Up to now, some Bay Area public health agencies have been more aggressive than those in Los Angeles and some other counties in issuing restrictions related to coronavirus.
But this could change.
With the first coronavirus case believed to be transmitted within the community, now reported in Los Angeles County, experiences in the San Francisco Bay Area could offer an insight into what Southern California is looking for.
Los Angeles County Public Health Director Barbara Ferrer on Monday called for “social removal”, a term that officials use to describe the need to move people away from crowded areas in hopes of drastically reducing the spread of an infectious disease. .
His call came after one of two recently confirmed coronavirus cases in L.A. county. he had had an unidentified source of exposure. This indicates that the virus is transmitted through people in the community, even those without travel history or close personal contact with people known to be infected.
Several counties in the San Francisco Bay Area have already put in place extraordinary measures to implement social distancing after it became clear that the virus was also spreading in the community and that institutions have responded here and elsewhere throughout California. UC Berkeley, San Francisco State, San Jose State, Santa Clara University, UC San Diego and Stanford University are moving the lessons online; a Stanford faculty member tested positive for coronavirus.
The danger became especially evident on Monday, when Silicon Valley reported his first coronavirus-related death on Monday: a woman in her sixties who had been hospitalized for several weeks and was the first person in Santa Clara County to be known to be infected with the virus without having traveled internationally or known contact with an infected person. It was California’s second death in connection with the new coronavirus.
With the number of cases growing rapidly in Silicon Valley, which has risen to 43 on Monday since just 11 Thursday, the county health officer with the most cases across the state, Santa Clara County, has issued a rare legal order applicable by the sheriff prohibiting the gathering mass of 1,000 or more people. The San Jose sharks, which continued to play at the end of last week despite the county’s recommendation to stop mass gatherings, have said they will comply with the new order.
In San Francisco, the St. Patrick’s Day parade and performances of the San Francisco Symphony have been canceled.
But even smaller meetings should be canceled, officials said, in the interest of stopping the spread of the disease.
“All non-essential meetings should be canceled, postponed or done remotely,” said Dr. Scott Morrow, San Mateo county health officer, in a statement Thursday. “Unfortunately, at the moment, I don’t have a standard definition of” nonessential “or” collection “to guide your decisions. Use your best judgment.”
Even a prom was canceled when Northern California’s largest school district, the Unified School District of Elk Grove in Sacramento County, said on Saturday that it was going up the spring holidays, closing schools and canceling all Student activity this week after some parents and family members, but no students tested positive for the virus.
The San Francisco Unified School District has canceled or postponed nonessential events for the next two weeks, including a mariachi festival and a solo and ensemble music festival. The health officer banned visitors from entering the Honda Lagoon hospital and rehabilitation center, the violation of which is a crime.
“We are clearly facing a historic public health challenge,” said Dr. Sara Cody, Santa Clara County Public Health Officer, at a press conference.
Some chose not to follow the recommendations of health officials; the Golden State Warriors performed at San Francisco’s Chase Center on Saturday, a day after the city’s health officer advised to cancel mass meetings.
But the audience seemed to be in pieces. Last week, the number of BART passengers declined 8% over the previous week, a spokesman said, and BART commuting on Monday morning seemed particularly light, arriving as the region carefully monitored the arrival of more than 3,500 stranded people. on the Grand Princess cruise ship in the port of Oakland. At least 21 people – 19 out of 1,100 crew members and two passengers – on the ship have confirmed cases of COVID-19, the coronavirus disease that originated late last year in Wuhan, China.
I haven’t seen since I moved to the Bay Area #BART this void on a Monday morning commute to San Francisco. Either people who are sick are finally home or the fear of the virus makes them use other modes of transportation. I’m just happy not to be packaged like sardines!
– Jean (@ jean_sn0w) March 9, 2020
Cities have announced measures to avoid mass gatherings: San Francisco’s senior classes have been canceled, from Argentine tango in the Noe Valley to mah jong in Nob Hill. San Jose’s senior meal program is moving to a takeaway pick-up format.
The libraries of San Francisco, Redwood City and Santa Clara have canceled all major events for at least a week. The rooms of the municipal council of Santa Clara have been reconfigured to allow more space between places for social distances.
Transit agencies have done their best to reassure commuters. BART said he was cleaning the surfaces in contact with his hands with “hospital disinfectant more frequently every day”.
People seemed to be home. On Sunday evening in San Jose’s Little Saigon, it seemed much easier to find parking for popular restaurants. Along the streets of downtown Millbrae, near San Francisco International Airport, the sidewalks seemed to have emptied.
Health officials said they understood that these recommendations and actions were disruptive. But to work, the measures must seem like an overreaction.
“If we wait for more action until we have more confirmed cases and deaths, the window of opportunity we have now will close,” said Dr. Grant Colfax, San Francisco health director, on Friday night. “We recognize that there will be involuntary difficulties and sacrifices for our residents and businesses. But it is best for public health and for protecting all of us from a worsening outbreak that is rapidly spreading across the country and our region.
“If the plan works in San Francisco, it may even seem like an overreaction. Because the spread of the virus will decrease and fewer people will fall ill, “said Colfax.
The goal of telling people to avoid crowds is to prevent many diseases that affect the region at one time, health experts said.
“Our goal is not to have them all at once,” said Dr. Shanthi Kappagoda, clinical associate professor of infectious diseases at Stanford University, “so that our local hospitals and clinics are not overwhelmed.”
While around 80% of those infected have a mild disease, some populations, such as the elderly and people with underlying medical conditions, are at a much greater risk of serious disease and death.
Measures such as the closure of schools, churches and theaters were associated with lower mortality peaks during the 1918 flu pandemic, according to a study published in the Proceedings of the National Academy of Sciences in 2007.
In particular, the difference in the way Philadelphia and St. Louis handled the flu was remarkable. Philadelphia downplayed the significance of the flu and allowed a parade across the city to continue for 11 days at the outbreak, and when officials ordered school closings and other bans in public meetings five days after the parade, it was too late – ” The spread of the disease was already beginning to overwhelm local public health and medical resources, “says the study.
St. Louis, meanwhile, has implemented social removal measures two days after the arrival of the flu. As a result, Philadelphia’s mortality spike was dramatically worse than that of St. Louis.
US officials warn that the spike in demand for intensive care unit beds and the number of fans needed to help breathe seriously ill people would be extremely scarce in a pandemic.
That’s why slowing the spread of the disease is so important, to reduce demand in hospitals, according to the pre-pandemic strategy of the US Centers for Disease Control and Prevention.
“If I had had a group of ninety-year-olds at a birthday party, I probably wouldn’t have so many there – and I certainly wouldn’t have many kids running around to infect them,” said Dr. George Rutherford, epidemiologist and infectious disease expert. at UC San Francisco.
Fears of the virus are well positioned when it comes to protecting the elderly and people with underlying medical conditions and focusing efforts on “keeping this virus away from nursing homes, long-term care facilities and the elderly whose lungs they can’t recover from this, “said Dr. Jeremy Faust, emergency physician at Brigham and Women’s Hospital and instructor at Harvard Medical School.
Among the subjects at higher risk there are those over the age of 70 and with basic diseases such as diabetes, obesity, asthma, heart, lung or kidney disease and subjects with weakened immune systems. If infection control fails, early detection is important to give more time to treat the patient by offering help such as supplying oxygen or putting the patient on a ventilator to help them breathe if their lungs start to fail.
Taking common sense measures to protect the elderly should be a priority, said Dr Anthony Fauci, director of the National Institute for Allergies and Infectious Diseases video interview with the editor of the Journal of American Medical Assn. released on Friday.
Among the top priorities, he said, was to speed up nursing homes with regards to infection control.
“You’ve seen what happened in the Seattle area – it’s not the last time that will happen,” said Fauci.
Among the recommendations and orders issued by officials from the counties of San Francisco, San Mateo and Santa Clara:
- San Francisco has canceled all the non-essential mass gatherings of 50 or more people where people are not separated by at least one and a half meters from each other (about the length of an average arm) at the City Hall, at the Moscone Center , at the Bill Graham Civic Auditorium, at the New Conservatory Theater, War Memorial & Performing Arts Center, Palace of Fine Arts Theater, San Francisco Public Library, Pier 27 and Pier 35.
- Recommendations for canceling concerts, sporting events, conferences and large community gatherings.
- Encourage people over the age of 50 and those with basic health conditions to go to mass meetings. The underlying conditions include heart disease, diabetes, cancer, lung disease, obesity and weakened immune systems.
- Tell companies to stop non-essential employee travel.
- Minimize the number of employees who work a short distance from each other.
- Minimize or cancel large meetings or conferences in person.
- Tell employees to stay home when they are sick.
- Ask for maximum flexibility in sickness benefits.
- It does not require a doctor’s note for sick workers.
- Consider teleworking.
- Consider the incredible start and end times of employee shifts to reduce a large number of people meeting simultaneously.
- For the events that continue, make sure there are hand washes, hand sanitizers and handkerchiefs available and that high-touch surfaces and handrails are cleaned frequently.
- Tell the audience not to go out when they get sick.
- Transit vehicles: increase the cleanliness of vehicles and high-touch surfaces.
- Nursing homes and long-term care facilities: screen all staff and visitors for disease and drive the sick away.
- Hospitals: if not necessary, the public should avoid hospitals, nursing homes and long-term care facilities. Healthy people should also stay away if it is not essential to go there.
- If you are sick: call your doctor first; you may be able to be served by phone. Visit emergency rooms only when necessary.
- Wash your hands with soap and water for at least 20 seconds.
- Stop shaking hands.
- Cover the cough or sneeze with a tissue, if available, or in the elbow.
- Use a paper towel or tissue to touch commonly touched surfaces such as elevator buttons and door handles.
- In any case, stop touching your face, eyes, nose or mouth with unwashed hands.
Lin reported from San Francisco; Shalby of Los Angeles. Times staff writers Soumya Karlamangla and Stephanie Chavez contributed to this Los Angeles report.