Gov. Gavin Newsom said California needs to increase testing, protect high-risk residents from infection and expand hospital capacity before the state can begin to modify the unprecedented stay-at-home order he imposed one month ago and gradually return to a sense of normalcy.
“I want you to know it’s not, it will not be a permanent state,” Newsom said of the restrictions put in place to fight the spread of coronavirus. “We recognize the consequences of the stay-at-home orders have a profound impact on the economy, your personal household budget, your personal prospects around your future.”
The governor broadly described the steps his administration expects to take in the weeks and months ahead to protect the public and gauge how long the order should remain in place, underscoring a transition in the fight against the virus in recent days as California and other states map out plans to ease restrictions.
Newsom also gave Californians a glimpse of what their “new normal” might look like when the rules are eventually loosened, noting that face coverings could become a mainstay, schools might stagger start times for students, restaurants may reopen with fewer tables and large gatherings would remain off limits.
The new parameters Newsom outlined Tuesday suggest the state must meet a high bar before walking back the order.
The administration highlighted six key indicators for altering his stay-home mandate, including the ability to closely monitor and track potential cases, prevent infection of high-risk people, increase surge capacity at hospitals, develop therapeutics and ensure physical distance at schools, businesses and child care facilities. The state also must develop guidelines for when to ask Californians to stay home again if the governor modifies the order and the virus surges, he said.
Newsom and officials in his administration say their strategy to slow the spread of the virus is working, pointing to relatively low growth in COVID-19 hospitalizations as evidence that staying home and social distancing are preventing a surge of infections.
But that success comes with a cost.
More than 2.3 million Californians filed for unemployment benefits in the last month as businesses closed due to state mandates, and the economy continues to unravel. Some students lost access to free and reduced-cost meals when schools shuttered, and many have not participated in virtual learning. The governor’s strategy of distancing residents can also lead to social isolation and increased health risks for the elderly and vulnerable populations.
Despite his attempts to quell uncertainty, Newsom has not yet provided a timeline for when the state’s nearly 40 million people can expect to return to work — or move about freely. And to those struggling to make ends meet, that’s the question they want answered most.
“When are the restrictions going to be lifted?” asked Miguel Tot, who last worked at his job managing a downtown Los Angeles restaurant on March 16. “There’s no timetable on that, so I have no idea, you know, when normality is going to come back.”
The 34-year-old said he and his wife have enough money saved to buy groceries, pay rent and bills and provide for their two young children for about two months. Despite having no health insurance, Tot said he began looking for a new job late last month in anticipation of that safety net running out and with no sense of when the order will end.
The governor said the length of the order largely depends on when hospitalizations and intensive care patients with COVID-19 flatten and decline in California. He said the end date is fluid and that he expects to provide an answer in the next two weeks if conditions continue to improve.
California has seen more than 25,000 confirmed cases of COVID-19 and 767 deaths. On Tuesday, Los Angeles County public health officials confirmed 40 more deaths linked to the coronavirus, the highest number of deaths reported in a single day.
The Newsom administration has predicted a peak in COVID-19 cases to begin in May and said hospitalizations are below expectations.
Newsom urged Californians to remain at home and practice physical distancing.
“You’ve met this moment in remarkable ways, and it’s put us as a state in a position where we can lay out this roadmap, but again it is all conditioned on us continuing to stay the course on the current road that we’re on,” Newsom said. “Stay at home, practice appropriate social distancing and make sure that we are physically distanced from one another.”
As chief executive, Newsom has the power to call off the statewide order, but individual counties can keep their own orders in place. Newsom announced a pact on Monday to work with his counterparts in Oregon and Washington to develop a regional strategy to reduce restrictions on residents in the coming months.
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“The most important thing for leaders is to be honest and be honest about what we don’t know,” said Daniel Zingale, a former aide to Newsom who retired earlier this year. “If it comes to a point where we do know more, then tell them.”
Lisa Berkman, a professor of public policy and epidemiology at the Harvard University T.H. Chan School of Public Health, agrees that offering false hope won’t help struggling Californians or anyone else.
“It’s not helpful to give an end date if we don’t know an end date,” Berkman said. “I don’t think that any governor should be saying that we’re going to end this in three, four or five weeks when it’s completely unknown. You don’t want to end this until you see a leveling out of the curve. You don’t want to end it early and have an uprising in cases.”
Berkman’s work is focused on the health effects of public and workplace policies. People who are socially isolated have a higher risk of mortality, including dying of cardiovascular disease, infectious diseases and a number of other causes, she said.
She said orders across the country have exposed socioeconomic inequality in disadvantaged communities, and she stressed the importance of reducing isolation by expanding internet access, introducing government programs to help at-risk residents and calling and checking on elders.
Newsom said earlier this month that Google would donate 100,000 mobile hot spots to provide free and unlimited high-speed Internet for the remainder of the school year, but it’s unclear which communities will receive that benefit.
Berkman and other academic experts support Newsom’s call for the state to expand its testing beyond sick patients to attempt to ascertain the percentage of the population that is infected, or to determine how many people previously contracted the disease and have immunity.
Newsom has said antibody blood tests are “critical in terms of our capacity to make a determination about community spread and about immunity.”
Diana Dooley, a chief of staff to former Gov. Jerry Brown, said the lack of access to tests has prevented California and other states from accurately determining how long to keep orders in place.
“The whole issue of how much it’s out there will drive the fundamental question of when could it end,” she said.
The governor has said testing broader samples of the public throughout the state, and not just people exhibiting COVID-19 symptoms, will help officials determine when to lift the restrictions.
For now, that kind of testing is occurring only at the local level or at universities. Los Angeles County, for example, began testing the blood of 1,000 randomly selected residents last week to see whether they have or previously had COVID-19.
Dooley called statewide random blood sample tests “a bit of an academic wish” given that California still doesn’t have enough tests for sick patients.
Mark Ghaly, secretary of the state’s Health and Human Services agency, said the state is prioritizing traditional diagnostic tests for patients suspected of having COVID-19 and expanding access to those tests to hospital workers, low-income Californians and communities of color. On Tuesday, he said the state needs to expand its ability to track and trace potential cases and isolate the exposed to prevent spread before modifying the orders.
Ghaly said the state expects to begin statewide antibody tests in the next few weeks, an undertaking supported by the scientific community.
“Right now it takes away from testing people who could be potentially ill, and that’s a horrible decision to make, but in the long run as a public health scientist, I would say we learn a lot from surveillance,” Berkman said. “It’s one of the bedrocks that we have. It’s how we first identify early cases. It’s how we learn how people survive or not, who is vulnerable or more resistant. Without some kind of a random sample, we can’t learn any of that.”
Absent a vaccine, Newsom said on Tuesday that Californians should expect to continue to wear face coverings or masks, and to visit restaurants with fewer tables, disposable menus and waiters wearing masks and gloves as the state slowly transitions back to normal. His administration suggested the state will introduce guidelines for businesses to conduct “health checks” when employees return to work.
The governor said it’s unlikely that mass gatherings will be allowed again at any point this summer. He also discussed the possibility of staggering school start times throughout the day for students if they return to campus in the fall.
“We talk about what the new normal will look like as I said, normal it will not be — at least until we have herd immunity and we have a vaccine,” Newsom said.
Dooley expects the state to allow businesses that are predisposed to social distancing, such as hair salons or certain retail stores, to reopen first before gradually expanding to other types of facilities.
Others suggest staggered work shifts, more telecommuting and, perhaps, the end of the handshake will become part of what Newsom has described as the “new normal” in the next several months.
With access to basic necessities such as water, heat and food, Berkman remains hopeful that Americans can endure stay-at-home orders for as long as it takes. The “we’re all in this together” message repeated by Newsom and other leaders across the country also helps people cope with the new conditions and feel a sense of connection with others across the world, she said.
“As Americans, we have rarely been called upon to do something for the public good,” Berkman said. “It’s not just to protect our own risk; it’s to help protect everybody. It’s a rare collective action, and if people understand they are forsaking their comforts and joys and the way they normally behave to really curb something that is for the good of the country and the world, there’s a lot of joy in that.”