While public health experts debate the wisdom of California’s decision to ease coronavirus restrictions, they are warning residents to step up precautions now that highly contagious variants and a still high positive test rate have combined to create “a more dangerous”.
“We will have to make a major educational effort to ensure that people do not misinterpret the removal of the regional order to stay at home and think that they can live their lives as they did before COVID,” said Dr. Robert Kim-Farley, an epidemiologist UCLA physician and infectious disease specialist.
“Otherwise,” he said, “we will see those numbers rise again.”
Experts who believe that more flexible restrictions were justified point to positive trends.
New cases and hospitalizations have plummeted since the peak of December, and no holidays are approaching to pressure people to get together, they note. Many mask criminals may have already become infected and gained some immunity, posing less of a danger to others, and vaccines continue to be released, albeit slowly.
But cautious optimism remains tempered by the spread of the virus in California, complicated by the new variants found here and elsewhere in the country. The Federal Centers for Disease Control and Prevention predicted that a UK variant, which is substantially more infectious and probably more deadly, will become the dominant strain in the United States in March.
Dr. John Swartzberg, an infectious disease specialist at UC Berkeley, believes that California ended the regional order too soon.
“If the issue is to save as many lives as possible, projections suggest that we will suffer far fewer deaths between now and June if we persist in the blockade,” said Swartzberg. “I’m not talking about a prolonged block. Even a few additional weeks will make a big difference in terms of lives saved. “
Swartzberg said the state’s decision on January 25 to close the regional order, allowing restaurants to offer outdoor dining and other locations to reopen, follows a now familiar pattern.
“Each time we experience a wave, we brake, the wave increases and then begins to decrease,” he said. “We opened things up very early (think of May and early June followed by the summer peak, and September and October followed by the winter peak), we accepted a steady state of new daily cases that is considerably higher than before the peak…. When opening very early, we will build a very high history of daily cases. “
In the meantime, he and other experts say that residents, when around other people inside the home, should wear more protective facial covers – not just single-layer masks or gaiters – and consider protecting their eyes with face shields or glasses.
Trips to the supermarket should be limited and made quickly, said Swartzberg.
“This advice is not very good for people who need to go out every day and work in the supermarket,” he added. “For these people, this has become a more dangerous world.”
The online project MicroCOVID, which measures and reports the risks of viruses, claims that the UK strain increased the risk of infection by 50% in a single encounter with someone else. The strain has already been detected in Southern California.
Shop buyers should only wear classified masks, such as KN95s, and people should wear facial covers outdoors, unless they are 15 feet or more from other people, says the website, which is read by many health professionals.
But that advice assumes that the UK strain is already widespread in California.
Dr. Robert Wachter, professor and chairman of the Department of Medicine at the University of California at San Francisco, remains skeptical.
If the UK strain had been more widespread in California, he said, cases would not have decreased so quickly in the past two weeks.
Governor Gavin Newsom established the regional order to stay home in December for locations where intensive care units were almost full. With the reduction in cases and hospitalizations, Wachter said, it makes sense to loosen 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 let their guard down with eased restrictions, Wachter said, “I think most people are smarter than that.”
“We’ve been at it for a year,” he said, “and if people don’t understand what this virus can do and how to stay safe, it will be difficult to figure out what message will work.”
The UK strain is not believed to travel farther in the air or stay longer in inanimate objects, but it is better linked to human cells to enter and multiply. People infected with it are more likely to spread more viruses, and those exposed to it are more likely to be infected.
The vaccines now distributed protect against the UK variant, but a South African strain appears to be more resistant to some of the drugs. Moderna, one of the vaccine manufacturers, is now working on reinforcement targeting this mutant. but other strains detected in the United States seem more resistant.
Wachter said that wearing face shields or goggles inside stores is a “reasonable” precaution. “It depends on everyone’s level of risk tolerance,” he said.
UC San Francisco doctors who treat patients are required to wear goggles as well as masks, whether or not they are dealing with patients with COVID-19, said Wachter. He noted that a study in China found that people who wore glasses were less likely to become infected.
Although he would be “a little more careful” now if he didn’t get vaccinated, he remains hopeful that compliance with health rules, vaccinations and immunity for those already infected can still save the state of the massive contagion that has hit the UK.
“At this point, it doesn’t make much sense to completely change your behavior based on the variants,” he said. “It makes perfect sense now that there are variants to make sure you’re not letting your guard down.”
If 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 detected.
“We have to be humble about it,” said Wachter. “This thing is constantly throwing curved balls at us.”
In addition to the UK variant, other strains from South Africa and Brazil have been detected in the USA. Another new variant found in California accounted for 24% of the approximately 4,500 viral samples in California at the end of last year, according to researchers at Cedars-Sinai Medical Center in Los Angeles. The strain was barely detected in early October.
A separate analysis of 322 samples mainly from northern California during late November and December found 25% of the same type. Researchers are now studying the new strain.
Many who have been infected say they have followed all health rules, but Swartzberg said that further investigation usually reveals lapses. He cited the case of someone who once forgot to wear a mask inside the house while he was around other people or someone else who wears a mask while walking, but joined people outside his house.
Vaccines represent the light at the end of the tunnel, but “the tunnel has become very ugly,” said Kim-Farley of UCLA.
Southern California is recovering from a viral tsunami, its “New York moment,” and many residents know of others who have fallen ill or died, he said. This frightening chapter, he added, probably made a strong impression that will not be quickly forgotten.
“It is better to fold now and make sure that our whole family lives, instead of being relaxed now and maybe losing family members,” he said.