The State of California: Re-Opening, Protests and Rising Cases

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By KCBS All News 106.9FM and 740AM

California is quickly reopening more of its economy, even as the number of coronavirus cases continues to spike in many parts of the state. Meanwhile, large protests continue in the aftermath of the police killing of George Floyd, leading many to worry about whether those big crowds will lead to a greater spread of COVID-19.

So, is the state reopening too soon? Will all the increased social contact lead to a statewide rise in cases? What about people potentially exposed at those demonstrations? 

We have a lot of questions about the way all of this is being handled. Some people think the Bay Area is moving too slowly to reopen, while others think this is all happening too soon and it’s still not safe. 

On Monday’s “The State of California” Dr. Peter Chin-Hong, an infectious diseases specialist, Professor and Associate Dean at UCSF, joined the conversation with KCBS Radio’s Doug Sovern, Jeff Bell and Patti Reising.

Let’s start with the big reopening question. The governor said today he’s encouraged that the rate at which Californians are testing positive for the coronavirus remains stable, in the range of 4.5%, and said the reason the raw number of cases is growing is simply because so many more people are getting tested. 

How comfortable are you with that positivity rate? Should we be concerned that it’s not declining

That could be suspended expectation, so I’m not quite sure where that number is going to go. California is right next to Arizona, which is not only having increased number of cases, but they’re also having an increased number of hospitalization and usage of the ICU. So I think once the cases translate into use of hospital resources, then I think something will hit the fan. 

I want to ask you about the emerging reopening protocols and your level of confidence in them. Specifically, these protocols rely on the public to do its part: wearing masks, social distancing and so forth. Can we count on the public, by-and-large, to do so?

No, I think what we’ve been seeing in California is really heterogeneous, sort of embracing of what we should do in public to protect each other. In places like Orange County, there’s been backlash against public officials, in fact, forcing them to resign because they’ve tried to get the community to put on masks. The Bay Area is where, I think, people have largely been pretty good about wearing masks in public, not everywhere, but I would say in general. I’ve been kind of happy going around and certainly a lot of groceries and farmers markets mandate that people wear masks when they’re in the facility.

What about the risk and how concerned you are with all the masked protests? Do you think it might lead to a possible spike in coronavirus cases? And I have to ask you a question I’ve gotten at least ten times in the past week: If it’s OK to go out and protest shoulder-to-shoulder with thousands, how come we can’t all go to the beach? How come we can’t have concerts? 

Because our calculus has changed a little bit when we think about protesting. Of course, we can get into the details: People are not all wearing masks on the beach anyway and they’re kind of crowded. 

But coming back to the calculus we use in health care, we think about why people are protesting. It’s really a response to thinking about systemic racism, and police violence and the health threat itself. Actually, when you look at the disparities in health care of cardiovascular health, lung disease, cancer, hypertension, you name it, it actually takes it up in the tens of thousands or more per year in additional lives lost. 

When you think about the additional lives that may be hospitalized because of protesting,  particularly with people wearing masks, it’s probably in the less than a hundred realm, depending on the community you go to. 

So again, the response to racism, the response to thinking of the effect of violence and health and with these lives lost is having your voice heard, so that favors people protesting and having their voices heard in order to change what we’ve been doing, which has, frankly, not been optimal. 

So it sounds like you’re saying it’s worth the risk, because in the long run, protests themselves could end up saving lives. But just from a practical standpoint, if I’m out there covering a protest or if someone is participating, how great of a risk is it to be in that kind of a crowd? Although I do think most people at the protests have been wearing masks.

It depends on how the community is around you while protesting and it depends on the community. So if you protesting in San Francisco and the Bay Area, it’s probably going to be safer than if you’re protesting in Texas, or Florida or Arizona. That’s just given the probability of getting hit by a virus if, for example, you weren’t wearing a mask or someone ripped you mask off. With that said, I think what we have come up with as a group, in infectious diseases and with other professionals, is how do you stay safe from a participant? And how do you stay safe from a law enforcement perspective or keep people safe while people are making their voices heard?

When you look at the horizon here, the eminent re-openings, what concerns you the most? A park like Disneyland reopening, movie theaters, movie sets, indoor dining? What causes you to be concerned at night?

I think it’s about the situations where you can’t control your environment, so that’s why Disneyland gives me a higher heart rate, and maybe large churches with numbers in the hundreds might do that. It’s the same way I think about prisons or cruise ships: you bring a group of people together and you can’t control  your environment. All bets are off in terms of protecting yourself.

But if you can control your environment with say outdoor dining; or going to a movie theater where they’ve sectioned off the area (all of that is indoors versus outdoors); a movie set where it’s really intimate and you really know who’s there and you’ve been vetted about symptoms before going in; a store where they’ve done really good employee screening and have a lot of available hand sanitizers. That’s a really different context from the playground, where even though you can control your little patch of sand, you can’t control the kids running around next to your kids. 

Can you share what your three W’s and your three C’s are when it comes to staying safe from the coronavirus?

It’s about getting down to the essentials. 

Wearing your mask, Washing your hands and Watching your distance. 

Wearing your mask is probably the most important thing if you want to be a minimalist, and that’s really because countries where masks are enforced, like in Asia, despite crowding they’ve managed to stave off the disease.

And in terms of the three C’s. Those are things to watch out for in any context to avoid, and that’s: Close contact, Confined spaces and Crowds.

It’s really about wearing your mask and controlling your environment.