per 100,000 people. FAIL.
- or: Positive tests per 100k people PASS
- Testing Capacity FAIL, MOSTLY
- contact tracing FAIL, MOSTLY.
Who’s opening and who is not
All California counties have been ok’d for reopening in “advanced Stage 2” as per the Governator’s benchmarks. That means dine-in restaurants, hair salons and schools can open.
However, 7 counties have chosen not to move beyond “Early stage 2” — i.e., no haircuts for you. 6 of the counties are in the Bay Area. The 7th is hard-hit Imperial County on the California-Mexico-Arizona border.
DID YOU HIT BENCHMARK 1? Fewer than 25 new Cases per 100k residents? Massive FAIL.
- To get approved for State 2 reopening, a county must report fewer than 25 new case per 100k residents over 14 days. All of the major counties in SoCal and most NorCal counties flunk that test.
However!
- a county can alternatively show fewer than 8% positive cases in the last 7 days.
That is much easier to do.
Increased testing is turning up frightening numbers of infected people, so the number of cases per 100k residents is skyrocketing. It don’t necessarily mean the pandemic is worsening. If we had been doing the same rate of testing consistently, increasing case rates would be worrying. But since California’s early testing was a disaster, the increased numbers may just mean we’re finally getting a picture of how widespread the infections—which have always been there — really is.
Enter alternative 2: fewer than 8% positive cases in the last 7 days. This is a benchmark that reflects what’s going on in the population more accurately. As testing increases, the percentage of positive cases should drop, because now you are not just testing obviously sick people. In that respect, all of NorCal and SoCal passes, but some just barely.
San Bernardino and the OC are barely below the guidelines. They have also been in a complete rush to reopen, as we all remember. Meanwhile, the OC’s case numbers have been soaring by every metric, but they don’t seem to care. The OC is FAR behind where it needs to be in terms of tests per day, not even doing a third of what they should be doing.
TESTING CAPACITY
- Marin (hooray!), SF, and LA are the only major urban counties meeting state testing benchmarks. C’mon people, get this done. Stop making excuses. What’s immensely irritating is that the state guideline is based on capacity, not actual tests, and most Bay Area counties have the capacity and just are not doing the tests.
- Take Santa Clara: it’s doing 1520 tests per day. What’s its testing CAPACITY? 7,000 tests per day. Then WHY aren’t you doing them? Only Los Angeles is getting the job done.
CONTACT TRACING
Oh come on. Only LA and SF have enough contact tracers. There are TONS of people who would volunteer to be trained to do this in the Bay Area. I keep saying, retired attorneys make excellent contact tracers because they know how to interview people. Even Marin County, which has an abundance of said attorneys, is dragging its feet. Bad!
Hospitalizations and deaths are down statewide. Take a look. www.latimes.com/...
Statistics sources:
www.sfchronicle.com/…
www.latimes.com/…
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TESTING NEWS
- California testing is finally improving, with upwards of 56k tests done per day last week.
- The US Government is requiring additional demographic data for people tested for Covid, including race, ethnicity, age and gender. They are, belatedly, going to try to get information about which groups are most heavily impacted. Well, better late than never, but don’t expect any surprises in the data. We already know: the young are getting sick, and the old are dying. Blacks and Hispanics are far more likely to get sick and die.
IN THE NEWS
- Oh damn department: The Governator’s highly touted 1-billion dollar mask deal may fall through after all, after the Chinese manufacturer failed to get the proper federal safety certification for its N-95 masks. Newsom is downplaying the whole thing and the masks may yet pass muster — current status is vague to the max. I guess you do crazy things during a pandemic, like signing a billion dollar deal with a Chinese company whose primary business before Covid-19 was manufacturing electric buses.
Bafflingly, the head of CMS (Centers for Medicare and Medicate Services) Ms. Seema Verma stated that “hand-washing continues to be a challenge in some nursing homes.” What?? You don’t have soap? Water? That’s depressing.
- SFO has restarted some routes to Europe and Japan this week. I sure hope they do some serious testing, masking, and distancing. The 1918 second wave spread along the rail lines; there’s nothing to stop that from happening in the airline hub cities now.
- Want to throw a party via Zoom? The Chronicle has a handy guide HERE.
- Starved for baseball news? San Francisco Giant fan Fav Hunter Pence, he of the scooter and lover of kale, is
donating June sales of his coffee company The Pineapple Labs to assist Bay Area residents suffering because of the pandemic. Plus, you get a free Giants mug. FYI, the June coffee, “with notes of dried apricot and vanilla, oy) is called “Forever Grateful”, a very Hunter-Pency sort of title.
AND FINALLY….
On Wednesday the protesters on Valencia Street in San Francisco were startled to find that they were being joined by two riders on horseback who trotted along with the crowd. The riders held up signs, led chants, and generally looked awesome. A fellow named Jaffe brought his horses up from San Jose after being inspired by Brianna Noble’s now-famous ride in Oakland. Then Nedu Anigbogu, a student from UC Berkeley, asked to ride one of Jaffe’s horses, and off they went to the delight of all concerned. Pretty impressive, considering that Nedu had only been on a horse twice in his life.
This was the first time that the horses had participated in a political demonstration, but they are Bay Area horses so of course they seized the moment despite the temperatures and the crowds. They are thinking of writing a screenplay and moving to LA. I made that up. But if you know a horse agent, they might be interested.