[Noozhawk’s note: Noozhawk publisher Bill Macfadyen will be interviewing Brian Goebel about his coronavirus data analysis and modeling at 1 p.m. April 13, in an exclusive conversation that will be livestreamed on Noozhawk’s homepage and Facebook page. Readers are invited to submit questions in advance. Click here to pose your question through our Noozhawk Asks platform.]
The time has come for California to change course in its coronavirus response and to re-empower local governments to take the lead in protecting public health.
In my April 8 column, I wrote that that the COVID-19 hospitalization data pointed to a bent curve. Just three days later, the data tell us the statewide curve was flattened days ago and is now completely bent downward.
Now what? The arc and timing of this curve was predictable and predicted. I’ve been urging our elected officials for weeks to plan for the success of Gov. Gavin Newsom’s March 19 stay-at-home order. Now they need to act.
One option they could implement by May 1: The state could replace the statewide order with a set of statewide minimum social distancing standards that could be augmented by locally based, and far more carefully tailored, public health measures that would allow people to lead more normal lives while still protecting public health and preventing a catastrophic spread of the virus.
The data tell us this can be done; it worked from March 8 to March 19. Austria is starting to do something similar. Italy is not far behind.
This is California. We are supposed to lead the nation. We did it by beating back the coronavirus. Now let’s do it again by gradually and sensibly resuming our lives.
Let me be entirely clear about this: I am NOT advocating that public health measures simply end when the statewide stay-at-home order is lifted. Please do not be distracted by the red herring that is beginning to appear in many public health presentations: arguing that the stay-at-home order must be extended because the virus would resume its uncontrolled spread if the order were lifted and not replaced with other social distancing measures.
No one is arguing that significant social distancing measures are no longer required. To the contrary, as I’ve written repeatedly, we are going to need a range of public health and social distancing measures for weeks and months to come. I am confident that these can be designed and implemented at the local level, beginning today.
Hospitalizations Are Plummeting
This following chart shows the updated trajectory of net daily hospital admissions since the state began reporting this data. (Click here for a primer on how California reports hospitalization data.)
As a reminder, the stated goal of the stay-at-home order was to flatten the daily hospital admission curve to the point where our health-care system could provide the highest quality care to both COVID-19 and all other patients by ensuring that new admissions never exceeded the number of discharges on a given day.
The early predictions were that we would need more than 50,000 beds to achieve this goal, with thousands of new admissions each day during the peak of the pandemic. We have done it with far less than 6,000 beds (we are reportedly using roughly 3,000 beds today), just as I predicted weeks ago.
Contrary to reports that it has yet to arrive, the statewide hospitalization peak has already occurred; it happened between March 27 and April 1. Today, California is almost certainly discharging more COVID-19 patients than we are taking into the health-care system.
We are restoring health-care capacity every day throughout the state (although the precise conditions in a local jurisdiction may vary depending on the timeliness and scope of compliance with the stay-at-home order).
Three days ago I wrote that I was confident that the decrease in hospitalizations was not a blip on the radar. With 10 days of data, now we know it is not. We are seeing the full impact of the stay-at-home order manifest itself in the data as I predicted it would.
Three days ago, I also wrote that I expected to see a continuous, but bumpy, deceleration in the virus. We have, and we will continue to do so.
I also wrote that we would continue to follow in Italy’s footsteps. Here, I may have been wrong: We may soon surpass Italy in our dramatic reversal of the trajectory of the virus.
In short, we did it!
Virus Has Changed Course, California Must Follow
The state can no longer credibly claim that it needs “a few more weeks” (as Newsom suggested Friday) to assess the impact of the stay-at-home order. The data are unequivocal.
It is equally clear that there is no “sneaker wave” of hospitalizations building in the statewide data, as some have claimed (without supporting data or precedent). Remember, the impact of staying at home for the past two weeks will be seen in the data for the next two weeks. With each additional day of social distancing we add now, we are ensuring there is simply no stimulus to change the overall trajectory of the virus into late April and early May.
The state may be belatedly figuring this out. On Friday, Newsom and the state Department of Public Health began publicly distancing themselves from prior projections by stating that new data showed the stay-at-home order had exceeded projections for curtailing the spread of the virus. Better late than never.
If the state still believes there is a reason for everyone in California to continue staying at home to preserve our health-care capacity (as opposed to empowering local governments to make the transition to less disruptive public health measures based on their unique circumstances), then it must transparently explain and defend its position with actual evidence (not its flawed modeling) that we are likely to see a roughly ten-fold increase in hospitalizations under the stay-at-home order sometime after April 25.
It will not find any support for its position in the trajectories of Italy or Austria — the two countries making the transition from full lockdown orders to less disruptive public health measures.
If the state cannot offer compelling evidence to support the statewide stay-at-home order, then it should restore local control over public health, with rigorous minimal standards that must be met (and that localities are empowered to exceed if necessary to ensure health-care capacity in their area).
Here too, Newsom and state public health officials signaled Friday that they are beginning to think about the next phase for California, starting perhaps in early-to-mid-May. Again, better late than never. But we should strive to be on time.
We have sacrificed for weeks. The toll this has taken on our residents is enormous and growing. We have more than achieved the stated goal of the statewide stay-at-home order.
Our statewide health-care system has at least 20,000 beds available for COVID-19 without any extraordinary surge capacity. We have used no more than 15 percent to 30 percent of that capacity to meet the moment.
The government has ample room to maneuver in protecting public health and moving to a new normal — the data over the past five weeks make this abundantly clear.
With the downward trajectory of the coronavirus cemented for another two weeks, the time to insist that the state begin the process of transitioning to our new normal by re-empowering our local governments to implement rigorous and tailored public health measures is now.
Please make your voices heard. Our elected officials need to hear them.
Be safe. Stay healthy.
— Brian Goebel served as a senior official in the Treasury and Homeland Security departments following 9/11. Since 2005, he has founded successful consulting and analytics firms serving governments around the globe; launched 2040 Matters, a nonpartisan public policy blog dedicated to restoring the American Dream for younger Americans; and was elected to the Montecito Water District Board of Directors in 2018. Click here for previous columns. The opinions expressed are his own.