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Opinion: California's new rules allow COVID-positive kids in school. Here's the problem

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Opinion: California's new rules allow COVID-positive kids in school. Here's the problem

The California Department of Public Health recently updated its COVID guidance to allow people who have tested positive to exit isolation sooner than before. Specifically, officials say that as long as you are fever-free for 24 hours without the use of medications, and other symptoms are mild or improving, you can exit isolation with a mask on. They also recommend avoiding contact with higher-risk people.

This change came as a surprise to many — and it prompted some outrage when the Oakland Unified School District announced a new policy as a result, one in which students who test positive without symptoms can return to school with a mask on and with the recommendation to avoid elderly or immunocompromised people. This policy doesn’t seem very feasible — and it reflects all that officials still haven’t learned about communicating health risks to the public.

California’s new guidance is inconsistent with the recommendations from the Centers for Disease Control and Prevention, which still advises waiting at least five days from a positive test result before going back out. From both, the recommendation is to wear a mask for at least 10 days, although in California, two negative tests at least one day apart allow you to remove your mask.

Neither guidance is perfect. People can shed virus for more than five days after a positive test. In fact, some studies suggest that peak viral load may now actually be around five days after symptoms start, meaning that following CDC guidelines, isolation could end right when people are shedding the most. As for California’s stance, people can be contagious even without a fever and with only mild symptoms.

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The California Department of Public Health’s change was prompted by “the reduced impacts from COVID-19” compared with prior years, per its website. COVID cases recently spiked in California and around the country, and the death rate remains concerning, though much lower than the U.S. peak in 2021. At the same time, much of the public has dropped everyday prevention tools such as masking and testing.

As an infectious disease physician and epidemiologist, I can think of potential justifications for the policy shift in this environment. For example, given that mask use has been low, a policy focused on encouraging masking as a means of leaving isolation earlier could theoretically help stop transmission. The alternative could be that people aren’t bothering to test, particularly if they don’t want to face the decision to isolate when it would inconvenience them. With less testing, we could have more potentially infectious people out in the community maskless — and so guidance that re-emphasizes masks has value.

But whatever the rationale for these changes, it’s a problem that they were not communicated clearly to the public, especially in the midst of yet another COVID-19 surge. There’s no reason public health leadership couldn’t flood broadcast television commercials, social media channels like Instagram or X, or the radio to thoroughly explain California’s policy (and encourage masking, if that was the intent). Instead, we were left with major policy changes presented with unclear logic aside from reassurance that we are in a better place now than in 2020.

With this lack of sufficient explanation, the Oakland school district applied the new state policy to create complicated rules for children. Kids may not be able to apply the rules properly, such as wearing a mask consistently (they tend to be particularly bad at this compared with adults) or avoiding immunocompromised or high-risk people (neither kids nor adults can know exactly who falls into this category around them at all times).

In the four years of the pandemic, we saw how important it is for public health leaders to communicate clearly and often. This builds trust, allows for accountability and helps to set expectations. Poor communication, by contrast, prompts disregard for policy, confusion and the misapplication of guidelines. Given the likelihood of students now testing positive and going to school with imperfect masking and without a way to know who is “high risk,” Oakland’s application of the state guidance may lead to more COVID outbreaks in school communities, or transmission to higher-risk staff and teachers.

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The state Public Health Department’s announcement was a troubling missed opportunity because the department has been otherwise exemplary, including in its communications around high-filtration masks earlier in the epidemic. Even before the guidance, I noticed very few people wearing masks, including while noticeably sick and symptomatic, during my travels on both airplanes and buses in the state. A policy statement imploring people to actually test and mask, with the incentive of isolating for less time if you do so, could help reduce transmission.

Public health policies that don’t match what people are willing to do are unlikely to be useful, so trying to maximize compliance while minimizing harms is a reasonable middle ground in our new world of weighing uncertain COVID risks. But without clear communication to tell people how to be safe and why, these efforts will fail.

Abraar Karan is an infectious disease doctor and researcher at Stanford University.

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Cluster of farmworkers diagnosed with rare animal-borne disease in Ventura County

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Cluster of farmworkers diagnosed with rare animal-borne disease in Ventura County

A cluster of workers at Ventura County berry farms have been diagnosed with a rare disease often transmitted through sick animals’ urine, according to a public health advisory distributed to local doctors by county health officials Tuesday.

The bacterial infection, leptospirosis, has resulted in severe symptoms for some workers, including meningitis, an inflammation of the brain lining and spinal cord. Symptoms for mild cases included headaches and fevers.

The disease, which can be fatal, rarely spreads from human to human, according to the U.S. Centers for Disease Control and Prevention.

Ventura County Public Health has not given an official case count but said it had not identified any cases outside of the agriculture sector. The county’s agriculture commissioner was aware of 18 cases, the Ventura County Star reported.

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The health department said it was first contacted by a local physician in October, who reported an unusual trend in symptoms among hospital patients.

After launching an investigation, the department identified leptospirosis as a probable cause of the illness and found most patients worked on caneberry farms that utilize hoop houses — greenhouse structures to shelter the crops.

As the investigation to identify any additional cases and the exact sources of exposure continues, Ventura County Public Health has asked healthcare providers to consider a leptospirosis diagnosis for sick agricultural workers, particularly berry harvesters.

Rodents are a common source and transmitter of disease, though other mammals — including livestock, cats and dogs — can transmit it as well.

The disease is spread through bodily fluids, such as urine, and is often contracted through cuts and abrasions that contact contaminated water and soil, where the bacteria can survive for months.

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Humans can also contract the illness through contaminated food; however, the county health agency has found no known health risks to the general public, including through the contact or consumption of caneberries such as raspberries and blackberries.

Symptom onset typically occurs between two and 30 days after exposure, and symptoms can last for months if untreated, according to the CDC.

The illness often begins with mild symptoms, with fevers, chills, vomiting and headaches. Some cases can then enter a second, more severe phase that can result in kidney or liver failure.

Ventura County Public Health recommends agriculture and berry harvesters regularly rinse any cuts with soap and water and cover them with bandages. They also recommend wearing waterproof clothing and protection while working outdoors, including gloves and long-sleeve shirts and pants.

While there is no evidence of spread to the larger community, according to the department, residents should wash hands frequently and work to control rodents around their property if possible.

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Pet owners can consult a veterinarian about leptospirosis vaccinations and should keep pets away from ponds, lakes and other natural bodies of water.

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Political stress: Can you stay engaged without sacrificing your mental health?

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Political stress: Can you stay engaged without sacrificing your mental health?

It’s been two weeks since Donald Trump won the presidential election, but Stacey Lamirand’s brain hasn’t stopped churning.

“I still think about the election all the time,” said the 60-year-old Bay Area resident, who wanted a Kamala Harris victory so badly that she flew to Pennsylvania and knocked on voters’ doors in the final days of the campaign. “I honestly don’t know what to do about that.”

Neither do the psychologists and political scientists who have been tracking the country’s slide toward toxic levels of partisanship.

Fully 69% of U.S. adults found the presidential election a significant source of stress in their lives, the American Psychological Assn. said in its latest Stress in America report.

The distress was present across the political spectrum, with 80% of Republicans, 79% of Democrats and 73% of independents surveyed saying they were stressed about the country’s future.

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That’s unhealthy for the body politic — and for voters themselves. Stress can cause muscle tension, headaches, sleep problems and loss of appetite. Chronic stress can inflict more serious damage to the immune system and make people more vulnerable to heart attacks, strokes, diabetes, infertility, clinical anxiety, depression and other ailments.

In most circumstances, the sound medical advice is to disengage from the source of stress, therapists said. But when stress is coming from politics, that prescription pits the health of the individual against the health of the nation.

“I’m worried about people totally withdrawing from politics because it’s unpleasant,” said Aaron Weinschenk, a political scientist at the University of Wisconsin–Green Bay who studies political behavior and elections. “We don’t want them to do that. But we also don’t want them to feel sick.”

Modern life is full of stressors of all kinds: paying bills, pleasing difficult bosses, getting along with frenemies, caring for children or aging parents (or both).

The stress that stems from politics isn’t fundamentally different from other kinds of stress. What’s unique about it is the way it encompasses and enhances other sources of stress, said Brett Ford, a social psychologist at the University of Toronto who studies the link between emotions and political engagement.

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For instance, she said, elections have the potential to make everyday stressors like money and health concerns more difficult to manage as candidates debate policies that could raise the price of gas or cut off access to certain kinds of medical care.

Layered on top of that is the fact that political disagreements have morphed into moral conflicts that are perceived as pitting good against evil.

“When someone comes into power who is not on the same page as you morally, that can hit very deeply,” Ford said.

Partisanship and polarization have raised the stakes as well. Voters who feel a strong connection to a political party become more invested in its success. That can make a loss at the ballot box feel like a personal defeat, she said.

There’s also the fact that we have limited control over the outcome of an election. A patient with heart disease can improve their prognosis by taking medicine, changing their diet, getting more exercise or quitting smoking. But a person with political stress is largely at the mercy of others.

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“Politics is many forms of stress all rolled into one,” Ford said.

Weinschenk observed this firsthand the day after the election.

“I could feel it when I went into my classroom,” said the professor, whose research has found that people with political anxiety aren’t necessarily anxious in general. “I have a student who’s transgender and a couple of students who are gay. Their emotional state was so closed down.”

That’s almost to be expected in a place like Wisconsin, whose swing-state status caused residents to be bombarded with political messages. The more campaign ads a person is exposed to, the greater the risk of being diagnosed with anxiety, depression or another psychological ailment, according to a 2022 study in the journal PLOS One.

Political messages seem designed to keep voters “emotionally on edge,” said Vaile Wright, a licensed psychologist in Villa Park, Ill., and a member of the APA’s Stress in America team.

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“It encourages emotion to drive our decision-making behavior, as opposed to logic,” Wright said. “When we’re really emotionally stimulated, it makes it so much more challenging to have civil conversation. For politicians, I think that’s powerful, because emotions can be very easily manipulated.”

Making voters feel anxious is a tried-and-true way to grab their attention, said Christopher Ojeda, a political scientist at UC Merced who studies mental health and politics.

“Feelings of anxiety can be mobilizing, definitely,” he said. “That’s why politicians make fear appeals — they want people to get engaged.”

On the other hand, “feelings of depression are demobilizing and take you out of the political system,” said Ojeda, author of “The Sad Citizen: How Politics is Depressing and Why it Matters.”

“What [these feelings] can tell you is, ‘Things aren’t going the way I want them to. Maybe I need to step back,’” he said.

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Genessa Krasnow has been seeing a lot of that since the election.

The Seattle entrepreneur, who also campaigned for Harris, said it grates on her to see people laughing in restaurants “as if nothing had happened.” At a recent book club meeting, her fellow group members were willing to let her vent about politics for five minutes, but they weren’t interested in discussing ways they could counteract the incoming president.

“They’re in a state of disengagement,” said Krasnow, who is 56. She, meanwhile, is looking for new ways to reach young voters.

“I am exhausted. I am so sad,” she said. “But I don’t believe that disengaging is the answer.”

That’s the fundamental trade-off, Ojeda said, and there’s no one-size-fits-all solution.

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“Everyone has to make a decision about how much engagement they can tolerate without undermining their psychological well-being,” he said.

Lamirand took steps to protect her mental health by cutting social media ties with people whose values aren’t aligned with hers. But she will remain politically active and expects to volunteer for phone-banking duty soon.

“Doing something is the only thing that allows me to feel better,” Lamirand said. “It allows me to feel some level of control.”

Ideally, Ford said, people would not have to choose between being politically active and preserving their mental health. She is investigating ways to help people feel hopeful, inspired and compassionate about political challenges, since these emotions can motivate action without triggering stress and anxiety.

“We want to counteract this pattern where the more involved you are, the worse you are,” Ford said.

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The benefits would be felt across the political spectrum. In the APA survey, similar shares of Democrats, Republicans and independents agreed with statements like, “It causes me stress that politicians aren’t talking about the things that are most important to me,” and, “The political climate has caused strain between my family members and me.”

“Both sides are very invested in this country, and that is a good thing,” Wright said. “Antipathy and hopelessness really doesn’t serve us in the long run.”

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Video: SpaceX Unable to Recover Booster Stage During Sixth Test Flight

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Video: SpaceX Unable to Recover Booster Stage During Sixth Test Flight

President-elect Donald Trump joined Elon Musk in Texas and watched the launch from a nearby location on Tuesday. While the Starship’s giant booster stage was unable to repeat a “chopsticks” landing, the vehicle’s upper stage successfully splashed down in the Indian Ocean.

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