SMARTER
CALIFORNIA
THE NEXT PHASE OF CALIFORNIA’S COVID-19 RESPONSE
2 California SMARTER| February 2022
Table of Contents
Introduction .........................................................3 The SMARTER Plan Includes ...............................4 The SMARTER Plan in Action ...............................5 SMARTER by the Numbers ..................................6 Putting Our Work Into Context ...........................7 Remaining Nimble and Adaptable ..................8
Maintaining and Expanding Focus on Equity ..8
The SMARTER Plan .............................................10 SHOTS .................................................................. 11 MASKS ................................................................. 13 AWARENESS ......................................................... 14 READINESS ........................................................... 16 TESTING ................................................................ 18 EDUCATION ......................................................... 20 RX ......................................................................... 22 Building on Experience ....................................23 Investments to Fight COVID-19 .......................28 Conclusion ........................................................29
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Californians have led the nation’s fight against the COVID-19 pandemic with early public health measures that saved lives. We have been led by science and data, and know more today than we did two years ago.
The release of the California SMARTER Plan: The Next Phase of California’s COVID-19 Response is critically timed. We are recovering from the intense Omicron variant surge when millions of Californians were infected. It is clear the virus will remain with us for some time, if not forever. It is less clear how often and how much it will continue to impact our health and well-being. However, we know what works, and have built the necessary tools over the last two years that allows us to learn and hone our defenses to this virus as it evolves.
As we enter the next phase with COVID-19, which may include future surges and new variants, we will continue to be the nation’s model for pr eparedness, ready to build on what
we have learned over the past two years to meet the COVID-19 challenges that lie ahead.
In our approach to this next phase, we will be smarter than ever before, using the lessons of the last two years to approach mitigation and adaptation measures through effective and timely strategies. Throughout the pandemic we have leaned on science and relied on tools that create protection. This includes vaccines, masks, tests, quarantine, improving ventilation, and new therapeutics. Moving forward, based on the evolving conditions of the virus, we will be prepared to use these different strategies in more precise and targeted ways all along the way, integrating new innovations and information to protect our state.
Federal, state and local leaders must continue to prepare for the future, even though we cannot fully predict it. But California’s path forward will also be predicated on our individual, smarter actions, that will collectively yield better outcomes for our neighborhoods, communities, and state. The main points of the SMARTER plan are as follows:
Introduction
Rx- Evolving and improving treatments will become increasingly available and critical as a tool to save lives.
Shots- Vaccines are the most powerful weapon against
hospitalization and serious illness.
Masks- Properly worn masks with good filtration help slow the spread of COVID-19 or other respiratory viruses.
Awareness- We will continue to stay aware of how COVID-19 is spreading, evolving variants, communicate clearly how people should protect themselves, and coordinate our state and local government response.
Readiness- COVID-19 isn’t going away and we need to be ready with the tools, resources and supplies we will need to quickly respond and keep public health and the health care system well prepared.
Testing- Getting the right type of tests - PCR or antigen - to where they are needed most. Testing will help California minimize the spread of COVID-19.
Education- California will continue to work to keep schools open and children safely in classrooms for in-person instruction.
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The SMARTER Plan Includes
The SMARTER Plan reflects upon what we have done as a state and how we have learned to manage COVID-19. Our lessons and experiences inform our approach to manage what lies ahead. We will stay prepared for whatever COVID-19 might bring our way next and we will continue to lean on the tools that worked to reduce spread, minimize infection and keep our community safe.
SMARTER is not just for or during COVID-19. The preparation, the flexibility and the systems we have developed make us SMARTER and better prepared for future emergencies. Our state will continue to learn and iterate in our response to the virus. California has always been a state that learns fast and adapts – it is in our DNA and will guide us moving forward. • With the COVID-19 Assessment and Action Unit the state will monitor the data and frontline conditions in real-time to ensure California is ready to respond to new and emerging variants and changing conditions.
• Building upon a robust, regionally based waste-water surveillance and genome sequencing network to have early and rapid insights into the changing nature of the virus and early identification of variants. This network can be scaled up to support identification of future infectious diseases.
• Work with external partners and the federal government to launch the first-in-the-nation impacts of COVID-19 longitudinal cohort study to look at and follow the direct and indirect impacts of COVID-19 on individuals and communities over time.
• Pursue of a public-private partnership with a test manufacturer to drive down the costs of at-home tests while securing a reliable and timely supply chain for California.
• Take steps to ensure our health care facilities can continue to ramp up with additional staff and resources to respond to surges to minimize the strain on our health care systems.
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The SMARTER Plan in Action
1. Sequence the circulating strain, and answer the question: “Is the circulating strain a variant we know or is it new?” If it does not match a known strain, rapidly expedite whole genome sequencing of clinical specimens in that area to identify the genotype of the circulating viral strain.
2. If it is a new variant, within 30-45 days in partnership with the Federal Government, the state will seek to:
a. Understand if the circulating strain responds to the existing therapeutics.
b. Understand if currently available tests pick up the strain reliably. c. Understand if there is immune escape from prior infection and/or vaccines.
3. Utilizing our statewide stockpiles, the state will quickly deploy testing supplies to regions picking up signals of increasing transmission allowing time for local and private testing efforts to be mobilized and scaled.
4. Deploy additional staff that have been secured through new staffing contracts for vaccine administration to regions picking up signals of increasing transmission allowing time for local and private testing efforts to be mobilized and scaled.
5. State will help facilitate the deployment of surge staff for facilities in impacted regions via state coordinated staffing contracts to ensure hospitals are prepared especially in impacted communities.
6. State will work with local partners, health experts, community-based organizations and others to develop messaging and communication to ensure that the public is well informed in a culturally appropriate manner using authentic community messengers. Also, make data available to ensure visibility and transparency.
As California maintains focus on communities disproportionately impacted, the SMARTER Plan outlines specific steps to prepare and be ready for the next covid-19 threat.
To put this into practice, imagine a California county through its wastewater surveillance system picks up a signal indicating a higher level of transmission of COVID-19 than normal.
Californians should expect the following six efforts to kick into action:
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SMARTER by the Numbers
Our smarter path will enable us to be fully prepared and respond to the changing nature of the COVID-19 pandemic. The specific metrics of preparedness below will help focus our efforts to ensure we have the necessary resources and capabilities in place.
SMARTER METRICS OF PREPAREDNESS
Shots
Vaccine administration
Capacity to administer at least 200,000 vaccines
per day on top of existing pharmacy and provider
infrastructure.
Masks
Personal protective equipment
distribution
Maintain a stockpile of 75 million high quality masks
and the capability to distribute them as needed.
Awareness
Communications
Maintain capability to promote vaccination, masking
and other mitigation measures in all 58 counties and
support engagement with at least 150 community-
based organizations.
Readiness
Surveillance and surge staffing
Maintain wastewater surveillance in all regions and
enhance respiratory surveillance in the healthcare
system while continuing to sequence at least 10% of
positive COVID-19 test specimens. Ability to add 3,000
clinical staff within 2 - 3 weeks of need and across
various health care facility types.
Testing
Maintain commercial and local public health
capacity statewide to perform at least 500,000 tests
per day - a combination of PCR and antigen.
Education
Expand vaccination rates
among kids
Expand by 25% school-based vaccination sites
supported by state to increase vaccination rates as
eligibility expands and vaccination requirements are
enacted.
Rx
Therapeutics
Maximize order for the most clinically effective
therapeutic available through the federal
partnerships. Ensure allocations of effective
therapeutics are ordered within 48-hours.
As we have learned throughout the pandemic, each surge and each variant brings with it unique characteristics relative to our neighborhoods and communities specific conditions (e.g., level of immunity). Therefore, instead of laying out specific thresholds or triggers, California will continue to evaluate the data quickly and nimbly to determine how to best handle future changes in the behavior of the virus. The SMARTER Plan does lay out specific response metrics that will ensure our preparedness and guide our work moving forward.
Critical to this is the idea that governmental public health will remain vigilant.
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Putting Our Work Into Context
Our individual actions have saved tens of thousands of lives. Though many have lost loved ones to this disease, California has among the lowest cumulative death rate among large states.
Our
collective
and
individual
actions
have saved
tens of
thousands
of lives.
Though
many have
lost loved
ones to this
disease,
California
has among
the lowest
cumulative
death rate
among
large
states.
70+ million COVID-19
vaccines administered.
870+ million
COVID-19 N-95 and
surgical masks distributed.
140+ million COVID-19
tests administered.
33 million+ at-home
COVID-19 antigen tests
distributed.
7,500+
COVID-19 testing
sites established.
28,000+ state supported
staff deployed to 800+
health care facilities.
700+
community-based
organizations partnered
with and supported.
Our collective work has resulted in a whole-of-government response that led the nation in providing resources to local and community partners. 8 California SMARTER| February 2022
Remaining Nimble and Adaptable
Throughout the COVID-19 pandemic, Californians have adapted as we learned more about the virus and the most effective strategies to manage it. From the initial stay-at-home orders to the recent need to reinstate temporary and limited mitigation requirements during this Omicron surge, our adaptability has saved lives.
While we learn more about how to live with COVID-19, California must support the ongoing ability of our state to adapt during the coming months and years:
Our state’s ability to be ready and remain flexible will not only make us better and smarter at managing COVID-19, but it will also make us better altogether.
The COVID-19 pandemic has impacted each of us over the last two years. However, there ar
e some communities, mainly underserved, low-income communities of color as well as older and disabled Californians, that have been more disproportionately impacted. Much more work is required to tackle these disparities. The SMARTER Plan coupled with our fiscal investments are intentionally and directly addressing historical and systemic inequities. Our focus on equity and our efforts to support these communities with targeted interventions and outreach has significantly closed disparities in infection and death rates. Although much more work is required to tackle these disparities, our focus on equity has been fundamental to building a Healthy California for ALL.
• We must continue to identify and
interpret the data we need to keep
people safe. For example, if we have
another highly infectious but not as
virulent variant in the future, we may
focus on hospital numbers to gauge
whether and how the state should
react. On the other hand, if the
virulence is high, we may again make
decisions based on case numbers, as
preventing a case may mean saving a
life.
• Individuals who have tested positive
for COVID-19 should continue to stay
home for the period recommended by
the federal Centers for Disease Control
(CDC) and California Department of
Public Health (CDPH). This time period
may be different at different times in
the future depending on the dominant
variant circulating at a given time. The
difference is because each variant has
a distinct incubation and replication
period. Because of this difference,
the length of time an infected person
remains likely to spread the infection
to another person changes. For
individuals who feel sick, they too
should stay home until they feel well.
If an individual has been exposed to
someone who tested positive, they
should consider getting tested and
masking until they are sure they are not
infected.
• With masking, there may be conditions
that warrant temporary, targeted and
risk-based masking requirements. These
can be loosened once conditions
improve.
• We must also adapt to the emergence
of new interventions and innovations.
For example, the development of new
pharmaceutical agents for COVID-19,
the way our communities are built
with a greater emphasis on spending
time outdoors, the way we receive
our healthcare with rapidly improving
innovations in telehealth.
Maintaining and Expanding Focus on Equity
California SMARTER| February 2022 9
Death rate for Latinos is 17%
higher than statewide rate
Deaths per 100K people:
221 Latino • 189 all ethnicities
Case rate for Pacific Islanders
is 75% higher than statewide rate
Cases per 100K people:
32,389 NHP • 18,469 all ethnicities
Death rate for Blacks is 16%
higher than statewide rate
Deaths per 100K people:
219 Black • 189 all ethnicities
Case rate for communities with
median income <$40K is 24%
higher than statewide rate
Cases per 100K people:
22,975 income <$40K
18,469 all income brackets
Over 90% of deaths were age
50 or older and 12% of all
deaths were among residents
of skilled nursing facilities.
Maintaining and Expanding Focus on Equity
Despite our efforts, there is much more work
ahead of us and the following data are
important in anchoring our work:
As we enter this next phase, it is important
for us not to forget that COVID-19
disproportionately affected our low-income,
Latino, Black, Native American and Pacific
Islander communities, individuals in rural
parts of the state, as well as workers in high-
risk settings. It will be equally important for us
not to lose sight of the impact the COVID-19
pandemic has had on our older and
disabled Californians. We must accelerate
change to address these longstanding
inequities.
Committed to a Healthy California for All, we
developed an equity measure to sharpen
the data-driven focus on curbing transmission
in communities most impacted. Then we
directed resources to those communities
to address COVID-19’s unequal impact on
health outcomes. Additionally, we published
a COVID-19 Health Equity Playbook for
Communities to support local communities in
building an equitable recovery. Furthermore,
each county was required to develop a plan
demonstrating targeted investments around
testing and other COVID-19 mitigations to
eliminate disparities in levels of COVID-19
transmission and promote equitable
recovery.
We must continue to work to build the
mindset and awareness of inequity across
our state. That if significant surges in
cases and risk for death return, we can
immediately implement community level
approaches to ensuring gaps in outcomes
emerge. For example, the ability to provide
targeted testing strategies, the ability
to unleash appropriate education and
messaging, and to distribute high quality PPE.
The tendency for some groups to experience
a greater impact is avoidable. But with a
transformation of our health systems and
proposed expansions of coverage and
access to all income eligible Californians
a hallmark of Governor Newsom’s 2022-23
Budget, California is making short- and long-
term investments to reduce the likelihood
of such inequities. As a result, no state more
than California is prepared to avoid the
tragic inequities we have sought to close
throughout this pandemic.
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The SMARTER Plan
We have come a long way in our journey with COVID-19. To use an analogy, we started our journey driving on an unfamiliar road with low visibility, heavy rain, worn-down brakes, and no windshield wipers. In contrast, today, we are driving on a road that we have mostly driven before with good weather conditions, and in a car with new brakes and windshield wipers. There are still potential hazards on the road ahead, but we are much better equipped to anticipate and react to them.
These upgraded capabilities have come through hard fought lessons, timely and significant investments, and a data-driven approach guiding our response.
Rx- Evolving and improving treatments will
become increasingly available and critical as a
tool to save lives.
Shots- Vaccines are the most powerful weapon
against hospitalization and serious illness.
Masks- Properly worn masks with good filtration help
slow the spread of COVID-19 or other respiratory
viruses.
Awareness- We will continue to stay aware of how
COVID-19 is spreading, evolving variants, communicate
clearly how people should protect themselves, and
coordinate our state and local government response.
Readiness- COVID-19 isn’t going away and we need
to be ready with the tools, resources and supplies we
will need to quickly respond and keep public health
and the health care system well prepared.
Testing- Getting the right type of tests - PCR or
antigen - to where they are needed most. Testing will
help California minimize the spread of COVID-19.
Education- California will continue to work to keep
schools open and children safely in classrooms for in-
person instruction.
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We have administered more than 70 million doses of COVID-19 vaccine, and nearly 80% of those over 12 have been fully vaccinated. Early vaccine efforts to prioritize the most vulnerable and most at-risk Californians have been followed by a persistent focus to close gaps among communities of color. The ongoing need for us to maintain our immunity in the face of new variants and the anticipated waning of immunity without boosters will require continued investments in vaccine distribution efforts, especially for older individuals and those who are immunocompromised. Most immediately, we will continue to focus on closing stubborn equity gaps which started at roughly a 26% difference in adult vaccine administration between higher income and lower income neighbors, currently this difference is at 16%, a 40% reduction. This same equity gap for kids ages 5-17 is at 27%, so we will also intensify our ef
forts to vaccinate those under 18 years of age, and prepare for those under 5 to become eligible soon. The need to improve vaccination rates among our youngest Californians will support our broader efforts to keep in person instruction across the state.
Furthermore, battling mis-and dis-information that has deepened hesitation among unvaccinated Californians will continue to be critical. We will maintain the widely distributed network of trusted local providers who are in place to quickly vaccinate Californians in anticipation of any additional focused efforts, such as another booster dose. Having demonstrated the capability to administer over 400,000 doses in a single day during initial peak demand, keeping this network in place to deliver at least 200,000 shots through state- partners in counties, health facilities and pharmacies should well position the state for future needs.
The SMARTER Plan
SHOTS
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What’s Next?
We will expand messaging on vaccinations and shift to the concept of staying “Up-To-Date” on vaccination, like other vaccines. Specifically, our work will focus on the following:
Prepare for the approval of vaccines for kids under 5 years old – including targeted messaging and ensuring the pediatric providers (pediatricians and family practitioners) are prepared to administer these vaccines.
• Continue to educate Californians
about the benefits of boosters and
ensure they are available in broad and
equitable ways.
• Continue assessing the growing
evidence and data on the strength
of hybrid immunity - immunity both
from vaccine and prior infection - and
consider this information as we look at
vaccine requirements in California.
• As the 7-12th grade immunization
requirement is coming, we will work
to be clear about the message and
ensure parents are educated and have
their questions answered.
• Ensure that health care workers can
stay up to date on their vaccines.
• Work to decrease disparities in
vaccination rates and ensure that all
Californians can remain up to date on
their vaccines.
• Remain focused on current vaccine
disparities so all Californians have
ample opportunities to maintain their
immunity.
SHOTS (continued)
California built its own Digital COVID-19 Vaccine Record, a tool that is a convenient option for Californians who received a COVID-19 vaccination to access their record from the state’s immunization registry systems. It was launched in June 2021, and has issued 13.3 million records to more than 7.2 million individuals. Our open source code builds on the SMART Health Cards framework for vaccination verification. Today, 13 states, along with Puerto Rico and Washington, DC, support SMART Health Cards, and at least another 5 states are expected to launch soon. SMART Health Cards have become the de facto standard for COVDI-19 vaccine verification in the United States.
California SMARTER| February 2022 13
Masking as a mitigation tool has proven effective in helping minimize transmission, moving forward we will lean on the below. Public health officials will continue to assess the science and the data as we have been, and as appropriate, make changes to current masking guidance.
The data have clearly demonstrated that properly worn masks with good filtration are an effective mitigation tool that not only protects the wearer but minimizes the transmission of COVID-19. Use of masks should be supported by all who want to use them and should be required in high-risk settings or in other public indoor settings during periods of high transmission or when a variant emerges with potentially high virulence.
On the supply side, we now have procured and distributed over 250 million N-95 respirators, and over 600 million surgical masks. We have forged new and innovative partnerships directly with vendors and manufacturers. When national mask supplies were short, we procured enough not only for our state needs but for those of other states. This strategy of partnering with federal agencies AND ensuring we have other options to meet our needs will continue.
Depending exclusively on the federal government for immediate supplies and resources proved challenging throughout the pandemic. Since the beginning we have turned to our own capabilities to meet our needs, whether with masks, testing supplies, other personal protective equipment (PPE), or life-saving tools like ventilators.
We will leverage our broad purchasing powers to procure critical supplies like masks and testing supplies or making them easily available to counties and communities for needs related to COVID-19 and other emergencies such as wildfires. • Maintain a strong strategic stockpile
with the goal to have 75 million high
quality masks in the stockpile with the
capability to distribute them across the
state on an as-needed basis.
• Strongly recommend properly worn,
high-quality masks in public indoor
settings, especially in high-risk settings.
• Emphasize and encourage mask use
messaging for the following settings:
o High-risk settings where vulnerable
individuals live or are cared for
(hospitals, nursing homes, prisons)
o Public transportation and air travel,
per federal guidance
• Public indoor settings that are crowded
• Emphasize mask use messaging for the
following individuals:
o Unvaccinated, per the CDC
o At-risk for severe disease (elderly,
underlying medical conditions)
o Decreased immunity
o With known significant exposure to
COVID-19
• Continue outreach during winter
respiratory virus season so our
communities increase voluntary mask
use when viruses most commonly
circulate.
MASKS
What’s Next?
14 California SMARTER| February 2022
To remain aware, we must watch how COVID-19 is spreading, better understand the long- term impact of COVID-19, and further leverage our coordinated, whole-of-government response.
Our public health response has evolved throughout the pandemic. We began with 61 loosely coordinated local health jurisdictions moving at different speeds, with different resources and different objectives. Using well established emergency management protocols, California’s State Operations Center has been the connection between local communities, the state and the federal government. While local communities will continue to have flexibility to develop more specific regional approaches, the state will continue to provide the infrastructure to drive objective metrics and deliverables throughout the pandemic.
Our efforts to augment and expand local disease investigation and surveillance capabilities have allowed the state to be a leader in tracking the virus and its impacts. The early investments in new information technology systems, data modeling and whole genome sequencing have created a robust system to track and monitor transmission. We now have the surveillance and disease tracking infrastructure in place to ensure we can respond to COVID-19 and outbreaks of other infectious diseases. Similarly, we will continue to leverage
AWARENESS
California SMARTER| February 2022 15
We know COVID-19 is a global challenge that plays out locally. Our experts across various disciplines (technology, public health, laboratory, and infectious disease) have all it takes to be vigilant for the next variant or early signs that a surge is rearing its nasty head once again. • Build on the California COVID-19
Assessment Tool (CalCAT) which brings
the best COVID-19 models together
in one place to support policy and
public health action, while developing
ensemble estimates of critical
COVID-19 metrics from a variety of
models, giving us the ability to facilitate
comparisons about trends.
• Focus on continuing to build a
robust, regionally based waste-water
surveillance and genome sequencing
network to have early and rapid insights
into the changing nature of the virus
and variants. This network can be
scaled up to support identification of
future infectious diseases.
• With the COVID-19 Assessment and
Action Unit the state will monitor the
data and frontline conditions in real-
time to ensure the state is ready to
respond to new and emerging variants
and changing conditions.
• Work with external partners and the
federal government to launch the
first-in-the-nation impacts of COVID-19
longitudinal cohort study to look at
and follow the direct and indirect
impacts of COVID-19 on individuals and
communities over time.
• Continue to support and amplify local
and community-based partnerships
through the newly proposed Office of
Community Partnerships and Strategic
Communications.
• Maintain the monthly COVID-19
California survey that has engaged
the diversity of the state on their beliefs
and perspectives on a wide range of
COVID-19 related issues.
• Leverage existing infrastructure to
deepen the understanding of COVID,
especially the effectiveness and safety
of vaccines. Support community-
based organizations to build upon the
state’s equity work.
• Continue to maintain regular
coordination activities through the
State Operation Center to mobilize an
all-of-state-government response to
future needs, and facilitate local and
federal engagement, reliably.
• Promote the ability of CA Notify, a
free exposure notification system for
smartphones, to alert individuals if they
have been exposed to COVID-19 so
Californians have the information they
need to act.
What’s Next?
academic and research partners to assess COVID-19 impacts over weeks, months, years and decades. Just as California identified the first U.S. case of the Omicron variant, our new statewide COVID-19 Assessment and Action Unit will bring together the tools we have built to keep us ready and help inform the development of future interventions such as care delivery models and clinical care best practices and standards.
Directly communicating with Californians was a critical pillar in our overall response. We invested in community outreach, that has included direct appointment and referral assistance, and public education. Despite the rapidly evolving nature of the pandemic response, our consistent messaging framework has been that California is prepared and will take necessary actions to save lives.
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READINESS
We cannot predict the future, but we can take what we’ve learned to better prepare for it. That means continuing to bolster our public health infrastructure, preparing for potential future hospital surges, maintaining sufficient stockpiles of PPE and working to improve air quality and ventilation in schools and other public settings.
Early in the pandemic, we moved quickly to develop surge capacity outside the health care delivery system by building up two new surge hospitals as well as other alternate care sites across the state to ensure every Californian could have access to the health care they needed. Over time, experience showed a better approach was to increase capacity at existing health facilities that leveraged established core services and resources. California’s public health leaders recognized early on that COVID-19 is an airborne pathogen that spreads readily indoors when air circulation is not optimized. This understanding guided our actions since the earliest days of our response. This fact drove many efforts, including regulatory relief for businesses, to encourage Californians to meet, dine and play outdoors; to keep a door open and windows up to help circulate fresh air indoors.
The pandemic has taught us that improvements to air quality do not always require massive infrastructure investments or take years to implement. There are cost effective, immediate tools available. Californians also spent a great deal more time outdoors, enjoying the fresh air and nature.
California has built a sustainable and reliable logistics pipeline in response to COVID-19. This includes a robust supply of PPE and other critical supplies available for rapid deployment to the medical/health sector, first responders, front line workers, and communities in need.
Items such as N95 respirators, surgical and cloth masks, face shields, goggles, surgical gowns, coveralls, and gloves are included in this critical capability.
To date, the state has distributed over 1.6 billion individual items of PPE to support the pandemic. At the height of pandemic response, the state managed a comprehensive distribution system consisting of all facets of procurement from production to ordering and delivery, warehousing, and direct shipments from vendors.
California SMARTER| February 2022 17
Our work moving forward will enable us to be ready to respond to any changes in our conditions.
• Maintain an up-to-date, strategic
stockpile that allows California to
independently respond to local needs.
• Work with local public health
departments to develop, support,
and implement these strategies to be
ready for the next surge and the next
infectious disease emergency.
• Allocate state appropriated resources
to further accelerate the building of a
21st Century public health system. The
Governor’s 2022-23 Blueprint proposes:
o $300 million ongoing for state and
local public health to build up
capacity and transform California’s
public health system.
o Requiring 25% of a non-profit
hospital’s community benefit funds
be allocated toward community-
based public health organizations
that address the social drivers of
health. This 25% equates to roughly
$500 million each year.
o $1.7 billion over three years to recruit,
train, hire, and advance an ethnically
and culturally inclusive health and
human services workforce, with
improved diversity, wages, and
health equity outcomes.
• Establish three key efforts for health
care facilities preparing for or
responding to surges so, at any time,
we can bring up to 3,000 additional
staff to facilities across the state within
2-3 weeks of the need:
o Support the local county or regional
expansion of existing Medical
Reserve Corps teams;
o Maintain master contract
agreements with 3-5 national registry
companies that can be directly
accessed by health systems; and
o Monitor facility registry/traveler staff
use data throughout the year to
determine when staffing needs are
highest and establish strategies to
best support facility demand.
• Scaling back Executive Order provisions
and terminating provisions as they
cease to be necessary.
• Work with long-term care facilities
to provide technical assistance and
guidance regarding infection control
protocols.
• Issue an Innovation Award to urge the
development of low cost, effective
ways to improve indoor air quality via
improved filtration and air circulation
and develop standards for high-risk
settings.
What’s Next?
Governor Newsom proclaimed a State of Emergency based on the unprecedented threat of COVID-19 and its variants to the health and safety of all Californians. As we saw with the Omicron surge that is only now subsiding, COVID-19 is still very much with us. Through the state of emergency and limited number of executive orders that remain in effect, the state was able to act quickly and get millions of tests and PPE into the hands of our students and Californians across the state, expand vaccination efforts, and bolster our healthcare system capacity. The Governor will continue to assess the necessity of each open Executive Order provision and terminate provisions as they cease to be necessary. 18 California SMARTER| February 2022
We have come an incredibly long way since the earliest days of the COVID-19 pandemic, when doing more than a thousand tests in a day was an accomplishment of note. After nationwide challenges with supplies and collection strategies coalesced to eventually hamper California’s ability to track and respond to the first surge of cases in the summer and fall of 2020, we were the first and only state in the nation to build our own high-throughput testing laboratory.
The state has increased testing availability in communities at highest risk for contracting COVID-19 such as essential workers, those in congregate care settings, and communities of color. State facilities have performed more than 8.4 million tests on samples from a network of more than 4,700 specimen collection sites developed with churches, schools, clinics, essential workplaces and community-based organizations.
California laid the essential groundwork of building up testing capacity across our communities with more than 7,500 sites established and, over time, expanded to help keep us prepared to track COVID-19. This work created deeper and wider access to testing.
Roughly 65 percent of tests performed for PCR-only specimens are among racial minorities with 32 percent in the most disadvantaged neighborhoods based on the California Health Places Index (HPI) Quartile 1 and 26 percent in Quartile 2.
More than 4,800 schools have state-supported testing programs, nearly 200 OptumServe sites exist across California’s communities, and more than 2,800 community-based entities supported sites are offering antigen or PCR testing or both. Our understanding for how to use the various modalities of testing to help manage the pandemic has grown, as well.
Leveraging antigen tests as an additional tool has helped navigate the latest COVID-19 surge. We have procured and distributed over 33 million at-home COVID-19 antigen tests.
Our capacity on PCR testing has helped keep communities and families safe when the trajectory of the disease was uncertain, allowing us to identify early on those who are infected, even before they become symptomatic. During the Omicron surge, California used the testing groundwork of the last 20 months to keep our businesses open and our schools in person.
The effort to buy and distribute over 13 million at-home antigen tests for use by school staff and students during the recent return from winter break is in no small part the reason California has made up less than 1% of the nation’s overall school closures in January 2022, despite having 12% of the national student population. We also distributed at-home antigen tests to long-term care facilities and hospitals allowing us to keep residents safe and staff working as much and as safely as possible.
In addition to these school efforts, California demonstrated its capability to quickly scale up testing capacity at an unprecedented speed during the Omicron surge– deploying the California National Guard, expanding hours and access to testing sites, and ensuring 90% of Californians are within a 30-minute drive of a state sponsored or supported testing site.
California was the first in the nation to detect an Omicron variant case, largely due to our robust whole genomic sequencing network. COVIDNet is a statewide network of more than 40 partners across the state including local public health laboratories, academic centers, private, and commercial laboratories. Over 450,000 specimens have been sequenced in California, and between March -November 2021, at least 15% of positive COVID-19 samples per month have been sequenced. We have developed advanced bioinformatics capabilities to provide data visualization, dashboards at the state and county level, an alert system for monitoring detection of emerging variants, tools to inform outbreak investigations, and linkage between sequence and epidemiologic data that can further characterize variants and inform public health investigation and response.
TESTING
California SMARTER| February 2022 19
California will continue to prioritize testing, not only to get through the remainder of the current surge but also ensure we are ready to respond to new COVID-19 challenges down the road. Moving forward, these key efforts will position California to pivot and move in whatever way we are required:
• Maintain the ability to perform at least
500,000 tests per day - a combination of
PCR and antigen tests
• Ongoing procurement of additional at-
home tests with nearly 30 million more
on order or already delivered;
• Ongoing expansion of testing sites in
the community and efforts to ensure
these sites are “built in” to the health
care delivery system already in place in
California; and
• Ensuring trusted community sites
and schools have the capability to
continue serving their communities with
convenient testing options.
• Provide greater clarity on the role
of testing, particularly in supporting
disease surveillance, supporting
isolation, and early identification of
the disease for patients who are most
likely to benefit from treatment and
therapeutics.
• Release a Request for Innovative Ideas
to pursue a public-private partnership
with a test manufacturer to disrupt
the testing market to drive down the
costs of at-home tests while securing
a reliable and timely supply chain for
California and leveraging existing state
assets.
• Continue the important genomic
surveillance testing, network, and
genomic epidemiology analysis for
SarsCoV2, and use the infrastructure
built to monitor evolving variants,
expand genomics for other infectious
diseases of public health significance,
and be prepared for the next
pandemic.
What’s Next?
20 California SMARTER| February 2022
California leads the nation in keeping children safely in classrooms. California has made up less than 1% of the nation’s school closures in the 2021-22 school year, despite educating over 12% of the nation’s students. This school year, we weathered two COVID-19 surges, all the while successfully prioritizing in-person instruction and the safety of students and staff. Hospitalizations for COVID-19 (including pediatric hospitalizations) and disruptions to in-person learning, although never inconsequential, have been substantially lower than in comparable states.
This is due to collective efforts of Californians to protect school communities. Roughly 1.3 million youth ages 5-11 have stepped up and received one dose and more than 1 million are fully vaccinated. Billions invested into school safety protocols. In the last two months, 28 million high-quality masks have been delivered to schools. Over 4,400 school-based COVID testing sites have been supported by the state at no cost and, in the last two months, more than 15 million at-home tests have been distributed to school communities.
California’s response to conditions in schools has adapted to the dynamic challenges of the pandemic, based on science and humility. Emerging evidence continues to suggest that the Omicron variant is milder than prior variants. That future variants will be similarly mild is neither inevitable nor predictable, and we must remember the lessons learned from the Alpha and Delta variants, both of which came after and were more deadly than the original strain.
As we collectively move beyond the Omicron surge, the next phase of mitigation in schools focuses on long-term prevention and preserves safe in-person schooling, which is critical to the mental and physical health and development of our children.
EDUCATION
California SMARTER| February 2022 21
The goal remains to preserve safe and in-person schooling. Presented below is a summary of mitigation strategies for K-12 schools. For additional information, please visit Safe Schools for All.
• Continue to promote childhood
vaccination efforts, including school-
located events with sustained emphasis
on ensuring equitable access to
COVID-19 vaccines. K-12 schools
should prepare for forthcoming vaccine
requirements which will help protect the
most vulnerable among us and keep
schools safe and classrooms open.
• Focus on improving indoor air quality
in schools to protect students and staff
against COVID-19 and many other
respiratory infections and sources of
unhealthy air, including emissions,
seasonal allergens and wildfire smoke.
California will continue to provide
guidance and technical assistance
to schools leveraging state and
federal funds to make cost-effective
improvements to ventilation and air
filtration systems.
• Emphasize tools, such as updated
group tracing guidance, so students
who are not ill can remain in school
and monitor for symptoms. Multi-
layered mitigation in K-12 schools,
along with declining case rates and
improving community immunity, allow
for an ongoing transition away from
quarantining students. Evidence
demonstrates that students potentially
exposed to COVID-19 can remain
safely in-school when mitigation
protocols are followed.
• Continue to address the stigma and
trauma children have experienced
from this collective experience and
much more. $4.4 billion has been
devoted to improving mental and
behavioral health for California’s
children and youth, and a recent
partnership with the Child Mind
Institute on the launch of the
California Healthy Minds, Thriving Kids
Project to provide free, evidence-
based resources for kids, educators
and caregivers.
• Prepare for the eventual change to
universal school masking in schools,
which include ensuring equitable
access to vaccination, testing, and
individual protections for students,
families, and school staff. Universal
indoor masking has been the
cornerstone of the state and national
strategy to keep schools open.
The goal of such efforts remains to
preserve the sanctity and safety of in-
person schooling.
• Continue working with federal
partners to procure and distribute
COVID-19 tests to schools. As
resources allow, the state will also
support a transition toward increasing
use of over-the-counter (OTC) test
in school settings, with particular
attention to equity.
• Support outbreak investigations in
schools with state and local public
health resources through consultation
and deployment of testing and
vaccination resources.
What’s Next?
22 California SMARTER| February 2022
Throughout the COVID-19 pandemic we have utilized and benefited from all modes of managing the virus by embracing the value and impact of treatments for those who have been infected. We are home to some of the leading scientists and clinicians who helped develop therapeutics that are now available. Once these life-saving interventions became more widely available, California was an early partner with the federal government to stand up specialized infusion sites capable of delivering therapies to thousands of infected Californians, saving more lives through treatment.
At 25 state-supported sites, California has continued to ensure these resources are available to our communities, even when federal resources have been withdrawn. For every newly available medication or intervention, our clinical leaders work with local teams to ensure our distribution is led by equity and is efficient. We will always back the science but never fear early adoption and use of a lifesaving intervention. Moving forward, we will double down our collective work to have those who test positive start effective treatments quickly to spar
e burden on our health systems and, most importantly, reduce avoidable morbidity and mortality.
Just as we have disrupted the pricing of other medications, California will work to ensure lifesaving phar
maceuticals are not only available but also affordable. • Connecting those who test positive
for COVID-19 with the appropriate
clinical assessment and medication
supplier.
• Ensure allocations of effective
therapeutics are ordered within 48
hours by local entities.
• Leveraging technology and
telehealth specifically to accelerate
this work and save more lives. The
rapid expansion of virtual care and
telehealth tools in California throughout
the pandemic make the possibility of
linking treatments to eligible infected
individuals more likely.
• Continue to provide continuing
education and real-time information
to health care providers on new
therapeutics.
What’s Next?
RX
California SMARTER| February 2022 23
Building on Experience
State-Level Coordination
Under the leadership of the Governor’s
Office of Emergency Services, we activated
our response systems early on, working
closely with federal and local governments
on the initial repatriations of Americans
from Wuhan, China and the docking of the
Grand Princess in Oakland, and we have
maintained a significant infrastructure to
drive objective metrics and deliverables
throughout the pandemic. Using well
established emergency management
protocols, California’s State Operations
Center has been activated and managing
the pandemic for over two years.
Coordinated Response
Our public health response has evolved
throughout the pandemic. We began
with 61 loosely coordinated local health
jurisdictions moving at different speeds, with
different resources and different objectives.
Although localism is still determinative, there
is a connectedness and increased attention
to regional approaches across our state’s
counties that did not exist before.
Our efforts to augment and expand local
disease investigation and surveillance
capabilities have allowed the state to be a
leader in tracking the virus and its impacts.
The early investments in new information
technology systems and in staff training and
standardized reporting functions, allowed
us to transform a brittle set of disease
investigation tools into a robust system to
track and monitor transmission. Thousands
of state workers were recruited and trained
to support contact tracing efforts, ultimately
working at the community level to help slow
the spread of the virus. Additionally, the state
is increasingly using technology to leverage
automated notifications, such as CA Notify,
a free exposure notification system for
Over the last two years, California took action to keep people safe, and make investments that will continue to benefit our state into the future. Below are some additional changes and improvements the state has made since the initial outbreak of COVID-19. smartphones, to alert individuals if they have
been exposed to COVID-19. Finally, having
reported more than 143 million COVID-19
test results and more than 8 million COVID-19
cases, we have done more than any other
state. As a result, we have a foundation
and the infrastructure as we move into the
next phase of our surveillance and disease
tracking efforts, ensuring we can respond to
COVID-19 and outbreaks of other infectious
diseases.
Bringing together early efforts with
effective wastewater, hospital, and sentinel
surveillance, growing a whole genome
sequencing program along with local state-
supported outbreak investigation efforts,
anchored in an updated platform to report
and monitor trends, Californians should
feel confident in our state’s ability to see
what’s coming with as much clarity and
precision as possible. We also initiated data
modeling and advanced analytics through
the development of the California COVID-19
Assessment Tool or CalCAT, partnering with
academics and data scientists early in the
COVID-19 pandemic to inform projections
and policies, and invested in a team to
continue these efforts. Just as California
identified the first U.S. case of the Omicron
variant, our new statewide COVID-19
Assessment and Action Unit will bring
together the tools we have built to keep us
ready.
Hospital Surge
Over time, experience showed a better
approach was to increase capacity at
existing health facilities that leveraged
established core services and resources.
Following this model and based on a hospital
burden score that looks at a composite of
measures to assess hospital need, the state
currently supports 31 surge hospitals and six
surge skilled nursing facilities. The state has
24 California SMARTER| February 2022
also funded the expansion of beds with state
funded staff, adding more than 1,200 new
surge beds throughout the state. There are
also 22 state-supported ambulance patient
offload programs, helping emergency
departments accept patients more quickly,
allowing ambulances back into communities.
In total, there are currently over 3,500 staff
deployed to 217 facilities statewide and over
28,000 staff have been deployed throughout
the pandemic to over 800 health care
facilities.
Recognizing the tremendous toll the
pandemic has had on California’s health
care delivery system and incredible health
care workers, the Governor’s 2022-23
Budget proposal has proposed a $1.7 billion
investment to further build up our health
and human services workforce. Ensuring
we have a diverse and well-trained health
and human services workforce to serve and
support Californians has been a state priority
well before COVID-19. But now more than
ever, the need to make these investments, to
support maintaining nation-leading nurse-to-
patient ratios and ensuring protections of our
workforce so they can thrive at work and in
their communities, will remain top of mind for
the foreseeable future.
Communications and Community
Partnerships
At the beginning of the pandemic, we
launched the Your Actions Save Lives
campaign, which has served as the umbrella
for the state’s pandemic communications
initiatives. We primarily leveraged in-kind
donations, engaged influencers, and
partnered with philanthropy. As we built up
our infrastructure, we recognized directly
communicating with Californians was a
critical pillar in our overall response. We
invested in community outreach, that has
included direct appointment and referral
assistance, and public education.
As a result, we built a web of
communications efforts throughout the
pandemic to educate Californians about
complex public health guidance and
interventions and help citizens understand
the overall goals in managing the virus
and how to best use the tools to mitigate
its spread. Despite the rapidly evolving
nature of the pandemic response, our
consistent messaging framework has been
that California is prepared and will take
necessary actions to save lives. Leveraging
the infrastructure of the State’s 2020 Census
outreach effort, we were able to quickly
build a model that centered most of our
communications approaches around
community engagement and focused on
issues of equity.
Leading this effort is the Vaccinate ALL 58
campaign, which has engaged more than
700 community-based organizations in
partnership with philanthropy and dozens
of Community Ambassadors. Additionally,
the campaign has partnered with over 250
ethnic media outlets and utilized innovative
tactics to meet people where they are, in
the language they speak. The campaign
has proactively engaged other state
departments and agencies, truly taking a
whole-of-government approach. All of these
efforts have supported our commitment and
proactive approach to tackling mis- and dis-
information.
Overall, the community engagement
efforts have led to California successfully
implementing masking efforts in a wide
variety of settings to reduce transmission
of the virus, closing equity gaps in the
administration of vaccines with nearly 75%
of eligible Californians fully vaccinated,
and supporting the most robust testing
program in the nation, which averaged
half-a-million tests per day during the
height of the Omicron surge. The future
approach to communications and
community engagement will advance
existing efforts, focus on keeping immunity
high and promote the most effective use of
masking. An added focus will be on the role,
availability and benefits of timely treatment
options, especially for those at highest risk
for serious complications and death from
COVID-19 infections. The overall focus will
continue to be on equity and investing in
California SMARTER| February 2022 25
communications and deepening community
engagement.
The approach of leaning on our local
partners through ongoing direct investments
into hundreds of community-based
organizations, which support and advance
our public health preparedness and response
efforts, will be supported through the newly
proposed Office of Community Partnership
and Strategic Communications. The
proposed new Office will continue to build
upon the data driven and equity centered
approach and offer a centralized state entity
to support coordination and collaboration
across state government and philanthropy.
These investments will support the important
community role in advancing public health,
among other things, and be critical to our
future success. In the end, California will not
shy away from focusing in on the simple, well
understood actions that make the biggest
difference. Communicating these messages
simply, clearly, and consistently will continue
to be our north star.
Protecting Workplaces
We took early actions to make our
workplaces safer. Through executive action
we ensured that qualified workers receive
the care and support they need through
worker’s compensation benefits if they
contracted COVID-19 at work. We took this
same approach to allow our most vulnerable
workers to take time off when sick from
COVID-19. We partnered with the Legislature
to codify these policies into statute.
To inform employers about new laws and
workers about their rights, we developed
training and workshops, including resources
such as a model COVID-19 Prevention Plan,
workplace postings, and infographics. Over
55,000 employers were reached through
these activities. Our approach leveraged
technology to make information more
accessible, including an online Training
Academy for employers and workers to
access video and written training materials
and an online wage claim portal to ensure
workers are compensated for taking their
paid sick leave.
Worker and Workplace Outreach and
Education
Given the increased risk to workers in
essential industries, we developed the
Safer at Work Campaign to assist workers
and employers in better understanding
and implementing the workplace health
and safety and paid sick leave laws.
This included a public awareness media
campaign, outreach funding to more than
70 community-based organizations, and
development of innovative navigator tools
to simplify access and understanding of the
laws and rules developed in response to
the pandemic. Ultimately, this campaign
reached over 20 million individuals
through radio, programmatic display and
social media. Through the community
engagement effort, we reached over a
million workers in interactive engagements,
such as training, meetings, phone calls, and
canvassing.
Through the Reaching Every Californian
campaign we partnered with community
organizations, schools and legal service
providers to offer more than 70 outreach
presentations for workers in high-risk sectors
on sick leave for COVID-19. Through the
Workplace Rights Ambassador Project, which
seeks to build a bridge to disenfranchised
and vulnerable workers, we partnered with
community organizations to provide in-depth
training and support to community leaders
(promotoras) to educate their members
about sick leave and assist them in exercising
their rights. Through our Business Engagement
Program, we held dozens of web-based
trainings and reached tens of thousands of
employers with information on workplace
laws.
Our Farmworker Rights Caravans partnered
with community organizations to take
an audiovisual message in Spanish and
indigenous languages on worker protections
directly to the fields in thirteen counties.
The Caravans also reached farmworkers and
their families in community gathering places
26 California SMARTER| February 2022
and at COVID-19 testing and vaccination
clinics. Nearly 8,000 farmworkers were
reached. We also ensured employers in this
sector had the information they needed
to comply with the law by communicating
regularly and holding in-person meetings
with dozens of growers and contractors
around the state. Through media outreach
for the Farmworker Rights Caravans, we
reached over 5.7 million views of messaging
in targeted agricultural regions.
Long-Term Care Facilities
By mid-year 2020, nursing homes had
become ground zero for the pandemic. Two
key factors coalesced to create a high-risk
environment for infections and ultimately
high morbidity and mortality: (1) facility
residents are among our community’s most
vulnerable and at-risk populations due
to their often older age and underlying
chronic conditions and (2) the congregate,
communal, nature of the facilities themselves
with the variable degrees of infection control
between staff and residents. Like the rest
of the nation, California experienced a
sweeping spread of COVID-19 in nursing
homes. However, an immediate and intense
focus on reducing the risk for residents
of nursing home and other congregate
care facilities quickly led to numerous
changes and interventions: infection control
standards were increased and supported
through technical assistance; staff were
augmented and trained to do their jobs
with a focus on minimizing transmission
primarily by advancing more protective,
standardized and universally applied use of
PPE; state initiated programs like Hotels for
Health Care Workers launched to provide
staff an opportunity to avoid broader
community mixing and better personnel
and resident protections; California invested
in creating data platforms to better track
testing, infections, PPE supplies and monitor
compliance with infection control measures.
Together, California’s facilities made
accelerated improvements that have
remained and been improved. These
tools that focus on the needs of long-term
care residents and facilities must also be
examined through higher level improvements
in our overall expectations of nursing homes
and their operators. While there is certainly a
need to stabilize and preserve our capacity,
we must also push for transformations in how
the facilities are supported and monitored.
California will continue to work with partners
across the state to maintain our advantage
over the virus in long term care facilities while
remaining prepared for potential challenges
that soon may emerge.
Veterans Homes
Additionally, California’s eight Veterans
Homes reacted very quickly and were
well-prepared to respond to the COVID-19
pandemic. This approach was characterized
by early action; proactive infection control
practices; strong coordination throughout
the system; and excellent teamwork at
all levels – including with local, state, and
federal partners. CalVet took key steps prior
to and early on in the pandemic, including
updating infection control protocols used for
a severe flu season and restricting visitations
even before the stay-at-home order went
into effect.
Over the last two years, the Veterans Homes
have adapted rapidly as circumstances,
guidance, and requirements have evolved
and has received national recognition
for their efforts. Staff and residents of the
Veterans Homes have been instrumental in
these efforts, which is evident in their high
rates of vaccination. As of February 7, 2022,
94.5% of residents and 89.8% of staff are fully
vaccinated, and 94.5% of residents and
70.3% of staff have received a booster shot.
Ventilation
California’s public health leaders recognized
early on that COVID-19 is an airborne
pathogen that spreads readily indoors
when air circulation is not optimized. This
understanding guided our actions since the
earliest days of our response. This fact drove
many efforts, including regulatory relief for
businesses, to encourage Californians to
meet, dine and play outdoors; to keep a
door open and windows up to help circulate
fresh air indoors.
California SMARTER| February 2022 27
Over the course of the last 15 months,
Californians have come together to make
innovative improvements to indoor air
quality in several settings. For example,
many restaurants made investments in air
circulation and filtration by upgrading HVAC
filters, windows and doors remained opened
to freshen air more regularly and effectively
across a host of small and large businesses,
and many schools used COVID-19-related
funding to invest in inexpensive, but
effective, devices to improve the circulation
and filtration of air in classrooms and other
spaces protecting staff and students. The
pandemic has taught us that improvements
to air quality do not always require massive
infrastructure investments or take years
to implement. There are cost effective,
immediate tools available. Californians also
spent a great deal more time outdoors,
enjoying the fresh air and nature.
Emergency Response
Governor Newsom proclaimed a State of
Emergency based on the unprecedented
threat of the COVID-19 pandemic to the
health and safety of all Californians. Of
the 561 Executive Order provisions issued
throughout the course of the pandemic
response, fewer than 15% remain
operative.
These open provisions ensure continued
flexibility from statutory or regulatory
requirements that remain critical to support
our ongoing COVID-19 response, for
example, ensuring hospital and medical
staffing in the face of the Omicron surge,
maintaining the State’s robust testing
program, waivers of state contracting rules
to ensure quick access to critical masks and
test kits, and maintaining effective workplace
safety standards. None of the operative
provisions directly impact or restrict the
activities of the general public.
As one specific example, without the state
contracting flexibility, California would have
been unable to move swiftly to procure
the more than 13 million home test kits
distributed to county offices of education
across the state in December and early
January to support the safe return to in-
person learning as students returned from
winter break. Likewise, other provisions
ensure that the home addresses of public
health officials remain confidential amidst
unprecedented personal threats to these
public servants and direct that the California
Office of Emergency Services can utilize state
fairgrounds and other property as needed to
support the ongoing pandemic response.
The foregoing examples illustrate why
maintaining the State of Emergency and
keeping certain Executive Order provisions
in place was critical to getting through the
Omicron surge and remains critical to our
ongoing response in the immediate term.
Nonetheless, the Governor will continue to
assess the necessity of each open Executive
Order provision and terminate provisions as
they cease to be necessary.
28 California SMARTER| February 2022
Investments to Fight COVID-19
California has led the nation’s fight against COVID-19, implementing first-in-the-nation public health measures that have saved tens of thousands of lives. The state has administered over 70 million vaccinations and boosters and has maintained one of the lowest death rates among large states.
Last year’s budget appropriated $1.7 billion to fight against COVID-19. Now, Governor Newsom’s $3.2 Billion Emergency Response Package will protect Californians by continuing that fight, focusing on keeping our schools open and our economy moving. The package includes $1.9 billion in funding that has already been approved to immediately equip California’s health care system with supplies and staffing.
Bolster Testing
• Expand hours and capacity at testing
sites throughout the state to help slow
the spread of the virus.
• Distribute millions of COVID-19 antigen
tests to local health departments,
community clinics and county offices of
education and schools.
• Support the state’s testing facilities,
including specimen collection and
expanding capacity in order to meet
demand.
• Assist state departments in testing their
staff and congregate populations.
Getting more Californians Vaccinated and Boosted
• Continue the “Vaccinate all 58”
public education campaign to
provide reliable information and build
vaccine confidence while combating
misinformation, all of which is in
partnership with 250 ethnic media
outlets.
• Maintain a robust community outreach
and direct appointment assistance
campaign by conducting door-to-
door canvassing, phone banking
and texting with over 700 CBOs and
community partners in partnership with
philanthropy.
• Support in-home vaccination and
testing programs and transportation
arrangement, for those unable to
travel, to meet Californians where
they’re at.
• Provide free transportation to
vaccination appointments throughout
the state to help get more Californians
vaccinated and boosted.
Support Our Frontline Workers and Health Care Systems
• Support and distribution of critical personnel resources for health care systems to help protect frontline workers, patient care and hospital surge capacity as well as additional staffing for vaccination sites.
Maintain State Response Operations
• Enhance the state’s emergency response and public health capacities, including staffing and information technology at California Department of Public Health, Office of Emergency Services and Emergency Medical Services Authority.
California SMARTER| February 2022 29
Support Mutual Aid, Bolster Public Health Investigation Efforts, Procure Personal Protective Equipment
• Provide mutual aid to support local governments.
• Continue statewide priority public health investigation activities to help keep Californians safe and slow the spread.
• Procure additional personal protective equipment, including children’s N95 and surgical masks, and other durable equipment
The Governor’s Comeback Plan (2021 Budget Act) and the Governor’s Blueprint (2022-23 Budget proposal) present a once-in-a-generation opportunity to equitably improve the lives of All Californians, by investing in programs and services that are designed to lift all boats, but especially those which need to be lifted higher. The Comeback Plan provided us an opportunity to invest in programs and efforts that deepen our focus on the whole person while also promoting equity across all facets of society in response to challenges COVID-19 laid bare.
The Governor’s Blueprint provides the opportunity to make additional bold investments to protect our most vulnerable communities—such as providing housing for individuals with serious behavioral health conditions who are experiencing homelessness — and to make investments that will address the upstream causes of health and human services needs in communities that have been deeply impacted by COVID-19—such as building up our public health infrastructure.
As we move forward, we will leverage the multiyear investments made to build up and strengthen the foundations of a Healthy California for All.
This January marked two years since we worked with the federal government to welcome the first flight of 221 U.S. citizens and diplomats who were being repatriated from Wuhan, China into California due to the emergence of a Novel Coronavirus that rapidly spread, infecting hundreds in a matter of days.
In hindsight, this gave us some early insights into the initial behavior of the virus, provided us with early data on secondary exposure, and gave us the opportunity to understand the non-pharmaceutical interventions (e.g., masking and physical distancing) that could help mitigate the spread of the virus.
Two years later, we are continuing to iterate on our response and learn about the evolving behavior of the virus. The initial days taught us to be nimble and humble. This is true now more than ever before. California has been a state that learns fast and adapts. It is in our DNA and will guide us moving forward.
Conclusion
30 California SMARTER| February 2022
COVID19.CA.GOV
Your Actions Saves Lives