COVID-19 cases are spiking in California and US, but not other countries

This week started with California reporting more than 6,000 new cases of coronavirus a day. That’s a record — double the average daily numbers from a couple of weeks ago. Despite early sheltering-at-home policies and the current statewide mask mandate, what happened? KCRW speaks with Dr. Edward Jones Lopez, infectious disease specialist and epidemiologist at USC.

KCRW: California was the first state to mandate stay-at-home orders, and it helped us flatten the curve. Are we reopening too quickly now?

Dr. Edward Jones Lopez: “That's the challenge. That's what is going on now in terms of what is the best way to reopen. New York, New Jersey, and other areas in that other side of the country will need to also navigate the reopening in the best way possible. 

What is very, very concerning in the U.S. in general is the opening is happening with spiking cases. That's very different than what's happening, for example, in Europe and in the Far East. 

Many countries have been able to reopen, if not at 100%, close to 100%. And they've not seen a spike in cases. That's very related to national leadership and supranational leadership in the case of Europe, and consistent messaging of doing certain things that we know work. That's what may be driving the increase in cases in a patchy format in the U.S.”

Local and state leaders can only do so much if the rest of the country is not doing the same thing. For example, if Gov. Gavin Newsom decided to shut down everything again, but Arizona and Texas did not, would that not go as far as you might hope? 

“Those are all the key questions. What I would say is we know there's been an explosion of research related to this disease in the last six months. So there's a fair number of things we do know already, and there's a few uncertainties still. 

The things we do know are that most of the transmission occurs in a congregated closed space and in the absence of masks. 

… Yesterday, there was [sic] almost 40,000 new cases reported in the U.S., and there were 4000 in Europe. In terms of populations, these are comparable. In terms of the history of the epidemic, it's also more or less comparable. So it's almost 10 times more cases as a country here than in Europe.

The only difference is not because of more vaccines, or more drugs, or anything else. It's really because people over there are doing things in a more or less homogeneous way. 

It's really about trying to not congregate, particularly in indoor situations and uniformly using masks. And just those two relatively simple things is [sic] probably responsible for the big differences in cases.”

Where do you think this is headed if California continues reopening like this?

“Dr. Fauci and others have mentioned it, and they're probably going to say it better than me. This is not looking good at all. We're really heading towards a situation where what happened in New York and New Jersey may start happening in different places in the country. Yesterday … [in] Houston for example, 97% of ICU beds are now occupied, and the number of cases is increasing. 

So it's not impossible that in Houston and Florida, it's something similar. Maybe not 97% occupancy rate, but not far away from that. And in both places and in other areas, cases are still increasing. Everything is dependent on the number of cases, because the proportion of severe cases and critical cases all depends on the number of cases. 

So it's very possible that things are going to get very, very bad in other areas of the country, despite knowing what happened in the northeast coast. 

California's still not quite there. And again, the early shutting has helped a lot. But the number of cases is increasing rapidly, and it's very likely that authorities will need to do something to decrease that trend again. 

The problem with shutting down is — as we all know now – it has a lot of consequences. Not only economic consequences, but also the psychological consequences. So it's not an easy decision.”

— Written by Erin Senne and Amy Ta, produced by Angie Perrin



  • Dr. Edward Jones Lopez - MD, MS, assistant professor of medicine at the Keck School of Medicine at University of Southern California; investigator of the AstraZeneca vaccine trial in the U.S.