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UCSF doctors say it’s time to end ‘mindless’ Covid rules in open letter to Gov. Newsom

Four doctors, including the director of Covid response for UCSF Medical Center's emergency department, are calling on state leaders to acknowledge the transition of Covid to an endemic disease and lift most masking policies for school-aged children.

The petition was first circulated Friday and currently has more than 9,500 signatures. It includes a strongly-worded open letter to Gov. Newsom and state public health and education leaders, and it notes that “restrictive policies …  have long lost their justification as necessary for prevention of serious illness and death.”

The letter focuses on the negative effect the state’s policies have on children and teens, particularly the mental health and developmental impacts caused by social isolation and masking. 

Covid-related hospitalizations in San Francisco have reached their highest point, although the 7-day average of new cases dropped from their peak earlier this month.  

Dr. Jeanne Noble, an associate professor of emergency medicine at UCSF and director of Covid response for the UCSF Parnassus Emergency Department, told The Standard we are at an inflection point where public health officials should weigh how to respond once the current wave passes.

“We felt it was necessary to really put this forth as we saw the Omicron cases peak and now enter their descent,” said Noble, adding that hospitalizations have started to drop at UCSF. “Throughout this pandemic we've looked at our children primarily through the lens of disease control or as vectors of disease. Now, we would like to get kids first in line to enjoy the benefit of peeling back Covid restrictions.”

Other signatories of the letter include UCSF epidemiologist Dr. Vinay Prasad, UCSF surgeon and bioengineer Dr. Jarrett Moyer and Dr. Jennifer Nguyen, a pediatrician at UCSF Benioff Children’s Hospital Oakland.

The California Public Health Department said in a statement responding to the letter that "vaccinations, boosters and masking remain our most effective tools in the fight against Covid-19" and pointed to their role in keeping schools and businesses open.

However, the department added that "policies must continue to adapt as the situation with the virus changes" and said to expect updates to the state's Covid policies once the Omicron surge subsides.

Noble drew a clear distinction between patients hospitalized “for” Covid versus those admitted “with” Covid. According to UCSF data, 31% of UCSF’s admitted adult Covid patients were there for unrelated medical issues. The proportion among pediatric patients was 40% 

Among the specific policies the petition calls for are immediately allowing school children to unmask while outdoors, making masking optional indoors at schools by Feb. 24 (12 weeks after the last public school child becomes eligible for vaccination) and immediately allowing preschool and daycare teachers and students to unmask.

The letter also calls for an end to “mindless” testing of asymptomatic individuals, which some health care professionals say leads to staffing shortages due to isolation requirements. 

With Covid widespread and endemic in the population, Noble said, society should be taking similar precautions to other common respiratory diseases like the flu.

“We don't do massive testing for the flu and try to pick up every left asymptomatic, or mildly symptomatic case and send that person home,” Noble said. “The argument for chasing down asymptomatic cases and blocking transmission is really to prevent serious illness and death. We really don't care about preventing runny noses and sore throats. Covid is a mild, non-threatening disease for the majority of people.”

Moving forward, the petition calls for state leaders to take a “cost-benefit approach for future Covid restrictions, without disproportionately prioritizing prevention of COVID-19 transmission above all other health considerations.” 

Future Covid protection policies, like regular boosters, should be targeted for those who are most vulnerable of dying or suffering serious illness from the virus. 

The petition was organized by Laura Chinnavaso, a registered nurse with Alameda County who fills in at nursing homes and hospitals facing staffing shortages. Chinnavaso said she was inspired to start the petition advocating for looser restrictions because of the impact she’s seen on her four school-age children.

“Everything I’ve done on this has been through the lens of a parent who watched this affect my children, like my 3-year-old who doesn’t remember a world before the virus or before masking,” Chinnavaso said.

Chinnavaso and Noble said they both understand the tendency to be cautious about the virus and recommend individuals speak to their own doctor to figure out what is best for them. 

“What we need is just the lifting of mandates. We don't need to force people to take off their masks or socialize or do anything that they feel is out of their comfort zone,” Noble said. “But I think to begin the transition towards normality, we have to stop prohibiting normal social interactions. And then the rest will follow suit.”

Kevin Truong can be reached at kevin@sfstandard.com