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California hoping to contain coronavirus spread as national cases surge

California hoping to contain coronavirus spread as national cases surge

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As coronavirus cases swell across much of the United States and the nation lurches toward a uniquely tumultuous election day, California has held off another pandemic upswing. Public health experts, however, warn the state is still vulnerable.

The United States topped 50,000 new cases on four of the past seven days, the highest numbers since August, after a two-month lull. Cases are spiking in several Midwest states such as Illinois and Wisconsin, which are reporting about as many new cases a day as places with much larger populations.

California is still in the top three to five states as far as new cases — including more than 2,600 reported on Monday — but the rate of transmission is comparatively low given the large population. And cases have plateaued, or are trending down, in almost all counties. The number of people hospitalized with COVID-19 in California, about 2,200 currently, is less than a third of the peak back in July, and nearly the lowest recorded since the state began tracking the data in April.

Gov. Gavin Newsom said at a briefing Monday that it’s a troubling sign that some metrics are starting to plateau and a few counties have reported upticks in cases. He warned Californians to maintain social distancing and other public health protocols. “It’s a sober reminder of how stubborn this disease is, and how prevalent this disease remains here in California,” he said.

The next three weeks will be a critical time for much of the country, with the presidential election on the horizon and the pandemic surging out of control in so many places, public health and infectious disease experts said. Dr. Anthony Fauci, the nation’s top infectious disease expert, warned in a virtual discussion at UC Berkeley last week that 50,000 cases a day was a dangerous level of community virus with the flu season coming up.

And though California is in good shape at the moment, past experience shows that the virus can quickly gain a new foothold if people drop their guard, experts said.

Hand sanitizing stations are seen in the Giants of Land and Sea section before set up around the the California Academy of Sciences on Monday, October 12, 2020 in San Francisco, Calif. The California Academy of Sciences is scheduled to reopen on October 13 for members only since being shut down in March.

“The rest of the country is not doing particularly well. There is a clear third wave that has started,” said Dr. George Rutherford, a UCSF infectious disease expert. “We’re doing well (in California). What we don’t want to do is rest on our laurels. We’re in reasonable shape now, but we’re poised right at the edge. We could go up very, very easily.”

Around the world many countries are struggling anew with the coronavirus, which has proven stubbornly tricky to control. Even as several countries have famously managed to keep the virus from spreading widely, many others have dealt with up-and-down swings.

The United States has wrestled with a far more damaging outbreak, reporting more deaths — about 215,000 as of Monday — than any other country and one of the highest case rates by population. About 7.8 million cases have been reported in the U.S., accounting for nearly a fifth of the total worldwide.

President Trump, diagnosed with COVID-19 less than two weeks ago, has hit the campaign trail again, with rallies planned in battleground states. Ahead of an event in Florida on Monday, Fauci said in an interview with CNN that such rallies were “asking for trouble.” Trump did not wear a face covering on Air Force One on his way to the rally in Florida, according to media reports, and many of his supporters in the crowd and behind him on stage were not wearing masks.

Bay Area public health experts said even if the rallies themselves, which are all being held outside, don’t lead to new infections, such gatherings are ill-advised and send the wrong message at a time when people should be wearing masks in public and avoiding large crowds.

“You’re seeing the high variation in leadership, nationally and then at the governor level and on down. That accounts for a lot of the spikes across the country,” said Dr. Stephen Shortell, former dean of the UC Berkeley School of Public Health. “People look to their leaders as to whether they’re going to wear masks and go to events.”

California is the “positive outlier” among most states, Shortell added. “We are holding our own,” he said. “And we’re seeing some rewards for our good behavior.”

Those rewards include soft reopenings of much of the economy in recent weeks, including some sectors that had been shut down completely since the first shelter-in-place orders were issued in March.

Statewide, small gatherings of three or fewer households are now allowed as long as people meet outside and limit the time spent together.

Carl Lieber (center), senior manager guest experience, conducts an operations of exhibit training, at the California Academy of Sciences on Monday, October 12, 2020 in San Francisco, Calif.

Even the Bay Area, which largely has been more conservative in its response than the rest of the state, has allowed activities like indoor dining and in-person education to resume with some limitations. The Bay Area has been reporting 400 to 500 new cases a day over the past couple of weeks, far below the summer peaks of 1,000 or more.

“Our metrics are very favorable right now. We have improved substantially since the peak of the summer surge,” said Dr. Nicholas Moss, the Alameda County health officer. He said hospitalization numbers are at their lowest since the county began tracking them.

Alameda County is allowing elementary schools to reopen Tuesday with proper protocols in place, a result of case counts and other markers of disease transmission being driven down, Moss said. Eight schools, all private, were scheduled to reopen Tuesday, according to the Alameda County Office of Education.

“What people have done with their own lives has helped get us to this point,” Moss said. “The flip side is we’ve had a lull before. And when it ended, things accelerated pretty fast. We’re going to be affected by what’s happening around the state and frankly around the country. What we’re seeing in other parts of the country should raise our level of vigilance.”

Also reopening Tuesday is the California Academy of Sciences in San Francisco, with revamped exhibits to keep visitors safe. Reservations are now required and museum operators will keep capacity under 25% throughout the day.

Some enclosed-space exhibits like the rainforest dome will require visitors to make an appointment so they don’t get too crowded. Others, like the Planetarium, will remain closed indefinitely. The fog in the fog room will be turned off, and visitors will not be invited to blow into a device meant to demonstrate how animals spray venom.

“I’m very thrilled. And a little nervous,” said Dr. Shannon Bennett, chief of science, about reopening; only Cal Academy members will be invited for the first 10 days, then the public can come. “I’m really confident we’re doing this right.”

She said scientists understand much better now than they did in March, or even in May when California first eased shelter-in-place restrictions, how to prevent the spread of the virus in most spaces. The state saw an explosive surge in cases after fumbling its reopening in the spring.

“Frankly, there’s not too much mystery to this virus,” Bennett said. “We know that masks are important. We know that sharing indoor, enclosed spaces where there’s a fair amount of aerosol and droplet exchange without a mask is not a good thing.”

That cases are climbing in much of the country, Bennett and other infectious disease experts said, is not entirely surprising. It means people aren’t paying attention to the protocols meant to keep them safe and stop the virus from spreading.

“We can use science to control this virus,” she said. “When we can’t control it, it’s because we’re ignoring the science or it’s just exhausting or we’re not complying with it.”

Erin Allday is a San Francisco Chronicle staff writer. Email: eallday@sfchronicle.com

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