California’s COVID-19 Restrictions Have Caused ‘Considerable Collateral Damage’ Without ‘Benefit Nor End In Sight’—An Open Letter from Five Bay Area Physicians

An Open Letter to Governor Gavin Newsom, California Department of Public Health Director Tomás J. Aragón, Secretary of the California Health & Human Services Agency Mark Ghaly, State Superintendent of Public Instruction Tony Thurmond, all California County Public Health Officers, and all California Public School Superintendents and School Boards:

We are writing to you today as public health and medical professionals and as California residents. Since this pandemic began, we have been living under the most restrictive COVID-19 policies in the country. For those of us in the Bay Area, we continue to navigate the most restrictive policies in the state.  These restrictions persist despite California’s high vaccination rate and low COVID-19 hospitalization rates. California’s COVID policies have failed to evolve with the advent of highly protective and widely accessible vaccines. Our restrictive policies, that have caused considerable collateral damage throughout the pandemic, have long lost their justification as necessary for prevention of serious illness and death. These pervasive policies continue to negatively affect our professional and personal lives without clear benefit nor any end in sight.

Present policies have driven thousands of people from this state and from our public schools, and we will continue to lose many great minds, great businesses, great families and great individuals if current policy is not righted.

We are particularly concerned about the toll that our state’s polices continue to have on children and teens. 

We are writing to ask California officials to acknowledge the endemic nature of COVID-19 after the Omicron surge and immediately shift our public dialogue toward defining a path for removing all remaining COVID-19 restrictions in public schools.

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We implore you to do the following:

1. Acknowledge that any adult and most school age children have now had the opportunity to be fully vaccinated, and that forcing further mandates, particularly requiring boosters for children, is likely to increase mistrust and resentment of government and public health officials.
2. Acknowledge that many families in California vaccinated their children for the good of society since children are at lower risk of severe disease.
3. Acknowledge that vaccinated individuals of all ages in this state have been waiting for a reward for their efforts in the form of a major relaxation of restrictions which they have yet to receive.
4. Acknowledge that the public is weary from two years of restrictions, shifting messages from government officials, and a failure to acknowledge that the risk of severe COVID among children is significantly lower than in adults; indeed, it could take well over a generation for government leaders and infectious disease experts to regain the public’s trust.
5. Acknowledge the smaller risk that COVID-19 illness poses to children compared to the disproportionate toll that mitigation measures have taken on children.
6. Acknowledge the ongoing mental health crisis that is present in our children and teens due to social isolation and anxiety that has been created by this pandemic.
7. Acknowledge the ongoing educational crisis that is unfolding before us so long as children cannot see their teachers’ and peers’ faces and adequately hear and interact with them.
8. Immediately allow school children to unmask while outdoors, including during sports, by clarifying that outdoor exposures to COVID-19 are exceedingly low risk encounters and should not qualify as close contacts for the purpose of quarantines.
9. Make masks optional while indoors in school settings when California’s general mask mandate expires on February 15, 2022, or no later than February 24, 2022, twelve weeks after the last public school child became eligible for the vaccine.
10. Acknowledge the potential developmental harm that is caused to infants and toddlers who do not get to see their caregivers’ and teachers’ mouths when they are being spoken to nor see their full facial expressions in their interactions.
11. Immediately allow preschool and daycare teachers and students to unmask at all times if they so choose. If they do not choose to, please provide them with the CDC guidance on masking options, emphasizing one-way masking as a protective strategy.
12. Work towards ending the mindless testing of asymptomatic individuals with no clear purpose given that COVID-19 is here to stay.
13. Acknowledge that policies on college campuses should recognize that population’s relative low risk and high vaccination rate, thus not warranting returns to distance learning that deprive our young adults of social interaction that is formative for a lifetime.
14. Immediately shift away from a public health response that is based on case rates to one that strictly looks at hospitalizations and deaths in a broader context.
15. Acknowledge that the present Omicron variant is less deadly than prior variants.
16. Acknowledge that true COVID-19 hospitalizations remain low in this state and particularly in the Bay Area, and that we should refrain from panic-driven restrictions that inflict additional collateral damage on our most vulnerable populations, unjustified by a less deadly variant.
17. Commit to a rigorous cost-benefit analysis for all COVID restrictive policies to ensure that benefit always outweighs harm, without disproportionately prioritizing prevention of COVID-19 transmission above all other health considerations.

We stand ready with our collective experience and expertise to help this state establish a path to normalcy in our schools and beyond.

Sincerely,

Jeanne Noble, MD, MA, Associate Professor of Emergency Medicine, Director of COVID-19 Response for the UCSF Parnassus Emergency Department

Jennifer Nguyen, MD, Pediatrician, UCSF Benioff Children’s Hospital Oakland, Alta Bates Summit Medical Center

Vinay Prasad, MD, MPH, Associate Professor of Epidemiology and Biostatistics, UCSF, Hematologist-Oncologist, San Francisco General Hospital

Jarrett Moyer, MD, Surgery and Bioengineering, UCSF

Laura Chinnavaso, RN, BSN, Alameda County Disaster Relief, COVID-19 Response 

CC: (1) Joseph R. Biden, Jr., President of the United States of America; (2) Xavier Becerra, Secretary of the U.S. Department of Health and Human Services; (3) Dr. Miguel Cardona, Secretary of the U.S. Department of Education; (4) Rochelle Walensky, MD, MPH, Director of the Centers for Disease Control; (5) Lawrence A. Tabak, DDS, Ph.D., Acting Director of the National Institutes of Health