Amid rising COVID-19 deaths, why isn’t Santa Clara County shutting down like it did in March?

Morgues are on the brink of overflowing. Hospitals have fewer beds for patients by the day. More than 1,100 people have died.

Yet, in Santa Clara County, people can still shop for perfumes, phones and clothes at the mall. It’s a stark difference from nearly a year ago when officials closed everything down — all nonessential retail, restaurants, schools and offices — to get a grip on the contagious coronavirus, an illness most scientists were scrambling to figure out.

Santa Clara County Health Officer Dr. Sara Cody made national headlines and earned herself slots on CNN and other cable news networks for being the first in the nation to issue a shelter-in-place order, requiring residents to stay inside for nearly everything except the essentials — food, gas and medicine, for example.

The idea, Cody insisted against growing criticism, was to flatten the curve. It worked.

But now COVID-19 cases are at an all-time high, the latest wave in new cases stemming from people gathering for the holidays. So why are Santa Clara County’s restrictions looser today than they were in March — despite COVID-19 cases surging far past any previous rise?

The answer is economical, psychological and political.

‘Shutdown fatigue’

Experts say health officials are approaching closures and restrictions more cautiously today, despite more people dying every day, because of pandemic fatigue and financial hardship. Health leaders like Cody have also faced extraordinary political pressure to reopen businesses, heightened scrutiny and even death threats.

“There’s a lot of quarantine fatigue and a lot of shutdown fatigue,” said Dr. Georges Benjamin, the director of the American Public Health Association. “There are other implications to the society when you do that, not just economic.”

Benjamin said health officials must weigh economic and educational consequences when making decisions to close down.

“Your kids are not going to school and they fall behind in their classes,” Benjamin said. “Those kids who get free and reduced school lunches may become more food insecure. Obviously the impact on the economy is people who lose their jobs will often lose their health insurance.”

There are some slight — but notable — differences between the March 2020 shelter-in-place order and the one in effect today that began Dec. 6.

In March 2020, health officials closed schools, restaurants, movie theaters, hair and nail salons, canceled sporting events and nonessential retail. This time around, schools with vouchers can continue and nonessential retailers and shopping centers can have up to 20% of their capacity. 

Travel restrictions

One of the biggest sources of the recent COVID-19 surge is holiday gatherings and travel, officials said. Another important difference between restrictions today and those in March is related to travel.

The current health order advises no travel and requires people traveling 150 miles or more to quarantine for at least 10 days, if they show no symptoms of COVID-19. In March, officials ordered all nonessential travel to cease.

“We know the virus spreads when people move around, when people are sharing space and sharing air, so reducing that should reduce the spread,” said Kat Saxton, an associate professor of biology and public health at Santa Clara University. “But people are also tired of COVID.”

Some health experts say the reason people ignored health officials’ travel advice during the holidays is because officials preached abstinence rather than harm reduction.

McGill University law professor Daniel Weinstock writes in a study that if people are given measured steps to reduce the risk of transmitting disease when gathering, they would feel empowered — not forced — to make rational decisions. And fewer people would flout safety measures.

Violations by businesses

Despite fewer businesses closing this time around, a county spokesperson said enforcement for scofflaws has increased. Business compliance officers monitor and fine establishments for violating COVID-19 health protocols.

Health experts added that counties neighboring Santa Clara County must follow suit with shelter-in-place orders to be consistent and effective. Neighboring San Mateo County, for example, did not start following the state’s stay-at-home order until Dec. 17, almost two weeks after Santa Clara County.

“It’s like the barrier for a county health department to make decisions without the other surrounding areas,” Saxton said. “People obviously are crossing county lines so how effective can one county be without a more regional approach.”

Contact Mauricio La Plante at [email protected] or follow @mslaplantenews on Twitter.