Omicron criticized the California workforce. Was there another way?

By Ben Christopher and Grace Gedye, CalMatters

As the omicron wave of COVID-19 appears to have peaked, it leaves in its wake sick nurses and exhausted bus drivers, understaffed hospitals and canceled surgeries, school districts scrambling to find substitute teachers and grocery store cashiers forced to choose between their health and their finances.

Other countries have encountered this variant with new lockdowns. Other states allowed state bureaucrats to moonlight as teachers. In New York and Washington DC, businesses are now required to verify the vaccination status of their customers.

Would all of this have kept California workers safe, reduced the worst of the spread, and averted cascading labor shortages? And what can lawmakers do now to prepare for the future of COVID – whether it’s the next deadly variant or a low-level simmer of a pathogen that has become endemic?

Five waves and nearly two years into the COVID-19 pandemic, this virus still does not tolerate any easy solutions.

Should it be like this?

If public opinion were no object, stricter mask mandates and an increase in vaccinations after the delta wave in late summer would have blunted some of omicron’s impact, said Dr. John Swartzberg, clinical professor emeritus of infectious diseases and vaccinology at UC Berkeley. But the variant’s transmissibility is so formidable that even with these measures, omicron would still have been a problem, he said.

“Frankly, I think California has done a reasonable job of trying to balance protecting people from the virus and allowing people’s lives to function in more normal ways,” Swartzberg said.

Broad shutdowns, he said, likely wouldn’t have made a demonstrable difference in the number of people who got sick, a sentiment shared by other public health experts contacted for this story.

While other states and countries have reacted differently to the spread of omicron, the number of cases suggests that policy differences have not had a drastic impact on the course of this surge, said Jeffrey Clemens, economist at health and associate professor at UC San Diego.

“There probably weren’t many actions that governments could have taken in real time in an effort to significantly dampen the wave,” Clemens said.

It may take a few months to find out if local or state policies have made a difference in the number of people seriously ill or dying from this surge.

If the state deserves criticism for its strategy leading up to the current crisis, it’s for focusing too narrowly on promoting vaccines, said Peter Chin-Hong, an infectious disease physician at UC San Francisco. .

“Putting all the eggs in the vaccine basket” meant less focus on stockpiling masks, tests and new treatments like monoclonal antibodies that have made COVID much less threatening for the vast majority of vaccinated patients. , did he declare. “I think we could have been more proactive as a state. We have the resources, we have the gray matter, we have the means. »

Another cohort of health professionals and researchers based in the Bay Area say that if there is one lesson to be learned from the most recent COVID surge, it is that public health officials in the State have been too slow to recognize the real and much reduced threat the virus poses. to most people in 2022.

Last week, four physicians associated with UC San Francisco wrote a controversial letter drawing a very different lesson from the state’s experience with omicron: California must eliminate masking and testing requirements in schools as soon as that the current thrust will have diminished.

Whether the state could have done more to limit the spread of omicron is the wrong question to ask, said emergency medicine professor Jeanne Noble, co-author of the letter. Instead, public health policy should strive “to achieve maximum protection for this very small segment of our population and not this clumsier way of restricting the lives and social norms of the population as a whole.” “.

No containment in sight

Even as many Californians were still learning to pronounce “omicron” in early December, Newsom had already ruled out the possibility of another lockdown. With so many state residents vaccinated, such drastic social distancing measures were no longer required by science, he said at the time. Nor would they likely have been tolerated by much of the COVID-weary public.

The Democratic governor of California was not the only governor to make this calculation. Even though hospitals were running out of beds, schools were running out of unexposed teachers, and charts lacked the vertical space to accommodate the number of stratospheric cases, not a single state imposed new lockdown measures.

It was a stark contrast to two years before. At the time, governors of blue states in particular were rapidly shutting down businesses and schools. This time the main focus has been to keep things up and running. In Michigan, Oklahoma and North Carolina, governors issued emergency orders deploying state employees and school district administrative staff to classrooms to keep schools open. New Mexico Governor Lujan Grisham went further and became an alternate herself.

Other states have attempted to address omicron-induced labor shortages with financial incentives. Kentucky lawmakers are considering offering loan forgiveness to nurses and social workers.

Earlier this month, U.S. Health and Human Services Secretary Xavier Becerra said the department would spend $103 million on programs to address burnout among health care workers, including 8, $7 million would go to three hospitals and a nonprofit organization in California.

Newsom’s omicron answer

Since omicron arrived in California, the Newsom administration has tried some version of all of these approaches. Earlier this month, the governor issued an executive order making it easier for schools to hire substitute teachers. In the budget proposal the governor submitted to the Legislative Assembly earlier this month, he asked that the state continue to waive certification fees for new teachers and that $3 million be set aside for “research on health care shortages”.

In November, ahead of omicron’s arrival, the administration finalized a request to the Legislature to set aside an additional $1.4 billion in emergency COVID spending beyond the enacted state budget. Last year. Of that total request, $478 million would be used to hire more nurses and clinicians to relieve understaffed hospitals. This week, they bumped that total request up to $2.3 billion, with an additional $8 million set aside for “peak” staffing.

Despite all this extra spending, the administration seems optimistic that the wave will soon recede and that a new one is unlikely to follow. His budget proposal is based on the assumption that Californians will be back to work at “pre-pandemic labor levels” by late summer or early fall 2022.


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Michael A. Bynum