While California lifts mask, vaccine mandates, some restrictions will endure in LA County

As the state officially eased many COVID-era masking rules on Monday, April 3, Los Angeles County will retain its vaccine requirement and mask mandate for all health workers when they are around patients. Visitors and patients, however, will no longer be required to wear a mask.

The county’s rules are more restrictive than other parts of the state. The California Department of Public Health ended the statewide mask requirements in healthcare and other indoor high-risk settings — including correctional facilities and emergency and homeless shelters.

It’s unclear how long the tougher guidelines will be in place locally, but county Public Health Director Barbara Ferrer has said they will be reassessed in September, if not sooner.

Many other restrictions have gone away in the county, however. Local leaders have already aligned with the state’s five-day isolation and quarantine recommendations. And workers in correctional roles, detention facilities and adult day care centers are no longer be required to be vaccinated.

“Our communities did a lot of the hard work by getting vaccinated and boosted, staying home and testing when sick, requesting treatments when positive, and masking to slow the spread,” said CDPH Director and State Public Health Officer Dr. Tomás Aragón. “With these critical actions, and a lot of patience and persistence, we have now reached a point where we can update some of the COVID-19 guidance to continue to balance prevention and adapting to living with COVID-19.”

As rules ease, monitoring of the virus will continue. County officials will continue to require schools, employers and hospitals and clinics to record COVID numbers and report  outbreaks.

“This is when we take the training wheels off, ” said Dr. Kimberly A. Shriner, infectious disease expert at Huntington Hospital, Pasadena. “We have to learn to live with COVID19 … There are things that we’ve sort of trained the public to do now, hopefully, that ingrained in them to do the right thing when they sense that there’s a risk.”

That said, Shriner added that the timing of the mandate release is not ideal. Masking is a vital first defense from infection, especially in healthcare settings. Because the vaccine does not completely prevent infection, and the possibility of new variants are ever present, them the outcome — if people choose not to wear a mask — is the higher possibility of an uptick in infection rates.

“It’s very hard to measure what’s happening out in the community until you start seeing sick people and, by that time, the horses out of the barn,” Shriner said. “That’s what they’re gonna do — they’re using hospitals, hospital admissions, hospital evaluations as sort of the canaries in the coal mine.”

By default, this all means that as mandates lift and masking becomes a thing of the past, immunocompromised and disabled populations are left to further isolate and ramp up their personal protections.

Along with the mandate lifts, the state will “wind down” other COVID initiatives such as state-funded testing and test-to-treat sites, vaccine staff, outbreak response teams, mobile vaccine units and pop-up vaccination events.

Other impacts to public health programs and initiatives include:

• Reduced state support for local contact tracing efforts.
• Fewer staffing flexibilities for hospitals and nursing homes.
• End of reduced training and certification requirements for certified nursing assistants and home health aides.
• Ending the expedited license processing for facilities performing COVID-19 tests.

In a late 2021 report, the National Council of Disabilities People said that disabilities and chronic conditions who were at particularly high risk of infection with, or severe consequences from the virus, were not recognized as a priority population by many states when vaccines received emergency use authorization. It found that roughly one-third of all U.S. COVID-19 deaths were at facilities that house seniors with disabilities and people with disabilities aged 31-64.

“While the struggles faced by people with disabilities have been widespread and urgent during the pandemic, advocates have had less opportunity to bring attention to them due to sheltering in place, social distancing, and the general movement to online communications during the pandemic,” wrote Nikki Zeichner in Disability in the Time of Covid-19: a publication of stories and policy recommendations for American Association of People with Disabilities.

There are still risks for “healthy” populations.

At least 65 million individuals worldwide are estimated to have long COVID, a multisystemic chronic health condition experienced people who were infected with SARS-CoV-2. The condition is disabling, can last for years and has no known cure or treatment. Repeat infections put people at increased risk of Long COVID. The condition can lead to concurrent diagnoses like myalgic encephalomyelitis, dysautonomia, cardiovascular disease along with many others.

Marginalized people living with “Long COVID” and its concurrent diagnoses face heightened medical bias and financial hardships.

Shriner, who is also director of Huntington Hospital’s Long COVID Recovery Clinic, said that the risk of getting Long COVID if the patient stays up-to-date on vaccinations. Through it’s research, the clinic identified markers in patients blood that confirmed their claims of Long COVID symptomology. The finds were surprising for Shriner, who shared that upon early opening of the clinic she was unsure how many patients would truly have Long COVID.

“I thought we may have a lot of folks that sort of think they have it and they don’t really have it. They’ve all had it. They have the symptoms … their stuff is abnormal. So I think that it’s real, and it’s important and debilitating disease,” she said.

Because the disease is only newly researched, experts are still working to find treatments that will relieve patients suffering and allow them to return to normality.

Shriner added that to avoid infection, people must consider masking if they are high risk or are entering a high risk scenario and to maintain regular COVID vaccinations.

“We need to be very careful,” Shriner said. “The  next six to eight weeks will be critical as people really start not using their masks, and there’s less testing. If a new variant emerges, you want to try to catch it before everybody’s coming into the emergency room with it.”

To read the CDPH update, visit www.cdph.ca.gov/Programs/OPA/Pages/NR23-014.aspx. For Los Angeles COVID resources, visit www.publichealth.lacounty.gov.

 

Source: Orange County Register