California hit another grim milestone in the coronavirus outbreak this week, with its largest single-day number of new cases Tuesday — a statewide total of 2,546 COVID-19 infections coming amid torrid debate over whether it’s safe to start lifting economically crippling lock-downs.
But although the Golden State topped a daily high from more than a week earlier, Tuesday’s new high number of daily cases doesn’t necessarily reflect a rapidly expanding contagion. It may simply be the result of the state’s push to expand testing.
Gov. Gavin Newsom’s administration Wednesday would not comment on the figure, indicating a need to see more days worth of figures before drawing conclusions.
But Newsom himself in his daily news briefing said in regard to the number of positive cases that “you’re going to hear a lot about case rates — the percentage of people testing positive versus the number of people testing positive” as testing increases.
Tuesday’s spike in cases also may reflect a reporting lag over the weekend, as California had 1,241 new cases reported Monday and 1,196 as of 3 p.m. Wednesday. Before Tuesday, the highest single-day case total was 2,383 on April 29. The Bay Area News Group and other news organizations compile the totals directly from county health department reports, which are updated more often than those reported by the state each day.
Newsom also mentioned that other data are more encouraging. One key metric the state is tracking to gauge whether it’s time to ease up on the statewide restrictions is hospitalizations of both confirmed and suspected COVID-19 patients. They have leveled off, totaling 4,681 Wednesday. Intensive-care cases also have plateaued.
And the daily number of COVID-19 fatalities has been trending downward, from a high of 118 April 22. After a spike of 94 cases Tuesday, deaths Wednesday dropped to 66.
One number the state wants to see rise is the number of tests conducted each day.
Dr. Robert Siegel, a professor of microbiology and immunology at Stanford University, said the increase in testing and other factors could have played a role in Tuesday’s spike in new cases. After a slow start, total statewide tests for COVID-19 have slowly risen, reaching more than 809,000 Wednesday, a 3.7% increase.
“The amount of testing continues to go up, and that reveals more infected individuals,” Siegel said.
There are likely to be more positive results, he said, because testing has increased for particular groups such as hospital staff and employees and residents of long-term care facilities where there is higher risk of exposure, there are likely to be more positive results.
“Those are going to produce an arbitrarily high rate of positivity because there are more infections there,” Siegel said.
Newsom’s administration announced Wednesday an interactive website to help Californians find COVID-19 community testing sites near them by entering their location, address, city or zip code. It features an interactive map and users can schedule an appointment.
In addition to increased testing, statistician Nate Silver of FiveThirtyEight added that lags in reporting test results also can be a factor in daily spikes.
“If someone gets infected, it will likely take ~2 weeks before they get symptoms, get tested, and the test shows up in the data,” Silver said this week on Twitter.
Another mistake is not understanding lags in the data. If someone gets infected, it will likely take ~2 weeks before they get symptoms, get tested, and the test shows up in the data. Yet many articles assume that cases will *instantly* rise when regulations are changed.
— Nate Silver (@NateSilver538) May 5, 2020
Siegel said it takes an average five days after infection for a person to become symptomatic, and that patients typically don’t get tested until symptoms become severe.
“I don’t think everybody who first starts feeling funny is going to go out to get tested that day,” Siegel said. “It might be days after they first got sick.”
All of that means reopening will have to be carefully thought through, Siegel said.
“You can open up a lot of stuff if you do it very carefully,” Siegel said. “If we do it the wrong way, we’ll be right back where we started from.”
The governor said Wednesday the state is also busy monitoring the economic casualties of the pandemic.
Newsom announced an executive order extending worker’s compensation benefits to employees in essential jobs such as grocery stores and transit that have stayed open amid the lockdown if they fall ill with COVID-19.
Under the order, the state will provide benefits to health care, public safety and other front-line workers with the assumption that their infection happened while they were on the job. Those benefits will apply for workers infected since March 19, and will extend for 60 days after other state and federal benefits run out.
