CALIF. TO RELAX MASK RULE FOR HIGH-RISK SETTINGS

COVID-19 vaccine mandate for health care workers to end

With the COVID-19 state of emergency a thing of the past, California health officials on Friday unveiled plans to relax guidance on masking in high-risk settings and to end vaccination requirements for health care workers.

Among the changes announced by the California Department of Public Health is the end of statewide mask requirements in health care and other indoor high-risk settings — including correctional facilities and emergency and homeless shelters — beginning April 3.

Effective the same day, California will no longer require COVID-19 vaccinations for health care workers, including those in adult and direct care settings, correctional facilities and detention centers.

The monthlong delay is meant to allow local health departments and health care facilities time “to develop and implement plans customized to their needs and local conditions to continue to protect Californians through the end of the winter virus season,” according to the Department of Public Health.

In other changes, starting March 13, an individual who tests positive for COVID-19 can exit isolation after five days, provided they feel well, symptoms are improving, and they have been fever-free for 24 hours.

The state’s earlier recommendation was to exit isolation upon receiving a negative rapid test on or after the fifth day following the onset of symptoms or the first positive test. For those who couldn’t test, or continued to test positive after Day 5, the state recommended isolating for at least 10 days.

“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,” Dr. Tomás Aragón, California’s public health director and state health officer, said in a statement.

The changes were announced three days after Gov. Gavin Newsom officially terminated California’s 3-year-old COVID-19 state of emergency.

State health officials emphasized that Californians will still be able to get their hands on COVID-19 vaccines, testing and treatment.

Californians “will continue to be able to access COVID-19 vaccines, testing and therapeutics with no out-of-pocket costs,” according to the state Health and Human Services Agency.

Until Nov. 11, those with private health insurance or who are enrolled in Medical “can access COVID-19 vaccines, testing and therapeutics from any appropriately licensed provider without any out-of-pocket costs, even if the provider is outside the enrollee’s health plan network,” the agency previously told the L.A. Times.

Cost-sharing or coinsurance amounts may apply to those who access those resources from an out-of-network provider after that date.

Nardi and Puri said that brain fog, a condition that Harvard University describes as when a person’s thinking is “sluggish, fuzzy and not sharp,” has been particularly frustrating to treat, especially when those experiencing it may be highly educated and used to finding quick insight that has helped them build successful careers.

“These very high-functioning individuals, we’ll send them for a pretty significant three-hour neurocognitive testing to see if there is an issue that’s causing their brain fog, and the test comes back completely normal,” Nardi said.

Many, Puri noted, are sent to Scripps’ brain injury program in Encinitas to participate in neurocognitive therapy that seems to help.

“A lot of patients would say that they’re getting better with the techniques and treatment options in the brain injury program, but they are not 100 percent better, they still have good days and bad,” Puri said.

As a recent research article from Scripps Research Institute and other authors attests, evidence has been found documenting novel coronavirus’ impact on myriad bodily systems.

“Multiple studies have revealed multi-organ damage associated with COVID-19,” the report states. “One prospective study of low-risk individuals, looking at the heart, lungs, liver, kidneys, pancreas and spleen, noted that 70 percent of 201 patients had damage to at least one organ and 29 percent had multi-organ damage.”

But linking particular observations to helpful treatments has been slow going.

On the front lines, trying to help individual patients like Yepis day in and day out, ordering test after test that fails to explain the long-term suffering they’re witnessing, many believe that real answers will only be found by looking at the microscopic changes that this virus has caused at the cellular level.

“I think it’s becoming a bit more clear that whatever the injury is, you know, it’s happening at the microscopic level, because our echocardiograms, our CTS our MRI are not finding a lot,” Nardi said.

For Yepis, though hope still exists, it hard not to feel like progress will remain too far away to achieve.

“I remember my lung capacity was like 51 percent when I was in the hospital, and now it’s 71 percent, so it’s improving, but it’s going really slow,” Yepis said. “I plateau and then fall back down for a couple of months, it’s just a roller coaster trying to get better.”