The first case relating to the COVID-19 pandemic in the U.S. state of California was confirmed on January 26, 2020. A state of emergency has been in place in the state since March 4, 2020. A mandatory statewide stay-at-home order was issued on March 19. As of June 27, 2020, the California Department of Public Health (CDPH) reported 206,433 confirmed cases and 5,872 deaths in the state. As of July 2020, California has the 2nd highest number of confirmed cases in the United States. Also that month, the state surpassed the 200,000 mark, but a lower per capita infection rate per population for the state’s over 40 million residents.

On March 4, California public health officials in Placer County reported a second confirmed case in an “older adult” resident with underlying health conditions who was aboard the Princess Cruises cruise ship Grand Princess on a cruise to Mexico that departed San Francisco on February 11 and returned on February 21. Although initial reports indicated that the new case had been hospitalized in “critically ill” condition, public health officials in Placer County subsequently reported the new case’s death later on the same day. This marked the eleventh death in the United States attributable to coronavirus, the first death in the U.S. attributable to coronavirus outside Washington state, and the first death in California attributable to coronavirus.

The source of the new case’s infection appears to be the same as that of a resident of Sonoma County who tested positive on March 2 and who was also aboard the cruise ship Grand Princess on the same dates. In relation to this, Governor Gavin Newsom declared a State of Emergency in California. Consequently, Princess Cruises, the owner and operator of the cruise ship Grand Princess, working with the CDC, the state of California, and public health officials in San Francisco, terminated a port call in Ensenada, Mexico planned for March 5 and ordered the cruise ship to return to San Francisco over concerns about the potential for an outbreak of coronavirus aboard the cruise ship. Sixty-two passengers still aboard Grand Princess who may have made contact with the Placer County case that died earlier in the day were quarantined aboard the cruise ship at the request of the CDC.

On March 10, Governor Gavin Newsom announced 24 new cases of COVID-19 for a total of 157 confirmed cases in the state. Alameda County reported its third confirmed case in the county. The new case is the spouse of the second case, who was a passenger aboard Grand Princess. The new patient had already been quarantined at home and remains isolated. San Francisco reports a new case in a patient who had known contact with a confirmed case, bringing the total number of confirmed cases of COVID-19 in the city to 14 with 89 confirmed cases in the Bay Area. The patient of the new case is currently hospitalized. The city announces a ban on large gatherings and relief for small businesses.

Many doctors and nurses and EMS workers expressed fears and frustrations at being asked to wear the less effective surgical masks and at the overall lack of proper masks, gowns and eye gear which imperils their ability to fight the coronavirus and puts their own lives at risk. The medical workers are concerned that the shortages have not been addressed by the CDC, whose changing guidance for healthcare over how to stay safe themselves and protect the patients remained unclear and misleading.

The American Nurses Association sent a letter to Congress, saying there is concern “that C.D.C. recommendations are based solely on supply chain and manufacturing challenges,” and “that these recommendations do not offer strategies to address the limited manufacturing and supply chain of necessary personal protective equipment.” By May 10, at least 36 healthcare workers had died from COVID-19 in California.

On July 1, Governor Newsom ordered the closure of most indoor businesses, including restaurants, wineries, and movie theaters, in Contra Costa, Fresno, Glenn, Imperial, Kern, Kings, Los Angeles, Merced, Orange, Riverside, Sacramento, San Bernardino, San Joaquin, Santa Barbara, Santa Clara, Solano, Stanislaus, Tulare and Ventura counties.