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The US state of California, which was an example at the beginning of the pandemic due to its management and low numbers of cases and deaths, has become the global epicenter of the health crisis for several reasons. What has happened?

The abandonment of rural areas; the low review of working conditions by the health authorities; the lack of economic relief for the poorest population; the shortage of beds in the Intensive Care Units (ICU) and the psychological consequences of the prolonged closure of schools and outdoor activities are some of the factors that have led to this situation.

And all this has caused Los Angeles County to be the place in the country with the most detected cases (663,954) and deaths (9,153) within the United States, a nation with more than 18.4 million infected and 326,259 deaths from COVID-19, according to The latest independent count data from Johns Hopkins University.

Despite the fact that during the summer the number of cases in California decreased notably, the infections in rural areas of the state, such as the Central Valley, were maintained or increased.

“We do not pay enough attention to the fact that, in rural agricultural communities, infection rates were very high during the summer and then this took its toll on us,” the American epidemiologist and doctor at the University of California in San Francisco (UCSF), Kirsten Bibbins-Domingo.

According to data from an analysis by Stanford University, more than 5 million people live in rural California, representing 13% of the total population of the state.

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Another circumstance that has played a relevant role in the growth of the number of cases and deaths from covid-19 in California is the low revision of working conditions in places with “essential” workers, such as supermarkets or food plants.

In this sense, the president of the UCSF Department of Epidemiology and Biostatistics believes that the state of California “has not adopted a very active position to enforce protections in the workplace.”

“We have detected great transmission in essential workers with low wages,” he says.

For Bibbins-Domingo, the lack of powerful economic relief for the poorest communities in the state has also been one of the main factors that the pandemic has had a strong impact on California, one of the most expensive states to live in the US, mainly in terms of of transport and accommodation costs.

“In ten months of a pandemic, essential workers need to rest, isolate themselves if they are infected, recover if they lose their jobs. But without economic relief, this is not possible,” emphasizes the expert on pandemics.

Precisely this Thursday, Republicans in the US Lower House blocked the attempt by Democrats to modify the stimulus plan of 900,000 million dollars, approved in Congress, after the US President, Donald Trump, threatened to block it if not there are changes.

Specifically, Democrats wanted to increase the direct payments that millions of taxpayers will receive from $ 600 to $ 2,000 after Trump demanded that increase on Tuesday, in a request that breaks with the position of his party.

Over the past week, California has averaged 42,452 new confirmed cases per day, about 107.4 per 100,000 residents.

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These high numbers of infections and the low capacity of beds in the state’s ICUs (in Southern California they are at 0% capacity) have resulted in a collapse in the California hospital system.

“The reality is that we have less capacity to endure a great emergency of this type, and this is legitimately a great factor. But I think prevention is more important,” the doctor highlights.

In trying to control the pandemic, California Governor Gavin Newsom has been one of the strictest restrictions in the state, keeping schools closed throughout the pandemic and preventing access to natural parks. and beaches for several months.

“People are very tired of all this, and now that it is really important to stay at home, the attention is less,” argues Bibbins-Domingo.

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