Health Experts Support Protests But Warn of Possible Surge

California Governor Gavin Newsom on Thursday warned that the past week’s mass protests against police violence and racial injustice will likely cause an increase in coronavirus cases in the state, and that the black community will be hit hardest. 

“If you’re not (concerned), you’re not paying attention to the epidemiology, to the virulence of this disease,” Newsom said during a visit to Stockton for a meeting to discuss racial issues with Mayor Michael Tubbs, quoted by San Francisco Chronicle reporter Aidin Vaziri.

Newsom cited statistics that he said showed black Californians accounting for 5 percent of positive coronavirus tests, but 10 percent of deaths from COVID-19 in the state. His numbers were largely accurate, according to California Department of Public Health numbers as of June 3. 

Nonetheless, Newsom said he supported the protests—a seemingly contradictory view shared by many public health experts.

An open letter by public health experts based at the University of Washington, which gathered signatures from about 1,200 health professionals nationwide, explains the mixed message by saying that racial injustice itself is a public health crisis.

“We wanted to present a narrative that prioritizes opposition to racism as vital to the public health, including the epidemic response,” the letter’s authors state. “We believe that the way forward is not to suppress protests in the name of public health but to respond to protesters demands in the name of public health, thereby addressing multiple public health crises."

California has seen 122,808 total cases of coronavirus as of June 4, and 4,484 people have lost their lives due to the disease, according to the population data site Worldometers. The state’s rate of positive tests has held mostly steady between 4.1 percent and 4.8 percent since mid-May, according to data from Johns Hopkins University.

But Johns Hopkins data on June 3 also showed that California was one of 20 states where cases showed an increase over the previous five days. And on Monday, June 2, the state recorded 3,131 new cases, according to a count by the Mercury News. That gave California a rolling seven-day average of 2,608 cases per day, a new high, according to Merc reporter Martha Ross.

In the Bay Area, the seven day average of new cases on June 2 was 237, down only somewhat from the region’s peak of 249 back on April 5, according to figures cited by Ross. The Bay Area region reported 263 new cases and four deaths on June 2, as well.

Now, health officials say that those numbers could see an increase as a result of the protests, where demonstrators and police have ignored social distancing guidelines, and other precautions to mitigate spread of the disease. 

“I think everyone in public health is concerned,” San Francisco Health Officer Dr. Tomás Aragón told the Chronicle. “We know that being outdoors is definitely much better than being indoors. The risk depends on how many people in the crowd are carrying the coronavirus. If very few people are carrying, you’re probably going to be fine. But we don’t know, and that’s the problem.”

In Los Angeles, new positive test numbers may be difficult to determine, because the widespread protests which have also been accompanied by looting and violence, led to the city's closure of many testing sites, according to a Los Angeles Times report by Cindy Carcamo, Soumya Karlamanga, and Phil Willon.

The largest testing site in Los Angeles, however, Dodger Stadium, remained open since June 2, and Mayor Eric Garcetti said that he expected all of the city’s eight testing sites to be open by June 5, according to the Times report.

Los Angeles County case numbers have continued to rise, and the state’s—and country’s—most populous county averaged 1,405 new cases with 41.6 deaths over the week leading up to June 4.

Like the 1,200 public health pros who signed the University Of Washington open letter, however, California health experts say that the risk of spreading the virus is outweighed by the cause of racial justice, in the protests set off by the brutal killing of George Floyd in Minneapolis on May 25—a police killing seen in a horrifying viral video. 

“To see many people from all walks of life from 50 states and actually all over the world gives me hope that people care,” Mark Smith founding president and CEO (now retired) of the California Health Care Foundation said, in an Zoom discussion of Bay Area medical experts, reported by Gayle Ong of KRON TV News. “At the same time, I recognize there is a pandemic going on and I worry about those protesters.”

While the majority of protesters appear to be in the younger age groups who are statistically less likely to die from COVID-19, according to Centers for Disease Control data, the protests have frequently added at least one increased risk factor: tear gas.

The term “tear gas” is a generic expression used to describe a variety of chemical compounds used for “riot control” by police, according to a National Public Radio report. But all act as severe irritants to the eyes and respiratory system, and cause both immediate and long-term health damage. 

In addition to the respiratory harm that can make a victim more susceptible to COVID-19 symptoms, and lower immunity to disease in general, blasting protesters with tear gas can also hasten the spread of the virus, according to the NPR report.

"This is a recipe for disaster," Duke University med school scientist Sven Eric Jordt, who has studied the effect of what he calls "pain gas" on humans, told NPR. "You have this excruciating pain, sneezing, coughing, the production of a lot of mucus that obstructs breathing."

He called police use of tear gas on protesters in the midst of the coronavirus pandemic “completely irresponsible.”

Both elected and public health officials say that protesters should seek out coronavirus testing—but according to experts cited in a report by Lyanne Melendez of KGO TV News the timing of that test is critical, bearing in mind that the novel coronavirus can take between two and four days to become detectable.

"On the third or fourth day, if you feel like you've been exposed, you weren't able to physically distance, it's okay to go ahead and try to get a test,” University of California at San Francisco doctor Alok Patel told KGO.

But the protests also present a challenge to public health officials, because with the large and fluid crowds, contact tracing of people who test positive for the virus would be essentially impossible, according to the KGO report.