California health officials so far report only a few people who attended protests against police brutality have tested positive for the coronavirus but already they are seeing the futility in trying to track down all in the crowds who could have been infected by them.
California was the first state to impose a stay-at-home order and in recent weeks has accelerated the pace of reopening the economy and loosening restrictions on where people can go. The state's rollback plans were laid with the idea there wouldn't yet be large crowds but after the Minneapolis police killing of George Floyd thousands of protesters have filled the streets in major cities and dozens of smaller locations had crowds above 100.
Many demonstrators didn’t practice physical distancing or wear masks — twin pillars of the fight to limit spread of the virus. On Thursday, California Gov. Gavin Newsom started requiring face coverings in most indoor settings and outdoors when distancing from others isn’t possible.
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“The risk is broad, but low” at protests, said Dr. George Rutherford, an epidemiologist at the University of California, San Francisco. “It all depends on what proportion of people wear masks.”
California has been moving forward on a four-phase plan to reopen its economy and allow greater freedom of movement for its 40 million residents. To open more businesses, counties must show they have sufficient testing capacity and enough “contact tracers" to interview those infected about who they may have exposed.
Ideally, the infected person can provide names and contact information for people who had been around them but that's not possible when the person has been surrounded by strangers at a protest.
Some county health officials have urged anyone who attended protests get tested for the coronavirus. Los Angeles County, where some demonstrators have tested positive for the virus, has urged those who attended protests and were around people without masks for as little as 15 minutes consider self-quarantining for 14 days.
LA County Public Health Director Barbara Ferrer said there are more than 1,000 contact tracers in the county of 10 million people who make thousands of calls daily to try to reach those exposed to the virus. But she said that isn't possible for virus cases among protesters
“The contact tracing will get extraordinarily hard in those crowded situations,” she said.
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Large demonstrations began May 29 and while they tapered after a week or so in most locations they continue to attract crowds in cities including Los Angeles and San Francisco. It takes up to two weeks for symptoms to appear, and longer for people to seek testing and get results, so any surge from the early days of the protests could materialize over the next week.
Contact tracing, which has long been used to stem other communicable diseases, is seen as critical to halting COVID-19. But patients don’t always remember everyone they’ve seen over the course of such a long incubation period and some may be reluctant to share information with the government knowing those people will be asked to quarantine.
Orange and Sacramento counties are among those that have reported virus cases among demonstrators, but so far no indications of an outbreak, health officials said.
In Sacramento County, three people tested positive and one refused to share details about the protest with those tasked with tracing the infections. The other two attended so many events officials felt issuing specific warnings would be futile and just urged all demonstrators to consider getting tested, said Dr. Olivia Kasirye, the county's public health officer.
“Right now we don’t have enough detail to be more specific,” Kasirye said, adding the contact tracers continue to follow up with those who were infected.
Dr. Matthew Zahn, medical director of the Orange County health care agency’s communicable disease control division, said the county's contact tracers reach those infected about 85 percent of the time. In smaller outbreaks of other illnesses, contact tracers might go to a person's house to follow up, but that's not possible in a pandemic with hundreds of new cases each day, he said.
“Contact tracing is an exceedingly important part of the public health response, but to perceive of it as a silver bullet I think is a misunderstanding,” Zahn said.
Dr. Cameron Kaiser, Riverside County’s health officer, said he doesn’t know of cases in his county tied to protests. But that doesn't mean they haven't occurred.
“Out in the community, all bets are off,” he said.
