Virus World

Public health officials Tuesday reported a 17% increase in active tuberculosis cases in San Diego County over the previous year. In 2023, 243 cases of TB were reported, exceeding the average of 205 cases in 2021 and 2022. Over the last 10 years, annual reported cases have ranged from a high of 264 in 2019 to a low of 193 in 2020. TB is passed through the air from person to person when someone who is sick with TB coughs, speaks, sings or breathes. Symptoms could include lasting cough, fever, night sweats and unexplained weight loss. "If you or a loved one have TB symptoms or think you may have been around someone with TB, it's important that you call your doctor or health care provider and get tested," said Dr. Wilma Wooten, county public health officer.

"We are seeing more cases of TB, not just in San Diego County, but around the state. We all need to be aware of the symptoms and take action quickly so that we can stop the spread of TB and protect ourselves, our families and our communities," she added. According to the county, cases of the disease declined during the coronavirus pandemic. Some COVID-related precautions such as masking and social distancing might have reduced TB transmission. People might also have missed getting diagnosed or it might have taken longer to see a doctor because of strains on the health care system or changes in their own care-seeking behaviors. More than 175,000 people in San Diego County are believed to have latent TB infection, and most do not know it. Without preventive treatment, as many as 10% of those people may go onto get sick with active, contagious TB disease. The county is hosting the San Diego TB Prevention Education and Community Engagement Summit at the Southeastern Livewell Center on March 22. Those in the medical community and health care organizations are encouraged to attend and participate.

More information on California TB cases :

https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/TB-in-California-2023-Snapshot.aspx 

A recent outbreak of avian flu has killed 7 per cent of the wild population of California condors, and officials are bracing for the virus’ spread. At least 20 California condors have died of avian flu in recent weeks, and wildlife officials are preparing for the virus’ spread among the critically endangered birds. The highly contagious H5N1 bird flu that is killing North America’s biggest bird is the same strain that forced farmers to cull millions of chickens over the last year. It is a major blow to the population of California condors (Gymnogyps californianus), which were pushed to the edge of extinction in the 1980s. Intensive breeding and habitat conservation efforts have since bolstered their numbers to around 500 birds, around 300 of which live in the wild. Clusters of the giant vultures can now be found from western Canada down to northern Mexico. Wildfires have drastically reduced lynx habitat in Washington state. In recent weeks, the US Fish and Wildlife Service had confirmed at least 20 condor deaths in a flock located around Arizona and Utah. So far, 10 of the condors in that flock have tested positive for avian flu and the 10 remaining birds are currently undergoing examination.

The deaths represent a 7 per cent loss of the species’ wild population. As of 17 April, the US Fish and Wildlife Service was rehabilitating four condors from the flock in the south-west US. They were “receiving supportive care and have shown improvement”, according to a statement. “My worry is that avian flu could spread throughout the regional condor groups as the disease becomes more prevalent in bird populations in general,” says Ileene Anderson at the Center for Biological Diversity in Arizona. “Since there is no known vaccine or proven treatment, at a minimum it could set back California condor recovery for years and at the worst it could decimate the population.” Avian flu has not been detected in neighbouring flocks in California or Mexico’s Baja California peninsula. Officials say they are monitoring nearby condors and preparing in the event that it spreads, especially as migratory birds that could ferry the virus fly north for spring migration. Though there have been rare cases of avian flu illness and deaths in humans, public health officials say that transmission is rare and advise avoiding close contact with sick or dead wildlife.

California lifted most of its Covid-19 restrictions Tuesday as part of a grand reopening in which the state will end capacity limits, physical distancing and -- at least for those vaccinated -- mask requirements. 

SARS-CoV-2 entry is mediated by the spike (S) glycoprotein which contains the receptor-binding domain (RBD) and the N-terminal domain (NTD) as the two main targets of neutralizing antibodies (Abs). A novel variant of concern (VOC) named CAL.20C (B.1.427/B.1.429) was originally detected in California and is currently spreading throughout the US and 29 additional countries. It is unclear whether antibody responses to SARS-CoV-2 infection or to the prototypic Wuhan-1 isolate-based vaccines will be impacted by the three B.1.427/B.1.429 S mutations: S13I, W152C and L452R. Here, we assessed neutralizing Ab responses following natural infection or mRNA vaccination using pseudoviruses expressing the wildtype or the B.1.427/B.1.429 S protein. Plasma from vaccinated or convalescent individuals exhibited neutralizing titers, which were reduced 3-6 fold against the B.1.427/B.1.429 variant relative to wildtype pseudoviruses. The RBD L452R mutation reduced or abolished neutralizing activity of 14 out of 35 RBD-specific monoclonal antibodies (mAbs), including three clinical-stage mAbs. Furthermore, we observed a complete loss of B.1.427/B.1.429 neutralization for a panel of mAbs targeting the N-terminal domain due to a large structural rearrangement of the NTD antigenic supersite involving an S13I-mediated shift of the signal peptide cleavage site. These data warrant closer monitoring of signal peptide variants and their involvement in immune evasion and show that Abs directed to the NTD impose a selection pressure driving SARS-CoV-2 viral evolution through conventional and unconventional escape mechanisms.

Preprint available at bioRxiv (April 1, 2021):

https://doi.org/10.1101/2021.03.31.437925 

Two studies confirm that a new coronavirus mutant in California is more contagious, although the scale of its threat is unclear.  A variant first discovered in California in December is more contagious than earlier forms of the coronavirus, two new studies have shown, fueling concerns that emerging mutants like this one could hamper the sharp decline in cases over all in the state and perhaps elsewhere. In one of the new studies, researchers found that the variant has spread rapidly in a San Francisco neighborhood in the past couple of months. The other report confirmed that the variant has surged across the state, and revealed that it produces twice as many viral particles inside a person’s body as other variants do. That study also hinted that the variant may be better than others at evading the immune system — and vaccines. “I wish I had better news to give you — that this variant is not significant at all,” said Dr. Charles Chiu, a virologist at the University of California, San Francisco. “But unfortunately, we just follow the science.” Neither study has yet been published in a scientific journal. And experts don’t know how much of a public health threat this variant poses compared with others that are also spreading in California. A variant called B.1.1.7 arrived in the United States from Britain, where it swiftly became the dominant form of the virus and overloaded hospitals there. Studies of British medical records suggest that B.1.1.7 is not only more transmissible, but more lethal than earlier variants.

California officials had distributed 7.2 million N95 masks from Advoque, a Santa Clara-based company that normally makes retail displays. A $90 million state contract with a South Bay company that started manufacturing N95 masks during the coronavirus pandemic is in jeopardy after the company’s respirators failed to pass muster with federal inspectors.  California officials had distributed 7.2 million N95 masks from Advoque, a Santa Clara company that normally makes in-store product displays, before the National Institute for Occupational Safety and Health last week revoked the temporary certification it had previously granted the business. Brian Ferguson, a spokesman for Gov. Gavin Newsom’s Office of Emergency Services, said the state had another 3 million masks from the company on hand as of Sept. 8.  A copy of the state recall notice, posted online by the group California Advocates for Nursing Home Reform, told recipients, “If you have current inventory of Advoque N95 masks … immediately cease use and distribution of this product.” Neither the state nor Advoque disclosed why the masks’ certification was revoked.

A crush of demand for N95 masks, which experts say offer the most protection from the spread of COVID-19, has created a global shortage since the early days of the pandemic, putting California and other states in a desperate scramble to obtain millions of the masks for health care workers and other critical employees. The shortage was so great that many health care facilities and elder care homes asked their workers to conserve and reuse masks and other protective equipment. That frantic market has led to large and expensive contracts with less-experienced manufacturers such as Advoque that only weeks earlier were making entirely different products. The Advoque contract was inked in June, according to Politico, around the time a far bigger — nearly $1 billion — N95 mask deal with the Chinese car manufacturer BYD appeared at risk of falling apart as the company similarly struggled to get federal certification. Those problems were eventually resolved, and California later extended its contract with BYD. State authorities began recalling Advoque’s masks once they found out about the revoked certification, Ferguson said, replacing them with other certified respirators. Advoque Chief Business Officer Paul Shrater wrote in a letter to customers Thursday that the company is working with federal regulators to recertify its masks, a process he said is expected to take two more weeks. In the meantime, Shrater said Advoque is not recalling its masks but instead providing a “product replacement program as a courtesy to our customers,” who can exchange their inventory for certified products once they receive NIOSH approval.

As for that $90 million contract, Ferguson did not say how much the state has paid Advoque so far. But he said the contract requires the vendor to maintain its certification. “The contract with this vendor has strong provisions to safeguard the state and the administration is exploring appropriate legal and contractual actions to protect the interests of Californians,” Ferguson wrote in a statement.

Newsom reports that 12,807 new coronavirus infections have been reported in the past 24 hours — a record high — bringing the state's total to 413,576.  As of Wednesday morning, data from Johns Hopkins University showed California had reported about 1,100 more cumulative COVID-19 cases than New York — which was besieged by the virus in the early spring but has since seen the numbers of newly confirmed infections, deaths and hospitalizations drop dramatically. California, however, is trending in the opposite direction. “It’s just another reminder … of the magnitude of impact that this virus continues to have,” he said.

Despite the higher case count, California has not experienced nearly as many fatalities as New York has. The Empire State has recorded more than 25,000 COVID-19 deaths, three times as many as California. Officials also were quick to point out that California’s population, by far the highest of any state, also plays a major role in its number of infections. The state’s population of nearly 40 million is more than double that of New York. California’s case rate per 100,000 residents, about 1,046, is significiantly lower than New York’s, which is just under 2,081, according to The Times’ coronavirus tracker. “I don’t myself over-read into the significance of that number,” California Health and Human Services Secretary Dr. Mark Ghaly said Tuesday when asked aboutCalifornia overtaking New York as the state with the most confirmed cases — pointing to both the state’s population and geographical size.

“I look at every day as an opportunity to do more and do better with our response to COVID-19, and at the end, I really expect and hope that California is going to be the state that adapted the most, learned the most, prepared the best and that we are going to really reduce its impact.” 

Newsom agreed that especially given the state’s size, “it’s not surprising now, in some respects, as we’ve begun to reopen key sectors of our economy, people continue to mix and people continue to come in close contact with others that may have contracted this disease, that our numbers would start to go up.” 

Newsom agreed that especially given the state’s size, “it’s not surprising now, in some respects, as we’ve begun to reopen key sectors of our economy, people continue to mix and people continue to come in close contact with others that may have contracted this disease, that our numbers would start to go up.”....

A new analysis reveals that more than 44% of new diagnoses are in people age 34 or younger, up from 29% a month ago. Only 30.5% are in people over age 50. 

As California’s economy opens up, coronavirus cases are getting younger and younger. An analysis released this week reveals that more than 44% of new diagnoses are in people age 34 or younger, up from 29% a month ago. There’s a corresponding drop in cases among older people. The proportion of COVID-19 cases among Californians older than 50 has plummeted from 46% to 30.5% in the past month. The proportion of cases among middle-aged Californians — ages 35 to 49 — has plateaued, neither rising nor falling.

“It is striking that there is such a strong shift. Cases are much younger now than they were earlier in the pandemic,” said infectious disease epidemiologist George Lemp, who calculated the trends using historical data from the California Department of Public Health. “It may reflect the opening up of California since mid-May, particularly among younger people who may have started to move away from the practices of social distancing and consistent mask use,” he said. It’s unknown whether the shift is in part due to the increased availability of tests to everyone who wants one. California has significantly expanded its testing capacity — scaling up from just 2,000 per day in April to more than 60,000 tests per day this week. The state does not report overall trends in COVID-19 cases, by age. But Lemp recorded and archived the data from three different snapshots in time to detect the dramatic shift.

People between ages of 18 to 34 now claim the largest share of new infections in the state, with 12,919 known cases diagnosed between May 31 to June 13. The second largest group, with 9,691 new cases, are people between the ages of 35 and 49. There has been a worrisome jump in youth under the age of 17. From the beginning of the pandemic until May 13, cases were rare, with a cumulative tally of only 2,799 diagnoses reported in this group. But that number was surpassed in merely two weeks, between May 14 and May 30, with 3,455 new cases. And it was exceeded again between May 31 and June 13, with 3,930 new cases....

More than 20 of the birds, which are critically endangered, have died in recent months.

The News

Federal officials have granted emergency approval to a bird flu vaccine for use in California condors, an agency of the U.S. Department of Agriculture announced on Tuesday. The move comes after more than a dozen of the birds, which are critically endangered, recently died from the virus, known as H5N1. Worldwide, there are fewer than 600 California condors, which can have wingspans of nearly 10 feet. The emergency approval is “an attempt to prevent additional deaths of these birds,” said the agency, the Animal and Plant Health Inspection Service. The vaccine was initially developed for a different version of avian influenza, and the condors will not begin receiving it right away. Three federal agencies — the Animal and Plant Health Inspection Service, the U.S. Fish and Wildlife Service and the U.S. Geological Survey — are now working together to test the vaccine in black vultures, a species related to California condors. Twenty vultures in North Carolina received the shots on Tuesday, the agencies said in a joint email. If the results are promising, the next step will be to vaccinate 25 captive condors, they said.

Why It Matters: Condors are at high risk.

The virus was first detected in a California condor found dead in late March. Since then, 20 more condors have died and four additional condors are currently in rehabilitation facilities, according to the federal agency. The virus has been confirmed in 15 of those birds. Condors appear to be “highly susceptible” to the virus, said Dr. Carlos Sanchez, the head veterinarian at the Oregon Zoo, which has a condor breeding program. “Once they get it,” he said, “they tend to have high mortality.” California condor populations dropped precipitously during the 20th century; in the 1980s, fewer than 30 birds were left. In the decades since, captive breeding programs have helped the population recover. If the virus gets into more condor populations, it could erase this progress, Dr. Sanchez said: “We’re talking about a potential catastrophic collapse of the conservation project.”

Background: A new version of an old threat.

The H5N1 virus was first detected in China in 1996. Since then, various versions of the virus have circulated in wild birds and caused repeated outbreaks in poultry. A new version of the virus arrived in North America in late 2021. Since then, it has spread rapidly throughout the United States, causing the largest bird flu outbreak in the nation’s history and resulting in the death of almost 60 million farmed birds. It has also taken a far heavier toll on wild birds than previous outbreaks. It has been detected in more than 6,700 wild birds — a figure that is surely an underestimate — in every state but Hawaii and has resulted in mass die-offs of wild birds around the world. It has also repeatedly spilled over into mammals and caused a small number of human infections, generally in people who were known to have been in close contact with birds. The virus is best adapted to birds, and the threat to the general public remains low, officials say. But scientists have long been concerned that the virus could evolve in ways that help it spread easily among people.

What’s next: Officials are considering a broader bird vaccination campaign.

The small size of the existing California condor population will allow the vaccination program to be monitored closely, the Animal and Plant Health Inspection Service said. Federal officials have not authorized the vaccine for use in other birds. But the size and scope of the current outbreak have prompted officials to consider a mass poultry vaccination campaign. U.S.D.A. scientists have been testing numerous potential poultry vaccines and have said that some results could be available this spring. The country could see more animal outbreaks in the coming weeks as infected wild birds migrate north for the summer.

California’s new COVID cases are settling down after this summer’s surge, and a divide has clearly emerged. Although the Golden State as a whole is doing well compared to the rest of the country, some smaller and more rural counties where vaccination rates are among the lowest in the state are only now starting to level off after experiencing their highest ever new case rates in the past few weeks. Every county with a vaccination rate under 50% has a case rate over 25. In the Bay Area where vaccination rates range from 64% to 82%, every county has a case rate under 20. And despite the downward trend in cases, hospitals in some of those places still have more COVID patients than at any other point in the pandemic.  An analysis by the Bay Area News Group shows that every California county with a vaccination rate under 50% had more than 25 new cases in the previous 14 days per 10,000 residents. In the Bay Area, where vaccination rates range from 64% to 82%, there is not a single county with a case rate over 20.  “This demonstrates in a poignant way something we have always known,” said Dr. John Swartzberg, clinical professor emeritus of infectious diseases and vaccinology at UC Berkeley’s school of public health. “The fewer people vaccinated in a community correlates directly with the risk of getting COVID-19.” “If data presented like this will not change peoples’ minds about getting vaccinated,” Swartzberg added, “I don’t know what will.”

State health officials said the California variant is present in about 75% of the island’s cases. 

A new strain of the pandemic coronavirus, first identified and now spreading in California, appears to be somewhat more transmissible and heighten patients’ risk of admission to the intensive care unit (ICU) and death, according to a preprint reporting lab studies and epidemiological data. The variant is also present in other states, but its prevalence among more than 2000 samples collected in California swelled from 0% to greater than 50% between September 2020 and late January, according to researchers at the University of California, San Francisco (UCSF). “This variant is concerning because our data shows that it is more contagious, more likely to be associated with severe illness, and at least partially resistant to neutralizing antibodies,” says senior author Charles Chiu, an infectious diseases physician and sequencing expert at UCSF. The data suggest the new strain “should likely be designated a variant of concern warranting urgent follow-up investigation,” the authors write in their preprint, which has not been peer reviewed and which they say is expected to be posted online soon.  The findings “warrant taking a much closer look at this variant,” says Angela Rasmussen, a virologist at Georgetown University’s Center for Global Health Science and Security who was not involved with the research. They “underscore the importance of pulling out all the stops in terms of both exposure reduction and increased vaccine distribution and access.” But other coronavirus experts say more data are needed before conclusions are drawn, noting that among patients with the variant, the study included fewer than 10 who were admitted to the ICU and fewer than 10 who died. “If I were a reviewer, I would want to see more data from more infected people to substantiate this very provocative claim,” says David O’Connor, a viral sequencing expert at the University of Wisconsin, Madison, who was not part of the research.

For their study, the authors sequenced 2172 genomes from virus samples captured from patients in 44 California counties between 1 September 2020 and 29 January. The new variant, which comes in two forms labeled B.1.427 and B.1.429 that carry slightly differing mutations, accounted for 21.3% of these sequences overall. (Under a different naming scheme, the variant is sometimes referred to as 20C/L452R.) The scientists also studied the medical records of 324 people with COVID-19 who were cared for at UCSF clinics or its medical center. The researchers adjusted the data to account for differences in age, gender, and ethnicity, and found that, compared with patients who had other viral strains, those carrying the variant were 4.8 times more likely to be admitted to the ICU and more than 11 times more likely to die. Other data suggest the variant is more contagious. The scientists found that people infected with the variant harbored about twice as much virus in their noses, an index of viral shedding, which may make them more infectious to others. In the lab, viruses engineered to carry a key mutation found in the variant were better than control viruses at infecting human cells and lunglike structures called organoids. And in one nursing home where the variant took hold, it spread severalfold faster than in four other nursing home outbreaks caused by other viral variants. “The evidence is growing that this [variant] is more transmissible than [its] immediate competitors,” although not as transmissible as some other variants of concern, says William Hanage, an expert on viral evolution at the Harvard T.H. Chan School of Public Health. (Variants of concern are coronaviruses with mutations that make them more likely to spread, evade vaccines, or make people sicker.) In lab studies, B.1.429 also impacted the effectiveness of antibodies: It was four times less susceptible than the original coronavirus to neutralizing antibodies from the blood of people who recovered from COVID-19, and two times less susceptible to antibodies from the blood of people vaccinated with the Pfizer or Moderna vaccines. That diminished potency is “moderate but significant,” the researchers wrote. Robert Schooley, an infectious disease physician and virologist at UC San Diego, praised the paper’s ambition and noted its findings of high viral loads in infected people’s noses. “The biology of having a higher level of virus … would certainly fit the thesis that people would not do as well,” he says. That comports with the fact that “we are seeing here in Southern California more people … for a longer period of time in our ICUs.” The patient data suggest the variants may be linked to worse outcomes. But although the ICU and mortality findings reached statistical significance, the numbers were small: Eight of 61, or 13%, of hospitalized patients with the variants were admitted to the ICU, compared with seven of 244, or 2.9%, of hospitalized patients who did not harbor the variants. Seven of 62 people (or 11.3%) with the variants died, versus five of 246 (or 2%) of people without the variants. The authors admit it is not possible to tell whether the variants actually make people sicker or whether, for instance, most of the patients with the variant got sick during the worst months of the pandemic, when health care systems were overloaded and patient care may have been suboptimal. All the variant-infected patients in the study who died at UCSF did so between 22 December 2020 and 28 January, when the area was experiencing a surge of infections. “Could any of the seven individuals who died with this variant have survived if they received treatment when the state wasn’t in the midst of a surge?” O’Connor asks. “It’s really impossible to know, as the authors acknowledge.”

In addition to other mutations, B.1.427 and B.1.429 each have an identical trio of mutations in the coronavirus spike protein, which allows the virus to invade human cells. One of those mutations, dubbed L452R, is thought to stabilize the interaction between the spike protein and the receptor it uses to attach to and invade human cells, increasing infectivity. None of those three spike mutations is found in the three other variants of concern, which emerged in the United Kingdom, South Africa, and Brazil. Evolutionary biologists also caution against overinterpreting the study. “The work is definitely worth reporting, but I don’t buy that on its own this is sufficient to categorize these as variants of concern,” Hanage says. He notes that B.1.427 and B.1.429 likely emerged in July and June 2020, respectively, but infections have not exploded in the exponential curves seen with the three identified variants of concern. “The real evidence will be seeing if, when introduced elsewhere, these lineages start to take off in similar fashion.” The paper also offers another cautionary tale about the United States’s subpar effort to sequence coronavirus samples nationwide. It’s “worrisome” that a state like Nevada, which borders California, has fewer than 500 sequences in GISAID, the leading coronavirus sequence repository, O’Connor says. The limited data from Nevada currently suggest the variant represents 27% of collected sequences, according to a database created by Scripps Research using GISAID data. 

Signaling its distrust of the Trump administration’s accelerated “Operation Warp Speed” initiative, California will conduct its own independent review of potential COVID-19 vaccines. To vet a vaccine before distribution to state residents, California Health and Human Services Secretary Dr. Mark Ghaly said Friday that the state will assemble a “review board” of leading scientists at academic institutions to assess the safety and effectiveness of any vaccine candidate. “We think it is an appropriate approach to take, especially because things are moving so quickly,” Ghaly said. “We want to make sure — despite the urge and interest in having a useful vaccine — that we do it with the utmost safety of Californians in mind.” The announcement came at a press conference in which Ghaly also expressed concern that California’s coronavirus numbers are beginning to move in the wrong direction after weeks of declines. Based on current trends, he projected an 89% increase in COVID-19 hospitalizations over the next month. That would still be far below hospital capacity and the worst rates in other states. On the vaccine testing issue, several other states, including New York, have signaled that they’ll also take the unusual step that Ghaly outlined. “Frankly, I’m not going to trust the federal government’s opinion, and I wouldn’t recommend to New Yorkers, based on the federal government’s opinion,”  New York Gov. Andrew M. Cuomo announced at a Thursday news briefing, according to the New York Times. President Trump has insisted a vaccine will be ready as early as next month, an assertion that other federal authorities say is unlikely.

California is already building a rollout plan for distribution of the vaccine, including whom to prioritize in the process, said Ghaly. Led by the state’s Department of Public Health, members of a new Vaccine Task Force include other state agencies, as well as academic experts, community groups and individuals. Once the state confirms the safety of the vaccine, this task force will advise distribution “in an equitable and smart way, to serve all the needs of Californians,” said Ghaly. “That absolutely is our plan.” Conflicting information about the timing of the vaccine and whether it will be safe and adequately tested has created growing concern that people are hesitant to take it, despite its importance in stopping the pandemic. The share of Americans who say they would get vaccinated for the coronavirus has declined sharply since earlier this year, according to a survey conducted this month by the Pew Research Center. About half of U.S. adults (51%) now say they would definitely or probably get a vaccine to prevent COVID-19 if it were available today, down from 72% in May. Only about 21% said they would definitely get a coronavirus vaccine, half as many as in May.

While it is the federal government’s role to approve a vaccine, states have authority for actual distribution — and could, in theory, reject a vaccine they think is unsafe. “Each state, indeed, has that sort of responsibility,” said Vanderbilt University’s Dr. William Schaffner, an internist and infectious disease specialist who formerly worked for the U.S. Public Health Service and the Centers for Disease Control and Prevention, at a Sept. 24 National Press Foundation program. “Some may be more ready to independently evaluate the data than others.” An FDA committee — called the Vaccines and Related Biological Products Advisory Committee comprising 15 authorities selected by the FDA commissioner — reviews the safety and effectiveness data at a public meeting. The FDA commissioner usually follows the committee’s recommendation, but not always. Typically, states follow the decision of the Advisory Committee on Immunization Practices, or ACIP, an independent committee that assesses data on FDA-approved vaccines and makes recommendations to the CDC. But there is growing worry that the federal regulators may feel pressure from the White House to activate “Emergency Use Authorization” of an unlicensed vaccine, which would not require completion of a full “Phase 3” trial, during which efficacy is tested in thousands of people...

An image is worth a thousand words, and few images exemplify more clearly the daunting situation many Californians are currently living. the COVID-19 pandemic is still causing about 7000 average daily cases, and over a hundred daily deaths in the Golden State. Now, the destruction caused by fires and the added pollution covering much of the state is adding to the suffering of thousands of families evacuated from their homes.

In a major step back from reopening measures in June, California Governor Gavin Newsom closed indoor dining, bars, and entertainment venues statewide, and also closed churches, hair and nail salons, gyms and malls in 31 counties. The 30 “monitoring list” counties contain approximately 80 percent of the state’s population, including Alameda (Oakland), Napa, Sonoma, Sacramento, Marin, Fresno, and Monterey counties in the northern and central parts of the state and most counties in Southern California, including Los Angeles and San Diego.

Newsom’s actions were taken in the midst of troubling developments in the Golden State: Coronavirus hospitalizations have risen by about 28 percent over the last two weeks, from 5,077 on June 29 to 6,485 as of Sunday. In the last week, the state’s seven-day average of positive coronavirus tests rose from 7,876 on July 6 to 8,211 on Monday. The state’s positivity rate has also continued trending north of 7 percent even as the number of tests across the state has surpassed 100,000 per day. In the early days of the pandemic, California was among the toughest states in imposing restrictions on activities associated with the spread of the coronavirus. But last month it began allowing local governments to relax restrictions, as the Los Angeles Times points out:  The setback comes after the state said June 12 that dine-in restaurants, retail stores, bars, religious services, and gyms could reopen with modifications in counties that met the state’s guidelines. Newsom said the move Monday to resurrect tough restrictions was a response to a rise in COVID-19 hospitalizations in the state. 

The governor ordered tougher restrictions ahead of the July 4 holiday on indoor activities for counties experiencing a spike in infections. Counties are placed on a watch list when they experience a rise in hospitalization rates, community transmission or declining hospital capacity, with three consecutive days of troublesome trends requiring the area to add the restrictions.