Is Los Angeles County’s safer-at-home order necessary in its current form?

Businesses have been shut down. Unemployment has skyrocketed and anxiety levels in Los Angeles County are unprecedented. With Gov. Gavin Newsom now thinking about how to reopen the state, is Los Angeles County’s “Safer at Home” order still necessary in its current form?

Coronavirus spreads like the flu. You touch a door handle that has live virus from someone who earlier touched it. Then you touch your mouth, nose or eyes and that’s how you’ll likely get it. If someone near you has coronavirus and coughs, you can get it by breathing in the droplets.

How can you avoid getting coronavirus?

1) Know where your hands are at all times.

2) Wash your hands often (soap and water or hand sanitizer) especially after you touch a door handle or other commonly touched objects.

3) Don’t touch your face.

4) Social distancing.

The above recommendations are from Dr. David Price, a lung specialist in New York City who is spending all day treating coronavirus patients at Weill Cornell Medical Center. Price discussed these recommendations in a widely seen video that has nearly 5 million views. Following these commonsense recommendations will likely prevent people from getting coronavirus.

Price’s recommendations omit “shutting down a city.” In fact, we already know that’s not necessary. Tokyo, a city of 14 million people — similar in population to Los Angeles County but with the density of New York City — has a small number of COVID-19 cases compared to New York City. Despite Japan declaring a state of emergency, there was no economic devastation in Tokyo because all businesses remained open. People freely move and tend to practice all the recommendations that Dr. Price described. Tokyo has not had the massive number of hospitalizations and deaths New York City did, which suggests that high “hygiene IQ” and social distancing worked in Tokyo.

Contrast to LA County

People are scared and misinterpreting “Safer at Home” to mean “Stay at Home at All Costs.” Parents are refusing to bring in their otherwise healthy children and teenagers to see their doctor. One of us is a child psychiatrist and we expect the incidence of suicide to increase from inadequate treatment of depression and anxiety in this population because of the “Safe at Home” order.

On April 4, the Los Angeles Times reported that the Didi Hirsh Suicide Prevention Center in Century City saw an explosion in calls from 20 in February to over 1,800 in March. We are also concerned about increased domestic violence. Reports now show large spikes in calls for domestic violence against women and children.

For all but the most stable patients, phone and video conferencing provide sub-standard care and place patients at physical risk — far greater risk than the coronavirus. Clearly, there are groups of people who should not stay at home. Is it safer to cancel Alcoholics Anonymous meetings and keep alcoholics at home? Is alcohol poisoning or drunk driving safer than coronavirus? One might ask, “But what about the risk of millions of Americans dying if we don’t continue to sequester everyone in their homes?”

The daily changes of Los Angeles County’s coronavirus cases are stable, not exponential. As of Friday, April 17, there were 11,391 cases countywide, with 495 deaths. It is terrible to learn of anyone dying, especially from coronavirus. But the health-related costs of shutting down Los Angeles County for much longer, with a population of 10 million people, are far greater than what coronavirus has done and will likely do to our city.  People have lost their jobs and businesses are going bankrupt. As with domestic violence, increased rates of depression and suicide will soon to follow because of a greater lag time.

Is there a middle ground to keep coronavirus in check in Los Angeles while alleviating the far-reaching economic and health side effects to our city? We think so. Our area is now highly educated about “hygiene IQ” and social distancing. Innovative essential businesses like grocery stores have placed marks on the ground for people to be six feet from each other. There is no reason nonessential businesses can’t operate the same way.

Now is the time Los Angeles County and city officials should consider allowing nonessential businesses to reopen if they voluntarily employ high “hygiene IQ” and social distancing with their customers (and require cloth face masks if people are less than six feet from each other), which are keys to prevent transmission.

After four weeks of shutdown, will we continue to be “safer at home” than we would be back at work and engaging in activities essential for a healthy, productive society?

We don’t think so. We think there is a solution that provides a safe middle ground for all that also allows the economic stimulus to work.

Los Angeles County, with its relatively low number of cases, which appear to be on the decline, is well-positioned for now modifying the “Safer at Home” order to unshackle our economy, improve mental health and reduce domestic violence while maintaining our public health and safety.

Brian Boxer Wachler, MD is an eye surgeon. Mark McDonald, MD is a psychiatrist. Liza Capiendo, MD is a colorectal surgeon. Jay Grossman, DDS is a dentist. David Shirazi, DDS is a dentist. David Soomekh, DPM is a foot and ankle surgeon. They practice in Los Angeles County.