Does the Bay Area need to shelter in place until June? An expert weighs in

A driver wears a face mask and gloves as Uber and Lyft drivers with Rideshare Drivers United and the¨ Transport Workers Union of America conduct a caravan protest outside the California Labor Commissioner'ss office amidst the coronavirus pandemic on April 16, 2020 in Los Angeles, California. less A driver wears a face mask and gloves as Uber and Lyft drivers with Rideshare Drivers United and the¨ Transport Workers Union of America conduct a caravan protest outside the California Labor Commissioner'ss ... more Photo: Mario Tama/Getty Images Photo: Mario Tama/Getty Images Image 1 of / 45 Caption Close Does the Bay Area need to shelter in place until June? An expert weighs in 1 / 45 Back to Gallery

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On Monday, health officials across six Bay Area counties announced the region-wide shelter-in-place order first issued March 17 will be extended "through May," but will allow for an unspecified “limited easing of specific restrictions for a small number of lower-risk activities."

The full details of the new order have not been released, but news that shelter-in-place will continue through May is likely the last thing Bay Area residents suffering from "quarantine fatigue" wanted to hear.

A four-week extension of the order — originally scheduled to expire on May 3 — is curious, especially when evaluating where the region currently stands in combating the coronavirus pandemic, as well as the four criteria for reopening established in a widely circulated American Enterprise Institute report. The four criteria are: 1. High testing capacity, 2. A robust contact tracing system, 3. Enough hospital beds to handle COVID-19 patients, and 4. A sufficiently low rate of transmission.

When speaking to SFGATE two weeks ago, UCSF epidemiologist Dr. George Rutherford stated the Bay Area has plenty of hospital beds, and hypothesized that the infection rate was already sufficiently low, citing the region's encouraging hospitalization data and the leveling off of new cases. On Monday, the number of coronavirus patients in Bay Area hospitals hit its lowest point since the state started recording county-by-county data, seemingly confirming that conditions 3 and 4 have already been met in the Bay Area.

That leaves testing and contact tracing, but Rutherford stated that both could be in place sometime in early-to-mid May, which raises the question of why localities felt the need to extend shelter-in-place all the way to June.

Rutherford said Monday he understands why local officials extended the order to May 31 — so long as they are prepared to lift the order once the testing and contact tracing conditions are met.

"I think it’s wise to extend and miss on the long end and not the short end," he said. "They don't want to set the date for May 10 and then say, 'Oh we're not ready, it's May 14, now,' and then say, 'Wait, actually, it's May 20.' Or, they can set the date for June 1, and if they get to the right place beforehand, then they stop early. There’s enough quarantine fatigue out there that rather than have small incremental increases, they can just put it out there at the farther end and one day say, 'Oh we’ve gotten there sooner than we thought. We can open up now.'"

The Bay Area has not yet met the testing and contact tracing requirements, but appears to be well on the way toward that goal. Rutherford stated that contact tracing is "online" in the city of San Francisco, but not the rest of the Bay Area yet. Ramping up testing remains a challenge, but the number of testing sites in the Bay Area continues to increase, and Rutherford is still optimistic the region can be where it needs to be sometime in May.

However, even if the Bay Area meets the four criteria for reopening, the region is subject to the mandates of Governor Gavin Newsom and state health officials.

"The statewide shelter-in-place order supersedes the local ones," Rutherford said. "It doesn’t matter what we say locally, the state order takes precedence."

It is unclear when the state would consider lifting shelter-in-place. Newsom and health officials have previously relied on an internal model that projects a mid-May peak of cases, hospitalizations and deaths even when accounting for rigorous social distancing. These predictions have not come to pass and Newsom himself has since acknowledged the state has hit a "plateau" with officials waiting for hospitalization and death numbers "to decline on a consistent basis and not episodic basis."

Antibody studies in Santa Clara and Los Angeles counties have also revealed initial projections regarding COVID-19's mortality and hospitalization rates were likely too high due to a massive underreporting of infections.

“We haven’t known the true extent of COVID-19 infections in our community because we have only tested people with symptoms, and the availability of tests has been limited,” said Neeraj Sood, a USC professor who served as lead investigator for the Los Angeles study. “The estimates also suggest that we might have to recalibrate disease prediction models and rethink public health strategies.”

Some level of social distancing will be required to prevent the rapid spread of the virus, but the sweet spot between balancing public health and economic health remains a challenge for officials.

"I don’t have a crystal ball and I'm not advising either the city government or the governor, but a scenario I like is allowing manufacturing and construction to come back as well as medical services that are not hospital-based," Rutherford said. "Get that stuff back into place soon and see how it goes, then go a little further and bring more stuff back, just gradually introduce things."

However, any gradual reopening will not be possible until the region has a comprehensive system of widespread testing and contact tracing in place. Rutherford is optimistic we will be there sometime soon and he, like you, needs a haircut.

"I want a haircut, and I don’t want my wife to do it," he said. "I guess I'll have to start looking for hair ribbons or something."

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Eric Ting is an SFGATE digital reporter. Email: eric.ting@sfgate.com | Twitter:@_ericting