In the post-omicron surge era, Sonoma County begins shift from mandate to personal responsibility

In the aftermath of the omicron-fueled winter surge, with key COVID-19 restrictions being either lifted or loosened, Sonoma County health officials have begun to shift their strategies, relying less on public health mandates and more on local residents’ personal responsibility.

It’s a tenuous transition that could at any time be derailed by a COVID-19 variant that is more virulent than the omicron mutation.

But for now, increasing immunity through vaccinations and previous infection, along with the dominance of omicron, have set the stage for what county officials describe as “a new normal” of living with the disease while trying to limit the pandemic’s impact on essential workers, racial and ethnic minorities and seniors.

“The shift will be toward focusing on those populations, but also recognizing that we have a greater immunity as a population,” said Dr. Sundari Mase, the county’s health officer. “And rather than tie everything to (public health) orders, we're going to move toward more personal responsibility.”

Mase said this “population-level shift” in strategy will be the subject of a public health community briefing on Feb. 16, where “we’ll be talking about masking and getting vaccinated and boosted and all those things as really being more of a personal responsibility to take care of yourself, your family, your community, and the onus is going to be on each person to do the right thing.”

As of Friday, the county lifted its restriction on large gatherings, which limited indoor events to 50 people or less and certain outdoor gatherings to 100 or less. What’s more, the county will lift its indoor mask rule next week, after which only unvaccinated residents will be required to wear facial coverings in indoor public spaces.

The county is able to loosen local masking rules because the state is allowing a similar statewide mask rule to expire on Feb. 16. Officials said the changes are a direct response to an ever improving pandemic landscape, as new COVID-19 infections and hospitalizations continue to decline from a record high in January.

The current rate of virus spread is 65.6 new daily cases per 100,000 residents, down from 249 on Jan. 10, according to the most recent county data. As of Thursday, there were 60 people with COVID-19 in local hospitals, down from 116 on Jan. 21.

Gov. Gavin Newsom is expected to announce details of an “endemic strategy” for dealing with the virus, one that reportedly allows for more local control, according to CalMatters, a nonpartisan newsroom that focuses on California politics and policy.

But some local infectious disease experts argue it's too soon to celebrate the end of the pandemic.

Dr. John Swartzberg of UC Berkeley pointed out that while most Bay Area counties are following the state’s lead on easing indoor masking rules next week, Santa Clara is not. Mendocino County will also keep the status quo on pandemic masking.

“There’s a real disconnect between what's actually happening with the pandemic and what people are perceiving is happening,” Swartzberg said, adding that current conditions are very similar to what they were one year ago, when minimal virus spread in the spring gave many the impression the pandemic was over. Then delta hit.

“It’s not like the ballgame has completely changed,” he said. “We still have facing us some real fundamental challenges. COVID may rear its ugly head up again with a surge by new variant.”

Dr. Lee Riley, another infectious disease expert at UC Berkeley, said barring a new, more deadly variant, public health strategies in the United States will become more regional, with county-by-county policies based on such parameters as vaccination rates.

“In the United States, we'll probably have state or county-based rather than national based policies on lifting or maintaining restrictions,” he said. “In a way, that's what's happening in Europe. There, each country is small so they are making regional decisions, country-by-country.”

He said regions in the United States where the vaccination rate is low will continue to have high rates of hospitalization and deaths and the only way to prevent them will be to maintain restrictions.

Swartzberg said talk about endemic COVID-19 may be wishful thinking at this point. Both he and Mase said omicron may not be the end of the line for SARS-CoV-2, the novel coronavirus that causes COVID-19 illness.

“That’s why we’re not saying it’s endemic yet, because we still are not sure — we just had the omicron surge,” Mase said. “We’re not sure what’s coming. But the fact that omicron, though it had devastating effects on vulnerable populations, the fact that it’s less severe in the general population suggests that there is a shift in that virus toward living with us.”

She said a deadly virus like Ebola, with a mortality rate upward of 60%, kills off the majority of people it infects and will never become endemic. “It's not going to live with us like many other bacteria and viruses do. She said the belief that omicron is the first step toward endemicity is still “a theory” at this point.

“The shift from delta to omicron certainly seemed like it was moving in an endemic direction,” she said.

You can reach Staff Writer Martin Espinoza at 707-521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @pressreno.