IT’S been five months since the U.S. Centers for Disease Control and Prevention announced the first known case of COVID-19 in the United States — a Washington State man in his 30s who had arrived from a trip to Wuhan.
Since then, cases have been climbing with California being the country’s new hotspot.
On Thursday, June 25, the U.S. reached a record of coronavirus cases in a single day with 37,077 new cases, according to John Hopkins University. The last recorded high for new cases was back in April.
The U.S. total of infections now reaches over 2.4 million people and over 124,000 deaths.
In California, the first state that ordered a lockdown, the number of coronavirus cases also reached a new high of 200,451 cases as of Friday morning. Earlier in the week, it reported a new daily record with more than 5,000 new cases on Monday. That record was eclipsed a day later with a new high of 7,149 new cases.
A great majority of California’s cases come from Los Angeles which had more than 89,600 cases as of Friday morning, according to data from John Hopkins University.
The increase in cases hasn’t been stopping many from going out as many establishments have been opening up as part of the state’s reopening plan. California is currently in Stage 2, which allows “lower risk workplaces” and nonessential businesses to operate provided they follow public health precautions.
However, Newsom made clear that California would not be going through the next stages if the state did not see any improvements.
“To the extent we do not see progress being made, and we’re not advancing the cause of public health and public safety, then we certainly reserve the right to put a pause in terms of advancing into the subsequent phase,” Newsom said on Thursday. “We have the capacity and ability to toggle back in terms of the stay-at-home order and the guidance we put out.
Meanwhile, health experts urge the public to understand that despite restrictions loosening up, the virus still exists and that guidelines and information surrounding the virus may change.
“We’re all learning about this virus in real time,” said Dr. Lisa Maragakis, senior director of infection prevention in the John Hopkins Health System, at a recent roundtable.
“Whatever recommendations we make today may look differently after about a month.”
Below are some things to continue to keep in mind as reopenings happen.
COVID-19 impact on health
Early on, health officials have said that older people and those with pre-existing medical conditions such as asthma, diabetes, and heart disease are more vulnerable to severe illness or death from the coronavirus.
However, officials have increasingly made it point to emphasize that younger people are far from safe from the virus. In fact, the growing percentage of new coronavirus cases in the surging states and cities are made up of mostly younger people.
Officials attribute increases in the age group to the fact that many states have begun reopening establishments frequented by young people like restaurants and bars, thus allowing the virus to spread widely.
The danger comes as those who are pre-symptomatic or asymptomatic bring the virus home to loved ones who are older or are more vulnerable.
Public health officials and other health experts have also been trying to understand how the virus affects communities of color.
“We are still in a pandemic, and so following the death of George Floyd, there have been a lot of protests,” said Dr. Sherita Hill Golden, vice president and chief diversity officer at John Hopkins Medicine.
She added, “If we think about what is at the root of the protests about police brutality, and then look at the COVID-19 disparities, they really have the same root and the structural racism, and the discrimination. That’s really what everyone is trying to address.”
According to the LA County Department of Public Health, Latinos and Hispanics currently have the highest mortality rate at 38 deaths per 100,000 people followed by Black Americans at 37 deaths per 100,000 people. Asian Americans have also seen relatively high mortality rates at 25 deaths per 100,000 people. Among White Americans, the mortality rate is 19 per 100,000 people.
Mortality rates have also been found to be higher in areas of poverty at 64 deaths per 100,000 people.
“We’ve been pushing to make sure that those communities are screened and informed because they have a very high infection rate and then can also pass that on to additional vulnerable populations,” said Golden.
Push for contact tracing
The term “contact tracing” has been heard a lot in recent months and refers to the process of managing the spread of the coronavirus through chains of transmission.
Experts say contact tracing is especially needed as communities begin opening up.
The White House has announced a plan for widespread testing and contact tracing with roughly 28,000 people doing contact tracing across the U.S., however much work is still needed.
“It’s not going well. I have to tell you, it’s not going well,” White House health advisor Dr. Anthony Fauci told CNBC’s Meg Tirell in an interview on Friday, June 26. “What we need to do is we need to rethink, and we are right now, the idea of many more tests getting into the community and even pooling tests.”
In California, a contact tracing program called California Connected was introduced and involves local public health departments contacting those who have tested positive as well as those who have been in contact with someone who tested positive via phone call.
“We’re seeing surges of cases now, so we need to build this capacity so we can manage this in a more effective way,” said Dr. Crystal Watson, a senior scholar at the John Hopkins Center for Health Security.
“This is not an easy thing to do,” she added, emphasizing the need for a massive workforce upgrade for contact tracing. “We’ve never scaled up a public health workforce to this level before.”
John Hopkins School of Public Health has put out a free Contact Tracing course on Coursera.org. Over 440,400 have already enrolled.
Both Apple and Google launched a program last May to provide states with tools to build contact tracing apps, however, they too found themselves stalled with one reason being privacy concerns.
In response to privacy concerns, Watson said that while contact tracing has already been used prior to the COVID-19 pandemic, public health officials need to make sure they address privacy concerns to mitigate public fear.
Treatments
According to World Health Organization (WHO) data, approximately 200 COVID-19 vaccines are currently being developed. However, no vaccine is yet available and likely won’t be for some time.
While the race for a vaccine continues, other treatments are in the works and include antibodies, antiviral therapies, and convalescent plasma.
One of the most popular antiviral drugs, remdesivir, recently got the green light to begin human trials for an inhaled version of the drug. Gilead Sciences, which manufactures remdesivir, plans to begin studies in August.
Another promising treatment touted by scientists has been convalescent plasma therapy, a form of immunity therapy that uses blood plasma from patients who have already recovered from the coronavirus and who have developed antibodies. The treatment has previously been used to treat severe flu, MERS, and SARS.
“The convalescent plasma research is going to help to improve the hyper immunoglobulin research which will hopefully get us to a vaccine sooner,” said Dr. Shmuel Shoham, an associate professor of medicine at the university.
The new ‘normal’
The outbreak has undoubtedly altered daily life. As efforts for a vaccine and other treatments continue, health officials continue to emphasize that avoiding contracting the virus is the best way to survive it. This means practicing good hygiene, limiting group gatherings, keeping safe distances of at least six feet, and wearing face coverings.
Masks continue to be crucial in getting through the pandemic given that the virus can spread through coughing, sneezing, or even speaking.
As people head outside — whether it be protests or other gatherings — Golden said that it is important people to wear masks, socially distance themselves as much as possible, engage in hand hygiene by carrying lots of hand sanitizer.
Wrapping cell phones in plastic is another step people can take when around large groups.
“These are all important preventive measures,” said Golden.
And with the Fourth of July approaching, it’s expected that many will be heading outside for celebrations. Maragakis said that outdoor events and staying away from each other to the extent possible are the best ways to celebrate.
“Outdoors is much lower risk than indoors for group activities or even just having a conversation with someone in that ambient air dilutes the virus and decreases the possibility of transmission,” said Maragakis. The risk of transmission though is still not zero.
“But, indoor rally settings, or any activity like going to a concert or a sporting event — this is not the time to do that,” she added. “The risk is very high in indoor settings and people need to be very cautious.”
When it comes to opening social circles, health experts encourage people to remain cautious in deciding who they decide to begin meeting.
“As you bring in one new person, you’re also bringing in all the people that those people are exposed to,” said Dr. Aaron Milstone, professor of pediatrics at the university. “See whether their priorities align with your priorities.”
“We are not out of the woods yet,” said Maragakis. “We need patience and perseverance to get through this crisis and to focus on the very basics of infection prevention practices that we all know.”
