California Bungles Its Fight Against Covid

The state reopened at lightning speed, ceding decisions to counties and disregarding some of its own rules

By Ian Lovett of The WSJ. Excerpts:

"Mr. Newsom has taken steps aimed at bringing the spread of the virus back under control. In June, he issued a statewide mask order. On July 1, he closed bars and many indoor businesses in much of California, and he soon extended the order to the entire state.

States including Florida, Texas and Arizona took similar steps at similar times to combat a rise in cases, and saw their infection rates start to drop within weeks. But in California, the rate kept climbing for more than a month after Mr. Newsom’s mask order. Just over a week ago, California passed New York as the state with the most Covid-19 cases since the start of the pandemic."

 "A confluence of factors has frustrated California’s efforts to bring the virus under control again. A shortage of testing, as well as long waits for results, have thwarted local health officials’ efforts to isolate people who are sick. Closing bars and indoor dining has slowed the spread in some areas, but outbreaks in workplaces and crowded homes have taken off.

Latinos, who are more likely to live in crowded households and work in agriculture or other essential jobs, have been hit especially hard.

Getting residents to comply with mask and social-distancing rules has also been a challenge.

While other states were reopening their economies, Californians were still sheltering in place in May, two full months after the lockdown began.

“That made us overly optimistic when we opened up, but it also makes us reluctant…to say, ‘Let’s lock down again,’ ” said Kirsten Bibbins-Domingo, a professor of epidemiology and biostatistics at the University of California, San Francisco.

Residents in the beach towns of Orange County and the sprawling suburbs east of Los Angeles have chafed at following the same rules that apply to urban areas. Some churches have continued to hold regular services, defying restrictions that they say violate their religious liberty. Many California residents and business owners say they are fatigued by the rules, and complain they cannot keep up with shifting guidelines on what’s allowed in public spaces."

"In practice, counties were given wide latitude to control their reopening. In documents filed to the state requesting permission to start reopening, 17 out of California’s 58 counties said they didn’t meet the requirements for testing or contact tracing. They were allowed to reopen anyway.  

Mark Ghaly, secretary of the California Health and Human Services Agency, said the state tried to ensure that, even if counties weren’t yet testing at the target level, they had the capacity to scale up. “We felt comfortable moving forward with that, because we knew we were moving in the right direction.”"

"Some 38 of California’s counties—home to more than 95% of the state’s population—are now on the watch list. Counties are added when they fail to hit certain metrics, like a rate of positive tests below 8%. The World Health Organization recommends a lower positivity rate of 5% before reopening. 

The 8% figure, said Dr. Bibbins-Domingo of UCSF, meant that by the time a county ended up on the watch list, it was already a challenge to get transmission of the virus back under control.

“There were ways in which metrics were not set appropriately,” she said. “When you set the threshold at a higher level, you don’t really understand where transmission is coming from.”"