As the state moves into the next phase of the COVID-19 pandemic, on Feb. 17, Gov. Gavin Newsom announced the Californian SMARTER Plan as it is recovering from the Omicron variant surge where millions of Californians were infected. Newsom said as the state moves forward, with potential future variants and surges, it will be utilizing what has been learned over the past two years to approach mitigation and adaptable measures through effective and timely strategies. SMARTER is an acronym for Shots, Masks, Awareness, Readiness, Testing, Education, and RX (treatments).
California Health & Human Services Secretary Dr. Mark Ghaly said he was thankful for the Californians who have been diligent with the pandemic, and though California lost more than 83,000 in the state, its actions did save lives, especially in comparison with other larger states. He said it is important to understand that COVID is still here and there is no way to predict its course in the future but being prepared is the key in moving forward.
“We also recognize the difficulties the last two years have brought us,” he said. “Howbeit at different degrees and different forms, many have lost loved ones, lost jobs, lost opportunities, and lost a sense of confidence of what tomorrow might bring. The presence of a wildly sneaky, shapeshifting and deadly novel virus was not predictable, and the level of innovation and adaptation our state has shown is noteworthy.”
Ghaly said in discussing the next phase of the pandemic, many believe that it is long overdue, while others say it is premature. But he said, today is about balance. Balance between a message of hope and successful adaptation, but also vigilant preparedness and moving forward. He said the governor’s plan does not “draw a line in the sand,” but delivers the promise that after two years that government and health will continue to work together, even more than before.
“To be aware with antennas up high and readied resources, and the right people to fight back as we need be,” he said. “We will be there with an anchor on equity, guided by the needs of the most vulnerable, and most often overlooked, to raise any disparities that may emerge.” Ghaly said today, COVID-19 is no longer a “novel foe,” and that the wall of immunity built by vaccines is strong but must become stronger. He said that awareness and preparedness is important as COVID is still a “long term nemeses,” but the knowledge of the virus has vastly improved. He said that vaccines are the key tool in staying alive with the virus, and though people have lived in fear for the past two years, the knowledge gained will help the state move forward with a smarter approach.
Ghaly said predicting the future is a less reliable approach than having a predictable, well prepared response in the unknown future of COVID-19. He said the “domains” in the SMARTER plan are meant to protect citizens while keeping culture and commerce constantly moving forward. He said vaccines have worked with recent data showing the unvaccinated 5.6 times more likely to get COVID, 12 time more likely to be hospitalized, and 17 times more likely to die, than people who are up to date on their vaccines. He said the focus now is on the kids who just became available or who remain ineligible for vaccines, and boosters for the elder and immunocompromised.
Ghaly said mask are still a key mitigation strategy and are tailored to the strain of virus at any given time.
“The fact that masks do not work should not be the debate,” he said. “We should work together that those the benefit the most have access to the highest quality masks that we can provide. And there may be a time when we all need to wear masks so that we do not overwhelm our healthcare system or cripple our businesses.”
Ghaly, said it would refine it messages about masking, be clear when and where it is required, and if not formally required, be clear about whether they are strongly recommended, recommended, or optional.
Ghaly said awareness means leaning on predicting actions that are predictable that are timely, yet focused.
“Using our world class institutions, who not only collect and report the data, but can analyze it and track it over time so we can understand the collective impact of COVID and be smarter about what works and what does not,” he said. “Surveillance is going to be key. Understanding when and where we see signals of transmission and being able to trigger a set of responses that Californians can come to depend on.”
Ghaly said two years ago, the collective systems were not ready for what COVID would bring, but California has accelerated change and preparations faster than almost anywhere else in the nation in areas of hospital surge, PPE availability, collecting data, modeling trends, and deploying “armies of staff” towards this work.
“We will be ready for whatever COVID-19 throws our way,” he said. “The key is testing. We will work to test more effectively than we have before.”
Ghaly said its work with school in education, and these domains are meant to keep schools open for in-person learning. He said monitoring transmission in schools will be instrumental in managing schools as needed, and that data will be unquestionable.
“We have learned that schools can be safe and continue through the worst ups and downs of the pandemic,” he said.
Ghaly said that due to its strategies, California had the fewest school closures in the nation, and that it is reassessing guidance for school districts and will give an update on Feb. 28, based on the movement of a strong recommendation for general indoor public masking, to see if there is any change in the data.
“In more likelihood, because we are more comfortable with the trends, we will be able to set a date in the optimal future when masking in schools will also be strongly recommended rather than required.”
Ghaly said the state will continue to treat those infected with supported treatments.
“We will once again lean on California’s innovative spirit and track where we can bring together testing, technology and treatment, as a triple threat to fight disease. We will work with our private and public partners to ensure available treatments, quickly made available. This is the catalysts to push us forward in the state. Not only to allow us to live with the virus but continue to thrive.”
Ghaly said smarter means action on future COVID scenarios that may occur. in some cases, mitigation will be determined by case numbers, and at other times hospital metrics. He said for example, a highly virulent virus like Delta, it would be determined by case numbers, but with a less virulent virus like Omicron, it would be hospital metrics, even if more transmissible.
Ghaly said people should anticipate an increase in the virus at the beginning of the school year in late summer and early fall, and a higher surge in December as winter begins, whether it is a familiar or a new variant. He said citizens should be prepared for the possible seasonality of COVID.
Ghaly said it plans to keep a supply of masks, ventilators, tests, and the ability to deploy staff, something that lacked at the beginning of the pandemic. He said the state commits to having 75 million masks, thousands of ventilators, a goal of bringing 30 million tests, and successful resources for schools that require resources to keep students safe and schools open.
“It is important for Californians to know that we will be more precise and focused on not only the state of the disease, but the state of how we live with the virus,” he said. “Public health after this suppression phase is about healthy containment. We are committed to that by using these tools to get us there.”
