'But we're not out of the woods yet,' Newsom says

In a press conference April 14, California Governor Gavin Newsom stopped short of giving a date when the current social distancing directive might be modified or lifted, but hinted he could make a decision around the first week in May – provided the state is seeing a continued decline in hospitalizations and ICU use and if workforce and infrastructure and personal protective needs are being met.

“Ask me the question then,” he said.

Newsom said by following state isolation guidelines, Californians have successfully bent the curve and prevented the worst-case scenario of a surge of COVID-19 cases that could potentially overwhelm the state’s medical system.

“Because you practiced physical distancing, the stay-at-home orders, you have bent the curve in the state of California. The models have changed because of your behavior,” he said.

Newsom noted however, that with a record number of deaths that day at 758 (an increase of 71 since the previous day) and “a modest increase in hospitalizations” the state is “not out of the woods yet.” On the hopeful side, the number of ICU beds declined modestly the day before, he added. The number of persons under investigation for exposure is also starting to decline.

Newsom hinted that changes to the current stay-at-home directive might eventually include expanding the definition of “essential” to include more workers and scale down the stay-at-home order.

Another important factor in making such decisions will be COVID-19 testing availability. Dr. Galli said that the state is beginning to move beyond making tests available to just the sickest people to testing frontline workers and healthcare workers, as well as expanding community testing sites across the state.

Newsom described the next phase of COVID-19 response as moving from preventing a surge to transitioning to suppression, “hopefully on our way into herd immunity and ultimately to a vaccine.”

He said he hopes the state to achieve herd immunity and a vaccine to be developed within the next year or so.

In a press conference lasting around an hour, Newsom laid out in detail the factors to be considered before the stay-at-home order is lifted, along with his ideas on how the crisis will likely be managed going forward.

Newsom described the next phase as “optimistic,” noting “we do see light at the end of the tunnel.”

He pointed out that once the stricter stay-at-home order is lifted, the next phase will encompass a new normal, complete with increased social distancing at schools, workplaces and other institutions. Newsom noted that going out to dinner, for example, might include servers wearing gloves, paper menus and tables more widely spaced.

“Normal it will not be, at least until we have herd immunity and we have a vaccine,” he said.

He also noted that when and if stay-at-home guidelines are lifted, large public gatherings will likely be banned until there is a vaccine and herd immunity has been achieved in the population.

“The prospect of mass gatherings is negligible at best until we get to herd immunity and we have a vaccine,” he said, particularly during June, July and August. He said this projection could change drastically if, for example, testing was available on a large scale.

Decisions about resuming school attendance are still being made.

Newsom said that decisions will be made based on, science and “public health not politics must be the guide. We must be open to argument.”

Factors weighing on the decision to re-open the state include the following: capacity to expand testing and to address tracing, tracking, isolation and quarantining of individuals; protecting the most vulnerable segments of the population; considering the ongoing needs of hospitals and alternative care delivery systems to function as well as meet the needs of potential surges; continuing to engage academia and research partners and those on the front lines; working toward heard immunity and a vaccine and “redrawing floor plans literally” for businesses to practice safe physical distancing.

Newsom said the state plans to “toggle from stricter to looser interventions back and forth as things change” and will have the capacity to reinstate stronger controls if necessary.

“There is no on-off switch here. It’s more like a dimmer that’s toggling back and forth between more restrictive and less restrictive measures,” he said.

Newsom and his advisors expressed concern about being prepared with medical support if infections flare up due to changes in stay-at-home strategies. Newsom also noted the state does not want to lift the directive prematurely, leading to an increase in infections.

“We’re not in a permanent state, as long as we don’t make the ultimate decision to pull back too soon,” he said.

They also talked about adding directives about face coverings as more people return to the public sphere.

Newsom also emphasized coordinating state decisions with local input, “Localism is determinative, we have a state vision but it will be realized at the local level,” he said.

Newsom also said he collaborated with and received input from governors from the states of Washington and Oregon. The three states issued a collective announcement April 13 that they are forming a Western States Pact and will work collectively in their response to the COVID-19 pandemic.

Newsom encouraged everyone to continue to follow the stay-at-home directives for the time being, to allow the curve to continue to flatten – hopefully leading to the state loosening the restrictions in the future.