California coronavirus surge tied to increase in testing, not reopening businesses, official says

California continues to see big increases in coronavirus cases as its death toll approaches 5,000, causing alarm from some as the state continues to reopen its economy.

But are caseloads the best measure of how well California is controlling COVID-19?

Not necessarily, one of California’s top health officials said Friday as he announced a new round of businesses that are eligible for reopening, including nail salons.

The move came as the state reported two consecutive record single-day increases in coronavirus cases, logging 3,620 new cases Thursday and 3,644 Friday. Los Angeles County, which remains California’s leading virus hot spot, recorded 1,848 new cases Thursday, which was also a single-day high, and 1,575 cases Friday.

Dr. Mark Ghaly, the state’s secretary of Health and Human Services, said Friday that overall case counts are not necessarily a measure of how the state is faring in its fight against the novel coronavirus. Increased testing can drive up the number of cases as more infections are identified among those who are not seriously ill.

“We’ve ramped up testing in an extraordinary way, nearly hitting our goal that was set for August — not June, not July, but August — of getting to 60,000 to 80,000 tests a day,� Ghaly said. “We’re already knocking on that door, averaging in the mid- to high 50s over the past few days across the state.�

Instead, officials are closely monitoring two metrics: the positivity rate, which is the proportion of people who have tested positive out of all those who have been tested, and the daily number of hospitalizations. A rise in the former could indicate an uptick in community transmission that’s taking place separately from increased testing. A rise in the latter could mean that more people are becoming seriously ill, possibly jeopardizing the ability of the healthcare system to deal with the influx in patients.

So far, California’s positivity rate has continued to trend downward, and hospitalizations have remained within the range of stability, Ghaly said Friday.

L.A. County has seen similar trends, with slight declines in both the positivity rate and number of hospitalizations, Barbara Ferrer, the county health director, said Friday.

The uptick has come as California has allowed many businesses to reopen with preventive measures in place. That has sparked concerns that California is reopening too quickly and could face new outbreaks. But Ghaly believes the increases are mostly due to testing.

“I think it’s natural, that it’s easy to just focus on the number of new cases. But I think that’s really anchored — if you’re not seeing a tremendous uptick in the number of hospitalizations in the right timeline or … ICU cases, that’s really connected at least in California’s case to an increase in testing. So I think it’s always important to kind of have that in the context.�

He said the stepped-up testing, combined with enhanced contact tracing efforts, is enabling the state and counties “to contain and suppress disease transmission like we couldn’t before the stay-at-home order and even during the stay-at-home order.�

California saw far fewer deaths than hot spots such as New York and New Jersey, and many attribute that to Gov. Gavin Newsom’s stay-at-home order, the first in the nation. Officials said those weeks of restrictions are now allowing for gradual reopening.

“We closed down to prepare, we created the awareness among those in our communities, and we’re starting to begin the reopening — bringing back the economy, bringing back that vital social and economic presence in our communities — while we still stay vigilant and watchful over the movement of COVID-19 so we can stay in front of it as much as we can,� Ghaly said.

State officials have continued to allow more businesses, including movie theaters and gyms, to reopen this week with restrictions and pending county approval.

On Friday, officials announced nail salons, tattoo shops and massage therapists in California will be permitted to reopen in a week as the state continues to ease stay-at-home restrictions.

Each county will have to greenlight the businesses to open within its jurisdiction, and the establishments will be required to follow detailed guidelines issued by the state. Those guidelines, issued Friday, dictate details including the flow of people in and out of the establishments and the way in which pedicure bowls are disinfected.

The weeklong delay between the release of the guidelines and the date that salons and parlors can start to reopen is intended to give businesses time to prepare and local officials an opportunity “to look at their data and determine if in the global move to reopen, whether it’s the right timing to have an additional sector come back into their communities,� Ghaly said.

Though many nail salon employees say they will be thrilled to get back to work, one huge hurdle remains for many of them: face masks. In some counties in California, officials are not requiring people to cover their faces when out in public.

“Nail salon owners in a county that does not require face coverings for clients are now put in a predicament to ask customers to wear those coverings when they come in for services. It’s a way to protect both the customer and the worker. That’s one of the safety measures we need in place when we reopen,� said Tam Nguyen, president of Advance Beauty College, which has locations in Laguna Hills and Garden Grove. “We are not in a position to enforce. That’s unfair to the small-business owners.

“The million-dollar question becomes: Do you lose your business walking out the door to a competitor down the street — or do you welcome the client and risk your health, along with your staff?�

Nguyen and supporters launched Nailing It for America, an all-volunteer initiative that in recent months has delivered more than 1.2 million pieces of personal protective equipment and 52,000 restaurant meals to healthcare workers and others fighting COVID-19. He said safety remains the top priority, “no matter where you’re operating. For counties with mask regulations, more power to them. Their salons should be able to reopen with less of a burden.�

But in Orange County, where his network is based, officials Thursday announced a sudden change in health orders after weeks of arguments over the use of face coverings. Masks, previously required, are now just strongly recommended in public settings, said Dr. Clayton Chau, the county’s Health Care Agency director.

“This does not diminish the importance of face coverings,� Chau said. “I stand with public health experts and believe wearing cloth face coverings helps to slow the spread of COVID-19 in our community and save lives.

“By being consistent with the state, this will give our business community and individuals the ability to make the most appropriate decision for them and their situation.�