San Diegans have stayed at home or 6 feet away for weeks to prevent the spread of coronavirus, but new cases are still reported every day. A La Mesa resident asked KPBS to find out how people are still becoming sick despite the orders.
Q: San Diego and California have been under stay at home orders and practicing social distancing for a month now. If the incubation period for covid19 is up to 14 days, why are we still seeing new cases? Where are they coming from? Is there something more we should be doing? Or doing better? Are the new cases coming from essential workers?
As part of our ongoing Curious San Diego series, KPBS Health Reporter Tarryn Mento tracked down the answer.
Experts from four San Diego medical facilities said there are multiple reasons new cases are continuing to show up, including cross-border traffic and better testing. But among their responses, two factors stood out: people either can’t or won’t abide by the rules.
Dr. Christian Ramers at Family Health Centers of San Diego said new cases may be occurring among individuals who live in close quarters with others or are essential workers who become infected while on the job.
“Many people are not able to fully isolate — especially those who live in crowded settings or those who are still required to go to work–and probably the reason we see the disease affecting lower-income people and minority populations more than others,” Ramers said in an email.
Does San Diego County’s contact tracers document where or how people believe they became infected?
When asked if the county’s contact tracers would be documenting where or how infected people believed they contracted the virus, San Diego County Public Health Officer Dr. Wilma Wooten said individuals are often unable to determine the source or time or infection.
“However, if individuals are in sensitive occupations, are from locations where we know there are other cases that would lead us to believe that there is an outbreak, then we take the appropriate procedures and process to investigate the outbreak situation. As you can tell, one of the locations where we have outbreaks is our congregate care facilities and we report that information to you daily as well as any other community settings,” Wooten said at the county’s daily update Thursday.
The virus could then spread to others in a household, especially because not everyone shows symptoms.
Rady Children’s Hospital’s Dr. Mark Sawyer also pointed to the risk of exposure among essential workers, but said others who may be following the rules on distancing and masks may be picking it up in the community because they’re becoming lax on other practices.
“In this second category, there are people following the distancing guidelines but are not being careful enough about handwashing and avoiding touching surfaces and then touching their eyes, nose, or mouth,” Sawyer, also a UC San Diego professor of clinical pediatrics, wrote in a message to KPBS.
However, Scripps Health Chief Medical Officer Dr. Ghazala Sharieff said some residents may be ignoring restrictions altogether.
"I see more people out on the streets in the last week. Kids playing together not wearing a mask. People having potlucks, things like that, and so people are not adhering,” Sharieff said.
Sharieff, who oversees clinical excellence and experience at Scripps, also pointed to the U.S.-Mexico border as a big source of new cases. San Diego’s South Bay hospitals have treated a higher volume of COVID-19 patients than elsewhere in the region leading officials to suspect people are crossing to access health care as Mexican facilities become overwhelmed. A county health official previously said those patients are largely U.S. citizens.
She said Scripps is now transporting its Chula Vista patients as far north as its facility in La Jolla.
Dr. Hai Shao at Sharp Chula Vista Medical Center also cited border traffic as a reason for new cases. Scripps and Sharp HealthCare late last month formally requested help from federal officials to identify potential cases among people crossing the border.
Shao and Ramers identified increased testing as an additional reason the tally of cases is increasing.
