Friday, March 1, 2024

California ends COVID isolation rule for asymptomatic cases as winter infections rise

Californians infected with COVID-19 can go about their lives without self-isolation or testing negative as long as their symptoms improve, according to new and largely stripped-down guidelines from the California Department of Public Health.

California’s top public health official, Dr. Tomás Aragón, quietly repealed the previous state order last week, which encouraged people infected with COVID-19 to self-isolate for five days.

The new health order allows Californians with COVID-19 to return to work or school as long as their symptoms improve and they don’t have a fever for 24 hours without medication. Asymptomatic individuals who test positive are not considered contagious and do not need to be isolated, according to the order.

“Instead of staying at home for a minimum of five days, individuals may return to work or school once they begin to feel better,” state public health officials said in a statement. signature statement.

The guidelines came as California teeters on the brink of a major respiratory illness caused by COVID-19, seasonal influenza, and the respiratory syncytial virus, also known as RSV. Flu and COVID-19 hospitalizations both peaked in the first week of January and have been trending downward since, according to state data.

Masking requirements have not changed, and people with COVID-19 must wear a mask for 10 days, whether they have symptoms or not. The new guidelines do not apply to employees in high-risk health care settings such as hospitals and nursing homes, which may also have different policies for visitors.

It’s unclear whether employers can ask workers to return to work if they want to isolate until they test negative. Cal/OSHA, the agency that enforces state workplace safety laws, did not respond to a request for clarification of the rule by the deadline.

Some experts say the new guidelines represent a major shift in California’s COVID-19 strategy, but it’s not necessarily an unexpected change.

“I think it makes sense, especially for the amount of immunity in the population that we have, including children, and for the fact that we have a menu of options to prevent and treat COVID,” said Dr. Peter Chin-Hong, an infectious disease expert. with UCSF Health. “It’s a responsibility. It’s still necessary to wear a mask and take care of people who are older or immunocompromised.”

A national study from the Centers for Disease Control and Prevention in June estimated that about 96% of people 16 and older have acquired immunity to COVID-19 through vaccination, prior infection, or both. State data shows that while relatively few Californians are fully vaccinated with updated boosters—only about 12%—at least 82.5% of the population has gotten at least one COVID-19 shot.

The state’s move also heralds a shift toward treating COVID-19 like all other endemic respiratory infections.

“Many people may be infected with COVID-19 or other respiratory infections and not get tested or know what infection they may have. The update to our public health approach and recommendations includes our recommendation of a broader, multi-pronged approach to multiple respiratory viruses,” department officials said in a statement.

Noha Aboelata, chief executive of Roots Community Health Center in Oakland, is one of many community doctors who expressed frustration with the state’s new direction. COVID-19 doesn’t necessarily behave like other respiratory viruses—hospitalizations and deaths never drop to zero like the flu does outside of the winter months—and it’s still unpredictable, Aboelata said. .

“We still believe that if enough is found (in a test), there is enough to be contagious,” Aboelata said. “That’s why I recommend people test negative before going around others.”

California schools are adjusting to new COVID-19 rules

The state’s new strategy also seeks to minimize school disruptions where extended periods of quarantine and virtual instruction have impacted student learning and led to widespread mental health challenges for youth. on.

Some California school districts adopted the new guidelines immediately, while others said they were waiting for direction from their local public health agencies.

Oakland Unified was among those that notified parents of its new policy shortly after the state released the guidelines. In an email to families, the district said students and staff can come to school if they test positive for COVID-19, as long as they have no symptoms, wear a mask, and avoid people at high risk of the disease, such as those who are immunocompromised.

In accordance with state guidelines, those with symptoms of COVID-19 should stay home but may return to school if symptoms improve. The district said it will continue to stock masks and COVID-19 tests and keep air purifiers in classrooms.

Los Angeles Unified, the state’s largest school district, said it was awaiting direction from the county’s public health agency. In a note to families, Fresno Unified recommends that students and staff who test positive for COVID-19 stay home, regardless of their symptoms.

The mixed response mirrors the earlier reactions of schools to COVID-19 in 2020. While most districts closed in March of that year, some began bringing back special education students in late spring, while others—mostly large districts—don’t reopen for in-person instruction until fall 2021.

Teachers and parents are on board with the COVID rules

For many districts, reopening decisions depend on negotiations with teacher unions. This week, California’s largest teacher’s union generally supported the state’s updated COVID-19 guidelines, saying schools are adopting adequate safety measures to keep staff safe. students and families.

“We are always concerned about high-risk individuals, and we will continue to monitor the situation and reopen contracts if necessary,” said Rachel Warino, spokeswoman for the California Teachers Association. “But we are confident that the negotiations that took place at the height of the pandemic—on air filtration, testing, masks, and reasonable accommodation—will be enough for now.”

Some parents are relieved by the new guidelines because they encourage students to go to school. Thousands of students across the state are still struggling to catch up academically after remote learning, and many have suffered mental health challenges during the quarantine.

Scott Davison, who is part of a parent group at Carlsbad Unified near San Diego, said parents send asymptomatic students to school for a year or more, regardless of state or local. guides.

“It hasn’t changed for most parents,” Davison said. “We could have made these guidelines two years ago, and the result is still the same. We all know that children belong in school.”

Concern for vulnerable Californians

Disability and equality advocates have been particularly critical of the new guidelines. They believe the change could increase the risk of infection for vulnerable Californians.

“This policy is not based on science, equity, or public health. It devalues ​​the lives of immunocompromised and disabled people, and completely ignores the high risk of COVID,” said Lisa McCorkell, co-founder of Patient -Led Research Collaborative, which studies the long-term effects of COVID.

There is no treatment for advanced COVID, which can leave some patients debilitated for years, and increased transmission will harm poor communities, McCorkell said.

California officials have made other significant changes to the state’s COVID-19 response strategy in recent months, including returning much of the state’s Paxlovid stockpile to the federal government in December, which effectively ends California’s free antivirus program.

The free COVID-19 hotline, where residents can get Paxlovid prescriptions and vaccine appointments, will also close at the end of February, state public health officials told CalMatters in a statement. The state has spent $2.3 million on the hotline since July 2022.

These changes, too, are worrying for equity advocates.

“Not everyone has a primary care physician. If you don’t have a primary care provider or good access to a primary care provider who is knowledgeable about treatment, then it’s going to be difficult for you to access it,” said Aboelata.

State-regulated health insurance plans are required to permanently cover in-network COVID-19 testing, vaccinations, and treatment at no cost, even though about 6 million Californians are enrolled in federally regulated plans that are only required to cover vaccines. You can ask your employer what type of coverage you have.

By Kristen Hwang and Carolyn Jones, CalMatters. Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.

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