Kendall Allred.jpg
Sukhjit Takhar.jpg

Minutes after heading to the park to play with friends, my 10-year-old son called to tell me he was on his way home.

Confused, I queried, “Didn’t you just leave?”

“Yep, [a friend] is out of quarantine, but the other kids don’t wanna play with him because they’re afraid he’ll give them the ‘Rona,” he replied.

“Huh?” I questioned. “He’s out of isolation, feels fine [aka no symptoms], you’re playing outside, and you guys don’t want to play with him?”

“OK,” I say to myself, “they’re 10. They’re allowed to be confused. Kids can’t always be expected to get it right with all that has changed recently.”

Not an hour later, I got a text from my wife (an ICU nurse), who sent me a screenshot of the California Department of Public Health’s updated All Facilities Letter (AFL) 21-08.7 released Saturday which states, “Health Care Professionals (HCPs) who test positive for SARS-CoV-2 and are asymptomatic, may return to work immediately without isolation and without testing, and HCPs who have been exposed and are asymptomatic may return to work immediately without quarantine and without testing.” The words that popped into my head at that moment are not suited for publishing here, but you get the idea. Does it really make sense to bring back a single potentially infectious individual, who may be taking care of immunocompromised individuals, who can spread COVID-19 to other HCPs and thus create an even larger shortage? Obviously not.

These two stories highlight the ongoing struggles we face educating the public around COVID-19 isolation and quarantine “guidance” nearly two years into this seemingly never-ending pandemic.

I write this with my colleague Dr. Takhar, and while we applaud our public health and scientific colleagues for their relentless dedication to helping us all navigate the muddy waters of the ever-changing evidence around SARS-CoV-2, there have been too many missteps along the way. Those of us on the front lines have become tired of the countless confusing messages, press releases, graphics and “guidance” released by those who are supposed to be knowledgeable authorities.

In the last three weeks we’ve seen recommendations from federal and state officials change repeatedly. While true that new and substantiated scientific evidence must drive changes in guidance, the way it has been shared is sloppy, contradictory, confusing and, simply put, not helpful.

Getting it right is hard. But it’s imperative that our officials do just that. That’s their job. The public is depending on these officials to be thoughtful, thorough and pragmatic. In this, they have failed us. Again. And, if the past is a predictor of the future, they will continue to do so.

Some of our colleagues have written appropriately about how draconian COVID policies are creating staff shortages that endanger patients. While COVID-19 related testing and positive cases are higher in the Bay Area now than at any other time during the pandemic, inpatient units including ICUs have not been overwhelmed with the number of critically ill patients that spilled over into overflow ICU beds last winter. Instead, emergency departments have been crushed with asymptomatic and mildly symptomatic patients seeking quick, reliable testing due to our public health authorities’ failure to adequately prepare for the omicron wave that came with weeks of warning. Officials were afforded ample time to dust off old surge plans and deploy adequate resources before the wave smacked us off our boards. This has necessitated new workflows for already overwhelmed Emergency Departments to deploy “screeners” at the front door to encourage those only seeking COVID-19 testing to go elsewhere.

On Friday, these same officials released confusing guidance to K-12 schools on return-to-school procedures by requiring “a negative test” as a proof of cure when testing kits are in short supply, many testing centers doors were shut over the weekend, and Emergency Departments were already struggling to care for those turning to us for testing when they had nowhere else to go.

It’s mind-blowing that even after all we have learned, federal and state officials continually implement reactionary, and poorly thought-out ideas which create confusion, frustration and ultimately a lack of confidence. Get it right or get out of the way so someone else can.

Kendall S. Allred, MD/MPH, FACEP is an emergency medicine and public health physician trained in disaster management and emergency response. Since the start of the pandemic, he has served as the Mills-Peninsula Medical Center’s COVID-19 Medical Branch director and Surge Branch director leading medical teams in Sutter Health’s pandemic response. Sukhjit S. Takhar, MD is an emergency medicine and infectious disease physician who works alongside Dr. Allred at Mills-Peninsula Medical Center and has been equally instrumental in Mills-Peninsula Medical Center’s COVID-19 pandemic response. Their opinions are their own.

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(1) comment

Lou

Dr. Allred - Bravo, and thank you, for taking the time to write this. Please publish it far and wide. Informative and reassuring to us who observe and think the same things. What can we do as citizens to help stop these atrocities?

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