Though most Californians recognize that we're enveloped in a continuing pandemic — yes, the same one that's taken nearly a million lives and counting in the U.S. — Gov. Gavin Newsom unexpectedly announced last week that the crisis phase of Covid-19 was now over, and we in the bright-blue state of California were going to break pioneering ground with a new approach to the disease: treating it as "endemic."
(And yes, this news did come from the same person who was caught failing to abide by the pandemic policies he ordered.)
Should future outbreaks require reactivation of strict social distancing and masking measures, Newsom's decision could also lower compliance with public health directives.
The Centers for Disease Control and Prevention defines "endemic" as the "constant presence and/or usual prevalence of a disease or infectious agent in a population within a geographic area." By declaring Covid endemic, Newsom isn't saying that it's over. He's saying that it's here for good, and that we need to accept that we'll have a baseline level of deaths from it forever — a baseline, we should remember, that even with the omicron wave apparently fading is still at its highest point since early 2021, well before a vaccine was widely available.
But that won't matter to millions of Californians and people beyond the state who are already taking the receding wave as a signal that we should take a deep breath of maskless air and go back to business as usual because, as Newsom suggested, the crisis has passed.
And that's the tremendous danger of Newsom's seemingly politically motivated decision to make California the poster child of the "Pandemic is over if you want it" movement. It might be interpreted as a statement of victory, but it's actually a flag of surrender. U.S. history has shown us that when people in power make bold, symbolic speeches in front of a banner — literally or figuratively — that reads MISSION ACCOMPLISHED! (hello Dubya), the outcome is poor, both for the legacy of those politicians and for the people.
In his remarks about his "endemic response plan," which he has dubbed SMARTER (Shots, Masks, Awareness, Readiness, Testing, Education, Rx), Newsom has been careful to make clear that this isn't intended to be a declaration of an end to the war on Covid. He said that the new framing means that we are "turning the page, moving from this crisis mentality, moving from a reactive framework to … living with this virus." And the plan states: "We know what works, and have built the necessary tools over the last two years that allows us to learn and hone our defenses to this virus as it evolves."
There are three big problems with Newsom's assertion. First, we don't fully know "what works." There are many significant outstanding questions about Covid-19's transmission and prevention that are still being actively researched. Questions like how long immunity from prior infection or vaccination is likely to last and how and where Covid attacks the body. There have been several signs that it's not just a respiratory disease, that it has cardiological, vascular and neurological effects, and that in some cases, primary damage doesn't come from the virus itself but the body's "cytokine storm" response to infection.
With these significant questions still unresolved, it's hard to say that our present approaches to response, treatment and long-term therapy are correct, or that they will remain correct as the disease continues to throw off new variants.
And that points to the second problem. The virus will continue to evolve, and it's more likely to do so now that we are largely, as a state and a nation, deciding to give up trying to contain it. New variants pop up as Covid transmits from person to person. Preventing transmission, or at least tamping down spread as much as possible, is our best chance at restraining the proliferation of new variants. Dropping even the minimal restrictions we have now in favor of a damn-the-torpedoes strategy will in short measure generate new Covid spin-offs from Pi through Omega and beyond — any one of which could combine the contagiousness of omicron with the deadliness of delta.
This leads to the third problem with Newsom's new tack on Covid: The assumption that we are ready to start "living with the virus." It's quite a thing to talk about living with the virus when there are still so many people dying from it. Seven-day rolling death averages in California finally started falling two weeks ago but are still higher than they've been at any time since the delta wave of last summer.
Yes, vaccines are effective in preventing hospitalization and death, and broad societal vaccination would help us live with the virus. But omicron has been a game changer, with its ability to partially evade the vaccine. In California, while 79 percent of people between the ages of 18 and 64,and 71 percent of those between 12 and 17 are fully vaccinated, only 31 percent of 5- to 11-year-olds are in that group. And where boosters are concerned — necessary to provide fuller protection from severe illness, given omicron's greater contagiousness — the numbers are even lower: 63 percent of people between the ages of 18 and 64, and 6 percent of 12- to 17-year-olds. Boosters haven't yet even been approved for those 11 years old and younger.
So omicron's magic-bullet dodging trick has set us back — back far enough that public health experts now believe that achieving herd immunity is effectively impossible. All of which might underline Newsom's decision to announce an end to looking at the disease with a "crisis mentality."
That doesn't mean the crisis is over, of course, just that we've changed how we think about it, like flipping a switch. And unfortunately, as Albert Ko, chair of epidemiology and microbial diseases at Yale School of Public Health told The Washington Post in January, "This is not a situation where you have a flip of the switch, like, we're pandemic one day and then we switch to endemic."
Unless you're Gavin Newsom, that is. Of course, there are some good things in the SMARTER plan — such as expanded wastewater testing to detect potential viral surges and the formal addition of Covid to the list of mandatory vaccines school kids need for in-person attendance. But the bigger consequence of this arbitrary overnight reversal in policy, with no clear trigger other than Newsom's political desire to get out in front of pandemic exhaustion, is going to be reduced trust in government crisis communications.
And should future outbreaks require reactivation of strict social distancing and masking measures, Newsom's decision could also lower compliance with public health directives. The right thing to do would've been to set very clear milestones for vaccination levels or case and fatality rates, and then use those as triggers for a shift in policy — or to wait for formal guidance from the CDC. But then, I guess, California wouldn't have been first.