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San Diego County Reports Single-Day Record Of 497 New COVID-19 Cases

 June 29, 2020 at 11:35 AM PDT

Speaker 1: 00:00 In the first of his COVID-19 updates this week, governor Gavin Newsome added four more counties to the state watch list for possible renewed shutdowns of recently reopened businesses. Newsome explained that because of the trend line of increasing cases, increasing positivity rates and increasing hospitalizations in California, he ordered bars shut down in seven counties, including Los Angeles County. The state is watching COVID rates in 12 other counties to see if similar action might need to be taken. Speaker 2: 00:33 Numbers are going up, but our ability to manage and absorb also is significant. And so I just want to, for the purposes of full disclosure, tell you the challenges, but also tell you, uh, what we have done to meet those challenges. Speaker 1: 00:51 San Diego County is not on any state watch list at this time, but we have seen record numbers of positive COVID-19 tests in San Diego over recent days, Speaker 1: 01:07 Much of the surge in COVID-19 cases, we're seeing in California and across the nation is due to an increasing number of young people testing positive last week. For instance, as positivity rates climbed 56% of people diagnosed with COVID in California were 18 to 49 years old. That demographic only makes up about 43% of the state's population. Health officials warn that young people may not be taking proper precautions against the disease because they believe the virus can't make them very sick. So how much of a threat is COVID-19 really to the younger population and shared San Diego consider shutting down many of its reopened businesses. Jeremy has dr. Mark Sawyer and infectious disease specialist with Rady children's hospital and UC San Diego. And dr. Sorry. Welcome back to the program. Good to be here, Maureen, some people are making the argument that we're seeing this bump in younger people testing positive because more tests are now available for people who are not feeling sick. What do you think about that? Speaker 3: 02:13 Well, it is true that we are testing more and we're testing in some situations, people with no symptoms just to see what's going on in our community or because they're curious, but what's happening in San Diego over the last few weeks is a true increase in the number of cases. In other words, it's not simply because we're testing or we're seeing a bounce back and that's concerning Speaker 1: 02:38 Younger people have been told they should take precautions against COVID-19. So they don't spread it to older and more vulnerable people. But isn't the virus also a threat to younger people, especially those with preexisting conditions. Speaker 3: 02:52 Yes. We have seen stories of, of previously healthy, uh, young adults ending up very ill with COVID or even dying with COVID. It's sort of like influenza in that most young adults do okay. With these respiratory infections, but a small number don't do. Okay. And so, uh, it isn't correct for young adults to feel that they're not at any risk, they are at risk. Speaker 1: 03:18 And what are those preexisting conditions for instance, is asthma a one of them Speaker 3: 03:24 We think asthma probably is. And it makes sense anything that affects your heart or lungs, which are the Oregon's most directly impacted by COVID is likely to make it worse if you get COVID. So if you have asthma, if you have any other chronic lung or heart condition, but you know, probably the more common situation that people probably don't think about is obesity. Obesity seems to be a risk factor. And people don't think about that as a concern. Speaker 1: 03:52 What about young women who are pregnant? Speaker 3: 03:54 Yes. We've recently learned that young women who are pregnant may be at increased risk. We have seen that with other viruses. It's certainly true for influenza. It's a combination of the fact that your immune system is a little bit suppressed when you're pregnant. And then in the later stages of pregnancy, your lungs are compressed because you've got a baby kicking up from below and you can't take deep breaths or sometimes cough effectively. So for both those reasons pregnant women are at risk. Speaker 1: 04:23 Do we know enough about this virus to be certain that getting a mild case won't produce some side effects down the road? Speaker 3: 04:31 No, we don't. And of course, and so the problem is we're not down the road yet. In other words, not enough time has gone past for us to assess the longterm effects of COVID. And there have been some concerns that there could be some COVID seems to cause increased clotting in your blood system. For example, that could lead to permanent injury. Even if you have mild respiratory symptoms, when you're, when you have the infection, Speaker 1: 04:57 What have we been learning about COVID lately? I read that researchers are now saying most people who catch the virus should develop symptoms in three to five days, instead of the 14 days originally thought, what else is new? Speaker 3: 05:10 Well, we're learning that it can be transmitted from people who don't have symptoms, but that's not a major part of our story. Most people do have symptoms or get symptoms shortly after they pass it on to somebody else. So they know that that something has happened. So that's one thing we're learning. We're continuing to learn that young children are generally not severely affected by that, by this infection. And that's good news. Uh, but we're also learning how incredibly contagious this virus is. And that is illustrated by the return of cases that are being seen around the world. As we start to relax our social distancing. Speaker 1: 05:50 Well, as you mentioned, dr. San Diego has seen record numbers of positive tests in recent days, hospitalizations are up 20% and we've hit trigger numbers for community outbreaks. Is this the kind of spike everyone said we should expect when society began to reopen? Or is this worse? Speaker 3: 06:11 No, this is exactly what people were predicting would happen. And they quit. The only question was how bad would it get? And so this entire COVID control effort has been about trying to level the curve as people would say, or flatten the curve that is too spread out cases. So we don't overwhelm the health system and to isolate people as much as we could. So we did that very effectively in March, April and may. We've started to relax the social distancing so people can get back to work and school, and there are other activities. And as a result of that, we're seeing the cases go back up. Hopefully they won't go up to much higher, but that remains to be seen. Speaker 1: 06:56 Would you like to see San Diego County pulled back on some reopenings? Speaker 3: 07:01 Well, it's hard to know exactly when to pull the trigger on that, but certainly if the case has continued to rise, we need to rethink this whole experiment that we've been trying in the last week of opening up parks and beaches and bars and restaurants. And as, as you know, in some other States where the rise is even worse, they have started to reverse the, the relaxation. In other words, they've closed restaurants again, or closed buyers again. And we may get there in San Diego. Speaker 1: 07:29 Well, governor Newsome has ordered bars in seven counties to close while recommending they close and about eight others, San Diego County isn't on that list yet. Is that something you think needs to happen here? Speaker 3: 07:43 Well, I think we need to be prepared for that to happen here. And our cases are clearly going up. We know that there's a lot of illness across the border in Mexico, and we're trying to help people with that, but inevitably that could spread to San Diego as well. So I think we just have to keep monitoring the numbers and if they keep going up, we need to do something Speaker 1: 08:05 Along those lines. Our neighboring County Imperial County is seeing a 23% positive test rate compared to a statewide rate of almost 6%. So what do you think are the driving factors in Imperial's high positivity rate? Speaker 3: 08:20 Well, I don't have all the details in Imperial, but they have certainly been suffering a major outbreak for the last several weeks. And I think it is likely related to the cross border traffic people coming back and forth from Mexico, where there is also a very long and sustained outbreak. And those hospitals are becoming overwhelmed and Imperial County and patients are even being sent to San Diego to, to be taken care of because they don't have the capacity. Speaker 1: 08:47 Now governor Newsome and others have been saying that this is not the second wave because we're not out of the first wave yet, but there had been a decline in COVID cases. So why this resurgence? Speaker 3: 09:00 Well, I think it's simple. The decline happened when none of us were going to work and nobody was going to restaurants and people weren't, we're getting online delivery of all their goods. And we've changed all that in the last month. And we've relaxed our restrictions and people as, as we see on TV, uh, people are gathering in large groups and having a good time at the beach and restaurants and bars, and very close contact with no masks on. And that's how the virus spreads. So it's going to, it is coming back. It's expected. And I think among the lessons we've already learned is that if people don't wear masks out in public, when they're around other people, this virus is going to spread. Speaker 1: 09:45 So we were not able to get the level of virus down enough so that it didn't, it was not able to revive itself again and become a real problem. Speaker 3: 09:56 Yeah, there is no sign that this virus is going away or going anywhere. I know people were hoping in the summertime, it might, it might go down, but clearly this resurgent tells us that it's still around. We are all almost all still susceptible. In other words, very few people have actually had it. If you look at the entire population and everybody is still at risk and it's going to continue to spread, Speaker 1: 10:19 How do you see the next months of COVID progressing? Should cases go down significantly? Or will we see this kind of up and down bumpy graph all the way into the fall? Speaker 3: 10:32 I think it's going to be a roller coaster ride for the next year, not just into the fall. I think we're going to see cases going up and down in part based on the level of, of restriction in the community and in part on how well people do with the restrictions that are in place. If you ignore the restrictions, we're going to have widespread infection. If you follow the restrictions, the hope is we'll have a steady low number, which will allow us to more or less live, uh, live a normal life. Speaker 1: 11:01 And what's your advice to people most vulnerable to this disease, older people and people with preexisting conditions. Should they remain at home as often as possible? Or are they okay outside with masks on? Speaker 3: 11:15 No. I think people who have high risk conditions are unfortunately need to heed the recommendations that they stay as isolated as they reasonably can. And so that means not going out into public, not having lots of visitors. You know, I'm not going to go so far as to say you shouldn't ever visit your family for example, but you do have to be careful even in that setting, wearing a mask and staying six feet apart whenever possible. And so high risk people need to stay isolated until we have a more permanent solution, which will either be a treatment that we can count on very effective Speaker 1: 11:54 Or hopefully a vaccine that those people can then get and then be protected. I've been speaking with dr. Mark Sawyer and infectious disease specialist with Rady children's hospital and UC San Diego, dr. Sawyer as always. Thank you so much. Thank you, Maureen.

The San Diego County COVID-19 case total rose rapidly over the weekend and health authorities have reported more than 300 new COVID-19 cases seven times in the past eight days.
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