Today’s update is a bit of a difficult one to formulate, given the significant civil unrest and widespread protest marches we have seen nationwide after the murder of George Floyd on 25 May 2020. Adding to the complexity is the World Health Organization (WHO) statement today from Dr. Maria Van Kerkhove that asymptomatic spread of COVID-19 is “very rare”. She offered no data, although hinted at such, and if true this would absolutely change the dynamics of our modeling and response. A post for another time.

To be sure the protest marches will increase transmission of COVID-19. The Infectious Disease Society of America explains, “People aren’t just standing, they’re yelling, shouting, chanting. This creates droplets to transmit the virus person-to-person.” Changes in case, hospitalization and mortality rates that follow will be confounded by the near simultaneous openings in many cities and states.

There has been considerable backlash against an apparent “double standard” among public health officials who had advocated for robust shelter-in-place orders and are now assessing the role of protest marches and encouraging them to be done “safely.” This is also a separate post, but suffice it to say that for those of us who have been involved in health outcomes research, it is not difficult to notice social structure in the patterning of illness across the population. Even in my brief (and ancient history) research career, I published multiple papers on health disparities (e.g. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1553-2712.2001.tb01134.x?fbclid=IwAR3YLCYGTcwJM_k2HvbuDLFO8GmF8moq3auDeME-F5gXVlKI2zDioQ8ffwI)

The bottom line for me is that we continue to need to look at case numbers. hose who have followed my posts will remember that I have drawn particular attention to Riverside County who one month ago on May 8th, decided to rescind public health orders including a previous requirement for face coverings. Riverside County Sheriff Chad Bianco had refused to enforce these public health mandates and, notably, while taking a knee with protesters declined to wear one himself (link). Now the County is moving forward with Stage 3 reopening of all sectors including bars, day camps, gyms, schools and professional sports.

While the confluence of protest marches and regional reopening may lead to mixing of effects (are rates going up because of marches? are rates going up because of relaxed measures?), there is one point where I think we can all agree. The effect of marching and relaxing #saferathome measures in the context of an already rising case rate is a recipe for disaster.

While the confluence of protest marches and regional reopening may lead to mixing of effects (are rates going up because of marches? are rates going up because of relaxed measures?), there is one point where I think we can all agree. The effect of marching and relaxing #saferathome measures in the context of an already rising case rate is a recipe for disaster.

Riverside County is such a place. Case rates dropped to their lowest rates of 3.89 daily cases per 100,000 population on 5/15/2020. By no coincidence, rates began rising two weeks after the County Board of Supervisors rescinded protective public health measures. Rates are now above their trendline and are at the highest rates observed since the pandemic began at 6.70 daily cases per 100,000 population the week ending 6/5/2020. Yet they are full steam ahead on Phase 3 reopening.