Coronavirus Today: California’s big backslide

Good evening. I’m Amina Khan, and it’s Tuesday, Nov.10. Here’s what’s happening with the coronavirus in California and beyond.

California, brace yourself for impact. On Tuesday, 11 counties were demoted to more restrictive tiers in the state’s coronavirus reopening road map — and, for the first time, no counties were elevated to a less restrictive tier. That’s an unprecedented backslide, even if it wasn’t entirely unexpected.

Among the backsliders: San Diego, Sacramento and Stanislaus counties all moved into the purple tier, the strictest of the four tiers in the state’s reopening rubric. They join Los Angeles, Riverside, San Bernardino, Imperial, Monterey, Tulare, Madera, Sonoma, Tehama and Shasta counties. This means that Californians in nearly a quarter of the state’s counties are living under the most stringent coronavirus-related restrictions.

And things in the state will get worse before they get better, according to California Health and Human Services Secretary Mark Ghaly.

“We anticipate, if things stay the way they are, that between this week and next week, over half of California counties will have moved into a more restrictive tier,” Ghaly said. “And that certainly is an indication that we’re concerned, and we have to keep a close watch on what’s happening.”

California’s road map determines the extent to which businesses, schools and other places can operate in the midst of the pandemic. It’s broken into four color-coded tiers: purple, red, orange and yellow. Purple is the most restrictive tier; yellow is the least.

Counties are placed in those tiers based on three metrics: the average daily number of new coronavirus cases for every 100,000 residents, the percentage of coronavirus tests that are positive and a measure of health equity that ensures gains are shared among all residents. Counties are reclassified after their metrics have met the criteria of a new tier for two straight weeks.

Moving from red to purple will force many businesses and organizations to reduce their capacity. Some, like restaurants and gyms, will have to move their operations outdoors.

The reasons for increased coronavirus transmission — and the type of behaviors and venues driving that spread — vary from county to county. But Ghaly highlighted one common theme: “Almost each county that’s having increased transmission, they mention private household gatherings as a major source of spread,” he said Monday.

That’s something to keep in mind as Thanksgiving approaches and Californians are tempted to participate in even more, and potentially bigger, private household gatherings.

By the numbers

California cases and deaths as of 4:59 p.m. PST Tuesday:

(Los Angeles Times Graphics)

Track the latest numbers and how they break down in California with our graphics.

See the current status of California’s reopening, county by county, with our tracker.

Across California

Unlike the 11 counties that dropped to more restrictive tiers of California’s reopening plan, San Francisco has maintained its position in the yellow tier, the least restrictive in the state’s rubric. It boasts one of the lowest rates of new coronavirus cases and COVID-19 deaths, and it hasn’t been forced into any new restrictions since the latest surge.

Still, it’s not taking any chances. City officials announced Tuesday that they would be tightening their coronavirus-related restrictions — suspending indoor dining, reducing capacity at gyms and theaters and delaying high school reopenings. The new restrictions will go into effect Friday at 11:59 p.m.

“Unfortunately, we’ve been in this for a long time now, and people are tired and people have gotten complacent,” said Mayor London Breed, who has received both praise and criticism for her handling of the pandemic.

In spite of San Francisco’s low case and fatality numbers, health authorities have noticed a rise in the city’s coronavirus positivity rate, with cases more than doubling since early October.

“We are unfortunately taking a step back to make sure we can move forward in the future,” said Dr. Grant Colfax, San Francisco’s public health director.

It’s a strange time to be a kindergartener in California, learning your ABCs from a teacher on the other side of a computer screen. Now, schoolkids in Las Virgenes Unified, a small public school system in the Calabasas area, are dealing with a whole new challenge — they’re heading back to school for socially distanced instruction. Sharing pencils and crayons is off the table. So is bouncing a ball from one to another. Instead, kids are being taught to use outstretched “airplane arms” to maintain a safe distance from classmates.

Even with all of these new restrictions, officials said they were excited to be the first public school system in L.A. County to reopen campuses under county-approved waivers, which allow selected campuses to open even when COVID-19 infection rates are high. Las Virgenes Unified got approval to welcome back children in transitional kindergarten through second grade.

As of Monday, 84 elementary schools had received waivers — and 64 of those schools were private. That’s a small fraction of the 2,104 schools serving elementary students in L.A. County, education writer Howard Blume tells me.

So far, though, the county’s largest school systems are not applying. Many districts that serve large numbers of students from low-income families are holding back as well. This includes Los Angeles Unified, which is chalking up its reluctance to safety concerns as the county remains in the purple tier. Some officials also cite a lack of funding to provide necessary health and safety equipment, as well as resistance from employee unions.

Many parents expressed deep worry about sending their kids back to school.

Liraz Benelisha said she was glad her son would finally get to meet his classmates in person. Still, she teared up as he headed off to kindergarten. “Outside of school, some people are still not wearing masks, still socializing as if nothing is happening,” she said. “I’m trusting others with my son’s health.”

The Los Angeles Convention Center has gone dark during the pandemic, since mass gatherings present a public health risk. But it could find new purpose as a shelter for homeless people who are facing increasingly desperate circumstances.

“We’re in a panic situation along with a pandemic situation,” said Councilman Curren Price, who introduced a motion to study the feasibility of the idea. The pandemic has worsened conditions for the city’s homeless population, he added: “Folks on the streets are just suffering.”

The move was supported by several members of the City Council, which is facing a lawsuit alleging that the city and county have not done enough to get homeless people off the street. The judge overseeing the case has said he’d like each council member to set a target for the number of new beds they would create.

This wouldn’t be the first time the Convention Center has been recruited for emergency purposes. The California National Guard set up a field hospital there earlier in the pandemic, when local hospitals anticipated they would be overwhelmed by COVID-19 patients. That never quite happened, and the center has largely remained empty since.

Price said he expects it will be years before convention business returns. But others expressed concern that once hundreds of people are sheltered there, the lack of adequate supportive housing could keep them stranded there long after the pandemic is over, my colleagues Benjamin Oreskes and Doug Smith write.

Other officials impressed upon council members the need to be realistic about the costs of maintaining the center as a temporary shelter.

“Specifically, our Convention Center does not have enough bathrooms, does not have any showers,” said Doane Liu, executive director of the city’s Department of Convention and Tourism Development. “When the building is empty, electricity and utilities are not on. Those are costs that are going to need to be borne by somebody.”

Resources

— For general safety, wash your hands for at least 20 seconds (here’s a super-fun how-to video). Stop touching your face, and keep your phone clean. Practice social distancing, maintaining a six-foot radius of personal space in public. And wear a mask if you leave home. Here’s how to do it right.
— Watch for symptoms including fever, cough, shortness of breath, chills, repeated shaking with chills, muscle pain, headache, sore throat and loss of taste or smell. If you’re worried you might be infected, call your doctor or urgent care clinic before going there.
— Need a COVID-19 test? Here’s how to receive a free test if you’re in L.A. County. And here’s a map of testing sites across California.
— Here’s how to care for someone with COVID-19, from monitoring their symptoms to preventing the virus’ spread.
— If your job has been affected by the pandemic, here’s how to file for unemployment.
— Here are some free resources for restaurant workers and entertainment industry professionals having trouble making ends meet.
— Advice for helping kids navigate pandemic life includes being honest about uncertainties, acknowledging their feelings and sticking to a routine. Here’s guidance from the CDC.
— In need of mental health services? Here are resources for coping during the crisis from the CDC and the L.A. County Department of Mental Health. L.A. County residents can also call (800) 854-7771 or text “LA” to 741741.
— For domestic violence victims, the pandemic can pose a “worst-case scenario,” advocates say. If you or someone you know is experiencing such abuse, call the National Domestic Violence Hotline at 1-800-799-SAFE (7233) or L.A. County’s hotline at 1-800-978-3600. Here are more ways to get help.

Around the nation and the world

President-elect Joe Biden delivered a speech Tuesday in defense of the Affordable Care Act, the same day that the Supreme Court heard oral arguments in a case that could potentially overturn the Obama administration’s landmark healthcare law.

In his remarks, Biden highlighted the need for affordable healthcare as the worst pandemic in more than a century has washed over the U.S., sickening millions and straining hospitals. “Now, in the middle of a deadly pandemic that has infected more than 10 million Americans — nearly 1 in every 32 Americans, often with devastating consequences to their health — these ideologues are once again trying to strip health coverage away from the American people,” he said.

The speech signals the extent to which the incoming president is making healthcare and public health a priority. He asked Americans to wear masks to protect both themselves and the people around them from the coronavirus.

“We could save tens of thousands of lives if everyone would just wear a mask for the next few months,” Biden said. “Not Democrat or Republican lives — American lives.”

In Brazil, the nation’s health regulatory agency, Anvisa, has halted clinical trials of a Chinese-made COVID-19 vaccine candidate, citing an “adverse, serious event,” according to a statement posted on its website Monday night. The agency did not say what exactly happened in the event, which apparently took place Oct. 29. “With the interruption of the study, no new volunteer can be vaccinated,” the statement said.

The state-run institute tasked with producing Brazil’s supplies of the vaccine said in a statement that it was surprised by Anvisa’s decision. It’s the latest twist in a pandemic that some critics say President Jair Bolsonaro has mishandled for months. Brazil is currently dealing with one of the worst outbreaks in the world, logging more than 5.6 million cases (making it third in the world after the U.S. and India) and more than 162,000 deaths (second only to the U.S.).

Europe is running low on intensive care unit beds for the most severely ill COVID-19 patients as cases spike across the continent. Ambulances in Italy are parked outside hospitals, awaiting beds for incoming patients. A hospital in France recently wheeled in refrigerated rental trucks to prepare for a dreaded rise in deaths there. Patients from France, Belgium and the Netherlands are being sent to ICUs in Germany, causing the number of free beds there to shrink to alarmingly low numbers.

That’s a problem, given that COVID-19 isn’t the only medical problem that requires intensive care beds, experts say. “There are also traffic accidents, heart attacks, pulmonary embolisms and so forth,” said Dr. Uwe Janssens, who heads Germany’s Interdisciplinary Assn. for Intensive Care and Emergency Medicine.

Much of Eastern Europe avoided a coronavirus wave this spring. Now, many countries there are barely treading water. Hungary says it could run out of ICU space by next month under a worst-case scenario, while hospitalizations in Poland have risen to three times the levels seen in the spring.

“There’s no end in sight,” said Fernando Maltez, who works at a hospital in Portugal where all 20 ICU beds set aside for COVID-19 patients are now occupied. “No health service in the world ... can withstand a deluge of cases that just keeps coming.”

Your questions answered

Today’s question comes from a reader who wants to know: Am I more likely to get COVID-19 if I get the flu?

There isn’t really enough data to say whether getting the flu makes you more likely to come down with COVID-19, said Dr. Paul Auwaerter, clinical director of the infectious diseases division at Johns Hopkins University School of Medicine. But you definitely can get both at the same time. (Yes, I know. Horrible but true.)

“It’s not clear that you’re necessarily more ill,” Auwaerter added. “We just don’t know that. But the concern about influenza is that we don’t want to overwhelm the health systems.”

The pandemic really took off in the U.S. at the tail end of the flu season early this year, so there weren’t that many double-whammy patients. But this winter, we’ll experience the full brunt of both COVID-19 and influenza season as we head into the colder months. That could leave doctors reeling from a “twindemic” as severely ill patients fill up limited hospital beds. It’s also why you should get a flu vaccine pronto, experts say.

There may be a small silver lining: It’s possible that the steps many of us are taking to evade the coronavirus — such as mask-wearing, social distancing and limiting travel — may impede the spread of influenza as well. Regardless, by next spring we’ll probably know a lot more about what happens to people caught between these two viruses, Auwaerter said.

Our reporters covering the coronavirus outbreak want to hear from you. Email us your questions, and we’ll do our best to answer them. You can find more answers in our Frequently Asked Questions roundup and in our reopening tracker.

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