After six months of shelter, why did things collapse

Duck, Cover and Catch: California’s earthquake response is global and effective.

But our response to a different natural disaster – the Coronavirus – is deeply personal and often divisive, revealing differences in perception of risk, governance and equity as widely as the Golden State.

Six months after the state’s strict stay-at-home order, this response demonstrates our notable early success against the virus, as well as recent failures, experts say. It also sheds light on why the virus is so widespread.

“Every day, 40 million people make 20 individual decisions,” said Dr. Bob Wachter, chair of the department of medicine at the University of California, San Francisco.

In the case of the charges and the burial, he said, “We see the differences in what those decisions are.”

From the start, COVID-19 has been a complex, invisible and abstract threat. Humans are prepared to respond to immediate danger, like the rumblings of the ground beneath our homes. But vigilance is difficult to maintain – especially since the shutdowns, which were initially intended to be short, have been protracted.

From early April through late June, the average daily death toll in the state for seven days was well below 100 – but increased to 145 by August 6. That rate dropped seven days since then to 88 as of Friday.

Medical workers wearing personal protective equipment deal with a COVID-19 victim in March at Brooklyn Hospital Center in Brooklyn Borough in New York. (AP Photo / John Minchillo)

If we need another lockdown this winter, as Andrew Noimer of the University of California, Irvine fears, the public may not want to comply. We locked her up tight for months. Few of us have had personal issues with death. Now, we run out of patience.

Back in March, we were watching the China disaster, we mobilized. The rapid and unified shutdown of the state saved us a similar fate.

“California deserves credit for the teamwork and the utmost caution at the start of the epidemic,” said Dr. Kirsten Bibbins-Domingo, chair of the department of epidemiology and biostatistics at the University of California, San Francisco. “We acted quickly, and we acted decisively.”

California residents were shocked at the sight of temporary New York mortuary.

The overall response was’ This is dangerous. it’s scary. I’ll believe the experts. I’ll believe the data. Although it is difficult personally and economically, Wachter said, I would do the right thing.

what happened after that?

Some places, such as the Gulf region, have used the time to stockpile personal protective equipment, prepare hospital beds, expand testing, set up clinics, and launch educational campaigns. Early in the first week in March, global tech companies sent their employees home. Only the basic workers were expected to take risks.

SAN FRANCISCO, CA – March 24: The Sir Francis Drake Hotel in Union Square in San Francisco is closed as the Coronavirus lockdown enters its second week, Tuesday, March 24, 2020 (Karl Mondon / Bay Area News Group)

The region has a deep confidence in public health, which has been born out of the womb of the tragic AIDS epidemic. Likewise, we believe in data, which is the basis of many Silicon Valley technologies. Affordable Degerti finds it easy to work remotely.

The result was a shift in the behavior of the cultural herd in the Gulf region. Just as yoga is elegant and smokeless, masks are a must. Social distancing is expected, not required.

In reconciling the cost with the benefit, these sacrifices may seem minor.

But this is not everyone’s experience. While an earthquake is a common shock, a virus – especially one that is transmitted asymptomatically – is an abstract threat, affecting different people in different ways. While the danger is evident from collapsed bridges or destroyed school homes, it is hard to imagine how deadly a family barbecue would be.

Also, COVID-19 cases and death rates are disproportionately high among some people, such as Hispanics, many of whom are “essential workers” in low-income neighborhoods. The worst epidemic has shifted to agricultural areas, clustered in Central Valley provinces with the highest number of cases per capita in the state.

As weeks to months passed, our reactions to the rules for the reopening varied, driven by personal perceptions, local leadership, cultural influences, education, ethnicity, social status, mixed messages, and real-life experiences.

RICHMOND, CA – SEPTEMBER 1: Face mask vendors Marisol Zaragoza, left, and her partner Adrian Ahwazzi stand next to their face masks display in their car on 23rd Street in Richmond, California, on Tuesday, September 1, 2020. Ray Chavez / Bay Area News Group)

And what seemed like a triumphant moment in March turned deadly with swift reopening in May and early June. The weekly death toll in the summer nearly doubled the spring tally. The devastating Loma Prieta earthquake kills 63 people; Every day, a small virus kills many more.

The problem, said Dr George Rutherford of UCSF, was that the state had handed responsibility over to the counties, and what had become a unified response had collapsed.

Wachter agreed, saying, “58 provinces have done their own thing.” “This was where we saw the biggest reversals in our gains,” said Pippins Domingo.

And many provinces have not taken advantage of those precious months to prepare.

Meanwhile, local politicians have pressed provincial health officials to ease restrictions on faltering businesses and bemused residents.

Orange County reversed its rules regarding mandatory masks on June 11. In Merced County, even after an order was issued to shut down the massive Foster Farms poultry plant on August 27 following the outbreak, employees received emails asking them to come to work. Across the state, churches defied county and state orders to limit internal services.

As expected, cases rose.

SAN DIEGO, CA – May 01: Activists hold banners and protest against the California lockdown due to the Coronavirus (COVID-19) pandemic on May 1, 2020 in San Diego, California. Protesters’ demands included the opening of small businesses and churches and support for President Trump. (Photo by Shawn M Havey / Getty Images)

Philip Cohen, a professor of sociology at the University of Maryland in College Park, said that such a decentralization of power only works if local officials have strong direction and support.

In more rural areas, he said, “the provinces lack the infrastructure, personnel, expertise or resources to deal with the epidemic.”

California’s fractured approach violates one of the core principles of emergency risk communication: “Communicate a clear and consistent message from trusted messengers,” said Lori Peck, director of the University of Colorado Natural Hazards Center in Boulder.

Instead, the messages were mixed and confusing. Masks were useless, then necessary. The virus may kill you or do nothing. Children safely, except occasionally; Schools are dangerous, depending on. Messengers were politicized: Republicans said the threat was exaggerated, killing jobs and undermining the president. Democrats warned of disaster and urged more spending.

In the beginning, we had a clear goal: Don’t overwhelm hospitals. That has changed, Dr Rajiv Bhatia, clinical assistant professor of primary care and population health at Stanford University, said.

He said, “You cannot fight something without aim and management.”

Governor Gavin Newsom wears a protective mask over his face while talking to reporters at Miss Ollie’s restaurant during the coronavirus outbreak in Oakland, California, Tuesday, June 9, 2020 (AP Photo / Jeff Chiu, Pool)

For example, early on, state officials considered hospitalization rates one of the most important metrics for knowing whether we were controlling the virus, but that metric was no longer included in the state’s new monitoring system.

Experts say this confusion makes it easier for us to engage in what’s called “information avoidance” – putting our heads in the sand.

“It’s a rational response to unpleasant information,” said economist Plamin Nikolof of the State University of New York at Binghamton, who studies responses to the pandemic.

Without accurate information, he said, we might underestimate the real risks. Moreover, humans are bad at understanding exponential growth – failing to provide enough for retirement, for example – so we weren’t prepared for the quick access of the virus.

Other traits also influence our response, according to Nikolov’s research. Women, Democrats, married couples, and college graduates are more likely to have social disguise and distancing.

Stanford’s Bhatia said messaging works better if it targets the most vulnerable demographics.

It should be reasonable and “actionable,” Beck added. Without more funding, she said, it is difficult to provide protection for people in the crowded small apartments who are working essential jobs.

Unlike people afflicted with malaria and other deadly diseases in parts of the world, some Californians resist health directives. Nearly a third of those newly infected in the booming Los Angeles County refused to speak to the county investigator – or they disappeared.

Very light traffic moves along the 110 Harbor Expressway towards downtown at mid-afternoon, Friday, March 20, 2020, in Los Angeles. (AP Photo / Mark J. Terrill)

Beck said that an effective disaster response requires “top-down” and “bottom-up” efforts, working in tandem. This does not happen.

“I’m still grateful that we got together to build a strict shelter in place in March.” Dr Sarah Cody, Santa Clara County Health Officer who helped lead the nation’s first provincial lockdown, said, “I feel we prevented so many deaths and grief as a result.”

“After that, it got a lot more complicated,” she said. “We no longer have a common vision of what COVID is, what it means … and what we all have to do together.”

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