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Santa Clara County hopeful about slowed growth in COVID-19 cases

Original post made on Apr 7, 2020

In the latest sign that the Bay Area shutdown is effectively containing the spread of the coronavirus, Santa Clara County is seeing the rate of new cases gradually stabilize.

Read the full story here Web Link posted Tuesday, April 7, 2020, 12:34 PM

Comments (26)

Posted by TimR
a resident of Downtown North
on Apr 7, 2020 at 12:52 pm

Since Dr. Cody believes everyone will likely be infected before a vaccine arrives, wouldn't it be prudent to put the extra hospital beds to good use now? I understand the thinking behind kicking the can down the road in order to make sure hospitals have capacity, but if everyone will likely be infected, shouldn't we get on with it, in a very managed way, while resources are available? Basically, beds that are idle right now are being wasted. One COVID-19 case treated today is one less that has to be treated tomorrow.

Posted by Jennifer
a resident of another community
on Apr 7, 2020 at 1:06 pm

I hope the shutdown everywhere is effectively containing the spread of coronavirus. Otherwise, the economy is tanking for nothing. Even the experts can't agree. Until there's a vaccine, and everyone takes social distancing seriously - this will continue.

Posted by Reply for TimR
a resident of Adobe-Meadow
on Apr 7, 2020 at 1:13 pm

I think you should google the purpose of flattening the curve.

The real issue is that our population is in the millions, but our hospital beds are counted in the dozens or hundreds.

There is no great way for us to ensure that only 250 additionally people every 2 weeks get Coronavirus. The risk is that more like 250,000 get it if the stay at home or social distancing measures are relaxed.

That would lead to a NYC-style epidemic and thousands would die.

I’m also getting really tired of the stay at home, but I’m not going to figuratively open the door of the airliner at altitude because I need some fresh air and we are gonna open it when we land anyway...

Posted by Erik Brown
a resident of another community
on Apr 7, 2020 at 3:44 pm

I saw an NBC video of an interview with Dr. Cody that had graphs showing some of the data noted in this article. Namely, there was a graph of confirmed case count vs time (with and without social distancing), a graph of available hospital beds and case count vs time (with and without social distancing), and a graph of confirmed case count time to double vs time. Does anybody know where I could find those graphs? I looked on the Santa Clara Public Health webpage, but couldn’t find them.

Posted by Donald
a resident of South of Midtown
on Apr 7, 2020 at 3:53 pm

Take a look at the dashboard at Web Link

It has the county data displayed in a nice way.

Posted by Anon
a resident of Another Palo Alto neighborhood
on Apr 7, 2020 at 4:06 pm

Posted by Reply for TimR, a resident of Adobe-Meadow

>> I think you should google the purpose of flattening the curve.
>> The real issue is that our population is in the millions, but our hospital beds are counted in the dozens or hundreds.

"Flattening the curve will not be enough." Many hard-hit areas don't have enough capacity in the acute-care healthcare system. I've read conflicting information about the status of SCC and ventilators, for example. Gavin Newsom seems to think we have enough, but, others think we need a lot more:

Web Link

I don't know enough about the details of this to judge for myself, but, clearly, we need to have enough capacity in the system to deal with the "flattened" demand.


I'm also wondering why *counties* are suddenly so important? During the last fifty years, it seems to me that in California, cities and the State have grown in power and importance and counties have been progressively weakened. Now, suddenly, everything is being done at the county level, even to the point of residents of some counties being "ordered" to stay in their own county. Is it OK for someone in Menlo Park to be hospitalized for COVID-19 at Stanford, or, a patient of PAMF to be hospitalized at Sequoia? You would think we are still operating under the old "county hospital" system.

Posted by Trump promised tests a month ago
a resident of Midtown
on Apr 7, 2020 at 4:51 pm

[Post removed.]

Posted by Another TimR Reply
a resident of Midtown
on Apr 7, 2020 at 5:49 pm

Hi TimR

How do you propose to keep the hospitals just 'full' and not exploding on an exponential curve? Its a chain reaction that
you don't have precise control over. You need some headroom to avoid disaster. It's like pulling the control roads out of a reactor you didn't design.

There are other ideas that benefit if you flatten the curve (besides not flooding the hospitals)..good things can happen in that extra time:

--- if you get more testing resources down the road you can do more aggressive tracking of case contacts to reduce the spreading multiplier and mop up the cases even more. (like Germany)

-- Drugs that can reduce the fatality rates can be tested and brought online and benefit more people and prevent more deaths.

-- More people are once a vaccine is available

Posted by Erik Brown
a resident of another community
on Apr 7, 2020 at 6:41 pm

Some data from Santa Clara County Public Health Department from this morning’s Board of Supervisors meeting are now posted online:
Web Link

This includes some model projections into the future (with and without social distancing).

Posted by Resident
a resident of Adobe-Meadow
on Apr 8, 2020 at 10:03 am

I thought Tim's suggestion was an interesting one. Sooner vs. later, many are going to count those who got infected (and have the antibody test to prove it) as "lucky" since they will have mobility (work, shop, etc.) while the rest remain quarantined.

Given that, I imagine younger and healthier people might volunteer to be exposed, one household at a time, especially since there is available treatment capacity if they do get sick. They would still be quarantined - even more so - but once they are done, they are good to go.

Transmission rate of zero is sub-optimal, since we can never go make to normal life until there is herd immunity (or effective low-cost treatment). To build up herd immunity, you need to reduce the number of available hosts. Controlled exposure ("inoculation") was the strategy for smallpox before a vaccine existed.

Posted by Anon
a resident of Another Palo Alto neighborhood
on Apr 8, 2020 at 11:18 am

Posted by Resident, a resident of Adobe-Meadow

>> I thought Tim's suggestion was an interesting one. Sooner vs. later, many are going to count those who got infected (and have the antibody test to prove it) as "lucky" since they will have mobility (work, shop, etc.) while the rest remain quarantined.

Interesting idea. Back in Ben Franklin's day, some people tried to give their children a limited exposure to smallpox because people realized that they would be less likely to get a bad case during an outbreak. The first problem being, of course, that a certain percentage (2% ?) of children would die as a result of the preventative treatment. Web Link So, I'm not sure anybody should be seeking infection.
The second problem being, that not everyone is going to develop strong antibodies. That may also be be case with coronavirus: Web Link

But, presumably, people who get coronavirus and do test positive for a high level of antibodies will be significantly more immune. So-- interesting idea.

Posted by S_mom
a resident of Community Center
on Apr 8, 2020 at 1:36 pm

Couldn't we also eventually try easing up on some restrictions? Schools are out this year regardless, but maybe businesses with fewer than 5 employees could resume work, outdoor construction work could resume, open spaces reopen -- that sort of thing. Probably we need to wait until the end of April before anything is done to really be sure that we are containing cases, but I hope that if the levels stay where they are they aren't planning to just have us proceed as is for 12 months until there's a vaccine. The economic harm lower income residents are facing is terrible.

Posted by Jonathan Brown
a resident of Ventura
on Apr 8, 2020 at 2:04 pm

It feels like we are being punished for obeying the shelter-in-place rules by having to stay on lockdown for longer. It's easy for people to believe that they were misled. Also, the statements pasted below are self-contradictory. An outdoor sport with players infrequently in close contact like youth softball (to choose one example) is low risk, I would think, so why is Jeff Smith saying not to expect any sports until Thanksgiving at the earliest? Who's doing the cost-benefit analysis on this? Greater transparency is needed the longer the lockdown continues, but I feel like we're getting less.

>>County Executive Jeff Smith and Cody also signaled that social distancing rules won't be entirely lifted for a long time. Smith suggested that of the currently prohibited activities, those that carry a lower risk of infection will likely be looked at first.

"I don't expect that we'll have any sports games until at least Thanksgiving, and we'll be lucky to have them by Thanksgiving," Smith said. "This is not going to be something that's going be easy to do."

Posted by Anon
a resident of Another Palo Alto neighborhood
on Apr 8, 2020 at 2:04 pm

Posted by S_mom, a resident of Community Center

>> Couldn't we also eventually try easing up on some restrictions?

Sure, but, growth of cases is still pretty fast - doubling every 2-3 weeks instead of 3-5 days. And, unfortunately, if someone does need the ICU, the average stay is over a week: Web Link
So, if we let up now, we could very easily overflow the existing acute-care/ICU resources. We need to remain socially distanced for a while.

Posted by S_mom
a resident of Community Center
on Apr 8, 2020 at 2:13 pm

@Anon - but people move out of hospitals and ICUs as well -- it is misleading when the county publishes only the total number of cases in the county without also showing the total number of active cases, because people do recover (or very sadly, but much less often, not). What matters is the total number of cases we have at once. It seems more important to look at our hospital usage.

When you look at the Santa Clara hospital dashboard it looks like usage has been pretty steady and not close to capacity.
Web Link

I agree we should wait out April for sure and maybe May, but at some point I think they need to consider easing up on restrictions to alleviate the drastic economic harm. The more people get pushed into poverty the more impossible and difficult it becomes for them to come out of it, even if the economy goes back to normal.

Posted by TimR
a resident of Downtown North
on Apr 8, 2020 at 2:37 pm

Follow-Up Reply,

To add a little more, I got this idea after hearing a few different people talk about the virus and shelter in place. First was Gavin Newsom saying last week that people who have had the virus, recovered, and are now immune might be allowed to return to work first (but this wasn't a policy announcement, it was almost an aside). Then there was Dr. Cody saying that she thinks it's likely everyone in the county will get infected before a vaccine is found. And then there's the SCC Dashboard, which shows a fair number of open ICU beds. Add all that up, and it seems like sitting around waiting to get infected like Dr. Cody thinks will happen doesn't seem all that optimal. Too much "backloading." But I realize sitting in the ICU is much worse, so treatments would have to be available first. And I'm certainly no expert, it's just an idea I had listening to the experts.

Posted by Yo timx
a resident of Old Palo Alto
on Apr 8, 2020 at 2:59 pm

Gosh, Timmy, you are so magnanimous in being willing to wait out the rest of April.

Thank you!!!!

Posted by Resident.
a resident of Community Center
on Apr 9, 2020 at 5:36 pm

The true heroes are the parents in the county. They are the one who fought the county and the school districts at the beginning. They had to call for emergency meetings, create petitions and even threaten legal actions while the county health dept and the school districts chose to ignore the number of infected patients walking around in the community. There was no serious efforts in investigative medicine in a county sitting in between two major international airports.
Now, she is taking all the credits and fame. If she were to hear the parents and acted earlier, the outcome would be different.

Posted by Insider/Outsider
a resident of Old Palo Alto
on Apr 10, 2020 at 6:39 pm


I agree that the County Health Department dragged their feet and ignored the data regarding the trajectory of the virus. Now they are patting themselves on the back and making false statements. SCC was not the first to shut down and in fact was one of the last school districts to close the schools. Need to remember the missteps made and look for leadership that looks at data from a scientist lens instead of a political one.

Posted by Really ?
a resident of Barron Park
on Apr 10, 2020 at 7:50 pm

When they publish the number of hospital beds, ventilators, and ICU’s, that publication is the total number of units. It is not “empty” units. It is total units.

Without Covid, the beds, ventilators, and ICU’s are being used by heart attack, strike, auto accident, Gunshot, burn, etc. victims. If the demand due to Covid is for half the available units, it does not mean the other half sit empty. If the demand due to Covid equals the available units, it means every bed, Ventilator, and ICU is consumed by Covid alone. There are no units available for anything else.

It is incorrect to look at Covid demand being less that total units and try to suggest that there is excess capacity. Everything is being used.

Posted by S_mom
a resident of Community Center
on Apr 11, 2020 at 10:16 am

@Really ?

Actually the hospital stats do show available beds:
Web Link

Acute beds still have a lot of open beds, ICU beds have fewer open but would still allow for twice as many COVID patients, and surge capacity beds are essentially unused.

Posted by Palo Alto Resident
a resident of Barron Park
on Apr 11, 2020 at 1:30 pm

Yard work should not be a crime. We need to protect people who have no other source of income. There is no harm in having a single person come into your yard to mow the lawn. I hope they begin to reopen as many jobs with safety precautions as possible. We need to start thinking about the people who are not collecting pay checks.

Posted by Anon
a resident of Another Palo Alto neighborhood
on Apr 12, 2020 at 12:01 pm

Posted by Palo Alto Resident, a resident of Barron Park

>> Yard work should not be a crime. We need to protect people who have no other source of income.

Gardening work, far from others, may be OK in my book, as long as people are trained in how-to-not-share-viruses. But, you can't justify it because they need the income. If they can't do landscaping in safe way, then, they can't do it, no matter how much they need the income. It is a question of the safety of themselves and others, not how much they need the income. Two or three people sharing the cab of a Toyota Tacoma driving among worksites is a great way to transmit viruses, even if they work 20 feet apart when they get there. Maintaining social distancing throughout a work process is unnatural; training will be needed. Sometimes it is just better to not do something than to try to make it safe.

Worryingly, there was another jump in new cases:

Web Link

Posted by Mark Weiss
a resident of Downtown North
on Apr 13, 2020 at 6:37 pm

The UWash panel you link to above, and I mention in two previous posts here on this thread, says we have peaked already in CA and it now predicts, loosely, 140 deaths in county, down from what I said was "250" in a county with 2 million people.

It predicts 1,400 deaths statewide, and we have roughly 10 percent of the state total so far (60 of 600) -- previously I had predicted 250 based on us being roughly 5 percent of the state's population.

Either way, it looks like social distancing is working and the curve is indeed flattening.

For my short dog walks and the rare ducking into a store for essential provisions, I wear a bandana my wife bought at the Rolling Stones concert in August. Terry meanwhile, and she is a nurse, wears a pretty good mask, the likes of which she won't let me use -- better in a pinch it goes to one of her co-workers. Help is on the way from Marine Layer, makers of converted t-shirt masks for $5.

Posted by Resident
a resident of Midtown
on Apr 14, 2020 at 8:24 am

There is no doubt that Americans have been getting a civics lesson as they turn to Washington for answers to the coronavirus crisis, but discover that their state governors have assumed far more control over what goes on in their daily lives than the constitution allows. It has been State and local authorities making decisions about shutting down businesses and allocating medical equipment to hospitals – not the President. They have merely listened to Bill Gates and the compromised Anthony Fauci whose recommendations are illegal.
This is what the “United States” meant that there was a separation of powers between federal and state. This is the system the founding fathers designed, though it seems anachronistic to many while people like Fauci have been the stooge for Bill Gates claiming this is a deadly disease that warrants we be locked-down as prisoners in our own homes without any legal authority under the Constitution.
It is the Commerce Clause in the United States Constitution (Article I, Section 8, Clause 3) that governs this question. The Commerce Clause states that the United States Congress shall have power:
“[t]o regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes.”
The Supreme Court ruled in Swift and Company v. United States, 196 U.S. 375 (1905), that Congress had the authority to regulate local commerce, as long as that activity could become part of a continuous “current” of commerce that involved the interstate movement of goods and services.
My interpretation of this is simple. It is unconstitutional for any state to block interstate commerce. Consequently, the President has the executive power to issue a binding order to open up commerce and the states cannot legally resist that order for keeping the economy locked-down violates the Commerce Clause. Over the years, the meaning of the word “commerce” has been a source of controversy. The Constitution did not explicitly define the word. That has led to legal arguments back and forth.
Some argue that the word “Commerce” refers only to trade or exchange. Others counter that claim arguing that the Framers intended to describe more broadly commercial and social connections between citizens of different states. Hence, the interpretation of “Commerce” has been the dividing line between federal and state power. My reading is that they intended to prevent states from discriminating against each other and to ensure the free-flow of both the people with the freedom to travel and commerce in an economic sense.
In Gibbons v. Ogden, 22 U.S. 1 (1824), the Supreme Court held back then that intrastate activity could be regulated under the Commerce Clause, provided that the activity is part of a larger interstate commercial scheme. In Swift, as I said, the Supreme Court held that Congress had the authority to regulate local commerce provided it was part of a continuous “current” of commerce that involved the interstate movement of goods and services. Therefore, from 1905 until about 1937, the Supreme Court used this narrow version of the Commerce Clause. However, that changed with Franklin D. Roosevelt who stacked the court to justify his socialism and the New Deal. Beginning with NLRB v. Jones & Laughlin Steel Corp, 301 U.S. 1 (1937), the Supreme Court recognized broader grounds upon which the Commerce Clause could be used to regulate state activity since FDR was seeking more power to dominate the states.
The Supreme Court held in NLRB that activity was commerce if it had a “substantial economic effect” on interstate commerce or if the “cumulative effect” of a single act could have an effect on such commerce. Then in NLRB v. Jones, United States v. Darby, 312 U.S. 100 (1941) and Wickard v. Filburn, 317 U.S. 111 (1942), the Supreme Court revealed its socialist interpretation which broadened the scope of the Commerce Clause. Suddenly, what emerged was a highly dynamic and integrated national economy, whereby the Court applied its broad interpretation of the Commerce Clause, reasoning the even local activity will likely affect the larger interstate commercial economic scheme. The limitations between state and federal were no longer so clear.
After 1937 until 1995, the Supreme Court never invalidated a single law on the basis of the Commerce Clause. State’s rights seem to fade into the distant horizon. Then in 1995, the Supreme Court attempted to curtail this expansive interpretation of the Commerce Clause and was returning to a more conservative interpretation. This decision came down in United States v. Lopez, 514 U.S. 549 (1995). In Lopez, the defendant was charged with carrying a handgun to school in violation of the federal Gun-Free School Zones Act of 1990. The defendant argued that the federal government had no authority to regulate firearms in local schools, while the government claimed that this fell under the Commerce Clause, arguing that possession of a firearm in a school zone would lead to violent crime, thereby affecting the general economic conditions. The Supreme Court rejected that argument and held that Congress only has the power to regulate the channels of commerce, the instrumentalities of commerce, and action that substantially affects interstate commerce. The Court declined to further expand the Commerce Clause holding:
“To do so would require us to conclude that the Constitution’s enumeration of powers does not presuppose something not enumerated, and that there never will be a distinction between what is truly national and what is truly local. This we are unwilling to do.”
In Gonzales v. Raich, 545 U.S. 1 (2005), the Supreme Court returned to its more liberal construction of the Commerce Clause in relation to intrastate production. In Gonzales, the Court upheld federal regulation of intrastate marijuana production.
Then in 2012, the Supreme Court again dealt with the Commerce Clause in NFIB v. Sebelius, 567 US. 519 (2012) concerning the individual mandate in the Affordable Care Act (AFA), which sought to require uninsured individuals to secure health insurance (Obamacare) in an attempt to stabilize the health insurance market. Focusing on Lopez’s requirement that Congress could regulate only commercial activity, the Court held that the individual mandate could not be enacted under the Commerce Clause. The Court stated that requiring the purchase of health insurance under the AFA was not the regulation of commercial activity so much as inactivity and was, accordingly, impermissible under the Commerce Clause.
Therefore, relying on these decisions, the attempt by the states to lock-down the economy is UNCONSTITUTIONAL and the President has the power even under National Security to reopen the economy since it has been illegally shut down at the request of Bill Gates and his surrogate Anthony Fauci. This is dealing DIRECTLY with interstate commerce which is no different than protectionism that each state could then impose tariffs on imports from another state, which was the clear intention of the Founding Fathers to prohibit.

Posted by Anon
a resident of Another Palo Alto neighborhood
on Apr 14, 2020 at 11:02 am

Back on topic, the trend is hopeful, but, I'm also seeing more of what appear to be friends meeting/talking/walking too close together. We are still seeing (slower) exponential growth, with roughly one of every 1000 Palo Alto residents known cases. It certainly would be better if much more widespread testing was available.

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