Coronavirus spreading ‘uncontrollably’ in much of U.S. — but not California. Here’s why - San Francisco Chronicle

Seven months into the pandemic, the coronavirus is spreading rampantly across much of the U.S. — with California a very notable exception.

More than half of all states now fall into the “uncontrolled spread” category, according to data gathered by the COVID Exit Strategy. California, by contrast, is one of eight states where transmission is decreasing or flat.

The only states with better case rates than California are New York, New Hampshire, Hawaii, Maine and Vermont, according to the COVID Exit Strategy, a volunteer project created by public health and crisis experts that tracks the states’ performance using data from the COVID Tracking Project and others.

Experts point to several reasons behind California’s current success. But in short, “The decisions made during summer and the end of summer are paying off,” said Ryan Panchadsaram, COVID Exit Project co-founder and former U.S. deputy chief technology officer, who lives in San Francisco. “We’ve sort of hit a plateau, which is reminding us we have to be vigilant.”

California currently has 75 coronavirus cases per million population, according to the COVID Exit Strategy. It has also seen a 4% decrease in total hospitalizations and 3% decrease in ICU admissions over a 14-day period, Gov. Gavin Newsom said at a news conference Monday.

That’s a far cry from the 32 states that currently fall into the “uncontrolled spread” category — defined by the COVID Exit Strategy as more than 150 new cases per million people per day.

Newsom on Monday repeated the mantra to remain vigilant following California’s relative success over the last six to eight weeks in avoiding the dreaded “third wave” public health officials had warned of. He praised the state for its work around treatment in the fields of biotechnology, bioinnovation and biotherapeutics. “No one does it better than we do,” Newsom said.

But many may be wondering if a wave is indeed on its way. The state appears to be facing its first big test in striking the balance between a degree of normalcy and containing the virus.

And the question remains: Is California’s relative success a reflection of the state’s major efforts over the last few months, including ramped-up testing, phased reopening, and conservative measures around distancing and mask-wearing? Or is the containment just a blip, a period of random luck perhaps coinciding with warmer weather or the stretch of poor air quality that kept millions of residents cooped up inside?

Experts say it’s unlikely poor air quality had an effect on keeping case counts low. The Bay Area’s miserable month of bad air due to wildfire smoke may actually have set the stage for increased coronavirus transmission by keeping people indoors, said John Swartzberg, a UC Berkeley infectious disease expert. And while it's possible California’s warm weather could have aided its overall success by keeping interactions outside, where transmission is less potent, experts don't believe weather is a primary factor in improving or worsening case counts. Maine, for example, has seen the onset of cold weather but cases have declined 12% and the positive test rate is the lowest in the nation

Such variables aside, Swartzberg said at least three elements of California’s efforts have certainly paid off: compliance around mask-wearing and social distancing; overall trust in public health officials and organizations; and sustained caution with phased reopening.

The Bay Area in particular has performed quite well in all of these arenas, Swartzberg said. With a death rate of only 1%, San Francisco has accounted for 133 of the 16,970 deaths statewide. One factor of that could be helping the Bay Area is the sheer number of residents able to work from home, said Lee Riley, an infectious disease expert at UC Berkeley.

By contrast, one-third of the cases and 40% of deaths in California have come out of Los Angeles County. “There are parts of Southern California that we remain very concerned about,” Newsom said on Monday.

Another factor in the state’s favor could be an increase in Californians’ willingness to show consideration for others, said Riley.

“In general, I think people are very accepting of what it takes to control an epidemic, as opposed to many of these other states, where people are more concerned about practicing personal freedom than preventing infections,” said Riley.

The Bay Area was the first region to mandate shelter-in-place, which helped to blunt the epidemic from kicking off early on in March. But in the summer, when the state moved quickly to reopen, it experienced a surge.

“If you look at the data, (we’re) about where we were before the surge happened in June,” said Riley. “So we still have to be careful.”

Experts see the potential for trouble in late fall and winter, as people make plans to fly around the holidays and host more gatherings — many of them likely indoors.

“The fact is, this epidemic doesn’t spread like a wave, it spreads like a wildfire,” Swartzberg said. “Embers fly off to another place — and there’s a conflagration there.”

Annie Vainshtein is a San Francisco Chronicle staff writer. Email: avainshtein@sfchronicle.com Twitter: @annievain

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Coronavirus spreading ‘uncontrollably’ in much of U.S. — but not California. Here’s why - San Francisco Chronicle
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