Coronavirus Today: Is the new lockdown working?

Good evening. I’m Amina Khan, and it’s Monday, Dec. 21. Here’s what’s happening with the coronavirus in California and beyond.

In March, within weeks of the first official COVID-19 death in California, Gov. Gavin Newsom issued a sweeping lockdown order that shut down all nonessential activities in the state. By April, that stay-at-home order appeared to have produced results. “You have successfully bent and arguably flattened the curve in the state of California,” he said to residents who heeded the mandate.

It doesn’t feel like that’s happening now. The state’s most recent stay-at-home order — which is now expected to be extended for Southern California and the San Joaquin Valley — was issued amid a frightening surge in coronavirus cases, hospitalizations and deaths. But about two weeks in, it has triggered a question in the minds of many Californians who find themselves navigating closures and avoiding loved ones: Why isn’t this lockdown working as well?

There are a few possible explanations, my colleagues Maura Dolan, Rong-Gong Lin II and Stephanie Lai report. Perhaps it’s that the current restrictions are looser than the broad closures of the spring. Or it could be that many Californians are fatigued by the public health orders, or militantly resistant to them, and they are mixing with folks from other households.

But experts are pointing to another probable explanation: There may simply be too much coronavirus out there now.

The first order came when there had been just a small number of officially documented cases in California. Although the outbreak was growing and spreading, the caseload was a small fraction of what it is now. In contrast, the latest state order came after the virus was already raging out of control, partly because people traveled and mixed with members of other households during Thanksgiving.

“The virus is unforgiving and relentless, and there is just so much community transmission,” said Dr. Tomás Aragón, who next month will take over as director of the California Department of Public Health. When new daily case counts reach more than 20 per 100,000 people, “it becomes really difficult to control the infections,” Aragón said.

California’s daily case rates have surpassed that number several times over. The state’s daily case rate last week was 82.2 per 100,000 residents, well above the national average of 64.6. In Los Angeles County, the daily case rate was 153.6 per 100,000 residents. “Once the rates get really high,” Aragón said, “it is not like you can fine-tune it with levers.”

Yet even in these overwhelming circumstances, it appears the new stay-at-home order is having an effect. GPS data from cellphones show that people in California are moving around less, Newsom has said. That’s a good thing, since more movement has been linked to higher case counts. And health experts say the situation would have been even worse without the new stay-at-home order.

But their predictions for when cases might stabilize or even drop ranged widely, from about a week to after the holidays. Keep in mind that Christmas and New Year’s may again bring a fresh wave of infections.

In the meantime, intensive care units are filled at many hospitals, which are struggling to deal with the influx of patients. The crush is expected to get worse before it gets better. More people will die, not just because of COVID-19 but also because people with other life-threatening ailments won’t be able to find an available hospital bed. The state has already braced for this grim likelihood by ordering thousands of body bags and refrigerated storage units to store the dead.

So have California’s current restrictions been enough? None of the health experts my colleagues interviewed said the state should have imposed an order as strict as the springtime lockdown.

This time, said Dr. John Swartzberg, an infectious-disease expert at UC Berkeley, “I think we have done it more intelligently.”

By the numbers

California cases and deaths as of 5:59 p.m. PST Monday:

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

Across California

A group of scientists and other experts from California, Nevada, Oregon and Washington has endorsed the COVID-19 vaccine developed by Moderna and the National Institutes of Health, clearing the way for the shots to be given to residents in the Golden State and much of the West. Shipments are expected to reach California early this week, officials said.

The influx can’t come soon enough. My colleagues Alex Wigglesworth and Soumya Karlamangla report that in hospitals across California, there’s a “growing sense of dread” that the already dire conditions are about to get far worse, especially if people don’t stay home for the holidays.

There were 16,843 COVID-19 patients in California hospitals on Saturday. Of those, 3,614 were in intensive care units. That’s a huge increase from two months ago, when there were 2,291 hospitalized patients, including 657 in ICUs. On Saturday, Los Angeles County hospitals were treating the largest share of patients: 5,709, with 1,175 of them in ICUs.

One doctor at an L.A. County public hospital said the number of COVID-19 patients is “increasing exponentially, without an end in sight.” Many parts of that hospital are being turned into COVID-19 wards, and ICU teams are being staffed with workers from other departments that are temporarily halting their usual services.

“We’re going to be New York, with bodies piling up. Wouldn’t be surprised if L.A. rings in the new year as the COVID capital of the world,” the physician said. “I don’t know how many ways to explain to people to isolate and stay home, short of bringing a camera to the ICU and [emergency department] to show them the mess of what we’re experiencing.”

In another sign of how precarious the situation in Southern California has become, the Los Angeles Unified School District said it will not be reopening its campuses when the spring semester beings Jan. 11. Supt. Austin Beutner did not say when students might be allowed to return. But he did reveal some “alarming” data from the district’s own testing program: 10% of students and 5% of adults coming to school-based coronavirus testing sites are finding they are positive for the virus, even though they did not report any symptoms.

“Think about that — 1 in 10 children being tested at schools show no symptoms but have the virus,” Beutner said. “It’s clear we’re a long way from reopening schools with the level of virus this high.” Schools will remain in online-only mode until community health conditions improve, he said.

Newsom is in the midst of another quarantine after being exposed to a staff member who tested positive for an infection, a representative said Sunday night. The governor tested negative but is quarantining for 10 days as a precaution, in line with state public health guidelines. Other staffers who were exposed also tested negative and began 10-day quarantines.

This isn’t Newsom’s first quarantine rodeo: He and his family went into quarantine over Thanksgiving after his children were exposed in two separate incidents to someone who had tested positive for the virus.

See the latest on California’s coronavirus closures and reopenings, and the metrics that inform them, with our tracker.

Around the nation and the world

President-elect Joe Biden stepped in front of the cameras, rolled up his sleeve and got his coronavirus shot Monday in a move meant to assure Americans that the vaccine was safe. The nationally televised moment also raised an intriguing question: Why isn’t President Trump grabbing this spotlight?

Trump was a no-show when Vice President Mike Pence got the shot at the White House complex on Friday, my colleagues Evan Halper and Chris Megerian point out. House Speaker Nancy Pelosi (D-San Francisco), Senate Majority Leader Mitch McConnell (R-Ky.) and other lawmakers also received shots on Friday as part of the effort to encourage Americans to take — and trust — the vaccine. But the president has not yet said when he will receive the vaccine, or if he will do so publicly.

Changing the minds of the large share of Trump supporters who don’t believe the shots are safe or even necessary has become an urgent public health matter, as experts estimate that 70% of Americans need to get the vaccine in order to achieve herd immunity. “Trump’s hedging embrace of the shot adds to the challenge of moving those numbers,” Halper and Megerian write.

Meanwhile, air traffic is rising in spite of health officials’ urgent pleas for people to say home. More than 1 million people have passed through U.S airport security checkpoints in each of the last two days, the first time that’s happened since Nov. 29, which came at the end of a Thanksgiving weekend that saw far more travel around the country than officials had hoped.

More travel is expected as Christmas nears. AAA projects that about 85 million people will hit the road between Dec. 23 and Jan. 3, most of them by car. That would be a drop of nearly one-third from a year ago, but still a massive movement of people in the middle of a pandemic.

U.S. public health officials fear the holiday season travel will lead to more super-spreader events, as people unwittingly infect family and friends while gathering indoors for Christmas and New Years’ celebrations. The best way to protect yourself and your loved ones? “Postponing travel and staying home,” the Centers for Disease Control and Prevention said.

In the United Kingdom and several other nations, researchers have detected a cluster of genetic changes in the coronavirus that appear to make it more infectious. The discovery prompted British Prime Minister Boris Johnson to renew lockdown measures across much of England and caused several European nations to ban incoming flights from the U.K.

Virus samples collected from infected Britons revealed a set of 17 genetic alterations, including three that appear to make the virus easier to transmit from person to person and that improve its ability to sneak past the immune system’s defenses, my colleague Melissa Healy writes.

Several of the changes appear to alter the virus’ spike protein, which the coronavirus uses to break into human cells and turn them into virus-producing factories. That could be a problem, because all five of the COVID-19 vaccines furthest along in development, including those from Pfizer and Moderna, train the immune system to recognize and target the spike protein. Theoretically, these genetic changes might alter the protein enough to hamper the vaccines’ effectiveness.

Some experts are quick to note that not all changes to the virus’s genetic code are cause for alarm. Mutations happen all the time in the family tree of practically any living thing, and the coronavirus is no exception: It has incorporated thousands of modifications since it emerged late last year. Still, others warn that this case may be different — read Healy’s full story to find out why.

Your questions answered

Today’s question comes from readers who want to know: Are the Pfizer and Moderna vaccines effective in children and teens?

For this question, I turned to Dr. Yvonne Maldonado, chair of the American Academy of Pediatrics Committee on Infectious Diseases. So far, the vaccine from Pfizer and BioNTech appears to be safe and effective in teens who are 16 and 17 years old, although it hasn’t been tested on very many people in that age group, she said. No data on anyone younger than that were included in the Food and Drug Administration’s review of Pfizer’s Phase 3 clinical trial.

There’s even less to say about the vaccine developed by Moderna and the National Institutes of Health — the trial data reviewed by the FDA didn’t include anyone under the age of 18.

So far, we don’t yet know exactly how the vaccine will affect younger children. While the efficacy should be similar to the efficacy in adults, researchers will need to conduct trials to find an answer to this specific question, she said. Until then, the vaccines won’t be authorized for their use.

But some of that work is already underway: Moderna has posted plans to test the vaccine in an estimated 3,000 adolescents age 12 to under 18, according to a listing on ClinicalTrials.gov.

And in an interview on MSNBC, Dr. Jose Romero, chair of the CDC’s Advisory Committee for Immunization Practices, has said that if the vaccines are proved safe and effective in this age group, children could start receiving vaccines in the second half of 2021.

We want to hear from you. Email us your coronavirus questions, and we’ll do our best to answer them.