California became the first state to formally shift to an "endemic" approach to the coronavirus with Gov. Gavin Newsom's announcement Thursday of a plan that emphasizes prevention and quick reaction to outbreaks over mandated masking and business shutdowns.
The milestone, nearly two years in the making, envisions a return to a more normal existence with the help of a variety of initiatives and billions in new spending to more quickly spot surges or variants, add health care workers, stockpile tests and push back against false claims and other misinformation.
"We are moving past the crisis phase into a phase where we will work to live with this virus," he said during a news conference from a state warehouse brimming with pandemic supplies in Fontana, east of Los Angeles.
The first-term Democrat, who last year survived a recall election driven by critics of his governance during the pandemic, promised the state's nearly 40 million residents that as the omicron surge fades, "we're going to keep them safe and we're going to stay on top of this."
A disease reaches the endemic stage when the virus still exists in a community but becomes manageable as immunity builds. But there will be no definitive turn of the switch, the Democratic governor said, unlike the case with Wednesday's lifting of the state's indoor masking requirements or an announcement coming Feb. 28 of when precisely schoolchildren can stop wearing face coverings.
And there will be no immediate lifting of the dozens of remaining executive emergency orders that have helped run the state since Newsom imposed the nation's first statewide stay-home order in March 2020.
"This pandemic won't have a defined end. There's no finish line," Newsom said.
The World Health Organization declared the COVID-19 outbreak a pandemic on March 11, 2020, and with Omicron fading in many parts of the world some countries have begun planning for the endemic stage. But no state has taken the step Newsom did and offered a detailed forward-looking plan.
Republicans have been frequent critics of Newsom's handling of the coronavirus and were quick to disparage his latest effort. State GOP Chairwoman Jessica Millan Patterson called it "an extra-large helping of word salad" and renewed the call to "follow the lead of other blue states and end his state of emergency or lift his school mask mandate."
Newsom's plan sets specific goals, such as stockpiling 75 million masks, establishing the infrastructure to provide up to 200,000 vaccinations and 500,000 tests a day in the event of an outbreak, and adding 3,000 medical workers within three weeks in surge areas.
Newsom's administration came up with a shorthand acronym to capsulize key elements of its new approach: SMARTER. The letters stand for Shots, Masks, Awareness, Readiness, Testing, Education and Rx, a reference to improving treatments for COVID-19.
Dr. Jeffrey Klausner, an epidemiologist at the University of Southern California, said while some may argue these should have come sooner, he believes "the timing is right on."
"Surveillance, testing, vaccination and treatment make the context very different and make it appropriate to shift our response from a pandemic response of trying to do everything possible, to a more rational response to try to implement things that we have strong evidence that work," Klausner said.
The plan includes increased monitoring of virus remnants in wastewater to watch for the first signs of a surge. Masks won't be required but will be encouraged in many settings.
If a higher level of the virus is detected, health officials will determine if it is a new variant. If so, state and federal officials have a goal to within 30 days determine if it responds to existing tests, treatments and immunities from vaccines or prior infections.
California's health secretary, Dr. Mark Ghaly, said one of the goals is to avoid business closures and other far-reaching mandates. However, he said the state's requirement that schoolchildren be vaccinated against coronavirus by fall remains in effect.
The plan includes new education, including "myth-buster videos" to fight misinformation and disinformation and help interpret ever-evolving precautions for a confused public whiplashed by safeguards that seemingly shift by the day and vary across county lines.
In coordination with the federal government, it calls for a first-in-the-nation study of the pandemic's direct and indirect impacts long-term on both people and communities.
All this will cost billions, much of it already outlined in the pandemic response package Newsom sought as part of his budget last month. That includes $1.9 million that lawmakers already approved to boost staffing at hospitals and increase coronavirus testing and vaccine distribution, as well as existing money and anticipated federal funds.
His proposed budget also includes $1.7 billion to beef up the state's health care workforce, with more investment in increased laboratory testing capacity, data collection and outbreak investigation.
Newsom, who has faced criticism for sometimes failing to follow his own rules, defended keeping in place some of his executive emergency orders, which he said most recently have allowed the state to quickly bring in temporary medical workers and to quickly distribute more than 13 million home test kits to schools.
Those orders have dwindled from 561 to fewer than 100 in recent months, he said, and his administration is working with legislative leaders to eventually make them unnecessary.
Additional Reporting by The Associated Press.