Americans are desperate to know when a coronavirus vaccine will be available to finally curb the pandemic that has already taken nearly 200,000 lives in the United States, and allow schools and the broader economy to reopen.
Scientists and vaccine makers have long said that a handful of vaccines could be available by the end of the year, if everything goes according to plan. But in recent weeks, President Trump has insisted that a vaccine will be ready before the presidential election on Nov. 3, raising fears that one could be rushed against the advice of scientists and regulators.
Testing and producing a vaccine is a complex process with a lot of uncertainties. But the best guess for now, experts say, is this: If every aspect of the vaccines development and distribution goes exactly as planned and history has shown that rarely happens certain people in high-risk groups could get vaccinated this year. Most other Americans, however, will quite likely have to wait until well into next year.
At a news conference on Wednesday evening, Mr. Trump doubled down on that unrealistic timeline, saying that a vaccine could be ready by mid-October and that it would then be made available immediately to the general public.
Were not looking to say, Gee, in six months, were going to start giving it to the general public, he said. No, we want to go immediately.
In doing so, he contradicted his own director of the Centers for Disease Control and Prevention, Dr. Robert R. Redfield, who had testified to senators earlier in the day that a vaccine would most likely not be available until the middle of next year. Mr. Trumps statements also contrasted with comments made Wednesday morning by officials with Operation Warp Speed, the federal effort to accelerate a vaccine, who said that supplies would be limited in the first months that a vaccine is available.
It was not the first time the president had pushed an accelerated timeline. Just the night before, at a town-hall meeting hosted by ABC News, he said one could be available in three to four weeks.
Dr. Redfields timeline is consistent with the best guess estimates from other vaccine experts, who say that the general public wont have access to the vaccine until February at the very earliest, and possibly more like July or August.
Of the three companies with vaccines in late-stage clinical trials in the United States, just one Pfizer has said that it could have initial results by the end of October. The other two companies, Moderna and AstraZeneca, have been more vague, saying only that they hope for results before the end of the year. If a coronavirus vaccine were to show results this year, it would shatter the previous record of four years for the development of a new vaccine.
Dr. Paul Offit, a professor at the University of Pennsylvania and a member of the Food and Drug Administrations vaccine advisory panel, was skeptical that Pfizer could be so sure of its timeline. I think its irresponsible they dont know, he said. I think the more responsible answer is, Hopefully, well know something by the beginning of next year. That would seem to me to be the most likely scenario.
Modernas top executives said in interviews this week that they could have initial results by November. But a trial blueprint the company released on Thursday indicated an even longer timeline, suggesting that the first analysis of the trial data may not be conducted until late December, and that there may not be enough information then to determine whether the vaccine works. Later analyses, projected for March and May, are more likely to provide an answer, the company said in its blueprint. (A company spokesman said the November estimate is an updated assessment of what was in the blueprint.)
AstraZenecas timeline is also in question after it halted global trials this month because of a participant who had developed severe neurological symptoms after receiving the experimental vaccine. The company has not released details about the medical condition of the person, nor has it said whether the reaction was because of the vaccine. The trials have since resumed in the United Kingdom and in Brazil, but not in the United States, where it has been paused since Sept. 6.
While clinical trials are underway, independent panels of experts periodically check in on the data. If the vaccine shows signs that it is extremely effective, the board could decide it would be unethical to continue the trial and keep giving some participants a placebo. This outside panel could also ask a company to stop a trial if it was not preventing Covid-19 cases, or if there were serious safety concerns.
Whether the vaccine is effective is determined by comparing how many people in each group the vaccine group and the placebo group develop the disease. If many more people in the placebo group get infected, that means the vaccine works. As a result, the trials speed is determined by how fast the virus is spreading in the communities where trials are underway. Organizers try to guess where infections are on the rise and set up trials there, but in a fast-moving pandemic, thats not always easy.
Trial pauses for safety reasons like the one recently announced by AstraZeneca could also slow down the timeline, even if the safety problems are ultimately found to be unrelated to the vaccine.
Once the results are available, the Food and Drug Administration will review the data and either issue an emergency authorization most likely for specific, high-risk groups of people like health care workers or a broader approval for commercial licensure. Either way, the agency has said that it will consult with an advisory board of experts before making a decision.
Companies have been in contact with F.D.A. officials all along the way, and many experts predict that the agency will be able to approve an emergency authorization within days, if the results are clear enough.
The best-guess range from scientists, investors and federal health officials is the first half of next year.
Even if one of the front-runners gets an answer about its vaccine this year, too few vaccines will have been produced to distribute them widely to the public. The head of Operation Warp Speed, Dr. Moncef Slaoui, told NPR that he estimated about 20 to 30 million doses of a vaccine would be ready by the end of the year, far short of the 100 million doses that Mr. Trump said Wednesday. (The front-runner vaccines all require two doses, given several weeks apart, further complicating the process.)
Dr. Slaoui also recently said that Americans would most likely not be widely vaccinated until the middle of 2021, and that the chance of having a vaccine by October or November was extremely unlikely.
The first few months of a vaccines availability will limit access to high-risk groups like older people or health care workers and police officers.
Peter Lurie, president of the Center for Science in the Public Interest and a former F.D.A. official, said he thought it was not unreasonable to expect that the first batches for high priority groups could be ready by February if everything lines up. And the lesson of drug development is that everything hardly ever all lines up.
Earlier this month, the C.D.C. told public health agencies that two million doses of a vaccine might be available by the end of October, with 10 to 20 million doses possibly available by November, and 20 to 30 million by the end of December.
In a briefing for reporters Wednesday, officials with Operation Warp Speed described the first few months of a vaccines availability as a constrained phase when it would be available only to high-priority groups.
Those groups alone include millions of people. At a recent meeting of the Advisory Committee on Immunization Practices of the C.D.C., an agency official presented a slide showing that in the United States, there are as many as 20 million health care workers, up to 80 million essential workers and about 53 million people older than 65. Each of those people would need two doses of the vaccine for it to be effective.
For everyone else, the timing depends on the speed of manufacturing and distribution, and a willingness by the public to actually get vaccinated.
In the best-case scenario, additional vaccines could become available to the public early next year. Johnson & Johnson has said it expected to begin late-stage trials of its vaccine this month, and another company, Novavax, could begin its trial soon.
Stphane Bancel, the chief executive of Moderna, said in an interview Wednesday that he expected a global shortage of vaccines well into next year. In the first half of next year, at least maybe until Labor Day next year, I anticipate that the world is going to be massively supply-constrained, meaning not enough vaccine to vaccinate everybody, Mr. Bancel said.
And thats assuming that everyone wants to take a vaccine. Recent polls have shown that is not necessarily the case, especially if the vaccine is seen to have been rushed to market for political reasons.
Carl Zimmer contributed reporting.
After months of bleak figures and forecasts, California now appears to be riding a wave of success beating back the coronavirus as officials express cautious optimism about what is next for the state.
Hospitals across the state are treating the fewest patients with COVID-19 since April. The percentage of tests coming back positive for the virus is lower than ever, proof that the state has reined in a massive surge that began this summer.
We are turning the corner, said Gov. Gavin Newsom in a news conference Wednesday as he listed multiple coronavirus metrics now lower than what weve seen in a number of months.
But these signs of progress also bring concerns that it could be erased. Many businesses are pushing for a faster reopening timeline, including Disneyland, Universal Studios and other theme parks, which wrote a letter to Newsom this week urging him to quickly issue guidelines so they can start allowing visitors again. Also this week, a group of nearly 300 fitness centers filed suit against the governor protesting their extended closure.
Experts fear that reopenings could coincide with flu season as well as with people becoming more complacent in their day-to-day lives, wearing masks less or choosing to attend gatherings likely to spread the virus. Such loosening happened before, in late May and June, and there is no reason it would play out differently this time, they say.
The virus is the same. These numbers we generate are markers of how efficiently were avoiding the virus, said UC San Francisco epidemiologist Dr. George Rutherford. Were not doing anything to the virus except avoiding it.
Ideally, there is a delicate balance that can be struck, with eased restrictions that cause only a slight increase in case numbers that dont overwhelm the healthcare system or lead to hundreds of deaths. But California failed in its first attempt, so the question now is whether it can pull it off this time.
In recent weeks, as much of the states attention has turned to devastating wildfires, significant gains have been made against COVID-19. Daily case numbers have dropped from more than 10,000 a day a few months ago to fewer than 3,000. The number of people hospitalized with COVID has shrunk from a peak of 7,170 in late July to 2,821 on Tuesday, according to the California Department of Public Health.
This is all good news, said UCLA epidemiologist Dr. Timothy Brewer. Everything is moving in the right direction, so I would personally be positive.
Brewer attributed the progress to a combination of business closures, wearing masks, physical distancing, more testing and faster contact tracing. But he warned that if people socialized unsafely on Labor Day, the numbers could start heading in the opposite direction.
Both the Memorial Day and July Fourth holiday weekends proved to be breeding grounds for coronavirus as people used the time off to throw parties and share meals with friends and family. It will be a few weeks before the data show the complete picture of what happened during the holiday weekend, he said.
I think we have been, as a community, doing an excellent job, but fatigue does kick in, he said.
The trends could also change in the short term if evacuations from the wildfires have pushed people to stay with their friends or family, or in shelters where the virus could easily spread among people in close quarters.
Testing in some places, including Los Angeles County, has also been limited because of testing site closures because of extreme heat and hazardous air quality in recent days, which could also affect the numbers.
Assuming the numbers stay low, many counties could soon begin reopening businesses. State officials said Wednesday that they expect that several counties will get the green light next week to move into a less restrictive tier, which would allow more reopenings.
But it is reopenings that largely drove the surge earlier this summer, experts say. As cases skyrocketed in July, Newsom was forced to close bars, zoos and museums as well as indoor dining statewide to curb the spread. Some counties, including L.A. and Orange, were also forced to close gyms, houses of worship, hair salons and malls.
Though the standards for opening in May were smart and well-crafted, the shortcoming was not hard-wiring those or following them diligently, which allowed reopenings to happen too quickly, said USC epidemiologist Dr. Neha Nanda.
In early summer, counties were allowed to ask for exemptions to the criteria that had been set, and often opened multiple sectors at once. In a single week in May, L.A. County officials opened restaurants for indoor dining, barber shops and hair salons, places of worship, in-store shopping at retail stores and malls, drive-in movie theaters and flea markets.
Obviously, we learned a lesson, Nanda said.
Now Newsom is mandating that counties follow a step-by-step plan, spending at least three weeks in each tier. To move into a less restrictive tier, counties must meet the criteria for two weeks straight. If a county moves into a new tier but then fails to meet the criteria, it will be bumped back down, according to Newsoms plan.
On Wednesday, Dr. Mark Ghaly, California Health and Human Services secretary, said that San Diego County, one of a few counties in Southern California to move into a tier that allows indoor dining, movie theaters and gyms, appeared to be failing to meet the standard required to stay in that tier.
He said that if the numbers persist, the county could be forced to close those businesses until the numbers improve.
If thats what the data shows, thats what the state is going to expect, Ghaly said. Were reaching levels of transmission that are lower than weve seen in many months, but we still need to continue to keep our guard up.
Ghaly said hospitals need to keep their coronavirus numbers low to prepare for winter and the flu season, which could fill hospital beds. In the coming days, the state will provide an update about theme parks and other sectors looking to reopen, Newsom said.
The logic behind the reopenings is not that the threat of coronavirus has vanished, but that some things can be open because they become less risky as the spread of the virus falls. For example, if everyone has COVID-19 in a community, then going to a restaurant becomes very dangerous. If only one out of 1,000 people is infected with the virus, the risk drops.
Thats the balance that counties will be trying to achieve over the next months: keeping the numbers low enough so that the risk of doing activities doesnt skyrocket. No one yet knows exactly how to strike that balance, and the stakes are high, experts say.
As long as community transmission exists, as long as its higher than zero, it can come back, Brewer said.
Times staff writer Iris Lee contributed to this report.
That will not happen soon, Mr. Gates conceded. The Trump administration has publicly refused to join the international collaborative agreement known as Covax, under which the World Health Organization; GAVI, the Vaccine Alliance; and the Coalition for Epidemic Preparedness Innovations have joined forces to make sure both rich and poor countries receive new coronavirus vaccines simultaneously.
Instead, Operation Warp Speed, the Trump administration's unilateral effort to fast-track vaccine development, has paid out $11 billion to six vaccine companies in return for ensuring that at least 100 million doses from each company, and options for millions more, are exclusively earmarked for the United States.
Although that position looks selfish, Mr. Gates said, he did not feel it was unjustified. Realistically, he said, Youre not going to succeed in getting the U.S. to treat itself as just a random 5 percent of the worlds population. American taxpayers, he noted, have paid two-thirds of the costs of the clinical trials and of manufacturing doses even before the trials end.
Absent that money, the only available vaccines would be those from Russia or China, which Mr. Gates considered untested and potentially weak. You cant call up Johnson & Johnson or AstraZeneca and say, Hey, heres a chance to lose $500 million.
If just three of the several vaccines that the United States is backing succeed, he said, the country would have more doses than it could use, and the rest could be shared with the world.
Also, Mr. Gates said he expected that by early next year, regardless of who wins the presidential election, the United States would come around to paying much of the estimated $4 billion needed to get vaccines to all the worlds poor.
He noted that Congress had repeatedly kept funds for AIDS, malaria and childhood vaccines in the foreign aid budget, despite numerous attempts by the White House over the past decade to slash those items; the programs are popular both with liberals and Christian conservatives.
Ortiz told New England Sports Network (NESN) announcers during Friday's Major League Baseball game between the Boston Red Sox and New York Yankees.
"Yeah, man, I just got it. I just had my last test yesterday. Thank God I tested negative," Ortiz said, adding that he was asymptomatic so he didn't struggle too badly.
"My brother had it really bad, he had to be in the hospital for about a week. He ended up losing like 25 pounds and, man, this is no joke," he said. "You don't realize how crazy this is until it hits home."
CNN's Jill Martin contributed to this report.
A growing number of cities in France are experiencing a worrying spread of the coronavirus and will have to enact new restrictions on public gatherings, the French health minister said on Thursday as he urged people to reduce their social contacts.
Olivier Vran, the minister, said at a news conference that local authorities in the cities of Lyon and Nice plan to tighten restrictions in the coming days, and he warned that other cities like Paris, Dijon or Toulouse might have to do the same soon.
The epidemic is once again very active in our country, Mr. Vran said.
Frances rate per capita of new cases over the last seven days is currently one of the highest in Europe, with 91 cases per 100,000 residents, up from 10 at the end of July. Gatherings of family and friends had become massive vectors of infections, Mr. Vran said.
In cities like Marseille and Bordeaux where the number of cases has surged the most, and where authorities had limited public gatherings to 10 people last week Mr. Vran said authorities might have to close bars and restaurants or ban gatherings completely.
Mr. Vran said that France had carried out over 1.2 million tests over the past week, but he acknowledged that massive demand had led to long lines and growing waiting times. Hundreds of medical lab workers even went on strike on Thursday over strained working conditions because of the overwhelming demand. Mr. Vran said the authorities were improving the process, while working on rolling out faster antibody tests and greenlighting saliva tests.
Mr. Vran also said that the authorities were able to monitor the pandemic much more closely than they could in the spring and that doctors have improved at treating severe cases of the virus.
We are not fighting with the same weapons and we know our opponent better, Mr. Vran said.
Reporting was contributed by Peter Baker, Aurelien Breeden, Luke Broadwater, Nick Bruce, Emily Cochrane, Stacy Cowley, Hana de Goeij, Elizabeth Dias, Sydney Ember, Nicholas Fandos, Emma G. Fitzsimmons, Jeffrey Gettleman, Denise Grady, Anemona Hartocollis, Jan Hoffman, Mike Ives, Jennifer Jett, Apoorva Mandavilli, Alex Marshall, Claire Cain Miller, David Montgomery, Claire Moses, Roni Caryn Rabin, Livia Albeck-Ripka, Anna Schaverien, Nelson D. Schwartz, Christopher F. Schuetze, Michael D. Shear, Eliza Shapiro, Daniel E. Slotnik, Mitch Smith, Kate Taylor, Katie Thomas, Glenn Thrush, Maria Varenikova, Lauren Wolfe and Sameer Yasir.
Some people, like Ms. Kim, have paid a price. Online harassers labeled her a cougar, suggesting she used sex to proselytize to a younger man. Others said that, should she get pregnant, the infant should undergo a paternity test. Officials in the city of Busan debunked the rumors, but they continued to spread online.
Once discharged, she filed complaints with a major web portal to remove the fake content. But after trying to hound dozens of blogs, she gave up. There were too many of them, she said.
The global fight against the pandemic has raised privacy concerns across countries. Governments, including those of Italy, Israel and Singapore, have used cellphone data to track potentially infected people and their contacts. China has employed mobile phone apps with little disclosure about how they track people. Venezuela has urged neighbors to turn each other in.
South Korea, an intensely connected country where nearly everyone totes a smartphone, has taken those efforts a step beyond. In addition to making some personal data public, the authorities sometimes use it to send text messages to people whose cellular data history indicates they were in proximity to an infected person. Other than China, South Korea is virtually the only country in the world whose government has the power to collect such data at will during an epidemic, according to Prof. Park.
In the initial desperate months of the pandemic, government websites uploaded a detailed sketch of each patients daily life until they were diagnosed and isolated. The government did not reveal patients names but sometimes released revealing data such as their addresses and employers.
That rush of data fed a growing culture of online harassment. In South Korea, doxxing digging up and publishing malicious personal information had already been a growing problem, often cited in the recent suicides of K-pop stars.
Restaurants visited by patients were sometimes treated as if they were cursed. Citing one female patients frequent visits to karaoke parlors, online trolls claimed that she must be a prostitute. Gay South Koreans began to fear being outed, prompting the government to promise them anonymity in testing after an outbreak erupted at a gay club in Seoul in May.
In the early weeks of the pandemic, before coronavirus cases crushed hospitals in New York and spiked in other states, Dr. Rebecca Shadowen asked her friends a question on Facebook.
"If you could save the life of another person without harming your own, would you?" Shadowen, an infectious disease specialist in Kentucky, posted on March 13.
From the start, the doctor advocated for social distancing, hand-washing and mask-wearing, and she hoped her community of Bowling Green could become a model for the rest of her state, where residents sparred over stay-at-home orders and challenged Kentucky's mask mandate in the courts.
In May, while offering her expertise as a member of the Bowling Green-Warren County Coronavirus Workgroup, Shadowen fell ill. At first, she complained of feeling tired, but on the night she was taken to the hospital, she woke up saying she was short of breath, her husband, David, said.
She toggled between local hospitals for the next four months, at times being placed on a ventilator and in the intensive care unit. During weeks she regained her strength, she was lucid enough to continue working from her hospital bed and sharing what she knew about a virus that was ravaging her body in unexpected ways.
"There were multiple times she thought she was turning the corner and we thought she was on the road to recovery," David Shadowen, who is also a doctor, said.
But after dealing with complications from the virus, including abdominal bleeding and weakened lungs, Shadowen died on Sept. 11 surrounded by her husband and two adult children. She was 62.
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David and Rebecca Shadowen were college sweethearts at Western Kentucky University, and together they enrolled at the University of Louisville School of Medicine. Shadowen went on to specialize in infectious diseases, including HIV/AIDS and Lyme disease, and, this year, Covid-19.
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She worked out of the Medical Center at Bowling Green, where colleagues leaned on her more than three decades of medical knowledge and she enjoyed helping medical students and residents.
Even after she became sick, she continued on the county's coronavirus workgroup, urging the need for a local mask ordinance. When she learned something especially important, she would send out a group text, sometimes in the middle of the night. She believed the simple act of wearing a mask could stop the spread of the disease.
"She'd say, 'Look folks, this isn't politics. This is science,'" said Dennis Chaney, the Medical Center's vice president of ancillary services. "I heard her say that many times."
After her death, Kentucky Gov. Andy Beshear tweeted his praise of Shadowen as being a "front line hero."
David Shadowen believes his wife contracted Covid-19 the way he and their daughter, Kathryn, did: from a home health aide who had infected his elderly mother.
But the Shadowens' son, Jesse, did not test positive for the virus. David Shadowen said he and his daughter had mild symptoms from Covid-19, which made Shadowen's debilitating struggle all the more frustrating.
Before she got sick, Shadowen went to her church, empty during the pandemic, and prayed in a pew. She was conflicted, wrestling with all the risks and her responsibilities as a health care worker, said Adam Shourds, senior pastor at Broadway United Methodist Church.
"She said, 'We all have a responsibility,'" Shourds recalled. "'My role is important, but it's no more important than anyone else's.'"
He said Shadowen texted him the day she was scheduled to be placed on a ventilator: "I'm going on the vent today. This is not the end."
She wasn't bitter, she said, and used her last few months to understand everything she could about the coronavirus.
"She fought the virus harder than anybody because she knew how," Shourds said.
During Shadowen's visitation and funeral service this week, former patients and family members of patients approached David Shadowen and his children.
Many told them the same thing: "'I'm alive today because she saved my life,' or 'She saved my mother's life,'" David Shadowen said.
He described her as the glue that held their household together, working long shifts, taking care of the finances, making meals and shuttling the kids between soccer practice and ballet, all without breaking a sweat.
She embodied so much, David Shadowen said: a person of faith, a mother, a wife and a doctor.
Their daughter, Kathryn, 23, said there were countless times when they were out in public that someone would stop her mother to thank her for what she did.
"It was really powerful to be the kid of someone who saved people," she said. "A lot of kids think of their parents as heroes. Mine actually was."
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If you want to know whats happening with business reopenings during the pandemic in Texas, watch your local hospital.
Gov. Greg Abbott said Thursday that COVID-19 hospitalizations are the most important number in his decision-making about how many people to allow in restaurants and other businesses in the state.
He made the announcement a few days after the states health department rejiggered its calculations of positivity rates a measure of how many people tested for COVID-19 are infected, and the governors old favorite metric.
Instead of concentrating on the spread of the virus, the state is now concentrating on the severity of the spread. Its not primarily about how many Texans are infected, but about how many of them get sick enough to go to the hospital.
As long as that COVID-19 hospitalization rate the percentage of occupied hospital beds that are occupied by coronavirus patients remains below 15% for at least seven days in a row, the governor said Thursday, businesses dependent on crowds can admit more customers. That excludes only three of the states Trauma Service Areas Laredo, Rio Grande Valley and Victoria which means that most of the states businesses will be on longer leashes starting Monday.
What businesses? The governor specified restaurants, retail stores, office buildings, manufacturing facilities, gyms and exercise facilities, museums, and libraries. Elective surgeries were reauthorized. Bars, which remain closed unless theyve transformed themselves into restaurants, didnt make the cut.
Texas schools and colleges remain as they were, most operating a mix of virtual and in-person classes. Whether and how much those reopenings have sped the spread of the coronavirus is still not clear.
Abbott said hospitalizations are the primary metric, but not the only one. Hospitalization rates will tell you what share of the people in Texas hospitals by district are coronavirus patients.
But the governors new standard is a lagging indicator of COVID-19 cases. Epidemiologists say it takes nine to 16 days to see increases in infections from social interactions and another five to seven days to see changes in the number of people hospitalized. That means someone infected at a particular social gathering might not show up at the hospital for two to three weeks.
The hospitalization number misses a lot about how things are going. It wont tell you how many people have died and whether deaths are rising or falling. It wont reveal the spread of the virus, whether case numbers are going up or down, and it wont provide any information about how many infected Texans have symptoms and how many are asymptomatic. It doesnt tell you anything about how a patient contracted the disease.
One piece of news got buried in state leaders conversation about metrics and reopenings, and thats because they didnt say it directly: This amounts to a declaration that Junes coronavirus numbers arent as scary as they seemed in June, when attention was more on the rising numbers than on the numbers themselves.
After a summer spike in the coronavirus in Texas that followed Abbotts first round of reopenings whether you measure that rise by positivity rates, hospitalizations, deaths or something else state leaders have adopted June numbers that revealed that surge as normal enough to justify more social activity.
The trends are encouraging. Just look at The Texas Tribunes coronavirus tracker: On Wednesday, the number of people hospitalized for COVID-19 was down 355 from the previous week to a number not seen since mid-June, and 5.5% of occupied hospital beds were being used by people with the virus, at June levels and down from a high of almost 20%.
Those are less ghastly numbers than the July and August tallies, but thats no consolation to the Texans wrestling with the virus or at risk of being infected. The trends might even be reason for optimism, but not too much: Abbott was emphatic about the continuing need for masks, social distancing and hand washing.
But with those numbers on the status board, state officials have set their acceptable level of ongoing damage from the pandemic the numbers of new cases, hospitalizations and deaths that justify looser restrictions on people getting together in large groups for business and commerce, sporting events, and in-person public and higher education.
Watch the hospitals. In two or three weeks, well know how this new standard is working out.
Photo by KPBS Staff
Above: File photo of a banner in the Gaslamp Quarter showing restaurant workers pledging to keep customers safe during the pandemic, Sept. 17, 2020.
San Diego County health officials have reported 174 new COVID-19 infections and six deaths tied to the illness, raising the region's totals to 43,619 cases and 754 deaths as the county waits to see if it will have to roll back business openings next week.
Of the 9,495 tests reported Thursday, just 2% returned positive potentially a good sign as San Diego County appears poised to regress into the state's most restrictive public health tier due to increasing COVID-19 numbers by Tuesday, when state data is released.
However, as the data runs on a seven-day lag, it may be too little, too late to prevent moving to a more restrictive tier with Gov. Gavin Newsom rejecting a county effort Wednesday to discount the more than 700 positive tests recorded by San Diego State University since the semester began.
The county will find out Tuesday if it will slip back to the "purple" tier of the state's coronavirus reopening roadmap. If so, it would likely shutter indoor operations for restaurants, houses of worship and gyms, limit retail businesses to just 25% capacity and have major impacts on indoor business for most other industries until the county can improve its numbers.
RELATED: Governor Won't Exclude SDSU COVID-19 Cases From County Figures
Should the county be placed in that tier, it would have to wait a minimum of three weeks before moving back to less restrictive tiers.
Data released this week showed one of the two metrics the state monitors being flagged as "widespread."
SDSU is playing an outsized role in the county's 7.9 new daily cases per 100,000 population, the San Diego Public Health Officer, Dr. Wilma Wooten, said Tuesday. The positive testing percentage for the county is 4.5%, good enough for the "orange" tier of the state's four-tier reopening plan.
Should the county have a case rate higher than 7 next week, it could be moved into the purple tier the most restrictive. However, if the numbers from the university were removed from the equation, San Diego County would suddenly drop below the mark to remain in the "red" tier.
County Supervisor Greg Cox said Wednesday he was writing a letter to Newsom to ask for considerations in excluding SDSU cases or for other alternatives to avoid rolling back business openings.
But Newsom said he isn't inclined to overlook the SDSU cases. The governor said the county can't separate cases at a university because it goes to "what a community by definition is and that is integrated individuals, and as a consequence, you can't isolate as if it's on an island, a campus community that is part of the larger community. So the answer is 'No."'
County Supervisor Nathan Fletcher said it was a difficult decision by Newsom, but the county had to do the best it could from here on out.
"We are in a battle against the coronavirus, not the state of California," Fletcher said Thursday. "Their public health experts looked at the situation in San Diego closely and made a decision that I understand and respect."
According to Dr. Eric McDonald, the county's epidemiology expert, the vast majority of those students live in the 92115 ZIP Code around the university many just a few blocks off campus. He said that while it is true they are technically in the community at large, they are close enough to campus to make the county's request to exclude those positive tests from the countywide number a realistic endeavor.
SDSU reported 17 COVID-19 cases Thursday.
The university has not received any reports of faculty or staff who have tested positive, SDSU health officials said, nor have any cases been traced to classroom or research settings.
Four women and two men died between Sept. 11 and Sept. 15, and their ages ranged from early 60s to mid-90s. All had underlying medical issues.
Of the total cases, 3,366 or 7.7% have been hospitalized, and 791 or 1.8% have spent at least some time in intensive care units.
County health officials reported six new community outbreaks on Thursday. In the previous seven days, 20 community outbreaks were confirmed. Two of the new outbreaks were in business settings, one in a restaurant, one in a food processing setting, one in a residence and one in a grocery setting.
The number of community outbreaks remains above the county's goal of fewer than seven in a seven-day span. A community setting outbreak is defined as three or more COVID-19 cases originating in the same setting and impacting people of different households in the past 14 days.
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We were extremely saddened to learn of the loss of the states first adolescent with COVID-19. On behalf of all of us at VDH, I extend sincere condolences to the teenagers family and loved ones, said State Health Commissioner M. Norman Oliver, M.D., M.A. No age group is immune from the devastating impact of the COVID-19 pandemic, and this unfortunate event, along with the increasing numbers of coronavirus cases we are seeing in some areas of the Commonwealth, is a reminder that we all need to do our part to help slow the spread of virus in the community.
