As of April 21, nearly 5,000 Californians are hospitalized and more than 1,300 have died due to COVID-19, but proactive public health measures may have safeguarded many others. Because the coronavirus spreads exponentially, days matter. And early actions before the statewide shelter-in-place order may have proved especially effective in reducing transmission.

The Bay Area had some of the state’s earliest cases of coronavirus, which spurred a rapid response. Santa Clara was the first county to declare a public health emergency, and large companies in the region asked employees to work from home as early as the first week of March.

Seven Bay Area counties—including Alameda, Contra Costa, Marin, San Francisco, San Mateo, Santa Clara, and Santa Cruz—implemented shelter-in-place orders beginning on March 17. Los Angeles County instituted a comparable order mere days later, but the virus was already spreading rapidly.

As of now, regions are in different phases of flattening the COVID-19 death curve. In Los Angeles County, the last week of data suggest the number of deaths doubles about every 8 days. That is a faster rate than Florida (12 days), but still far slower than New York in its deadliest week—when deaths doubled almost every day.

Other parts of Southern California also saw a spike, with deaths doubling every 8 days. Meanwhile, at 12 days, deaths in the Bay Area are doubling more slowly, as they are in the Sacramento region at 15 days. Both the San Joaquin Valley and other parts of the state have essentially plateaued at 19 and 32 days.

Local policies have also curbed demand for COVID-19 hospital care. Statewide, hospitalizations and ICU beds filled due to COVID-19 have been trending downward for two weeks, but have ticked up slightly the last few days. Certain counties—notably Los Angeles—have continued to see an upward trend in COVID-19 patients in intensive care, although it does seem to be plateauing.

In Los Angeles in recent weeks COVID-19 patients occupied about 30% of total ICU beds, compared to less than 15% in the Bay Area. The San Joaquin Valley and Sacramento regions also seem to be faring well, with about 10% of ICU beds filled due to the coronavirus. Regional estimates of ICU occupancy rates (as of 2018) suggest hospitals can manage current levels of COVID-19 patients while meeting other intensive care needs.

Governor Newsom listed clear criteria for reopening the state’s economy in the midst of the global pandemic. All of California will meet certain benchmarks, such as data tracking and scientific advances in testing and treatment, on a single timeline. Others, such as plans for conducting business while social distancing and protecting vulnerable residents, will likely differ by region.

The state acknowledges that communities may reopen at different times based on circumstances. Recent experiences suggest that responsive local policies could help the state reopen while suppressing COVID-19 hospitalizations and deaths.