It has been nearly sixteen weeks since the first case of the novel coronavirus (COVID-19) was diagnosed in the United States and more than two months since California’s stay-at-home order began on Tuesday, March 17th. Though not hit as hard as many other states, California was one of the first states to report community spread of the virus (the spread of a disease to individuals who have not have traced contact with someone with the virus or traveled to a region with the virus). Consequently, California was the first state to implement a stay-at-home order for its citizens.

California’s stay-at-home order, which only permits state residents to leave their homes for essential activities (accessing food and healthcare, exercising, and participating in the necessary workforce) has led to a noticeable decrease in the spread of COVID-19. “I think the stay at home order has been tremendously effective at lowering the rate of transmission,” said Shannon McCune, a Family Medicine doctor in Berkeley, California, in an interview with the Urban Legend. “We never ended up seeing the surge that we were expecting and that they had in New York, which is a great sign.”

The Bay Area, in particular, never experienced the spike in cases and deaths that is to be expected in an outbreak. In fact, in the nine counties that comprise the San Francisco Bay Area, the number of daily hospitalizations due to the virus has been decreasing by approximately 5% each day as of May 8th, according to a local news source. With these positive developments in mind, individual California counties, as well as the state government as a whole, have begun the slow process of reopening California.

At the forefront of California’s reopening plan is Governor Gavin Newsom’s four-stage plan, also known as the Resilience Roadmap. Outlined on the CA.gov website, the Roadmap begins with Stage 1, focused on safety and preparedness, and finishes with Stage 4, with the end of the stay-at-home order and the reopening of high-risk events such as concerts and sports games. As of May 10th, California moved to Stage 2 of the plan, to “gradually reopen retail (curbside only), manufacturing and logistics, [and] later, relax retail restrictions, adapt and reopen schools, child care, offices and limited hospitality, personal services,” according to the website. Looking forward, Step 3 in the Resilience Roadmap would include the reopening of movie theatres, religious services, and other personal and hospitality services.

In addition to the fact that California residents cannot be asked to stay at home forever, the devastating economic impact of the pandemic has led many to believe that California should move forward with the Resilience Roadmap sooner rather than later. Only several months ago, California had a six billion dollar budget surplus, record low unemployment, and GDP growth that greatly outperformed the rest of the United States.

“Those numbers are [now] completely flipped,” stated Governor Newsom during a May 11th update. As a result of only three months of shelter-in-place, essentially every sector of California’s economy has suffered, which begs the question of how much longer the economy can withstand the impact of the stay-at-home orders.

However, a major factor contributing to the low infection rate currently seen in California is the same strict social distancing measures that have drastically affected Californians’ lives and the economy over the past few months. Once restrictions are loosened and the state moves closer to Step 4 in the Resilience Roadmap, many worry that cases will spike once again.

Christy Boscardin, a faculty member at the UCSF School of Medicine, echoed this concern in an interview with the Urban Legend. “Even the hospitals in New York that thought they were prepared were really surprised and caught off guard,” Boscardin said. “I think that could easily happen to San Francisco if we aren’t careful, so it’s just a good reminder, looking at other hospitals and what’s happening, that we have to be really prudent about how we ease the restrictions.”

McCune shares this fear. “It’s a bit scary to me what will happen when we start to reopen the state, especially if we see a surge of infection that we weren’t prepared for, although I think we are a lot more prepared for it than we were before,” she said.

When it comes to ending the stay-at-home order, a spike in cases isn’t just a possibility, it’s an inevitability, making preparedness crucial to any reopening plan. In order to be prepared for a spike in cases, the Newsom administration has teamed up with both UCSF and UCLA to create a team of “coronavirus detectives.” A group of nearly 20,000 state employees who have or will be selected for this program will be trained to test patients, track transmissions, and isolate individuals who have been diagnosed with the virus. With this system and others such as the PPE distribution system in place, California will be more prepared for a spike in cases when the time comes to relax stay-at-home orders.

Many also worry that with the lifting of the stay-at-home order, some Californians will be under the impression that they can return to life as usual. However, “there’s no light switch here,” said Governor Newsom in a coronavirus press conference, emphasizing the fact that even when the shelter-in-place order ends, life may not be back to normal for many months.

The end of stay-at-home orders doesn’t equate to throwing parties or hanging out with large groups of friends. Recently, tens of thousands of Californians flocked to Orange County beaches during a heatwave, and “we saw an uptick in cases that weekend,” said Boscardin. When the state begins easing restrictions, “we need to continue to have social distancing in place and have people wear masks and not congregate in crowds because we did see an increase in cases as soon as people started congregating,” she continued.

A vaccine will likely not be available until “the end of this year to early next year [at the earliest],” said McCune, and it may be quite some time until California reaches Stage 4 in its Resilience Roadmap. Until then, and even after that point, it’s important to understand that life won’t return to normal for quite some time. “You may be having dinner with the waiter wearing gloves and maybe a face mask…where your temperature is checked before walking in,” said Governor Newsom. “These are likely scenarios.”