In a statement, officials from the Californian county which has declared a state of emergency over COVID-19 said the advice roll-back applies to the general public as well as healthcare workers and first responders. However, those who develop respiratory symptoms of COVID-19, such as a dry cough, “should stay home in order to protect those who are well.”

Advising those who are sick, the statement said: “Those with cold-like symptoms who can manage their symptoms at home with over-the-counter drugs should do so, regardless of whether they have a cold, the flu, or COVID-19.

“If, however, difficulty breathing and lethargy develops, or symptoms were better and then got worse, they should call their healthcare provider, or urgent care center ahead so they can prepare to take care of them.”

To avoid draining resources, “people should only call 911 or go to an emergency department if they believe that they are extremely sick or their life is in imminent danger,” the statement read.

People who are at a higher risk of suffering complications from COVID-19 than the average person should consider staying at home and avoiding crowded social gatherings where people are within arm’s lengths, like parades, conferences, sporting events and concerts, the authorities said.

That includes those who are older—particularly those over 80—and those with chronic conditions like cardiovascular disease, cancer, heart disease, lung diseases like chronic obstructive pulmonary disease, and those with severely weakened immune systems, according to the statement.

Officials said the new recommendations come as the city moves to focusing on mitigating the spread of COVID-19 and protect the most vulnerable. According to the county’s Department of Health Services website, three residents have been diagnosed with COVID-19, and one has recovered. No one has died.

Dr. Peter Beilenson, head of the county’s Department of Health Services, told the Sacramento Bee that officials had quarantined the sick and those who had been in contact with infected individuals as a way to slow down the spread of COVID-19.

Beilenson said: “Once you get a certain number of cases, it’s hard to continue to contact-trace back the way you tried originally. So we move to mitigation, which is basically trying to mitigate the risk to those who are most at risk: the elderly and those with chronic underlying conditions.”

Such individuals and their families should take precautions to avoid exposure, he said. Beilenson suggested those in their 70s or 80s might want to avoid attending AARP gatherings, and parents might want to think twice before taking children with symptoms of COVID-19—like a fever, cough, and shortness of breath—to visit their grandparents at their home or in an assisted living facility. He expects other counties in California to make similar announcements, he said.

Michael Head, senior research fellow at the U.K.’s University of Southampton and an expert in epidemiology and health policy, told Newsweek: “This policy revision from Sacramento has the potential to allow, for example, healthcare workers to remain on the frontline whilst they are symptomless but after an exposure to COVID-19.

“Exposure does not mean you will become infected, merely that you have a chance of being infected. The recommendations for quarantine are not removed altogether, but are now aimed at vulnerable populations, and those who are sick,” he said.

“The benefits of this are, of course, more frontline staff available to support increasingly-stretched hospitals and healthcare centres. The downsides are the potential for transmission before any symptoms become apparent,” but he said “the vast majority of COVID-19 transmission will be from those with symptoms).”

“This is a calculated revision from the Sacramento public health authorities that the advantages will outweigh the disadvantages,” Head argued. “It will be very interesting to observe what happens. If the outbreak continues to increase as we think it might, then policy revisions like these will probably become more common.”

However, Jonathan Eisen, an evolutionary biologist at University of California, Davis, tweeted that Sacramento’s announcement “does not seem like a good plan,” adding “especially the plan to shift from containment to mitigation.”

“It is one thing to say we need to do mitigation, but there is no doubt that containment & slowing progression is still important so ditching quarantine for contact at this point seems to misguided, especially due to the still limited testing,” he said.

“Let’s suppose #Sacramento County is correct (which I think they are not) that it is time to ditch containment. That would mean it is time for aggressive mitigation strategies. Yet their mitigation plan is woefully minimalistic, almost a joke.” For instance, Eisen argued, telling the sick to stay home is “a weak guideline at best.”

Eisen told ABC10 the announcement was “premature,” and said quarantining those who are exposed to the virus will prevent it from spreading.

“People still get infected, but they get infected over a month or year, not weeks,” he said. “And that means there will be hospital beds available.”

Tom Hopkins, a doctor in the city of Roseville, told ABC 10 there is there is no need to quarantine for 14 days as the virus is spreading in California. “What would you do if it was a bad flu season? What would happen,” Hopkins asked. “We wouldn’t be quarantining. It wouldn’t exist. There’s no difference.”

According to the U.S. Centers for Disease Control and Prevention website updated on March 9, 110 cases had been reported in the state. As shown in the map by Statista below, the virus has spread to over a dozen states.

Since the outbreak started in China last December, more than 760 people in the U.S. have been diagnosed with COVID-19. In total, over 114,000 cases have been diagnosed worldwide, with more than 64,000 recovering and over 4,000 dying, according to Johns Hopkins University.

Sacramento County did not immediately respond to a request for comment from Newsweek.

Clean hands frequently with soap and water, or alcohol-based hand rub. Wash hands after coughing or sneezing; when caring for the sick; before; during and after food preparation; before eating; after using the toilet; when hands are visibly dirty; and after handling animals or waste. Maintain at least 1 meter (3 feet) distance from anyone who is coughing or sneezing. Avoid touching your hands, nose and mouth. Do not spit in public. Cover your mouth and nose with a tissue or bent elbow when coughing or sneezing. Discard the tissue immediately and clean your hands.

Medical advice

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