Coronavirus Today: Has California been too lax?

Good evening. I’m Amina Khan, and it’s Tuesday, Dec. 22. Here’s what’s happening with the coronavirus in California and beyond.

Close to half a year ago, Gov. Gavin Newsom promised to target businesses that refused to follow public health orders meant to control the spread of COVID-19. But in that time, even as many restaurants and other businesses continued to operate in violation of safety restrictions, state regulators issued only 424 citations and suspended only two business licenses as of Monday, data from regulatory and law enforcement agencies show.

As Californians find themselves deep in an unprecedented surge in coronavirus cases, and hospitals find themselves calamitously flooded with new COVID-19 patients, it raises the question: Is it time to reconsider the state’s relatively light touch on enforcement?

For example: The state Department of Alcoholic Beverage Control has handed out just 45 citations to bars and 119 to restaurants since July. And no fines have been issued, nor licenses revoked, among the roughly 94,000 businesses under its watch.

Contrast that with the state of New York, which has half the population of California and fewer eating and drinking establishments. The Empire State issued 1,867 fines against bars and restaurants and temporarily suspended 279 business liquor licenses between June 18 and Dec. 8.

In California, authorities have contacted establishments typically by email, sending out 1.3 million messages since July 1 in an effort to persuade them to comply with state and local public health orders — despite the fact that bars and restaurants where alcohol is served have been identified by the Centers for Disease Control and Prevention as one of the highest-risk environments for coronavirus transmission.

“The reality is it’s not enough to send an email and say, ‘Wear a mask,’” said Dr. Kirsten Bibbins-Domingo, a professor of epidemiology and biostatistics at UC San Francisco. “We see workplace violations that we know are major sources of transmission. We have to be willing to enforce or there’s no point in doing these things.”

California and New York are the nation’s two most populous Democratic-led states, and both have put primary responsibility for enforcing health mandates on cities and counties. But California has been less aggressive than New York in targeting and penalizing violators. Instead, Newsom and state agencies have relied on tough talk, emphasized “personal responsibility,” and given businesses ample time to comply.

This lenience has shifted the burden to cities and counties that are struggling to get businesses to comply with COVID-19 measures. Those struggling with deep budget cuts can’t find the resources to embark on a coherent enforcement strategy of their own. And many are already fighting pitched political battles over mask mandates, curfews and other safety measures. So some counties enforce the rules while others do not, and businesses are often free to flout the rules, allowing the virus to spread further.

“It would be nice to have some air support from the governor,” said Nevada City Councilman Doug Fleming, who backs his city’s new ordinance imposing fines on those who violate the state mask mandate. “He’s kind of forcing local jurisdictions to enforce his rules.”

State regulators, meanwhile, describe long hours of arduous work to inform businesses about the quickly changing COVID-19 rules and restrictions. And while they want them to comply, they don’t want to be the reason they go under.

“This is extremely difficult, and we don’t want to do it,” said Luke Blehm, an acting supervising agent in charge of the ABC. “We are all compassionate and empathetic, and it’s a very hard thing to tell somebody that they’ve got to close and they may lose everything because of these rules they have to comply with.”

By the numbers

California cases and deaths as of 6:16 p.m. PST Tuesday:

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

Across California

COVID-19 hospitalizations are surging so quickly in Los Angeles County that the numbers are heading literally off the charts, forcing officials to redraw the graphics used to illustrate their alarming projections. For example, in October, fewer than 150 coronavirus-positive patients were being admitted to hospitals each day. By late November, that number had doubled to about 300. Now it has more than doubled again, to roughly 700 new hospital patients every day.

This exponential rate of growth, just a few days before Christmas, is ringing in a whole new crisis. If Angelenos’ disease transmission behavior doesn’t change for the better, the county could be dealing with up to 1,400 new hospitalized patients per day by New Year’s Eve, one projection shows.

“The model is suggesting that we could easily be seeing 10 times or more daily admissions than we saw in October,” said Dr. Roger Lewis, director of COVID-19 hospital demand modeling for the L.A. County Department of Health Services.

The surge in cases has not spared law enforcement. More than 10% of L.A. County Sheriff’s Department employees are in quarantine or isolation due to the coronavirus, officials say. As of Monday, 655 non-sworn and 1,216 sworn personnel were off duty after having tested positive or having had a confirmed exposure, department data show.

The department has about 17,500 employees, of whom more than 10,100 are sworn personnel. Officials have tried to deal with the situation by staggering schedules, hiring extra staff and encouraging strategies to limit transmission.

Los Angeles Police Department officials say they‘ve also been struggling with infections among their ranks. In one week in early December, 156 personnel tested positive, bringing the total number of positive tests to more than 1,200 in a department with about 13,000 employees. As of Dec. 15, some 408 employees were still at home, and 751 had recovered.

Meanwhile, California state officials have expressed deep concern about a new and potentially more infectious strain of the coronavirus that has been detected in the U.K. and a handful of other countries, leading officials to renew lockdown measures across much of Britain. Newsom said Monday that he has been having discussions with airlines and others about possible new quarantine protocols for travelers flying into California from the U.K. in an effort to keep the new variant out of the state. Several European countries have already said they would ban incoming flights from the U.K.

“I hope the federal government takes action in this space,” Newsom said. “They should.”

Dr. Mark Ghaly, the California health and human services secretary, said the variant in the U.K. is essentially “a little bit more sticky than the COVID virus that we’ve seen seeing to date.”

So far, this variant has not been found in California. If it appears, it’s unclear how it might affect the state’s virus-fighting efforts.

A big concern is that genetic changes in the new variant could theoretically make it resistant to certain COVID-19 vaccines, including those made by Pfizer and Moderna. But there’s no evidence of that so far. And the head of BioNTech, Pfizer’s German partner, said he’s confident his team’s vaccine will work against the new strain. Other scientists agree.

Meanwhile, California is desperately searching for 3,000 temporary medical workers to help beleaguered hospitals, and they’re reaching out to places as far away as Taiwan and Australia.

In a typical emergency, California can pull nurses and doctors from other states that aren’t in the midst of a crisis. But in a pandemic, all hands appear to be already on deck. “We’re now in a situation where we have surges all across the country, so nobody has many nurses to spare,” said Dr. Janet Coffman, a professor of public policy at UC San Francisco.

Faced with this reality, the state is updating its planning guide for how hospitals would ration care if necessary. A document circulated among doctors at the four L.A. County-run hospitals said that instead of trying everything to save a life, their goal during the crisis is to save as many people as possible. This means patients who are less likely to survive would not get the same level of attention they normally would.

These kinds of changes are triggering moral distress among healthcare workers, experts say. “The patients that aren’t yet intubated, and even the ones intubated, aren’t getting the kind of nursing care that I want to give them because our resources are so limited and time is taxed,” said intensive care nurse Sara Houze. “It’s really disheartening.”

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

As the coronavirus rampages across the country, deaths in the United States in 2020 are expected to surpass 3 million for the first time, making it the deadliest year in U.S. history. While final mortality data for the year won’t be available for months, preliminary figures suggest that the country is on track to record more than 3.2 million deaths — about 400,000 more than in 2019, according to data from the CDC.

U.S. deaths increase in most years as the population grows and ages, but the 2020 increase amounts to a 15% jump, and it could go even higher once all the December deaths from the post-Thanksgiving surge are counted. Either way, the country is looking at the largest single-year percentage leap since 1918, when the demise of tens of thousands of U.S. soldiers in World War I and hundreds of thousands of Americans in a flu pandemic led to a 46% year-over-year spike in deaths.

In Oregon, far-right protesters tried to force their way into the state Capitol in Salem during a special legislative session on Monday. Some wielded guns; others attacked authorities with bear spray. Demonstrators banged their fists against the doors and chanted, “Let us in,” even though the building is closed to the public as part of COVID-19 prevention measures. State police declared an unlawful assembly, and at least two people were arrested.

The demonstration didn’t stop state lawmakers from passing four bills that together will send $800 million in relief to people struggling due to the pandemic and to wildfires, extend an eviction moratorium through June, and allocate funds for renter and landlord relief.

Lawmakers said the chemical agents used by protesters lingered in the Capitol’s hallways and caused them to cough as they discussed bills. House Speaker Tina Kotek described the violence and damage to the Capitol as “disconcerting and frightening.”

Rich nations, including the United States, have hoarded nearly all the global supply of the two leading COVID-19 vaccines through the end of 2021, leaving many middle-income countries to turn to unproved options developed by China and Russia while poorer states face long waits for their first doses, my colleagues Shashank Bengali and Kate Linthicum report.

This every-country-for-itself approach means that the pandemic will likely continue to kill people across much of the world for years, delay a global economic recovery and eventually resurge even in nations that manage to control it soon with vaccinations.

While there has never been such high simultaneous global demand for the same few medical products, this kind of pandemic nationalism is sadly nothing new. A decade ago, during the swine flu outbreak that killed more than a quarter of a million people around the world, the U.S. and other wealthy countries grabbed nearly all the available vaccine supplies. They agreed to share a limited amount with poorer countries only after ensuring they had enough to meet their own needs.

Your questions answered

Today’s question comes from readers who want to know: Does a negative coronavirus test clear me for holiday gatherings?

This question is likely at the top of many Californians’ minds as Christmas and New Year’s approach. The short answer is no, it absolutely does not clear you to head out to holiday gatherings, my colleagues Hayley Smith and Rong-Gong Lin II explain.

First off, we’ve already been down this road, to disastrous effect. Just before Thanksgiving, Californians flocked to testing sites and then attended holiday events after testing negative for the virus. Many got sick from those events, fueling the current surge that is filling hospitals and setting new records for daily deaths.

Here’s why the pre-testing strategy doesn’t work: A negative test does not necessarily mean you have a clean bill of health and pose no risk to people from other households who you might see at a holiday gathering. With the virus spreading like wildfire, you could become infected on your way home from the testing site.

“By the time you get a negative test result, you may no longer be negative,” said Los Angeles County Public Health Director Barbara Ferrer. “And even if you have no symptoms, you can easily infect others.” Indeed, scientists say that people are most contagious nearly a day before their first symptoms appear (if any even do).

On top of that, people who are infected at the time of their test can get a negative result if the virus hasn’t yet replicated to detectable levels. If that’s the case, by the time they get to their gathering, these folks can become unwitting virus-spewing machines.

That’s why relying on testing to determine whether it’s safe to gather “is a very dangerous strategy,” said Dr. Christina Ghaly, the L.A. County health services director.

“It’s one that has failed and is a large part of what has led us to the situation that we are in today,” Ghaly added. “So, please, celebrate the holiday just with your household. ... Please leave those in-person celebrations with extended family members or with friends until later in 2021.”

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