One of the more useful analogies I read about the community spread of COVID-19 came from Trevor Bedford, a computational biologist at the University of Washington. In early March he described each small cluster of cases as an ember in a windstorm. Some stay in place, some get caught in the wind but flare out. Others, however, flare up and spread – igniting fires as they go along, each of which on their own produce more embers.
The difficulty with letting an epidemic smolder, as we did in Los Angeles County from August through October, is that you give it space, oxygen and fuel to explode.
This is precisely what has happened and, this week, our case rates exceeded those we saw in mid-July. The upward slope of the curve is shocking (Figure 1 below). We now stand at 30.17 new daily cases per 100,000. The previous maximum was 29.60 the week of 7/14/2020.
The last time we had an acceleration of cases (granted it was nowhere near this steep), it took over 6 weeks to begun to flatten out and turn the corner. Six weeks from now is the first week of January 2021.
Public health advice from the County has been muted. Restaurants have been asked to cut patronage by 50% and to close between 10pm and 6am. Outdoor gatherings are to be limited to three households or fewer. Once again, our health officials are not acting decisively.
Patients have asked me for practical advice and here it is:
- Cancel your Thanksgiving plans
- Cancel your Christmas or seasonal Holiday plans
- Cancel your New Years plans
- Don’t travel
- Don’t expect school to open in January
- Do expect another round of shelter-in-place
- Count ourselves fortunate that COVID-19 treatment modalities have significantly improved over the past several months
- Count ourselves fortunate that vaccines are on the horizon (but practically will not be available until late Spring, early Summer)