California’s three-year-old COVID-19 state of emergency will be lifted on Tuesday — a development that reflects the dawn of another hopeful phase of the pandemic, even as officials and experts say continued vigilance and preparation are needed to continue its current promising trajectory. to put .
While the global pandemic itself is not yet over, the withdrawal of the health emergencies issued by all levels of government during the early days of the outbreak recognizes the extent to which the overarching COVID threat has subsided, allowing many residents to return to a large extent or completely to normal life before the outbreak.
With robust community immunity – both through vaccination and natural infection – the availability of updated boosters and effective therapies, as well as a well-worn toolbox of nonpharmaceutical interventions, many events and activities are safer today than they have been in years.
“While the threat from this virus is still real, our preparedness and collective work have helped make this once crisis crisis a manageable situation,” said California Health and Human Services Secretary Dr. Mark Gayly.
Since the future isn’t set in stone, officials and experts say it’s important to stay prepared to deal with the ongoing fallout from COVID, as well as any new tricks the coronavirus may have up its sleeve. Withdrawing emergency declarations could also change the way residents access vital resources such as vaccines, treatments and tests.
“As we experienced during the pandemic, there are no absolutes,” said Barbara Ferrer, director of Los Angeles County Public Health. “There is a great temptation to say that the pandemic is coming to an end and for some this experience is very real. For others, they continue to feel the impact on a daily basis — whether it’s living with the loss of a loved one, the economic toll of the pandemic, or the effects of prolonged COVID.”
But given that “we haven’t seen a major winter surge and our hospitalization and death rates have been stable, that’s positive,” she added at a recent briefing. “I’m optimistic about this next phase.”
Here’s what you need to know.
Why is California ending its emergency situation?
Governor Gavin Newsom unveiled the timeline for ending the state of emergency last October, saying California has built up the resources it needs to continue its fight against COVID-19 without the added flexibility the statement offered.
“The state of emergency was an effective and necessary tool that we used to protect our state, and without it we would not have gotten to this point,” he said. in a statement at the time. “With the operational readiness we have built and the measures we will continue to implement going forward, California is ready to phase out this tool.”
His announcement came ahead of the crucial fall and winter season, when many officials and pundits feared another resurgence of the coronavirus could add pressure to California’s healthcare system.
But while the state saw an increase in transmissions and hospitalizations in mid-fall, it was volatile and relatively mild — leading to by far the calmest winter of the COVID-19 era.
What does ending the emergency mean?
California’s first emergency declaration was issued on March 4, 2020, and served as a prelude to more than 70 executive orders, many of which Newsom has already terminated.
“Many of these things are gradually winding down, in terms of waivers or emergency orders associated with these various statements,” said California state epidemiologist Dr. Erica Pan during an online forum this month. “There are a lot of state resources in the field that are being used less and less and that we are demobilizing over time.”
Looking ahead, perhaps the biggest impact of withdrawing the emergency declaration will be changes in how residents access COVID-19 vaccines, tests and treatments. However, many Californians will not see a seismic shift.
According to the California Health and Human Services Agency, “Californias will continue to have access to COVID-19 vaccines, tests and therapies at no out-of-pocket cost” even after the state of emergency ends.
Until Nov. 11 — six months after the scheduled end of national emergency and public health declarations — Californians with private health insurance or enrolled in Medi-Cal “will have access to COVID-19 vaccines, tests, and therapies from any appropriate licensed provider without out-of-pocket costs, even if the provider is outside the insured’s network,” the agency told The Times earlier this month.
Californians may be subject to cost-sharing or coinsurance fees if they access those resources from an out-of-network provider after that date. But “if the enrollee has access to the services of an in-network provider, the enrollee does not have to pay anything out of pocket,” the agency said.
A federal policy that required insurers to reimburse covered individuals for eight home COVID-19 tests per month ends May 11 along with the nationwide public health emergency. But in California, state legislators have taken action to preserve this resource for most health plans. regulated by the Department of Managed Health Care – which covers approximately 23.5 million people with private insurance or health plans administered by Medi-Cal.
California legislators also passed legislation requiring health plans and insurers to cover anti-COVID medications.
Los Angeles County still has a COVID-19 emergency declaration, but negotiations are underway to finalize it, perhaps by the end of March.
How will California respond in the future?
Just over a year ago, California officials unveiled their blueprint for the next phase of the pandemic response. They dubbed it the “SMARTER” plan – with the acronym of the same name outlining an approach rooted in seven key areas: injections, masks, awareness, preparedness, testing, education and Rx (or anti-COVID drugs).
The 30-page document lists a handful of specific preparedness goals that officials say would position the state well to respond to the changing nature of COVID-19. Those include benchmarks regarding how many vaccines California should be equipped to administer daily and how many masks it should store, as well as commitments to maintain robust testing capacity, wastewater monitoring and sequencing efforts — which together help officials track transmission trends and evolutionary changes of the coronavirus itself. .
The plan uses the analogy of a road trip to describe the shift in state thinking. At the start of the COVID-19 era, California was driving “on an unfamiliar road with poor visibility, torrential rain, worn brakes and no windshield wipers.”
Now “we are driving on a road we have mostly driven before with good weather conditions, and in a car with new brakes and wipers. There are still potential hazards on the road ahead, but we are much better equipped to anticipate and respond to them.”
What are the current COVID-19 trends?
The number of cases in California has hit another seasonal low: 55 for every 100,000 residents for the weekly period ending Feb. 21. That is comparable to the seasonal silences of last September and October.
In contrast, the winter peak was 222 cases per week for every 100,000 residents. A weekly case count of 100 or more is considered high.
As of Friday, 2,516 coronavirus-positive patients had been hospitalized in California. That’s significantly lower than the winter high of 4,648 recorded on Jan. 3, but still higher than the previous fall’s lows of 1,514; or last spring, 949.
Statewide, 227 COVID-19 deaths were reported for the week ending Feb. 21 — a tally that brought California’s cumulative COVID-19 death toll above 100,000. At the winter peak, 407 COVID-19 deaths were reported for the week ending Jan. 17; and the fall low was 102 deaths for the week ending Nov. 29.
COVID-19 is expected to remain a leading cause of death for some time to come, especially among people who are unaware of their vaccinations and booster shots, and who are not receiving anti-COVID drugs like Paxlovid if they do become infected.
About 60,000 US residents have died of COVID-19 since October, an amount more than triple the 18,000 estimated U.S. flu deaths during the same period.
Another concern is lung COVID — a set of symptoms that can persist for months or years following an acute coronavirus infection that is expected to result in a significant cause of disability in the US for some time to come. A federal estimate, based on survey data, suggests that 28% of people who have had COVID-19 have had long-term COVID.
Most people with long-term COVID experience improvement in symptoms over a long period of time, Ferrer said, but some people experience long-term COVID as a disability that has lasted for years and has not ended.
“It is sobering to see how many people are still affected by the protracted COVID, almost three years into the pandemic,” she said.
