How California’s public health approach turned its Covid-19 outbreak around and saw coronavirus cases come back down, and how others can learn from California to battle the pandemic back too.

First published in October 2020.

You know about the dramatic increases in cases and hospitalizations across the United States. The surge began after Labor Day.

But one state has done well during this time. A big state that would move national numbers. And what they have done holds a lesson for all of us.

Yes — Let’s talk about California.

Walk down memory lane: California was early to act, back in March, preventing a surge of cases that affected many other states. Over April and May, California cases were low.

But then California had an awful summer surge, especially in Southern California. Cases peaked in late July with over 12,000 cases and 150 deaths per day.

But in August, came strong leadership from the California Health and Human Services Agency (CHHS)’s Secretary, Mark Ghaly, and the Governor of California, Gavin Newsom.

What did they do? Huge increases in testing, including bringing new capacity online. They created a highly customized approach on a county by county level – micro targeting policies.

What did California do? Huge increases in testing. | abc News

Did it actually work? Here is the data over the past 6 weeks (since Labor Day):

USA (outside of California):

  • Cases, up 68%
  • Hospitalizations, up 22%
  • Percentage of tests positives: 5.6% --> 6.6%


  • Cases, down 9%
  • Hospitalizations, down 26%
  • Percentage of tests positives: 3.5% --> 2.4%
California Covid Map and Case Count. | New York Times

California is a big state (40 million folks), so this is not about small numbers or a fluke. Throught its concerted effort to increase testing (up 32% since Labor Day) and smart, county-level policies, California is bucking the national trend.

Here is their approach:

Blueprint for a Safer Economy. | California State Government Website

And this is their county level guidance.

What do I like here?

Instead of approaching lockdowns as light switch (on or off), the California approach is that of a dimmer switch. And it looks like it is working.

Obviously, we don’t know if it will last, but so far so good...

And here is the bottom line: when so many states are struggling, micro-targeting and more testing are smart policies that can avoid big surges.

The Golden State is leading the way in that. We don’t have to look abroad to see this success story. And we can learn to keep COVID under control.🔷

Dr Ashish K. Jha, Physician, health policy researcher. Dean of the School of Public Health, Professor of Health Services, Policy and Practice, Brown University, Rhode Island.


Check their Voting Record:

🗳️ Gavin Newsom

[This piece was first published as a Twitter thread and turned into the above article on 19 October 2020 with the purpose of reaching a larger audience. It has been minorly edited and corrected, and published with the author’s consent. | The author of the tweets writes in a personal capacity.]

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(Cover: Wikipedia/Russ Allison Loar. - A freeway warning sign about Covid-10, in Southern California. | 16 March 2020. / Licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.)

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