Social distancing could be ‘lots more draconian,’ plus the state of coronavirus testing

Angelenos flooded to the beaches and hiking trails over the weekend. That led to closures of the boardwalk, parking lots by the beaches in Venice and Santa Monica, and parks and overlooks in the Santa Monica Mountains. 

LA Mayor Eric Garcetti implored Angelenos to do a better job at social distancing: “This weekend we saw images of too many people crowding beaches or canyons beyond their capacity. Too many people, too close together, too often. The longer we do that, the more people will get sick, and the more people will die. There’s no way to sugarcoat it.”

Meanwhile, President Trump has approved Governor Gavin Newsom’s request to declare a major disaster in California. Eight emergency FEMA mobile hospitals and roughly 2,000 beds are coming to the state. 

Trump has also been touting a drug typically used to treat malaria as a potential cure for COVID-19.

We talk about all this with George Rutherford, MD. He’s a professor of epidemiology at UC San Francisco and director of UCSF’s Prevention and Public Health Group.

KCRW: How effective are shelter-in-place and self-isolation measures (all voluntary)? 

We don't totally know yet, says Rutherford.

He points to data from Italy that compares two adjacent provinces (Loti and Bergamo) in the Lombardy region, near Milan. He says in Loti, where residents sheltered in place early, the number of cases is only one-fifth of that of Bergamo. 

“That's remarkable data that suggests this is really working. But we're looking at a couple of weeks worth of data to be able to say that,” he says. 

The Bay Area is in its eighth day of sheltering-in-place, whereas Southern California began that practice later. So would SoCal have more coronavirus cases? Rutherford says that would be a valid hypothesis, assuming that the virus was introduced to populations at the same time, which may or may not be the case. 

Social distancing isn’t uniform nationwide. In Florida, photos show people partying on beaches for spring break. Domestic air travel is still happening. How effective can our measures be if people from other places are still allowed to enter California? 

“I'm pretty confident that this is the right move. Could it be more draconian? Sure, it could be lots more draconian,” Rutherford responds.

He says consultants from Wuhan came into Italy, who said, “You guys just aren't doing this right. You need to shut transit. You need to not screw around and let people go out all the time or go out as much as they are. You’re really just talking grocery stores and pharmacies, period.”

Also, South Korea has been very aggressive about testing and quarantine. “At one point in time, when we tested something like 900 people in the United States -- in South Korea, they tested 170,000. Just to give you an idea of the orders of magnitude needed for that kind of response,” explains Rutherford. 

Rutherford says tests are coming online and will be easier to get in the U.S., but we’re not there yet. 

In China, most transmissions apparently happened in family clusters. If someone got sick, they weren’t allowed to go home, but were put in temporary hospitals. Should the U.S. do that?

“We don't have that kind of bed capacity here. And if we were going to do that, we would probably use it more restrictively, like for instance, first for people who are homeless, who really have no place to go. We don't have the beds to keep them in the hospital for an isolation period. If we could put them in a hotel, great, that's one thing we can do.

… Once somebody is noninfectious, or if they can be isolated within a house (if you have a big house for instance), fine, I think they can go home. 

But what we can't do is just keep them in the hospitals indefinitely -- because we're gonna need that space for other people,” says Rutherford.

President Trump is touting drugs that are used to treat malaria and lupus as a possible treatment or cure for coronavirus. What do you make of that? 

“Until this can be proven in a randomized controlled trial that they … don’t harm people, it's snake oil. People make claims about all sorts of stuff. And if this works, great, it’s a miracle. There's not a lot of it in the United States because we don't have a lot of malaria in the United States. … There are some harms that come with this drug if you have a specific enzyme defect, which is very common in people of Mediterranean ancestry. It can cause hemolytic anemia. … It's not completely foolproof, but we're certainly looking at it. 

… But lots of stuff looks like it has activity, and then we actually do the trials, it either doesn't work or does more harm than good. And that's what we need to know,” says Rutherford.

How long will this be an acute problem in the U.S.?

“If I had my crystal ball out, and got the Windex out and rubbed it up really good, we’re going to get over this hump here pretty quickly in California because we've moved to shelter-in-place. We'll get some additional benefit in the summertime,” he says. “What I'm worried about is the fall when people go back to school, and we're out of this period of intensive isolation and quarantine, and we're well beyond the shelter-in-place.”

--Written by Amy Ta, produced by Brian Hardzinski