Vaccines and boosters
Much like treatment, you can still access vaccines and the bivalent booster at a local pharmacy or through your primary care provider.
Sacramento County still conducts weekly pop-up vaccine clinics, and intends to through November 2023.
While the Biden administration is considering how to continue offering free vaccines and boosters for uninsured people, there is no confirmation yet on whether it will do so.
Sacramento City Unified offers free vaccinations through at least the end of the 2023 school year for students who are under 19 and have Medi-Cal, no insurance or are Native American or Native Alaskan.
Long COVID
At least 65 million people who have had COVID have post-COVID syndrome — more colloquially known as long COVID — which the U.S. Centers for Disease Control refers to as persistent COVID symptoms weeks, months or years after the initial acute infection. More reinfections with the virus generally lead to a greater likelihood of adverse health outcomes.
If you believe you have long COVID or post-COVID syndrome, some experts advise that you seek clinical care and get labs taken, especially since COVID-19 may have just unmasked other illnesses. In the Sacramento region, that could look like getting in touch with the clinicians at the UC Davis Post-COVID-19 Clinic.
“We're still at the infancy with long COVID, but I wish I could tell you that we have the magic secret formula to who's going to get it,” Pollock, the UC Davis epidemiologist, said. “Unfortunately, we don't. There doesn't seem to be a lot of risk factors for somebody who does get a Long COVID infection other than getting a COVID infection.”
Aside from avoiding infection entirely, rest during a COVID-19 infection has been found to help reduce the likelihood of long COVID.
For those navigating long COVID symptoms, Body Politic, a group led by patients with long COVID, put together a handout for providers and patients compiling several patient-led and moderated Facebook groups. Patients also share their experiences with long COVID via #LongCOVID on Twitter.
Long COVID qualifies as a disability, per the Department of Health and Human Services, which means those with it have the legal right to have access needs met at work and may be eligible for disability benefits.
Looking forward
We asked some local health policy experts some of our most pressing questions.
What would it take to enact another state of emergency?
Pollock from UC Davis says since the number of people vaccinated is very high, it’s possible — but not probable — that the state and federal government would enact another state of emergency.
“To reach the threshold of getting to an emergency again, again, we'd have to have a very high level of infection in the community, maybe very high levels [of COVID in the] wastewater,” he said.
California residents can monitor wastewater levels in their area here.
What might future COVID policy look like?
Jean, the California COVID Justice policy director, said there’s an opportunity for the state to revise its emergency framework overall and figure out how to provide resources to community-based organizations.
Public Health Advocates put forward AB 2360 last year, which made it far in the legislature before stalling in committee. The bill would have created a working group to develop a plan to reduce racial disparities following state and local emergencies.
Jean said the organization is still undertaking those conversations and hope to produce a report laying out an equitable funding framework for emergency response in the state.
“What communities are really being challenged by an emergency declaration, a pandemic, a fire, a climate disaster?” she said. “These zip codes are being impacted the most. So our efforts and our resources need to go there.”
Another of Public Health Advocates’ biggest policy priorities includes advocating for a more robust public health ecosystem in Sacramento County. That includes more support for community-based organizations.
“They become the vessels for communities to have equitable access to testing, vaccines, resources, to understand how to keep themselves safe during the pandemic,” she said. “Many of these organizations had to translate that material [about public health declarations] so that their communities understood what was happening during the pandemic. So we can't just let that go away.”
What gaps are created by the emergency declarations ending?
Aside from stratifying access to COVID-19 testing, vaccinations and treatment based on insurance status, Jean says there’s a lack of long-term support and investment in helping people recover from ongoing impacts of the pandemic.
“Recovery is rolling, right? It’s not something that happens in a vacuum,” she said. “There are long-term consequences that we still do not understand quite yet. And so to make a blanket statement to lift our declarations is really, in some senses, a bit irresponsible.”
She points to the end of eviction moratoriums last year as one example of withdrawn support for people whose impact and livelihoods have been affected by the virus.
With state funding for testing shrinking, Jean said the responsibility shifts to local governments for COVID-19 response.
“I'm not quite sure if our local government is prepared to sustain those sorts of recovery efforts, specifically at the county and city level,” she said about Sacramento County.
And she added that she had questions about how COVID-19 care moving back to managed health care will impact not only low-income people, but people who are non-English speakers or come from communities of color.
“I am middle class and a policy director who still has challenges navigating my managed health care plan,” she said. “You layer on that issues of marginalization, issues of cultural, linguistic needs. What does that mean for our community to continue to maintain safety and to continue to understand how COVID can still potentially impact them?”
What have we learned from COVID-19 response so far?
Dr. Brad Pollock, the UC Davis epidemiologist, said the world of how we build spaces, how we monitor diseases and how we teach health seem forever altered.
As a public health professional, he said he’s got his eyes on the possibilities of the sewers.
“The public surveillance [for COVID] has sort of now come down to wastewater monitoring, which is a very big deal,” he said. “The state is investing in that. The federal government is also putting money into this.”
Pollock also said the way public health is integrated into medical schools has changed, with students learning from county public health officials, and those officials gaining access to academic institutions’ technology. He said he believes more work needs to be done earlier, too, to combat health misinformation.
“The level of health literacy we have in our country is so low,” he said. “I think we need to start improving that literacy starting in young ages in school, so that people understand what is this idea of a virus that can infect three people and those three people can infect three or more people, having this exponential increase in the number of cases.”
Pandemic response has shown the crucial role community-based organizations play in connecting communities to resources, Jean said, since they’ve built trust in places the government has often failed to.
“I know there are people that look like me [at those organizations],” she said. “There are people who speak my language. There are people who understand my cultural needs. I can walk in there and ask them specific questions about vaccinations or even historical consequences that racism has propagated.”
But another lesson she’s taking from the emergency declarations ending: A desire to move back to “the status quo.”
“What that signals to the rest of our populations is that we maintain support for the comfortable but not for the oppressed,” Jean said.
The Sacramento County board of supervisors will vote on whether to end the local emergency declaration on Feb. 28.
