15 Jun 2021: Re-opening Day

social@drbretsky.com
social@drbretsky.com

To a moderate degree of fanfare, California “reopened” from COVID-19. As aptly summed up by the LA Daily News (link: https://www.dailynews.com/2021/06/14/la-county-joining-california-set-to-largely-reopen-tuesday-june-15-after-more-than-a-year-of-coronavirus-restrictions-heres-what-that-means/):

“After a year of scrambling to stay alive, businesses will be allowed to forgo coronavirus-related social distancing and open to full capacity, while fully vaccinated individuals can largely ditch masks.”

In reality, case rates have not really moved much since the first week of May when they stood at 2.7 new daily cases per 100,000 as they stand now at 1.6 new daily cases per 100,000.  In fact, case rates have been completely flat for the last 3 weeks (Figure 1 below). Traditionally, viral containment has been defined as <1 new daily case per 100,000 population. In Los Angeles County, we still remain above that threshold.

The good news is that mortality rates continue to fall:  from 0.06 daily deaths per 100,000 population the first week of May to most recently 0.03 daily deaths per 100,000 (also in Figure 1).

The linked LA Daily News article points out:

“Some questions remain, however, including whether the region could see coronavirus metrics tick back up after Tuesday — since the county is not yet at the vaccination threshold most experts say would create herd immunity. Officials reiterated on Monday that getting vaccinated and wearing a mask if you aren’t inoculated are the best tools for keeping case rates low.”

In actuality, my question is “why are we reopening now?”  There are two possible ways to look at this – in the first, since numbers really aren’t any different than they were 6-8 weeks ago, why did we wait so long?  Or, secondly, what was the rush to reopen when we have not yet reached viral containment (to say nothing of herd immunity)?

Vaccination rates in the County have trailed off precipitously since their late March / early April peak (Figure 2 below).

Figure 2:  Number of vaccinations given per week, Los Angeles County.  Source:  http://publichealth.lacounty.gov/media/coronavirus/vaccine/vaccine-dashboard.htm

County projections now have us reaching 80% vaccination threshold in October 2021 (Figure 3 below – blue dashed lines).  One can readily see that the County’s prior projections have been overly optimistic (their first had us crossing 80% in mid-May) as is their current estimate. Clearly the vaccination curve has flattened and no matter how many Lakers tickets or lotteries are run, enthusiasm for vaccination seems to have run its course.

Figure 3:  Percentage of the population 16 years and older with 1 or more dose of COVID-19 vaccine, Los Angeles County.  Source:  http://publichealth.lacounty.gov/media/coronavirus/vaccine/vaccine-dashboard.htm

Reopening was mostly met with a shrug while Governor Newsom enthusiastically declared “California Roars Back” (link: https://www.gov.ca.gov/2021/06/15/california-roars-back-at-universal-studios-hollywood-governor-newsom-ushers-in-states-full-reopening-and-draws-15-million-in-vax-for-the-win-grand-prizes/)

Fittingly, the announcement was made at Universal Studios – a theme park based on fantasy rather than reality. From the Governor’s indoor dining at French Laundry, poorly timed closures, lack of political will to shut down Thanksgiving travel, and now a reopening that is either 8 weeks too late or not yet warranted, we are hardly roaring back.  Vaccination rates have slipped, case rates remain flat, and now there is mounting evidence to jeopardize further two dose vaccinations of teenagers. While I do not think that we will have a significant jump in case rates, we will continue to see cases and deaths when such isn’t necessary.

Meanwhile, the Governor can hand out millions of dollars in “vax for the win” and declare the economy open, but collectively we sigh, shrug, and go on with our day.

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