SAN FRANCISCO - California has largely avoided a new wave of coronavirus cases that has sparked alarm elsewhere in the country, but the state faces new dangers in the coming weeks as key businesses reopen and the holidays arrive.
In what health experts describe as a significant achievement, California over the last two months has managed to reopen key parts of the economy without seeing the widespread spike in cases, hospitalizations and deaths that occurred this summer.
They credit Gov. Gavin Newsom's overhauled system - introduced Aug. 28 and much tougher than the state's disastrous first reopening - as a big reason for California having so far staved off a new surge in cases.
Moreover, the state has been sticking to the rules, a change from the more haphazard approach taken in the spring. For example, Riverside and Shasta counties on Tuesday were pushed into the most restrictive tier, or the purple category - requiring gyms and places of worship to operate outdoors and restaurants to close indoor dining rooms - as cases began to rise again.
New threats are looming. Officials are worried that Halloween, Thanksgiving and Christmas could encourage super-spreader events if people, fatigued by months of isolation, decide to start socializing again without proper precautions, which is what caused so many problems in the summer. More than 17,000 Californians have died from COVID-19, and the summer was the state's deadliest season.
A third wave may come down to whether Californians can continue to make the sacrifice of isolation over tradition as the holidays roll around.
"This is the year, unfortunately, to stay with those loved ones that you have been sheltering with up to now, to stay within your smaller, intimate bubble and to have a low-key Thanksgiving and winter holidays," said Dr. Kirsten Bibbins-Domingo, chair of the University of California, San Francisco's Department of Epidemiology and Biostatistics. "The challenge of understanding viral transmission is the exponential rate that it grows. So when things are low, if we are not vigilant, they can go high very quickly."
For the moment, California remains a standout in a nation still struggling to contain the virus.
"We have no sign yet - yet - of a third wave," said Dr. George Rutherford, epidemiologist and infectious diseases expert at the University of California, San Francisco.
By contrast, "it's gone so wrong in the rest of the country. There's a clear third wave (nationally). The cases have doubled since early September," Rutherford said. "The rest of the country is doing a lot of stuff wrong."