Why Is California Doing So Well?
It might sound like a strange question, coming from a Californian, but I do have to wonder why California seems to be doing so well in fighting off the coronavirus pandemic, compared to other states. If this is a real difference, it would behoove others to study why we've been so successful, but there is another possibility -- that we just haven't realized how hard we've been hit yet. Either way, the question of why we're doing so well would seem to be an important one to answer.
By the raw numbers, we're not doing all that wonderfully. California is the third-most-infected state, with 6,895 current cases. New York is by far the worst off, with 66,497 cases, followed by New Jersey with 16,636 cases. But then right after California come some states with a lot less population: Michigan (6,498), Massachusetts (5,752), and Florida (5,704). But the real difference is in the rate of change. Today (as of this writing), New York added 5,818 more new cases, New Jersey 3,250 cases, Michigan 1,102 cases, Massachusetts 797 cases, and 754 cases were added to Florida's total -- all while California only reported 691 new cases in the past 24 hours. At this rate, California could soon move down the national list to fourth, fifth, or even sixth place.
The raw numbers don't really reveal how much better California is doing, though. For that you need to compare the state's population with the others. While New York has 19.5 million people and Florida has 18 million, the other states on the top of that list are much smaller: Michigan (10 million), New Jersey (8.8), and Massachusetts (6.9). But California has twice the population of New York or Florida, and more than four times the population of all the others, clocking in at a whopping 39 million people. This is why the disparity in the raw numbers is so pronounced. New York is obviously an outlier, but if Michigan had the same population as California, it would now have over 25,000 cases (everything else being equal).
So what, exactly, is going on? Why are California's per capita numbers so low? Well, the answer might be a simple one -- not enough people have been tested yet to accurately see the true spread of the COVID-19 disease. Not having enough tests is a nationwide problem, and to date represents the biggest failure of the Trump administration in fighting the outbreak. California has performed roughly 90,000 tests, but when that number is broken down, you can seen how recently most of them were given. We have results for a little under a third of those tests, while a full two-thirds of them are still in the labs -- meaning they were likely given over the past few days to perhaps the past week. So a week ago, we had only conducted fewer than 30,000 tests. When the results for the past week start coming in, California could see a real spike in our caseload, and our numbers might not look so out of whack with the other states.
But then again, all states have suffered a lack of testing resources. Nationwide, fewer than 750,000 tests had been performed as of this writing, which is a lot less than what Mike Pence promised had already been sent out on March 9 -- three full weeks ago. If the whole country had had those million tests (and four million more "by the end of the week," as he also promised), then we would know a lot more about the actual spread of the coronavirus right now, and we might be in a lot better shape as a country as a result. But if lack of testing is really the problem in California, it should also be a big problem in Michigan and Massachusetts. We'll have to see, over the next week or so, whether the relative numbers change much for California versus the other states.
What's truly strange about this disparity is that California was one of the earliest hotspots in the spread of the pandemic. In the very earliest days of the outbreak, coronavirus hit Washington state first and then California was next in line. This was before New York had really even begun to be affected, it's worth pointing out.
Of course, California did lead the nation in extreme measures to fight the spread of the disease. First the counties in the San Francisco Bay area were put under lockdown, and then the entire state was told to "shelter in place" until further notice. California was the first state to issue such a statewide order. Silicon Valley, in particular, was already very familiar with the "work from home" concept, so perhaps it was easier for us to adjust to the new reality. For the most part, Californians took the order seriously and shifted into social distancing without a whole lot of drama or pushback -- which wasn't as true in other states, from what I hear.
Governor Gavin Newsom has acted quickly and forcefully to react to the crisis -- much quicker and much more forcefully than any other, to give credit where it is due. He doesn't command a television audience the way that Andrew Cuomo now does, but Newsom acted many days before Cuomo finally decided to also issue a shelter-in-place order. So perhaps that made a lot bigger difference than people realize. People say New York City is unique because it is such a crossroads of the world -- people coming in from dozens of countries on a daily basis and interacting with each other -- but the same could be said to at least some degree about San Francisco and Los Angeles. And while New York is a major arrival point from Europe, the West Coast is the first stop for many travellers from China and South Korea. And yet with half the population, New York state has ten times the cases we do.
But I still am reluctant to give in to state boosterism and claim we handled things so much better here than elsewhere, and are less affected now as a direct result. Because I can't quite bring myself to trust the numbers -- at least until testing has become much more widely available. So it wouldn't surprise me in the least to see the California numbers suddenly spike upwards in the next few days. In fact, it would be much more understandable than where the numbers now sit.
But like I said, the entire country really needs to know the answer to the question of how trustworthy the California numbers are, because if they are realistic -- still a big "if," at this point -- then California will have achieved more success in "bending the curve down" than anywhere else. You heard a lot of talk of this a few weeks back, before the numbers exploded into the tens of thousands and the new range of one-hundred-thousand-plus. You don't hear so much talk about bending the curve anymore, because the curve on the national graph right now is headed straight up, with no bending in sight. We've obviously lost our best chance to achieve such a bending -- due to all the dithering at the top for a solid month while the danger grew.
But if California did manage to bend the curve successfully, and if our numbers don't suddenly begin climbing by multi-thousands per day, then other states should hear about it and learn from our experience. It's too late to change things for the hardest-hit states, obviously, although even they can help things from getting catastrophically worse by adapting any of the mitigation efforts California has already adopted which they haven't yet (to be fair, most of the hard-hit states have already fully done so). But for states with very low infection rates now, the message will become crystal clear: the earlier you take drastic steps, the better things will be for your citizens in the long run. By far. Again, I have no idea if that lesson can accurately be drawn from California's experience, but I do think a lot more attention should be paid by the media to what is -- perhaps -- going right out here as opposed to in other states. Because that would send a very important message to the places who haven't yet been hit as hard.
-- Chris Weigant
Follow Chris on Twitter: @ChrisWeigant
Of course, California did lead the nation in extreme measures to fight the spread of the disease. First the counties in the San Francisco Bay area were put under lockdown, and then the entire state was told to "shelter in place" until further notice. California was the first state to issue such a statewide order.
Once all of the data is in, I think the speed and comprehensive nature of the response by California to the outbreak will prove to be the biggest factor in flattening the curve.
Of course, testing is the other side of the response coin. And, the lack of widespread testing and lack of national testing protocols will, hopefully, lead to a steep learning curve, beyond the plague - not just in California but, everywhere!
Which states do not currently have state-wide stay-at-home orders?
I hope all of the states bordering Canada do. :)
Another thing that worries me to no end … the absolute lack of US global leadership during this crisis; and worse, the presence of an America First worldview in the WH which, practically speaking, is a US Alone proposition.
All of which bodes well for the novel coronavirus and a pandemic that could have an should have been nipped in the bud.
The only silver lining, perhaps?
We will all learn what we did wrong and make a concerted effort to make changes to everything from healthcare systems to solving the homelessness crisis; from improving global supply chains to mass migrations in the wake of war and climate change, not to mention the unregulated use of animals in our food chain.
It's a lot to learn and an endless amount of work ahead.
I understand that president Trump was asked today if he thought that a nationwide stay-at-home order should be put in place and that he said it should not.
I'd say it's time for Americans to take matters into their own hands.
And, by that I mean, just stay home!
Well, if this is the equivalent of talking to oneself, I hope the implications are not the same.
Ha!
Great question.
I would say that alot of it is very cosmetic due in fact to the lack of available testing. California was also one of the first to restrict available testing to cases where it would make a diffrence in the treatment/clinical outcome of the patient.
This restriction means that we still have yet to test a meaningful portion of the population to determine the actual infection rate across all demographic/age groups.
Speaking of testing, as the hospital ships and field hospitals are being deployed it is important to note that again, the lack of testing opens up the possibility that entire facilities can be shut down due to required quarantine not only stressing taxed medical systems but adding to it as well.
Each of the hospital ships has 1000 beds plus 800 crew. Given how these ships are designed (which is not for infectious deseases) one C-19 case means there are others, resulting in the lockdown of the ship and all onboard.
Both MTF Capitains have indicated that while all potential patients have been screened they will all not have been tested. While the protocols have been designed to prevent mixing of the medical staff from off the ship with those on the ship the problem still presents itself that both vessels had extensive maintanence periods interupted for this deployment, this means technicians from outside "the bubble" will be accessing the ship and social distancing is just not practical in that environment.
I know both MTF capitains as well as both of the ships masters and chief engineers, they are savy professionals who will do what they can to minimize risk, but, unfortunately that cannot overcome years of underfunding for the program that has resulted in lack of maintenence.
Field hospitals will also utilize the same protocols for patients and will also have the same problems with outside "the bubble" people coming in to conduct repairs to equipment, thus they also have the same risk factors.
Both the field hospitals and the hospital ships are designed as battlefield trama centers and as such they do not possess the facilties to conduct C-19 test analysis even if they wanted to. As a result they are operating at elevated risk. If something gets missed those beds will no longer be available.
Hopefully, the worst case will not be realized and we make it out with everyone intact. But if it does happen hopefully the pointed question of WITF was the WHO test available at the time of the first case not approved, manufactured, and pushed out when we still had time.
Given how precious bed space is right now and people trained to provide acute care, the loss of one of these facilities is gping to lead to an immediate cascading spike of cases and deaths.
Just food for thought...distance well, stay safe.
goode trickle,
Good answer!
You make a lot of good points about how things could go seriously wrong and fast.
Though, I think the hospital ships have been adapted for this mission.
As important as testing is in the fight against this virus, I still believe that if we don't all take our role in this fight seriously - stay home and all the rest - then even if/when testing gets up to speed it'll just confirm the obvious.
Just read about a company, Kinsa Health, that produces internet-connected thermometers enabling it to create a national map of fever levels that they have used to track influenza and have typically predicted trends before the CDC! (Am I surprised - CDC is going to have to restore its credibility when this thing is over)
They started doing this for the novel coronavirus on March 22 and, within one day, they spotted a trend that suggested social distancing was having a positive effect reducing levels of fever, nationwide.
Interesting stuff!
https://www.nytimes.com/2020/03/30/health/coronavirus-restrictions-fevers.html
One final thought, a bit unrelated to this discussion but, it's been bothering me … my new rule, of sorts ...
The daily briefings from the WH should exclude the WH Press Corps until one of them, at least, figures out how to ask a relevant and enlightened question.
Liz [12]
Yeah, Rachel Maddow has been pushing this company’s site for a few weeks as having a better source of real world data than just about any of the health organizations for locating where the virus numbers are spiking and where to expect it to spike in the future. I’m glad that the medical community has been willing to accept this data and recognizing that it comes from people who may be showing symptoms of having the virus days before they get bad enough that they finally go to a doctor.
CW,
Sorry to report this, but California ended up with 1,437 new cases on Monday, up 25% — which was higher percentage, but not total number of new cases, than New York (13% increase from Sunday — 7,736 new cases).
But I cannot stress enough that we still don’t have enough people tested to have a true sense of how bad it truly is. The fact that Trump’s now saying that we could have as many as 200,000 deaths from this virus (a number that you know is far lower than what Trump was told is the projection at this point) should worry us all.
I'm worried about Michale. His last comment was on Thursday and it said this:
Well, this is a fine kettle of fish... on top of everything else I got a mild case of the flu.. :(
I NEVER get sick!!!
Oh well, life goes on...
Only comments did not go on for Michale.
So now I'm worried because he's in a high risk category for COVID-19 (age and underlying health issues) and he lives in a state that has not issued a stay-at-home order. Florida reports over 5,700 cases but still has severely limited testing so the true figure may be as much as ten times that.
Chris, do you have a contact for Michale? Can you email or phone him to make sure he's okay?
CW: So what, exactly, is going on? Why are California's per capita numbers so low? Well, the answer might be a simple one -- not enough people have been tested yet to accurately see the true spread of the COVID-19 disease. Not having enough tests is a nationwide problem, and to date represents the biggest failure of the Trump administration in fighting the outbreak.
Ding, ding, ding: We have a winner here!
So I'm calling it now, CW... PolitiFact's "Lie of the Year" for 2020:
I would wager without hesitation that whatever the "Lie of the Year" ultimately turns out to be, it'll no doubt come out of the Orange Blowhole of President Pathological, but if that utter asinine bullshit quoted above is not the falsehood that proves to be of real consequence in 2020, God help us all for what is.
Russ
14
Yeah, Rachel Maddow has been pushing this company’s site for a few weeks as having a better source of real world data than just about any of the health organizations for locating where the virus numbers are spiking and where to expect it to spike in the future.
When she first pulled out her Kinsa thermometer, I about fell out of my seat. I have been dutifully taking the readings of multiple persons daily for about a year, as we have long been reduced to insignificant data points on the Kinsa map.
I’m glad that the medical community has been willing to accept this data and recognizing that it comes from people who may be showing symptoms of having the virus days before they get bad enough that they finally go to a doctor.
Well, now I suddenly don't feel like the daily temperature checks have been for "nothing." Also, I just realized the dang blue Internet connected thermometer is likely the closest thing that the majority of "We the People" of America are going to get along the lines of a COVID-19 test... that we were told anyone who wanted could get one. Yes, sir... still fuming about that bullshit on behalf of Americans everywhere.
Mopshell,
I don't think we have too much to worry about with regard to Michale.
He's probably just taking one of his breaks away from this place. Can't say that I blame him.
And, I'm pretty sure that Chris would keep us informed.
Goodtrickle-10
The US Navy has a fine tradition of going in deep into harm's way.
Kamikaze's and robotic kamikaze's
Airplanes controlled crashing on your roof
Piloting or crewing an airplane that controlled crashes on roofs
Going deep underwater for months
Typhoons.....
It's a long list.
A virus must seem a relatively tame risk.
EM-12
That is really clever concept.
My ordinary house hold medical thermometer died a few days ago. I cannot find a replacement anywhere. Thermometers are as rare as toilet paper.
A close friend had a "helpful" suggestion. "Just hold the back of your hand to your forehead."
I have been in home isolation for 2 weeks now and it is seriously awful.
Listening to music helps, a lot, TS!
I'm also without a thermometer, internet-connected or no.
Guess we'll just have to stay healthy.
Who's your favourite band(s) of all time? What gets you through the down times ...
Just held the back of my hand to my forehead … I'm pretty hot.
[17],
HEH.
Liz [28]
Don't expect us to take your word on the "hot"' thing - send a picture!
[10]
goode trickle,
First off, welcome to the Comments section. Always happy to welcome a new member of Chris's "small, deeply disturbed following." If you meet any of us on the street the secret password is the word, "heh."
I believe the hospital ship are going to take non-CV patients to free up beds in LA & NYC.
Of course, non-CV people can have the virus, so sooner or later the virus will make it aboard ship.
MtnCaddy
31
First off, welcome to the Comments section. Always happy to welcome a new member of Chris's "small, deeply disturbed following."
GT is neither "new" nor "deeply disturbed." Heh.
Of course, non-CV people can have the virus, so sooner or later the virus will make it aboard ship.
Does "non-CV" people mean "non caronavirus"? If it does: How does a "non caronavirus" person have the virus if they are non-CV by virtue of not having the virus?
Have you been drinking? Heh. ;)
No drinking... yet.
Lemme rephrase: if patient needs a bed on a hospital ship to free up beds on land for CV patients, in the absence of universal testing there's a real chance at least one will carry the CV virus on board.
Alternatively, even if this doesn't happen one of the crew may already have it, ormay get it interacting with someone on shore during a food, medicine or equipment transfer from shore to ship.
For these reasons sooner or later the virus will make it aboard.
New column up... took a break from the pandemic news today...
http://www.chrisweigant.com/2020/03/31/can-democrats-flip-the-senate/
-CW
OK, let's answer some comments...
goode trickle [10] -
Good point about the restrictions on testing.
As for the hospital ships, they are supposed to take the non-CV patients to lessen the load on the other hospitals in the area. But you're right, if the virus gets in, that could go out the window. But even if that does happen, the ships could then transition to an all-CV patient role, I would think.
You know the captains and crew of these ships? Wow. Tell them we're all fervently hoping for their own safety. And please report back if there's anything going on with the ships that the media is missing, as well.
LizM [13] -
PBS' Yamiche Alcindor (hope I spelled that right...) has actually been pretty stellar. Trump's yelled at her twice now, meaning she must be doing something right!
Heh.
ListenWhenYouHear [15] -
Yeah, I saw that. I failed to take one thing into consideration -- CA reports later than other states, due to time zone difference. The site updates things on an hour-by-hour basis, so I saw figures that were late in the day for the East Coast, but not so late in the day from CA.
Even so, others are beginning to notice the difference in CA's numbers. Saw a story today (WashPost? Politico? I can look it up...) about how the Bay Area got out in front of the stay-at-home thing and it has actually flattened the curve somewhat. Santa Clara County was still hit pretty hard, but the whole Bay Area is doing better than expected. Also saw a story out of a university in Washington state that showed that red states are taking longer to institute stay-at-home, and will likely see worse outbreaks as a direct result.
Mopshell (and others) [16] -
I will check on Michale, and get back to you.
Kick [18] -
I agree about that "lie of the year," with the runner up being Pence's "we've shipped a million tests out, with four million more by the end of the week" a close runner-up.
Don Harris [23] -
Yeah, that made my jaw drop too. Why is it that all Republicans think that they'll lose if more people vote? Heh.
LizM [27] -
What's been running through my head is the Talking Heads' "Life During Wartime."
"I got some groceries, some peanut butter / To last a couple of days"
"This ain't no Mudd Club, or CBGB, I ain't got time for that now. / Heard about Houston? Heard about Detroit? Heard about Pittsburg P.A.?"
Anyone else? Disaster soundtracks, anyone?
-CW
MtnCaddy
33
No drinking... yet.
Heh. I teasing you... knew what you meant, of course.
Lemme rephrase: if patient needs a bed on a hospital ship to free up beds on land for CV patients, in the absence of universal testing there's a real chance at least one will carry the CV virus on board.
What do you mean "the absence of universal testing"? "Anybody who wants a test can get a test." *shakes head*
I freely admit I'm still fuming about the months of inaction and misleading of Americans by Donald Trump and the right-wing echo chamber... and fast forward to today when Trump finally informs about impending deaths estimated by the White House coronavirus task force to be in the range of 100,000 to 240,000 range with mitigation.
The Trump administration ignored warnings, downplayed the seriousness, mislead millions of Americans without the good sense to recognize a bullshit artist when they see one, and now here we are... with Trump attempting to rewrite history and claim how well he's handled the situation.
At what point do the rubes finally clue in? If Trump's verbal whiplash and current flailing in his attempts to rewrite the total con job and mishandling of this pandemic doesn't do it, then there are a subset of Americans who are the living embodiment of the very gullible morons that Trump played them for.
For these reasons sooner or later the virus will make it aboard.
Yes, sir... this virus is that contagious, always has been, and I cannot fathom how Trump thought he could con the American people regarding this novel coronavirus that, doesn't check passports (props to CW) and isn't the least bit concerned with how it is falsely characterized by the liars like Rush "common cold" Limbaugh, Donald "hoax" Trump, and the talking heads on Fox News and their useful idiots repeating the BS claims.
And now... bartender, time for that drink. :)
Make mine a double.
I made yours a double, EM... Crown & Coke. It was really good too. :)