California had the worst coronavirus infection rate in the country last week.
Now Arizona has claimed the grim distinction, with one university health expert calling it ‘the focal point of the world’.
The New York Times coronavirus tracker listed Arizona’s daily rate for the previous week as 124 per 100,000 people on Thursday, followed by California at 99. On December 28, California’s rate was still 99.7, but Arizona’s was lower at 84.9, showing an increase of almost 50% in ten days.
The states have followed a similar path in the upswing since November, with California peaking earlier. But the nationwide approach to COVID-19 restrictions and mandates for California and Arizona was quite different, especially in the current boom.
Why are the two West Coast states struggling so much?
Experts point to many of the same problems in both places, including the fallout from the Thanksgiving and Christmas holidays and fatigue in the pandemic. The virus has affected extraordinary communities of color and low-income populations in both states, especially in Latino and American.
The Bay Area and San Francisco have taken a very different path compared to Arizona and its largest province, Maricopa. Since November, Maricopa has had a much higher infection rate. Access to ICUs and deaths per capita were higher in Arizona, with deaths in Maricopa rising above the Bay and San Francisco.
Take a closer look at the boom in Arizona and California:
ARIZONA
The state saw nearly 4,000 cases a day in the summer boom that began in early June. Now Arizona sees 8,000 a day. Deaths are close to 10,000, with a record 297 announced Thursday.
Maricopa County, home of the capital Phoenix, has the largest population and most cases in the state. But the current areas hardest hit are Yuma and Santa Cruz provinces, both on the Mexican border with large Latino populations, and Navajo and Apache provinces with predominantly American Indian communities. The coronavirus has plagued the Navajo nation, forcing an extensive closure.
Joe Gerald, a professor of public health policy and management at the University of Arizona, said the state pushed the curve in the summer with restrictions on businesses, including restaurants, bars, gyms, cinemas and water parks.
“Since the venues of the places are at the highest risk, it really helped,” he said. “Between the end of June and the end of August, we were on a downward trajectory and it actually went pretty well.”
By the end of August, Gerald said, the state’s three major universities had brought students back, leading to outbreaks. Most businesses have also reopened. Infections increased widely in the entire population and affected all ages.
“These outbreaks have continued unabated since mid to late September to where we really are in a terrible situation,” Gerald said. ‘Our daily number of cases has never been higher, hospitals are at their capacity. … And while we have not yet reached the same levels of overcrowding as we see in media reports in LA County hospitals, I do not think we are that far behind. ‘
More than 4,600 virus patients were hospitalized, and menus were postponed. State data showed that 7% of ICU beds are available on Tuesday.
In early December, Governor Doug Ducey announced that businesses were being warned of violating protocols, and a second complaint could lead to closure. He called on local jurisdictions to extend security measures for events with 50 or more people, but did not ban them. This week, the governor came under fire after a video of his son appeared among maskless parties.
“The policy across the country has not changed, which has been very upsetting to me and my colleagues for public health,” Gerald said. ‘Public health officials and heads of hospital systems have called for tougher measures, but the Ducey government has been reluctant to change course. … It’s literally the Wild West in Arizona, and every man, woman and child basically takes care of themselves. ‘
Gerald refers to a letter from health care and hospital leaders asked in mid-December for a break over the reopening of businesses. Last weekend, the state superintendent appealed to the governor to teach schools remotely for two weeks. So far, Ducey has not gone beyond the previous measures.
Arizona is one of about a dozen states without a mask mandate. The pressure from officials during the summer led the governor to allow municipalities to draw up their own mask ordinances.
“I think Arizona will see a very bad January, probably worse than December,” Gerald said. ‘We now see more than 500 deaths a week and probably go to the 600 to 700 deaths. And these are just the ones we know about. … It is difficult for us to make COVID tangible and conspicuous to the general public. It’s there, but hidden. ‘
CALIFORNIA
California Gov. Newsom on Monday announced more than 70,000 new cases of coronavirus, the state’s highest in a single day.
“We are going in on what we expect – the boom on top of a boom – is going to put a lot of pressure on (intensive care units) coming out of the holidays,” he said.
California has relatively strict coronavirus mandates throughout the pandemic. George Rutherford, an expert on infectious diseases at UCSF, said that while these restrictions were helpful early on, not enough is being done during the worst of the boom.
“Our restrictions are mandatory, but not necessarily enforced, which is a problem,” he said. “You do not need so many people who do not comply.”
Challenges by groups across the state have caused uproar, including continued protests against health guidelines in Huntington Beach, and restaurant owners refusing to close for personal meals. This week, anti-maskers storm a Trader Joe’s in Fresno and a mall in Los Angeles.
Rutherford pointed to states, including New York, that have strong constraints but also strong enforcement. In California, it is up to each jurisdiction to punish offenders. Some provinces have hotlines for complaints and pay fines to businesses or individuals who do not wear masks.
Brad Pollock, co-dean of public health sciences at the UC Davis School of Medicine, said California’s key drivers over the past few weeks appear to be linked to small gatherings where households mix. Thanksgiving was the first impulse, and now nails from Christmas and New Year’s Eve.
Southern California has the current increase in the state, with more than 190,000 cases in Los Angeles County alone in the past two weeks. The area has 0% ICU capacity, with hospitals being forced to treat patients in vestibules, corridors and gift shops, and touching oxygen. Ambulances were told not to bring patients to hospitals if they were unlikely to survive.
Many of the essential staff members in Southern California were particularly vulnerable, with many in manufacturing and agricultural work, and in densely populated areas.
“Most of us feel it’s population density,” Pollock said. ‘It’s just as much denser than the rest of the state. San Francisco is super dense, but it’s a much smaller area. Many people are part of the Latino population and live in multi-generation households. ”
Those who work in frontlines with a high risk of exposure can bring the virus home and spread it to their entire households. In the farthest southern provinces – Imperial and San Diego – many people cross the border to work or return home, which can spread the virus further.
Morgues in San Diego County overflowed at the end of the year. According to the province, in recent weeks, cases have mostly been exposed to exposure to the community, especially in workplaces and shops, as well as in homes and exposure to travel. The new, more transmissible COVID-19 variant, recently discovered in a number of states, has led to dozens of cases in San Diego County.
Many of the same problems occur in the San Joaquin Valley region, where ICU capacity is also at 0%. A significant portion of the population is Latino, and many are farm workers or need work. The high cost of living in California has forced many low-wage workers to live under pressure.
The Bay of Plenty seven-day rate per 100,000 has hovered in the high 40s and low 50s over the past few weeks, much lower than the state rate. Experts said that compliance with mask mandates and other health orders in the region and that they have a general trust in public health officials.
San Francisco has one of the lowest rates, at 32.4 per 100,000, while the Marin County rate is 34.4. Both have risen significantly over the past few months, but have remained much lower than the other Bay Area provinces.
San Francisco has long acknowledged that it took the precautionary approach during the pandemic by instituting an early shelter-in-place order, masking mandate and limiting reopening, even when the fall in the fall was extremely low. wash. Many residents who work technically or work for other large enterprises work remotely.
Marin County’s leading health official said the suburban, usually health-oriented population is older and more affluent, can mostly stay at home or work there. He also acknowledges the provinces and community organizations to reduce the spread in lower-income communities.
Bay Area cases are still the highest in the provinces of Santa Clara and Solano. The daily rates over the past week have approached or exceeded 80 per 100,000 in both provinces. The Solano County health official blamed the high incidence of holiday and weekend gatherings, including some where those who knew they were sick still met with people outside their households. The health officials of the province of Santa Clara attribute the increase in pandemic fatigue and color communities that are excessively affected.
In the far north of California, ICU capacity is much higher at 24.4%. It is the only non – state-owned area that is activated once the ICU availability drops below 15%.
Most counties in the Northern California region fell lower. Trinity County has the lowest with 5.3 per 100,000. Lassen County’s much higher rate of 72.2 can mostly be attributed to prisons, with more than 1,000 infections associated with correctional facilities.
Kellie Hwang and Mike Massa are writers of San Francisco Chronicle staff. Email: [email protected], [email protected]