California adopts nation's first 'endemic' virus policy
Speaker 1: (00:00)
California has embarked on an effort to live with COVID 19 governor Gavin Newsom has announced a shift in the state's response to the virus, moving from pandemic to endemic.
Speaker 2: (00:11)
We move into a phase which should allow you confidence that we are not walking away, that we're taking the lessons learned and we're leaning into the future.
Speaker 1: (00:24)
That shift anticipates that the virus will continue to exist in the community, but vigilant public health measures can keep it under control. California is the first state in the nation to declare an endemic policy toward the virus. Joining me as K P S health reporter, Matt Hoffman, Matt. Welcome. Hey
Speaker 3: (00:43)
Speaker 1: (00:43)
In a practical sense, what does this change to endemic mean for people in their daily lives? Like will all mask mandates be lifted, have testing or vaccination requirements changed?
Speaker 3: (00:56)
Well, in terms of will all mask mandates be lifted, the state's mask mandate for VA or for people who have vaccinated is gone. Now, local jurisdictions can do what they want. So we know up in LA county, they are continuing to have a, a mask mandate, but that's sort of what the governor was talking about in terms of like communities, uh, assessing the situation on the ground and taking appropriate steps. Now we did hear from the governor too, that they want to be in lockstep with communities. Um, but in terms of a, a change to their daily lives, you know, we've sort of been in this situation the last few months where, you know, aside from the, the mask requirement, there, weren't a lot of heavy restrictions, you know, on, on, on, on the business side of things. Um, so generally, you know, when the governor says, we're moving away from this crisis mindset, um, you know, moving from a more reactive approach to a more set approach. So it's not gonna be like, you're gonna notice a huge change from yesterday to today.
Speaker 1: (01:47)
The governor used the letters of the word smarter to outline the new policy. Can you take us through what they mean?
Speaker 3: (01:55)
Bear with me here for a minute, cuz there's a lot of letters here. So smarter, the S is stands for shots. So, you know, the state says, we know that vaccinations are the most powerful, full weapon, uh, in terms of fighting this virus, the am is for masks. Uh, talking about how we know that masks can stop the spread of the virus and in terms of what people can expect in their daily lives, that might be something where they said, Hey, if there is a variant that comes out, uh, we may have to reintroduce some mitigation measures like universal masking, uh, a is awareness, um, in terms of, of, you know, making sure that they know what's coming. Um, and how COVID 19 is spreading are as readiness. That's the understanding that when we talk about endemic, you know, COVID, isn't going away, uh, in the states recognizing that they wanna be more proactive and ready to react. Um, and that includes monitoring things like wastewater, all that kind, uh, the tea and smarter stands for testing. And the state basically says, we're gonna continue to provide this testing. E is education. They want schools to stay open for in-person instruction and they think that they can do that safely. And finally, the RN smarter stands for RX. We're talking about treatments. So like antivirals monoclonal antibodies, continuing to use tho those as another, you know, tool in the tool belt to fight this virus.
Speaker 1: (03:06)
I wanna expand on something that you mentioned when it comes to an example of increased monitoring that goes along with this endemic policy, Newsom said, analysis of wastewater will be improved to search for sign of the virus. What happens if a surge or a new variant is detected?
Speaker 3: (03:24)
Well, it's gonna kind of de depend on what that surge or, or, or what that variant is. And if it's staying in one spot or if it's spreading statewide, uh, we heard the governor's team talk about that. They don't want to be too prescriptive in terms of like, even when you look at their response to Delta, in terms of the response to OCN, you know, OCN a lot more contagious, less deadly Delta, more deadly. Uh, so they want to be ready, uh, to prepare, uh, for different variants in different ways. Um, but if they were to detect something in wastewater, like we have here in San Diego, they test wastewater regularly. Um, and it can give up to a, a few weak, uh, notice in terms of what's, uh, if they saw increases, then, you know, we heard Dr. Galley said they would flood that area area with testing, uh, to see if they can get a, a track on the virus. They wanna work closely with cities and counties, Maureen.
Speaker 1: (04:10)
So does the new endemic policy take into consideration the special needs of underserved communities? You know, those communities who've seen the highest rate rates of disease and death.
Speaker 3: (04:22)
Yeah. So something the governor has said throughout the pandemic and he reiterated yesterday is that, uh, E is that equity will guide, uh, this plan and this framework. So that's something that we're definitely hearing. Um, even when he talks about, uh, you know, the S and, and smarter shots, uh, that we need to get, uh, boosters out there for people, you know, there's kind of been a low uptake for are boosters. Uh, we are seeing generally, you know, some of that older population, the more vulnerable are the ones that are going out there and getting that, uh, but making sure that even the booster distribution is equitable. So something that's definitely top of mind for the administration,
Speaker 1: (04:53)
What's been the reaction of San Diego officials to the governor's endemic policy.
Speaker 3: (04:58)
We had a chance to talk with county supervisor and board chair, new eighth and Fletcher. He also chairs the county's COVID 19 subcommittee, kind of in, you know, one of the front men in terms of the county. He says, he thinks that we're at a point now where we can safely and responsibly be aware, um, and, you know, recognize that COVID is gonna stay here with us, but that, that state of crisis, you know, that we don't need to be there anymore. Um, he also touched on restrictions for businesses. It's the state hint to that likely won't be super, super restrictive. Like we saw early on,
Speaker 4: (05:26)
You know, the probabilities, the, any restrictions moving forward is, is, is highly unlikely because again, and we now have the tools they're readily available. Folks can access a vaccine, a booster or hospitals have better treatments. You know, we have some of the natural immunity that's been built up via infection. And the combination, all of that, you know, just puts us in a very different position and situation than we've been in, uh, for the last few years.
Speaker 1: (05:49)
So this endemic plan doesn't seem to actually change that much on a practical level. Did the governor explain why he's chosen to make this announcement? Now,
Speaker 3: (05:58)
The governor says that California is more prepared than ever, uh, to tackle the pandemic. He talked about going back even a couple years ago, how we didn't know hardly anything about how the virus spread, uh, you know, how deadly it was, uh, what was likelihood people, uh, could go to hospitals or overwhelm the hospital system. Um, and he says that combined with, you know, recently cases have been, have been going down, um, the, the vaccination wall that we have, and not just the vaccination wall, you know, people that have had COVID, um, and have some of that immunity, but he says that we're sort of here to meet this moment and, and, and we are prepared for the future. And he does say, you know, the approach isn't to let the virus just ravage us, but to be ready to act, instead of, you know, being in a more reactive framework, a more proactive, uh, response to this pandemic,
Speaker 1: (06:46)
K P S health reporter, Matt Hoffman. Thank you so much.
Speaker 3: (06:49)
California Gov. Gavin Newsom on Thursday announced the first shift by a state to an “endemic” approach to the coronavirus pandemic that emphasizes prevention and quick reactions to outbreaks over mandates, a milestone nearly two years in the making that harkens to a return to a more normal existence.
Newsom said the approach — which includes pushing back against false claims and other misinformation — means maintaining a wary watchfulness attuned to warning signs of the next deadly new surge or variant.
“This disease is not going away,” he told The Associated Press in advance of his formal announcement. “It’s not the end of the quote, unquote, war.”
A disease reaches the endemic stage when the virus still exists in a community but becomes manageable as immunity builds. But there will be no definitive turn of the switch, the Democratic governor said, unlike the case with Wednesday’s lifting of the state’s indoor masking requirements or an announcement coming Feb. 28 of when precisely the school mask-wearing mandate will end.
And there will be no immediate lifting of the dozens of remaining executive emergency orders that have helped run the state since Newsom imposed the nation’s first statewide stay-home order in March 2020.
“This pandemic won’t have a defined end. There’s no finish line,” he told the AP. With that in mind, he said his administration tried to craft “a plan that allows us to be prepared without being paranoid and more alert to what’s happening around us without being anxious.”
The World Health Organization declared the COVID-19 outbreak a pandemic on March 11, 2020, and with omicron fading in many parts of the world some countries have begun planning for the endemic stage.
Newsom’s administration came up with a shorthand acronym to capsulize key elements of its new approach: SMARTER. The letters stand for Shots, Masks, Awareness, Readiness, Testing, Education and Rx, a common abbreviation for prescriptions and a reference to improving treatments for COVID-19.
Living with COVID-19 under Newsom’s plan means boosting the state’s surveillance, including increased monitoring of virus remnants in wastewater to watch for the first signs of a surge. Masks won't be required but will be encouraged in many settings.
If a higher level of the virus is detected, health officials will analyze its genotype to determine if it is a new variant. If so, state and federal officials have a goal to within 30 days determine if it responds to existing tests, treatments and immunities from vaccines or prior infections.
Testing and staffing in the affected area will be increased, including temporary medical workers to assist strained hospitals.
The plan sets specific goals, such as stockpiling 75 million masks, ramping up to 200,000 vaccinations and 500,000 tests a day, and adding 3,000 medical workers within three weeks in surge areas through ongoing contracts with national registry companies.
Dr. George Rutherford, an epidemiologist and infectious-diseases control expert at the University of California, San Francisco, has urged a cautious approach to lifting mandates. He saw drafts of Newsom’s plan and likes it.
“They have a long-term plan that’s trying to capture these events as they occur and has the supply chain stuff you need to have pre-positioned so that we can move forward in a thoughtful but rapid way to control new outbreaks,” he said. “We’ll be able to apply them quickly and in a targeted way that’s least disruptive to get the job done.”
California’s health secretary, Dr. Mark Ghaly, said one of the goals is to avoid business closures and other far-reaching mandates. However, he said the state's requirement that schoolchildren be vaccinated against coronavirus by fall remans in effect.
The plan calls for a continued emphasis on efforts in vulnerable and underserved populations that have experienced disproportionately high death rates. And it includes new education, including “myth-buster videos” to fight misinformation and disinformation and help interpret ever-evolving precautions for a confused public whiplashed by safeguards that seemingly shift by the day and vary across county lines.
It relies on continued testing sites including in schools, more over-the-counter virus tests, building and tracking strategic stockpiles of testing kits, surgical and K95 masks, hospital gowns and gloves, ventilators to breathe for the most seriously ill. In coordination with the federal government, it calls for a first-in-the-nation study of the pandemic’s direct and indirect impacts long-term on both people and communities.
“One of the fundamental lessons we’ve come to understand is that the disease has evolved and our understanding has to evolve in terms of how we approach it with the kind of flexibility that is required,” Newsom said. “We have to prepare for that uncertainly, we have to communicate that uncertainty and this plan is put forth with that in mind.”
Newsom and Ghaly said the same constant monitoring will be useful in spotting other similar respiratory airborne diseases, while leading to improvements in California’s overall public health system.
All this will cost billions, much of it already outlined in the $3.2 billion pandemic response package Newsom sought as part of his budget last month. That includes $1.9 million that lawmakers already approved to boost staffing at hospitals and increase coronavirus testing and vaccine distribution, as well as existing money and anticipated federal funds.
His proposed budget also includes $1.7 billion to beef up the state’s health care workforce, with more investment in increased laboratory testing capacity, data collection and outbreak investigation.
Newsom defended keeping in place some of his executive emergency orders, which he said most recently have allowed the state to quickly bring in temporary medical workers and to quickly distribute more than 13 million home test kits to schools.
Those orders have dwindled from 561 to fewer than 100 in recent months, he said, and his administration is working with legislative leaders to eventually make them unnecessary. Republicans in both legislative chambers have been lobbying the Democratic majorities for weeks to lift California’s state of emergency.
The omicron surge is ebbing as quickly as it spiked in December, with new cases falling back to near pre-surge levels. Hospitalizations and intensive care cases were also falling, and the state's forecasting models predict a continued gradual easing over the next month.
“This is exactly what people are going to be asking in the next few weeks: Are we in a new phase? How do we live with this disease without living in fear?” Newsom said.
He expects other states and the federal government to soon follow California, because "I think the public will be demanding of this.”