In California, a person who tests positive for Covid and has no symptoms does not need to isolate, according to new state health guidelines.People who test positive and have mild symptoms, meanwhile, can end isolation once their symptoms improve and theyve been fever-free for 24 hours without medication even if that point arrives in less than five days.
The California Department of Public Health updated the policies earlier this month.
"We are now at a different point in time with reduced impacts from COVID-19 compared to prior years due to broad immunity from vaccination and/or natural infection, and readily available treatments available for infected people," the department said in a news release.
"Our policies and priorities for intervention are now focused on protecting those most at risk for serious illness, while reducing social disruption that is disproportionate to recommendations for prevention of other endemic respiratory viral infections," it added.
The state's guidance differs from that of the Centers for Disease Control and Prevention, which continues to advise people with Covid to stay home for at least five days, regardless of whether they have symptoms.
If symptoms havent improved after five days, people should keep isolating until they feel better and have been fever-free for 24 hours, according to the CDC. Many state health departments direct residents to follow the CDC or base their recommendations on the agency's, which have not changed since August 2022.
California isnt the first state to deviate from the CDC. Since May, the Oregon Health Authority has similarly said that people with Covid dont need to isolate for a set number of days, but should stay home if they have a fever and avoid contact with high-risk people for 10 days.
Californias policy still asks everyone to wear masks indoors around others for 10 days after their first day of symptoms or positive test, as do Oregon's guidelines.
Several public health experts said the policies balance what scientists know about Covid transmission with peoples growing fatigue of Covid safety measures.
"We have to develop effective, safe ways to live with Covid-19 but not let Covid-19 hijack our life or work anymore," said Chunhuei Chi, a professor of health management and policy at Oregon State University.
"What California and Oregon are doing is not just based on evidence, but they have to consider practicality. What is feasible?" he added.
Even before the policy change, many people in California werent testing for Covid or, if they did test positive, were returning to school or work once they felt better, said Dr. Peter Chin-Hong, an infectious disease expert at the University of California, San Francisco.
"A lot of people are not diagnosing the sniffles anymore," he said.
Dr. Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security, said Californias new recommendations are not surprising.
"Over time, its always been kind of assumed that Covid-19 guidance would collapse into the same type of guidance that we use for other respiratory viruses like influenza," he said.
But some other public health experts worry that Californias policy could increase Covid transmission.
Saskia Popescu, an assistant professor of epidemiology and public health at the University of Maryland School of Medicine, said the change "almost feels like an overcorrection" to Californias historically conservative approach to the virus.
The message that "if you dont have symptoms, youre not really risky to those around you," she said, is "not only counter to what the science says, but its also very dismissive of the fact that this person does have an infectious disease."
Asymptomatic people can spread Covid, but scientists think the risk might be lower than those with symptoms. Chi said its hard to know how infectious asymptomatic people are, since research on the subject has declined since 2022.
Built-up immunity from vaccines and infections might also limit peoples ability to transmit Covid, regardless of symptoms, according to Adalja.
"Right now, even people who are symptomatic might test negative because theres so much immunity thats keeping the viral load below a contagious level," he said.
Still, a positive rapid test is usually a good indicator that you can spread the virus, he added.
Given that some past research has shown people can transmit Covid before and after they have symptoms, Popescu said it doesnt make sense to lump Covid isolation guidelines with those for other respiratory viruses.
"We really just dont see asymptomatic cases of influenza and RSV. If youve got it, you know it. You feel like you got hit by a bus. Covid is different in that regard," Popescu said.
Other states may follow California and Oregons example.
Jonathan Modie, the lead communications officer for the Oregon Health Authority, said state health officials have discussed its isolation policy in calls with representatives from six other states and the CDC. In addition, California reached out "as they began contemplating a change in their guidance, and we met with them separately," he said.
Thus far, Oregons policy has not led to a disproportionate increase in transmission or severe disease, Modie added.
He said that telling people to isolate "was doing almost nothing to halt transmission," and that "isolation was placing a significant burden on the workforce and schoolchildren."
Some public health experts think the CDC might revise its recommendations eventually, while others expect no change.
"While Covid-19 remains a concern we are seeing fewer hospitalizations and Covid-related deaths as compared to last year likely a result of widespread vaccination and prior infection," a CDC spokesperson said in an email. "CDC will continue to evaluate the latest dataas it considers its recommendations."
Aria Bendix is the breaking health reporter for NBC News Digital.
When Brendan Crabb finally caught COVID-19 for the first time late last year, it was because he'd broken his own rule he took a risk he says he shouldn't have. Since 2020, Professor Crabb, director and chief executive of the Burnet Institute, had been sticking to a rigorous anti-COVID routine, effectively using layers of protections to avoid getting the virus.
And then in a moment of lapsed judgement, he joined a crowd of hundreds of people at an awards event in a small room in Sydney, without his portable air purifier and N95 mask. "The waiters couldn't even get to us to give us a drink," he says it was that tightly packed. "That's a situation I never get myself into and three days later, I tested positive."
Fast-forward a couple of months and a similar story has been playing out for thousands of Australians as COVID-19 surges again. Partly it's because the highly mutated new subvariant JN.1 has driven a worldwide spike in infections, hospitalisations and deaths. But it's also probably because so many of the precautions we used to embrace masking, testing and isolating, vaccination have been abandoned, deemed unnecessary by those who think the danger has passed, or who misguidedly believe COVID-19 is "just a cold" or necessary to catch for immunity.
Some commentators have described this situation the crashing of wave after wave of COVID-19, a steady drip, drip, drip of death and mounting chronic illness as the "new normal". But other experts insist it doesn't have to be, and that continuing on the current trajectory is unsustainable especially in light of data showing that COVID has decreased life expectancy, will cost the global economy an estimated $US13.8 trillion by 2024,and is decimating the lives of millions of people who have developed long COVID.
Meanwhile, studies continue to pile up showing COVID-19 can cause serious illness affecting every organ system in the body, even in vaccinated people with seemingly mild infections. It can cause cognitive decline and dysfunction consistent with brain injury; trigger immune damage and dysfunction; impair liver, kidney and lung function; and significantly increases the risk of cardiovascular disease and diabetes. Then there's long COVID, a debilitating disease that robs fit and high-functioning people of their ability to think, work and exercise.
All of this is why governments must invest in long-term strategies for managing COVID-19 into the future, experts say particularly by introducing standards for indoor air quality. But until then, they say, Australians can and should take precautions against COVID-19 to reduce transmission and protect their health. And doing so is relatively simple: it just takes a little planning, preparation and common sense.
Here, three of Australia's leading COVID-19 experts share their personal COVID safety strategies and reflect on what must happen if we're to blunt the growing health crisis the pandemic is causing and prepare for the next one.
When the COVID-19 pandemic hit Australia in 2020, Associate Professor Stuart Turville had been working in the Kirby Institute's level-three physical containment (PC3) lab, researching another well-known RNA virus: HIV. His team quickly pivoted to SARS-CoV-2, capturing the virus and characterising it very quickly. Still today when the NSW Ministry of Health's genomic surveillance unit identifies a new variant of interest, Dr Turville, a virologist, will use a swab from a positive case and grow the virus to understand its mutations and virulence.
Scientists working in the PC3 lab must wear robust personal protective equipment primarily for respiratory safety. Before he enters the lab Dr Turville dons several layers of gear: a full-face Powered Air Purifying Respirator (PAPR) mask, a collar with its own HEPA filter ("it's like being in a scuba suit"), two pairs of gloves, a disposable Tyvek suit, a generic gown that is laundered after use, booties, gumboots and little plastic socks that go over the boots. "Not only could [getting infected] impact our research colleagues and the general community," he says, "but we could also take the virus home."
For Dr Turville, the risk of taking COVID-19 home was particularly serious. In 2020 he was caring for his elderly father who had heart problems and his mother was also at risk of severe disease. If he brought the virus into his dad's aged care facility, it would be put into lockdown and "he would be eating cold meals in his room alone". "So for me personally it was incredibly important to maintain that protection and ensure I remained negative," he says. "I've still only got it once I got it from undergraduate teaching, which will teach me."
As for how he protects himself outside the lab, day to day? For starters, "As a scientist I don't get out much," he jokes. He drives to work, avoiding crowded public transport. If he's going on an overseas trip, he'll plan to get a booster vaccine four weeks before he gets on a plane. "I know from the studies that we do and other people do that if you get a new formulation vaccine you're going to encourage the mature B cells to generate better cross-reactive antibodies," he says, "and so you're going to have better protection if you're exposed to [COVID-19]."
If someone in his family gets sick, he says, they immediately isolate themselves. "It's only happened once or twice where one of us has been positive but they've generally been isolated to one room and wearing a P2 mask" to protect the rest of the household. "Another thing we've been doing, which has been somewhat of a side benefit of looking after my father in aged care, is RAT testing before going into those facilities even though we might be asymptomatic," he says. "I think it's really a situation of common sense in the context: if you don't feel well, you isolate, you keep germs to yourself."
Still, Dr Turville is acutely aware of the vitriol frequently directed at people who promote COVID-19 safety. Strangers will circulate photographs of him in his lab kit, particularly on social media, to mock him: "They'll say, 'Oh, this guy is an idiot, why is he using that, he shouldn't fear [the virus] anymore'." This both puzzles and amuses him. "It's my job; I'm not going to bring it home when I have a sick father pull your head in," he says. "Unfortunately there is a lot of negativity towards people who choose to protect themselves. We never really saw that in the HIV era there was never really a pushback on condom use."
Then again, the differences between how the two pandemics HIV/AIDS and COVID-19 were managed in Australia are probably quite instructive, says Dr Turville. With HIV, experts and health ministers collectively built a strong public health strategy that they strove to protect from politics. "When we look at COVID, it was political from the start and continues to be," he says. We also now lack a "mid to long-term plan to navigate us through" this next phase of COVID-19: "Some argue that we are no longer in the emergency phase and need to gear down or simply stop," he says. "But should we stop, and if not, what do we gear down to as a longer-term plan?"
Perhaps one reason Australia lacks a long-term plan for managing COVID-19 is the complexity of instigating one in light of the community's collective trauma. The first couple of years of the pandemic were stressful and frightening and as much as border closures, lockdowns and other restrictions saved tens of thousands of lives in 2020 and 2021, they are still resented by some people whose livelihoods or mental health suffered and who now push back against precaution. This backlash is so fierce in pockets of the community that some seem to conflate any kind of protective action with lockdowns.
"There might have been some things we went too hard with but I think we have to look at it in perspective," Dr Turville says. "We didn't have those really, really dark months in Australia we never had the mass graves like we saw in Italy or New York. We got a scare during [the] Delta [wave] and that helped get us our really high vaccination rates But my worry now is, are we stepping away too soon?"
Aside from much of the general public abandoning measures like masking, he says, political support for genomic surveillance work is also now "shrinking". And without the critical data it generates, he says, there's a risk scientists like him will miss new, more dangerous variants. "I think there's a lot of patting on the back at the moment job well done. And that's nice, but I think it's somewhat job well done, there goes the rug," he says. "I think it's the apathy that's the concern. And I think it's coming top-down, it's coming very much from the government. I just don't understand why, like we had with HIV, there can't be a mid-term strategy."
Associate Professor Robyn Schofield can rattle off data on the harms and benefits of clean indoor air as breezily as if she were reciting her own phone number. We breathe in about eight litres of air a minute. We consume 14 kilograms of air a day. Our lungs have the surface area of half a tennis court. Globally, nine million people die from air quality issues every year. In Australia, she says, it's somewhere between 3,000 and 11,000 deaths "way more than the road toll". But people generally don't know any of that, she says. "They don't appreciate how important breathing is until it's hard to do. It's like the air: you can't see it, so it's out of mind until it's a problem."
In 2020, the air became a massive problem. The main way COVID-19 spreads is when an infected person breathes out droplets or aerosol particles containing the virus think about aerosols as behaving similarly to smoke, lingering in the air potentially for hours. An atmospheric chemist and aerosol scientist at Melbourne University, Dr Schofield quickly began working with respiratory specialists to understand how to reduce the risk of viral transmission by improving the ventilation and filtration of indoor air.
What she still finds thrilling is that indoor air quality can be assessed with a battery-powered CO2 monitor; popular devices like the Aranet cost about $300 but some companies are developing tech to allow smartphones to do the same. And the investment is worth it, many argue, because it can help you avoid catching COVID-19. It's also good for productivity, with studies showing higher CO2 levels decrease cognitive performance. If CO2 is 800 parts per million, Dr Schofield says, 1 per cent of the air being inhaled has been breathed out by someone else and is therefore a good proxy for infection risk.
One of the findings from the past few years she finds "most exciting", however, is the role of relative humidity in indoor spaces. When relative humidity is below 40 per cent, Dr Schofield says, the risk of catching COVID-19 increases. (A good sign of that, for those who wear contact lenses, is dry eyes, which she says is "a really good indication that you should get out!") "Because you are becoming the moisture source. Your mucous membranes which are protecting you from getting COVID or the doses you acquire are giving up that moisture, and so it's easier to be infected."
Dr Schofield is particularly concerned with preventing infection in healthcare settings. She bravely spoke out last year when, while being treated for breast cancer at Peter Mac in Melbourne, the hospital decided to relax its masking policy for patients. "COVID cases were actually rising at the time, so it was a bad call," she says. "And it was then reversed." But she was still "disgusted" and lost respect for the hospital's leadership, she says: she expected that staff would understand the science of COVID-19 transmission and take steps to protect vulnerable patients.
Even before she was diagnosed with cancer, Dr Schofield was taking precautions for starters, she knows where the "most risky settings" are. Trains, planes and automobiles are big red zones: "Buses are actually the worst," she says, because they recirculate air without filtering it. She regularly uses nasal sprays, wears an N95 respirator when she's indoors with other people in meetings at work, for instance and makes sure air purifiers are switched on. "If I walk into a space, I will also open windows. I just go around and open them," she says. "Because actually, no one's going to tell me not to."
When eating out, she chooses restaurants that have outdoor dining areas: a newly revamped boathouse in the Melbourne suburb of Kew is a favourite of hers, and Korean barbecue is "always excellent", she says, because there are generally extractor fans at each table. It's all about good ventilation clean air. "I always take my Aranet [CO2 monitor] along, and if you sit close enough to the kitchen, the kitchen fans are very effective."
All of these issues point to an urgent need for governments to develop indoor air standards, Dr Schofield says for air quality to be regulated and monitored, just like food and water are. Before the pandemic, in 1998, the economic cost to the Australian economy of poor indoor air was $12 billion per year $21.7 billion in 2021 money. "So why aren't we learning from that, and moving forward?" she says. "This is not about going back to 2019, it's about having the future we deserve in 2030."
Four years into the COVID-19 pandemic we're living in a "public health Barbieland", says Professor Brendan Crabb, director and chief executive of the Burnet Institute. Too many of us are playing "make-believe" that life has returned to "normal", he says, and there's an "enormous disconnect" in the community: a failure to grasp both the true scale of COVID circulating and the impact of infections on our health and longevity.
Australia recorded more than 28,000 excess deathsbetween January 2022 and July 2023, he says. "These are unheard of numbers, people who wouldn't have otherwise died, let alone the hundreds of thousands in hospital we don't know exactly because no one publishes the numbers." Then there are the hundreds of millions globally with long COVID-19, the risk of which increases with each infection. "I find what we know about COVID concerning enough to call it an elevated public health crisis," Professor Crabb says. "And we need sustainable solutions to that now and in the longer term."
The lack of action against COVID-19, Professor Crabb says, is fundamentally a problem of a lack of leadership. "The most common thing said to me is, 'Brendan, I really do trust what you and others are saying. But if there was a real problem the prime minister, the government, would be telling us that,'" he says. "I don't think people are all of a sudden profoundly individualistic and don't care about COVID anymore that they're suddenly willing to take massive risks and hate the idea of vaccines and masks. I just don't think they're being well led on this issue."
A crucial factor shaping Australians' apathy towards COVID-19 in 2024, Professor Crabb believes, was Chief Medical Officer Paul Kelly's statement in September 2022 that the virus was no longer exceptional. "It is time to move away from COVID exceptionalism, in my view, and we should be thinking about what we do to protect people from any respiratory disease," Professor Kelly said at a press conference. Those comments, Professor Crabb says, have never been turned around. "If I'm right and I say that was a profoundly wrong statement then that has to be corrected by the same people."
He also points a finger at two unhelpful ideas. "There is a strong belief, I think, by the chief medical officer and many others that once we got vaccinated, infection was our friend," he says. Australia's vaccine program was highly successful, Professor Crabb says. Most people were inoculated against COVID-19 before large numbers were infected. "If we were the US, we'd have had 80,000 deaths [instead] we had 1,744 deaths in the first two years," he says. But while vaccination broadly protects against severe illness and death, it does not protect against (re)infection or the risk of acute and chronic health problems.
The other idea is hybrid immunity, which holds that vaccination and infection provides superior protection against severe outcomes compared to immunity induced by vaccination or infection alone. For Professor Crabb, the concept is flawed: first, because it encourages infection, which he believes should be avoided, and second, because it does not work at least not with the predictable emergence of new variants like JN.1 which are capable of evading population immunity. "Immunity is good," he says. "But it's not good enough."
In a perfect world, Professor Crabb says, political leaders would speak regularly about the pressure on health systems, about deaths, and about the potential health consequences for children, which are often overlooked. "And then underneath that they'd set a blueprint for action around the tools we currently have being properly implemented: a vaccine program, a clean air program, advice around wearing masks when you can't breathe clean air, and testing so you can protect those around you and get treated." But who speaks matters, too: "If it's not [coming from] the prime minister, if it's not the premiers if it's not consistent it's probably not going to cut through."
In the meantime, he says, people can and should take precautions they can be leaders in their community, and start conversations with their employers and kids' schools. For him, in addition to getting current booster vaccines, it means using a toolkit he built with his wife who, as a paediatrician who works in a long COVID-19 clinic in Melbourne, comes face to face with the harm the virus is doing every day. The kit includes a well-fitted N95 mask, a CO2 monitor and a portable air purifier. "It's another line [of defence]," he says. "If you're in a restaurant, say, and you've got a few people around you, putting one of those on the table, blowing in your face, is a good idea."
Masks, he adds, should be worn in crowded places or spaces with poor ventilation. Of course, the topic sometimes sparks heated debate. A Cochrane review which last year suggested masks do not work was later found to be inaccurate and misleading and subject to an apology. But the damage it did was significant. Since then a vicious culture war has raged, much to the dismay of respected scientists who continueto make the point: numerous studies show high-quality, well-fitted N95 and P2 respirators prevent infection when they're worn correctly and consistently.
Professor Crabb's home is also as "airborne safe" as he can make it. An "enormous amount of transmission" occurs in homes, he says. And his analysis of excess deaths from COVID-19between January 2022 and March 2023 paints a striking picture: Moving down the east coast from Queensland, excess deaths increase, with Tasmania recording the highest proportion last year it was more than double that of Queensland. "There's no way Queensland has better COVID strategies than Victoria," he says. "So very likely it's to do with less time spent in poorly ventilated indoor spaces."
Ultimately, strong evidence supporting the benefits of clean air is why Professor Crabb believes the future of COVID-19 and other pandemics to come is regulating indoor air quality: a responsibility for governments, public institutions and workplaces. "That's where we are really headed, and that's where I think there's strong interest at a government level," he says. "Of course everyone is stressed about what that will cost, but let's at least have the conversation. We have to move towards an airborne future. How you do that in economically sensible ways is a separate discussion whether we do it or not should not be up for discussion, and the gains are enormous."
A total of 1,513 cases of COVID-19 sub-variant JN.1 have been recorded in the country so far with Maharashtra and Karnataka registering the highest number of cases of the variant, according to INSACOG on Sunday. Data compiled by the Indian SARS-CoV-2 Genomics Consortium (INSACOG) showed Maharashtra has recorded the highest number of JN.1 cases at 382 followed by Karnataka at 249.
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Rajasthan has recorded 38 JN.1 cases, Telangana recorded 32, Chhattisgarh 25, Delhi 21, Uttar Pradesh nine, Haryana five, Odisha three, and Uttarakhand, Manipur and Nagaland one each, according to the data accessed by PTI.
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The states have been urged to ensure effective compliance of the detailed operational guidelines for the revised surveillance strategy for COVID-19 shared with them by the Union Ministry of Health and Family Welfare.
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The World Health Organisation has classified JN.1 as a separate "variant of interest" given its rapidly-increasing spread, but said it poses a "low" global public health risk.
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Jan 19
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(Tang Ming Tung/Getty Images)
Updated 5:20 p.m. Friday
California health officials have updated the states official guidance on how long people with COVID-19 should isolate from others with new recommendations that represent a relaxing of the isolation guidelines still in place from the Centers for Disease Control and Prevention (CDC).
Up until now, the CDC has recommended that people who test positive for COVID-19 stay home and away from other people for at least five days regardless of whether or not they have symptoms. But on Jan. 9, the California Department of Public Health (CDPH) issued an update that their official recommendations for Californians would now move away from the five-day rule in favor of instead focus[ing] on clinical symptoms to determine when to end isolation.
Now, the new guidance for COVID-positive Californians says that they should still stay home until their symptoms improve and wear a mask around others indoors for 10 days. But COVID-positive people without symptoms can leave their homes and be in public, CDPH says albeit as long as they stay masked for that period.
This big change in state guidance, coming amid a wave of respiratory virus infections around California and running counter to the CDCs current advice might be causing confusion in your household. Keep reading for the breakdown of the new official guidelines for what happens when you test positive, why the state says theyre making this change, and how to think about the risk your positive COVID-19 test poses to others.
CDPHs new isolation guidelines are focused on whether or not a COVID-positive person has symptoms. (Jump straight to the guidance for people without symptoms.)
The new guidance for COVID-positive Californians who have symptoms:
CDPHs message is clear: You still need to stay home initially. But now, instead of setting a clear time period like before five days at home, 10 days masking CDPH now says that you should judge when youre safe to leave the house: until you have not had a fever for 24 hours without using fever-reducing medication AND other COVID-19 symptoms are mild and improving.
Not everyone gets a fever as one of their COVID-19 symptoms, so what should you do if thats you? CDPH confirmed via email to KQED that you should still stay home if sick until symptoms are mild or improving.
Once your symptoms have improved, CDPH recommends that you Mask when you are around other people indoors for the 10 days after you become sick. You should only remove your mask before the 10 days are up if you have two sequential negative tests at least one day apart, says the new CDPH guidance. If you have symptoms, Day 0 is the day those started.
CDPH also says to Avoid contact with people at higher risk for severe COVID-19 for those 10 days. The agencys definition of higher-risk individuals includes the elderly, those who live in congregate care facilities, those who have immunocompromising conditions, and that put them at higher risk for serious illness.
CDPHs new guidance includes a reminder that youre potentially infectious with COVID-19 two days before your symptoms start.
The biggest change in CDPHs guidance: If you test positive for COVID-19 but dont have symptoms, you should now:
The CDC still says that COVID-positive people should stay home a full five days whether they have symptoms or not. But now, CDPH says that symptom-free people with COVID-19 can leave their homes as long as they follow the guidance above.
Like people with symptoms, you should only remove your mask before the 10 days are up if you have two sequential negative tests at least one day apart, the new CDPH guidance says. If you have no symptoms, your Day 0 is the day you tested positive.
CDPHs new guidance advises that even if you have no symptoms, youre still potentially infectious with COVID-19 two days before you get a positive test.
The states updated isolation protocol applies to schools, and the Oakland Unified School District was one of the first to announce it will be adopting the new recommendations that allow students who test positive for COVID-19 but have no symptoms, to attend school, as long as they wear a mask for 10 days after testing positive. Cal/OSHA has also adopted the new rules for most workplaces around the state (PDF).
Remember, theres growing evidence that some people take longer to get a positive test on an at-home antigen test. If you have symptoms but have tested negative, dont assume it means youre COVID-free. The CDC recommends that you take another antigen test 48 hours later and then test again after another 48 hours. You can also seek out a PCR test, which is more sensitive.
CDPH is firm that for California, the time has come to make this change.
Previous isolation recommendations were implemented to reduce the spread of a virus to which the population had little immunity and had led to large numbers of hospitalizations and deaths that overwhelmed our healthcare systems during the pandemic, the agency says in the introduction to its new guidelines. We are now at a different point in time with reduced impacts from COVID-19 compared to prior years due to broad immunity from vaccination and/or natural infection and readily available treatments for infected people.
The agency says its now recommending these new guidelines to align with common practice of other respiratory viruses, and in an email to KQED, elaborated that a significant proportion of COVID-19 infections are asymptomatic or include minimal symptoms, and many people may be infected with COVID-19 or other respiratory infections and do not test or know what infection they may have.
Acknowledging that COVID-19 now spreads alongside flu, RSV and other respiratory viruses, CDPH says in its email that this update incorporates our recommendations into a broader, multi-pronged approach to multiple respiratory viruses.
But if you look now at the weekly hospitalizations and deaths theyre much higher for COVID than they are for flu, like for the flu season, says Dr. Abraar Karan, an infectious disease physician and researcher at Stanford University. Late December, we had [around] 6500 [nationwide] recorded deaths for COVID. It was [around] 1500 to 2000 per week.
I wouldnt say that COVID has come down to the level where its less pathogenic than the flu per se, just by the numbers, Karan says.
The states COVID-19 dashboards show that hospitalizations and deaths of people with COVID-19 have risen since early November 2023. And when it comes to COVID-19 levels in Bay Area sewage, Stanford Universitys WastewaterSCAN team says that those levels of COVID-19 are high and increasing right now.
Dr. Peter Chin-Hong, an infectious disease expert at UCSF, says this new chapter in the states health policy took us all a bit by surprise.
But when you step back and think about it, were in a different place in January of 2024 compared to March of 2020, Chin-Hong says. There are some things that are changing. It seems dramatic, but there are many things that are not changing in terms of continuing to protect each other.
CDPH says that in 2024, the agencys policies and priorities for intervention are now focused on protecting those most at risk for serious illness while reducing social disruption that is disproportionate to recommendations for the prevention of other endemic respiratory viral infections. Chin-Hong says that he sees this latest CDPH guidance as really speaking to workplace and schools, and especially notes the impact of the pandemic on kids education, particularly in California and in the Bay Area because we probably were shut down more than most places in the country for a long, continuous time.
So I think in some ways it might be a response to that and sort of a nervousness around making sure that our kids are really as well prepared for the future as they can be, Chin-Hong says, given the fact that were going to be seeing these kinds of viruses emerge at least twice a year, we know, for COVID and at least once a year for many of the other respiratory viruses.
While Stanfords Dr. Karan says he has concerns about how much the general public will be able to adhere to mask guidelines and avoid higher-risk people after testing positive, he also says that even before this new guidance, a lot of people werent testing at all or even if they were testing positive, they probably werent following [existing isolation] guidance to 100%.
So I think what the health officials were trying to do was to be more practical and more pragmatic and say, Okay, well, people are probably going out anyways if they feel okay so lets at least just try to emphasize wearing a mask [and] staying away from others who are higher risk, Karan says. Thats my assumption of what drove this.
After almost four years of public health policy at the federal and state levels thats emphasized If youre COVID-positive, stay the heck away from other people, this new update might seem jarring to you.
Theres also the fact that since 2020, weve been told that not only can asymptomatic people be contagious with COVID-19, they might be responsible for fueling a lot of the spread of COVID-19 because those folks are so often unaware they even have the virus.
We know that you can be contagious without symptoms, Karan says. We also know that symptomatology can increase the risk of transmission. So if youre coughing and sneezing, youre probably emitting more viral particles.
This new California guidance focuses on symptomatic people as posing the most risk to others, noted Karan hence the continuing recommendation that those people stay home until those symptoms get milder. As for those asymptomatic people, Karan says, CDPHs take appears to be that if those people wear a mask for 10 days after their positive test, their risk is going to be pretty low that theyre going to be transmitting over time.
Karan says it might also be helpful to see this recent change in the context of how isolation recommendations have evolved throughout the pandemic but also how they havent. At the outset, the CDC stipulated a 10-day period of isolation for COVID-positive patients, a period shortened to five days in December 2021. But this update was still accompanied by guidance to wear a well-fitted mask for another five days.
That aspect wearing a mask for 10 days is something thats remained the same in this latest California update, and the mask part of it is key, Karan says. Its just sort of extending this a little bit to say people who no longer have any symptoms: To people that are either asymptomatic or theyve been fever-free without medications for 24 hours, he says. So theyre adding a contingency.
I think it will confuse the public, Karan says.
One big element hes looking at: As the isolation advice shifts from a clearly set time period five days, regardless of symptoms toward monitoring your own symptoms and you deciding when youre safe to leave the house, will people still remember that crucial next step of wearing a mask for 10 days? And will they have all the necessary information to also follow the other part of CDPHs new guidance that urges them to stay away from people at higher risk from COVID-19?
Karan says that he worries that people are going to forget the second and third part of that, Karan says and hes especially concerned that the importance of that well-fitted, high-filtration mask is going to get lost.
Karan says hed also liked to have seen CDPH give the public more information about the rationale behind why they were doing it, so that the public could understand that this new guidance wasnt a green light to go out into the world with COVID-19.
If theyd said, People that are not symptomatic can be contagious, but its less likely, and people without symptoms are likely going to be shedding less virus, so if you wear a high filtration mask, your risk of infecting others is quite low, and thats why were doing it? I think that would have made a lot of sense, Karan says.
Chin-Hong also acknowledges the emphasis these new guidelines place on avoiding exposing people who are at higher risk of severe illness and death from COVID-19. I worry about that population every night I go to sleep, he says, and thats because were still seeing 1600 Americans die every week.
When I look at the patients who Im taking care of in the hospital right now, the people who are doing poorly are people who didnt get the recent vaccines, Chin-Hong says. Theyre generally older than 75, and they didnt get access to or take advantage of Paxlovid.
Calmatters has reported that disability and equity advocates have particularly criticized CDPHs new guidelines, which they say could increase the risk of infection for Californians most vulnerable to severe illness or death from the virus.
This policy is not based in science, equity or public health, Lisa McCorkell, co-founder of the Patient-Led Research Collaborative that studies the impacts of long COVID, told CalMatters. It devalues the lives of immunocompromised and disabled people and completely ignores the risk of long COVID.
Michelle Gutierrez Vo, a registered nurse with Kaiser Permanente and a president of the California Nurses Association, echoed these concerns, calling the new guidelines a step backwards from protecting public health and very dangerous.
High risk people do not walk around with a flag saying I am high risk, so then the people that are COVID-positive can identify them and stay away from them, said Gutierrez Vo. It doesnt work that way.
So therefore, if you cannot be selective of who you need to be getting away from, then there just has to be a general understanding or a mandate which is what we had to make sure to protect the general public. It is is the Department of Public Healths responsibility to uphold public health, and they are not doing that with this new guidance, said Gutierrez Vo.
On the risks of long COVID, Gutierrez Vo said that Californias relaxing of isolation protocol puts everyone in danger. COVID, she said, is not like any other respiratory illness. When you have flu and you get over it, it doesnt have long term effects. When you have RSV, or any other respiratory illness like a viral syndrome, it doesnt damage your kidney or it doesnt damage your heart.
Chin-Hong urged the public to remember the ongoing basics of COVID-19 prevention seeking out the latest vaccine, wearing a well-fitted mask when necessary, remembering the importance of ventilation indoors and testing for COVID-19 amid the latest guidance. Reminding ourselves of those things should be really front and center, he says.
This story contains reporting by KQEDs Lesley McClurg.
At KQED News, we know that it can sometimes be hard to track down the answers to navigate life in the Bay Area in 2024. Weve published clear, practical explainers and guides about COVID-19, how to cope with intense winter weather, and how to exercise your right to protest safely.
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The genetic sequence of SARS-CoV-2, the virus that causes COVID-19, was submitted to a National Institutes of Health database two weeks before its release by the Chinese government, according to documents that were shared with US lawmakers and released Wednesday.The sequence doesnt indicate the origin of the coronavirus but undermines the Chinese governments claims about its knowledge of the information, one expert told CNN and could have cost critical weeks in the development of a vaccine against the virus.On Dec. 28, 2019, virologist Dr. Lili Ren of the Institute of Pathogen Biology at the Chinese Academy of Medical Sciences & Peking Union Medical College submitted the genetic sequence to GenBank, a genetic sequence repository that collects, preserves, and provides public access to assembled and annotated nucleotide sequence data from all domains of life, according to a letter that Dr. Melanie Egorin, assistant secretary of legislation at the U.S. Department of Health and Human Services, sent to House Energy and Commerce Committee Chair Cathy McMorris Rodgers last month.GenBank is managed by the National Center for Biotechnology Information, part of the US National Institutes of Health.Rens submission was incomplete and lacked the necessary information required for publication, the letter says. She was sent a resubmission request three days later, but NIH never received the additional information requested. The submission was removed from a processing queue on Jan. 16, 2020, and the sequence was never made publicly available on GenBank.However, a different submission of the genetic sequence that was nearly identical to Rens was published on GenBank on January 12, Egorin said, one day after the World Health Organization said it had received the sequence from China.McMorris Rodgers, R- Washington; Subcommittee on Health Chair Brett Guthrie, R-Kentucky; and Subcommittee on Oversight and Investigations Chair Morgan Griffith, R-Virginia, said in a news release Wednesday that the committees investigation into the origins of COVID-19 will help policymakers strengthen the nations biosafety practices in addition to helping prepare for the next pandemic.They noted that they received the new information almost two months after they informed the NIH of their intent to issue subpoenas for copies of documents related to any early coronavirus sequences, early COVID-19 cases or other pertinent information.Dr. Jesse Bloom, a virologist at the Fred Hutchinson Cancer Center, wrote Wednesday in an analysis of Rens submission that it clearly falsifies the Chinese governments claim that the causative agent of the Wuhan pneumonia outbreak still had not been identified near the end of the first week of January 2020.The earlier submission would have provided adequate information to initiate vaccine production in late 2019 if it had been made public, he said, noting that drugmaker Moderna used the spike sequence to design its COVID-19 vaccine within two days of the Jan. 12 release.However, he said, the genetic sequence is unlikely to represent the first virus that infected humans and does not provide any new insights into the origin or early spread of SARS-CoV-2 in Wuhan.The belated discovery of the submission underscores the importance of rapid data sharing during outbreaks, since immediate public release of the sequence could have accelerated by several weeks the development of COVID-19 vaccines that saved thousands of lives per week in the United States alone, he said.Even two weeks would have made a huge difference in the pandemic, agreed Dr. Eric Topol, founder and director of the Scripps Research Translational Institute. The fact that the vaccine program began immediately on publication of the genetic sequence shows you how important that sequence was.When you sequence a virus its not even just a vaccine then youve nailed it. You know exactly the features, about the spike protein and all the other major components: the nucleocapsid, the envelope, the whole entire panoramic view of the virus. You cant get that without the sequence.The documents should be read in the context of hindsight, says Dr. Kristian Andersen, an evolutionary biologist and director of infectious disease genomics at the Translational Institute.In late 2019, nobody knew that a pandemic would later ensue, he wrote in an email. This is a really critical part that most people seem to forget nobody knew back then that a never-before-seen coronavirus only distantly related to SARS-CoV-1 was causing mysterious illnesses in patients associated with a wet market in the middle of Wuhan, which would later spark a devastating pandemic.Should the sequence have been released at the time and as preliminary data? Sure, that would have been great, and is a good example of where we could hope to do better in the future, he said. Whoever reviewed the sequence at NCBI over the holiday period in 2019 would have no way of connecting this sequence to a mysterious illness in Wuhan because it was yet to be reported.CNNs Jen Christensen and Brenda Goodman contributed to this report.
The genetic sequence of SARS-CoV-2, the virus that causes COVID-19, was submitted to a National Institutes of Health database two weeks before its release by the Chinese government, according to documents that were shared with US lawmakers and released Wednesday.
The sequence doesnt indicate the origin of the coronavirus but undermines the Chinese governments claims about its knowledge of the information, one expert told CNN and could have cost critical weeks in the development of a vaccine against the virus.
On Dec. 28, 2019, virologist Dr. Lili Ren of the Institute of Pathogen Biology at the Chinese Academy of Medical Sciences & Peking Union Medical College submitted the genetic sequence to GenBank, a genetic sequence repository that collects, preserves, and provides public access to assembled and annotated nucleotide sequence data from all domains of life, according to a letter that Dr. Melanie Egorin, assistant secretary of legislation at the U.S. Department of Health and Human Services, sent to House Energy and Commerce Committee Chair Cathy McMorris Rodgers last month.
GenBank is managed by the National Center for Biotechnology Information, part of the US National Institutes of Health.
Rens submission was incomplete and lacked the necessary information required for publication, the letter says. She was sent a resubmission request three days later, but NIH never received the additional information requested. The submission was removed from a processing queue on Jan. 16, 2020, and the sequence was never made publicly available on GenBank.
However, a different submission of the genetic sequence that was nearly identical to Rens was published on GenBank on January 12, Egorin said, one day after the World Health Organization said it had received the sequence from China.
McMorris Rodgers, R- Washington; Subcommittee on Health Chair Brett Guthrie, R-Kentucky; and Subcommittee on Oversight and Investigations Chair Morgan Griffith, R-Virginia, said in a news release Wednesday that the committees investigation into the origins of COVID-19 will help policymakers strengthen the nations biosafety practices in addition to helping prepare for the next pandemic.
They noted that they received the new information almost two months after they informed the NIH of their intent to issue subpoenas for copies of documents related to any early coronavirus sequences, early COVID-19 cases or other pertinent information.
Dr. Jesse Bloom, a virologist at the Fred Hutchinson Cancer Center, wrote Wednesday in an analysis of Rens submission that it clearly falsifies the Chinese governments claim that the causative agent of the Wuhan pneumonia outbreak still had not been identified near the end of the first week of January 2020.
The earlier submission would have provided adequate information to initiate vaccine production in late 2019 if it had been made public, he said, noting that drugmaker Moderna used the spike sequence to design its COVID-19 vaccine within two days of the Jan. 12 release.
However, he said, the genetic sequence is unlikely to represent the first virus that infected humans and does not provide any new insights into the origin or early spread of SARS-CoV-2 in Wuhan.
The belated discovery of the submission underscores the importance of rapid data sharing during outbreaks, since immediate public release of the sequence could have accelerated by several weeks the development of COVID-19 vaccines that saved thousands of lives per week in the United States alone, he said.
Even two weeks would have made a huge difference in the pandemic, agreed Dr. Eric Topol, founder and director of the Scripps Research Translational Institute. The fact that the vaccine program began immediately on publication of the genetic sequence shows you how important that sequence was.
When you sequence a virus its not even just a vaccine then youve nailed it. You know exactly the features, about the spike protein and all the other major components: the nucleocapsid, the envelope, the whole entire panoramic view of the virus. You cant get that without the sequence.
The documents should be read in the context of hindsight, says Dr. Kristian Andersen, an evolutionary biologist and director of infectious disease genomics at the Translational Institute.
In late 2019, nobody knew that a pandemic would later ensue, he wrote in an email. This is a really critical part that most people seem to forget nobody knew back then that a never-before-seen coronavirus only distantly related to SARS-CoV-1 was causing mysterious illnesses in patients associated with a wet market in the middle of Wuhan, which would later spark a devastating pandemic.
Should the sequence have been released at the time and [marked] as preliminary data? Sure, that would have been great, and is a good example of where we could hope to do better in the future, he said. Whoever reviewed the sequence at NCBI over the holiday period in 2019 would have no way of connecting this sequence to a mysterious illness in Wuhan because it was yet to be reported.
CNNs Jen Christensen and Brenda Goodman contributed to this report.
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Scientists in China have recently conducted experiments on a novel coronavirus strain, GX_P2V. It resulted in a 100% fatality rate in genetically-modified mice. This strain is a mutation of GX/2017, a virus initially identified in Malaysian pangolins in 2017.
The study, originating from Beijing, notes the swift and lethal impact of GX_P2V on mice with human-like genetic structures. The virus, targetting multiple organs including the brain, led to rapid deterioration in the mice's condition, culminating in death within eight days.
The mice got very sick quickly. They lost a lot of weight, couldn't move well, and their eyes turned white before they died. This study is different because all the mice died, which is more than what happened in other studies about similar viruses.
SARS-CoV-2-related pangolin coronavirus GX_P2V(short_3UTR) can cause 100% mortality in human ACE2-transgenic mice, potentially attributable to late-stage brain infection. This underscores a spillover risk of GX_P2V into humans and provides a unique model for understanding the pathogenic mechanisms of SARS-CoV-2-related viruses," wrote the authors.
But, it's not clear what this means for people. The study does not directly correlate these results with potential effects on humans.
Some experts, like Francois Balloux from the University College London, think this study is not useful and could be dangerous.
It's a terrible study, scientifically totally pointless. I can see nothing of vague interest that could be learned from force-infecting a weird breed of humanised mice with a random virus. Conversely, I could see how such stuff might go wrong," he posted on X (formerly Twitter).
This madness must be stopped before too late," posted Dr. Gennadi Glinsky, a retired professor.
This study is separate from the research in Wuhan, which was linked to different ideas about where COVID-19 came from. The origin of COVID-19 is still not known. The new study in China raises questions about doing risky experiments with viruses.
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Chinese researcher in Beijing uploaded a nearly complete sequence of the Covid virus structure to a U.S. database run by the National Institute of Health on December 28, 2019, two weeks before Beijing shared the viral sequence with the rest of the world, U.S. Department of Health and Human Services documents recently obtained by a House committee reveal.
The HHS documents, first reported by theWall Street Journal, were obtained by Republicans on the House Energy and Commerce Committee after they threatened to subpoena the agency.
When Beijing shared the SARS-CoV-2 sequence with the World Health Organization on January 11, 2020, two full weeks had elapsed since the virus was sequenced by a researcher at the Institute of Pathogen Biology in Beijing, an arm of the state-affiliated Chinese Academy of Medical Sciences which has ties to the Chinese Communist Party (CCP) and Peoples Liberation Army.
Those two weeks represent a crucial period in the evolution of the pandemic, as the international health community scrambled to assess and respond to the burgeoning viral threat. In late 2019, scientists across the globe were racing to understand the viral disease that would eventually kill millions.
During that period, Chinese officials still described the disease outbreak in Wuhan, China, as a viral pneumonia of unknown cause to the greater public. The latest congressional investigation has again raised questions about what China knew in the crucial early days of the pandemic.
As to the origins of Covid-19, different U.S. government agencies still hold disparate conclusions. While some still hold that the dangerous coronavirus emerged from an infected animal at the Huanan Seafood Market, the FBI and the U.S. Department of Energy concur that Covid most likely emerged from a lab leak in Wuhan.
Cathy McMorris Rodgers (R, W.A.), Chair of the House Energy and Commerce Committee, saidthat the recent discoveries demonstrate thatthe U.S. cannot trust any of the so-called facts or data provided by the CCP and calls into serious question the legitimacy of any scientific theories based on such information. The committee has spent months probing the origins of Covid-19 and U.S. government funding of overseas research.
Jesse Bloom, a virologist at the Fred Hutchinson Cancer Center in Seattle, reviewed the Health Departments documents and the recently discovered gene sequence. The revelation underscores how cautious we have to be about the accuracy of the information that the Chinese government has released. Its important to keep in mind how little we know, Bloom told the Journal.
The Chinese researcher who uploaded the virus sequence in December, Dr. Lili Ren, did not respond to the Journals email seeking comment. Ren was contracted as a collaborator on a U.S.-funded project to study how coronaviruses can be transferred from animals to humans. The nonprofit EcoHealth Alliance oversaw the project, which included the collection of bat samples in China.
Ren is also underthe same National Institute of Allergy and Infectious Disease (NIAID) grant as the Wuhan Institute of Virology (WIV), which has been disqualified from receiving NIH grants for ten years for failing to provide laboratory records requested by NIH and for conducting research that did lead or could lead to health issues or other unacceptable outcomes.
China continues to defend its lack of transparency around the virus.
China has kept refining our COVID response based on science to make it more targeted. Chinas COVID response policies are science-based, effective, and consistent with Chinas national realities. They can stand the test of history, aChinese Embassy spokesperson said.
As the winter season brings back a surge in respiratory illness and pandemic-era practices such as mask mandates, global health experts are thinking ahead about how to prepare for the next big outbreak.
At the World Economic Forum in Davos, Switzerland, a panel of health industry leaders discussed the importance of preplanning for the outbreak of a hypothetical Disease X.
News of the panel sparked conspiracy from right-wing accounts on social media that world leaders are launching the next pandemic or moving to once again restrict free speech and reinstate mask mandates. The WHO has said that such preparation is meant to reduce COVID-19-era devastations such as the insufficient capacity of medical systems or the trillions of dollars that were lost in the economy.
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Heres what we know about Disease X, and what pandemic preparedness means.
Disease X is not a specific disease but is the name given to a potential novel infectious agent.
It represents an illness which is currently unknown but could pose a serious microbial threat to humans in the future. It is necessary to be prepared because there is a vast reservoir of viruses circulating among wildlife which could become a source of a new infectious disease to which humans do not have immunity.
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In 2018, the World Health Organization (WHO) added Disease X to a list of pathogens that are a top priority for research, alongside known killers like Severe Acute Respiratory Syndrome (SARS) and Ebola.
Labelling this potential threat as Disease X is meant to prioritise preparations for dealing with a disease that does not yet have vaccines or drug treatments, and could give rise to a severe epidemic.
The WHO has warned that Disease X could result in 20 times more fatalities than COVID-19.
COVID-19 has killed approximately seven million people around the world. In 2023, healthcare professionals warned that any new pandemic could be even deadlier killing an estimated 50 million people worldwide.
At the Davos summit on Wednesday, healthcare experts emphasised that preparing for Disease X could help save lives and costs if countries begin research and preemptive measures in advance of a known outbreak.
Of course, there are some people who say this may create panic. Its better to anticipate something that may happen because it has happened in our history many times, and prepare for it, said WHO Director-General Tedros Adhanom Ghebreyesus, who joined the panel.
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He said that the WHO has already started implementing measures to prepare for another outbreak. This includes a pandemic fund and a technology transfer hub in South Africa that enables the local production of vaccines and would help overcome issues of vaccine inequity across high and low-income countries.
Michel Demare, chair of the board at AstraZeneca, said the company is working to carry out an assessment of health systems across the world to present recommendations for pandemic management.
Preetha Reddy, executive vice chairperson at Apollo Hospitals, pointed to conversations around inequity at the G20 forum, and that using technology to reach rural populations in India is a key focus of current planning.
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This involves international cooperation, including on research and development, as well as the development of country-level initiatives such as tentative response plans in the event of an outbreak of a new disease.
Such plans could include mapping out how to increase hospital capacity, scale up supply of treatment and adopt new technologies to support medical workers.
The European Centre for Disease Control and Prevention recommends strengthening existing systems instead of developing new ones for a pandemic, and also encourages testing any new systems prior to a new pandemic.
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Preparedness also involves increased surveillance of disease to quickly detect any novel pathogens that could turn into a serious threat. Studies show that, on average, at least two new viruses are discovered each year.
Such measures are also expected to dramatically reduce the costs associated with a pandemic, should one occur. While COVID-19 cost the world about $16 trillion, global investments of just $124bn over five years could make the world significantly better prepared for major epidemics in the future, according to a study by the Gates Foundation-backed organisation, Resolve to Save Lives.
The WHO first classified Disease X as a placeholder term for a potential deadly virus in 2018.
However, news of the Davos panel sparked a social media firestorm. Right-wing accounts slammed discussions about Disease X, warning that governments could use it to impose policies such as vaccine and mask mandates, while some conspiracy theories suggest governments could even create pandemics themselves.
In a post on X a week before the summit, former Trump administration official Monica Crowley suggested that the panel was signalling the advent of a preplanned disease.
Just in time for the election, a new contagion to allow them to implement a new WHO treaty, lock down again, restrict free speech and destroy more freedoms, she wrote.
However, the WHO maintains that the designation of Disease X will allow governments to better cope with a novel pandemic as worldwide, the number of potential pathogens is very large, while the resources for disease research and development (R&D) is limited.
While the WHO has not specified the identity of Disease X, experts suggest it is likely to be a respiratory virus, given the higher survival rates for such viruses. The WHO has created an R&D blueprint for various priority diseases, any of which could mutate and become Disease X. The current list includes zoonotic viruses present in India, such as Covid-19, Crimean-Congo haemorrhagic fever, Ebola, and others.
