Newsom's Roadmap to Guide California Out of Isolation

Gov. Gavin Newsom laid out an approach Tuesday for how he plans to eventually unwind the restrictions California has enacted to slow the spread of the coronavirus, guidelines that have altered daily life for millions of residents over the past month.

The parameters unveiled by Newsom, released in concert with similar plans from the governors of Oregon and Washington, stand as a regional statement to the Trump administration that states are moving ahead with their own plans on how and when to exit sheltering in place. 

“We are not out of the woods yet, we are not spiking the ball,” Newsom said, while acknowledging that a sheltered existence “can’t be a permanent state. It will not be a permanent state.”

The focus on what Newsom called “the light at the end of the tunnel” is an acknowledgement that California’s aggressive efforts to mitigate a disastrous COVID-19 outbreak have been largely successful.

As residents have mostly stayed in their homes for more than a month, hospitals have yet to see the kind of surge in patients that many initially feared. And while overnight deaths from the coronavirus reached a new peak of 71 on Monday, the number of Californians in intensive care slightly declined overnight.

Those positive signs have allowed Newsom and his team to turn their attention to what the governor labeled "the most difficult and challenging phase" of California's coronavirus response: easing the restrictions that have kept millions indoors, shuttered businesses and classrooms, and prohibited large gatherings.

Newsom's presentation on Tuesday was more of a roadmap than a timeline. He didn't provide a date when the shelter-in-place order would be lifted, and he cautioned that any such announcement would likely wait until May, when the state could have greater clarity on case numbers and hospital supplies.

Instead, Newsom laid out six “indicators” that he said will guide his administration’s decisions on how and when to end the statewide stay-at-home order:

• The ability to monitor and protect our communities through testing, contact tracing, isolating and supporting those who are positive or exposed;
• The ability to prevent infection in people who are at risk for more severe COVID-19;
• The ability of the hospital and health systems to handle surges;
• The ability to develop therapeutics to meet the demand;
• The ability for businesses, schools and child care facilities to support physical distancing; and
• The ability to determine when to reinstitute certain measures, such as the stay-at-home orders, if necessary.

The list begins with testing and tracing: the ability to identify who has the virus and any contacts who may have been infected.

Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, said the state does not have a target level of testing to prompt ending the order, but he hopes to see tens of thousands of tests being conducted daily by the end of April.

With outbreaks of coronavirus sprouting up in nursing homes across the state, Newsom's plan emphasized the need to protect at-risk populations from future outbreaks.

And as the state has moved to increase the production and acquisition of hospital beds for patients and protective equipment for health care workers, Newsom stressed that any relaxation of guidelines would have to be accompanied by an ability to handle further surges in cases.

"As we loosen the stay-at-home order, ultimately and eventually the prospects of increased infection spreads," Newsom said. "We need to make sure that that infrastructure is protected and those assets are well prepared."

The roadmap also called for the development of therapeutics to help treat Californians who become infected.

"There is so much innovation and advancement in our medical community here in California," said Dr. Sonia Angell, director of the state's Department of Public Health. "We have a unique opportunity to collaborate and make sure that these therapeutics continue to evolve." 

Angell did not detail whether the state would be involved in funding research into coronavirus therapeutics, which pharmaceutical companies have often deprioritized because of the lack of a permanent consumer base.

The final two steps on the governor's checklist signaled that a reopening would not mean a return to life that existed before the virus.

Angell said businesses, schools and child care facilities should be prepared to maintain physical distancing and that the state should be prepared to reenter a lockdown if necessary.

"This is a conversation about modifying, about transitioning to a point in the future to when COVID-19 does not pose a threat," Angell added. "It won’t look the same."

The gradual and halting move toward reopening will involve "more individual accountability, more individual responsibility," said Newsom, predicting a future of regular mask wearing, of restaurant waiters serving distanced tables with gloves and disposable menus.

"There’s no light switch here," Newsom said. "I would argue it’s more like a dimmer."

Newsom emphasized that his administration's action will be a "baseline guidance" to inform the decisions on distancing and mask wearing by the state's 58 counties and hundreds of municipalities.

"We will be guided by local decision making," Newsom said.

But a day after President Trump declared "ultimate authority" in the decision to lift physical distancing guidelines, Newsom was eager to promote his roadmap's regional reach. When asked to comment on Trump's assertion, Newsom declined to take the bait, saying, "I'm not going there. I just want to get stuff done."

The governors of Washington and Oregon vowed to follow similar prerequisites for opening as California, and Newsom said other western states could soon join.

"While we have to be careful, we also cannot stand still," said Oregon Gov. Kate Brown, in a press conference earlier in the day. "This virus doesn’t recognize state boundaries."