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Earlier stay-at-home order more effective, data shows

California's statewide stay-at-home order may have had a greater impact on reducing that state's number of new coronavirus cases than Tennessee's own stay-at-home order had on reducing its number of new cases, according to data obtained from two county health departments.  

Taking a forceful stance to help fight the spread of COVID-19, Gov. Gavin Newsom of California issued a statewide mandatory stay-at-home order on March 19.  This executive order was the first statewide order of its kind in the United States.  While some thought the governor's order to be unnecessary or too radical, Gov. Newsom maintained a firm stance during his announcement.  He may have even unintentionally predicted the success of his early stay-at-home order.  

"This is not a permanent state, this is a moment in time," he said during his speech.  "We will look back at these decisions as pivotal."

After Gov. Newsom issued the first statewide directive to help keep people at home, other states began to gradually follow suit.  Four days later, nine states had issued stay-at-home orders.  A week later, 29 states had joined California in issuing their own statewide orders. On April 2, two weeks after California's stay-at-home order went into effect, Gov. Bill Lee implemented his own stay-at-home order for the state of Tennessee.  

When asked by reporters for The Tennessean why he waited so long to issue the state's stay-at-home order, Gov. Lee initially stated that no such action was necessary and that he was focused on balancing public health and protecting personal liberties.  Repeated pleas from medical professionals and city and county leaders to issue a statewide order were influential in convincing the governor to implement the order.  Dr. Aaron Milstone, a Franklin physician who was one of the first in the medical community to speak out against Gov. Lee's refusal to implement a statewide stay-at-home order, went as far as to call the governor's leadership weak for asking residents to stay at home instead of mandating that they do so.


"In three months from now, no one will question the bold measure we are taking to save lives," Milstone said.  "But there will be plenty of questions if we settle now with half measures and PR campaigns.  Gov. Lee must do more." 

But how much of a difference did the two weeks between California's statewide order and Tennessee's statewide order make?  

Davidson County, Tennessee, and San Joaquin County, California, are very similar in population size. As of 2019, Davidson County had approximately 694,144 residents, while San Joaquin County had 762,148 residents, according to the U.S. Census Bureau.  By comparing day-to-day new coronavirus cases in these two counties for the entire month of April, the impact of an earlier stay-at-home order becomes clearer.  

On March 31, twelve days after Gov. Newsom issued the statewide order for California, San Joaquin had 151 cases of coronavirus, while Davidson County had 541 cases.  Although both counties continued to see new cases day to day throughout April, San Joaquin's daily increases remained in the single digits and low double digits, with a high single day increase of 39.  In contrast, Davidson County's day to day increases were mostly in the high double digits and triple digits, with a high single day increase of 182.  

As the graph shows, by enacting a statewide stay-at-home order nearly two weeks prior to April 1, San Joaquin's daily increases followed the "flatten the curve" initiative.  Comparatively, Davidson County's daily counts of new cases often showed drastic variations and frequent spikes of increases of 100 or more. 


Although Davidson County started April with almost four times as many cases as San Joaquin County, a statewide stay-at-home order for Tennessee enacted two weeks earlier may have resulted in a flatter, less drastic rate of increase.  Now that Tennessee's statewide stay-at-home order has been in place for nearly a month, the hope is that the curve of daily increases statewide will begin to flatten going forward.

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