As more businesses reopened on Monday with services indoors, a group of University of California San Diego doctors addressed a letter to county leaders asking them to consider slowing down the reopenings out of concern of potential spikes in coronavirus cases.
"If you have a situation where 8 or 10 or 12 percent of a population is infected and you get together with 10 people, there's a good chance one of them is going to get infected,” said Dr. Robert Schooley, who was among the dozen of doctors who penned the letter.
Reopening San Diego
How the county is slowly reopening during the coronavirus pandemic.
In the letter, the medical professionals expressed their “deep concern” of Monday’s reopenings. Restaurants, places of worship and movie theaters are among the establishments that are permitted to offer indoor services at 25% capacity. Meanwhile, salons, tattoo parlors and other personal care establishments are allowed to offer indoor services under some modifications.
“We firmly believe the County is on the right path, as evidenced by the decreasing incidence of COVID-19 in recent weeks,” the letter stated. “However, broadly re-opening activities immediately before the Labor Day holiday weekend and while K-12 schools are resuming instruction puts the county at risk of a resurgence, especially because we have only recently moved into the red phase and have not yet fully contained the outbreak.”
The doctors asked county leaders to consider delaying the openings until Oct. 1, citing their anticipation of an increase in case numbers due to the Labor Day holiday weekend.
Schooley, a Distinguished Professor of Medicine at UCSD and infectious disease specialist who studied COVID-19, told NBC 7 that it’s not a good idea to permit indoor operations for certain businesses, especially in zip codes that are considered coronavirus hot spots.
“We just need to not have ourselves in situations where that virus comes barreling out of our lungs and out of our mouths and noses and into the air, where it can be picked up by other people,” he explained. “If you wear a mask, a large fraction of that virus is caught."
On the contrary, some local business owners on Monday expressed frustration over the restrictions and encouraged Gov. Gavin Newsom to loosen them. In a press conference organized by Supervisor Jim Desmond, small business owners questioned why some of them, such as event organizers, were excluded from being permitted to continue with their business. Others stated that they could not survive under the state's new modifications.
In a statement to NBC 7, Desmond said that while he values the doctors' insight, it is his responsibility to balance public health and the pandemic's impact on the county.
“I appreciate the clinical expertise from the UC San Diego Doctors and their desire to keep people safe. It is my job as a policymaker to make sure that we are balancing government’s response to public health issues and the impacts caused by the economic shutdown," Supervisor Desmond stated. "I want to keep people safe and believe we can achieve that while getting people back to work. There will always be risks with life and we need to be able to balance those risks for the best possible overall outcomes. I’m advocating for a safe and responsible reopening of businesses while protecting our most vulnerable.”
Board of Supervisors Chairman, Supervisor Greg Cox, reiterated the sentiment in a statement, saying county leaders are trying to balance the support for business owners and the public's health.
“The County is relying on our public health experts and on state guidelines that allow for limited reopenings of businesses," Supervisor Cox said. "We are trying to balance the need to support our local businesses and economy while also protecting public health. We will monitor the case numbers and other important data and make adjustments as necessary.”
Meanwhile, Supervisor Nathan Fletcher last week called for a more cautious approach to reopening the county.
"My concerns are with the size, scope and speed of what (was) reopened on Monday," Supervisor Fletcher said in a statement. "While there are some lower risk entities that could safely reopen at this point, what we are doing is very similar to what we did in June with a large segment of indoor operations all opening at the same time. This led to a large increase in cases and required new restrictions."
A representative for Supervisor Dianne Jacob recommended speaking with the Board of Supervisors COVID subcommittee.
Supervisor Kristin Gaspar's team has not responded to NBC 7's request for comment.
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To read the doctors’ letter in its entirety, see below:
We are writing to express our deep concern regarding the recently announced plan to re-open a wide array of businesses in San Diego County starting on August 31, and to suggest that this move be delayed until October 1, 2020. We firmly believe the County is on the right path, as evidenced by the decreasing incidence of COVID-19 in recent weeks. However, broadly re-opening activities immediately before the Labor Day holiday weekend and while K-12 schools are resuming instruction puts the county at risk of a resurgence, especially because we have only recently moved into the red phase and have not yet fully contained the outbreak. We anticipate a rapid increase in case numbers (as happened after the Memorial Day and 4th of July holidays), and the subsequent re-closing of businesses and schools.
While the County as a whole has done a commendable job of mitigating the pandemic, the improvement has not been evenly distributed across the region. Residents of approximately two dozen historically underprivileged zip codes, primarily concentrated in South and East Counties, shoulder significantly higher incidence rates. For example, San Ysidro currently reports an average of approximately 35 new cases per 100,000 residents per day - 5 times higher than the prescribed 7 new cases to move from “widespread” to “substantial” risk, while Lemon Grove and La Mesa both consistently report over 10 new cases per 100,000 residents per day.
It is now recognized that COVID-19 is an airborne infection (https://tinyurl.com/y2royhnz). Thus, the highest risk of transmission occurs in crowded indoor locations, those with poor ventilation, and among individuals who are talking, singing, or speaking loudly and not wearing masks (https://tinyurl.com/FAQ-aerosols). Much of the spread is occurring in aerosols produced in the breath and speech of people who do not know they are sick (https://t.co/T2Dd9mFKfO?amp=1). Consistent with this, most outbreaks in San Diego County have been linked to clusters in indoor businesses, restaurants, gyms, and bars.
For the sake of the San Diego economy and the health of our community, we ask you to consider delaying the re-opening until after Labor Day, or if this is not possible, stepping up enforcement of masking requirements over the holiday weekend, and to develop a staged reopening plan that takes into account the relative risks of various activities due to the airborne nature of the COVID-19 pandemic. We understand that reopening many of these businesses is critically important but we would urge that a priority be placed on providing more opportunities for outdoor operation than on reinitiating indoor unmasked operations.
UCSD is finalizing plans to ensure the safety of our students, faculty, and staff while working closely with the San Diego Unified School District so that they can reopen safely, and parents can go back to work. We urge you to consider prioritizing education in your reopening plans, to help mitigate the demographic disparities in both the health and educational impacts of the COVID-19 pandemic on our community, while allowing San Diego county to safely re-open and remain open.
Robert Schooley (Distinguished Professor of Medicine, MD, UCSD)
Kimberly Prather (Distinguished Chair in Atmospheric Chemistry, PhD, UCSD)
Kit Pogliano (Dean, Division of Biological Sciences, PhD, UCSD)
Jennifer MacKinnon (Professor, SIO, PhD, SDUSD parent, UCSD)
Rebecca Fielding-Miller (Assistant Professor, Wertheim School of Public Health and Human Longevity, MSPH PhD, UCSD)
Steffanie Strathdee (Harold Simon Professor of Medicine, Associate Dean of Global Health Sciences, PhD, UCSD)
Thomas Patterson (Distinguished Professor of Psychiatry, PhD, UCSD)
Helen Amanda Fricker (Professor, SIO, PhD, SDUSD parent, UCSD)
Jennifer MacKinnon (Professor, SIO, PhD, SDUSD parent, UCSD)
Matthew Alford (Professor, SIO, PhD, SDUSD parent, UCSD)
Ian Eisenman ((Professor, SIO, PhD, SDUSD parent, UCSD)
Fiamma Straneo (Professor, PhD, SDUSD parent, UCSD)