Yes, Californians Should Be Worried About Thanksgiving, Too

Good morning.

For the past week or so, I’d been wondering when or if another significant lockdown was coming amid a frightening rise in coronavirus cases. So on Monday morning, I called up Dr. Bob Wachter, a professor and chair of the University of California, San Francisco’s department of medicine, to weigh in on whether it would be warranted.

[Read about California’s move to “pull the emergency brake” on reopening.]

By the end of the day, those questions had been answered: Gov. Gavin Newsom announced a major reopening rollback — a move Dr. Wachter told me he saw as a reasonable step.

But it was one move in broad efforts to head off what officials have been warning for weeks could be a catastrophic holiday season.

I asked Dr. Wachter more about what’s on his mind now. Here are excerpts from our conversation, lightly edited for length and clarity:

First, tell me about what you’re tracking most closely in California.

The state of the pandemic is just terrible across the country. But then you have this vaccine news, which is unbelievably hopeful. I think the human brain has a hard time reconciling those two data streams.

The contact tracing data that’s emerging is supportive of the premise that when you start seeing exponential spread, what’s likely going on is people are spending more time indoors, in spaces with their masks off. Restaurants, by definition, fit that description, unfortunately.

Does this mean we’ll never get back to it until we’re all vaccinated? I don’t think so. But we’ll certainly never get back to crowded restaurants.

[Read more about why Covid hits already vulnerable communities hardest.]

California is in a very different spot from the last time we talked at length in terms of testing. How are you thinking about it now?

Testing is really complicated in all sorts of dimensions.

It’s partly why the failure of the C.D.C. during this is so maddening, because part of a vigorous federal response would have been to ramp up testing capacity and then to create clear guidelines for different situations. Lacking that, we’re all doing improv.

In a different world, you can imagine a widespread availability of rapid 15-minute turnaround tests that people take before they go into work to be sure that everybody in the workplace that day is not contagious. And if they are, they go home. If they don’t have the means to stay isolated, society says it’s worth using some communal money to be sure they have a place to stay so they don’t go and infect a whole bunch of other people. That would have been a reasonable and rational response to this. Of course, we’ve seen none of that.

Testing and then sort of the related issue of contact tracing are systems that can be an important part of the response, but not everything. Both of them tend to fall apart just when you need them most.

You can have a testing and contact tracing program that’s working reasonably well when your case volumes are low. People can get a test quickly and get it back. It’s a little bit like hospitalizations, in that these are systems that you have to design and resource not for a good day, but for a bad day.

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