‘I don’t believe we’ve seen our peak,’ SLO County health officer says of coronavirus
Surgeon General Jerome Adams warned on Sunday that the coming week would be America’s “Pearl Harbor moment, our 9/11 moment” in the coronavirus pandemic — and San Luis Obispo County’s Public Health officer agreed that we could see cases escalate over the next two to three weeks.
More than 1.34 million cases of the COVID-19 virus have been confirmed worldwide with more than 74,565 deaths as of Monday, according to Johns Hopkins University. The United States has more than 366,614 confirmed cases and more than 10,500 deaths.
While early efforts in California may help the state avoid the kind of devastating scenes playing out elsewhere, officials and experts caution any early gains can be wiped out if safety measures are eased.
San Luis Obispo County Public Health Officer Dr. Penny Borenstein said that it’s very difficult to know when the local peak will come, but health officials will be watching closely over the next two to three weeks.
“Different (counties) are not seeing the same trajectory of spread,” Borenstein said. “We know the Bay Area in California probably started at least two weeks before us. ... I don’t believe we’ve seen our peak, and I have a really hard time telling you when we will.”
SLO County predictions have been inaccurate
Thus far, Borenstein said that “all of the county’s models have proven” inaccurate and in need of adjustment as more data comes in.
“I have stood here many times and said I expect to see cases doubling every three to five days,” Borenstein said. “We’re not seeing that right now. The reasons for that many be some combination of we’re not testing enough, and/or we’re doing a really good job with the mitigation measures in place. But we have to stay the course because many people in our community are still very much at risk.”
The number of confirmed cases in SLO County held steady at 95 with no new cases reported Monday. Over the last three days, only two cases have been confirmed, both on Sunday. No cases were confirmed on Saturday.
But health officials believe this is due in part to people who have symptoms of COVID-19 but who haven’t yet been tested. In response, the Public Health Department is looking to increase testing and said public and private labs are capable of testing at higher numbers.
“We think there is more COVID-19 in our community than the numbers are showing,” Borenstein said in a press release. “When more people get tested, we will have a better understanding of where and how this disease is spreading here in SLO County — and that will help us target efforts to protect the community from further spread.”
She expanded on that idea at Monday’s news conference.
“We think that perhaps the public has ceased even trying to get a test because early on the message was, ‘There aren’t enough tests, there aren’t enough tests,’ ” Borenstein said. “We believe anyone in this county (with symptoms) that wants to get a test can, if they go to the right place.”
Locally, the county has conducted 511 tests, with 42 returning positive. The other 53 positive cases were reported by private labs.
California officials believe peak could be mid-May
Peak day for California as a whole is estimated to be April 14, according to widely cited projections from the Institute for Health Metrics and Evaluation, a global health research center at the University of Washington.
But state health officials say they believe the peak moment is still well off and likely to hit in mid-May.
Gov. Gavin Newsom has declined to answer questions about how the state’s modeling differs from others, but said the state’s current case-growth pace suggests a peak moment later than April.
Newsom and health officials say the state’s dramatic stay-at-home order nearly three weeks ago may have bought the state’s hospitals a bit more time to prepare, and that will mean lower numbers of more serious patients for hospitals to deal with.
The University of Washington institute forecasts 5,068 Californians will die in the next three months before fatalities largely stop by the last week of June.
That death number is notable: California comprises 12 percent of the U.S. population. That number of deaths is less than 6 percent of the institute’s estimate of 93,500 deaths nationally. The Trump administration has warned the death toll could be between 100,000 and 240,000.
But to hold the death number down in California, not only will people have to continue staying home as the peak arrives, they also will have to stay home for a month after the peak hits.
“In California, by the end of June, early July, we will have controlled this,” said Dr. Ali Mokdad, a professor of health metrics science at the Washington institute. “But our concern is: What is next?
We haven’t seen this virus before. We don’t have antibodies. Another surge later is possible if we don’t control it now.”
Put another way: “Instead of becoming a peak, it can become a roller coaster ride,” said Dr. John Swartzberg, a professor emeritus at UC Berkeley School of Public Health.
Bay Area coronavirus curve
Public health experts in the Bay Area have been hesitant to say when they expect a surge to come. But two weeks after Bay Area counties issued some of the first orders to shelter in place in the state, hospitals have been reporting fewer cases than previously expected.
There was “reasonably good evidence of some flattening of the curve,” Dr. Bob Wachter, a professor and chair of the University of California, San Francisco’s department of medicine, told the New York Times last week.
Still, as of the end of last week, Bay Area counties had topped 3,000 cases, and mounting.
Los Angeles
For weeks, local officials have been juggling questions about whether Los Angeles will become the next New York, where coronavirus cases have overwhelmed the hospital system.
“A week or two from now, we will have images like we’re seeing in New York here in Los Angeles.” Mayor Eric Garcetti said last week, according to the Los Angeles Times.
Dr. Barbara Ferrer, Los Angeles County public health director, has said her office plans to release a report this week that includes modeling for when the peak date might arrive.
“The truth of the matter is none of us really know,” she told reporters Monday. “We’re all making the best guess that we can using the different modeling techniques that are available.”
The Navy’s Mercy medical ship has arrived in the port of Los Angeles to treat up to 1,000 non-COVID-19 patients, beginning Monday. That ship will treat only non COVID-19 patients, freeing up space in onshore county hospitals for virus patients. The Los Angeles Convention Center is also set to be converted into a field hospital, and the county is rapidly increasing the number of overall beds available.
Stay-at-home orders in Los Angeles are set to expire April 19, but Garcetti told Vanity Fair “My gut has been that it’s going to be at least two months.”
New York epicenter
New York and New Jersey are the epicenters of the virus in the United States.
According to Johns Hopkins University, nearly one half of the 366,000-plus cases in the country were in those two states, focused on the dense New York-Newark metropolitan area, where hospitals already are overwhelmed.
Last week, New York Gov. Andrew Cuomo said he thought the peak could be three weeks out. He’s since said it will come much sooner.
The Washington institute projection is for a peak in New York this week on April 8.
Newsom worries about post-peak behavior
Newsom is among many who worry what people will do when the news media announces the peak is over.
Already, he said, he is hearing of people suffering from “cabin fever” who want to get out. An upset friend reported to Newsom on Saturday that her son intended to go to a party.
“Give me his cell phone number,” Newsom said he told her, so he could disabuse the teen.
The crisis will not be over, though, in the first, second or even third week after new case numbers begin to drop. Experts say they fear if businesses open too soon, infections will spike again.
“If you really shut things down now and the number of cases goes down, it’s not like you’re past the danger point,” said Dr. Joshua Sharfstein, a vice dean at Johns Hopkins Bloomberg School of Public Health.
“Anyone who thinks you’re going to be flipping the switch in May and going back to the way things were is incorrect.”
Bee staff reporter Sophia Bollag contributed to this report.
This story was originally published April 7, 2020 at 5:00 AM with the headline "‘I don’t believe we’ve seen our peak,’ SLO County health officer says of coronavirus."
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