Coronavirus Today: The ‘Thanksgiving bump’ begins

Good evening. I’m Amina Khan, and it’s Tuesday, Dec. 8. Here’s what’s happening with the coronavirus in California and beyond.

Contact tracing is getting a digital boost in the Golden State. Starting Thursday, Californians will be able to receive a notification on their smartphone if they’ve been exposed to someone who has tested positive for the coronavirus.

The new capability, called CA Notify, takes advantage of the short-range Bluetooth radios in Apple and Android phones to determine when two devices have been within six feet of each other for more than 15 minutes within a day — the length of time the CDC says it would take for transmission potentially to occur. That way, when someone tests positive for the coronavirus, those who might be in jeopardy can be warned.

The tool comes seven months after Apple and Google released the digital interface that makes the warnings possible, and Gov. Gavin Newsom said it would play a key role in supporting the state’s contact-tracing efforts. Help can’t come soon enough: Hospitalizations in the Golden State have pushed past 10,000, marking the largest wave of infections to date. In some counties, including at least three in the San Joaquin Valley, intensive care units are already full.

“This holds a lot of promise,” Newsom said as he unveiled CA Notify. “The more people that participate in it, the more that opt in, the more effective this program can be.”

Contact tracing, in which public health employees reach out to people with confirmed infections to find out who they may have exposed to the virus, is one of the most important means of slowing the spread. By getting those people into quarantine quickly, a potential outbreak can be quashed before they unknowingly spread the virus to others.

The hope is that the smartphone tool will not only complement that process by quickly identifying potential contacts of infected people, but also flag interactions that infected people might not recall or even be aware of.

Here’s how it works: When users test positive, they’ll get a text notification from the California Department of Public Health with a code to input. Anyone else whose phones were in close proximity for more than 15 minutes in a single day during the prior two weeks will then receive an exposure alert. That will let them know that they should quarantine.

The tool is no substitute for other prevention measures, such as physically distancing from others, properly wearing a mask and continuing with interview-based contact tracing.

More than a dozen states have made the technology available to residents. But experts emphasize that the tool will only work if enough Californians actually sign up to use it.

Activation is simple. If you have an Android phone, you can download CA Notify from the Google Play store once it’s available Thursday. Then check to make sure your Bluetooth is turned on. If it is, you’re good to go.

No downloads are required for iPhone users running iOS version 13.7 or later. They can enable notifications by opening “Settings,” scrolling down to “Exposure Notifications,” selecting “Turn On” and setting California as the location.

By the numbers

California cases and deaths as of 3:59 p.m. PST Tuesday:

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

Across California

California’s caseload has exploded to yet another high, obliterating the past daily record in the process. The state reported 34,490 new coronavirus cases on Monday — “a figure stratospherically higher than any daily case count,” my colleagues Luke Money and Rong-Gong Lin II write.

That previous record was just set on Friday, when 22,369 new cases were logged. Indeed, the gap between Friday’s and Monday’s case counts is so great that the difference between them — 12,121 — would itself have ranked among California’s highest daily totals before the latest surge.

And officials say they’re only beginning to see the consequences of Thanksgiving travel and gatherings. Soon, daily infection counts that are the size of a small city’s entire population could become a regular occurrence.

“I would say this is the start of the Thanksgiving bump,” said Los Angeles County Public Health Director Barbara Ferrer.

Bleak as the next few weeks may turn out to be, health officials stressed that residents and businesses alike can still do their part to beat back the surge. This includes wearing a mask in public, washing your hands regularly, staying home when you’re sick and keeping your distance from people outside your household.

“While we know we’re going to see significant increases for the next two to three weeks, it can turn itself around at the moment we all start getting back into the game,” Ferrer said.

In L.A. County, Latinos are getting infected at more than twice the rate of white residents. It’s yet another sign of the racial and economic health disparities that have become impossible to ignore. And it’s a reversal in the progress the county saw in the late summer and early fall, when the disparity between racial and ethnic groups lessened as the spread of the virus flattened.

(Los Angeles County Department of Public Health)

Latino residents were also nearly three times as likely to be hospitalized for COVID-19 as white residents, the data show.

“It is very clear and quite alarming that certain groups are once again bearing a greater burden than others,” Ferrer said recently. “The gaps between race and ethnicity groups, where we made a lot of progress in closing in September, have now once again dramatically widened, particularly for our Latino residents.”

There are reasons Latino communities are at higher risk. Latinos tend to work in “essential” jobs where they’re required to engage with others in retail stores, manufacturing plants and other sites rather than work from the relative safety of home. And some Latino neighborhoods are more densely populated, which makes it easier for the virus to spread.

A judge has limited L.A. County’s outdoor dining ban to three weeks, even as a state order keeps the restriction in place past Christmas, according to a tentative decision announced Tuesday. County public health officials will be required to conduct a risk-benefit analysis to extend the closures once they expire on Dec. 16, Superior Court Judge James Chalfant said in his decision.

The ruling comes almost a week after Chalfant ordered the county to provide scientific evidence justifying the ban that took effect Nov. 25. While it was initially set to last just three weeks, the county later made the restrictions indefinite. The ban faced a swift backlash, as opponents said it could mean the end for restaurants and bars already struggling to survive the pandemic.

Some restaurants, meanwhile, have been defying lockdown rules. Dino Ferraro, who owns two Huntington Beach restaurants, said he owes more than $100,000 in back rent and has spent thousands of dollars deep-cleaning and disinfecting both businesses. He said he can’t get by with takeout and delivery orders alone. So he’s “experimenting” with staying open, offering outdoor dining and a few indoor tables spread 12 feet apart at both locations.

Ferraro said he and his family are “not in denial about the virus, but we have to move forward. We have to make a living. We do feel for the people at risk. They should stay home.”

But health officials insist that restaurant dining, even outdoors, is risky for the entire community when the virus is so prevalent. In L.A. County, when only 1 in 800 people was contagious, outdoor dining was a tolerable risk, Ferrer said. Now that 1 in 145 is contagious and the hospital system is close to being overwhelmed, “you have to look at all of the activities and say: ‘We need to reduce risk as much as possible everywhere,’” she said.

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

Around the nation and the world

COVID-19 deaths have climbed past an average of 2,200 per day nationwide, matching the peak in April near the start of the pandemic. And for the first time, average cases per day have risen past 200,000. Both bad numbers are almost certain to get worse, especially if Americans treat Christmas and New Year’s the way they did Thanksgiving.

“What we do now literally will be a matter of life and death for many of our citizens,” Washington Gov. Jay Inslee said Tuesday as he extended restrictions on businesses and social gatherings, including a ban on indoor dining and drinking at restaurants and bars.

Other officials emphasized that such messages are not hyperbole.

Former Alabama state Sen. Larry Dixon had followed masking and most social-distancing guidelines. But he met up with friends at a restaurant for what they called a “prayer meeting,” and three of them fell ill, a friend said. Before his death on Friday from complications due to COVID-19, the 78-year-old Dixon asked his wife to share a warning with others.

“Sweetheart, we messed up. We just dropped our guard. ... We’ve got to tell people this is real,” his friend Dr. David Thrasher, a pulmonologist, quoted him as saying.

The coronavirus vaccine developed by Pfizer and German partner BioNTech is highly effective, and there are no safety concerns that would prevent it being granted an emergency use authorization, according to a staff report by the U.S. Food and Drug Administration. The next step in the authorization process is a public meeting Thursday of outside advisors to the agency. The FDA could officially clear the vaccine shortly after the meeting, with up to 6.4 million doses immediately available.

The Trump administration, however, last summer opted not to lock in a chance to buy millions more doses of the Pfizer vaccine. That decision could delay the delivery of a second batch of doses until the company fulfills other international contracts.

Under its current contract, the White House committed to buy an initial 100 million doses, with an option to purchase as many as five times more. But this summer, the White House chose not to lock in an additional 100 million doses for delivery in the second quarter of 2021, sources told the Associated Press.

While the administration is reversing course now, it’s not clear that Pfizer will be able to meet the latest request on the same timeline.

Britain on Tuesday became the first Western nation to start vaccinating its residents against COVID-19, initiating a campaign that other countries will watch closely. Tears of joy and relief abounded as staffers at about 50 National Health Service hospitals began inoculating their most elderly and vulnerable patients with the Pfizer-BioNTech vaccine.

“I can’t tell you just how much emotion there was in that vaccination center,” said Stephen Powis, the medical director for NHS England. “This is truly a historical day, a turning point in this pandemic.”

It’s a turning point that will require careful navigation around the logistics of distributing, administering and tracking the vaccine, as residents must receive two shots administered 21 days apart in order to be protected against the virus. The vaccine also has to be stored at about minus-94 degrees and must be moved carefully and quickly from Belgium, where it is made. (That task will be made more difficult if current post-Brexit trade negotiations collapse in the next few days.)

Still, those receiving their first dose of vaccine expressed hope that life might soon return to some semblance of normalcy.

Margaret Keenan, who turns 91 next week, was first in line to receive her injection at University Hospital Coventry in central England. She called the vaccination “the best early birthday present I could wish for.”

Your questions answered

Today’s question comes from readers who want to know: If I already had COVID-19, should I still get the vaccine?

The short answer is yes, you should still get vaccinated even if you survived a bout with COVID-19.

“All COVID-19 infections are not alike,” said Dr. Marc Sala, a critical care and pulmonary specialist at Northwestern University Feinberg School of Medicine. For example, a person with a mild case of COVID-19 might not have the same level of antibodies as a person with a severe case — and that means differing levels of immune system defense. “Therefore having had COVID-19 is not itself an assurance against future re-infection for a given person.”

In contrast, vaccines have been tested in carefully controlled studies, and their protective effects have been quantified. For example, in their Phase 3 clinical trials, both Pfizer’s and Moderna’s vaccines were about 95% effective at preventing COVID-19.

Dr. Stuart Ray, an infectious disease specialist at the Johns Hopkins University School of Medicine, agreed that COVID-19 survivors should queue up for their shots.

Unlike viruses, vaccines “are engineered to generate strong responses” in the immune system, he pointed out.

There you have it. Just because you’ve had COVID-19 doesn’t mean you have the same protection as you’d get from a vaccine — so when the time comes, take your shots.

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12:10 p.m. Dec. 9, 2020
For the Record: An earlier version of this newsletter included an out-of-date California reopening map that did not show counties affected by the Stay Home Order. The map in the newsletter now is correct as of Tuesday.
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