164: California’s COVID-19 Plan

Dr. Erica Pan, California’s State epidemiologist, outlines the next phase of California’s COVID-19 response; Dr. Nicole Bhave, a cardiologist at the University of Michigan, discusses the cardiac effects of COVID-19 that continue to plague some...

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Dr. Erica Pan, California’s State epidemiologist, outlines the next phase of California’s COVID-19 response; Dr. Nicole Bhave, a cardiologist at the University of Michigan, discusses the cardiac effects of COVID-19 that continue to plague some patients; and the pandemic health emergency is extended for another 90 days.

The California SMARTER Plan

Washington Post Article: Five months post-covid, Nicole Murphy’s heart rate is still doing strange things

Route Fifty Article: Why Pandemic Food and Medicaid Benefits Could Soon an End


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This is Public Health Review Morning Edition for Monday, April 25th, 2022. I'm Robert Johnson.

Now, today's news from the Association of State and Territorial Health Officials.


Public health departments across the states and territories are considering how to manage the next phase of the COVID-19 pandemic. California wrote a plan and gave it to the public—it's called California SMARTER.

State epidemiologist Dr. Erica Pan outlines the strategy in today's morning conversation.

What's the best way to describe the California SMARTER Plan?


Sure. The SMARTER plan looks at where the state has been. It draws on our lessons learned from our collective experiences and lays out a path for how California will remain prepared for what COVID-19 might bring next. It also provides a summary for every Californian of how to apply key tools to mitigate individual risk and keep COVID-19 in check.

And to briefly cover what the acronym stands for:

S is for shots—so vaccines, of course, are the most powerful weapon we have against hospitalization and serious illness.

Masks, or the M—properly worn masks with good filtration helps slow the spread of COVID-19 and other respiratory viruses.

The A is for awareness—this is really crucial for my public health colleagues as well—this is really emphasizing that we will continue to stay aware of how COVID-19 is spreading the evolving variants, we're going to communicate clearly how people should protect themselves, and coordinate our state and local government response.

The R is for readiness: so, we know COVID-19 is not going away—we need to be ready with the tools, resources, and supplies, and we need to quickly respond and keep public health and the healthcare system well-prepared.

And then the T is for testing, making sure we get the right types of tests, that we maintain some surge capacity for tests, looking at PCR antigen, getting them to where they're needed most, and really hoping that will help also minimize the spread of COVID-19.

And then, we really wanted to focus on schools, which is education, E for education. California will continue to work to keep schools open and children's safely and classrooms for in-person instruction.

And then finally, the R is for RX or treatment, really. Prescriptions are evolving, and improving treatments are key tools that will become increasingly available and critical as we continue to have more of those as another tool to save lives.


Why did the department create the plan?


I think, you know, like everyone else, people wanted to know, you know, how do we start to learn to live with this virus, right? We wanted a way and a path and a tool to navigate the next phase of our COVID-19 response. It's here to stay, and how do we use what we've learned to protect our communities? And we've built necessary tools over the last couple of years that will allow us to target and prioritize the work that best reduces the impact of future challenges from COVID-19 and other viruses and public health emergencies.

So, really wanted to create that would give us a path and a plan for the way forward for this next phase. And we want to continue to be the nation's model for preparedness through effective and timely strategies and ongoing adaptation to the evolving virus and evidence about how to protect ourselves.


Do you hope the plan will set public expectations for whatever might come next?


Yes, absolutely. California's done what it takes to save lives throughout this pandemic, and we've invested where necessary to build up our infrastructure and processes needed to reduce the impact of COVID-19 on our communities. And these anchors will be the foundation moving forward of our preparedness. And we really hope that it helps highlight the importance of building on the investments we've made to date to improve our preparedness for not only the next variant and waves of COVID-19, but for other future public health emergencies to come.


How about the reaction so far? What kind of feedback have you gotten on the plan?


Yeah, overall, I think we've had a very positive reaction to our communication, that this pandemic is not over but that we can use these SMARTER tools to outline how much we've learned focused on these tools that we can use to reduce the impact and really learn to live with this virus while maintaining our awareness and readiness for the unpredictability we know this wily virus brings.


You can read the California SMARTER Plan using the link in the show notes.


Scientists and providers continue to seek answers about the lingering health effects of COVID-19. Some have declared it's a new risk factor for heart disease, given how it attacks the heart.

Dr. Nicole Bhave is a cardiologist at the University of Michigan.


Many patients with mild illness we're finding develop with what's called long COVID or post-acute sequalae of COVID-19. And those patients can have everything from abnormal heart rhythms to chest pains to shortness of breath, and sometimes it's very difficult to pin down what's actually happening with them with traditional diagnostic tasks.

So, I think it's very important for us as providers to listen carefully to our patients' symptoms, develop a targeted diagnostic plan based on their symptoms, and follow them in the long term and let them know that, "Hey, we're here with you for the long haul."


The Washington Post wrote about the cardiac impacts of COVID recently. There's a link to the story in the show notes.


Finally, today, the pandemic health emergency has been extended for another 90 days. The Biden administration ordered the extension that took effect last Saturday. It means federal support for health and food benefits will remain in place into the summer. The action also delays the so-called Medicaid purge when millions of people face being dropped from the rolls once the emergency ends.


Before we go, we want to remind you to follow the show on your podcast app. And if you're on Twitter, Instagram, Facebook, or LinkedIn, we'd love a shout out.

That'll do it for today's newscast. We're back tomorrow morning with more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great day.

Nicole Bhave MD

Cardiologist, University of Michigan

Erica Pan MD MPH

State Epidemiologist, CA Department of Public Health