SANTA ANA (CNS) - Are family and friend get-togethers to blame for Orange County's surge in coronavirus cases?
Or is it indoor dining in restaurants? Or more students returning to classrooms?
It's probably all of the above, according to Andrew Noymer, a UC Irvine associate professor of population health and disease prevention.
The issue has come to the fore as government leaders throughout Southern California struggle to find reasons for the surge and, therefore, ways to tamp down the spread of the highly contagious disease.
In Los Angeles County, officials have shut down al fresco dining, a move Orange County officials don't seem inclined to make.
Many officials are discouraging residents from holding large gatherings for Thanksgiving as well.
“I actually don't think it's all small family gatherings,'' Noymer said. “People have said that it is and others have pushed back on it... People are continuing to meet when maybe they shouldn't. They're also going to restaurants... How can you say it's one but not the other?''
COVID-19 transmission in Southern California is now so widespread there's really no way to finger any single culprit.
Noymer said some restaurants claim to be serving diners outdoors, but with enclosed tents, so it defeats the purpose.
A “hyper shedder'' in an enclosed tent with 50 people in it can infect 15 other diners, Noymer said.
“And if you think about how many home meetings you would have to have to make the equivalent of that it's really kind of incredible,'' Noymer said.
Noymer said he wouldn't rule out the contribution of home gatherings to the spread of the virus.
“But at the same time I wouldn't say you can definitely say it's home meetings,'' Noymer said. “I haven't seen any evidence that is conclusive either way, honestly.''
Some political leaders are reluctant to close restaurants for dining because of the loss of sales tax revenue, Noymer said.
“The issue is the states aren't getting a lot of support from the feds and the states need to use tax revenues to keep themselves afloat so they are reluctant to close restaurants for that reason, and it's kind of a mess, honestly,'' Noymer said.
“They should close down restaurants for dine-in, including these fictional safe outdoors stuff,'' Noymer said. “True al fresco is fine, but we're going to be back where we started because the restaurants will cheat again.''
Noymer predicted that hospitalizations will soon continue to increase to its highest levels back in July.
“There's reasons to believe we could just keep getting worse,'' he said.
That's because colder weather is driving more activity indoors, schools are continuing with personal education in classrooms, Noymer said.
“I think we're going to exceed the July peak,'' Noymer said of the death toll. “This is not just going to be like another July and go away. I think it's going to get worse.''
The imminent vaccines may help, however, he said.
“The vaccines are the wild card,'' Noymer said. “But the question is how quickly can we actually get them and there's still a lot we don't know about how long the vaccines will last. Will it be a vaccine that gives protection for more than 12 weeks? But, quite frankly, such a vaccine would still work to bring down the pandemic because it would lead to so much disruption in transmission.''
Noymer is concerned that news of vaccines is leading to some complacency.
“I feel like people are letting their guard down because a vaccine is four weeks away,'' Noymer said. “And it's important to remember that for most people it's not four weeks away.''
Orange County CEO Frank Kim said the county is prepared to disseminate the vaccines.
“A lot of these hospital systems here, they have their own infrastructure,'' Kim said.
“And the vast majority of Orange County residents have health insurance. They're not going to look to the county as a direct provider of vaccine. It will come from your medical provider.''
Kim said local hospital executives “feel confident they have good infrastructure and process in place to administer the vaccine. We have a good hospital delivery system and that will pay dividends as the vaccine is rolled out and how they reach their clients.''
For the county's poorer residents they can rely on CalOptima, the county's insurance program for the needy, to help with disseminating vaccines, Kim said.
Kim said he believes the vaccines will be widely available by March or April.
“How many people are going to suffer from the disease (in the meantime), that's the concern,'' Kim said.
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