Coronavirus Today: The messy reality of reopening

Good evening. I’m Deborah Netburn, and it’s Tuesday, March 16. Before we get going, I’d sincerely like to thank the dozens of people who responded to my query about how to handle vaccine envy. I am so grateful to all of you for sharing your thoughts for my upcoming story. Now, here’s what’s happening with the coronavirus in California and beyond.

There’s a big difference between the idea of reopening the economy and the reality of what that actually looks and feels like.

After so many months of masking, distancing and generally avoiding one another, the return of indoor activities will be thrilling for some and scary — or at least uncomfortable — for others.

That appears to be the case among restaurant workers in Los Angeles County, where indoor dining was allowed to resume Monday for the first time since June.

“Some are anxious about coming close to maskless customers. Some are eager to see their longtime regulars again. Many aren’t sure what to expect just yet, with so much changing, and fast, for both individuals and businesses as vaccinations ramp up and a semblance of normal life returns,� my colleagues in the Business section wrote.

Maxwell Reis, the beverage director at Gracias Madre in West Hollywood, said that as he drove to work Monday, he had the unsettling feeling that things were moving too fast. His workplace plans to open up 32 indoor seats Wednesday, the first time in roughly a year that people will eat inside there.

“I do think it’s incredibly rushed,� he said.

He believes his restaurant can handle the shift to indoor dining safely, and is relieved to have received his first dose of vaccine. But the second dose is weeks away, “and now I need to be inside with people without their masks on.�

Compounding the anxiety for some restaurant workers are warnings from public health officials that the risk of coronavirus spread is significantly higher in restaurants, compared with outdoor activities. Indeed, L.A. County requires that people dining indoors together live in the same household, while members of up to three households are allowed to gather when dining outdoors.

Restaurant workers became eligible for the vaccine on March 1. While many are still waiting for an appointment, those who have received the vaccine expressed relief.

“It feels great,� said Yecica Cervantes, a fully vaccinated waitress at Paco’s Mexican Restaurant in Arcadia. She wears a cloth mask and a plastic shield over her face at work.

Nancy Cooper, a waitress for 21 years at Maria’s Italian Kitchen in Pasadena, isn’t quite there yet. She is scheduled for her first vaccine dose Wednesday.

“I’ll feel a lot better after Wednesday,� she said.

By the numbers

California cases, deaths and vaccinations as of 6:46 p.m. Tuesday:

Track California’s coronavirus spread and vaccination efforts — including the latest numbers and how they break down — with our graphics.

Across California

In more reopening news, 10 more California counties — including San Diego, Riverside, Sacramento, Ventura and Santa Barbara — have qualified to move out of the state’s most restrictive purple tier and into the more lenient red tier this week.

Effective Wednesday, these counties will join Los Angeles, Orange, San Bernardino, Contra Costa, Sonoma, Placer, Mendocino, San Benito, Tuolumne, Siskiyou, Amador, Colusa and Mono in taking significant steps toward reopening the economy. That includes allowing indoor dining at restaurants and reopening gyms, movie theaters and other businesses in a limited capacity.

The tier progression was made possible by a significant shift in California’s reopening strategy that prioritizes getting COVID-19 vaccine doses into the most disadvantaged communities.

After meeting its self-set goal of administering 2 million doses to underserved residents, the state began allowing counties with an adjusted coronavirus case rate of up to 10 new cases per day per 100,000 people to exit the purple tier. Previously, the threshold for moving into the red tier was an adjusted case rate at or below seven new cases per day per 100,000 people. (For those keeping score, L.A. County’s adjusted case rate is now 4.1 new cases per day per 100,000 people, and Orange County’s is 4.0.)

The exodus from the strictest purple tier to the more lenient red tier leaves only a smattering of counties still subject to the most severe limitations and represents the widest unlocking of the state’s economy in months.

It’s not just businesses across the state that reopened this week. As we noted in Monday’s newsletter, 4.4 million Californians are newly eligible to get the COVID-19 vaccine, including people experiencing homelessness and those with disabilities and underlying medical conditions.

To protect people’s privacy and streamline the vaccination process, health workers across the state are relying on the honor system, trusting Californians to be honest about their eligibility rather than asking them to provide proof that they are truly next in line. Instead, those eligible will be expected to sign a self-attestation confirming they meet the criteria.

Today, my colleagues Colleen Shalby and Hayley Smith explain why most medical experts think this was the right way to go, and why they aren’t worrying about cheaters.

“I think the bulk of society in a situation like this is interested in fair play,� said Dr. Jeffrey Luther, a member of the state’s vaccine advisory committee and a board member of the California Academy of Family Physicians. “You start thinking there’s mad scramble for vaccines and no one can be trusted — I don’t think that’s true.�

Depending on your view of humanity, Luther’s take will seem either noble or naive.

But Tory Cross, a 27-year-old with severe asthma and Ehlers-Danlos syndrome, said the lack of verification requirements is in fact crucial to California’s commitment to vaccine equity.

“It’s really important for people to be able to self-attest,� she said, noting that many people lost their healthcare during the pandemic and might not have easy access to a doctor who could vouch for their place in line.

“Additionally, so many disabled people I know who have disabilities that are invisible [like asthma] were really worried that we would have to argue with vaccine providers to get them to believe that we’re high risk,� she said.

When Cross secured an upcoming appointment at Safeway, she “sobbed like a baby� from relief.

And finally, my colleague Jack Flemming writes about the battle brewing between California cycling studios and the tech-savvy stationary bike maker Peloton.

Peloton’s stock price rose by nearly 500% last year after gyms were shuttered by the pandemic and people looked for ways to work out at home. Now cycling studios will have to lure fitness enthusiasts back into in-person classes if they hope to stay afloat.

It won’t be easy. Current reopening rules allow for gyms to operate indoors only at 10% capacity and require everyone to wear a mask, which could be a deterrent for people doing intense cardio. In addition, once a rider has laid out the $1,850 or more for a Peloton bike, classes cost just $39 a month. There’s no way an in-person gym can compete with that pricing.

But Tatyana Fox, owner of Bespoke, a cycling studio in downtown L.A., is confident that when she’s able to reopen at full capacity, her riders will return because she sells an experience — not just an exercise. Bespoke offers a package of community, energy and ambience that can’t be achieved on a screen, she said.

See the latest on California’s coronavirus closures and reopenings, and the metrics that inform them, with our tracker.

Around the nation and the world

As the mother of fourth- and seventh-graders in the Los Angeles Unified School District, I’m always on the lookout for any story that gives me hope my children will get back into the classroom before they graduate from high school. (Hyperbole, you say? Who, me?)

That’s why I was pleased to read L.A. Times Science Editor (and tireless editor of this newsletter) Karen Kaplan’s report that Moderna Inc. has started testing its vaccine in children, including in infants as young as 6 months old.

However, as Kaplan explains, this particular trial could prove tricky. COVID-19 is less likely to strike children than adults, and cases for all age groups, including children, are expected to fall as vaccines roll out to adults and the country gets closer to achieving herd immunity.

Those factors may mean that there won’t be enough cases of COVID-19 among clinical trial participants for researchers to make a statistically significant calculation of vaccine efficacy.

In that case, the study team will also examine the immune response of kids in the trial and compare it with that of adults. If the kids generate enough antibodies in relation to adults, the researchers will take that as evidence of vaccine effectiveness.

Pfizer and BioNTech are currently testing their COVID-19 vaccine in children as young as 12. Their initial clinical trial included 16- and 17-year-olds, and the vaccine is the only one authorized for use in minors in the U.S. In addition, Johnson & Johnson plans to test both single and two-dose regimens of its vaccine in children ages 12 to 17, according to the Food and Drug Administration.

In other research news, a new study suggests that the number of asymptomatic or undiagnosed coronavirus infections in the U.S. may have been twice as high as the official tally of cases overall.

The findings, published Tuesday in the journal JAMA Network Open, indicate that there were millions more asymptomatic and undiagnosed people before the huge holiday surge than experts had realized — and suggest the pandemic could have been far more pervasive than it first appeared.

Researchers have long suspected that the official coronavirus case totals were an undercount of the true number of cases.

To try to see whether that was indeed the case, two researchers from Clinical Reference Laboratory Inc. in Lenexa, Kan., tested blood samples provided by 61,910 life insurance applicants to look for the presence of antibodies to SARS-CoV-2.

All of the applicants reported that they were healthy when they provided the blood samples. But in 4,094 of the 61,910 cases, the researchers found evidence of a past coronavirus infection in the form of antibodies.

Ultimately, the team estimated that 15.9 million asymptomatic or undiagnosed SARS-CoV-2 infections had taken place in the U.S. as of Sept. 30. At the time, the CDC reported a total of about 7.2 million cases.

Experts not involved with the study say that even that number could easily be an undercount. It could be a long time before we know the full extent of infections over the last year, and how that will affect future outbreaks, scientists said.

And before I sign off, consider this: There’s no need to experience vaccine envy if you live in Mississippi! The state just became the second in the union to make vaccinations available to anybody who wants one — no questions asked.

The first state to drop all eligibility criteria for the shots was Alaska.

Before Tuesday, vaccinations in Mississippi were available for anyone 50 or older, staff at K-12 schools, first responders, healthcare workers and those with underlying health conditions. Now, anyone in the state 16 or older can get a shot.

Mississippians can get vaccinated at state-run drive-through sites in counties across the state, at private clinics and community health centers, and at some pharmacies, such as Walmart and Walgreens.

Your questions answered

Today’s question comes from readers who are wondering: Can I get the vaccine if I have a cold?

If you’re experiencing cold symptoms when it’s time for your vaccine appointment, the first thing you need to do is get yourself a coronavirus test, said Dr. Elizabeth Hudson, regional chief of infectious diseases at Kaiser Permanente. That’s because the symptoms of the virus often mirror the symptoms of the common cold, especially in the early stages of infection.

If it turns out you do have the coronavirus, you’ll have to hold off on the vaccine until your infection clears, Hudson said. (If you become sick enough to require treatment with monoclonal antibodies, the Centers for Disease Control and Prevention advises you to wait 90 days before getting your vaccine.)

But a bout with COVID-19 is not a substitute for the vaccine. It’s unclear “how long or strong� the immunity from an infection will be, Hudson said, but “we know the vaccine will give a durable, high-quality protection.�

Even if your coronavirus test comes back negative, you’re better off waiting. “In general, if you are not feeling well, you should not get the [COVID-19] vaccine until you are completely better,� Hudson said.

The CDC says it’s not necessary to screen people for active coronavirus infections before they get vaccinated.

We want to hear from you. Email us your coronavirus questions, and we’ll do our best to answer them. Wondering if your question’s already been answered? Check out our archive here.