Updated 2:34 p.m.
Sacramento County announced Monday it no longer recommends a 14-day quarantine for people exposed to COVID-19, the disease caused by the coronavirus, according to new guidelines from the Department of Public Health.
"With the shift from containment to mitigation, it is no longer necessary for someone who has been in contact with someone with COVID-19 to quarantine for 14 days," the new guidelines read. "This applies to the general public, as well as health care workers and first responders. However, if they develop respiratory symptoms, they should stay home in order to protect those who are well."
The county says the change is a shift from trying to contain the disease to protecting those who are most seriously at risk for this virus.
“We’re recommending that those who are most at risk, the seniors and people with underlying conditions, avoid places of mass gatherings," said Dr. Peter Beilenson, director of health services for Sacramento County. "Avoid malls, avoid grocery stores as much as possible … They should buy two or three weeks of groceries at a time to keep the amount of time they have to go there at a minimum, and they should potentially go off hours."
The Sacramento Bee is reporting that one resident of the Carlton Senior Center in Elk Grove has tested positive for the virus. Sacramento County has 11 confirmed cases of COVID-19, including one person who has recovered.
Beilenson said the announcement doesn't mean the county is underestimating the impact of COVID-19.
"I understand there’s a lot of concern, a lot of it driven by social media," he said. "For most people this is very much like a regular flu season in that 80% of people show they have no or mild symptoms with this illness."
Santa Clara County announced Monday that they are canceling mass gatherings such as sports games and conventions starting Wednesday. Officials noted that even healthy individuals should follow the guidance, as they might transmit the virus to vulnerable people.
Beilenson said that Sacramento has “not gone quite that far,” and is instead focusing on keeping vulnerable populations including seniors away from places where transmission is likely.
“If there was a widespread outbreak of lots of sick folks, we might well consider shutting down gatherings but not at this point,” he said.
Other California counties are likely to follow Santa Clara’s lead, said Farrah McDaid Ting with the California State Association of Counties.
She says it’s rare for health officials to restrict where individuals can and can’t go. They gain that power only after declaring a public health emergency. Of California's 58 counties, 23 have made that declaration, she said, but no others have issued an order like Santa Clara’s.
“In my 20-year career I haven’t seen much,” she said.
Beilenson said Sacramento County made the decision to shift to a mitigation strategy in conjunction with UC health systems and with neighboring counties. He said that the U.S. Centers for Disease Control and Prevention “has not been as timely as one would hope” in terms of changing guidelines.
Placer and Yolo counties jointly announced a similar plan Tuesday. While they aren't requiring a 14-day quarantine period, they do suggest that people who have been exposed and have symptoms stay home for 72 hours after symptoms resolve or seven days after symptoms began.
Yolo and Placer have eight combined cases. The first California COVID-19 death was a Placer County resident.
Adriane Casalotti with the National Association of County and City Health Officials says counties can make their own decisions about how to react to community spread of the virus, regardless of federal guidelines.
She says there are counties across the U.S. making similar decisions about containment, but Sacramento has been the most transparent about it.
“Every day it’s more and more,” she said. “But it’s not an on/off switch, and it’s not a binary choice. In a lot of ways it’s a spectrum, and so folks are moving closer and closer to more of a mitigation lense as there’s community spread in their area.”
UC Davis infectious disease expert Dr. Dean Blumberg said recommendations from officials will change as they learn more about the virus and how it spreads.
"The quarantine recommendations are changing by the day as the virus gets out into the community, it's not feasible anymore to have people quarantined for so long periods," he said Tuesday on CapRadio's Insight with Beth Ruyak. "They need to be out and about and go about their business and it just doesn't make any sense anymore to have people have these strict quarantines."
He said that while that can be frustrating for both patients and clinicians, there are some basic things everyone should do, such as continuing to practice good hygiene and staying home when sick.
"We should be following routine public health advice for all infections, which is if you have a fever, if you're symptomatic, you shouldn't be exposing others and you should stay home," he said.
The symptoms of infection with the coronavirus are very similar to the symptoms of the flu. They include fever, a cough and shortness of breath, according to the CDC.
The vast majority of people who are infected with the coronavirus will experience mild symptoms or may even be asymptomatic, Blumberg previously told Insight.
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