As COVID-19 explodes, was California too strict for its own good?

By Eric Ting of SFGATE.

"Once seen as a model for managing the pandemic, California is now in crisis.

The Golden State is reporting the fourth-highest rate of new COVID-19 cases per capita in the country, and the state's hospitals are overwhelmed and considering rationing care. Several regions have gone under new stay-at-home orders in recent weeks, but compliance appears to be low.

"How did it all go wrong for the state that issued the nation's first stay-at-home order in March and imposed some of the country's toughest restrictions? One possible explanation: The state and its counties have been too strict for their own good.

"A significant number of people have lost faith in the public health guidance and don’t know what to believe anymore," said Daniel Kotzin, a member of two advocacy groups hoping to reopen schools and businesses in San Francisco. "One part of it is when our leaders say one thing and do another, and another part is it’s just been so strict with no escape valve and people can’t do it anymore. For over nine months we’ve been locked up with constantly shifting goalposts."

The "escape valve" theory makes sense to Dr. Monica Gandhi, an infectious disease expert at UCSF.

"When the new lockdown came down, a friend of mine said we've basically been under lockdown in San Francisco since March," Gandhi said. "So I think the dance of opening and closing elsewhere was a necessary dance, since it allowed people economic relief and social relief in between waves. But in California, the system was quite strict and didn't allow that release. And it wasn't just the state; counties like San Francisco didn’t even allow what the state was allowing to reopen. San Francisco was even more strict."

Gandhi said that the state's messaging encouraging people to stay home for the holidays is not working in large part because many went the entire year without seeing family members."California is unique because this particular lockdown came off as arbitrary and not data driven," she said. "That’s why the opposition to it is not just from those who believe COVID is a hoax; there's also opposition from medical professionals, lawmakers, parents and those with nuanced thinking who believe it’s too restrictive, and didn’t incorporate the biology of virus. A good example was the playground closures, which ended up getting reversed because it was not nuanced and didn't take equity into account.

"Another example is outdoor dining. We all saw that viral video from LA. Cities and states have yet to provide data to restaurateurs that they had any contribution to driving spread if they did everything right. So I think the current opposition comes not because California is more rebellious or fatigued, but Californians have listened to the news, they have seen the data on the virus, they know that being outside is safer, they know impact the lockdown will have on businesses that could die forever, and they just don’t buy it. It's fascinating; the opposition is quite widespread."

A new shutdown coupled with minimal compliance yields a worst of both worlds scenario: Thousands of lives lost and immeasurable economic damage.

Rory Cox leads the newly formed San Francisco Small Business Alliance and said several business owners are expressing newfound frustration over not being able to operate over the summer under the state's watch list framework, and therefore missing the window of economic relief Gandhi referenced.

"Experts have long said the winter will be the time of a surge no matter what we do, so the big argument for fitness centers, tattoo, massage parlors and others was, 'Hey we need to be able operate in the summer since we're probably going to be closed in the winter based on what the experts are predicting,'" he said. "They knew the winter was coming. They weren't listening and kept us locked down for so long for whatever reason, stopped kids from seeing their families over the summer and now look at where we are."

Cox said the new round of Paycheck Protection Program loans from the stimulus package passed by Congress will be helpful, but is in no way a saving grace. He also expressed anger the city and state did not make more relief immediately available after announcing the December stay-at-home order. Gandhi agrees with Cox's assessment that California officials could have done more.

"In Pennsylvania, every time they announced a new lockdown, they announced in the same breath new widely available grants," she said. "I know we’re broke and it’s really hard to find money, but I think if economic rewards were mentioned in same breath as business closures, they may have been more palatable."

Just how how many deaths the current surge will bring remains to be seen, but when it's all said and done, there's a real chance California's deaths per capita numbers — widely used to defend the state's strict restrictions — could eclipse several states that have been far less restrictive. Cox would find that both tragic and ironic.

"It feels like during this whole pandemic, the people in charge have been acting like this is an experiment in a lab at Stanford," he said. "It's all about, 'How can we win the COVID death rate race,' with no regard given to any other real-world concern that impacts society like livelihoods, well-beings and mental health.""