Newsom: Sweeping Stay-At-Home Order Possible Across State Amid Virus Surge

Speaker 1: 00:00 This is KPBS day edition. I'm Maureen Kavanaugh with Mark Sauer. San Diego County is seeing its rate of newly diagnosed coronavirus cases hovering at around 1000 per day. And even more concerning is that hospitals are filling up with COVID patients. At last count is 692 San Diego hospital beds were taken by COVID patients. That's three times the number from early November, the same situation or worse is happening in most counties across California. Here's governor Gavin Newsome. Speaker 2: 00:32 If these trends continue, we're going to have to take much more dramatic, arguably drastic action, the potential for a stay at home order for those regions in purple, the state Speaker 1: 00:45 Home order would be similar to the one California had in place. Last spring. The question is, did a lockdown really help last time and it, this time joining me is Rebecca fielding Miller, a UCS epidemiologist and assistant professor at UC San Diego school of medicine's division of infectious diseases and global public health. And Rebecca, welcome to the program. Hi, thanks for having me. Healthcare workers are already bracing for the surge coming after Thanksgiving. Now, if current conditions continue, how long before San Diego hospitals are in serious risk of being overworked Speaker 2: 01:23 Crowded, it's hard to give an exact timeframe. There is somethings that are different now than were happening in the spring and summer. Um, for example, it tends to be younger people. We're seeing more infections and folks in their twenties and thirties right now, whereas very early in the epidemic, it was folks who were a lot older, but certainly we're on a trend to see some pretty overwhelming numbers in our healthcare system. And there's really no reason to think that if things continue, we won't start looking the way New York or Phoenix or El Paso have been looking. Yeah, Speaker 1: 01:57 There's been so many openings and closings since the pandemic first began. Can you remind us what that locked down last spring was like? Speaker 2: 02:05 I think one of the things that was pretty unique about the lockdown in the spring was it was the first time it happened as opposed to the fact that we've been doing this now on and off, like you said, since March. And I think that first locked down that first day at home order was nobody was to leave their house except for essential business. So grocery shopping trips to the pharmacy, things like that, the schools closed retail closed indoor dining restaurants closed. And what we saw is that it worked, we saw case levels level off and then drop pretty quickly and stay that way actually until this summer, when they started to go up again and we had to put in another closing of businesses and indoor restaurants and dining, Speaker 1: 02:47 Should we have kept that original stay at home order in place, Speaker 2: 02:51 Everything we've learned about COVID-19 we've learned since January. And I think one thing that is becoming really clear that we didn't know, and in March and April is really how this is transmitted and that it is predominantly spread through aerosols through a lot of super spreading events, which tend to be indoors when you have a lot of people who are unmasked, who are talking, singing, things like that. And so it has become a little bit easier to calibrate what those stay at home orders should look like. For example, gyms, indoor dining, indoor businesses, anything where people are spending a significant amount of time and talking or doing anything else that would emit breath. Those things should probably be closed. And for awhile, until we have community spread under control, other businesses or things that can be done outdoors are certainly higher risk. But I think we know now that they are not the predominant sources of spread. So basically, Speaker 1: 03:48 Well you're saying a second stay at home order could be tailored to what we've learned about the virus. In fact, I think the first stay at home order closed some beaches, playgrounds parks. Would it be a good idea to close them again? Speaker 2: 04:04 Let me say yes. And I think that now numbers are staggeringly high. This is the highest that we've seen in San Diego County ever to date. We have, like you said, over a thousand cases a day right now, and with numbers that high even low risk events become risky, right? Because if you assume that there's a, I don't know, one in a thousand chance of getting infected by somebody at the grocery store, if somebody is infected, but all of a sudden there are more people infected at the grocery store than there were before then your chances of getting infected at the grocery store go up. If that makes sense, when absolute numbers go up, rare events happen more often. And so I think when numbers are this high, really all bets are off. And this is when we need pretty drastic measures that said that drastic closures, people simply can't sustain for that long. Speaker 2: 04:55 And I think we just need to be mindful of the fact that people are people. So while I do think there should be something fairly drastic for the next few weeks, I think coming out of that and more tailored approach is important. And we know people are people, um, we know perfection is hard. And so I think it's important that there be opportunities for people to engage in lower risk behavior. So for example, if you cannot completely isolate, then at least socialize outside. And so keeping outdoor venues open kind of provides the opportunity for some harm reduction, so to speak, considering Speaker 1: 05:34 Many people disregarded warnings, not to travel or gather for Thanksgiving, do you think it might already be too late to stop our hospitals from being overwhelmed in the final weeks of this year? Speaker 2: 05:48 You know, I I'm an eternal optimist. I don't think it's too late, but I think that the other thing to think about with the stay at home order and with the closing indoor businesses is a lot of our risk in the next few weeks is not going to come from bars and gyms and restaurants like it has been through the fall. It's going to come from people gathering with loved ones in their own homes. And that's not something that the state can really limit. And so I think it's really very much up to individuals to decide whether or not this is something that we can get under control. And so it's important to remember that this is finite. The first set of vaccines are being licensed. As we speak with emergency use authorizations, people are going to start getting vaccinated in December and January. And while this holiday may be lonely, this is not how we want to spend the Hanukkah and Christmas and Thanksgiving. It is finite. And I think by the spring and the summer, these gatherings will be so much safer. So at this point, because closing businesses, it's not going to do it. It's about holidays. It's really in the hands of individuals to say, I love you so much. And because I love you, we're not going to get together for that holiday party, but I cannot wait for the 4th of July. Speaker 1: 07:07 If we do see a surge at local hospitals, how long after Thanksgiving would you expect to see? Speaker 2: 07:14 So I think we would start to see it probably within a week or two. You can kind of think of it coming in waves. So there are going to be the folks who became sick over the Thanksgiving weekend, but then also there's going to be the folks who were part of that transmission chain, who maybe they didn't get together with somebody over the holidays because they're higher risk. But somebody who went to a family gathering then spent time with somebody else who then spent time with somebody who is elderly and vulnerable. So we'll probably start to see the beginning of it in a week or two. And then it'll probably keep climbing as just again, the sheer absolute number of cases means that people who are more vulnerable get exposed more. And I've been speaking Speaker 1: 07:55 With Rebecca fielding Miller, she's a UCLA epidemiologist and also assistant professor at UC San Diego school of medicine's division of infectious diseases and global public health. And Rebecca, thank you very much for speaking with Speaker 2: 08:09 Us. Yeah. Thank you so much. Speaker 3: 08:15 [inaudible].