California summer fun collides with coronavirus danger as hospitalizations, new cases keep rising

SAN FRANCISCO —  The California tradition of summer fun — barbecues, garden parties, group excursions to beaches and mountains — is colliding with the state’s desperate efforts to prevent new surges of coronavirus cases as the economy opens up and people begin freeing themselves from months of stay-at-home rules.

Confirmed coronavirus cases have continued to climb as California allowed many businesses to reopen. But on Monday, Gov. Gavin Newsom said COVID-19 hospitalizations are also beginning to rise again statewide, a troubling shift that raises new questions about whether the reopening might need to be slowed.

“Those that suggest we’re out of the woods, those that suggest this somehow is going to disappear, these numbers tell a very, very different and sobering story,” Newsom said.

The number of people hospitalized with confirmed coronavirus infections in California was up 16% over the last two weeks, rising to 3,702 as of Sunday. Of them, 1,199 were in the intensive care unit, an 11% jump over the same period.

In some counties, officials tied the increased hospitalizations to the resurgence of social gatherings as well as some people’s unwillingness to wear masks in public. Simply breathing can propel potentially infectious droplets from a person’s mouth a distance of 4½ feet; a sneeze can send droplets as far as 26 feet, Newsom said.

In Sacramento, health officials said they’ve seen multi-generational outbreaks from gatherings, with some residents assuming it was fine to begin socializing now that businesses had reopened. In San Diego County, officials have recorded several new outbreaks over the last week, including some at gatherings.

Health officials are trying to grapple with how to keep the coronavirus at bay while also addressing the pent-up needs of many residents to socialize during the summer months.

In the San Francisco Bay Area, officials have released new rules allowing small, limited gatherings, acknowledging that people are meeting up and need guidelines to keep them as safe as possible.

“We … know people are already congregating outside their households in more risky ways. This model provides guardrails so small gatherings can occur in a safe way, especially as we move into the summer season,” said Dr. Matt Willis, health officer for Marin County.

In rules released in San Francisco, social gatherings that do resume are to be held outdoors, except to use bathrooms, and last no longer than two hours. And people must wear face coverings at all times except when eating and drinking, unless they have a written exemption from a healthcare provider or are under 12 years of age.

“It’s less likely to be transmitted outdoors,” said Dr. Grant Colfax, San Francisco’s director of public health. “My mask protects you and your mask protects me.”

The Bay Area’s second-most populous county, Alameda, offers a framework in which people from more than one household can meet in what’s called a “social bubble.” This is defined as a stable group of no more than 12 people that can socialize together outdoors. Members can be part of only one bubble at a time, and should wear masks as much as possible and comply with social distancing requirements to stay six feet away from others.

Contra Costa County also outlined social bubble guidelines, warning that getting together indoors is much riskier. “If you meet people indoors, you must always wear a face covering. Make sure you are in a room with open windows or good ventilation. Try not to touch surfaces inside. … Try to avoid using other people’s bathrooms, if possible,” the county said.

That said, Contra Costa officials noted that seeing loved ones and friends “can be important for your mental health.”

But other counties harder hit by the pandemic are adamant that it’s too early for socializing.

“I’m really sorry — I know how desperate people are to be able to get back to events … but this is not a time for parties or gatherings at your house,” Los Angeles County Public Health Director Barbara Ferrer said earlier this month. L.A. County has recorded 31 deaths for every 100,000 residents; San Francisco has logged 5.5 deaths for every 100,000 residents.

San Diego County, which has recorded 10 deaths per 100,000 residents, has also not permitted social gatherings.

The concern over such gatherings is becoming all the more important as a higher percentage of tests are coming up positive for the coronavirus.

Just 10 days ago in L.A. County, only 5.8% of coronavirus tests were coming back positive over the previous week. But on Monday, that rose to 8.4%, Ferrer said.

And the number of new cases continues to climb. L.A. County reported more than 2,600 new cases Monday, and that’s only the third day on record that the county has reported more than 2,000 new cases in a single day, Ferrer said.

“And while some of this may be due to lags in reporting, the numbers do tell us that we’re seeing an increase in community transmission,” Ferrer said, adding that 40% of L.A. County’s cases are occurring among the youngest adults, ages 18 to 40.

“So while many of us are done with this virus, unfortunately, this virus is not done with us,” Ferrer said.

Though only about 30% of L.A. County residents had close contact with someone outside of their household in a seven-day period around early April, now more than 50% said they had such contact by early June, according to a survey by the USC Dornsife Center of Economic and Social Research that was analyzed by L.A. County.

Statewide, the rate of tests coming back positive for coronavirus infections also rose as more Californians sought to return to a greater sense of normalcy. Last week, the percentage of tests showing positive over the previous two weeks was 4.5%; it was 4.8% as of Sunday, Newsom said.

The Democratic governor started easing his stay-at-home order roughly six weeks ago and has now allowed 54 of the state’s 58 counties to open businesses again.

The state has closely monitored hospitalizations and positivity rates as key metrics in determining the spread of the coronavirus in California. Newsom has repeatedly said that the state may need to reinstate some of the restrictions of the stay-at-home order if those metrics spike, but has so far declined to provide details on the level of increases that would serve as an impetus to do so.

The governor said he felt confident that the state will be able to respond to the virus in the weeks and months ahead.

“We’ve always walked into this with our eyes wide open. We’ve always prepared for a surge,” Newsom said. “We’re in that band, where I feel like we anticipated the likelihood as we’ve reopened, of the numbers increasing, and they have.”

When asked how worried he felt about the data, Newsom pointed to some of the economic effects of the shutdown, including the 5.7 million Californians seeking unemployment benefits, and said poverty and hunger also have “profound health impacts.”

“One has to be mindful of that as well,” Newsom said. “That’s why we’ve worked hard to safely reopen the economy. That’s why we’ve given the tools to the locals to make the decisions for themselves.”

Last week, Newsom required Californians to wear masks in most public settings. On Monday, he repeated a call for people to move about safely when in public.

Some parts of California are struggling with COVID-19 more than others.

Riverside and San Bernardino counties have recently appeared or reappeared on the state’s list of counties needing targeted monitoring by state officials. In both counties, increases in gatherings were a factor in elevated disease transmission, as were outbreaks at state prisons, nursing homes and in patients being transferred from Imperial County, which is home to a particularly bad outbreak.

Gatherings were also a factor in increasing hospitalizations in Santa Barbara, San Joaquin and Stanislaus counties. Officials also blamed “decreased attention to personal protection measures such as face coverings and social distancing” in Stanislaus County, whose largest city is Modesto.

Some of the several new outbreaks over the last week in San Diego County have been tied to gatherings.

Of the eight outbreaks reported in the last seven days, the biggest had four or five cases, Dr. Wilma Wooten, the county’s public health officer, said last week. She said no deaths had been associated with any of the outbreaks.

Two confirmed Wednesday and announced Thursday were at a campground and a “social club,” according to county officials. San Diego County Supervisor Nathan Fletcher said the social club should not have been open. Officials said they were asking residents to voluntarily comply with the public health orders. If officials find egregious violations at businesses, they could be shut down or cited by law enforcement agencies.

As of Monday night, there were 5,564 deaths attributed to the coronavirus in California, and 184,715 confirmed cases, according to the Los Angeles Times’ survey of local health agencies in the state.

Nationally, there are more than 120,000 deaths and more than 2.3 million cases, according to Johns Hopkins University.

Lin reported from San Francisco, Luna from Sacramento. Times staff writers Colleen Shalby and Ryan Murphy contributed to this report, as did Paul Sisson and Morgan Cook of the San Diego Union-Tribune.