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California and San Diego County's pandemic emergencies are over, what's next

After three years California and San Diego County’s COVID-19 emergency orders are ending Tuesday. KPBS Health Reporter Matt Hoffman has a look at what’s next.

After three years, California and San Diego County's pandemic emergencies ended Tuesday, but that doesn't mean COVID-19 is gone. San Diego County's state of emergency was put into place in Feb. 2020 out of of caution. Soon after Gov. Gavin Newsom announced a stay-at-home order along with California's state of emergency. That resulted in 74 executive orders and nearly 600 additional provisions that state officials said helped save thousands of lives.

"There were a lot of regulations that were suspended as a result of the pandemic to allow us to move faster," said Scripps Health CEO Chris Van Gorder.

Van Gorder said hospitals were able to keep up with high demand thanks to those orders. They allowed for higher patient-to-staff ratios and the ability to quickly add extra bed space.


"We could have had a real health care catastrophe had the government not worked hand-in-hand with health care providers," Van Gorder said.

Last Thursday Scripps had 83 COVID-19 patients admitted at their hospitals across the county, but that is far from the daily counts, which reached up to 500 during surges. Van Gorder said it's time to end the state and local emergencies.

"That fear and verge of panic that we saw three years ago is really gone," he said. "Our physicians and nurses know how to take care of these patients."

A spokesperson from California’s Department of Public Health (CDPH) said out of the nearly 600 provisions issued during the emergency, just 27 were in place through February. Masking is still required in health care settings and long-term care facilities. The CDPH spokesperson said those orders are not tied to the pandemic emergency ending and Van Gorder is waiting for more details there. He is also looking to see if state officials will continue their vaccination requirement for health care workers.

"There’s probably a lot of people — including hospital employees — that are curious about that," Van Gorder said. "We’ll wait and see. The state may decide to waive that when they waive the health care emergency — or they may extend it."


The state and county have been winding down their pandemic responses. Long-gone are the mass drive-up vaccination and testing sites. San Diego County Public Health Officer Dr. Wilma Wooten has been leading the region's pandemic response.

"We still have to do the same things that we’ve been doing for the last three years — now at a smaller scale," Wooten said. "But who knows how the situation could change ... "

Wooten said plans are in place should they need to scale up again, but she said the pandemic is manageable.

"The cases are not as low as I’d like to see them," Wooten said. "They’re between the mid to 200’s (daily) — that is evidence that the virus is still circulating in our community and we can't rest on our laurels ... The pandemic is not over."

The number of San Diegans seeking lab-verified tests has dropped significantly with many opting for at-home testing, which does not make it into official case counts. County officials are still monitoring COVID-19 through San Diego's wastewater, and recently the amount of the virus has been going up.

"Things are overall pretty darn good in San Diego County," said Dr. Eric Topol, director of the Scripps Research Translational Institute. "The only issue that doesn't go in the right direction is that the wastewater surveillance shows some uptick, but hospitalizations are way down."

Topol is not forecasting any substantive changes with the state and local pandemic emergencies going away. The virus has been producing new variants, and while things are relatively quiet, he would like to see investments in better vaccines.

"Just in case we get a whole new family of variants beyond this omicron family that we’ve dealt with for well over a year," Topol said. "We’re not prepared. We could be working on this but we’re not serious enough."

He and other health officials say COVID-19 certainly isn't going away and could look similar to the flu — with vaccines recommended each year. Topol said if our region continues to have minor COVID-19 waves, the virus could be considered endemic, but that is too early to say for sure.

"It all depends on whether this virus can find a new path to hurt us," he said. "Whether it’s run its course with all these recent variants we’ve been through — then it will be in an endemic state."

UC San Diego assistant professor Rebecca Fielding Miller from the Herbert Wertheim School of Public Health in the Division of Infectious Disease and Global Public Health said COVID-19 in an endemic state is not a victory lap.

"Endemic just means that it (COVID-19) is here at the levels that we are seeing," Fielding Miller said. "(And those) are going to be the levels that we see moving forward."

The federal COVID-19 emergency is set to end in early May. For all Californians vaccines, testing and treatments will still be available with no out-of-pocket costs for an additional six months after that. A CDPH statement said after Nov. 11 if people seek those services from an outside their health network may have additional charges.

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