As public health experts debate the wisdom of California’s decision to relax coronavirus restrictions, they warn residents to take precautions now have highly contagious variants and a still-high positive test rate combined to create “ a more dangerous world. ”
“We will have to make a major educational effort to ensure that people don’t misinterpret the removal of the regional home commitment and think they can live their lives as they did before COVID,” said Dr. Robert Kim-Farley, a UCLA medical epidemiologist and infectious disease expert.
“Otherwise,” he said, “we’ll see these numbers just go up again.”
Experts who believed that looser restrictions were warranted point to positive trends.
New cases and hospital admissions have plummeted from December’s highs, and there are no holidays coming that will put the pressure on people to get together, they note. Many masks may already be infected and have gained some immunity, making them less of a danger to others, and vaccines continue to spread, albeit slowly.
But the cautious optimism remains tempered by how widespread the virus remains in California, complicated by the new variants found here and elsewhere in the country. The federal Centers for Disease Control and Prevention have predicted that a variant from the UK, which is significantly more contagious and likely to be deadly, will become the dominant US strain by March.
Dr. John Swartzberg, an infectious disease expert at UC Berkeley, believes California ended the regional order too soon.
“If the question is to save the maximum number of lives, projections suggest that we will suffer far fewer deaths between now and June if we go through with the lockdown,” Swartzberg said. ‘I’m not talking about a long lockdown. Even a few extra weeks will make a big difference in terms of lives saved. “
Swartzberg said the state’s Jan. 25 decision to end the regional order, allowing restaurants to reopen alfresco dining and other places, followed a now familiar pattern.
“Every time we experience a wave, we lock the peak, and then start to decline,” he said. “We are opening things too early (think May and early June followed by the summer wave, and September and October followed by the winter rise), we accept a steady state of new daily cases significantly higher than before the wave…. By opening too early, we are building on a very high background of everyday business. “
In the meantime, he and other experts say residents should wear more protective face coverings when they are around others indoors – not just single-layer masks or goggles – and consider protecting their eyes with a face shield or goggles.
Trips to the grocery store should be limited and done quickly, Swartzberg said.
“This advice doesn’t cut very well for people who have to go out every day to work in the supermarket,” he added. “For those people, this has just become a more dangerous world.”
The online MicroCOVID project, which measures and reports virus risks, says the British tribe has increased the risk of infection from a one-time meeting with another person by 50%. The species has already been found in Southern California.
Shoppers should only use approved masks, such as KN95s, and people should wear out of sight cover unless they are 5 feet or more from others, says the site, which is viewed by many health care providers.
But that advice assumes the British species is already widespread in California.
Dr. Robert Wachter, professor and chair of the Department of Medicine at UC San Francisco, remains skeptical.
Had the British tribe been more widespread in California, he said, cases wouldn’t have diminished as quickly in the past two weeks.
Gavin Newsom in December instituted regional stay-at-home order for places where intensive care units were nearing full capacity. With cases and hospitalizations now falling, Wachter said, it made sense to relax the rules. He and other experts noted that most of California remains in the purple layer, the most restricted category for communities where the virus remains widespread.
As for people who think they can lower their guard with the relaxed restrictions, Wachter said, “I think most people are smarter than that.”
“It’s been a year,” he said, “and if people don’t understand what this virus can do and how you can protect yourself, it’s going to be hard to figure out which message will work.”
The British species is believed not to travel farther in the air or remain on inanimate objects longer, but it attaches better to human cells to enter and multiply. People infected with it are more likely to release viruses, and those exposed to it are more likely to be infected.
The vaccines now being distributed protect against the British variant, but a strain from South Africa appears to be more resistant to some drugs. Moderna, one of the vaccine makers, is now working on a booster targeting that mutant. but other strains discovered in the United States appear to be more resistant.
Wachter said wearing face shields or goggles in stores was a “reasonable” precaution. “It depends on everyone’s risk tolerance,” he said.
UC San Francisco doctors who treat patients are required to wear both goggles and a mask, regardless of whether they are dealing with COVID-19 patients, Wachter said. He noted that a study from China found that people wearing glasses were less likely to become infected.
While he would now be “a little more cautious” about not getting vaccinated, he remains hopeful that compliance with health rules, vaccinations and the immunity of those already infected could save the state from the massive contamination that hit the UK.
“Right now, it doesn’t make much sense to completely change your behavior based on the variants,” he said. “It makes sense now that there are variants to make sure you don’t let yourself down.”
As the variants become more dominant, the calculations change, he said. The new strain in the UK was responsible for 70% of infections two months after it was discovered.
“We have to be humble about this,” said Wachter. “This thing is constantly throwing curveballs at us.”
In addition to the British variant, other strains from South Africa and Brazil have been discovered in the U.S. Another new variant found in California accounted for 24% of about 4,500 viral samples in California at the end of last year, according to researchers at the Cedars- Sinai Medical Center in Los Angeles. The species was hardly detectable in early October.
A separate analysis of 322 samples, mostly from Northern California in late November and December, found 25% of the same type. Researchers are now studying the new species.
Many who are infected say they have followed all of the health rules, but Swartzberg said that on closer examination are usually outcomes. He cited the case of someone who once forgot to wear a mask indoors while around others or another person who wears a mask while walking, but who is accompanied by people from outside their household.
The vaccines represent the light at the end of the tunnel, but “the tunnel has gotten very ugly,” said UCLA’s Kim-Farley.
Southern California is recovering from a viral tsunami, the “ New York moment, ” and many residents know of others who got sick or died, he said. That chilling chapter, he added, probably made a strong impression that will not be soon forgotten.
“Better to double down now and make sure our whole family is alive, rather than being lax now and maybe losing family members,” he said.