Shared from the 6/10/2020 San Francisco Chronicle eEdition

Bay Area reopens amid rise in cases

Experts wary as counts surge to March levels


Bar manager Marc Pontavella, masked and gloved, makes a cocktail at Teleferic Barcelona in Walnut Creek.

Photos by Jessica Christian / The Chronicle

Kids practice their skills at a day camp at Heather Farm Park tennis courts in Walnut Creek. Contra Costa County moved faster than other Bay Area counties in lifting restrictions.

The Bay Area is rolling forward with reopening the economy even as coronavirus case counts are comparable to or much higher than the earliest days of the outbreak, when the region made the unprecedented move to begin sheltering in place.

Several counties in the Bay Area, which remains more conservative than the rest of California in its pandemic response, are moving to reopen at a steady clip despite recent surges in cases. The region as a whole is reporting as many new cases each week now as in March, reversing several weeks of declining numbers.

Much of the recent increases have been anticipated due to expanded testing and a result of reopening, as more people begin to interact and are exposed to the coronavirus. And public health officials said they are much better positioned now than they were three months ago to handle large numbers of cases at once without stressing local health care systems.

But many experts remain wary of moving too fast to reopen the economy when the virus clearly is still spreading easily in communities.

“I’m very concerned about the pace,” said John Swartzberg, a UC Berkeley infectious disease expert. “It’s like the reopening has taken a life of its own. There’s this momentum behind it, and it’s very hard to stop it and pause it.”

The Bay Area also has reported a notable uptick since shelter-in-place restrictions began loosening in mid-May. As of Tuesday the region had about 15,900 cases total, and in the past couple of weeks it’s seen more than 200 new cases nearly every day — levels comparable to late March.

Case counts likely will continue to rise in the near future, Swartzberg and others said. The Black Lives Matter protests are expected to result in new infections over the next few weeks. As the summer progresses, there may be surges from children going to camp and people lowering their guard and socializing more often.

“There are definitely some scenarios where we could see an uptick in cases in late July or early August,” said Ori Tzvieli, deputy health officer with Contra Costa County, which has moved ahead of some of its neighbors in lifting restrictions. On Tuesday the county won permission from the state to accelerate its reopening, which will allow large sectors of the economy to resume over the next few weeks.

“We are aware of the pain that the shelter-at-home has caused a lot of people. It’s really about finding a balance between controlling COVID-19 spread and not inflicting too much pain,” Tzvieli said. “We’re trying to message wearing masks, handwashing, physical distancing — it’s becoming more and more incumbent on every member of the community to take those things seriously.”

Bay Area health officers say they’re trying to avoid moving too fast and being forced to then push people back toward sheltering in place. That happened in Israel after it reopened schools and was forced to shut some down after infections spread among students. South Korea and China also reintroduced social distancing restrictions when cases picked up.

Gov. Gavin Newsom began loosening statewide restrictions on May 5, about six weeks after issuing a stay-home order that ground the California economy to a halt. But the Bay Area, which began sheltering in place a few days before the rest of the state, remained largely committed to its regional quarantine.

Three North Bay counties sped past the rest of the region and began opening businesses in step with the rest of the state in mid-May. The other six counties have moved at a much slower pace, but nonetheless continue lifting restrictions at regular intervals, every two to three weeks.

The state and counties have set benchmarks to safely reopen, but many places are moving forward before reaching those goals — even as cases of COVID-19 are hitting record levels. California has more than 135,000 cases in all, and the number of new cases has been climbing week over week since mid-May. A handful of counties in Southern California, in particular, have seen alarming spikes.

The Bay Area has reported less dramatic jumps, but cases are climbing here too. Several counties reported recent surges far greater than at any other time in the pandemic. Marin and Napa counties reported their single largest case counts last week: 105 and 29 cases for the week, respectively. Alameda and Sonoma counties also have seen their highest numbers in the past two to three weeks; Alameda reported 529 cases in the last week of May, and Sonoma County reported 109 cases a week before that.

The increases can be attributed to expanded testing in some places, but sometimes it’s not obvious what’s to blame. In Solano County, Health Officer Bela Matyas said many recent cases came from Memorial Day gatherings of friends and family. He said he anticipates more new cases in a few weeks due to unauthorized graduation parties. Most public health officials expect to see increases from the protests.

In a handful of situations, the increases have caused health officers to slow down or reconsider reopening. Sonoma County delayed by a few days plans to reopen retail and some other businesses after seeing a sudden climb in cases and hospitalization numbers late last month.

Alameda County has been particularly hesitant to allow some sectors to resume operating after seeing similar increases — even as pressure is mounting to keep pace with its neighbors, said Health Officer Erica Pan.

“There was a 10 days or so increase in our cases, and then it went down and it looks like it’s stabilizing now,” Pan said. “As things loosen up, even though we’re going really slow in Alameda County — the slowest — we’re going to see more cases. It’s the result of more social interactions.

“Now that things are a little more stable, I’m hoping we may be able to move a little faster. We’re feeling a lot of pressure to move faster,” she said.

Pan and other health officers noted that increases in case counts alone don’t paint a full picture of the coronavirus in their community. Just as important — if not more so — are hospitalization numbers, which have remained fairly low, though a few worrisome increases have been reported. Statewide, 3,257 people are hospitalized with COVID-19, the most in nearly a month.

Another key point, Pan said, is that even if the case counts are as high or higher now than they were three months ago, the rate of increase in cases is much less concerning. When the Bay Area began sheltering in place, in some counties the case count was doubling or tripling every few days. Now cases are doubling about every month.

Still, there’s legitimate cause for concern, and some counties are opening up even as they warn residents that the pandemic outlook is still bleak.

“If you are feeling on edge, out of sorts, a bit unhinged, these feelings are completely normal. We are certainly in the midst of the biggest disaster of our lives,” said Scott Morrow, the San Mateo County health officer, in a June 1 message to the community.

Morrow said the county would continue to move toward reopening even as case counts and hospitalization numbers climb, and “the virus is likely now circulating at higher levels than before.”

Morrow’s commitment to reopening reflects the understanding across the region that sheltering in place isn’t healthy or sustainable for much longer. Easing out of it, public health experts say, involves striking a balance between avoiding further economic devastation and controlling a highly infectious, unpredictable new disease.

“We don’t want people to keep living their lives sheltering at home. We want them out at the world and being together, and we want to offer guidelines to do that as safely as possible,” said Susan Philip, director of disease prevention and control at the San Francisco Department of Public Health. “We have a commitment to keep moving forward, because we know there are impacts on people’s health and economic well-being and happiness that are so important as well.”

Erin Allday is a San Francisco Chronicle staff writer. Email: Twitter: @erinallday

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