Coronavirus Today: ‘Band-Aids on a very big wound’

Good evening. I’m Amina Khan, and it’s Tuesday, Nov. 24. Here’s what’s happening with the coronavirus in California and beyond.

As the world’s worst pandemic in more than a century rages, how should we try to manage a safer Thanksgiving?

It’s a question at the top of many Americans’ minds this week, and my colleague Rong-Gong Lin II is, dependably, here with the answers for you.

The lowest-risk option is to cancel those travel plans, stay home for Thanksgiving and not travel, according to a panoply of federal, state and local officials. And “travel” includes everything from flying across the country to walking down the street to a neighbor’s home. The point is to keep households from mixing and inadvertently transmitting the coronavirus to one another.

“The safest way to celebrate Thanksgiving is to celebrate at home with the people you live with,” said Barbara Ferrer, director of public health for Los Angeles County.

College students returning home just for the Thanksgiving holiday are a particularly risky bunch, especially if their homes include family members who are elderly or have common medical issues like high blood pressure, diabetes, obesity, high cholesterol, or kidney and lung disease. Keep in mind, people who are infected but don’t feel sick can be highly contagious and easily infect others, who could then develop severe complications and even die from COVID-19.

If you plan an extended stay, you should quarantine yourself in a room alone for 14 days, avoid sharing a bathroom (or clean it every time you do share one), eat alone and have everyone at home wear masks all the time when indoors.

“The tighter you can restrict your activities over those 14 days, the better off we all are,” Ferrer said.

Remember, a negative coronavirus test can be misleading. All it means is that the test didn’t detect the virus in your body. It could still be there, but at levels too low to pick up. This can happen early in infection, before the virus has a chance to make enough copies of itself to trigger a positive test result.

That’s why “you can’t ‘test out’ of quarantine, as much as people would like to,” Ferrer said. “Because it’s a 14-day incubation period, that really means that from the time of your last exposure to the virus ... it could take the full 14 days for you to be able to actually test positive for the virus.”

If you do decide to hold a Thanksgiving meal anyway with folks from other households, there are ways to mitigate the worst coronavirus risks. For example, California has announced certain requirements and recommendations for gatherings in counties in the most restrictive “purple” tier of the state’s pandemic reopening plan. Among them:

• Gatherings must be held outside and involve people from no more than three households. (In Los Angeles County, they are also limited to no more than 15 people.)

• The gathering space must be large enough for everyone to maintain at least a six-foot distance from others who don’t live in their household.

• Food and beverages must be served by someone who wears a face covering and washes their hands often.

• Face coverings must be worn, and removed only when people are actively eating or drinking.

• Gatherings should be kept to two hours or less. The longer an event, the higher the risk of transmission, authorities say.

By the numbers

California cases and deaths as of 3:45 p.m. PST Tuesday:

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

California has completely smashed its past daily record for coronavirus cases, coming in with 20,654 new infections on Monday — far above the previous all-pandemic record of 13,400 infections. Los Angeles County also posted a daily record of more than 6,000 new cases.

Over the last five days, the state has logged a total of 65,168 new coronavirus cases, according to data compiled by The Times. That’s nearly three times as high as the 24,263 new cases recorded in the state during the five-day period that ended Oct. 23, just a month ago.

This major surge has moved the state into troubling new ground right on the cusp of the Thanksgiving holiday, which could touch off another round of super-spreading events.

The number of COVID-19 hospitalizations climbed roughly 82% from two weeks earlier, to 5,459. Coronavirus-related intensive care admissions also rose 59% over the same period, to 1,333, state data show.

It’s not just records being shattered, said L.A. Mayor Eric Garcetti. Lives are being shattered alongside them.

“There’s too much transmission happening here right now in this county — too much transmission with too many meetings of too many people,” Garcetti said. “So the solution is simple; we know it, and we can do it: Stay away from each other. Assume everybody you would see is infectious and, please, let us not make this Thanksgiving the deadliest day of this pandemic.”

The pandemic continues to threaten many of California’s 5 million small businesses. For a time, loans and grants from Congress’ $2.2-trillion CARES Act helped some of them weather the collapse in their customer bases and supply chains. Now those funds have dried up — and many are wondering if they can survive a longer downturn without some federal assistance.

Take Cynde and John Harris, who operate Go Kart World in Carson along an industrial strip by the 405 Freeway. After customers fled and health officials shut down the business, the couple furloughed 35 workers. Over the next few months, they managed to get two federal loans for a total of $270,000. A $30,000 grant from Los Angeles County came through in October, and Go Kart World reopened this month.

Harris is still worried, though. “You can only take on so much debt,” she said. “It’s bitter medicine to be told, ‘You can borrow the money,’ when a government closure just drove a truck through your business.”

Without new federal aid, tens of thousands of California small businesses may find themselves back on the brink.

“The loans they got gave many businesses some moments of respite,” said John Kabateck, California director of the National Federation of Independent Business. “But they were Band-Aids on a very big wound. Now they’re very, very terrified.”

Los Angeles County’s ban on outdoor dining is being met with some resistance from the California Restaurant Assn., which filed suit in Los Angeles Superior Court to block it from going into effect. But a judge declined to do so Tuesday, which means that restaurants must shut down their open-air operations Wednesday night.

Jot Condie, the restaurant group’s CEO, expressed disappointment that the judge didn’t “pump the brakes” on the closure but said he was glad the suit could move forward.

“We are pleased that the court recognized our right to put the county to the test to prove that they have a scientific basis for the shutdown of outdoor dining, and we plan to move forward in requiring the county to offer that proof,” Condie said.

The outdoor closure order, which applies to restaurants, breweries, wineries and bars for at least three weeks, was announced Sunday as part of a larger effort to get surging coronavirus cases under control.

The restaurant association isn’t the only source of pushback. The city of Pasadena said Monday that it will let restaurants continue outdoor dining despite the county order. The city has its own public health department that can issue independent orders, but has generally followed L.A. County’s lead. (Long Beach’s public health department sided with L.A. County and issued a similar health order.)

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

If you’re like me, you’re waiting with bated breath for the arrival of the first COVID-19 vaccines, the first of which could be arriving in a matter of weeks. But let that breath out — safely, behind a mask — because it’s still going to be a long while before you can hit up a concert, laugh with friends in a crowded restaurant or hug your grandparents.

The first vaccine shipments in the United States will be just the beginning of what could be a long and turbulent ride to herd immunity and the return of something resembling normal life.

“If you’re fighting a battle and the cavalry is on the way, you don’t stop shooting; you keep going until the cavalry gets here, and then you might even want to continue fighting,” said Dr. Anthony Fauci, the nation’s top infectious disease expert.

First off, most folks won’t get those early vaccine supplies. They’ll likely be reserved for first responders and the most vulnerable among us, such as the elderly. Second, the front-running vaccines must be taken in two doses administered a month apart — which means we’ll probably be well into late January before even the earliest birds are fully protected.

Getting to herd immunity will take even longer. Early data on the efficacy of the Pfizer and Moderna shots suggest that about 70% of the population will need to be vaccinated to reach that milestone, and that will likely happen in May, according to Moncef Slaoui, head of the U.S. vaccine development effort.

The federal prison system will be among the first government agencies to get the COVID-19 vaccine — with a caveat. Those first precious doses will be given to staff and not to inmates, even though infected prisoners far outnumber infected staff. Since the pandemic first arrived on U.S. shores, 18,467 inmates and 1,736 staff have recovered from COVID-19, and 141 inmates and two staff members have died.

Prisons are a dangerously easy environment for the coronavirus to spread; with inmates sleeping close together and sharing bathrooms, social distancing is essentially nonexistent behind bars. In the pandemic’s early days, prisoners and staffers said the Bureau of Prisons had run short of even basic supplies such as soap.

Now the situation appears to be getting worse. Nearly 25% of all inmate cases and 30% of staff cases have been reported just in the last month.

“If true, it’s a disgrace,” David Patton, the head of the federal defender office in New York, said of the plan to vaccinate staffers but not inmates. “Prisoners are among the very highest-risk groups for contracting COVID-19. ... The government should certainly prioritize prison staff, but to not also prioritize the people incarcerated is irresponsible and inhumane.”

Across the pond in Britain, authorities Tuesday gave residents a green light to gather for the holidays, relaxing restrictions on social mixing over Christmas. They also offered inbound international travelers a way to cut quarantine short if they test negative for COVID-19.

Between Dec. 23 and 27, members of up to three households can form a “Christmas bubble” and move freely between them. Under current restrictions, people are barred from visiting members of other households in much of the U.K.

Cabinet minister Michael Gove said the agreement “will offer hope for families and friends who have made many sacrifices over this difficult year.”

But while government scientific advisers have signed off on the restriction-relaxing plan, others have warned that the policy will probably lead to a rise in coronavirus infections around the country.

The U.K. logged 11,299 new coronavirus cases on Tuesday, marking the lowest level since early October.

Your questions answered

Today’s question comes from a reader who wants to know: If your toes turn red but you have no other symptoms, could you have the coronavirus?

This reader appears to be referring to what’s come to be known as “COVID toes,” a condition that causes a person infected with the coronavirus to develop discolored and swollen toes. According to the American Academy of Dermatology Assn., COVID toes most commonly seem to develop in children, teens and young adults, though they can appear at any age.

Many of these patients never develop more common symptoms of COVID-19, such as a dry cough, fever and muscle aches. And when they do have symptoms of COVID-19, the symptoms tend to be mild.

“In general, individuals who get COVID toes are otherwise healthy,” said Dr. Amy Paller, director of the Skin Disease Research Center at Northwestern University Feinberg School of Medicine. “A subset have — or more often have had in the previous month — some other types of symptoms that can be seen in viral disorders.”

So yes, it‘s possible that COVID toes are your only sign of a coronavirus infection. But plenty of people with red, swollen toes also test negative for infection, Paller said. More work needs to be done to suss out the link between the virus and this phenomenon.

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.

For the most up-to-date coronavirus coverage from The Times over the weekend, visit our homepage and our Health section, sign up for our breaking news alerts, and follow us on Twitter and on Instagram.