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It’s time to end the state of emergency over COVID-19
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It’s time to end the state of emergency over COVID-19
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By Rajiv Bhatia and Jeffrey Klausner, Special to CalMatters
Dr. Rajiv Bhatia is an affiliated assistant clinical professor of Medicine at Stanford University. He is a former deputy health officer for the San Francisco Department of Public Health, drajiv@stanford.edu. Dr. Jeffrey Klausner is a professor of Medicine and Public Health at the University of California, Los Angeles. He is a former medical officer for the Centers for Disease Prevention and Control and a former deputy health officer at the San Francisco Department of Public Health, JDKlausner@mednet.ucla.edu. Klausner has also written about California’s shelter-at-home-policy and the sexually transmitted disease crisis. They wrote this commentary for CalMatters.
In March, Californians needed a state of emergency on COVID-19 because the virus was unfamiliar and our health system was unprepared. California is now prepared. It’s time to end the emergency, return the decisions to the people, and bring in more perspectives, more questions and more oversight.
COVID-19 was not an earthquake. It was an emergency only of uncertainty and unpreparedness. When it arrived, we didn’t know how fatal it was or how quickly it would spread, and we feared that it would overwhelm our hospitals.
Because of the uncertainty and unpreparedness and the anticipated need for local mutual aid, Gov. Gavin Newsom declared a state of emergency on March 4. This declaration gave unlimited powers to health officers, both locally and at the state level, to slow the virus. The orders requiring Californians to stay at home and shutting schools and businesses relied on these rare and unchecked public health powers. Under a state of emergency, no one can overrule a health officer’s orders, not their bosses, not the legislatures and not the governor.
After months of living with COVID-19, we have more certainty. The virus is 10 times less fatal than we first thought. The vast majority who catch it will have mild or no symptoms. Children are largely spared.
California counties have not needed mutual health aid. Hospitals retooled quickly for a tsunami that never came. California hospitals have about 40% of their beds empty. Re-opening in steps is safe if we carefully watch new hospitalizations. If another wave comes, hospitals are prepared.
Infections will smolder along whether we reopen or not. The spread is a natural progression of the epidemic across California geographies. The virus does not land everywhere at once; it finds a susceptible group, moves from person to person within limited transmission networks often extinguishing itself on its own. Our epidemic curve does not look substantially different than most other states. We have a stable share of tests turning positive. Medical visits for respiratory infections are lower today than at the same time last year.
Public health is better prepared with testing centers and contact tracing. Good hygiene and bread and butter public health can control COVID-19. South Korea brought their epidemic under control with scaled-up testing and public awareness alone.
We should be thankful that we have the breathing room. Making decisions about our livelihoods, our schools and our freedoms is too important to be made by a small circle of people.
The collateral damage from the emergency public health orders has hit every aspect of our lives. Our children are out of school with no clear prospect of returning; businesses are declaring bankruptcy; millions of workers are unemployed; and with extra unemployment assistance ending, thousands may be facing hunger and homelessness.
In most states, public health officials do not have unchecked powers but play an advisory role, bringing scientific evidence to the table. If we need to extend economic restrictions or bring them back, the officers can still bring their expertise to the sunlight of our legislative chambers. We should have the economists have a say and know what’s happening to our budgets and other social programs. We should hear from the pediatricians and teachers on how children will fare. We should have a public record of science and facts.
The governor can end the emergency today with a stroke of the pen. The Legislature could do this with resolutions passed by the state Senate and the Assembly. If there are reasons to extend the emergency, we the people should be told.
In democracies, emergencies that give extraordinary powers to a few people should never be prolonged. We declared an emergency to prepare for the COVID-19 pandemic. It’s June and California is prepared. So, isn’t it time to end the emergency? Or, if not now, when?
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Dr. Rajiv Bhatia is an affiliated assistant clinical professor of Medicine at Stanford University. He is a former deputy health officer for the San Francisco Department of Public Health, drajiv@stanford.edu. Dr. Jeffrey Klausner is a professor of Medicine and Public Health at the University of California, Los Angeles. He is a former medical officer for the Centers for Disease Prevention and Control and a former deputy health officer at the San Francisco Department of Public Health, JDKlausner@mednet.ucla.edu. Klausner has also written about California’s shelter-at-home-policy and the sexually transmitted disease crisis. They wrote this commentary for CalMatters.