Social distancing works. The earlier the better, California and Washington data shows
SAN FRANCISCO -- Mandatory social distancing works. The earlier the better, preliminary data from two weeks of stay-at-home orders in California and Washington show.
Those states were the first to report community cases of covid-19 and were also the first in the nation to mandate residents stay at home to keep physically apart. New analysis from academics and federal and local officials indicates the moves bought those communities precious time - and may have also "flattened the curve" of infections for the long haul.
While insufficient testing limits the full picture, it's now clear that the disease is spreading at different speeds in different places in the United States. California and Washington continue to see new cases and deaths, but so far they haven't come in the spikes seen in parts of the East Coast. Even still, social distancing efforts need to continue for several more weeks to be effective, experts say.
The data "gives us great hope and understanding about what is possible," said White House Coronavirus Response Coordinator Deborah Birx during a Tuesday briefing. "In New Orleans, and Detroit, and Chicago and Boston right now, [we're] trying to make sure that each of those cities work more like California than the New York metro area."
It has been 16 days since counties in the San Francisco Bay area told some 6 million residents to stay at home, and 13 days since the order extended to all of California. As of Tuesday, the number of confirmed infections per capita in densely populated New York City was 15 times that of the Bay Area. In New York City, a flood of coronavirus patients has overwhelmed local hospitals and 1,096 people have died. New York state ordered people to stay home 11 days ago.
Compared to the Boston area, which has a more-similar population density, California's Bay Area has about a third of the of the cases, per capita. The state of Massachusetts ordered people to stay home eight days ago.
"Every aggressive action appears to have helped stop the spread," San Francisco public health head Grant Colfax told The Washington Post. He warned on Tuesday about the virus potentially spreading in the 750-person long-term care Laguna Honda Hospital, but so far the city has seen a total of 397 confirmed cases and six deaths. The hardest-hit part of the Bay Area is Santa Clara County in Silicon Valley, which has seen 890 cases and 30 deaths as of Tuesday.
Aggressive social distancing efforts haven't stopped the virus, say public health experts. But the goal was to slow the spread to keep it from overwhelming health care resources, so not as many people require hospital beds and ventilators at the same time. California hospitals, which saw their number of covid-19 patients double over the last five days, have yet to buckle under the load.
"The ER is eerily quiet right now," said Jahan Fahimi, an emergency care physician at UCSF Health in San Francisco. He credited early action by policymakers in the Bay Area, even as he braced for what's next. "The surge is still coming. It's not that we've averted anything," he said.
Academic models of the coronavirus spread from the University of Washington's Institute for Health Metrics and Evaluation, which Birx cited in her remarks, indicate California's steps reduced the state's total projected death toll from 6,100 to about 5,100. "We are seeing less deaths and flattening of the curve," said Ali Mokdad, a senior faculty member at IHME. So far, California has reported 150 deaths.
The IHME's model, which projects some 94,000 deaths across the entire country, is updated daily with data from each state. It is designed to help hospitals and other decision-makers determine what they'll need in terms of intensive-care beds and ventilators.
In Washington state, where the virus first took off in a nursing home in February, officials first banned events of 250 people or more in Seattle on March 11, ordered bars and restaurants to close on March 16, and then ordered the whole state to stay at home on March 23. Following those moves, IHME death projections for Washington fell from 2,000 originally to about 1,600. So far, 195 people have died in the state.
California Gov. Gavin Newsom, D, said on Tuesday that he wants to be "cautious" about drawing conclusions about the effectiveness of the state's social distancing efforts, but he's now more confident its health care system can handle what's coming.
"We have the time to prepare. That was the whole point of moving early on physical distancing," Newsom said. "The only regret we will have is if we cut the parachute before we land."
Coronavirus models and the public policy game plan they're informing are based on some very sophisticated guesswork. Since patients can take days or even weeks to show symptoms, case counts are a lagging indicator of the success of social distancing efforts.