California Gov. Gavin Newsom on Thursday announced the first shift by a state to an “endemic” approach to the coronavirus pandemic that emphasizes prevention and quick reactions to outbreaks over mandates, a milestone nearly two years in the making that harkens to a return to a more normal existence.

Newsom said the approach — which includes pushing back against false claims and other misinformation — means maintaining a wary watchfulness attuned to warning signs of the next deadly new surge or variant.

“This disease is not going away,” he told The Associated Press in advance of his formal announcement. “It’s not the end of the quote, unquote, war.”

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 the school mask-wearing mandate will end.

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,” he told the AP. With that in mind, he said his administration tried to craft “a plan that allows us to be prepared without being paranoid and more alert to what’s happening around us without being anxious.”

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.

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 common abbreviation for prescriptions and a reference to improving treatments for COVID-19.

Living with COVID-19 under Newsom’s plan means boosting the state’s surveillance, including 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 analyze its genotype to 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.

Testing and staffing in the affected area will be increased, including temporary medical workers to assist strained hospitals.

The plan sets specific goals, such as stockpiling 75 million masks, ramping up to 200,000 vaccinations and 500,000 tests a day, and adding 3,000 medical workers within three weeks in surge areas through ongoing contracts with national registry companies.
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Dr. George Rutherford, an epidemiologist and infectious-diseases control expert at the University of California, San Francisco, has urged a cautious approach to lifting mandates. He saw drafts of Newsom’s plan and likes it.

“They have a long-term plan that’s trying to capture these events as they occur and has the supply chain stuff you need to have pre-positioned so that we can move forward in a thoughtful but rapid way to control new outbreaks,” he said. “We’ll be able to apply them quickly and in a targeted way that’s least disruptive to get the job done.”

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 remans in effect.
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