On April 14, California Governor Gavin Newsom detailed what will be required before the Golden State can begin to open up, shake off the effects of the COVID-19 pandemic. Newsom's grim assessment stands in marked contrast to the position of Donald Trump.
While acknowledging that California has made significant progress "flattening the curve" of the pandemic, Newsom cautioned that it was premature to declare victory: "As we contemplate reopening parts of our state, we must be guided by science and data, and we must understand that things will look different than before." (https://www.gov.ca.gov/2020/04/14/governor-newsom-outlines-six-critical-indicators-the-state-will-consider-before-modifying-the-stay-at-home-order-and-other-covid-19-interventions/ ) California currently has 28,156 Coronavirus cases and a mortality rate of 3.4 percent -- compared with 5.1 percent for the U.S.
Newsom presented a six-part plan that will enable California's leaders to determine when to begin to "dial back" the current stay-at-home order:
- The ability to monitor and protect our communities through testing, contact tracing, isolating, and supporting those who are positive or exposed;
- The ability to prevent infection in people who are at risk for more severe COVID-19;
- The ability of the hospital and health systems to handle surges;
- The ability to develop therapeutics to meet the demand;
- The ability for businesses, schools, and child care facilities to support physical distancing; and
- The ability to determine when to reinstitute certain measures, such as the stay-at-home orders, if necessary.
1.Testing: Throughout the United States, approximately 1 percent of the population has been tested -- 3.4 million. California has only tested 227,600 -- .5 percent. Newsom points out the obvious: we need to do more testing. Two questions need to be examined: "How prepared is California to test everyone who is symptomatic?" and, "Does California have the ability to identify contacts of those who are positive to reduce further transmission?" (Of the 28,156 California COVID-19 cases, 10,146 are in Los Angeles County; where, so far, testing has been inadequate.)
2. Protecting the most vulnerable: In California, the coronavirus has struck all sectors of the community. Seniors and "special circumstances" populations are particularly vulnerable. Newsom pointed out two obvious questions that need to be examined before we modify the stay-at-home order: "Are older Californians and the medically vulnerable living in their own homes supported so they can continue appropriate physical distancing? and, Has California developed a plan to quickly identify and contain outbreaks in facilities housing older Californians, those living with disabilities, those currently incarcerated, and those with co-morbidities? " Obviously adequate testing is a pre-requisite. But so is additional financial support for older Californians.
3. Strengthening hospitals and health systems: California's hospitals/health systems are barely covering our current caseload -- 25,833 active cases; there's a statewide shortage of masks and PPE (personal protective equipment). Newsom wants to address these shortages to make sure California has the capacity to deal with a sudden influx of coronavirus cases. "Do we have adequate bed capacity, staff and supplies such as ventilators and masks? Can our healthcare system adequately address COVID- 19 and other critical healthcare needs?" It's estimated that California is short several hundred million masks. Recently Newsom signed a deal to procure millions of masks each month. (https://calmatters.org/health/coronavirus/2020/04/california-coronavirus-mask-shortage-solution-deal-newsom/ )
4. Developing Therapeutics: "Have we built a coalition of private, public, and academic partners to accelerate the development of therapeutics? Have we identified potential therapeutics that have shown promise?" When Governor Newsom speaks of therapeutics he means not only a COVID-19 vaccine but also the related antibody-blood test.
5. Strengthening the ability for businesses, schools, and child care facilities to support physical distancing: Newsom mentioned that the new California normal will likely include substantial social-distancing measures. "Have we worked with businesses to support physical distancing practices and introduced guidelines to provide health checks when employees or the general public enter the premises? Do we have supplies and equipment to keep the workforce and customers safe?" Once again, an important element of this is fast reliable testing.
6. Developing the ability to determine when to reinstitute certain measures, such as the stay-at-home orders, if necessary: "Are we tracking the right data to provide us an early warning system? Do we have the ability to quickly communicate the need to reinstate these measures?"
Several things jump out from Newsom's presentation. The first is that we won't be ready to start reopening California until we have substantially more tests -- we've only tested 227,600. Newsom talked about ramping up testing to a level of "tens of thousands per day." In two weeks, he plans to report back on our progress reaching this goal. By May 1, the Golden State should have at least tested 1 million (2.5 percent).
By May 15, California should have received it's first big delivery of masks and PPE. If this happens, and testing has expanded -- to perhaps 10 million residents, this might be the time to begin reopening the Golden State.
The second thing Governor Newsom made clear, is that when California reopens things will look different as. For example, when we go to our favorite restaurant we'll be wearing masks and be tested at the door; the restaurant is likely to configure fewer tables and have disposable menus.
The third thing that Gavin Newsom made clear is that he is an authentic leader. Watching the April 14th Newsom speech was to be reminded how inadequate Donald Trump is. Newsom was calmly informative -- he spoke for about 30 minutes and then handed the microphone to the state's public health officer, Sonia Angell. It was impossible to imagine Trump giving a similar presentation.
Postscript: On April 17, Donald Trump presented his recovery "plan" (https://assets.documentcloud.org/documents/6840739/Guidelines-PDF.pdf ) and punted to the states: "You're going to call your own shots," Trump told U.S. governors, according to an audio recording provided to the New York Times. Trump acknowledged the importance of comprehensive testing but did not propose a national plan for rapid testing. In California, we'r fortunate to have a governor who has stepped into this leadership breach and prepared a real plan for recovery.