Too Much Coronavirus Spread For Full Contact Tracing; 'Dimmer Switch' Needs To Be Used, CA Health Secretary Says
California Health and Human Services Secretary Dr. Mark Ghaly today reiterated a common message from Gov. Gavin Newsom's updates: that reopening the economy is a "dimmer switch," with modifications and closures being toggled up and down to avoid large-scale surges. And, he said, it's time for that switch to get used.
Ghaly spoke during a live-streamed update on coronavirus in California. You can read the highlights below or watch the full video above.
USING THE "DIMMER SWITCH"
Ghaly noted that some have viewed the reopening of different sectors of the economy as a "green light" to resume normal life. That's led to hospitalizations, case positivity rates, and deaths increasing, he said.
"Despite early behaviors which felt a lot more normal than we expected, we now need to use our dimmer switch to ensure that we get transmission rates under control," Ghaly said.
The state wants to avoid closing in the future, Ghaly said, but their fingers will remain on the "dimmer switch" and they aren't afraid to use it, based on health data.
"We continue to expect transmission to come down with some of the dimming actions that we made over the past few weeks," Ghaly said.
It may take more than the two- to three-week period that has been discussed in the past to see an impact on the numbers — it could even take up to five weeks, Ghaly said. He added that the state hopes to see numbers that show the impact of the statewide mask mandate, moving indoor businesses outdoors, closing businesses that couldn't do that, limiting further openings, and targeting certain counties.
Reducing the spread will allow contact tracing to be used more broadly, and will allow the economy to keep going at the level that it's currently at, Ghaly said. But, he added, there remains the potential for further "dimming" in certain parts of the state if the data indicates that is needed — particularly in counties on the state's monitoring list, such as Los Angeles.
Ghaly said that he and the governor won't commit to a certain date for when the state will or won't take further action when it comes to adjusting that "dimmer switch."
Ghaly said that California is preparing to put out what he described as a "playbook" that helps augment the guidance that has already been put out. It's meant to help factories and businesses of all sizes reduce transmission. One of the biggest challenges remains physical spacing, Ghaly said.
TOO MUCH SPREAD FOR CONTACT TRACING
Ghaly indicated that, while the state's contact tracing program is operational, there are still issues in that area.
"High levels of transmission have made traditional contact tracing impractical and difficult to do," Ghaly said.
But he added that the hope is that combining reducing transmission with continuing to scale up the program will make contact tracing more doable on a wider scale — he described it as a point of equilibrium.
"At the level of transmission that we're seeing across the state, even a very, very robust contact tracing program in every single county will have a hard time reaching out to every single case," Ghaly said.
Ghaly said that it can be helpful for COVID-positive people to reach out to their contacts themselves to reduce transmission.
While the state has contact tracing staff available, it takes time for counties to onboard them into their own local systems and in a way that makes sense for their communities, Ghaly said. It's "not realistic" to trace every single case, but he said he thinks it's smart that some counties are targeting their contact tracing. That includes focusing on contact tracing for essential workplaces like larger factories and businesses, allowing for the transmission pattern to be understood and addressed.
Ghaly said that L.A. County is working hard to build up its own contact tracing.
"No one has anticipated building a program to contact trace the level of cases we're seeing here," he said said.
Ghaly noted that disease investigators are also needed alongside contact tracers. Those disease investigators look at the case initially, trying to understand where the case may have come from and where it led to. Then contact tracers talk to contacts, as well as working on messaging and following up on isolation and quarantine, Ghaly said.
Ghaly reiterated the need to wear a mask, maintain six feet of distance, wash your hands, and minimize mixing. He said that it's important to do these things consistently. He added that the evidence is clear that masks are the single most important action that we can take to decrease the spread of the virus.
WHERE CALIFORNIA'S BEEN SO FAR
The state's goal remains to "box in" the virus, Ghaly said, using guidance for different sectors, alongside testing and contact tracing. People doing as much of a quarantine as possible is what helps to box in the disease, Ghaly said.
Pointing to data from the month of May, Ghaly said that the reopening was guided by data showing stability in hospitalization numbers. It remained stable after county variances were announced May 8, as well as when churches, in-store retail, and hair salons were allowed to reopen in late May.
The state succeeded in fighting COVID-19 early on because of the state coming together, Ghaly said. He emphasized the need to continue to learn and adapt throughout this process to lead to the best outcomes.
Ghaly reminded viewers that California was the first state to issue a stay-at-home order. He said that order was meant to help change personal and community behavior, and to prepare California's health care delivery system. Doing so helped to avoid a single high surge, according to Ghaly. Instead of uncontrolled surges that would exceed hospital capacity, the state has seen moderate surges, Ghaly said.
Ghaly said that time spent planning means more is known about COVID-19 as a disease, that California's supply inventory has been built up, and that the state has sufficient hospital surge capacity. He noted that there have even been some effective therapies now in use.
Closing the economy and schools caused mental, economic, and educational impacts, Ghaly said. Those losses may be felt not only now, but in the long-term — even affecting several generations of Californians, according to Ghaly. He said that the overall health and well-being of Californians guides the state's decisions when it comes to COVID-19.
Ghaly acknowledged what he described as grave consequences for the state's economy that officials are working to address, as well as mental health consequences. The state is particularly focused on vulnerable and overlooked members of the community, Ghaly said, and will remain to focus on these communities, including communities of color.
He noted that testing capacity has grown from 2,000 tests to more than 100,000 tests per day.
Ghaly said that leaders are proud of the work that's been done so far, but that they're in it for the long run. He said that they are confident that their data-driven approach and commitment to ongoing learning, adapting, and adjusting will guide California successfully through the pandemic.