Dr. Roger Hicks: California’s new regional stay at home order | TheUnion.com
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Dr. Roger Hicks: California’s new regional stay at home order

Dr. Roger Hicks
Columnist

On Dec. 3 Governor Newsom announced California’s strongest COVID measures since March. How did we get here, what does it mean, and what do we do now?

The U.S. has led the world in COVID-19 since April, but not in the way we would like. We have had 14.3 million cases and more than 282,000 deaths, far surpassing our closest competitors, India and Brazil. With just over 4% of the world’s population, we have 22% of the cases and over 18% of the deaths. We now have nearly the same number of Americans dying of COVID-19 every day as died on 9/11. This makes COVID-19 the leading cause of death in the US, surpassing heart disease, lung cancer and stroke. We had more than 226,000 new cases in the country this past Friday alone, a new single day record, and we have not yet seen the surge from Thanksgiving, expected in mid-December.

California and Nevada County responded relatively well to the pandemic through the early fall, but the current trends in our state and county are alarming. There were 27,634 new cases in California on Saturday, a record high. Hospitalizations from the virus in the past month have doubled in the US but have tripled in California. The number of available Intensive Care Unit (ICU) beds is critically low in several parts the state. ICU beds are needed not only for COVID patients, but also for people with heart attacks, strokes, serious injuries and other medical problems. Our ability to add ICU beds is limited by the shortage of trained ICU nurses and doctors caused by the nationwide surge in hospitalizations and ICU admissions. Bringing them in from other parts of the country like New York City did in the spring is not an option because now they are needed everywhere.



Currently, to prevent hospitals from being overwhelmed, Governor Newsom is using the availability of ICU beds to determine whether the new Regional Stay At Home Order is needed. If a region’s ICU capacity falls below 15%, as has already happened in the San Joaquin Valley and Southern California, the new measures will be applied. Nevada County is part of the Greater Sacramento Region, which as of Dec. 6, had 18.2% of its ICU capacity still available. This number is expected to drop below 15% sometime this week. More information and regional maps are available at covid19.ca.gov and mynevadacounty.com.

What does the new Regional Stay At Home Order mean? It still allows access to “critical services”, such as groceries and retail, but with new restrictions. Critical infrastructure work (when remote is not possible), non-urgent medical and dental services, childcare and pre-K are allowed, and there are no changes to the existing guidance for schools. Outdoor activities are encouraged for physical health and wellness. But, as the name implies, the Stay-at- Home Order bans all unnecessary travel. Because much of the spread of COVID has been tracked to getting together with friends and family, gatherings with anyone from another household is prohibited. And businesses that are not defined as “critical infrastructure” must close for in-person activities, except for retail. Restaurants will be limited to take-out and delivery. Religious services and political expression must be outdoors.




There is no doubt these restrictions will hurt. But what we have been doing is clearly not working, and painful as they are, this “emergency brake” is needed so that we don’t overwhelm our hospitals and ICUs. We can get through this if we pull together, and the vaccines are the light at the end of the tunnel.

What can we do now to stop the spread and help our businesses and our fellow citizens? It’s not rocket science, it’s basic public health. Keep in mind the virus hasn’t changed, we just haven’t been paying close enough attention to dealing with it.

Research has shown that people shed the most virus and are most infectious right before they develop symptoms, while some people never develop symptoms but can still spread the disease. We have so many cases in our community right now, it is safe to assume that everyone you come in contact with might have COVID, even if they don’t know it. To protect you and the people around you, wear a mask whenever you are in public, especially indoors. A good mask is a 3-ply surgical mask or one that has a double layer of washable, breathable fabric. Both kinds help the wearer from spreading potentially infectious droplets into the air. Bandanas tied around the face do not work as well because they are open at the bottom. Neck gaiters that can be pulled up around the mouth and nose are usually made of knit stretchy fabric that is too porous. Vented masks are good for construction work but let droplets escape into the air, so they don’t protect the people around the wearer. Since we breathe through our mouths and noses, for the mask to be effective it must cover both.

Some people object to mask mandates because they think the mandates impinge on personal freedom. I would argue that we have other public health and safety laws that are universally accepted, like speed limits, seat belt and drunk driving laws, not smoking on an airplane or in a restaurant, and not dumping pollutants into rivers and streams, even on one’s own property. Wearing a mask in public during the pandemic is no different.

Some have said we should not have mask mandates or other restrictions, but instead rely on people’s “individual responsibility.” For those of that mind, this is the time to step up and be responsible. Help your fellow citizens and yourself — wear a mask, maintain social distance, and for now, stay home whenever you can.

Vaccines are around the corner. The FDA is likely to approve Pfizer’s vaccine this week, Moderna’s shortly thereafter and there are others close behind. But until enough people have been vaccinated, we all need to take care of ourselves and each other.

Until then, please stay in place, keep your space, and cover your face.

Dr. Roger Hicks is the Medical Director for Yubadocs Urgent Care in Grass Valley and the founding president and current Director of the California Urgent Care Association.


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