Mia McDermott is no stranger to isolation. Abandoned as an infant in China, she lived in an orphanage until a family in California adopted her as a toddler. She spent her adolescence in boarding schools and early adult years in and out of psychiatric hospitals, where she underwent treatment for bipolar disorder, anxiety and anorexia. The pandemic left McDermott feeling especially lonely. She restricted social interactions because her fatty liver disease put her at greater risk of complications should she contract COVID-19. The 26-year-old Santa Cruz resident stopped regularly eating and taking her psychiatric medications, and contemplated suicide. When McDermott’s thoughts grew increasingly dark in June, she checked into Second Story, a mental health program based in a home not far from her own, where she finds nonclinical support in a peaceful environment from people who have faced similar challenges. Second Story is what is known as a “peer respite,” a welcoming place where people can stay when they’re experiencing or nearing a mental health crisis. Betting that a low-key wellness approach, coupled with empathy from people who have “been there,” can help people in distress recover, this unorthodox strategy has gained popularity in recent years as the nation grapples with a severe shortage of psychiatric beds that has been exacerbated by the pandemic . Peer respites allow guests to avoid psychiatric hospitalization and emergency department visits. They now operate in at least 14 states . California has five, in the San Francisco Bay Area and Los Angeles County. “When things are really tough and you need extra support but you don’t need hospitalization, where’s that middle ground?” asked Keris Myrick , founder of Hacienda of Hope , a peer respite in Long Beach. People with serious mental illness are more likely to experience emotional distress in the pandemic than the general population, said Dr. Benjamin Druss, a psychiatrist and professor at Emory University’s public health school, elaborating that they tend to have smaller social networks and more medical problems. Science Signs of depression have tripled in the U.S. since the COVID-19 pandemic got underway Science Signs of depression have tripled in the U.S. since the COVID-19 pandemic got underway The prevalence of depression symptoms in the U.S. has more than tripled in the COVID-19 era compared to the period before the pandemic.   That was the case with McDermott. “I don’t have a full-on relationship with my family. My friends are my family,” she said. She yearned to “give them a hug, see their smile or stand close and take a selfie.” The next best thing was Second Story , in a pewter-gray split-level, five-bedroom house in Aptos, a beach community near McDermott’s Santa Cruz home. Peer respites offer people in distress short-term (usually up to two weeks), round-the-clock emotional support from peers — people who have experienced mental health conditions and are trained and often certified by states to support others with similar issues — and activities like arts, meditation and support groups. “You can’t tell who’s the guest and who’s the staff. We don’t wear uniforms or badges,” said Angelica Garcia-Guerrero, associate director of Hacienda of Hope’s parent organization . Peer respites are free for guests but rarely covered by insurance. States and counties typically pick up the tab. Hacienda of Hope’s $900,000 annual operating costs are covered by Los Angeles County through the Mental Health Services Act , a policy that directs proceeds from a statewide tax on people who earn more than $1 million annually to behavioral health programs. In September, California Gov. Gavin Newsom signed a bill that would establish a statewide certification process for mental health peer providers by July 2022. For now, however, peer respite staff in California are not licensed or certified. Peer respites typically don’t offer clinical care or dispense psychiatric drugs, though guests can bring theirs. Peers share personal stories with guests but avoid labeling them with diagnoses. Guests must come — and can leave — voluntarily. Some respites have few restrictions on who can stay; others don’t allow guests who express suicidal thoughts or are homeless. Peer respite is one of several types of programs that divert people facing behavioral health crises from the hospital, but the only one without clinical involvement, said Travis Atkinson, a consultant at TBD Solutions , a behavioral healthcare company. The first peer respites arose around 2000, said Laysha Ostrow, CEO of Live & Learn , which conducts behavioral health research. The approach seems to be expanding. Live & Learn counts 33 peer respites today in the U.S., up from 19 six years ago. All are overseen and staffed by people with histories of psychiatric disorders. About a dozen other programs employ a mix of peers and laypeople who don’t have psychiatric diagnoses, or aren’t peer-led, Atkinson said. Though she had stayed at Second Story several times over the last five years, McDermott hesitated to return during the pandemic. However, she felt reassured after learning that guests were required to wear a mask in common areas and get a coronavirus test before their stay. To ensure physical distancing, the respite reduced capacity from six to five guests at a time. During her two-week stay, McDermott played with the respite’s two cats and piano — activities she found therapeutic. But most helpful was talking to peers in a way she couldn’t with her mental health providers, she said. In the past, McDermott said, she had been involuntarily admitted to a psychiatric hospital after she expressed suicidal thoughts. When she shared similar sentiments with Second Story peers, they offered to talk, or call the hospital if she wanted. “They were willing to listen,” she said. “But they’re not forceful about helping.” By the end of the visit, McDermott said that she felt understood and her loneliness and suicidal feelings had waned. She started eating and taking her medications more consistently, she said. Science Feeling anxious and depressed? In California, you’re right at home Science Feeling anxious and depressed? In California, you’re right at home It’s official, California: COVID-19 has left us sick with worry and increasingly despondent. And young adults — ages 18 to 29 — are feeling it worst.  The small number of studies on respites have found that guests had fewer hospitalizations and accounted for lower Medicaid spending for nearly a year after a respite stay than people with similar conditions who did not stay in a respite. Respite visitors spent less time in the hospital and emergency room the longer they stayed in the respite. Financial struggles and opposition from neighbors have hindered the growth of respites, however. Live & Learn said that although five peer respites have been created since 2018, at least two others closed because of budget cuts. Neighbors have challenged nearby respite placements in a few instances. Santa Cruz-area media outlets reported in 2019 that Second Story neighbors had voiced safety concerns with the respite. Neighbor Tony Crane told California Healthline that guests have used drugs and consumed alcohol in the neighborhood, and he worried that peers are not licensed or certified to support people in crisis. He felt it was too risky to let his children ride their bikes near the respite when they were younger. In a written response, Monica Martinez , whose organization runs Second Story, said neighbors often target community mental health programs because of concerns that “come from misconceptions and stigma surrounding those seeking mental health support.” Many respites are struggling with increased demand and decreased availability during the pandemic. Sherry Jenkins Tucker, executive director of Georgia Mental Health Consumer Network, said its four respites have had to reduce capacity to enable physical distancing, despite increased demand for services. Other respites have temporarily suspended stays because of the pandemic. McDermott said her mental health had improved since staying at Second Story in June, but she still struggles with isolation amid the pandemic. “Holidays are hard for me,” said McDermott, who returned to Second Story in November. “I really wanted to be able to have Thanksgiving with people.” This story was produced by KHN (Kaiser Health News), which publishes California Healthline , an editorially independent service of the California Health Care Foundation . KHN is not affiliated with Kaiser Permanente.
Public health officials sounded the alarm for months, complaining they did not have enough federal support or money to get COVID-19 vaccines quickly into arms. Now the slower-than-expected start to the largest vaccination effort in U.S. history is proving them right. As they work to ramp up the pace that shots are administered, state and local public health departments across the U.S. cite a variety of obstacles, most notably a lack of leadership from the Trump administration. Many officials worry they are losing precious time at the height of the pandemic and that the delays could cost lives. States lament a lack of clarity on how many doses they will receive and when. They say more resources should have been devoted to education campaigns to ease concerns among people leery of getting the shots. And although the federal government recently approved $8.7 billion for the vaccine effort, it will take time to reach places that could have used the money months ago to prepare to deliver shots more efficiently. Such complaints have become a common refrain in a nation where public health officials have been left largely on their own to solve complex problems. “The recurring theme is the lack of a national strategy and the attempt to pass the buck down the line, lower and lower, until the poor people at the receiving end have nobody else that they can send the buck to,” said Gianfranco Pezzino, who was the public health officer in Kansas’ Shawnee County before retiring last month. California Battered by COVID surge, hospitals are admitting patients faster than they can discharge them California Battered by COVID surge, hospitals are admitting patients faster than they can discharge them The work of discharge planners has never been more critical, as they try to free up beds in dangerously full hospitals confronting a deluge of COVID-19 patients in Los Angeles County.  More Coverage Operation Warp Speed, the federal vaccine program, had promised to distribute enough doses to immunize 20 million people in the U.S. in December. It missed that target , and as of Friday, about 6.6 million people had received their first shot. About 22 million doses have been delivered to states. The American Hospital Assn. has estimated that 1.8 million people need to be vaccinated daily from Jan. 1 to May 31 to reach widespread immunity by the summer. The current pace is more than 1 million people per day below that.  President-elect Joe Biden on Friday called the rollout a “travesty,” noting the lack of a national plan to get doses into arms and reiterating his commitment to administer 100 million shots in his first 100 days. He has not shared details and is expected to discuss the effort this week. His office announced a plan to release most doses right away , rather than holding second doses in reserve, the more conservative approach taken by the Trump administration. The Trump administration defined its primary role as developing coronavirus vaccines and delivering them to states, which would then take over and ensure that vaccine doses traveled “the last mile” into arms. Each state had to develop its own plan, including issuing guidelines for who gets vaccinated first. Several health experts complained about that approach, saying it led to confusion and a patchwork response. “Let’s just say that I was disappointed how they handled testing, and the vaccine deployment has reminded me of how disappointed I was when they handled testing,” said Dr. Mysheika Roberts, health commissioner in Columbus, Ohio. Several public health officials and experts say they believe some of the early glitches are smoothing out. Marcus Plescia, chief medical officer for the nationwide Assn. of State and Territorial Health Officials, said the slow start should not be surprising given the immense scale of the task. “It was not going to be seamless,” he said. Still, Plescia said the federal government could have done more ahead of the rollout — such as releasing billions of dollars earlier to help with staffing, technology and other operational needs. An ongoing investigation by the Associated Press and Kaiser Health News detailed how state and local health departments had been underfunded for decades. Public health officials have warned since the spring that they lack the staff, money and tools that are needed to deploy a vaccine. The money was not approved until the end of December. Vaccine distribution involves a long, complex chain of events. Every dose must be tracked. Providers need to know how much staffing they will need. Eligible people must be notified to schedule their shots, given the vaccine’s handling requirements and the need to observe people for 15 minutes after the shot — all while social distancing is observed. It’s difficult to plan too far ahead because the number of doses the state receives can fluctuate. Hospitals cannot give all their workers shots on the same day because of possible side effects and staffing issues, so they must be spaced out. Rhode Island health officials said it could take up to seven days to get doses out to people once they were received. Officials in several states, including Rhode Island, Pennsylvania, Kentucky and New Jersey, said the lack of supply was one of the biggest obstacles to getting more people vaccinated. Some communities have seen large numbers of medical workers put off getting the shot, even though they are first in line. Columbus, Ohio, has had lower-than-expected demand among top-priority groups, including emergency medical workers. A public education campaign could have helped address the hesitancy among healthcare workers that has slowed the rollout of the first shots, said James Garrow, a spokesman for the Philadelphia health department. Instead, officials for months talked about the speed at which they were developing the vaccines — which did not help alleviate concerns that it might not be safe. “There just hasn’t been good messaging about the safety and the purposefulness of the safety protocols,” Garrow said. The federal government has done little to provide information resources that local officials can tailor to their own communities, to address concerns of people such as pregnant women, said Dr. Michael Osterholm, an infectious disease expert at the University of Minnesota, who is a member of Biden’s COVID-19 advisory board. “You don’t need 50 different states trying to do this kind of work. What you want to have is a smorgasbord of information sources that address different populations that any one state can use,” Osterholm said. “That’s what we don’t have right now.” Some states are getting creative. Oregon held a mass vaccination event at the state fairgrounds with the help of the National Guard. The governor said it aimed to vaccinate 250 people per hour. New Jersey planned to open six vaccine “megasites,” where officials hope more than 2,000 people per day can eventually get their shots. But without a federal plan, such efforts can amount to “throwing spaghetti at a wall to see what sticks,” said Chrissie Juliano of the Big Cities Health Coalition, which represents metropolitan health departments. What’s needed is a national, wartime-type effort to get vaccines out to as many people as possible, multiple experts said. Medical emergencies can be covered 24 hours a day, seven days a week, said Pezzino, who is also a senior fellow at the Kansas Health Institute. Why not make vaccinations available on that schedule? “It is possible. It is feasible,” he said. “I don’t see the level of urgency, the feeling of urgency in anybody around here. And that’s really, honestly, that’s the only thing that could make a difference.”
Los Angeles County Public Health Director Barbara Ferrer on Thursday called for all K-12 campuses to shut down through January amid the raging coronavirus surge , but stopped short of ordering them to close. Ferrer said the danger is too great from the unprecedented prevalence of COVID-19 in the community to continue to provide in-person services and instruction on campuses except in rare cases where it is absolutely necessary. She also called for a pause in athletic conditioning, which has been allowed. “I’m strongly recommending that schools not reopen for in-person instruction,” Ferrer said on a call with school leaders. “I’m recommending this for three weeks until the end of January.” She also urged school administrators to strictly limit exceptions to her recommendation. Regarding “students who really do need the additional support, but could, in fact, go back to virtual for three weeks, I would highly recommend that schools consider providing as many services for students virtually as possible.” No school in L.A. County has been allowed to reopen fully for all students since the pandemic resulted in campus closures last March. Instead, the vast majority of students have been taking classes online from home. In October, the county began permitting schools to bring back up to 25% of enrollment at a given time to serve students with special needs, such as those learning English or those with disabilities. Under these guidelines, students can receive in-person services individually or as part of small, stable groups. Schools also can bring back students in transitional kindergarten through second grade with a county-approved waiver . Some districts have pursued these options more assertively than others . Generally, districts in higher-income communities — where infections rates have been lower — have moved more quickly to provide in-person services and instruction. Ferrer made her recommendation in two calls that she and other officials defined as private briefings for senior school district officials and school operators, including those who manage private schools. The Times was able to listen to a recording of one call and obtained information about the other.  In the taped call, Ferrer prepared school leaders for the bad news by outlining the grim situation in L.A. County — 22% of tests are positive for the virus, over 19,000 daily cases, more than 200 deaths each of the last three days, more than 8,400 hospitalized, taking up nearly half the beds available to adults in the county and overwhelming intensive care units. In such conditions, she said, all activities are significantly risker and should be limited — and that includes providing in-person services at campuses. One school leader asked why Ferrer did not simply order schools to close. She said such an order would make it easier to explain to parents. Ferrer replied that the county is trying to remain consistent with the state’s preferred regional approach. It wasn’t clear whether she was referring to less-restrictive approaches in nearby counties or Gov. Gavin Newsom’s push to open campuses. Newsom last week announced that he plans to seek $2 billion in funding to open schools, hoping to bring back students in kindergarten through second grade by mid-February, with older elementary students soon to follow. His plan contained few details, which Ferrer and her team acknowledged in the calls. She said they, too, are trying to learn more details. Ferrer’s associate Dr. Robert Gilchick offered one important detail from a draft of Newson’s reopening plan that he had seen: Districts that want access to the new funding would have to conduct coronavirus testing according to recommended state guidelines. Another expected sate rule calls for all students to wear masks, which L.A. County already requires, he said. For the moment, the pandemic has curtailed reopening efforts in many school systems. On a more encouraging note, Ferrer said she expected teachers could begin receiving a vaccine in February. But she added a caveat: Those plans would rely on the availability of vaccine doses and the county is not yet certain what its allotment will be. Ferrer also reiterated that the health department is looking at the potential effects of a new, more contagious variety of the virus that has made it to the L.A. area. One school leader wanted to know if the presence of the new variant might mean that students and teachers would need to be more than six feet away from each other, which is the current standard. Ferrer said her department is looking at that issue along with many other unknowns.
It’s the most massive vaccine rollout in U.S. history, but many local governments are consigning patient appointments to web-based services better known for handling birthday-party RSVPs and online yoga sessions. Several Florida counties have deployed Eventbrite. Some Oklahoma governments dabbled with SignUpGenius, and one New Jersey county was still using the service. Elsewhere, some seekers of COVID-19 protection reported hours-long holds on appointment hotlines — only to be disconnected — or logging on to websites that locked them out. “Signing up to get a COVID vaccine is like trying to get a Beatles ticket,” said Jacob Saur, public safety director in Florida’s Manatee County, where demand for the shot crashed the web sign-up sheet he had set up. In its first three weeks, the effort to inoculate 328 million Americans has overwhelmed government websites and left unlucky shutouts fuming in first-come, first-served lines. The difficulty is one reason that distribution of the long-awaited vaccine is taking so long . States also have had to contend with deciding which groups have priority access, confusion over available doses, and navigating the daunting logistics of providing shots that must be kept at subzero temperatures. Overall, the U.S. has administered 4.73 million doses of the COVID-19 vaccine, but that’s just about a third of the doses distributed. California Only 60% of LAPD officers, employees willing to take COVID vaccine, internal survey shows California Only 60% of LAPD officers, employees willing to take COVID vaccine, internal survey shows An informal survey of LAPD employees found significant skepticism about COVID-19 vaccines, with 20% saying they’d opt out.  More Coverage Options are often confusing. A resident of Newark, N.J., can sign up for a shot with the city, surrounding Essex County or the state itself. And as older people in Florida and Georgia wait overnight in lawn chairs at pop-up sites, other vulnerable Americans — or, quite often, their tech-savvy children — are spending hours refreshing computer screens. Florida is piloting a scheduler of its own in certain counties, Saur said. But many of his peers turned to Eventbrite because it was familiar. It also was free.  “As the state is getting vaccines, they’re pushing them out as fast as they can,” he said. “When we get a large batch, I’m not going to do a first-come, first-served. We needed a quick way to schedule these people. We aren’t large schedulers, and Eventbrite came to mind, and we used it.” Saur didn’t get much advance notice when the state started making the vaccine available to the general 65-and-over population. He said call volume and web traffic had been more frenzied than in the worst hurricanes. Jason Salemi, an epidemiologist with the University of South Florida, marveled that even he, a health expert, couldn’t get an appointment for his parents and had instead wasted part of a morning in a futile battle with the crashed registration page for Hillsborough County. “I know what’s going on behind the scenes, and I’m immensely frustrated when I get to the site,” said Salemi, who runs a widely used dashboard on Florida’s coronavirus numbers. “I can only imagine other people who are just beside themselves.” In Florida’s Brevard County, the government decided to use Eventbrite on Wednesday when the phone lines stopped working at the local division of the Department of Health, according to Jesi Ray, a county spokeswoman. She said it took the county about three hours to set up the event, run tests, obtain approval and put out a news release. “We jumped on that idea,” Ray said. The state Department of Health didn’t respond to a request for comment. Eventbrite didn’t immediately respond to a request for comment, nor did SignUpGenius, which is courting business with a post titled “How to Organize COVID-19 Vaccine Appointments Online.” The company encourages would-be customers to buy one of its “feature-packed subscription plans,” which it says help people sign up for vaccinations and can also schedule staff shifts and manage sites. In Tennessee’s Hamilton County, which encompasses Chattanooga, there is no list at all. People eligible for early shots must show up and wait in line at a temporary site. One 83-year-old heart and lung patient on New Year’s Eve waited in line for five hours in his car with his wife, breathing with the help of a supplemental oxygen tank. Twelve spots from the front, though, the shots ran out. “He said, ‘I’m not doing this again — I’m not sitting in this car,’” said the man’s daughter, Kathryn Copeland, a 59-year-old real-estate agent from Orlando, Fla. He will wait, she said, until his doctor has a supply. Health officials in Hamilton County didn’t respond to verbal and written requests for comment. Tom Bodkin, a spokesman, referred to a Friday news release that cited “unprecedented interest.” “We ask for the continued patience of our residents as Health Department staff work through the challenges this massive undertaking brings,” the department’s administrator, Becky Barnes, said in the news release. New Jersey, among the hardest-hit states early in the pandemic, is immunizing only health professionals and residents of long-term-care facilities — in all, about 650,000 people — through at least the end of the month. New Jersey’s statewide scheduling system went live on Tuesday, but the site went down before noon. Even before shots are available to the broad population, the state is struggling to assemble an inoculation-certified workforce and appealing to medical retirees to help. Meanwhile, some of the state’s 21 counties, including Essex and Passaic, are operating their own appointment websites. Hunterdon County was offering appointments via SignUpGenius, whose users more typically organize potlucks, carpools and bridal showers. The muddled deployment effort across the U.S. adds to a series of logistical stumbles during the pandemic. Testing was initially slow to expand, and even then, the ill faced miles-long lines in their cars. Unemployment websites crashed when the virus put millions out of work. But states weren’t blindsided by the vaccine rollout in the same way, with the federal Operation Warp Speed announced officially on May 15 — half a year before the vials started arriving. “It just seems there’s a general lack of preparedness, even though we knew that there was a vaccine coming in the near future that would be a game changer,” said Salemi, the Florida epidemiologist. “Because of the lack of a national coordinated effort, we’re finding that we can’t get these vaccines into people’s arms.”
For as long as Juan can remember, he felt that he didn’t fit the concept of the ideal kid. He has had several serious episodes with depression and three suicide attempts. By age 12, his parents placed him in a psychiatric clinic. Today, he is 26 and recognizes that his depression had a very specific cause: He couldn’t accept that he is attracted to men. Juan, who agreed to tell his story without publishing his surname, now considers himself emotionally stable and has expressed his sexuality openly since he was 18. But depression is like an “old friend” that occasionally visits. The last time was during the quarantine, which he spent with his parents in Bogotá, Colombia, when he overheard his parents talking about him. “I’ll never accept the fact that Juan is gay,” Juan remembers his mother saying to his father one night. “I don’t know what I would do if someday he introduces me to a boyfriend.” The numbers show that the discomfort Juan lives with is shared by many LGBTQ young people in Latin America and the United States. And it has gotten significantly worse during the pandemic. Before the pandemic began, according to UNAIDS , LGBTQ people “had issues associated with their mental and emotional health in a greater proportion than the general population, with manifestations such as depression, anxiety, suicidal thoughts, etc.” That can be worsened by “confinement in solitude or in family groups where they may experience gender violence.” Recently, Chicas Poderosas — a global effort to inspire and develop the careers of women in media — copublished, with the office of UNESCO in Quito, a series of testimonials from Bolivia and Venezuela that document the discrimination and psychological and physical violence that LGBTQ people have experienced. The situation in the United States is not that different. Rob Todaro, communications manager for the Trevor Project , which operates a 24-hour crisis hotline for LGBTQ youth, explained that according to a recent Morning Consult survey , one-third of LGBTQ young people in the United States said  they couldn’t be themselves at home, and one-third of transgender and nonbinary youth felt unsafe with their life situation since the beginning of COVID-19.  California A crisis hotline for transgender people, by transgender people California A crisis hotline for transgender people, by transgender people In six years, the Trans Lifeline has answered more than 65,000 calls from people seeking support and solace from across the globe.  “We knew that even prior to the pandemic, LGBTQ youth had been found to be at significantly increased risk for depression, anxiety and attempting suicide — largely due to increased experiences of victimization,” Todaro said. “Additionally, LGBTQ youth already faced disproportionate rates of unemployment and homelessness, which are among the most consistent risk factors for suicide.” A rise in requests for expert psychological support and therapy reflects this. Cynthia Ruffin, director of Colors LGBTQ Youth Counseling Services , which offers free mental health services to LGBTQ people younger than 25, said her organization’s waiting list has doubled during the pandemic. If your mental and emotional health has suffered during the pandemic, here are some recommendations from Todaro and Ruffin that can help you and help guide families, caregivers and other supporters.   Crisis resources Here are some phone numbers and websites you can use if you need help immediately. National Suicide Prevention Lifeline: (800) 273-8255 Trans Lifeline: (877) 565-8860 The Trevor Project: (866) 488-7386; text “START” to 678678; TrevorChat Teen Line: (800) TLC-TEEN (6 p.m. to 10 p.m. Pacific time); text “TEEN” to 839863 (6 p.m. to 9 p.m. Pacific) LGBT National Hotline: (888) 843-4564 (times vary) California Youth Crisis Line: (800) 843-5200; chat Ruffin suggests that the first thing to do is to find a community of people around your age who share common interests and with whom you identify . In California, for example, support groups include Colors, the Los Angeles LGBT Center and Tarzana Treatment Center s. Todaro said the Trevor Project has been encouraging LGBTQ youth to stay connected to support systems: friends, supportive family and other allies. “These positive connections are vital to prevent suicide because they can absorb the stress, reduce depression and improve wellness,” Todaro said.  The Trevor Project also suggests that young people set a daily schedule, which can provide structure and some degree of certainty in uncertain times. “Setting aside time each day to engage in wellness activities like working out, cooking, doing yoga, or meditating could be a great way to reduce stress and positively impact one’s physical and mental health. Also, making sure that young people stay kind to themselves, not exerting pressure or judgment when they don’t engage in all of the wellness activities that they would have liked,” Todaro said. Lifestyle What is therapy? A beginner’s guide to mental health Lifestyle What is therapy? A beginner’s guide to mental health What is therapy and what happens in a session? What kinds are available? An introduction to a critical tool for better mental health.   Although it’s difficult to surround yourself with people in a pandemic, Ruffin said, finding ways to have socially  distanced activities with people is  important for mental health. “Mental health and nature work very well together. We are in California; fortunately, we can be outside almost all year long. So the suggestion is to not be locked down and isolated at home all the time,” Ruffin said. “Find ways to connect with their community, online with people of your same age, or with friends in the outdoors.” Educate yourself, express love and be alert. Ruffin explained that “the first thing that family members can do is to educate themselves, especially if they believe that their son or daughter could be dealing with gender dysphoria (when a person feels  dissatisfied and distressed about a mismatch between their gender and biological sex). She emphasized that it’s key to assure young people that you love them unconditionally and that they can ask for help. It’s OK if you don’t know exactly how to help. You can always seek out professional guidance, Ruffin said. What are some signs that  an LGBTQ person needs professional help for  mental or emotional health? Key warning signs, Ruffin said, include a person feeling alone or isolated, sad and not wanting to go out or talk to anyone. Other warning signs include excessive social media use, especially interacting with much older people, and excessive drug and alcohol use. In California, if a person is 12 or older, they do not need a parent’s permission to request therapy. Lifestyle How to find a therapist who is right for you Lifestyle How to find a therapist who is right for you It’s been a rough year, and maybe you are considering therapy for the first, second or fifth time. It takes patience and effort to find the right therapist. Here’s a breakdown of what you need to know.  After feeling rejected by his mother, Juan reflected on the meaning of that event. “Somewhat, it’s weird to understand that even though love and acceptance doesn’t mean the same thing, in order to build a healthy relationship free of resentment, both need to go hand in hand.” So what will he do next? “In fact, I have a plan to leave my house; I have a couple,” he said. But it won’t be right away. “And if I leave, I don’t want to do it on bad terms. After all, I love my parents, and I know that they love me.” Dávila and Gutiérrez are visiting fellows from the International Center for Journalists .
A conservative evangelical Christian singer with a history of defying COVID-19 health mandates plans three days of New Year’s gatherings in the Los Angeles area, including stops on skid row and at a tent city in Echo Park, raising fears that the events will be viral “super-spreaders.” Skid row activists plan a car blockade to stop Sean Feucht — a Redding, Calif., volunteer pastor and failed Republican congressional candidate — and his followers from staging what is billed as a “massive outreach” Wednesday evening  on skid row, at the height of Los Angeles County’s pandemic crisis. Feucht’s plans come as California, facing record case counts and a severe shortage of intensive care hospital beds, has extended its stay-at-home order. Feucht began hosting “Let Us Worship” open-air concerts nationwide to push back against government restrictions on religious gatherings, then broadened his focus to cities that erupted in protest after the police killing of George Floyd in Minneapolis. California L.A. County hospitals turn away ambulances, put patients in gift shop: ‘I’ve never seen anything like this’ California L.A. County hospitals turn away ambulances, put patients in gift shop: ‘I’ve never seen anything like this’ The number of people with COVID-19 inside ICUs has broken records for 16 consecutive days.  More Coverage Feucht’s events have featured hundreds of maskless worshipers tightly packed together and singing and dancing. He has another homeless outreach planned Thursday at Echo Park Lake, site of nearly 100 homeless tents, followed by a New Year’s Eve party and concert at a church parking lot in Valencia. In a YouTube video —part of an extensive social media campaign to promote the L.A. dates — Feucht said a couple of thousand glow sticks had been ordered for a bash he predicted could rival his worship service this year on the National Mall, which drew hundreds of people. Charles Karuku, a Feucht associate who travels with the singer, said they tell followers to  heed government health guidelines, “but we are not law enforcement. It’s up to the people how they choose to come.” But Stephen “Cue” Jn-Marie, pastor of Church Without Walls , a skid row congregation, said, “We know based on his track record whatever he’s going to do is going to be maskless.” Jn-Marie is organizing the car blockade with Los Angeles Community Action Network, a skid row anti-poverty activist group.  “The problem we’re facing is even prior to the stay-at-home order, people come into the community and say they’re bringing resources but what they’re bringing is the disease,” said Jn-Marie, adding that the outreach event could undo the self-help measures the skid row community took, including distributing masks and street wash stations and sponsoring testing events. “It doesn’t take thousands to start an outbreak.” California ‘Aren’t you going to help him?’ L.A. hospitals serving the poor and people of color hit hardest by COVID-19 California ‘Aren’t you going to help him?’ L.A. hospitals serving the poor and people of color hit hardest by COVID-19 Hospitals in lower-income, densely populated and nonwhite communities face the greatest challenge in providing care, a Times data analysis finds.  More Coverage The homeless population in Los Angeles has generally avoided serious COVID outbreaks throughout most of the pandemic, although it has seen a significant uptick in recent weeks, in keeping with the wider surge in  infections nationwide. The California Poor People’s Campaign wrote a letter calling for city and county officials to quash Feucht’s events. The campaign offered a legal justification for enforcement of county health orders, but Los Angeles has not generally used police powers on individuals to back up pandemic restrictions, and homeless outreach events do not require permits. “Police know how to show up and issue orders to disperse an illegal gathering,” said Nell Myhand, co-chair of the California Poor People’s Campaign . Asked for a response to the enforcement question, mayoral spokesman Alex Comisar said Mayor Eric Garcetti implored everyone to wear masks and practice social distancing. California Have L.A.'s homeless people dodged a COVID-19 catastrophe? California Have L.A.'s homeless people dodged a COVID-19 catastrophe? One reason L.A.'s homeless people have avoided a COVID disaster could be that they live outside  L.A. Councilman Kevin de León, who represents skid row, said his office and the mayor’s staff will be on skid row Wednesday morning distributing personal protective equipment and sanitation kits to homeless people, but did not comment on possible enforcement of county COVID-19 health orders. “ Our expectation is that those attending the scheduled outreach event take steps to care for our community and protect vulnerable Angelenos on skid row by wearing masks and honoring social distancing guidelines,” de Leon said in a statement. Feucht has upcoming events scheduled in Orange County and San Diego, according to his website. Tom Grode, a skid row resident and activist who began petitioning the city a month ago to stop the skid row event , called Feucht’s plan to come to Los Angeles “incredibly foolish ... divisive and dangerous.” California God, masks and Trump: What a coronavirus outbreak at a California church says about the election California God, masks and Trump: What a coronavirus outbreak at a California church says about the election The Bethel School of Supernatural Ministry caused a super-spreader event in Redding.  “The problem is any of these events could get weird in different ways,” Grode said. Cathy Callahan, who has been following Feucht’s career online with dismay, spent two hours Tuesday calling the Los Angeles Police Department, the mayor’s office, county health officials and the state attorney general, asking if they were going to shut the New Year’s events down. She said she was bounced from office to office without receiving an answer. ”If not, why is California issuing lockdowns or stay-at-home orders?” Callahan asked.
The Environmental Protection Agency has completed one of its last major rollbacks under the Trump administration, changing how it considers evidence of harm from pollutants in a way that opponents say could cripple future public health regulation. EPA Administrator Andrew Wheeler is expected to formally announce completion of what he calls the “Strengthening Transparency in Regulatory Science” rule in an appearance before a conservative think tank Tuesday. The EPA completed the final rule last week, but so far has declined to make the text public. The new rule would require the release of raw data from public health studies whose findings the EPA uses in determining the danger of an air pollutant, toxic chemical or other threat. Big public health studies that examine the anonymized results of countless people have been instrumental in setting limits on toxic substances, including the rules enshrined in some of the nation’s most important clean-air protections . Some industry and conservative groups have long pushed for what they call the transparency rule. Opponents say the real aim under the guise of greater transparency is to handicap future regulation. “If the American people are to be regulated by interpretation of these scientific studies, they deserve to scrutinize the data as part of the scientific process and American self-government,” Wheeler wrote in an opinion piece in the Wall Street Journal on Monday. But critics say the new rule could force disclosure of the identities and details of individuals in public health studies, jeopardizing medical confidentiality and future studies. Academics, scientists, universities, public health and medical officials, environmental groups and others have spoken out at hearings and written to oppose the change. Politics EPA overrides scientists’ calls for tougher pollutant limit Politics EPA overrides scientists’ calls for tougher pollutant limit The Trump administration on Monday made final its decision to leave limits for a deadly kind of air pollutant unchanged, overriding scientific findings that tougher standards could save tens of thousands of lives yearly.  “This really seems to be an attempt by Wheeler to permanently let major polluters trample on public health,” said Benjamin Levitan, a senior attorney with the Environmental Defense Fund advocacy group. “It ties the hands of future administrations in how they can protect the public health.”  The change could limit not only future public health protections, but “force the agency to revoke decades of clean-air protections,” Chris Zarba, former head of the EPA’s Science Advisory Board, said in a statement. Wheeler, in his Wall Street Journal piece, said the new limits wouldn’t compel the release of any personal data or “categorically” exclude any scientific work. The EPA has been one of the most active agencies in carrying out President Trump’s mandate to roll back regulations that conservative groups have identified as  unnecessary and burdensome to industry. Many of the changes face court challenges and can be reversed by executive action or by lengthier bureaucratic process. But undoing them would take time and effort by the incoming Biden administration, which also has ambitious goals to fight climate-damaging fossil fuel emissions and lessen the impact of pollutants on lower-income and minority communities.
A British judge Monday rejected the United States’ request to extradite WikiLeaks founder Julian Assange to face espionage charges, saying he was likely to kill himself if held under harsh U.S. prison conditions. District Judge Vanessa Baraitser rejected allegations from Assange’s lawyers that he was being prosecuted for political reasons or would not receive a fair trial in the U.S. But she said his precarious mental health would likely deteriorate further under the conditions of “near total isolation” that he was likely to face in U.S. prison. “I find that the mental condition of Mr. Assange is such that it would be oppressive to extradite him to the United States of America,” the judge said. She said Assange was “a depressed and sometimes despairing man” who had the “intellect and determination” to circumvent any suicide-prevention measures taken by prison authorities. The U.S. government said it would appeal the decision. Assange’s lawyers plan to ask at a bail hearing Wednesday for their client’s release from the London prison where he has been held for more than a year and a half . Assange, who sat in the dock at London’s Central Criminal Court for the ruling, wiped his brow as the decision was announced. His partner, Stella Moris, with whom he has two young sons, wept. World & Nation Who is Julian Assange? Arrest of WikiLeaks founder spotlights a showy yet enigmatic figure World & Nation Who is Julian Assange? Arrest of WikiLeaks founder spotlights a showy yet enigmatic figure With his shock of Warhol-white hair, black leather jacket and self-proclaimed mission to lay bare official malfeasance, Australian-born Julian Assange burst onto the world stage more than a decade ago with his creation of the WikiLeaks website.  Assange’s American lawyer, Barry Pollack, said the legal team was “enormously gratified by the U.K. court’s decision denying extradition.”  “The effort by the United States to prosecute Julian Assange and seek his extradition was ill-advised from the start,” he said. “We hope that after consideration of the U.K. court’s ruling, the United States will decide not to pursue the case further.” The judge’s decision is a dramatic moment in Assange’s years-long legal fight in Britain but likely not its final chapter. U.S. prosecutors have indicted Assange on 17 espionage charges and one charge of computer misuse. The charges carry a maximum sentence of 175 years in prison. World & Nation WikiLeaks founder Julian Assange faces new indictment in U.S. World & Nation WikiLeaks founder Julian Assange faces new indictment in U.S. A new Justice Department indictment says WikiLeaks founder Julian Assange sought to recruit hackers at conferences in Europe and Asia to provide his anti-secrecy website with classified information.  Lawyers for the 49-year-old Australian argued that he was acting as a journalist and entitled to 1st Amendment protections of freedom of speech for publishing leaked documents that exposed U.S. military wrongdoing in Iraq and Afghanistan. The judge, however, said Assange’s actions, if proved, would “amount to offenses in this jurisdiction that would not be protected by his right to freedom of speech.” Assange’s lawyers had accused the U.S. of an “extraordinary, unprecedented and politicized” prosecution that sought to “criminalize obtaining and publishing information relating to ‘national security.’” Assange’s legal team argued that extradition threatened his human rights because he risks “a grossly disproportionate sentence” and detention in “draconian and inhumane conditions” that would exacerbate his severe depression and other mental health problems. The judge agreed that U.S. prison conditions would be oppressive. She accepted evidence from expert witnesses that Assange had a depressive disorder and an autism spectrum disorder.  World & Nation Assange tried to warn White House about big classified documents leak, defense lawyers say World & Nation Assange tried to warn White House about big classified documents leak, defense lawyers say In second day of testimony, lawyers for WikiLeaks’ Julian Assange said he partnered with media groups instead of releasing cables naming secret sources.  “I accept that oppression as a bar to extradition requires a high threshold. ... However, I am satisfied that, in these harsh conditions, Mr. Assange’s mental health would deteriorate causing him to commit suicide with the ‘single-minded determination’ of his autism spectrum disorder,” Baraitser said in her ruling. Lawyers for the U.S. denied that Assange was being sought for extradition merely for publishing the leaked documents, saying that the case “is in large part based upon his unlawful involvement” in the theft of the diplomatic cables and military files by then-U.S. Army intelligence analyst Chelsea Manning. The prosecution of Assange has been condemned by journalists and human rights groups, who say it undermines free speech around the world. “This is a huge relief to anyone who cares about the rights of journalists,” the Freedom of the Press Foundation tweeted. “The extradition request was not decided on press freedom grounds; rather, the judge essentially ruled the U.S. prison system was too repressive to extradite. However, the result will protect journalists everywhere.” Breaking News Get breaking news, investigations, analysis and more signature journalism from the Los Angeles Times in your inbox. You may occasionally receive promotional content from the Los Angeles Times. “The mere fact that this case has made it to court, let alone gone on this long, is an historic, large-scale attack on freedom of speech,” WikiLeaks spokesman Kristinn Hrafnsson said earlier about the case. “This is a fight that affects each and every person’s right to know and is being fought collectively.” Assange’s legal troubles began in 2010, when he was arrested in London at the request of Sweden , which wanted to question him about allegations of rape and sexual assault made by two women. In 2012, to avoid being extradited to Stockholm, Assange sought refuge inside the Ecuadorian Embassy, where he was beyond the reach of British and Swedish authorities — but also in effect a prisoner, unable to leave the tiny diplomatic mission in London’s tony Knightsbridge district. The relationship between Assange and his hosts eventually soured, and he was evicted from the embassy in April 2019. British police immediately arrested him for jumping bail in 2012. Sweden dropped its sex-crimes investigation into Assange in November 2019 because so much time had elapsed, but Assange remains in London’s high-security Belmarsh Prison. He was brought to court in a prison van throughout his extradition hearing.
On Christmas Eve, Los Angeles County public health officials made a last-minute plea to residents preparing to celebrate the holiday: Don’t attend indoor church services — it’s not safe. In a statement posted Thursday on the Department of Public Health’s website, officials said they recognized that people have a “sincere desire” for a return to normalcy and to attend in-person indoor services as they have in the past. “Now, most unfortunately, is not the time to attend indoor religious services,” the message said. “The County of Los Angeles is in the midst of its highest surge of COVID-19 cases. The local emergency rooms and hospitals are over-capacity. And there are no indications of an end in sight to the current surge.” The statement added: “Attending an indoor service will result in transmission of COVID-19 and additional hospitalizations that the healthcare system cannot handle at this time.” L.A. County reported one of its deadliest days in the pandemic Thursday with 148 additional deaths — a new daily record. Officials warn the deaths will continue to mount unless residents take steps to stop the spread of the coronavirus. Houses of worship in the county have the right to meet inside after officials this week loosened their own guidelines for religious services, allowing for socially distanced and mask-wearing gatherings indoors. The move came after a series of judicial rulings across the country, including by the U.S. Supreme Court. They involved religious organizations claiming that public health orders violate their constitutional right of freedom of religion. The Supreme Court in late November ruled in a case about New York’s restrictions on houses of worship that states could not place more stringent limits on religious organizations than on other places where large numbers of people gather. This month, a Kern County judge, citing the Supreme Court decision, also ruled that restrictions on indoor religious services in California are unconstitutional.  Despite lifting the ban, L.A. County officials for days have told residents that meeting for religious services indoors over the holiday will increase chances of contracting the virus, saying that failure to follow guidance against gathering on Thanksgiving helped bring the deadliest wave of the pandemic. Many religious leaders have echoed the advice. In a letter to priests and pastors issued this week, Los Angeles Archbishop José Gomez said that although indoor worship was now permitted within the county, outdoor gatherings were safer and still strongly encouraged. Najuma Smith-Pollard, pastor at Word of Encouragement Community Church in Pico-Union, said her congregation held a virtual pre-Christmas worship Wednesday night. Smith-Pollard, who pastors about 160 families and knows three people who died from the virus in the last month, led the service from a studio with a musician. “If there is anybody still trying to have an in-person service gathering, they’re not paying attention to the numbers, and they’re not paying attention to the infection rate,” she said. “It’s really high, and it’s very close to home.” In their Christmas Eve statement, public health officials said people can spread the virus before they get symptoms or even if they are asymptomatic. Activities such as talking loudly or singing indoors increase the concentration of suspended small droplets and particles carrying the virus, they said. “No matter what a Superior Court judge says and given what’s happening now, it is simply too risky to gather indoors with other people who do not live with you,” the statement said. “Public Health urges you to continue to more safely worship as you have during the pandemic by attending remotely via streaming service or at outdoor services only.” Times staff writer Jaclyn Cosgrove contributed to this report.
As COVID-19 cases continue to surge in L.A. County, health officials have encouraged filmmakers to pause their work and refrain from traveling. In an update sent Dec. 24 to film industry contacts, the L.A. County Department of Public Health wrote that “although music, TV and film productions are allowed to operate, we ask you to strongly consider pausing work for a few weeks during this catastrophic surge in COVID cases.” Parts of the note were published on the website of FilmLA , the nonprofit group that handles film permits for the city and county. The department also said that travel for production is not advised because it is more likely people will be in shared vehicles, increasing the risk of spreading the novel coronavirus. FilmLA declined to comment, referring questions to the county’s department of public health. The department did not  respond to a request for comment. Due to the surge in COVID cases and out of an abundance of caution, CBS Studios delayed resuming production by a week to Jan. 11 on a few of its shows, according to a person familiar with the matter who declined to be named. The affected CBS Studios-produced programs include “NCIS,” “NCIS: Los Angeles,” “SEAL Team,” “Why Women Kill” and “Diary of a Future President,” the person said. California Stay-at-home order for much of California extended amid COVID-19 overload at hospitals California Stay-at-home order for much of California extended amid COVID-19 overload at hospitals The extension illustrates how the worst wave of the pandemic is hammering hospitals in Southern California and the San Joaquin Valley and threatening to exhaust available intensive care beds.  More Coverage The spike in COVID-19 cases has put immense pressure on L.A. County hospitals, as some hospitals have turned ambulances away and are running low on oxygen supplies. Space has been running out , with some patients placed in conference rooms and gift shops. On Monday, California reported a record number of new coronavirus infections in a single day — 66,811, according to a Times tally of local health jurisdictions. There have been 24,545 COVID-19 deaths in California as of Monday.  Hollywood has put guidelines in place to prevent the spread of the novel coronavirus. In September, studios and unions agreed on a set of safety protocols , including testing before employees start work on a set and during production. Steve Dayan, secretary-treasurer of Teamsters Local 399, which represents casting directors, location managers and drivers, said he believes the protocols are working. “The rate of community spread in the industry has been far lower than the community at large, and I think it’s partially because of our protocols,” Dayan said. He added that many productions have gone on hiatus during the holidays, with some not returning until mid-January. “Nothing is perfect, and we have to be mindful of what occurs,” Dayan said. “I do feel if things continue to get worse we have to look at that as well. If that is what the state and county mandates — a shutdown — we have to follow those guidelines.”
California is scrambling to find enough nurses, doctors and other medical staff for the increasing demands of the unrelenting pandemic, with the state having so far acquired just one in 10 temporary contracted positions needed to treat surging caseloads. Meanwhile, the state’s Health Corps , created by Gov. Gavin Newsom’s administration in March , has been unable to provide the help needed to make up the difference, with only a small fraction of the thousands of people who signed up for the volunteer service available to staff overloaded facilities. To address the shortage, Newsom said Tuesday that California is “looking overseas” for additional staffing because other states are “in a similar predicament” to California and can’t spare their own healthcare workers. “Staffing has gone to places that started surging a month and a half ago,” said Joanne Spetz, an associate director of research at Healthforce Center at UC San Francisco, which produces supply-and-demand forecasts on registered nurses in the state. “That makes our scramble harder.” Newsom said the state needs to hire 3,000 temporary contracted medical workers to meet increasing demands. California has 300 of those currently working, he said Tuesday. The state also has 186 medical staff members deployed from the California National Guard and the California Medical Assistance Teams and has submitted requests to the federal government for medical personnel. The California Health Corps has just 21 people currently helping with the surge in COVID-19 cases, a small number considering the thousands of people who signed up for the program after it launched to great fanfare in the spring, when Newsom initially estimated that the program could add up to 37,000 healthcare workers . Newsom said the need for additional hospital capacity and staffing was highlighted over the weekend when San Joaquin County ran out of ICU beds. He said he expected other parts of the state to run out of ICU beds this month. “We are very close within the next week or so,” Newsom said Monday during a visit to Los Angeles.  Newsom has also renewed calls for healthcare workers to join Health Corps, which aims to recruit recently retired providers, those in the process of getting a medical license and students enrolled in medical or nursing school to help meet the crushing workloads of the COVID-19 pandemic. The Health Corps allows those workers to sign up for paid shifts in different parts of the state that are experiencing staffing shortages. More than 94,000 people registered for the program, but most lacked the licenses needed to work in the medical field or did not follow up with necessary hiring paperwork. About 4,900 registrants ultimately were qualified to work in the spring, according to data from the state’s public health department. In recent weeks, Newsom  said the Health Corps now has about 900 people who are able to be deployed. When asked why there are only 21 Health Corps members working during the current surge, a state public health department spokesperson said Tuesday that the agency is looking for ways to optimize the use of the volunteer program. Since the program was created, Newsom said Health Corps members have covered almost 3,000 shifts at 143 facilities. State Sen. Richard Pan (D-Sacramento), a doctor who chairs the Senate Health Committee, said it’s understandable that Health Corps’ membership fell precipitously given the high demand for healthcare workers, particularly with high-paying temporary staffing agencies. Pan said that Health Corps is an altruistic program whose actual usefulness is limited. But, he added, the state is rightfully emphasizing the “all hands on deck” need for medical professionals. “Staffing is a huge challenge right now and that’s probably our biggest limiting issue,” Pan said. “Before, in the spring, we were all worried about how many ventilators we have, but if you don’t have the staff to operate the ventilators that’s a problem.” California has contracted with two staffing agencies to hire temporary workers. In April, the California Department of Public Health inked a deal with Medefis, a Nebraska-based company that maintains a national database of healthcare professionals for hire. When that contract expired in September, it was extended through June 2021 for up to $50 million. To date, the state has paid $15.1 million to Medifis. The public health department also signed a six-month contract through September with the healthcare staffing firm Aya Healthcare. That contract was extended through June 2021 for up to $50 million. California has so far paid $7.3 million to Aya Healthcare. Aya Healthcare reported surging demand for travel nurses across the country, with 29,000 open positions. In just the past month, the company said there has been a 92% increase in hospital systems posting urgent job requests. California tops the company’s list as the state with the most staffing requests deemed urgent, according to Aya Healthcare data. “There’s tremendous demand,” Pan said. “This is not a California-only problem. We are competing with every other state. Our country is one entire hotspot. There is no place to draw staff from.” California has 11 designated overflow facilities across the state that can be used when hospitals become too full, which allow for an additional 1,668 beds if needed. In most cases, those sites would be used for less serious illnesses and injuries in order to ensure hospitals have enough beds for the sickest patients. But although the state has the space and equipment to add those beds when needed, staffing  has presented a new challenge compared with the first surge in COVID-19 cases during the spring. Dr. Mark Ghaly, the California Health and Human Services secretary, said typically California would turn to staffing agencies for those kinds of needs. “Those registries are being used throughout the nation,” Ghaly said Tuesday. “We’re only getting a small percentage [of requests for temporary workers filled]. Usually, we get close to 100% of our requests. We’re lucky to get two-thirds at the moment.” Five of the state’s alternative care sites have been opened, including one on Monday at the Fairview Developmental Center in Orange County. That facility, which has a total capacity of 180 beds, has 10 beds considered active, with eight patients being treated there. In addition, Porterville Developmental Center in Tulare County has opened 10 beds for use, and the site can add an additional 113 beds. Last week, a site was opened at Sleep Train Arena, the former home of the NBA’s Sacramento Kings. That care site, which has 20 beds available and a capacity of up to 244 beds, is currently treating seven patients. An additional 23 patients have filled available beds at Imperial Valley College, which has space for an additional 100  beds. The state also has a site for patients from the California Department of State Hospitals, which has 43 of 46 available beds filled to treat patients. The remaining six sites could begin offering beds in the coming days and weeks as COVID cases continue to trend upward. Ghaly said two weeks ago that California was averaging around 15,000 cases a day, a number that has since more than doubled. “That should tell you that in the next couple of weeks what our hospitals will be facing, the amount of people knocking on the front door with COVID to the emergency room departments that need an in-patient hospital bed, that might need that ICU bed, are going to increase,” Ghaly said.
Health officials in Ventura County say parties, indoor church services and youth sports events currently banned amid COVID-19 restrictions are continuing, hindering the county’s ability to fight the spreading coronavirus. The county’s intensive care unit capacity has dropped to 1%, and COVID-19 hospitalizations have broken records for 10 consecutive days. On Sunday, 181 COVID-19 patients were in the county’s hospitals, 72% higher than  the peak of the July surge. “The numbers are getting to be astronomical,” said county health officer Dr. Robert Levin. “People are going to die that don’t need to die.” Two weekends ago, there were some 80 football players gathered at a park in Simi Valley. Sports tournaments are occurring in other counties involving volleyball and baseball players, and in those situations, people weren’t wearing masks, Levin said. Some church services are also still being held indoors in violation of the state rules, with worshipers sometimes sitting shoulder to shoulder. Outdoor sports have been an issue elsewhere too. A youth basketball league in Silicon Valley is at the center of a coronavirus outbreak that has infected more than 75 people. At the Oaks Mall in Thousand Oaks, there was a report of hundreds of people gathering to sing Christmas carols, many without masks, Levin said. And he’s heard of parties of up to 200 people  attending drive-in concerts — organized expressly to allow for social distancing — only to get  out of their cars. Singing is an extremely high-risk activity and has been documented to spread the coronavirus. One choir practice left dozens infected and two people dead in Washington state. “What’s understandable about this?” a frustrated Levin said at a news conference . “None of these justifications are acceptable in the face of the pandemic. We all need to be working together, just like we would be fighting any war.  “It’s incomprehensible to me, it’s baffling. It’s also irresponsible,” he said. “COVID is running so rampant in our county that one out of every 10 COVID test that we run are positive. “It’s too easy to run into someone with COVID nowadays and not know you’re being exposed. There are now 49 outbreaks at long-term care facilities in Ventura County. California California again shatters single-day coronavirus case record: more than 42,000 cases California California again shatters single-day coronavirus case record: more than 42,000 cases A Los Angeles Times county-by-county tally tallied 42,129 coronavirus cases across the state Monday. That’s the first time more than 40,000 cases have been reported by the state’s local health agencies in a single day.  Dr. Mark Lepore, an intensive care physician at Ventura County Medical Center, said he expects the county  to exceed hospital capacity, “and what exceeding capacity looks like is showing up to the hospital and not having a room to go into or not having a staff member to take care of you.” “The hardest part about caring for COVID ... it’s the lack of families being able to see their loved ones, and it’s horrible to watch,” Lepore said. “It’s how slow and insidious the COVID is that it hits the body. You have symptoms for the first eight or so days, and then you just don’t recover.” Maybe the fever goes away, but the shortness of breath can last until the end. “We’ve had to tell family members that their loved ones are not coming home, and it’s awful,” Lepore said. He urged people to avoid gathering for Christmas: “Just tell them you’ll see them next Christmas. This is that important: We don’t want your family members to get sick and not be able to get care.”
We see them every day. They are people like C, a woman in her mid-50s who has for years lived mostly in the parking lot of a Hollywood mall. She suffers from untreated, severe psychotic illness as well as from diabetes and hypertension. She spends much of her time talking to herself angrily and screaming profanities at passersby. Unfortunately, trapped by her profound sickness, she has resisted repeated attempts by L.A. County’s mental health workers to connect her with care and housing. Or there’s B, a man in his early 30s who lives next to the 110 Freeway, sleeping away much of his life wrapped in a soiled blanket on the ground. He is addicted to crystal meth, appears malnourished and has numerous skin lesions on his arms and face. He doesn’t speak much, and although he has accepted food and water from mental health outreach workers, he refuses all efforts to connect him with other resources, including housing. C and B suffer from different types of disease, but they both exemplify one of the chief challenges in trying to address chronic homelessness in California: Many people who live on the streets are unable or unwilling to accept services because of crippling mental illness, addiction or both. C and B — and many others like them — aren’t well served by existing policy. It’s complicated, of course. Legislators with the best of intentions have tried for decades to set the proper balance between self-determination and humane intervention. Today, the law allows for people presenting acute emergencies to be involuntarily hospitalized for short-term holds. But brief hospital stays rarely lead to a future in which people suffering like C and B can recover and live safely in communities. In fact, repeated short-term hospitalizations can be traumatic. But the bar on longer term, mandatory treatment is set arbitrarily high. If a person can articulate plans for providing for their food, clothing and shelter, even if that means getting donated food and clothes and sleeping in a tent on the street, that is enough to keep them from being considered “gravely disabled” in many courts under current state law.  Given this reality, we are constrained in our ability to design proper, proactive engagement strategies to serve and house people in desperate need. The current state of affairs is inhumane. The inflexibility of existing laws means we cannot deliver mental health care, addiction treatment and housing solutions to many who have, but do not recognize, severe, chronic and even life-threatening needs. Meanwhile, neighborhoods are left to deal with the fallout from our policy failures. In many areas of Los Angeles, families are understandably afraid to take their children to supermarkets or playgrounds, or to walk under local freeways. Not surprisingly, these concerns are festering into outright animosity toward the unhoused and toward local governments. The main tool we have to work with is the Lanterman-Petris-Short Act, which sets parameters for when a person can be compelled to accept treatment, including long-term care. But the act was passed more than half a century ago and was not designed to address mental illness, addiction and homelessness as they exist today. We need better and more nuanced tools of engagement to reach people who are in dire need yet refuse to accept care. To start, we need laws and practices that enable mental health workers to help those who simply won’t accept mental health care voluntarily. Laura’s Law, passed in 2002, allows for court-ordered outpatient treatment in certain circumstances, but it hasn’t been fully implemented and does not include the power to medicate at this time. We need to look far and wide for ideas. One tool being used with promising results in other countries, for example, is “psychiatric advance directives.” They allow an individual during a time of stability to legally commit to treatment during times of acute illness, with options to designate specific medications and providers of their choosing. We also need to acknowledge that our current definition of “grave disability” as a standard to compel intervention is inadequate, in that it leaves many of the most ill in dire need. We need policies that lay out a simpler set of indicators to determine when someone is unable to live safely in the community, and those indicators should be formulated by a full range of stakeholders, including formerly homeless people with profound mental illness who are in recovery. These policies shouldn’t differentiate between those who become homeless because of addiction as opposed to mental illness. People with either or both afflictions languish on the streets, and we need policies robust enough to address all of the needs that, unmet, leave people suffering on sidewalks or cycling in and out of jail. Though changing the laws is important, it won’t be enough. Meaningful reform will require adequate resources to meet the need for guardianships, psychiatric treatment, social support and housing. Every time we even consider limiting a person’s civil liberties, we must first exhaust all efforts to help that person find care voluntarily. And those efforts must be backed up with resources. We can’t be in the position of offering help without being able to deliver it. Shuttling people like C and B in and out of a broken system, with inadequate tools to ensure continued engagement, serves no one. It wastes time and money, and it erodes faith in the system. Though it is no simple feat to turn even one life around, thousands of Californians with serious mental illness, addictions or both are in recovery and living safely with proper care. Thousands more await our help. Dr. Jonathan Sherin is director of the Los Angeles County Department of Mental Health. Henry Stern is a California state senator representing parts of Los Angeles and Ventura counties.
Considering what we’re living through, we’re all probably due for some therapy. If you’ve never done therapy before, the concept can seem a little daunting.  Will you be just sitting in a room (or, these days, on a video call) with a stranger, telling them your darkest secrets? For the record: 5:05 PM, Jan. 04, 2021 This article incorrectly refers to Dorian Traube as an assistant professor at USC’s Suzanne Dworak-Peck School of Social Work. Traube is an associate professor. Well, yes. A stranger who knows to ask specific questions, look for specific patterns of behavior and teach you more productive ways to manage your life. Basically, it’s like having a deep conversation with a close friend where you only talk about yourself, said Joy Harden Bradford, a licensed psychologist and the founder of Therapy for Black Girls . “The difference is that the person is trained, so unlike talking with your friend, there are certain things that we’re listening for,” Harden Bradford said. “We’re paying attention to your body language. We’re paying attention to some things that someone who’s not trained as a therapist is probably not paying attention to.” It’s an opportunity to talk through what you’re experiencing and how you’re feeling in a place that’s free of judgment, with someone who is purely listening to help. It’s a time devoted entirely to you, where you can process stressors and talk though confusing or overwhelming emotions you might be experiencing. There’s no such thing as being “too smart” for therapy to be effective or having issues  too big or small to be addressed. There are lots of reasons people seek therapy and just as many  types of therapy available. Some people go with a specific symptom-reduction goal, such as reducing panic attacks or addressing phobias. Others seek out therapy because they feel as though they have trouble making good choices or struggle to adapt to new challenges. For some, it’s a chance to regularly check in with themselves. You might seek therapy if you’ve experienced a significant event that’s affecting your mental health, like the death of a loved one, a divorce, a miscarriage, job loss — oh, or a full-blown pandemic that has upended every aspect of your and everyone else’s life. A therapist can’t fix those things but  can help you learn to adjust and move forward.  “We definitely can’t wave a magic wand and make 2020 be better than the fire it is,” Harden Bradford said. “But I think sometimes it can be helpful to know that you’re not alone in that, and I think it can be helpful to have someone give you some grounding.” Lifestyle How to find a therapist who is right for you Lifestyle How to find a therapist who is right for you It’s been a rough year, and maybe you are considering therapy for the first, second or fifth time. It takes patience and effort to find the right therapist. Here’s a breakdown of what you need to know.   Once you find a therapist , your first session will be what’s known as intake, said Dorian Traube, an assistant professor at the USC Suzanne Dworak-Peck School of Social Work.  Therapists will introduce themselves, tell you about their background and specialty, and ask what brings you to therapy. There is no right or wrong answer to that question: “Everything is just a lot right now” is a perfectly valid reason to seek an expert’s help. “A lot of people are reluctant to seek therapy because what they’re experiencing can feel indescribable, so they’re worried they won’t get what they need,” Traube said. “A therapist is trained to ask questions to get to the root of what you’re searching [for] in the therapy experience.” Your therapist might give you a survey about what symptoms you’re experiencing and other indicators of your mental health, like your sleep habits, employment status and any drug  or alcohol use. These aren’t  to judge you; it’s so  your therapist can get a fuller picture of you and your life and use that to guide  your treatment. After intake — which  can last up to three sessions, Traube said — you move on to regular therapy sessions. Your therapist will typically check in with you about what’s been happening since your last session. A lot of what happens then depends on what type of therapy you’re doing. Generally, you’ll have space to talk about whatever’s on your mind and to process what’s going on in your life. Your therapist might look for patterns and point them out to you,  work on skills to mitigate negative feelings you’re having, or give you homework to put those skills into practice. It’s an open space for you to put your feelings into words and evaluate whether the coping mechanisms you’ve developed are really working for you. If you’re doing something like hypnotherapy or EMDR (read on for whether those therapies might be right for you), your therapist will work with you on that process. There are more types of therapy than can  be covered in one article. And all  these types of therapy have had entire books written about them. So consider this a very concise primer — a starting place for you to research the kind of therapy that might be best for you. Often, therapists will combine or draw from multiple therapeutic approaches. You can search for a therapist by what type of approach they practice or by what presenting issues they specialize in, such as grief or marriage therapy or eating disorders. Talk therapy: Talk therapy, or psychodynamic therapy , is the type of therapy you typically see on TV and in movies. It is a structured space to talk about your feelings and experiences and how your past is shaping your present. Talk therapy is suitable for depression, anxiety, and a wide range of other issues and conditions. It’s usually more long-term than the other types of therapies listed here: You may resolve things in a few sessions or you may keep coming back to your therapist over the course of months or years. Cognitive behavioral therapy: Cognitive behavioral therapy tends to be a more short-term form of therapy with a specific goal, like identifying and replacing negative thought patterns or challenging irrational beliefs. This can work best for people with specific anxieties, phobias, obsessive-compulsive disorder, eating disorders and substance abuse — issues where there are beliefs or patterns involved that the patient wants to change. Traditional talk therapy is generally about feelings and emotions while CBT focuses more on behaviors. CBT is “more therapist-directed, more focused, more specific goals, shorter timeline, observable and measurable goals,” said Emanuel Maidenberg, a clinical professor of psychiatry and biobehavioral sciences at the David Geffen School of Medicine at UCLA and director of the UCLA Cognitive Behavioral Therapy Clinic. It’s “more goal-oriented or specific, aimed at developing skills and tools to cope with life circumstances or stressors more effectively.” Trauma-focused CBT and behavioral therapies such as aversion therapy and systematic desensitization are subsets under the umbrella of cognitive behavioral therapy. Dialectical behavioral therapy is an offshoot of CBT that focuses on regulating emotions. Humanistic therapy: Humanistic therapy is a more whole-person approach that helps empower patients to make choices. It’s particularly beneficial for people with self-esteem issues or who deal with indecision or don’t trust themselves to make decisions. “Humanistic therapy is a more existential, long-term exploratory [therapy], finding things about yourself,” Maidenberg said. “It’s a personal discovery. It can be very helpful in dealing with some of the existential questions that we have.” Eye movement desensitization and reprocessing: Also known as EMDR , this is a newer type of therapy that’s shown to be particularly helpful for people dealing with post-traumatic stress disorder, traumatic memories or disturbing life experiences. Therapists need to be specifically trained to do EMDR, which involves patients revisiting negative memories while tracking the therapist’s hand as it moves. Group therapy: Certain issues might be best addressed in a therapist-led group setting, said Harden Bradford, the Therapy for Black Girls founder. She said that, for instance, if you have social anxiety or difficulty relating to others, “Group therapy is going to be the best way to get at that work, because you’re going to be able to get feedback in real time from other people.” Art therapy, bibliotherapy, music therapy, dance therapy: “When all of these theories [of therapy] were developed, it was primarily by straight white men,” said Harden Bradford. “The idea was that talking was best for everybody.” Now, we know that’s not the case. These alternative modalities of community are best suited for people who struggle to communicate or express themselves in words. Lifestyle The complete guide to pandemic-era wellbeing: A 13-step process Lifestyle The complete guide to pandemic-era wellbeing: A 13-step process Ready, set, reframe: Instead of stressing out about coronavirus and the shutdown, let’s use this time of social isolation to prioritize self-care and mental wellness.  :: Again, this is not a comprehensive list of every therapy available. Nor is it a complete picture of what these types of therapy entail. This is to help you get started and to demystify what therapy involves. The hardest part of doing therapy is deciding to seek help in the first place. “The most difficult thing is to start something,” Maidenberg said. “Once the process starts, it’s typically not as scary or overwhelming as it may feel, particularly when we talk about sitting with a new person that you meet for the first time in your life and telling them about your life and your secrets or things you may be hesitant to tell other people. But ultimately it pays off.”
For years, California and other states have collected detailed personal data from those getting immunizations to ensure children received the required shots. With the rollout of COVID-19 vaccines, experts say the collection of names, addresses, birth dates and other information will be vital to tracking the safety and effectiveness of products that were developed in record time. But there are concerns that the plan to collect such data could stop some of those most vulnerable to the coronavirus, including essential workers who are in the country illegally, from lining up for vaccination. “There has to be an exemption for people who are afraid to provide all their information,” said Jim Mangia, chief executive of St. John’s Well Child and Family Center, a nonprofit that is planning to soon deliver tens of thousands of shots a week at its clinics, which serve low-income families in South and Central Los Angeles. “Otherwise you’re going to have vast numbers of people who are not going to get vaccinated.” Other public health experts say the collection of data is crucial for safely administering doses and that patients have little to fear. “The benefits exceed any risks,” said Walter Orenstein, who ran the immunization program at the federal Centers for Disease Control and Prevention from 1988 to 2004 and is now the associate director of the Emory Vaccine Center. Science Your questions about COVID-19 vaccines answered Science Your questions about COVID-19 vaccines answered COVID-19 vaccines are now being administered to healthcare workers in the U.S. What are your questions about the timeline, the safety or the science?  Orenstein said that even though such personal data have been recorded in state vaccine registries for more than 25 years, he had never learned of a case in which it was used to determine someone’s immigration status.  State and federal health officials have explained that the data collection is needed to ensure patients received the required second dose of the vaccines manufactured by Pfizer and Moderna. The data will also help assess the vaccines’ effectiveness among different demographic groups. Alarms first sounded this fall when the Trump administration asked every state to agree to share  with the federal government personal data collected from patients and stored in vaccine registries at the state level. In October, four organizations representing state health officials from the across the country wrote to Robert Redfield , head of the CDC voicing concerns. People would shun the COVID-19 vaccine, they wrote, if the federal government insisted on obtaining the detailed personal information that the states were preparing to collect from vaccine recipients. Among those who may be most hesitant to share information, the state officials wrote, are migrant farmworkers and those employed by meat-processing plants, which have had some of the nation’s largest workplace outbreaks of COVID-19. This month, California negotiated a deal with the CDC to limit the personal data shared with the federal government to birth year, sex and the county where the vaccine was administered. State officials say the federal government will not be able to identify the person through that limited data. But vaccine recipients will still be required to provide more extensive personal information to the California vaccine registry. According to the state’s written vaccine plan , recipients must provide their name, address, sex, date of birth, ethnicity and race. Doctors must also record whether the patient refused the vaccine. The patient information will be collected in California’s Immunization Registry, known as CAIR. World & Nation People 75 and older and essential workers next in line for vaccine, panel says World & Nation People 75 and older and essential workers next in line for vaccine, panel says The development comes as the nation seeks to ramp up a vaccination program, begun last week, that so far has given initial shots to about 556,000 Americans.  For years, the registry has enabled doctors to quickly find what vaccinations a child has had and still needs, even when those shots are given at multiple clinics and locations. School districts and child care centers have access to the registry data to determine what vaccines their students have received. Ali Bay, deputy communications director for the state’s Department of Public Health, declined to  comment about whether employers would have access to the registry to determine if an employee had received the COVID-19 vaccine. She also declined to  comment about whether the state could allow patients to get the vaccine if they refused to provide their name and other personal information. Doctors and clinics who want to provide the COVID-19 vaccine must sign a federal agreement requiring them to send each patient’s detailed personal information to the state’s vaccine registry within 24 hours. Mangia at St. John’s Well Child and Family Center said his group was only now learning of some of the government requirements for providing the vaccines. The group has purchased freezers that can store 25,000 doses of the Pfizer and Moderna vaccines at a time, he said. Once health workers and others given priority have been vaccinated, the group’s network of clinics is planning mass vaccination events at gymnasiums in partnership with the Compton Unified School District, Mangia said. The clinics also plan to send out three mobile vaccination units to neighborhoods. As many as 30% of patients  at the group’s clinics in recent days have been positive for the coronavirus, he said. Mangia said the clinics’ staff performs contract tracing when patients test positive and has found that many  got infected at work. “They get sick, they come home and they give it to their families,” he said. He said  the clinics annually provide medical care to 30,000 to 40,000 people who had entered the country illegally. Nurses and doctors often struggle to persuade immigrants to get the medical care they need, he said, because of their fears it could lead to an investigation by federal immigration officials. Mangia said that clinics needed the flexibility to provide the vaccine even if the patient hesitates to provide information. “What is the state going to do to ensure that people who, for whatever reason, are uncomfortable giving all of that information can still get vaccinated?” he asked. California government statistics show that poor neighborhoods, where families often live in tight quarters, have been hit hard by COVID-19. By analyzing that data, The Times has found that Latino people are now 2.6 times more likely than white people to test positive. And among most age groups, and especially younger people, Black and Latino people are dying more often than other groups relative to their share of the population. State officials say they are working on a campaign to educate communities across California about how the vaccines can help protect them and their families from a virus that has been blamed for the death of almost 24,000 residents. In an email, Bay in the state’s public health department said officials were “conducting extensive outreach in 13 languages to promote vaccination.” The campaign includes “messaging about privacy, confidentiality and data use,” she said. “California law strictly limits how personal information about people who receive vaccines can be shared,” Bay wrote, without further explaining those limits. John Swartzberg, clinical professor emeritus at UC Berkeley’s School of Public Health, said it was “critical that any data obtained is never used for any purpose other than the public’s health.” But he added it was also crucial to collect the data, including at the national level. “Without knowing the demographics of who has received the vaccine and when and where,” he said, “we will be going into the future with a blindfold on.”
Maddie Cole in eighth grade stopped running cross country. She’d competed the year before, but the air quality in her native Sacramento was so bad that she got sick during a race; she soon learned she had asthma. The next year the sky above Sacramento turned gray with smoke from the 2018 Camp fire . Maddie and her classmates went to school with masks on. “It felt,” she said, “like a futuristic apocalypse.” The situation has only worsened as wildfires and their devastation have become so routine that she and her classmates are “just used to it,” said Maddie, now 16 and a junior. This fall “it was just like, ‘Yeah, California’s on fire again. It’s that time of year.’” Neither the polluted air nor the wildfires punctuating Maddie’s adolescence are random. Both are being exacerbated by climate change , and the future they portend has left Maddie feeling helpless, anxious and scared. Climate anxiety and other mental health struggles are rampant among Maddie’s generation, according to experts who warn that young Californians are growing up in the shadow of looming catastrophe — and dealing with the emotional and psychological fallout that comes with it.  Science Feeling distressed about climate change? Here’s how to manage it Science Feeling distressed about climate change? Here’s how to manage it Researchers and therapists say that grief linked to climate change is on the rise.  The scope of the problem is enormous. The Earth’s temperature has skyrocketed since the Industrial Age , fueled by human activity and accompanying greenhouse gas emissions. Dramatic reductions in those emissions, and in fossil fuel use, will be necessary to prevent temperatures from reaching a tipping point by 2030, the United Nations’ Intergovernmental Panel on Climate Change warned two years ago . Without reducing those emissions, climate change will make natural disasters, food shortages and rising sea levels even worse, experts say. The world is not yet on track to make the changes necessary to ameliorate its worst effects.  Such dire predictions can affect mental health, particularly among young people. Polls have found that climate change-related stress affects daily life for 47% of America’s young adults; over half of teenagers feel afraid and angry about climate change; and 72% of young adults are concerned that it will harm their community . Climate depression played a central role in teenage activist Greta Thunberg’s political awakening, and according to Varshini Prakash — executive director of youth-focused climate activism group the Sunrise Movement — it’s not uncommon for her group to meet kids who have contemplated suicide over the climate crisis . “Surveys have found that young people often experience more fear, sadness and anger regarding climate change than their older counterparts, as well as an increased sense of helplessness or hopelessness,” said Hasina Samji, an assistant professor at Simon Fraser University who has explored the mental toll of climate change on young people, in an email. In particular, “areas that suffer direct, visible effects of climate change … have been observed to face acute impacts such as trauma, shock and PTSD.” Young Angelenos described similar emotions and mental stress when contemplating the climate crisis. Kate Shapiro, 15, said humanity’s selfishness, greed and “lack of foresight” about the warming planet contributes to her depression. Sarah Allen, 25, said she shudders in “real terror” when contemplating the plight of future generations. And Sam Jackson, 29, said the enormity of the problem leaves him feeling “exhausted.”  Climate & Environment What’s behind the youth movement to tackle climate change? Fear  — but also hope Climate & Environment What’s behind the youth movement to tackle climate change? Fear  — but also hope Young people see climate change as a profound injustice and an existential threat. But they believe the world can still do something about it.  More Coverage To cope, many have become activists or taken steps to reduce their own effect on the planet. Some go vegetarian or vegan. Others have opted not to buy a car, even in car-centric Los Angeles, or are making plans to leave Los Angeles before the fires and droughts become unbearable. And a few said the looming environmental disaster has discouraged them from having children. “As I’ve gotten to learn more about how much or how disproportionate an impact an additional American has … [I’m] less and less inclined to create a new person,” said Elliott Lee, 26, of Palms. Climate & Environment California is broiling and burning. Here are ideas for dealing with climate despair Climate & Environment California is broiling and burning. Here are ideas for dealing with climate despair A bit of Jewish wisdom might help: “It is not your responsibility to finish the work of perfecting the world, but you are not free to desist from it either.”  Others are throwing themselves into climate activism as a way to deal with the stress. Lifestyle changes “empower individuals to feel like they can act,” said Abby Austin, 23, the political lead for the Sunrise Movement’s L.A. branch — echoing medical professionals who say that even small personal actions can help people feel like broader change remains possible . Getting involved with activism can serve a similar function. Many young Californians said volunteering with climate advocacy groups like the Sunrise Movement or for politicians who have made climate change a central plank in their platforms has given them a sense of purpose. “A lot of the people who are in Sunrise,” Austin said, “are literally organizing out of climate anxiety.”
An unpleasant tax surprise may be lurking next spring for some people who bought health insurance this year on the Affordable Care Act’s coverage marketplaces. The problem centers on income, or what shoppers think they will make. People can get help from the government to buy coverage, depending on their income. But they have to estimate their income for the coming year to figure out how much help they need in the form of tax credits. Those who estimate too low — and wind up getting more help than they should — will have to pay back all or part of the assistance at tax time. About 3.2 million returns for 2018 included a repayment, according to the latest statistics from the Internal Revenue Service. Insurance brokers see this problem surface every year, and some expect it to grow more acute for 2020. Because of job losses due to the COVID-19 pandemic, many people used the exchanges and tax credits for the first time to buy coverage this year. But spring’s tax headache can be softened with some planning before year’s end. “If they wait till April to figure it out, then there’s no time to do anything,” said Emily Bremer, a St. Louis-area broker.  It’s too late to adjust your tax credits for 2020, but here are some other tips from Bremer and others. Compare your income estimate to what you actually earned. Was your 2020 estimate too low? Those who make between 100% and 400% of the federal poverty level can get some tax credit help paying their premium. This year, 400% of federal poverty amounted to $104,800 for a family of four. Tax credit eligibility is based on modified adjusted gross income, and a lot of things are included in that figure. Unemployment compensation counts, and so do early withdrawals from retirement accounts such as 401(k) plans. The summer job income of any children or dependents also counts. “Be aware of all of your income sources and understand how quickly, for some people, you can lose all of your tax credit,” said Eric Bronnenkant, head of tax for the financial management company Betterment. People who wind up earning more than 400% of federal poverty levels will have to pay back their entire credit, and that can add a couple thousand dollars or more to a tax bill. Those who fall below the poverty level also should be concerned. If your income turned out too low to qualify for tax credits, you also may have to pay back some of the help you received. That can happen to restaurant workers, for example, if their employer shut down for a long stretch due to the pandemic. The federal government’s healthcare.gov website offers assistance with income estimates . Although it’s too late to adjust your tax credits for 2020, there are still some ways to adjust your taxable income. If you can, increasing contributions to work-based retirement accounts such as a 401(k) plan can lower taxable income. Doing the same for a health savings account for medical expenses can help. Look for last-minute deductions. Wichita Falls, Texas, broker Kelly Fristoe said a rancher client may buy a tractor before the end of the year partly to create a business expense that helps push his taxable income back below 400% of the poverty level. A tax professional or health insurance broker may be able to help. If you’re going to end up paying money back, you have time to start saving for that spring tax bill. It’s also a good idea to keep tabs on your income in the new year. Fristoe said he likes to meet with clients in the middle of the year to see how their income is shaping up compared with what they predicted when they bought health insurance coverage. There’s enough time at that point to adjust tax credits if needed. “That way,” Fristoe said, “you don’t get to the end of the year and go, ‘Oh my goodness, I need to pay the IRS how much money back?’”
Actor Kirk Cameron and his troupe of Christmas carolers are likely spreading more than holiday cheer this season. The “Growing Pains” star has come under fire recently for encouraging large groups of people to sing Yuletide tunes — in close proximity and without masks — as a protest against California’s stay-at-home orders amid the COVID-19 pandemic. Cameron has proudly participated in multiple demonstrations, including one held Tuesday in the parking lot of the Oaks mall in Thousand Oaks. During a Wednesday news conference, Los Angeles County Public Health Director Barbara Ferrer condemned Cameron’s behavior as “very irresponsible and very dangerous.” “Honestly, we get so many reports of these events, and I’m at a loss of words at this point,” Ferrer told journalists. “I don’t really understand it. ... It’s unnecessary. We’re in the middle of a pandemic. These are just extraordinary times. We all need to help each other live through these times. “And I’m just going to urge every single person to to do what’s right. And at this point, everyone actually knows what that means … right now it’s very clear what everyone needs to do: You need to wear that face covering, you need to keep your distance, you need to not mingle with people outside of your household. And if you have to go out, it’s for essential work and essential services.” California L.A. County records 140 COVID-19 deaths in one day, a new record California L.A. County records 140 COVID-19 deaths in one day, a new record As medical facilities throughout L.A. County experience an onslaught of COVID-19 patients, officials warn that only the sickest should be sent to the ER.  More Coverage As the Pfizer vaccine begins to make the rounds among healthcare workers, Ferrer urged the public to comply with stay-at-home guidelines until the vaccine has been widely distributed and activities can safely resume. “That’s how we get through this,” she said. “Vaccines are here. It will take us months to get everyone vaccinated. We won’t be in the same place next year. And I think all of us need to be able to to act with kindness, care and compassion for those around us — both for those we know and love, and those that other people know and love.”  Despite such pleas from public health officials, Cameron and his maskless musical entourage have continued to assemble in large quantities in defiance of safety protocols. On Thursday, California became the first state to surpass 2 million coronavirus cases , after L.A. County reported its second-highest daily total — 16,974 new infections — a day prior. “Have you ever watched the eye-opening, heart bursting movie, ‘The Giver’ with Jeff Bridges and Meryl Streep?” Cameron wrote last week on Instagram, referencing the 2014 film adaptation of Lois Lowry’s classic dystopian novel. “Today’s government leaders’ ‘safety rules’ of ‘no singing,’ ‘wear your mask at all times’ and ‘socially distance’ seem like they’re straight out of a scene from this scary movie about redefining life and reality for the ‘safety of the community’.” That’s how Cameron captioned a clip of himself defending his caroling antics in a recent Fox News interview, during which he billed the gatherings as “a chance for people to come sing songs of hope” amid “devastation” in his community.  A post shared by Kirk Cameron (@kirkcameronofficial)  Indoor singing at houses of worship in California is currently “strongly discouraged,” public health officials said, while health experts agree that face coverings and social distancing are key to protecting oneself and others from the respiratory illness. COVID-19 is now the leading cause of death in the United States. Tuesday night’s caroling happened near a testing facility, according to ABC7 News , which said about 100 people were gathered to sing. As COVID-19 cases and hospitalizations in Southern California continue to surge, and intensive care units in the state edge toward capacity , several in the entertainment industry and beyond condemned Cameron’s actions as “arrogant and thoughtless.”  Politics Supreme Court gives partial win to churches fighting California’s limits on indoor worship services Politics Supreme Court gives partial win to churches fighting California’s limits on indoor worship services Supreme Court told judges in California to take another look at the state’s rules banning most indoor worship services because of the coronavirus.  Early in the pandemic, an indoor choir rehearsal turned out to be a super-spreader event that resulted in dozens of COVID-19 cases and a couple of deaths. “We do not condone this irresponsible — yet constitutionally protected — peaceful protest event planned,” the Oaks shopping center tweeted. “We share your concern and have notified the Sheriff’s office. As well, we have reached out to the event planner to ask that they do not use The Oaks as their venue.” We do not condone this irresponsible - yet constitutionally protected - peaceful protest event planned. We share your concern and have notified the Sheriff’s office. As well, we have reached out to the event planner to ask that they do not use The Oaks as their venue. Cameron’s former “Growing Pains” costar and onscreen sister Tracey Gold also weighed in with concern for her “dear brother Mike,” addressing the actor by the name of his character from the hit ’80s sitcom. “As your more intelligent sister I want you to know that I disapprove,” Gold tweeted, along with a heart and a face-mask emoji. “I’m worried about you brother AND your family. Wear a mask. Stay home. Sing later.” On Wednesday night, Cameron’s actual sister, “Full House” star Candace Cameron Bure, chimed in to assure her followers that she has not been involved in her brother’s caroling campaign and to defend her family’s honor. “I did not attend any recent caroling events,” she tweeted. “Also, I choose to follow the greater guidelines by wearing a mask and social distance when I’m in public. However, I don’t appreciate the vile tweets about my family. I believe respectful dialogue is the key to being heard. Stay safe.” See more reactions to Kirk Cameron’s anti-lockdown crusade below.  Checking in with my dear brother Mike. @KirkCameron As your more intelligent sister I want you to know that I disapprove. I’m worried about you brother AND your family. Wear a mask. Stay home. Sing later. ❤️ 😷 I try really hard not to talk poorly of other former child actors, because most of us have been through enough, but it does not surprise me that Kirk Cameron does not know The Giver was a book Will Kirk Cameron be arrested for deliberately trying to spread a deadly virus by hosting super spreader events disguised as caroling like an unhinged fool in a Santa hat? If Kirk Cameron don’t sit his goofy ass down #thischristmas California COVID-19 surges at L.A. County shopping malls as holiday customers pack stores California COVID-19 surges at L.A. County shopping malls as holiday customers pack stores Malls have continued to welcome holiday shoppers, even as officials have banned other forms of gathering amid a massive surge in coronavirus cases.  More Coverage  Nothing to see here. It's just religious fanatic #KirkCameron and his cult of sociopaths displaying their ignorance and delusional beliefs. https://t.co/0OA8zK09v7 #KirkCameron arrogant and thoughtless https://t.co/AA4QkOw7vn Times staff writer Rong-Gong Lin II contributed to this report.
Weeks of warnings and pleas will be put to the test on Thursday as Thanksgiving arrives amid the worst pandemic in America in more than a century. Federal, state and local authorities have urged people to stay home for Thanksgiving and cancel travel plans. Although airports were far less busy than normal for the holidays, it was clear some people were traveling. But the bigger question comes with the Thanksgiving meal. Officials fear large traditional gatherings indoors may become superspreader events, increasing cases as California is already seeing unprecedented levels of coronavirus spread. Cases of infection have spiked dramatically in the last month across the state and particularly in L.A. County, spurring new restrictions on movements. Officials have warned that if infections spread further due to Thanksgiving gatherings, more restrictions will likely follow. California New L.A. County ‘Safer at Home’ restrictions revealed as COVID-19 surge worsens California New L.A. County ‘Safer at Home’ restrictions revealed as COVID-19 surge worsens As coronavirus cases surge, L.A. officials consider new rules that would allow many businesses to remain open but with limited customer capacity.  More Coverage L.A. County was reporting a seven-day average of nearly 4,300 new coronavirus cases a day as of Wednesday, the third consecutive day that number has hit a new high. Unless something dramatic is done to slow transmission , that number is on track to double within two weeks and quadruple in a month, said Dr. Christina Ghaly, L.A. County’s director of health services. Officials said hospitals could see a shortage of beds — especially in intensive care units — over the next two to four weeks if these trends continued. Hospitals are better equipped now than they were in the spring to handle a surge in cases, treatment for COVID-19 has significantly improved, and hospitals can cancel elective surgeries to make more room for critical COVID patients. But “that ability for hospitals to be able to surge and open up additional beds is not endless,” Ghaly said. Over the last week, officials have been urging people to have small gatherings and to avoid travel, even across town.  “The safest way to celebrate Thanksgiving is to celebrate at home with the people you live with,” Barbara Ferrer, director of public health for Los Angeles County, said earlier this week. On Monday, Ferrer verbally recommended that L.A. County residents not hold gatherings with people from more than one household, even if it is outside. But for those who are holding gatherings from more than one household, here’s some general Thanksgiving guidance , from state and county rules, on how to make it safer: Self-quarantine Gov. Gavin Newsom issued an advisory asking those arriving in California from another state or country to self-quarantine for 14 days. Ferrer advised that those who decide to travel — such as college students returning home for the next month or two — quarantine in a room alone for 14 days, avoid sharing a bathroom or clean it every time if they do share one, not eat with others in the household, and have people in the home wear masks at all times indoors. California With COVID cases spiraling, travelers into L.A. must sign a form acknowledging quarantine California With COVID cases spiraling, travelers into L.A. must sign a form acknowledging quarantine Out-of-state travelers arriving at LAX, Van Nuys airport and Union Station must sign a form acknowledging the county’s COVID quarantine.  If the students haven’t been able to quarantine for 14 days at their destination, Ferrer suggested they not take part in Thanksgiving festivities to reduce the chance of infecting others. For people returning home to California after a trip, a 14-day quarantine is advised, and that means staying at home as much as possible, and not leaving to go to the grocery store or to restaurants. Instead, people in quarantine should order food to be delivered, Ferrer said. During quarantine, you can go out for a walk by yourself, said Ferrer, as long as you don’t come into contact with other people. “We don’t want you going to restaurants and sitting and eating outside. And we don’t want you going into retail establishments, either, when we’ve asked you to quarantine.” “The tighter you can restrict your activities over those 14 days, the better off we all are,” Ferrer said. COVID-19 testing A negative result simply means the test hasn’t detected the virus in your body. It’s possible that the virus is actually there and the test just didn’t find it, health officials say. This can happen during the early stages of infection, when virus levels are too low to be detected. That’s why a negative test does not give you a pass to end the 14-day quarantine early, Ferrer said. Tests are particularly helpful, obviously, if you start to feel sick. “The quicker people are able to know that they’re a case, the quicker we can do contact tracing for people who may have had an exposure to you,” Ferrer said. Tracing helps warn people you’ve had close contact with that they might be infected and allows them to take steps not to infect others.
In Xavier Becerra , President-elect Joe Biden is getting a team player, savvy politician and competent manager — who excels at being in the right place at the right time. He’s also a truly nice guy who won’t be an administration troublemaker, but he can be tough in a fight. And he’s Washington-ready, not a naïve outsider who needs D.C. training wheels. But, unlike many in politics, he’s not a media-seeking grandstander. The California attorney general is unquestionably a liberal, but not a far-left radical as some Senate Republicans allege . Becerra once said he supported “Medicare for all.” But what does that mean? Leftists who advocate for that don’t mean real Medicare, which is supplemented with private insurance. They want government-only medical coverage. Becerra has said he favors Biden’s more moderate, practical proposal to expand the Affordable Care Act — Obamacare — with a “public option” of government-funded insurance. That’s just one of the complicated, heated battles Becerra will face as Biden’s secretary of Health and Human Services , a snake pit of programs that attract fiercely competing interests and ideologies and can overwhelm someone trying to lead it.  Politics Biden picks California Atty. Gen. Becerra for Health and Human Services secretary Politics Biden picks California Atty. Gen. Becerra for Health and Human Services secretary As California attorney general, Becerra battled the Trump administration over Obamacare and confronted rising healthcare costs.  The sprawling agency spends more than $1.4 trillion annually and is responsible for the health coverage of more than 100 million Americans, mostly through Medicare and Medicaid. Becerra, 62, seems up to the job based on his four-year tenure as California’s “top cop” running a large bureaucracy and 12 terms previously as a U.S. House member representing Central Los Angeles. He was chairman of the Democratic Caucus and helped maneuver Obamacare through the House. The son of working-class Mexican immigrants, he would be the first Latino U.S. health secretary if confirmed by the Senate. He also was California’s first Latino attorney general. It was a smart move by Biden to settle on Becerra for the job after two earlier potential nominees botched their chances to become prestigious cabinet members. New Mexico Gov. Michelle Lujan Grisham, a co-chair of Biden’s transition team, was eager to run HHS, according to published reports. She was offered Interior secretary instead and turned it down, upsetting the president-elect’s top advisors. She wound up getting nothing so far. Rhode Island Gov. Gina Raimondo was about to be offered the HHS job, according to news reports. But she has kids in school and wasn’t keen on moving to Washington. She also fretted about turf — how much of a role she’d have in fighting the pandemic and vaccinating Americans. So, the governor publicly announced she didn’t want the job. The Biden team quickly turned to Becerra, who had already been vetted and was on the short list for U.S. attorney general. Becerra didn’t hesitate. He jumped at the offer, realizing that an opportunity to become a cabinet secretary is usually a once-in-a-lifetime priceless gift. You’re powerful and treated like royalty, especially as a top player in a new administration. You don’t get choosy about the job or fight over turf before you’re even nominated. Politics 5 things to know about Xavier Becerra, Joe Biden’s nominee for top health official Politics 5 things to know about Xavier Becerra, Joe Biden’s nominee for top health official Here are five things to know about Xavier Becerra, California’s attorney general and Biden’s pick to lead the Department of Health and Human Services.  Biden showed strength in sticking to his guns and not giving in to the preferences of the two governors. Becerra was in the right place at the right time — as he was in 2016 when then-Gov. Jerry Brown selected him to fill the attorney general post being vacated by Kamala Harris. Harris had just been elected to the U.S. Senate, an office she would use as a springboard to vice president-elect. Right before the 2016 general election, Becerra was in Sacramento campaigning for two congressional candidates. At a reception, he ran into a former Washington acquaintance: the late Nancy McFadden, Brown’s top aide. They talked for a long while. Harris seemed a cinch to win the Senate seat, and Brown hadn’t decided on a replacement. McFadden started thinking: “What about Xavier?” McFadden suggested Becerra to Brown, who was impressed with the congressman’s résumé and political smarts, she told me later. The governor talked with Becerra on the phone and offered him the job. “It wasn’t a hard decision,” she said. “It just made sense.” It also made lots of sense for the Democrat to give up his House seat and return to his hometown of Sacramento to become state attorney general. Donald Trump had been elected president, and Republicans would control both houses of Congress. Becerra probably caught Biden’s eye by filing more than 100 federal lawsuits against the Trump administration over, you name it: the administration’s attempts to scuttle Obamacare, its anti-immigration policies, efforts to undermine California’s environmental protections and weaken the state’s attempts to fight climate change. Becerra has been steadily winning in court. Critics thought he was too obsessed with suing Trump. “We don’t wake up looking to pick a fight, but when the Trump administration threatens our people, values and resources, we’re ready,” Becerra has said. Becerra has also been criticized by many Republicans for writing official titles and summaries of ballot propositions with a Democratic bias. And they’re right. Chalk it up to his being a party team player. There was speculation that Gov. Gavin Newsom might select Becerra to replace Harris as senator. But that wasn’t going to happen. And Becerra wasn’t even campaigning for the Senate seat. He assumed — most likely correctly — that it will go to Secretary of State Alex Padilla, a longtime Newsom loyalist. Maybe Becerra’s first task now should be to teach his future boss to pronounce his name. Biden butchered it twice introducing his new nominee to a national TV audience.
A year ago, while Americans were finishing their holiday shopping and finalizing travel plans, doctors in Wuhan, China, were battling a mysterious outbreak of pneumonia with no known cause. Chinese doctors began to fear they were witnessing the return of severe acute respiratory syndrome, or SARS , a coronavirus that emerged in China in late 2002 and spread to 8,000 people worldwide, killing almost 800. The disease never gained a foothold in the U.S. and disappeared by 2004. But SARS cast a long shadow that colored how many nations — and U.S. scientists — reacted to its far more dangerous cousin, the novel coronavirus that causes COVID-19 .  Get our free Coronavirus Today newsletter Sign up for the latest news, best stories and what they mean for you, plus answers to your questions. You may occasionally receive promotional content from the Los Angeles Times. When Chinese officials revealed that their pneumonia outbreak was caused by another new coronavirus, Asian countries hit hard by SARS knew what they had to do, said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. Taiwan and South Korea had already learned the importance of a rapid response that included widespread testing, contact tracing and isolating infected people. The U.S., by contrast, had learned all the wrong lessons. This country’s 20-year run of good luck with emerging pathogens —including not just SARS, but also the relatively mild H1N1 pandemic, Middle East respiratory syndrome , Ebola , Zika virus and two strains of bird flu — gave us a “false sense of security,” Adalja said.  Many leading infectious disease specialists here underestimated the fast-moving outbreak in its first weeks and months, assuming that the United States would again emerge largely unscathed. American hubris prevented the country from reacting as quickly and effectively as Asian nations did, Adalja said. World & Nation Column One: What this West African village’s Ebola fight can teach the U.S. about COVID-19 World & Nation Column One: What this West African village’s Ebola fight can teach the U.S. about COVID-19 A reporter who covered an Ebola outbreak in West Africa discovers troubling parallels in the U.S. over the coronavirus, including conspiracy theories and denial.  During the first two decades of this century, “there were a lot of fire alarms with no fire, so people tended to ignore this one,” said Lawrence Gostin , director of Georgetown’s O’Neill Institute for National and Global Health Law, who acknowledged he underestimated the virus in its first few weeks. Back in January, Dr. William Schaffner was one of many who warned that the real danger to Americans was the common flu , which can kill up to 61,000 Americans a year. “Coronavirus will be a blip on the horizon in comparison,” said Schaffner, a professor of preventive medicine and health policy at Vanderbilt University Medical Center. “The risk is trivial.” Dr. Paul Offit , who led development of a rotavirus vaccine, predicted that the coronavirus, like most respiratory bugs, would fade in the summer. “I can’t imagine, frankly, that it would cause even one-tenth of the damage that influenza causes every year in the United States,” Offit told Christiane Amanpour in a March 2 appearance on PBS . Caitlin Rivers , an epidemiologist and assistant professor at the Johns Hopkins Bloomberg School of Public Health, worried — and tweeted — about the novel coronavirus from the beginning. But she says public health officials try to balance those fears with the reality that most small outbreaks in other countries typically don’t become global threats.  New sitrep out from Wuhan pneumonia outbreak. 59 cases between 12/12 and 12/29. SARS ruled out, but no other etiology identified. Still no evidence of H2H. https://t.co/b8ZdEGIzyJ “If you cry wolf too often, people will never pay attention,” said epidemiologist Mark Wilson of the University of Michigan School of Public Health. Many experts fell victim to wishful thinking or denial, said Dr. Nicole Lurie , who served as assistant secretary for preparedness and response during the Obama administration. “It’s hard to think about the unthinkable,” Lurie said. “For people whose focus and fear was bioterrorism, they had a worldview that Mother Nature could never be such a bad actor. If it wasn’t bioterrorism, then it couldn’t be so bad.” Had more experts realized what was coming, the nation could have been far better prepared. The U.S. could have gotten a head start on manufacturing personal protective equipment, ventilators and other supplies, said Dr. Nicholas Christakis , author of “Apollo’s Arrow: The Profound and Enduring Impact of Coronavirus on the Way We Live.” “Why did we waste two months that the Chinese essentially bought for us?” asked Christakis, a physician and sociologist at Yale. “We could have gotten billions of dollars into testing. We could have had better public messaging that we were about to be invaded. … But we were not prepared.” Dr. Anthony Fauci , the nation’s top infectious disease official, isn’t as critical. He said there was no way for scientists to predict how dangerous the coronavirus would become, given the limited information available in January. “I wouldn’t criticize people who said there’s a pretty good chance that it’s going to turn out to be like SARS or MERS,” said Fauci, director of the National Institute of Allergy and Infectious Diseases, noting this was “a reasonable assumption.” Solutions are always clearer in hindsight, Fauci said, adding that public health authorities lose credibility if they respond to every new germ as if it’s a national disaster. He has repeatedly said scientists need to be humble enough to recognize how little we still don’t know about this new threat. “You can say we should have shut things down much earlier because of silent spread in the community ,” Fauci said. “But what would the average man or woman on the street have done if we said, ‘You’ve got to close down the country because of three or four cases?’” Science The moment the reality of the COVID-19 pandemic sank in Science The moment the reality of the COVID-19 pandemic sank in When did you realize that the COVID-19 pandemic would profoundly alter your life? For this reporter, it was the last week of February 2020.  Scientists say their response to the novel coronavirus would have been more aggressive if people had realized how easily it spreads, even before infected people develop symptoms — and that many people remain asymptomatic. “For a virus to have pandemic potential,” Adalja said, “that is one of the greatest assets it can have.” Although the coronavirus has a lower mortality rate than SARS and MERS, its ability to spread silently makes it more dangerous, said Dr. Kathleen Neuzil , director of the Center for Vaccine Development at the University of Maryland School of Medicine. People infected with SARS and MERS are contagious only after they begin coughing and experiencing other symptoms. “When people got sick,” Christakis said, “they got sick pretty badly and went right to the hospital and weren’t walking around transmitting it.” Based on their knowledge of SARS and MERS, which are also caused by coronaviruses, doctors initially believed they could contain the new virus by telling sick people to stay home . Furthermore, there appeared to be no need for healthy people to wear masks. That led health officials, including U.S. Surgeon General Jerome Adams , to admonish Americans not to buy up limited supplies of face masks, which were desperately needed by hospitals. Seriously people- STOP BUYING MASKS! They are NOT effective in preventing general public from catching #Coronavirus , but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk! https://t.co/UxZRwxxKL9 Many scientists were skeptical of early anecdotes of pre-symptomatic spread. But as evidence of pre-symptomatic spread accumulated, the Centers for Disease Control and Prevention in April changed its advice and urged Americans to mask up in public. The CDC’s initial advice against wearing masks was based on research that found them to be ineffective against spreading influenza , Adalja said. New research, however, has shown masks reduce the transmission of the novel coronavirus, which spreads mainly through respiratory droplets but can travel in the air as tiny particles. Science New forecasts show why masks are the easiest — and cheapest — way to save U.S. lives Science New forecasts show why masks are the easiest — and cheapest — way to save U.S. lives If nearly all Americans would wear face masks when they leave their homes, they could save over 100,000 lives by the end of February, a study says.  More Coverage Adalja said the U.S. should have learned from its early stumbles. Yet in spite of abundant evidence, many communities still resist mandating masks or physical distancing. “I continue to be baffled that we keep making the same mistakes,” Adalja said. “It’s almost like we’re doomed to repeat this cycle endlessly.” There were experts who immediately recognized the threat from the novel coronavirus. One of them was Dr. Daniel Lucey , an adjunct professor of infectious diseases at Georgetown University Medical Center. In a Jan. 7 post on a website of the Infectious Diseases Society of America, Lucey labeled the pneumonia “Disease X,” using the WHO’s term for an emerging pathogen capable of causing a devastating epidemic, for which there are no tests, treatments or vaccines. Adalja was another early voice of concern. He began blogging about the virus about the virus on Jan. 20. “We had to immediately react as if this were going to hit every corner of the Earth,” he said. It was clear “this was not a containable virus.” He would know. In 2018, he led a project to identify the features that allow emerging viruses to become pandemic . He and his co-authors highlighted the threat of certain respiratory viruses that use RNA as their genetic material . Science By decoding the coronavirus genome, scientists seek the upper hand against COVID-19 Science By decoding the coronavirus genome, scientists seek the upper hand against COVID-19 Today, when a deadly virus explodes out of nowhere, geneticists are indispensable players in the international game of whodunit. Here’s how they help.  More Coverage The more Adalja learned about the novel coronavirus, the more it seemed to embody the very type of threat he had warned about: one with “efficient human-to-human transmissibility, an appreciable case fatality rate, the absence of an effective or widely available medical countermeasure, an immunologically naïve population, virulence factors enabling immune system evasion, and respiratory mode of spread.” Although the CDC set the wheels of its response in motion early, establishing an incident management structure on Jan. 7, the agency bungled its approach to testing . The outbreak escalated rapidly, leading the World Health Organization to declare a health emergency on Jan. 30 and the U.S. to announce a public health emergency the next day. Adalja and other experts dismissed some of the Trump administration’s early responses, such as quarantines and a travel ban on China , as “window dressing” that “squandered resources” and did little to contain the virus. Lucey noted that the international response was hampered by misinformation from Chinese officials. “The Chinese government said there was no person-to-person spread,” he said. “That was a lie.” When China revealed on Jan. 20 that 14 health workers had been infected, Lucey knew the virus would spread much farther. When the number of infected health workers grew to 1,716 on Feb. 14, “I almost threw up.”  At the National Institute of Allergy and Infectious Diseases, scientists had been studying the protein structure of coronaviruses for years. Researchers had developed a vaccine against SARS, Fauci said, although the epidemic ended before researchers could test it widely in humans. “We put the vaccine in cold storage,” he said. Dr. Barney Graham , deputy director of the National Institutes of Health’s Vaccine Research Center , asked Chinese scientists to share the coronavirus’ genetic information. After the genome was published, Graham went immediately to work. Although Graham’s team worried about how to pay for the research, Fauci said he told them, “Don’t worry about the money. I’ll find it.” That work was instrumental in developing the two COVID-19 vaccines now being rolled out across the country. Health experts hope the U.S. will learn from its mistakes. For Dr. Tom Frieden, who led the CDC during the Obama administration, the most important lesson is that “we can’t be this unprepared again.” “This should be the most teachable moment of our lifetime,” he said, “in terms of the need to strengthen public health in the United States and globally.” Dr. Céline Gounder , an infectious disease specialist advising President-elect Joe Biden, said that given how many novel viruses had emerged in the past two decades, it’s likely that “pandemics are going to become more frequent.” Yet U.S. public health funding tends to follow a cycle of crisis and neglect. “We tend to invest a lot in that moment of crisis,” Gounder said. “When the crisis fades, we cut the budget. That leads us to be really vulnerable.” Liz Szabo writes for Kaiser Health News , a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente.
Dozens of demonstrators converged outside the Echo Park home of Los Angeles County Public Health Director Barbara Ferrer on Sunday afternoon to express their displeasure with a new round of COVID-19 restrictions that will take effect Monday. Carrying signs and waving flags, the protesters called on Ferrer to “Open L.A.” and chanted, “No science. No data. No shutdown.” Few of the 50 or so demonstrators were wearing face masks. More people here now, and a bit of a shouting match erupting between the protesters and a resident on this street. pic.twitter.com/SQ6YYZ2FcB  The county’s latest Safer at Home order was announced Tuesday amid an alarming increase in coronavirus cases and COVID-19 deaths. Its slew of restrictions includes a ban on most gatherings, stricter limits on retail businesses, and closures of playgrounds that aren’t part of a school or childcare center. The order will be in effect for three weeks, until Dec. 20. Those restrictions came on the heels of a previously announced rule that suspended outdoor dining at restaurants throughout most of the county. Pasadena, which has its own health department, opted to allow outdoor dining to continue .  In addition, Gov. Gavin Newsom recently announced a statewide curfew that forbids nonessential gatherings with members of other households between the hours of 10 p.m. and 5 a.m. The recent restrictions have drawn the ire of business owners, exhausted parents and others who are simply losing patience with the pandemic way of life. One of the protesters outside Ferrer’s home carried a sign that read, “Newsom and Ferrer are non-essential.” Another shouted, “How dare you take away our guns and lock us in?” California L.A. County’s new stay-home order is the strictest in California. Here’s how it works California L.A. County’s new stay-home order is the strictest in California. Here’s how it works Los Angeles County has issued a new COVID-19 pandemic order in a desperate move aimed at slowing an unprecedented surge of coronavirus infections.  More Coverage Some of the demonstrators raised other grievances, including the outcome of the 2020 presidential election. Several people brought Trump flags, and one held a sign that declared “Trump won.” Several people got into heated exchanges with Ferrer’s neighbors, including one resident who called the protesters “fascists” and Nazis.” Though noisy at times, the protest remained peaceful until the demonstrators dispersed around 5 p.m. California Photos: Gov. Newsom announces new stay-at-home order as COVID-19 hospitalizations hit record California Photos: Gov. Newsom announces new stay-at-home order as COVID-19 hospitalizations hit record Gov. Gavin Newsom has announced a stay-at-home order affecting most of California.  A Los Angeles Police Department vehicle was parked in Ferrer’s shared driveway to monitor the protest. LAPD officials could not be reached for comment Sunday night. For the most part, L.A. County residents have taken heed of the public health orders intended to slow the spread of the coronavirus in the community. But patience is wearing thin, and some people have become more vocal in opposing them. The county is now averaging nearly 4,200 new coronavirus cases each day , a tally that exceeds the number of daily cases reported during the summer. Hospitalizations have been on the rise for the past two weeks and are now just shy of 2,200, nearly meeting the previous high from the summer. Over the last week, L.A. County has averaged nearly 28 COVID-19 deaths each day. Times staff writers David Zahniser and Laura Nelson contributed to this report.
Dissatisfied with Los Angeles County’s handling of the COVID-19 pandemic, the Lancaster City Council has voted unanimously to form its own public health agency. The council also on Thursday unanimously passed a symbolic “vote of no confidence” of Barbara Ferrer, the county’s public health director, who has been leading the county’s charge against the coronavirus. Mayor R. Rex Parris blamed county officials for not considering smaller cities — like Lancaster, where the population is about 158,000 — when making sweeping decisions, such as the county’s recent decision to suspend outdoor dining . “What I don’t want our city to do is to make decisions based upon anything other than what’s supported by the research and the people most knowledgeable about this — which I would suggest to you is not Barbara Ferrer,” Parris said. A representative for Ferrer did not respond to a request for comment. “If you compare what the state has done when it comes to regulating COVID, and the additional changes the county has made, they seem to be minor changes at best that are not based on science,” Lancaster City Manager Jason Caudle said. “They seem to have an unbalanced impact on restaurants specifically.” Although Lancaster’s case rates are lower than Los Angeles County’s, the city’s positivity rate is soaring and two local hospitals are filling up, said Deputy Mayor and infectious-disease specialist Dr. Jonathan Truong. He said Antelope Valley Hospital is caring for 68 confirmed COVID-19 patients, up from 23 last month. There are 45 COVID-19 patients at the nearby Palmdale Regional Medical Center, compared with 18 last month, he said. Still, Truong did not dispute the City Council’s displeasure with new county restrictions.  “Sometimes, not having the detailed number down to the local area, you end up making policies that’s one size fits all,” Truong said. “You basically close everything down, even when this community is doing well or the other community doing poorly. That’s the problem with one-size-fits-all numbers.” Dr. Lawrence Stock, deputy mayor and an emergency medicine physician at Antelope Valley Hospital, said his workplace is preparing for the worst, erecting new tents outside the emergency room to expand capacity. He also said hospitals have yet to see the effects of Thanksgiving gatherings, which probably helped spread the contagion even further. “Together with the rest of California, the rest of the county, [we’re] at some risk of overwhelming the normal hospital capacity,” Stock said. “We’re in a serious surge right now.” Parris, who called a special meeting of the council Thursday, acknowledged the gravity of the city’s current predicament in the pandemic. He blamed the city’s 77 coronavirus-related deaths on a failure of county leaders to enforce a mask mandate or properly educate people about the pandemic. “We don’t have the leadership with the courage to make those unpopular decisions,” Parris said in an interview Friday morning. He called the county Department of Public Health too big and “dysfunctional.” The city could maneuver faster on its own to secure resources and make necessary changes, he said. But despite his displeasure and the council’s unanimous vote, it could be months before a public health agency like the one Parris proposed — possibly as a joint effort with neighboring cities such as Palmdale — is operating. He acknowledged that the coronavirus crisis would probably be long passed by the time Lancaster formed its own agency. Still, he said, the COVID-19 pandemic has exacerbated inefficiencies in the county’s public health response and underscored a need for the city to take care of its own. The vote of no confidence in Ferrer also has no practical outcome. But Parris said the unanimous vote sent a message that the city felt “betrayed” by her handling of the pandemic. “What we’re about to do may not have an effect on her but, nonetheless, we’ve never had to do it to somebody before,” he said at Thursday’s meeting. “Without this expression of our contempt, and that’s really what it is, nothing’s about to change. … In my opinion, she failed.” Lancaster’s vote followed similar actions on Wednesday by the Beverly Hills City Council , which unanimously called for a repeal of the outdoor dining ban and pledged to explore forming its own public health agency. Demonstrators in recent days have gathered in front of Ferrer’s Echo Park home to protest some of the county’s new restrictions.
Doctors and nurses around the U.S. are becoming exhausted and demoralized as they struggle to cope with a record-breaking surge of COVID-19 patients that is overwhelming hospitals and prompting governors to clamp back down to contain the virus. New York Gov. Andrew Cuomo on Friday banned indoor dining in New York City, saying he had been waiting in vain for hospitalization rates to stabilize. Pennsylvania Gov. Tom Wolf did the same on Thursday and also suspended school sports and closed gyms, theaters and casinos. A record of more than 107,000 people were in the hospital in the U.S. with COVID-19 as of Thursday, according to the COVID Tracking Project. More than 294,000 Americans have died of the virus . Hospitals around the country have been overrun. “We’re constantly looking for beds,” said Cassie Ban, an intensive care nurse at Indiana University Health. Before the pandemic, an ICU nurse might handle two patients per shift. Ban said she now regularly cares for four or five. The national death toll doesn’t begin to capture what COVID-19 does to critically ill patients or the medical teams who care for them, she said. World & Nation Infected after 5 minutes, from 20 feet away: South Korea study shows coronavirus’ spread indoors World & Nation Infected after 5 minutes, from 20 feet away: South Korea study shows coronavirus’ spread indoors A South Korean study raises concerns that six feet of social distance may not be far enough to keep people safe from the coronavirus.  More Coverage “I wish people could see what I do,” Ban said. “People are terrified and they’re alone. Each one of those numbers is the death of a person who wasn’t ready to go yet.”  Although concerns remain about getting enough beds , masks and other equipment, many front-line health workers are most worried about staff shortages. Nurses are the most scarce resource of all, said Kiersten Henry, an ICU nurse practitioner at MedStar Montgomery Medical Center in Olney, Md. “I feel we’ve already run a marathon, and this is our second one. Even people who are upbeat are feeling run-down at this point,” Henry said. Many expressed frustration over some Americans’ disregard and even contempt for basic precautions against the virus. Dr. Lew Kaplan, a critical care surgeon at the University of Pennsylvania’s Perelman School of Medicine, said healthcare workers are treated as “heroes” for helping patients but are seen as “close to evil incarnate” when they ask people to wear masks. World & Nation For a border funeral home that survived the cartels, the coronavirus crisis is worse World & Nation For a border funeral home that survived the cartels, the coronavirus crisis is worse Time-honored traditions of mourning along the Texas-Mexico border are upended by the pandemic.  “It is very disheartening, while you are struggling to manage the influx of patients, there are others who won’t accept public health measures,” said Kaplan, president of the Society of Critical Care Medicine. Raju Mehta, a critical care physician at Advocate Health and Hospital in the Chicago area, said that early on in the pandemic, many front-line workers were energized by a sense of purpose. Now, that morale is beginning to crumble. “Seeing what we’re seeing, day in, day out, for eight months, takes a toll,” Mehta said. “It’s tough knowing what we see, and then what happens outside our walls.”
The Ventura County Board of Supervisors has unanimously approved a resolution declaring racism a public health crisis. Spurred by the recent killings of Ahmaud Arbery , Breonna Taylor and George Floyd — and by a nationwide history of discrimination and oppression against Black people, Indigenous people and other people of color — the resolution was the result of a months-long collaboration between county officials and community groups. “This resolution demonstrates Ventura County’s commitment to the continuation of having difficult and uncomfortable conversations around race, justice and inequities,” Rabiah Rahman, vice president of Black Lawyers of Ventura County, said during last week’s meeting. “While it is not perfect, it is without a doubt a step in the right direction.” The connection between racism and public health is well-documented, according to Dr. Stanley Patterson, who also spoke at the meeting. Patterson, a physician, said communities of color suffered from a systemic lack of access to affordable healthcare and health insurance, and from more insidious inequities, including a dearth of grocery stores and fresh produce markets that are commonly found in wealthier, more predominantly white neighborhoods. As a result of these and other failures, Patterson said, Black, Latinx and Indigenous people have higher-than-average incidents of diabetes, cardiovascular disease, respiratory disease, auto-immune disease, depression and even suicide. “The statistics are real,” he said. “They represent a problem that can only begin to be resolved with an inward reflection, understanding and embracing of our cultural differences and steps toward removing the barriers that prevent diversity, equity and inclusion where we live.” Science The concerted campaign that got public health experts to declare racist policing a crisis Science The concerted campaign that got public health experts to declare racist policing a crisis It took years for the American Public Health Assn. to say that police violence threatens the health of not just victims and their families, but entire communities.  Patterson said stark differences in treatment by law enforcement are also affecting those same communities.  “One in every 1,000 Black men,” he said, “can be expected to be killed by police in their lifetime.” The county’s resolution calls for a number of action items, including the establishment of an advisory group to work with law enforcement agencies to “foster meaningful discussions” and address public concerns relating to policing policies and procedures. It also pledges to establish a working group of experts to study the delivery of healthcare to underserved populations, and to continue to incorporate diversity and equity training for county employees. During one of the meeting’s more emotional presentations, Black Lawyers of Ventura County President Damon Jenkins read a letter he had written for his infant son. “My lips quiver, my heart pounds, my breathing increases, my hands sweat and tears gather in my eyes when I imagine the first time you tell me you have been called the N-word, or the day you have been mistreated by law enforcement,” he said. “I will tell you that I begged our elected officials to protect you.” Although Jenkins commended the county for its resolution, he also said community groups wanted even more action, including a recommendation that African American education be required in public schools, and that law enforcement advisory groups be run independently and have the power to make recommendations. California San Bernardino County declares racism a ‘public health crisis’ California San Bernardino County declares racism a ‘public health crisis’ By a 5-0 vote Tuesday, the San Bernardino County Board of Supervisors adopted a resolution “affirming that racism [is] a public health crisis.”  Jenkins also said local law enforcement agencies should provide clearer reporting on claims of excessive force, implement the widespread use of body cameras, adopt de-escalation techniques and require better training to deal with people of different backgrounds. “We continue to need more training, transparency and accountability,” he said. And although the deaths of several Black residents spurred Ventura County’s conversation around racism, the COVID-19 pandemic has also had measurable negative health effects on communities of color, the resolution said. According to the Centers for Disease Control and Prevention , Indigenous and Latino people are 2.8 times more likely to contract COVID-19, while Black people are 2.1 times more likely to die from it. All three communities experience 4.6 to 5.3 times more hospitalizations. “Your ZIP Code is a stronger determinant of your health than your genetic code,” said Rigoberto Vargas, Ventura County public health director. “Place matters: the context, the environment, the situations presented to us. ... Those opportunities or lack of opportunities all matter.” In passing the resolution, Ventura will join a growing list of places across the country that are declaring racism a public health issue. Twenty other counties and cities in California have made similar declarations, according to the American Public Health Assn., including Los Angeles . Calling it a “high-priority policy item,” Ventura County Executive Officer Michael Powers said there had been more than 27 versions of the resolution to account for its evolution of language and ideas. The final draft included input from the NAACP, Black Lawyers of Ventura County, the League of United Latin American Citizens, local law enforcement agencies, public health experts, the district attorney’s office and Ventura County Human Resources, he said. And although the resolution passed quickly and unanimously, most present agreed there was work yet to be done. “By approving and adopting this resolution, Ventura County is taking the first necessary step of acknowledging that we have a problem,” Rahman said. “There is no denying that we are a better and stronger community when the most vulnerable among us is elevated, celebrated and feels safe.”
Chris Varjabedian’s first stop after picking up his grandmother Zizi from her nursing facility was the salon. She hadn’t left the Mission Hills nursing home since March, before the COVID-19 pandemic erupted locally, and needed to get her hair and nails done if she was going to be home — finally — for the big holiday. “She was on Cloud Nine, like being in Disneyland,” said Varjabedian, 34. “She’s really happy and in good spirits, and grateful to spend Thanksgiving with her family.” Limited outdoor visits and calls from behind windows just hadn’t been enough for Varjabedian, who stops by Ararat Nursing Facility every Sunday to spend time with his grandmother — whom he got extra close with after his father’s death. So, after the better part of a year apart and a family decision that ensuring Zizi’s mental health was worth the risk of bringing her home, they did just that on Wednesday. “It’s so rewarding,” said his mother, Suzy Varjabedian, of seeing Zizi light up at the chance of being with family again. In a normal year, Thanksgiving is a festive time at many hospitals, nursing homes and other care facilities. Family members of patients stream in to pick up their loved ones, or bustle in with food to have fun there. They hug and laugh with their relatives,  pushing back against the weight of whatever illness or injury has brought them there. But in 2020, amid the latest surge of COVID-19 cases in Southern California and across the country — which on Thursday included 37 new deaths and more than 5,000 new cases in L.A. County alone — much of that has been curtailed. Hospitals and other facilities have implemented safety protocols severely restricting visitors, and in some instances banning them, in a desperate effort to ward off the spread of the virus. California Homeless families sought shelter from COVID-19 in vacant houses. CHP officers evicted them before Thanksgiving California Homeless families sought shelter from COVID-19 in vacant houses. CHP officers evicted them before Thanksgiving The Thanksgiving eve evictions came as activists argued that government officials had failed to provide shelter to keep people safe during the pandemic.   Into the void have walked doctors and nurses, care providers and technicians, hospital facilities staff and administrators — some of whom are bound by the Hippocratic Oath to care for patients, all of whom have accepted personal health risks and intense mental and emotional fatigue to stare down the greatest medical threat of a generation and push forward, day after day, to help those in its crosshairs. There are also the families of the elderly, ill or otherwise vulnerable, desperate to make the right decisions for their loved ones on a holiday even more oriented around family gatherings than most. Some are choosing head over heart and staying away, others deciding time together is too crucial to pass up during an already lonely year. Still others are trying to find some sort of balance, visiting through window panes or in socially distanced outdoor settings — forgoing the tactile comforts of a good holiday hug for fear that it might turn out to be a deadly embrace. California Photos: Gov. Newsom announces new stay-at-home order as COVID-19 hospitalizations hit record California Photos: Gov. Newsom announces new stay-at-home order as COVID-19 hospitalizations hit record Gov. Gavin Newsom has announced a stay-at-home order affecting most of California.  Those who are keeping their distance are leaving their loved ones in the care of health workers who themselves are sacrificing family time. Many said Thursday that they were doing their duty, showing up as they have for months on end, despite the fatigue. “We should be very thankful that we do have such a great healthcare system that has pivoted in just a matter of months to improve treatment and take care of people,” said Dr. Bill Stringer, a pulmonary critical care physician and head of the pulmonary division at Harbor-UCLA Medical Center. “It’s an army.” Stringer, 63, said he signed up to work the Thanksgiving holiday so younger colleagues with families could be at home. This year, that means dealing with patients who are critically ill from COVID-19 and the strange circumstances that come with the associated precautions — like trying to help patients communicate electronically with family members who can’t be in the hospital, even as some patients approach death.  California Column: Among the many volunteers deserving of thanks, this high school student is a standout California Column: Among the many volunteers deserving of thanks, this high school student is a standout To Pasadena seniors, Glendora High student Serena Lin is a big hit  “That’s obviously hard on the family, hard on the patient, but it’s hard on us too, because we have to be the ones who are there in the last minutes, the last seconds of people’s lives,” Stringer said. Still, Stringer said he wouldn’t want to be anywhere else this year. “Being a healthcare provider is a gift,” he said, “and I think we’re all thankful for that.” Ronnel Leones has always made it a point to put on a happy face when he makes rounds and sits at the bedsides of patients at  Rancho Los Amigos National Rehabilitation Center in Downey. Coming from a big family of nurses — including his wife, his mom and dad, his twin brother and his sister-in-law — Leones said he wants to make his family proud and do right by his patients by giving his all.  But that instinct has never been more important than this year, he said, when the extra effort might be as simple as giving a patient an extra clean shave so he can look his best for a FaceTime call home to family. “We want patients here to feel loved, cared for. It’s what they deserve, and it’s what we signed up for,” Leones said in the middle of a Thanksgiving shift Thursday. “We want to show resiliency and hope.” Leones, a 34-year-old father of two girls ages 5 and 6, contracted COVID-19 himself in March, along with one of his closest friends. He recovered, but his friend — an otherwise healthy 38-year-old — died, he said. For weeks he was terrified his daughters would get sick. Now, back at work, Leones believes his own experience with the illness has helped him treat patients in the intensive care unit. He said this year has been tough, but days like Thursday — working the holiday away from family — have been made easier by the bonds that hospital staff have made with one another after such a tough year. “It’s about our camaraderie,” he said. “We give hope to each other.” California Column: Dejected L.A. restaurants serve their last meals, fear for the future California Column: Dejected L.A. restaurants serve their last meals, fear for the future From Long Beach to Chinatown, restaurant workers and customers worry yet hope for the best on the day before the coronavirus shutdown — again.  More Coverage Erika Flores Uribe, an emergency medicine physician at Los Angeles County-USC Medical Center, was working a 7 a.m.-to-3 p.m. shift on Thursday. Usually on Thanksgiving, doctors and nurses have a big potluck lunch, she said. Not wanting to gather this year, they just ordered pizza, she said. But the shift seemed extra special. Having grown up in southeast L.A., seeing COVID-19 disproportionately  affect communities of color there has made her work this year feel personal, and being at the hospital on Thanksgiving — helping Spanish-speaking patients feel more comfortable by conversing with them in their native tongue — all the more important, she said. “The way that we’ve shown up every day, especially the holidays, really reflects that oath we took to take care of the community,” she said. Joel Clark, an emergency room technician, was spending his Thanksgiving working at El Centro Regional Medical Center as part of a traveling assignment to help hospitals across the country. The 22-year-old, spending his first big holiday away from his family in Santa Cruz, described his 12-hour holiday shift as part of a team effort — one in which he knows some of his patients are homesick just like he is. “Not only am I alone here, but the patients are, too. They don’t have access to family members visiting. So it’s like we’re all together,” he said. “It kind of feels like a community. We’re kind of all alone, but we’re still here.” Dr. Nikhil Barot, a pulmonary critical care physician at Olive View-UCLA Medical Center, said he was working day shifts Thursday and through the weekend, assisting staff as they watch over ICU patients with COVID-19 as his “superstar” wife — a nurse on leave — watched over their 5-month-old twins at home. Even at night, he takes calls, as he did Wednesday night. Four times between 11 p.m. and 2 a.m. Thursday, staff reached out to him about a COVID-19 patient who was crashing. Despite their best efforts, the patient died, he said. Barot said he and other medical staff fear a coming wave of new patients. They will be there to meet it, he said, but they hope people outside of hospitals will do their part to flatten the curve — wearing masks, washing their hands, following the directions from public health officials. Jeanie Bergen, 36, hopes for the same — for her and her sister’s sake. Bergen’s sister Edna, 37, has intellectual disabilities and lives in a care facility in the Valley. Bergen is her sister’s guardian, with their parents having passed away, and tries to visit her as much as possible. But in recent months, the facility locked down completely after having several COVID-19 cases among staff and residents. Finally this week, Bergen was able to visit again, but only from a distance. She and her sister sat outside, socially distanced. It was a comfort after only seeing her sister through a pane of glass for so long, Bergen said, but they still couldn’t communicate “by holding hands and sitting close and hugging,” as they always have. It was hard, especially when she thought about others in Los Angeles who have not heeded public health messages to stop the spread of the virus. “I wish people would realize that we are all connected and their choices affect other people that they will never meet,” she said. “I can’t hold my sister’s hand, I can’t take her in the car, I can’t explain to her why none of that is happening. It’s really hard. It’s painful. And I just have to pray every day and hope that there’s not another outbreak.”
Canada’s health regulator approved Pfizer’s COVID-19 vaccine Wednesday, days ahead of possible approval in the United States, and said it hopes to start giving the shots next week. The vaccine made by U.S. drugmaker Pfizer and Germany’s BioNTech already has been authorized for use by the United Kingdom and Bahrain, and officials have said they expect the U.S. authorization within days. “This is a momentous occasion,” said Dr. Supriya Sharma, chief medical advisor at Health Canada. “The geek in me is amazed. No one would have thought, even when we looked back at the first discovery of the virus, that less than a year later we would be authorizing and distributing a vaccine.” Sharma said Canadians should feel comfortable getting the shot, which was “authorized only after a thorough assessment of the evidence demonstrated that it met Canada’s strict standards for safety, efficacy and quality.” Health Canada said the terms of the approval require the manufacturer to continue providing information on the vaccine. Canada is set to receive up to 249,000 doses this month, and officials expect to start to administer 30,000 doses next week after an initial batch is shipped from Belgium on Friday. Britain began vaccinations Tuesday. U.S. regulators on Tuesday released their first scientific evaluation of Pfizer’s COVID-19 vaccine and confirmed it offers strong protection. Vaccines are emerging from an all-out worldwide race and are reaching the market less about a year after the virus was identified — a remarkable scientific achievement that shaved years off the usual process.  The encouraging developments come as the coronavirus continues surging across much of the world. The scourge has claimed more than 1.5 million lives, including over 285,000 in the U.S., the highest toll of any country. U.S. Food and Drug Administration scientists are meeting Thursday, when the agency’s independent advisors will debate whether the evidence is strong enough to recommend vaccinating millions of Americans. “It is encouraging to see that our mRNA vaccine is now authorized in Canada. Following U.K. and Bahrain, it is the third country to approve use of our vaccine within a week,” said Sean Marett, BioNTech’s chief business and chief commercial officer, referring to the new type of messenger RNA vaccine involved. In the U.S., FDA scientists reanalyzed data and found the Pfizer vaccine appears safe and more than 90% effective across patients of different ages, races and underlying health conditions. Health Canada said the vaccine is for use in people 16 years of age or older, but noted that could change. Pfizer and BioNTech are running further clinical trials on children of all age groups. Britain’s medical regulator warned Wednesday that people with a history of serious allergic reactions shouldn’t receive the vaccine from Pfizer and BioNTech for the time being. Sharma said Health Canada is advising only people with allergies to the ingredients in the vaccine to avoid it, but said the agency will review information out of the U.K. and decide whether to expand that advice. “The people that had the allergic reaction in the U.K. had histories of severe allergic reactions,” she said. “At this point in time we are not changing our recommendation.” Canada recently amended the contract with Pfizer so that it would deliver up to 249,000 doses this month. That will mean about 124,500 of the highest risk Canadians will get vaccinated at first; each person requires two doses that are administered a few weeks apart. Pfizer and BioNTech said it will supply a minimum of 20 million doses to Canada through 2021 and as many as 76 million. Canada has contracts with six other vaccine makers and is reviewing three other vaccines, including one by Moderna that Canadian health officials said could be approved soon. Dr. Howard Njoo, Canada’s deputy chief public health officer, said officials plan to get initial shipments of the new vaccine to 14 sites across the country by next week. “We have a reason to feel optimistic and excited about returning to the lives we had pre-COVID,” Njoo said. “We anticipate having approved vaccines for 3 million Canadians between January and March with supply ramping up the rest of 2021.” The government has said 14 distribution centers will be located in large Canadian cities initially. There will be at least one in each province and two each in Canada’s four largest provinces. “This is phenomenal news for all Canadians as we take the next step toward ending this pandemic. As soon as vaccines arrive on Ontario soil, we will be ready to deliver and administer them,” Ontario Premier Doug Ford said in a tweet.
As COVID-19 vaccinations roll out to more and more people, health authorities are keeping close watch for any unexpected side effects . On Tuesday, a health worker in Alaska suffered a severe allergic reaction after receiving the Pfizer COVID-19 vaccine . Doctors already knew to be on the lookout after Britain reported two similar cases last week. In the U.S., vaccine recipients are supposed to hang around after the injection in case signs of an allergy appear and they need immediate treatment — exactly what happened when the health worker in Juneau became flushed and short of breath 10 minutes after the shot. Allergies are always a question with a new medical product, but monitoring COVID-19 vaccines for any other, unexpected side effects is a bigger challenge than usual. It’s not just because so many people need to be vaccinated over the next year. Never before have so many vaccines made in different ways converged at the same time — and it’s possible that one shot option will come with different side effects than another. Staffers at the U.S. Food and Drug Administration have conducted scientific reviews of two vaccines — one from Pfizer and BioNTech, the other from Moderna and the National Institutes of Health — and have found no major safety risks. Science How the COVID-19 vaccines from Moderna and Pfizer compare head to head Science How the COVID-19 vaccines from Moderna and Pfizer compare head to head If the COVID-19 vaccine from Pfizer and BioNTech was good enough to get a nod from the FDA, the vaccine from Moderna and the NIH almost certainly is as well.  But the allergy concern “points out again the importance of real-time safety monitoring,” said Dr. Jesse Goodman of Georgetown University, a former FDA vaccine chief. And authorities have multiple ways of tracking how people fare as these COVID-19 vaccines — and hopefully additional ones in coming months — get into more arms.   Getting either the Pfizer-BioNTech shot or the Moderna version can cause some temporary discomfort, like many vaccines do. In addition to a sore arm, people can experience a fever and some flu-like symptoms — fatigue, aches, chills, headache. They last about a day, sometimes bad enough that recipients miss work, and are more common after the second dose and in younger people. Science COVID-19 vaccine side effects: What you need to know Science COVID-19 vaccine side effects: What you need to know For most people, side effects should be mild and may include flu-like symptoms for a day or two. People with severe allergies should consult a doctor.  These reactions are a sign that the immune system is revving up. COVID-19 vaccines tend to cause more of those reactions than a flu shot, about what people experience with shingles vaccinations. But some of the effects are similar to early coronavirus symptoms, one reason hospitals are staggering when their employees get vaccinated.   The FDA found no serious side effects in the tens of thousands enrolled in studies of the two vaccines. Still, problems so rare they don’t occur in even very large clinical trials sometimes crop up when a vaccine is used more widely and without the stringent rules of a clinical trial. The first allergy reports from England were in people with a history of serious allergies, and British authorities warned those with severe prior experiences to hold off vaccination until they determine what ingredient might be a problem. U.S. health authorities are giving more nuanced advice. People always are asked about allergies before vaccinations, and instructions for the Pfizer-BioNTech shot say to avoid it if you’re severely allergic to one of its ingredients or have had a severe reaction to a prior dose. Health workers can go over the ingredient list. The Centers for Disease Control and Prevention advises people to stick around for 15 minutes after vaccination so they can be treated immediately if they have a reaction. Those with a history of other allergies are asked to stay for 30 minutes. Science The FDA didn’t ‘approve’ Pfizer’s COVID-19 vaccine. Here’s why Science The FDA didn’t ‘approve’ Pfizer’s COVID-19 vaccine. Here’s why A lot of things are different when you’re in the midst of a global pandemic. A case in point: How federal regulators scrutinize and authorize new vaccines.  The Alaska health worker, who doctors said had no history of allergies, was following that advice and got prompt care for a particularly severe reaction called anaphylaxis . She has recovered after a night of observation in the hospital — but won’t be allowed a second vaccine dose. Alaska doctors alerted U.S. authorities, who will continue the monitoring required to tell just how common that kind of reaction really is. That will be especially important as enough vaccine arrives for injections to be given outside of healthcare settings that have lots of experience handling such a reaction. “Balancing any potential risks with the benefits the vaccine provides in the pandemic is an ongoing process,” Dr. Jay Butler , the CDC’s deputy director for infectious diseases, cautioned Wednesday.  The challenge is telling whether the vaccine caused a health problem or if it’s coincidence. Don’t jump to conclusions that there’s a connection, health authorities stress. Researchers look for such connections by comparing any reports of possible side effects with data showing how often that same condition occurs routinely in the population. Science Confused about COVID-19 vaccines? Here’s your guide to vaccine vocabulary Science Confused about COVID-19 vaccines? Here’s your guide to vaccine vocabulary When people talk about COVID-19 vaccines, they can sound like they’re speaking a foreign language. Don’t worry! Here’s your guide to vaccine vocabulary.  The government has multiple ways to do that. Doctors are required to report any patient problems. But the FDA is scrutinizing massive databases of insurance claims for early red flags that any health problems are occurring more often among the newly vaccinated than they are in everyone else. On its list to check is Bell’s palsy , a temporary facial paralysis that occurred in a handful of people in both vaccine studies. The FDA said it’s probably coincidence, but will track the issue to be sure. Vaccine recipients can help with the extra safety tracking. A program run by the CDC called “ v-safe ” automatically sends a daily text for the first week after each vaccine dose to ask how people feel. Weekly texts follow for the next five weeks. Any responses that suggest concern prompt a phone call for further information.
The Pasadena City Council will allow restaurants to continue outdoor dining despite a new L.A. County health order to suspend such operations for three weeks due to the a larming coronavirus surge . “We will assess our data daily but at this point will not close down restaurants on Wednesday or the near future based on a discussion at our City Council meeting tonight,” said Lisa Derderian, spokeswoman for the city of Pasadena. The announcement was made after Monday’s City Council meeting and a day after Los Angeles County said it would halt in-person dining at restaurants, breweries, wineries and bars for at least three weeks starting Wednesday. California Critics say L.A. County’s suspension of outdoor dining will ‘further devastate’ economy California Critics say L.A. County’s suspension of outdoor dining will ‘further devastate’ economy The decision to suspend outdoor dining came as Los Angeles County recorded its highest one-day total for COVID-19 cases on Monday.  Pasadena has its own Department of Public Health that has the authority to issue health orders independent of Los Angeles County. Its orders have generally followed those of Los Angeles. As of Monday, Pasadena has reported 3,405 coronavirus cases and 132 deaths. The Los Angeles County decision to temporarily halt outdoor dining has sparked a backlash from eateries and some county officials, who worry about the devastating economic toll . The county Board of Supervisors is expected to discuss the the health department order on Tuesday. County health officials argued that the outdoor dining restrictions are warranted given the critical healthcare crisis. They noted that restricting businesses has worked to bring down coronavirus cases in the past, and that action is needed before hospitals are overwhelmed. California New stay-home order looms for L.A. County as COVID-19 cases soar to new highs California New stay-home order looms for L.A. County as COVID-19 cases soar to new highs The new wave of coronavirus cases brings L.A. County closer to another stay-at-home order.  More Coverage  The city of Long Beach, which also has its own public health department, joined with the county and also issued a new health order to prohibit on-site dining. The order, which goes in effect Wednesday, will allow restaurants, bars and breweries to operate drive-through, curbside and other outdoor pickup and delivery. Over the last two weeks, the number of new cases has increased in Long Beach. Health officials say hospitalizations have jumped by 248% from 25 to 85 since the start of the month. The positivity rate is now at 5.8%, compared with 2.9% when it was at its lowest, and the most recent five-day average case rate is 34 per 100,000, up from a low of 6.9 per 100,000. As Monday, the city has reported 15,226 confirmed cases and 270 deaths.
The specter of COVID-19 reached the Lakers and Clippers on Sunday when three players and an assistant missed the teams’ second matchup of the preseason because of what were termed excused absences under the NBA’s health and safety protocols. Clippers assistant Chauncey Billups and reserve guard Reggie Jackson, along with Lakers forwards Kostas Antetokounmpo and Devontae Cacok, were not with their respective teams. All four had been at Staples Center for the teams’ preseason opener two days earlier. In addition, Lakers forward Alfonzo McKinnie has yet to report to the team since training camp began one week ago because of an excused absence. An excused absence applies to scenarios that include either a positive or inconclusive result or because of reasons related to contact tracing, a league source said.  Lakers LeBron James and Anthony Davis will be ‘ready to go’ for regular season Lakers LeBron James and Anthony Davis will be ‘ready to go’ for regular season LeBron James and Anthony Davis haven’t seen any playing time in the preseason, but Lakers coach Frank Vogel says his star duo will soon be ready.  Clippers coach Tyronn Lue said he did not know how long it could take for Billups and Jackson to rejoin the team. “All teams are going through the same thing, we’ve just got to follow protocols as best as we can and we have to adapt,” Lue said. Clippers forward Paul George said being prepared for alterations to the team’s lineup or staff because of COVID-related protocols was “just part of the job” now.  “There are going to be guys out — a lot,” Lakers coach Frank Vogel said. “We just have to get used to the fact that it’s going to be normal for this season leaguewide. And hopefully it’s as minimal as possible but we’re just trying to find the silver lining in it. “When certain guys are going to be out, other guys are going to get more opportunity. You saw that with the guys tonight.” Highlights from the Lakers’ 131-106 preseason win over the Clippers at Staples Center on Sunday. The NBA is currently in its self-described fourth phase of the lead-up to the regular season’s start on Dec. 22, during which players and staffers continue to undergo regular polymerase chain reaction testing and daily health monitoring. Billups, the most valuable player in the 2004 Finals, is in his first season as a coach after playing point guard in the NBA for 17 seasons before retiring in 2014. Jackson played 12 minutes in Friday’s preseason opener. His spot in the Clippers’ reserve lineup was replaced Sunday by second-year guard Terance Mann. Antetokounmpo played 24 minutes and Cacok 25 minutes Friday for the Lakers. After resuming and finishing last season at Disney World near Orlando, Fla., the NBA is pushing forward on its plan to play this season in teams’ home markets amid worsening rates of infection across the country. “Other leagues have been successful under these conditions,” George said. “It is part of the job. We hope for no one to get it and everyone to stay healthy. But realistically it’s probably not going to happen. But I think everyone is taking the steps to just make sure it doesn’t spread and we keep this league going.” Lakers The youngest Laker, Talen Horton-Tucker, is stealing the show so far in the preseason Lakers The youngest Laker, Talen Horton-Tucker, is stealing the show so far in the preseason Lakers second-year guard Talen Horton-Tucker shines again, scoring a game-high 33 points in a 131-106 preseason victory over the Clippers.  More Coverage Teams are abiding by more than 130 pages of protocols governing how the league will test and return those who have been infected by the novel coronavirus back to the court. The return-to-play guidelines state that at least 12 days must pass between a first positive test or the end of symptoms, if any. The league’s time-based procedure for returning to play requires an infected person to isolate for at least 10 days after the first positive test or the start of symptoms, if any; wait at least 24 hours since their fever has passed without using any fever-reducing medications; and ensure that other symptoms have improved. A testing-based procedure requires that infected person must test negative twice from samples collected at least 24 hours apart. Like its time-based procedure, this route to returning to play also includes a 10-day prohibition on participating in exercise training. “It’s kind of the new norm, the safety protocols,” Clippers guard Lou Williams said. “They continue to get updated every day. Different things that they implement, a lot of small things and so we just kind of get used to it, get over it, just take care of yourself personally and keep moving.”
Changes made to a union health plan will make it harder for thousands of actors and performers to retain their medical insurance, a new lawsuit alleges. A group of SAG-AFTRA members sued the union’s health plan and its board of trustees for breach of fiduciary duty and other claims, according to the complaint filed in Los Angeles Superior Court on Tuesday. The lawsuit was sparked by a series of changes made to the health plan this summer as trustees faced rising healthcare costs brought on by the global pandemic as well as financial pressures caused by the industry shutdown. The controversial changes included no longer allowing actors 65 years and older who vested their pensions to count  their earnings from residuals in the annual income threshold for maintaining health insurance benefits. Also eliminated was the so-called “age and service” criterion, which allowed actors over 40 with a decade of credits to qualify for coverage at a reduced level of $13,000 in annual earnings. “In 1960, all SAG performers gave away their right to all television residuals on all movies produced prior to 1960 in exchange for the studios’ commitment to seed and establish a pension and health plan for all members,” the lawsuit stated. “The health plan for which they personally sacrificed to begin for all members has now abruptly abandoned them.” The lawsuit highlights the plight of many actors in the industry who have either lost coverage or face the threat of higher earning thresholds to qualify for insurance at a time when work is increasingly scarce. The COVID-19 pandemic led to an industrywide production halt, making it harder for many of the 160,000 members of Hollywood’s biggest union to find employment. The plaintiffs argued that the health plan’s funding problems stemmed from the merger of the previously separate health plans operated by SAG and AFTRA. SAG health trustees, they alleged, “hastily” proceeded with the merger for “political purposes” and failed to disclose that the “benefit structure in the merged plan was in peril.” Actors who filed the lawsuit include “Lou Grant” star Ed Asner, David Jolliffe and other members of the Membership First faction , which has long opposed the current leadership of SAG-AFTRA and the 2017 merger of the two former rival unions.  In August, the SAG-AFTRA health plan, administered by trustees representing the union and management, detailed a restructuring that it said was necessary because the plan would run out of reserves by 2024. “We have been working diligently to try to control the growing costs of healthcare by negotiating better contracts and reducing costs within our control,” the health plan board of trustees said in a newsletter to members describing the changes. “Despite our success at managing costs within our control, ever-increasing healthcare costs have resulted in unsustainable deficits.” In response, the trustees announced that beginning in January, union members would be offered a single plan at a higher income eligibility threshold of $25,950 per year. Previously, there were two options: an affordable plan available to those earning a minimum of $18,040 a year; and a higher-priced plan with an earnings threshold of $35,020. Those who previously were entitled to coverage at lower levels could qualify for the same or better coverage at a lower or no cost under the Affordable Care Act, the union said. But the plaintiffs claim that the benefit cuts would remove from coverage 10% of the plan’s 33,000 participants and 9% of their 32,000 dependents. Some 8,000 seniors would also lose coverage, they said. The restructuring removed lifetime health coverage for members with 20 years of vested pension credit and withdrew accrued coverage from members or surviving spouses already receiving it, the actors said in their complaint. “As structured, the benefit cuts wrongfully and illegally discriminate based on age,” the lawsuit states. A representative of SAG-AFTRA could not be immediately reached for comment. The SAG-AFTRA plan in September offered reductions to premiums for continuation of healthcare (known as COBRA) for those who lost coverage in the wake of the pandemic and restructuring. Earlier in the year, the union waived copays, deductibles and coinsurance cost for COVID-19 testing under the plan.
Arguments over mask requirements and other restrictions have turned ugly in recent days as the deadly coronavirus surge across the U.S. engulfs small and medium-size cities that once seemed at a safe remove from the outbreak. In Boise, Idaho, public health officials about to vote on a four-county mask mandate abruptly ended a meeting Tuesday evening because of fears for their safety amid anti-mask protests outside the building and at some of their homes. One health board member tearfully announced she had to rush home to be with her child because of the protesters, who were seen on video banging on buckets, blaring air horns and sirens, and blasting a sound clip of gunfire from the violence-drenched movie “Scarface” outside her front door. “I am sad. I am tired. I fear that, in my choosing to hold public office, my family has too often paid the price,” said the board member, Ada County Commissioner Diana Lachiondo. “I increasingly don’t recognize this place. There is an ugliness and cruelty in our national rhetoric that is reaching a fevered pitch here at home, and that should worry us all.” Boise police said three arrest warrants were issued in connection with the demonstrations at board members’ homes. In California, Sacramento County health officials had to suspend a meeting Tuesday after more than two dozen protesters pounded on the chamber doors during a debate over whether to strengthen enforcement against businesses that violate virus restrictions. World & Nation Infected after 5 minutes, from 20 feet away: South Korea study shows coronavirus’ spread indoors World & Nation Infected after 5 minutes, from 20 feet away: South Korea study shows coronavirus’ spread indoors A South Korean study raises concerns that six feet of social distance may not be far enough to keep people safe from the coronavirus.  More Coverage And in South Dakota, the mayor of Rapid City said City Council members were harassed and threatened over a proposed citywide mask mandate that failed this week even as intensive care units across the state filled with COVID-19 patients.  “I think that’s a sad commentary here in the middle of a global pandemic, the worst health crisis in our lifetimes, and we’re fighting over a mask,” Mayor Steve Allender said. The tensions are flaring amid an epic surge across the U.S. in deaths, hospitalizations and infections over the last several weeks. Deaths are running at more than 2,200 a day on average, all but matching the level seen during the spring’s peak in and around New York City. New cases per day have rocketed to more than 200,000 on average, and the number of patients in the hospital with COVID-19 stood at more than 106,000 on Wednesday, another all-time high. Protesters in Montana’s Gallatin County have gathered for two consecutive weeks outside the Bozeman home of county health officer Matt Kelley to decry health regulations, including a statewide mask mandate. They have carried signs that read “We refuse to be your experiment” and “Oxygen is essential.” Last week, around 80 people lined Bozeman’s Main Street to support Kelley and other health officials. In Montana’s Flathead County, where officials recorded 17 coronavirus-related deaths over 18 days and resistance to masks runs strong, the interim public health officer is resigning when her contract is up at the end of the year, citing a lack of support from city and county authorities for measures to control the scourge. In Helena, Republicans who control both chambers of the Montana Legislature denied a request by Democratic lawmakers to require masks be worn inside the capitol during the legislative session next month. In Missouri, Greene County officials recorded 51 COVID-19 deaths in the first eight days of December as hospitals overflow and hundreds of healthcare workers are quarantined. The area’s two major hospitals asked the city of Springfield, the county seat, to renew the city’s mask mandate before it expires in January. The county itself does not have a mask mandate, nor does the state. As the deaths pile up, Springfield Mortuary Services owner Brian Simmons is overseeing the embalming and cremation of COVID-19 victims as his own 48-year-old daughter battles the virus. She spent the past week hospitalized on a ventilator in one of the city’s overwhelmed hospitals. “You are just helpless,” he said. “There is nothing you can do about it. We haven’t seen her since she’s gone in.” In Idaho, hospital officials have repeatedly warned they are becoming overwhelmed and could be forced to implement “crisis standards of care” — that is, reserve lifesaving treatment for patients most likely to survive. Idaho health authorities reported more than 2,200 new cases Wednesday and a running death toll of at least 1,103. South Dakota has suffered through the country’s worst rate of COVID-19 deaths per capita over the last week, but Gov. Kristi Noem has been ardent in her opposition to mask mandates or other aggressive efforts to slow infections. That hands-off approach drew vocal support at Rapid City council meetings, even as doctors warned that the only large hospital in the western half of the state is facing a crisis and patients are being flown out of the state. The meetings drew hours of testimony from people who said that the dangers of the virus are overblown and that mask requirements violate their liberties. Politics Trump administration chose to not lock in more Pfizer coronavirus vaccine doses Politics Trump administration chose to not lock in more Pfizer coronavirus vaccine doses The Trump administration opted last summer to pass up the chance to buy millions of additional doses of one of the leading coronavirus vaccine contenders.  Dr. Stephen Neabore, a physician with the biggest hospital system in the region, said he has been frustrated as he tries to persuade people to wear masks. After working in New York City and studying medicine in England, he said, he sees a distinct skepticism toward government around him. “I still see people out here that will tell me that they don’t believe it’s any worse than a common cold,” he said. Coronavirus deaths have also been rising rapidly in rural parts of Iowa, where many people disdain masks. Among the hardest hit is O’Brien County, population 13,800, where 42 deaths have been blamed on the virus. Ty Rushing, who covers the region as managing editor of the Northwest Iowa Review newspaper, said he thought the June death of 63-year-old James Fischer, a milk hauler who lived in Sheldon his whole life, would be a wake-up call to take the virus seriously. But he said obituaries in his newspaper have only been piling up since then. The recent deaths include Fischer’s mother, who like many other COVID-19 victims died at a nursing home. Science Only half of Americans want to get COVID-19 vaccine, poll finds Science Only half of Americans want to get COVID-19 vaccine, poll finds As states frantically prepare to begin months of COVID-19 vaccinations, a new poll finds only about half of Americans are ready to roll up their sleeves.  “It’s sad to say, but I think people are just numb to it or they are sticking their head in the sand about it,” Rushing said. He said some have reacted to the deaths of the elderly with the attitude: “Well, they were going to die anyway. Oh, they are older and there’s underlying conditions.” In Iowa’s Harrison County, 47 deaths have been attributed to the virus out of a population of about 14,000. Most of the deaths have resulted from outbreaks at nursing homes in the small towns of Dunlap, Logan, Missouri Valley and Woodbine. Dunlap City Clerk Meredith Van Houten said almost everyone in the town of about 950 people has a connection to those who have died. She said that she knew some from handling their water bills at City Hall and that another of the dead was her old neighbor. “It’s a horrible time right now,” Van Houten said. 
When children and teens are overwhelmed with anxiety, depression or thoughts of self-harm, they often wait days in emergency rooms because there aren’t enough psychiatric beds. The problem has only grown worse during the COVID-19 pandemic, reports from parents and professionals suggest. With schools closed, routines disrupted and parents anxious over lost income or uncertain futures, children are shouldering new burdens many are unequipped to bear. And with surging numbers of hospitalized COVID-19 patients, bed space is even scarcer.  Get our free Coronavirus Today newsletter Sign up for the latest news, best stories and what they mean for you, plus answers to your questions. You may occasionally receive promotional content from the Los Angeles Times. By early fall, many Massachusetts ERs were seeing about four times more children and teens in psychiatric crisis weekly than usual, said Ralph Buonopane , a mental health program director at Franciscan Hospital for Children in Boston. ”I’ve been director of this program for 21 years and worked in child psychiatric services since the 1980s and it is very much unprecedented,” Buonopane said. His hospital receives ER transfers from around the state. While ER visits for many health reasons other than COVID-19 declined early in the pandemic as people avoided hospitals, the share that were for kids’ mental health-related visits climbed steadily from mid-April through October, according to a recent report from the Centers for Disease Control and Prevention . Of the kids who showed up, more were for mental health than in the same period last year, although that might reflect that others stayed away, the authors cautioned.  California We need to prepare for the mental health effects of coronavirus on kids California We need to prepare for the mental health effects of coronavirus on kids More children are likely to experience toxic stress during the pandemic, which could lead to devastating effects in the future.  Claire Brennan Tillberg’s 11-year-old daughter was one of those kids who sought care. The Massachusetts girl has autism, depression and anxiety, and has been hospitalized twice in recent months after revealing that she’d had suicidal thoughts. The second time, in September, she waited a week in an ER before being transferred to a different hospital. The first time, in July, the wait was four days. She’d been hospitalized before, but Tillberg said things worsened when the pandemic hit and her new school and therapy sessions went online . Suddenly the structure and rituals that many children with autism thrive on were gone. “She’d never met the teacher, never met the kids,” said Tillberg, a psychotherapist. “She felt more isolated, more and more like things aren’t getting better. Without the distraction of getting up and going to school or to camp ... sitting at home with her own thoughts all day with a computer has allowed that to worsen.’’  Studies and surveys in Asia, Australia, the U.S., Canada, China and Europe have shown overall worsening mental health in children and teens since the pandemic began. In a World Health Organization survey of 130 countries published in October, more than 60% reported disruptions to mental health services for vulnerable people, including children and teens. Emergency rooms are often the first place kids facing a mental health breakdown go for help. Some are stabilized there and sent home. Some need inpatient care but many hospitals don’t offer psychiatric treatment for kids and transfer these children elsewhere. Some treatment centers won’t take kids without proof they don’t have COVID-19, ’’which is hard because you can’t always find a rapid test,” said Ellie Rounds Bloom. Her 12-year-old son has “significant mental health issues” including trauma, and has experienced several crises since the pandemic began. The Boston-area boy has been hospitalized since October, after spending 17 days in an ER. Many mental health advocates consider these waits unacceptable. For parents and their kids, they are that, and more. “There have been moments of frustration and moments of sheer pulling your hair out,” Rounds Bloom said. State health insurance covers her son’s treatment but not all providers accept it. Deficiencies in the U.S. healthcare system can leave families feeling helpless, she said. “You can’t give up, because it’s your kid,” Rounds Bloom said.  California Remote learning has created a new audience for an old ritual: Crying in school California Remote learning has created a new audience for an old ritual: Crying in school Crying has been part of school life from time immemorial. But never has it had such a vast and motley audience, as young kids’ emotional literacy is tested by COVID-19 and virtual class.  There are no national studies on kids’ ER waits for mental health treatment, a practice called “boarding,” according to a recent review published in the journal Pediatrics . The review included small studies showing that between 23% and almost 60% of U.S. kids who need inpatient care have to wait in ERs to receive it. They are kept stable but often receive little or no mental health care during those waits. Yale-New Haven Children’s Hospital has started offering teletherapy to kids waiting in its emergency room for mental health care, said Marc Auerbach , a pediatric ER physician. One in 6 U.S. children have a diagnosed mental, behavioral or developmental disorder, according to the CDC. Data show problems such as depression become more prevalent in teen years; 1 in 13 high school students have attempted suicide and at least half of kids with mental illness don’t get treatment. Shortages of psychiatrists in some areas and hospital closures have worsened the problem and contributed to rising ER mental health visits, the Pediatrics review said. Science Signs of depression have tripled in the U.S. since the COVID-19 pandemic got underway Science Signs of depression have tripled in the U.S. since the COVID-19 pandemic got underway The prevalence of depression symptoms in the U.S. has more than tripled in the COVID-19 era compared to the period before the pandemic.  The number of U.S. children’s mental health hospitals dropped to 38 from 50 between 2008 and 2018. The number of U.S. hospitals reporting that they offer any inpatient psychiatric services to adults or children dropped by almost 200 from 2008 to 2018, when the tally was 1,487, data from the American Hospital Assn. show. Children who need to be admitted for complex mental issues and behavior outbursts often have the longest ER waits — kids such as Laura Dilts’ 16-year-old son, who is chronically suicidal, has mild autism, anxiety, severe depression and attention deficit disorder. “Hospitals often refuse to take him,” said Dilts, a human resources recruiter who lives near Worcester, Mass. Early this year, before the pandemic hit, he waited for a hospital bed twice, once for a week, the second time for over two weeks. He had been living at an intensive residential treatment center and has been back there since April. Dilts worries about what will happen if he has another crisis. “There weren’t enough beds before COVID and there really aren’t enough beds now,” she said. At the 66-bed Clarity Child Guidance Center in San Antonio, demand has been surging, said Chief Executive Jessica Knudsen . About half their patients are Latino, and 60% receive some form of public health insurance. Some nights, there have been five or six kids sleeping in an observation area waiting for beds, she said. “I feel OK once they get to us,” even if in the observation room, she said. “They’re getting eyes on them by a mental health professional.” Kids left waiting idly in ERs, or who don’t seek emergency care, “that’s my real worry,” she said.
Senate Republicans raised red flags Monday over President-elect Joe Biden’s plan to nominate California Atty. Gen. Xavier Becerra to be secretary of the Department of Health and Human Services, although it is uncertain whether that could grow into enough opposition to scuttle the confirmation. At least five Republicans objected to Becerra’s nomination, citing his endorsement of a government-run “Medicare for all” healthcare system, his support for abortion rights or his relative lack of healthcare expertise and experience running an expansive government agency. “I have serious concerns about Xavier Becerra’s ability to lead Health and Human Services,” said Sen. Mike Braun (R-Ind.), who also pointed to $1 million in political donations Becerra has received from “the big healthcare industry.” The figure was calculated by the OpenSecrets.org website, which counted $1.2 million in political donations over the course of Becerra’s career from individual healthcare professionals and political advocacy groups that represent them. It is unclear whether Republicans’ skepticism over Becerra will remain once the nominee begins meetings with the lawmakers, nearly all of whom said they didn’t rule out supporting him once they review his record. But the immediate pushback is a reminder of the difficulties Biden will face in a closely divided Senate to confirm Cabinet picks viewed as too progressive or partisan. Last week, several GOP senators voiced opposition to Biden’s selection of Neera Tanden, president of a liberal think tank, to serve as his budget chief. Sen. Ted Cruz (R-Texas) said he would judge Becerra’s nomination on its merits “but his record of extreme left-wing activism certainly doesn’t inspire confidence.” Sen. Bill Cassidy (R-La.), a physician, questioned whether Becerra has enough subject matter expertise for the job, which in the past has gone to governors or others with executive experience. “Nice person,” Cassidy said. “I just don’t know what expertise he has in healthcare.” It was a sentiment echoed by Sen. Susan Collins of Maine, the most moderate Senate Republican, who refused to weigh in directly on Becerra’s confirmation prospects but said she was “surprised that it wasn’t an individual who had a healthcare background.”  Sen. Tom Cotton (R-Ark.) was the most definitive, pledging to vote against Becerra because of his support for abortion rights and his legal defense, as California’s attorney general, of Gov. Gavin Newsom’s COVID-19-related closures, including restrictions on church services . “Xavier Becerra’s lockdowns in California have been a disaster,” Cotton said on Twitter. Sen. John Cornyn (R-Texas) predicted his confirmation “will be controversial.” “I think most of us feel like there should be some deference to the president-elect’s choice for his Cabinet, but some of these folks are pretty radical,” Cornyn said. Many Republican senators have been reluctant to even comment publicly on Biden nominees because doing so would inherently acknowledge that Biden has won the election, potentially angering President Trump, who has falsely claimed that he won the election and was the victim of widespread voter fraud. If Democrats don’t win two runoff Senate contests in Georgia next month, Senate Republicans will potentially have the power to block any Biden Cabinet pick, assuming all Republicans vote together. Sen. Mitch McConnell (R-Ky.), if he remains majority leader, would be able to block a nomination from coming up for a vote at all. Several Senate Republicans have said Biden should have a right to a Cabinet of his choice, signaling that they would not reject every nominee out of hand. But others may feel pressure to oppose some picks to avoid looking like they are too compliant with the Biden administration. HHS stands to be one of the more difficult Cabinet posts to get through a GOP-controlled Senate, given the sharp ideological divides between Democrats and Republicans on issues under the agency’s portfolio, including the Affordable Care Act, care for immigrants and several programs that touch on abortion rights. But there are bipartisan factors working in Becerra’s favor, including the need to quickly have people in place to deal with the COVID-19 pandemic and rollout of a vaccine. Democrats would frame any attempt to stall Becerra’s nomination as a move to block the vaccine distribution. Becerra also served in the House with several Senate Republicans who will now vote on his confirmation, including Sens. Roy Blunt (R-Mo.) and Todd Young (R-Ind.). Those relationships may prove helpful to Becerra. Democrats have rallied around Becerra’s appointment, arguing that his experience as attorney general and member of Congress — including on one of the House committees that deals with healthcare — have left him well-prepared to handle the mammoth agency. Becerra would also be the first Latino to serve at HHS and among the highest-profile Latinos to get an appointment in the new administration so far. “Xavier Becerra is a highly qualified nominee,” said Sen. Patty Murray (D-Wash.), the top Democrat on one of two Senate committees that would oversee Becerra’s nomination. “I will be pushing for a swift, fair confirmation so we can get to work on the serious health issues our nation faces including not just the current threat of COVID-19, but also long-standing challenges like making sure healthcare is a right — not a privilege — for all Americans, lowering healthcare costs, addressing the systemic racism that is hurting communities of color across the country, and so much more.” In addition to his work enacting the healthcare law while he was in Congress, as state attorney general Becerra has led the effort to defend the healthcare law in the courts, including the case brought by Republican attorneys general who hope to strike the law. The Supreme Court heard oral arguments in the case last month. Becerra was part of the effort to defend the ACA’s requirement that nearly all employers provide birth control coverage in their employee health plans. The challenge was filed by the Little Sisters of the Poor religious order of nuns and has been a galvanizing point for conservatives. Becerra has also defended California’s requirement that antiabortion crisis pregnancy centers tell patients that abortion is a covered service in the state. The Supreme Court overturned it in 2018.
Picking a top law enforcement official to be the next secretary of Health and Human Services may not seem to make much sense. But Xavier Becerra is not your typical state attorney general. In announcing Monday that he intended to nominate Becerra to join his Cabinet , President-elect Joe Biden highlighted the California attorney general’s experience as a lawmaker who helped craft the Affordable Care Act and as a lawyer who fiercely defended it in court from Republican attacks. Here are five things to know about Becerra, a Los Angeles native, and why Biden believes he would be the best person to lead the $1.4-trillion, 80,000-employee department that is overseeing the nation’s response to the COVID-19 pandemic. 1. Becerra is a historic choice If confirmed, the 62-year-old Becerra would make history as the first Latino to hold the position. Biden has promised to have the most diverse Cabinet and White House staff in history. Becerra would be the second Latino tapped to hold such a top job in the Biden administration. Last month, Biden announced that he intended to nominate Alejandro Mayorkas, who grew up in Los Angeles, to lead the Department of Homeland Security. Becerra, who is fluent in Spanish, is the son of Mexican immigrants and was the first member of his family to attend college, earning a bachelor’s degree in economics from Stanford University and a law degree from Stanford Law School. Becerra’s mother was born in Jalisco, Mexico, and immigrated to the United States after marrying his father, who was born in Sacramento and raised in Tijuana.   2. He has legislative experience In 1992, Becerra won a seat in Congress and spent the next 24 years representing downtown Los Angeles, becoming the first Latino to sit on the Ways and Means Committee and to chair the House Democratic Caucus. He played an important role in helping pass the 2010 healthcare law, often called Obamacare, working alongside House Speaker Nancy Pelosi (D-San Francisco) to shepherd the bill through the House. Such experience could prove helpful as he pushes for Biden administration proposals on Capitol Hill. California As Newsom mulls over a U.S. Senate pick, Latino lawmakers and activists say it’s their time California As Newsom mulls over a U.S. Senate pick, Latino lawmakers and activists say it’s their time Newsom, who has not said when he’ll make an announcement on Vice President-elect Kamala Harris’ Senate successor, is facing an onslaught of competing pressures over what is perhaps one of the most pivotal and politically consequential decisions he will make during his first two years in office.  More Coverage  3. Becerra has fought hard to protect the law Becerra was tapped by then-Gov. Jerry Brown in 2017 to become California’s attorney general, filling the spot vacated by Kamala Harris, who had just won the Senate seat vacated after Barbara Boxer retired. Harris is now the vice president-elect. Since taking over as attorney general, Becerra has become a national leader in the legal battle to defend Obamacare. In particular, he led the charge against a lawsuit brought by Texas and other Republican-led states seeking to jettison the entire law. The Supreme Court heard oral arguments in the case last month, though justices appeared to signal they were not in favor of tossing the statute. Shortly after the hearing, Becerra issued a tweet that could have come from the Biden campaign: “The ACA saves lives. It is the law of the land. It is legal. We are confident the Supreme Court will agree.” 4. Becerra isn’t afraid to fight Becerra has actively resisted President Trump’s policies and has sued the administration more than 100 times since his appointment as the state’s top law enforcement officer. In addition to defending the Affordable Care Act, Becerra has filed legal broadsides against the Trump administration seeking to reverse policies such as the construction of the border wall and requiring a citizenship question on the U.S. census. Other lawsuits against the Trump administration have focused on gun control, consumer protection, the U.S. Postal Service and immigration. The overarching theme of the litigation barrage has been Becerra’s belief that the president has repeatedly overstepped his authority to change federal policies in a manner that harms California and its residents. “I am surprised that any president in any administration would at least 100 times be caught red-handed violating the law,” Becerra said in an interview with The Times in August when he reached the 100-lawsuit mark. “I am not surprised we have had to sue, because we have to protect our people, our resources and our values, and we use the rule of law to do that.” 5. Biden doesn’t see Becerra’s lack of direct healthcare experience as negative Becerra is sure to be pounded by Republican senators over his lack of healthcare experience. But Biden doesn’t see such a resume item as a requirement. As Times reporters Noam N. Levey, Evan Halper and Patrick McGreevy noted , the transition team also viewed Becerra as particularly well-qualified, in part, because he already runs a complicated department in California. Peter Lee, who heads California’s insurance marketplace, Covered California, told The Times that Becerra was the right fit because he was “a thoughtful, strategic leader who gets the importance of not only expanding healthcare coverage, but also addressing high costs for patients.”
President-elect Joe Biden has tapped California Atty. Gen.  Xavier Becerra to be the next Health and Human Services secretary, a historic choice that would make the former Los Angeles congressman the first Latino to hold the office, according to sources familiar with the decision. Becerra, 62, a rising star in California politics, has become one of the most important defenders of the Affordable Care Act, leading the fight to preserve the landmark law against efforts by the Trump administration and conservative states to persuade federal courts to repeal it. Becerra also has carved out an increasingly important role confronting healthcare costs, using his position to challenge pricing practices at Sutter Health, one of California’s most powerful medical systems. And he has become a leading champion of reproductive health, going to court repeatedly to challenge Trump administration efforts to scale back women’s access to abortion services and contraceptive coverage. Latino advocacy groups, including the Congressional Hispanic Caucus, have been pushing Biden to pick a Latino to fill a prominent Cabinet position. Many had advocated for Becerra, though New Mexico Gov. Michelle Lujan Grisham was considered a front-runner for HHS for some time. News of Becerra’s selection drew swift praise from politicians, healthcare leaders and patient advocates. “This pandemic has brought a glaring light to the health inequities in our country. … Having an individual who not only has outstanding qualifications, but also understands the needs of minority communities is imperative as our country moves forward in its fight against the pandemic,” Rep. Filemon Vela (D-Texas) said in a statement. Peter Lee, who heads California’s insurance marketplace, Covered California, lauded Becerra’s work in Congress and as attorney general to defend access to affordable medical care.  “It’s a great choice,” Lee said. “He is a thoughtful, strategic leader who gets the importance of not only expanding healthcare coverage, but also addressing high costs for patients.” Becerra’s selection drew criticism from Susan B. Anthony List head Marjorie Dannenfelser, a leading abortion opponent, who labeled the California attorney general “an extremist on abortion.” California As Newsom mulls over a U.S. Senate pick, Latino lawmakers and activists say it’s their time California As Newsom mulls over a U.S. Senate pick, Latino lawmakers and activists say it’s their time Newsom, who has not said when he’ll make an announcement on Vice President-elect Kamala Harris’ Senate successor, is facing an onslaught of competing pressures over what is perhaps one of the most pivotal and politically consequential decisions he will make during his first two years in office.  More Coverage As a congressman, Becerra played an important role in helping pass the 2010 healthcare law, often called Obamacare, working alongside House Speaker Nancy Pelosi (D-San Francisco) to shepherd the bill through the House. Becerra, who is fluent in Spanish, served 12 terms in Congress and was chair of the House Democratic Caucus before Gov. Jerry Brown picked him to be California’s attorney general. Becerra replaced Kamala Harris, who had won a Senate seat. The son of Mexican immigrants, Becerra was the first member of his family to attend college, earning a bachelor’s degree in economics from Stanford University and a law degree from Stanford Law School. Becerra’s mother was born in Jalisco, Mexico and immigrated to the United States after marrying his father, who was born in Sacramento and raised in Tijuana. Becerra has recounted how his father started out picking vegetables in the fields. “He got treated like he wasn’t a citizen,” Becerra recalled in 2017. “He couldn’t walk into restaurants because the sign said ‘No dogs or Mexicans allowed.’ He harvested the food that they were eating in those restaurants, but he could not go in there and eat.” Becerra said he learned his strong work ethic as a teenager  laboring alongside his father on construction jobs in Sacramento. Elected to a two-year term in the state Assembly and then to the House in 1992, he rose through the ranks to become the highest-ranking Latino in Congress at the time. The Becerra choice came as Biden faced pressure to add more Latinos to his Cabinet beyond Homeland Security secretary nominee Alejandro Mayorkas. There was considerable chatter about bringing Becerra on as U.S. attorney general, but the transition team also viewed Becerra as particularly well qualified to head the Health and Human Services Department, according to a person familiar with the process. Becerra already runs a sprawling, complicated bureaucracy in California. He has been a national leader in multistate efforts to preserve the Affordable Care Act. And he enlisted GOP attorneys general in  legal efforts to take on opioid makers, tobacco companies and pharmaceutical firms, showing an ability to work across the aisle that Biden values. While Becerra has been a proponent of “Medicare for all,” he is not expected to pursue that goal in the role of HHS chief, championing instead Biden’s plan to expand and strengthen the 2010 healthcare law with a so-called public option. The person familiar with the process said Biden also sees in Becerra’s personal history similarities to his own: working-class roots, parents who instilled  the dignity of work and a decades-long commitment to public service. If confirmed, Becerra will take the helm of a sprawling federal agency that spends more than $1.4 trillion annually and is responsible for the health coverage of more than 100 million Americans, mostly through the mammoth government Medicare and Medicaid plans. The health secretary also oversees the Food and Drug Administration and the Centers for Disease Control and Prevention, two of the agencies at the forefront of the federal response to the COVID-19 pandemic. Both agencies, though once considered international models, have been widely criticized for their response. They have also suffered serious blows to their credibility as Trump and his allies have pressured agency  leaders to change guidance to fit the White House political agenda. One of the new health secretary’s main jobs will be rebuilding public trust in these agencies, a goal that Biden has indicated will be a top priority for his administration. The president-elect announced last week that he would ask Dr. Anthony Fauci, the nation’s top infectious disease expert, to be his chief medical advisor,  restoring Fauci to a position of influence in the White House after Trump and his allies sidelined the longtime head of the National Institute of Allergy and Infectious Diseases. Biden is also expected next week to tap Dr. Vivek Murthy to be surgeon general, another important addition to the COVID response effort. Murthy, who has been helping lead Biden’s coronavirus planning effort, is viewed as a gifted healthcare communicator and champion of public health. He served for nearly 2 ½ years as surgeon general, mostly under President Obama. The son of immigrants from India, Murthy graduated from Yale Medical School. Murthy also has a business degree and a background in politics, having founded Doctors for America, an advocacy organization that supported Obama’s push to pass the Affordable Care Act in 2010. In addition to strengthening the federal coronavirus response, Becerra will likely be called upon to reverse the Trump administration‘s years-long campaign to weaken insurance rules and other protections enacted through the 2010 healthcare law. Trump and his lieutenants — including current Health and Human Services Secretary Alex Azar and Seema Verma, who heads the Centers for Medicare and Medicaid Services — failed to repeal the healthcare law. But the administration issued rules to allow broader sale of health insurance plans that don’t cover basic benefits and can turn away people with preexisting medical conditions. Times staff writer Sarah Wire contributed to this report.
“There is no pandemic.” The words from the white-haired pastor echoed inside the cavernous megachurch in Los Angeles. It was Aug. 30, only 18 days after L.A. County public health officials had demanded that Grace Community Church stop holding indoor services. But the pastor, 81-year-old John MacArthur, had kept the doors open, delivering defiance from his pulpit every Sunday. County health inspectors had tried to enter the church in previous weeks but were blocked by security guards. “We do not consent to a search or visit,” a security guard told the inspectors , reading from a prepared statement in early August. “This is a Jesus Life Matters protest.” If the inspectors had been allowed inside, they would have seen thousands of congregants sitting side by side, most without masks. California Coronavirus outbreak strikes L.A. megachurch that defied public health orders California Coronavirus outbreak strikes L.A. megachurch that defied public health orders Three cases have been confirmed at Grace Community Church in Sun Valley, which had defied orders from Los Angeles County public health officials and a judge to stop holding indoor services.  They hugged and sang hymns and shook hands and erupted in applause during MacArthur’s sermon. When the offering plate came around, the congregants gave $40,046 , almost six times more than the previous Sunday , according to the church bulletins.  This picture of worship in the time of the coronavirus has emerged as a seemingly intractable legal and emotional drama that turns on sharply differing visions of safe behavior during a pandemic. Most religious institutions have been following public health rules, turning to livestreams, outdoor services and drive-through events , but a handful have objected, arguing that the government doesn’t have the authority to restrict their prayer practices. Few churches have captured a bigger spotlight for their defiance than the megachurch in Sun Valley. The congregation has not only continued services but has also questioned the existence of the coronavirus. “There’s another virus loose in the world, and it’s the virus of deception,” MacArthur told the congregation in his Aug. 30 sermon. “And the one who’s behind the virus of deception is the arch deceiver Satan himself.” Throughout the summer, MacArthur repeatedly insisted no one from the church had contracted the coronavirus or been hospitalized with COVID-19. Yet congregants have indeed been stricken and hospitalized with COVID-19, according to MacArthur’s own account in a church interview in April. They included a young couple who were hospitalized and a visiting pastor who died of the disease shortly after attending a church conference in March. County health officials launched an outbreak investigation at the church in October after three other people contracted the coronavirus. Church officials in a statement released last month dismissed the investigation, saying it involves three part-time employees who have not been hospitalized. Three among 7,000 congregants is not an outbreak, they said, and they encouraged worshipers to keep attending services. “We are going to meet for worship this Sunday to celebrate the Lord’s Table together,” reads the statement. As of Sunday, the church had five confirmed cases. ` California Judge bars defiant Los Angeles megachurch from holding indoor services California Judge bars defiant Los Angeles megachurch from holding indoor services Grace Community Church in Los Angeles’ Sun Valley neighborhood draws thousands of worshipers, most of whom do not wear masks or socially distance.  The church and its magnetic leader, a descendant of pioneering pastors who preached to cowboy stars from a bygone Hollywood age, seem to revel in their contrarian role. When the county slapped a lawsuit against MacArthur and the church in mid-August , he quickly formed a legal team — including a senior legal adviser to President Trump’s reelection campaign — and kept holding services indoors. When a judge sided with health officials in mid-September and ordered the church not to meet indoors , MacArthur mocked the county’s health guidelines. And in a September appearance on "The Ingraham Angle” on Fox News, MacArthur seemingly dared authorities to throw him in jail . Grace Community Church’s attendance has not suffered, even as a third major wave of infections looms and outbreaks of the disease continue to be reported across the country, including an outbreak in Shasta County at an evangelical church’s ministry school . At times, Grace has been so crowded, people had to stand in the back, according to court records . MacArthur and church attorneys declined to respond to repeated requests for an interview. MacArthur, in the Fox News interview with host Laura Ingraham, stood his ground. “Our church is literally flooded with people. We have them in every nook and cranny jammed together,” he said , saying worshipers are attending “to hear the message of forgiveness and salvation in a time when fear is being propagated on every street.” Members of the church interviewed by The Times, most of whom declined to provide their full names because of privacy concerns, gave a wide range of reasons for agreeing with the church’s stance. Lance, 22, a Santa Clarita resident, said “it’s not that dangerous for someone like me,” referring to the lower, but sometimes serious, health risks the virus seems to pose to young people .  California coronavirus cases: Tracking the outbreak California coronavirus cases: Tracking the outbreak The latest maps and charts on the spread of COVID-19 in California.  A 33-year member wearing a surgical mask outside the church said that God knows when his believers will die and that they should not fear death. “When we breathe our last breath, and we aren’t right with God, nothing else matters,” said the woman. Outside the church walls, however, neighbors plead with congregants to consider the health implications for the largely Latino neighborhood. Many of the unmasked congregants park on nearby streets, worrying some residents so much that they fear coming out of their homes on Sunday mornings. Aurora Perez, a 50-year-old marketing professional who lives nearby, expresses her own interpretation of the Bible on the sign she holds outside the church each Sunday on Roscoe Boulevard. “Love thy neighbor, Matthew 22:39,” reads the sign. “And wear a mask.” Perez has light red spots across her body — scarring from COVID-19, a testimony to her own brush with the disease. :: MacArthur’s religious roots run deep in L.A. His father, Jack, drew throngs of worshipers while pastoring at Fountain Avenue Baptist Church in Hollywood, once erecting a giant tent on Santa Monica Boulevard for an event that featured celebrity believers like singer Roy Rogers and actress Dale Evans. John MacArthur, after taking over Grace Community Church in 1969, eventually became one of the most successful evangelical preachers in the country, with a congregation estimated at about 7,000. An author of almost 400 books and study guides, he has a radio program that broadcasts across the world. MacArthur, a former college athlete , avoids flashy services that he derides as showtime religion . Members consider him an approachable pastor and call him “John” or “J-Mac.” They are drawn to his preaching style, which espouses a literal interpretation of Scripture. Along with Christian parables come harsh judgments. MacArthur has called Catholicism a “false religion,” compared the “prosperity gospel” preaching of televangelist Joel Osteen to a spiritual Ponzi scheme and recently called Black Lives Matter “ an organization designed by Satan ” because of its support of LGBTQ equality. His initial stance on the pandemic was hardly controversial. In March, when the coronavirus outbreak struck, MacArthur complied fully with health orders requiring churches to close, telling his congregation that Christians should live peacefully under the government. Defiance of safety measures is a “foolish” thing to do, he said, that makes “Christianity look anything but loving.” “This is government law for the greater good of the population,” MacArthur said in a March 28 interview with a Grace staff pastor. But within one month, his views began to change. Soon, he was echoing the same arguments and hyperbole that Trump and conservative media have spread about the pandemic — that the mainstream media have overhyped the pandemic; that not that many people have died and the data are wrong , and those who did succumb actually died from other illnesses ; that it’s really just the flu — and saying it’s all the government’s ploy to control Christians. But in other settings, he said otherwise. In late April during an interview with a church elder, MacArthur said that a young couple in the Spanish-language ministry had contracted the coronavirus and wound up in a hospital. “It was such a virulent experience for them,” he said . In the same interview, he said that a 90-year-old Russian pastor who attended the church’s annual Shepherds’ Conference in March, which drew 3,500 men from around the world, became infected. Alexey I. Kolomiytsev, a pastor emeritus at a Battle Ground, Wash., church, died of complications from COVID-19 two weeks after attending the conference, according to his son’s online memorial message . MacArthur said in the April interview that the Russian pastor is the “only person that we know of that came out of the Shepherds’ Conference and had that virus and ultimately died.” But another man from the Washington church who attended the conference with Kolomiytsev, 77-year-old Vladimir Dyachenko, developed symptoms in early March and died of COVID-19 on April 1, according to a GoFundMe page by his family and news reports by Slavic Sacramento , a daily Russian-language news site in California. A third person from the Washington church, Associate Pastor Sergey Yelchaninov, also came down with COVID-19 and was hospitalized about a week after Kolomiytsev died, his family told a local ABC affiliate . He was hospitalized for 49 days and made a remarkable recovery . He did not attend the conference, his daughter said. News of more infections at a church-associated organization came in October. The Master’s University, where many of the church’s pastors serve as professors and support staff, reported three students had tested positive for the coronavirus, said university spokesman Corey Williams. As the pandemic spread across the county in midsummer, MacArthur began reopening the church doors. He said he had to because people just started showing up on Sundays. By July 12, at least dozens of people were inside the church awaiting that day’s sermon, according to social media posts from the day. Two weeks later, the church made its stance official, saying Jesus would want the church to reopen: “Christ, not Caesar, Is Head of the Church,” MacArthur and church elders said in a statement on the church’s website. The church provides masks and hand sanitizer outside the entrances and cleans worship spaces, a church member said, but no one’s temperature is taken and people are not screened for symptoms. County officials appear to be weighing their options. Although L.A. Mayor Eric Garcetti ordered power be shut off at a Hollywood Hills home hosting large parties, it remains unclear whether the church will face similar sanctions. At the next court hearing Friday, the county is asking a judge to find the church in contempt, which could lead to fines. The church is an outlier in the region, according to county officials. Most other houses of worship have complied with health orders, including more than 100 that asked for help in organizing outdoor religious services, they said. The church’s attorneys have argued that it’s MacArthur and Grace Community Church’s constitutional right to freely exercise their religion and that a key part of doing that is meeting in person, most practically indoors, given heat waves and smoke from fires. They also cite the complications of organizing a large enough space to accommodate the 3,000-plus believers who usually attend each Sunday service. “Our position has been that L.A. County shutting down churches indefinitely amid a virus with a 99.98% survival rate, especially when state-preferred businesses are open and protests are held without restriction, is unconstitutional and harmful to the free exercise of religion,” said Jenna Ellis, a senior legal advisor to Trump’s reelection campaign. The Sunday services don’t draw just congregants. In recent weeks, residents of the surrounding neighborhood have protested along Roscoe Boulevard. They place fliers on cars, wave signs and, at times, debate with congregants about the wisdom of worshiping without safeguards in the time of pandemic. Perez, the Sun Valley resident who has spent about $600 on these fliers and signs, said her protest is personal. She contracted COVID-19 probably while delivering food to a sick family member who works at a hospital. Months later, she has small round scars on her body, a lasting effect from the rash that the virus can cause. As congregants stream out of church, Perez tries to strike up dialogues. She thanks anyone wearing a mask, but they are far outnumbered by people who don’t. “Masks doesn’t work,” a woman in a pink Gucci T-shirt, holding two Pomeranians and a cup of coffee, told Perez on a recent Sunday. Perez’s husband, Felix, recording the encounter, disagreed. “It’s about doing the right thing,” he said. “But he said it’s fake,” said the woman, referring to MacArthur’s opinion of the pandemic. Not all church members agree with MacArthur. One member said his experience working in the healthcare industry conflicts with the pastor’s views. He said he has watched co-workers get sick from the virus and have panic attacks or pass out from exhaustion. At the height of the pandemic, he said, about four patients died in every 12-hour shift he worked. Jesus, the man said, would focus on helping the sick, not deny the existence of the pandemic. “I have people ask me every day, ‘Am I going to die?’ And [MacArthur] is saying, ‘Everybody meet in here, no problem,’” he said. “It’s like I live in two different worlds.” Times staff writer Leila Miller contributed to this report.
Soldiers triaging patients in parking lots in a capital city is normally the stuff of science fiction. Yet that’s the reality in Boise, Idaho, where troops direct people outside an urgent care clinic revamped into a facility for coronavirus patients as infections and deaths surge in Idaho and nationwide. Inside Primary Health Medical Group’s clinic, physician assistant Nicole Thomas works extra 12-hour shifts to help out. She dons goggles, an N-95 mask, a surgical mask over that, gloves and a body covering to examine 36 patients a day exhibiting possible COVID-19 symptoms. Some days, she says, half of them test positive. “I’ve had patients crying in the car because they think they’re going to die,” Thomas said last week, resting against a desk between patients. “There are some people that it’s just a mild cold, and there are some people in the ICU on life support. We don’t know, medicine-wise, how it’s going to affect them.”  California Garcetti says economy reopened too quickly, warns of new stay-at-home order California Garcetti says economy reopened too quickly, warns of new stay-at-home order L.A. Mayor Garcetti says the city is “on the brink” of new restrictions, but he also says he’d prefer more targeted interventions to stopping the coronavirus.  More Coverage What was once a facility with family practice doctors and an urgent care unit that treated things like cuts and colds has become a COVID-19 clinic, showing how a crush of coronavirus patients is straining intertwined healthcare systems. In a conservative state where many are resisting pandemic restrictions, overworked staff are getting sick themselves or quitting to avoid the stress. Idaho’s attempt to hold the virus in check is failing, health officials say. Just over 1,000 people have died from COVID-19 so far, about four to five times the number of annual deaths from flu and pneumonia. Confirmed infections have surpassed 100,000. Elective surgeries have been mostly halted to conserve bed space and staff. COVID-19 patients with mild symptoms have been sent home with monitoring devices to care for themselves. After Thanksgiving gatherings, officials fear a surge of infections that could force difficult choices about what to do with patients when room and staff to treat them run out.  “When would we reach absolute capacity? I just don’t know. But we’re nervous,” said Barton Hill, vice president of St. Luke’s Health System, which has hospitals in southwestern and central Idaho. “I never dreamed that we would be challenged like this,” Steve Judy, chief operating officer of Primary Health Medical Group, said as he visited the clinic where Thomas works. He was interrupted by a young woman there for a COVID-19 test who wandered out of an exam area, looking confused. She had had blood drawn and wasn’t sure where she was supposed to be, she said through her mask, eyes glazed. Judy gently led her past a row of workers taking phone calls and back to the exam area. The clinic bustled with workers, supporting Thomas and two other physician assistants as they examined patients. Combined, they see nearly 110 people a day, ordering chest X-rays and blood tests to make diagnoses. Seventy others without symptoms get drive-through COVID-19 tests in the parking lot every day. Primary Health’s 20 clinics in southwestern Idaho normally have an urgent care unit on one side and family practice doctors on the other. Eight have been transformed into facilities that see only COVID-19 patients. It’s taking sick people at least two days to get an appointment for a test. Primary Health will turn three more facilities into COVID-19 clinics by Dec. 30 and has plans to change over more if needed. “We’re at the maximum,” said Dr. David Peterman, a pediatrician and chief executive of Primary Health Medical Group. “We are so close to rationing care here. We are probably 10 to 15 days away.” About 20% of his staffers are out because they’re isolating or have tested positive for the virus. Judy said he’s trying to fill 50 openings after workers couldn’t take the stress anymore and quit. He’s increased front office pay by $2.50, to $14 an hour. Calls to the clinics have increased from 30,000 a month before the pandemic to 80,000 now. The Boise clinic has a half-dozen workers taking calls. When they’re not on the phone, they package test kits. “We’re working them hard,” said Judy, who worries about his staff. “They’re almost all pulling overtime.” At St. Luke’s hospital system, increasing numbers of workers are out because of COVID-19, officials said. Besides canceling elective surgeries, the hospitals tried to save bed space by sending 160 patients — 140 with COVID-19 — home with devices to measure the oxygen levels in their blood. Now, hospitals are planning what to do if there aren’t enough workers or beds available in an entire region. Healthcare workers would have to choose who gets treatment and who doesn’t. “That’s really when we’re at risk for what’s called the ‘crisis standards,’” said Hill, noting that the state would decide when to institute them. “We’re very concerned in the next two weeks.” Idaho’s crisis plan divides the sick into categories, prioritizing those with life-threatening illnesses or injuries who are expected to survive and giving only comfort care to those who aren’t. Rural areas generally avoided large numbers of COVID-19 infections for months, but now they’re widespread. Recently, a surge of infections in southern Idaho filled hospital beds and forced some patients to be transferred to the Boise area. When people started getting sick in March, Republican Gov. Brad Little issued a stay-at-home order that lasted just over a month and stopped the virus’ spread. But unemployment skyrocketed from under 3% to nearly 12%. Restrictions gradually were lifted, but as infections and deaths surged again, Little reinstated some rules last month, including limiting gatherings to 10 or fewer people. He also activated 100 National Guard troops to free up medical workers, getting them trained on mobile testing support, facility decontamination and COVID-19 screenings. Nickolas Orr was one of two soldiers meeting patients in their cars outside the Primary Health clinic. “Some people do seem a little nervous,” he said. While Little was among the first governors to publicly wear a mask last spring, he’s declined to issue a statewide mandate, saying more people will wear them if it’s a choice. There’s plenty of resistance. About 64% of Idaho voters supported President Trump, who has been dismissive of mask wearing and ridiculed President-elect Joe Biden for wearing one during the campaign. Some sheriffs say they won’t enforce mask requirements. A lawmaker has compared Little to Hitler for issuing pandemic restrictions. The Republican-dominated Legislature plans legislation next month limiting the governor’s ability to declare emergencies. And in Boise, which has a mask mandate, protesters recently went into stores and restaurants without face coverings to complain that their rights were being violated. Meanwhile, inside the Primary Health clinic, Thomas, the physician assistant, put on sterilized protective equipment as workers sanitized an exam room before seeing the next patient. The clinic no longer has time to call everyone who tests positive for COVID-19. Most get a text message. Only those in high-risk groups with the greatest chance of dying get a phone call, that human voice. “Not infecting others is kind of the name of the game right now,” Thomas said. But she doesn’t have a lot of hope. “I think we are going to get busier and busier.”
Orange County officials have for weeks strived to advance through the state’s color-coded reopening system — which ties reductions in new coronavirus cases and positivity rates to eased restrictions — from the red tier, or “substantial” risk, to the orange, or “moderate” risk, and one step closer to economic recovery. But as the county entered its 60th day in the red tier Friday, and with the number of new infections and COVID-19 hospitalizations continuing to rise, civic focus has shifted to keeping the county from sliding back into the most restrictive tier, purple, or “widespread” risk, and the additional closures that would come with that classification. Michelle Steel, chairwoman of the Orange County Board of Supervisors, recently acknowledged the importance of keeping the county from following the lead of neighboring Imperial and San Diego, which were booted back to purple earlier this week. “While Orange County remains firmly in the red tier, it is important that we continue this trend,” Steel said in a media briefing Thursday. “We have made a lot of progress as a county and continue to have stable numbers, and I am hopeful we can continue to do so.”  With the holidays and the lure of social gatherings approaching, and as COVID-19 fatigue begins to take hold eight months into the pandemic, Orange County Health Care Agency Medical Director Matt Zahn urged residents to remain vigilant. “We’re all aware the holiday season is rapidly coming upon us,” he said. “We all think of family gatherings, social gatherings, work gatherings. Unfortunately, you just have to think about those sorts of events differently, because there really is a risk there.” News Huntington Beach Union High School District reopens campuses, as Newport-Mesa Unified preps for Monday return News Huntington Beach Union High School District reopens campuses, as Newport-Mesa Unified preps for Monday return Even as Orange County COVID-19 cases rise, middle and high schools hope to provide students some normalcy. Newport-Mesa Unified, where 22 cases have been confirmed, will reopen secondary schools Monday.   The agency on Friday recorded 309 new cases of coronavirus and nine deaths, bringing Orange County’s cumulative case count to 61,421 and its fatality rate to 1,503. Area hospitals reported that they were treating 177 individuals for COVID-19, including 72 in intensive care units. The county’s seven-day average of new cases rose this week to six per 100,000 residents, while the average health equity quartile positivity rate decreased slightly, to 5.7%. Those figures would need to drop to 3.9 and 5.2%, respectively, for Orange County to be able to reopen more business sectors. But should new cases increase to seven per 100,000, the county could be subject to even greater restrictions.  Here are the latest cumulative coronavirus case counts and COVID-19 deaths for select cities in Orange County:  Here are the county’s counts by age group: Cardine writes for Times Community News.
When Yekaterina Kobzeva, a nurse at a preschool in Russia’s Ural Mountains, began having trouble breathing, she called an ambulance. It was four days before she managed to find a free hospital bed. The ambulance first took her to get a scan — which showed damage from pneumonia to 50% of her lungs, an indication she had the coronavirus. The paramedics then drove her around the city of Perm and its surroundings for hours as seven hospitals, one by one, turned her down, saying they didn’t have any beds available. At dawn, she went home. The journey took her through “circles of hell,” Kobzeva, 60, recalled in an interview with the Associated Press by phone from a hospital, where doctors confirmed she had the virus. She was only admitted there days after her first attempt — and after her story made local headlines. Russia’s healthcare system, vast yet underfunded, has been under significant strains in recent weeks, as the pandemic surges again and daily infections and virus death regularly break records. Across the country, 81% of hospital beds that have been set aside for coronavirus patients were full as of Wednesday. Three times last week, the Russian government reported a record number of daily deaths, and the number of daily new infections per 100,000 people has more than doubled since Oct. 1, from 6 to more than 15. Overall, Russia has recorded more than 2 million cases and more than 35,000 deaths, but experts say all numbers worldwide understate the true toll of the pandemic. World & Nation Russia says its COVID-19 vaccine is looking 92% effective, but skeptics wonder World & Nation Russia says its COVID-19 vaccine is looking 92% effective, but skeptics wonder Developers of Sputnik V, Russia’s experimental COVID-19 vaccine, say early data suggest that it is 92% effective, but skeptics raise questions.  Reports in Russian media have painted a bleak picture in recent weeks. Hospital corridors are filled with patients on gurneys and even the floor. Bodies in black plastic bags were seen piling up on the floors of a morgue. Long lines of ambulances wait at hospitals while pharmacies put up signs listing the drugs they no longer have in stock. Russian authorities have acknowledged problems in the health system. President Vladimir Putin even urged regional officials not to paper over the situation, saying that “feigning the impression that everything is perfectly normal is absolutely unacceptable.”  Yet Russian authorities continue to insist there’s no need for a nationwide lockdown or widespread closures of businesses, instead urging people to observe the measures ordered by regional governments. But in most regions, those measures don’t go beyond mask mandates, limiting the hours of bars and restaurants, ordering older people to self-isolate, forbidding mass public events and requiring employers to have some staff work from home. Health experts say the moves are clearly not enough. Paramedic Dmitry Seryogin says Kobzeva’s experience is not unusual. In the southwestern Oryol region where he works, patients can wait for up to 12 hours for an ambulance and then might spend five more in it, looking for a hospital bed. Those who happen to arrive when others are being discharged get lucky, he told the AP, but the rest are sent home. While the Perm region, where Kobzeva sought treatment, was among the top 20 of more than 80 Russian regions in terms of daily new infections last week, Oryol ranked somewhere in the middle. Still, 95% of hospital beds slated for coronavirus patients there were full last week, reflecting the pressure on a system crippled by widely criticized reforms that sought to cut state spending. “We’re witnessing simply a collapse of the healthcare system in the region,” Seryogin said. “It is absolutely not coping.” A partial six-week coronavirus lockdown in March only added to long-brewing public frustrations over Russia’s already weakened economy. Soon after that, Putin delegated the powers to impose virus-related restrictions to regional governors. Critics saw the move as an effort to protect himself from any more fallout over the pandemic. World & Nation FDA allows emergency use of antibody drug Trump received World & Nation FDA allows emergency use of antibody drug Trump received U.S. health officials have allowed emergency use of a Regeneron antibody drug to help the immune system fight COVID-19.  During the fall resurgence of the virus, the Kremlin has consistently pointed fingers at regional governors. “Colleagues, you have received broad powers for implementing anti-pandemic measures. And nobody has relieved you of personal responsibility for the adopted measures — I really do hope that they were adopted on time,” Putin reminded the governors last week. But just like the Kremlin, governments in the vast majority of Russian regions have been loath to shut businesses or impose lockdowns. The only exception has been the Siberian republic of Buryatia, where last week the region’s governor ordered cafes, restaurants, bars, malls, cinemas, beauty parlors and saunas to shut down for two weeks. Regional governors find themselves in an impossible position, explained political analyst Abbas Gallyamov. They face public frustration if they don’t impose tough restrictions and the outbreak continues to rage, and they face it if they do because they don’t have the funds to ease the pain of closures. “All the finances have been long centralized, and the regions don’t have spare money,” Gallyamov said. “So de jure, a governor’s hands are untied, but de facto they’re still tied because they don’t have the money to impose a lockdown and compensate people for their financial losses.” In addition, Putin has so thoroughly centralized power that regional governors are not used to acting independently, noted Judy Twigg, a professor of political science at Virginia Commonwealth University, specializing in global health. In the meantime, many Russian regions are buckling under the growing tide of patients. In Buryatia, the Siberian republic that has imposed the country’s strictest measures, Dr. Tatyana Symbelova told the AP that as the number of patients rose, her hospital kept adding beds — “in the corridor, in the outpatient ward next door” — but “the situation, still, grew worse and worse.” Symbelova, the chief doctor at Republican Infectious Disease Hospital in Ulan-Ude, and her colleagues are now taking patients whose condition was “severe or of moderate severity” and turning down those with milder cases. A new coronavirus ward with 180 beds opened last week in the city, and she hopes that and the shutdown will help. But in the meantime, she is worried. “Such risks we’re taking! Telling patients [with milder cases] they can go and treat themselves at home, when they may come in three days later with their lips blue,” Symbelova said. “We’re very seriously choking.”
Los Angeles County supervisors have unanimously approved a program in which workers from certain sectors will form public health councils to help ensure that employers follow coronavirus safety guidelines — an effort to expand the county’s enforcement of health orders and address the pandemic’s toll on essential workers. The motion, which passed Tuesday morning, will pair councils in the food and apparel manufacturing, warehousing and storage, and restaurant sectors with third-party organizations that will educate workers on health orders and help them report violations. The board also directed the county to prepare an ordinance to protect workers from retaliation, responding to concerns that low-wage workers are often reluctant to express safety issues because they fear being fired. “Every worker has the right to feel safe in their workplace and to voice concerns without fear of losing their job,” Supervisor Mark Ridley-Thomas, who authored the motion with Supervisor Sheila Kuehl, said in a statement. “The Public Health Councils and proposed anti-retaliation ordinance will protect thousands of workers and provide the tools desperately needed to curb workplace infections during the pandemic.” The effort comes as the county experiences a new surge of infections at levels seen during the summer, with social gatherings a particular area of concern. Health officials announced at least 2,000 new infections every day from last Thursday through Sunday. Before the uptick, the last time the county had surpassed 2,000 daily cases without the data being inflated by a backlog was Aug. 15, according to The Times’ tracker. The plan to implement the public health councils, outlined in a Nov. 5 report to supervisors from Department of Public Health director Barbara Ferrer, takes into account concern expressed by business leaders by narrowing its initial focus to certain industry sectors. Within these areas, chosen largely based on workplace outbreak data, the county may prioritize outreach to businesses in geographic regions with high case counts, as well as to those with histories of violations. Third-party organizations, such as nonprofits and unions, will be certified by the county to train councils on coronavirus health protocols. Employers are encouraged but not required to pay workers for their time participating on the councils, to allow councils to meet on-site and to help third party organizations reach out to interested workers, according to the motion. The program will have a year-long budget projected at about $5 million.  Labor groups applauded the idea but said it should be applied more broadly across industries. The motion faced sharp opposition from business leaders, who said it would unnecessarily burden employers already struggling to overcome the pandemic. Rob Nothoff, policy director for the L.A. County Federation of Labor, called the public health councils “a great step forward” that he wants to see applied in the grocery store sector as well. “When workers are engaged, the public is safer,” he said. “Workers are at the front line to understand and to see what’s being followed and solutions to better address it. When they have a hand in shaping that process and participating in that process, we’re all better off.” He expressed concern that workers may be reluctant to participate if they have to do  so on their own time. “Our take is, you can pay a little now and a lot later,” he said. “We have seen immense economic pain because we are not able to move forward because our cases continue to go up.” Marissa Nuncio, director of the Garment Worker Center, said the public health councils are critical for the garment industry, which has seen one of the worst outbreaks among businesses in the county, and that the pandemic has exacerbated long-standing poor working conditions including cramped facilities and inadequate ventilation. “We need to see workers really engaged in what their rights are, because this is literally life and death,” she said. Some advocates have pointed to Overhill Farms, a frozen-foods processor in Vernon, as a model for how workers and employers can address safety issues together. The company, which was fined by the state for coronavirus health violations, formed a safety committee in which workers and company representatives have met weekly. Some of these workers have said they’ve seen progress in enforcement of social distancing and that they feel safer. “When workers are empowered, they can actually enforce the county health order,” said Rachel Torres, deputy political and civil rights director at United Food and Commercial Workers Local 770, which represents several hundred Overhill employees. “Now that they have this regular interaction with their employer, they can talk things through and make sure it’s working.” The motion has been opposed by the Los Angeles Area Chamber of Commerce, which has said it should not be broadly applied to industry sectors. In a Nov. 9 letter to Supervisor Kathryn Barger, the Los Angeles County Business Federation, known as BizFed, encouraged the county to defer the establishment of public health councils, stating that it has “chosen to apply a fundamentally flawed process to target business owners with increased County scrutiny and frequently changing regulations at the most challenging time.” It expressed concern about the proposed anti-retaliation ordinance, saying that efforts to pass another worker protection law are unnecessary, and requested that the county impose penalties for false claims of violations. Sarah Wiltfong, BizFed’s policy manager, said the public health councils should only be used as a remedial action. “We don’t know if they are necessary across the board, especially if the business is in compliance,” she said. “It seems to add several different layers to trying to get businesses in compliance as opposed to working with the Department of Public Health directly.” The Board of Supervisors directed the Department of Public Health to report back in six months on the initiative’s progress.
Here are Orange County’s winners and favorites for Best of TimesOC’s health and wellness categories. Kiromark / Marc E. Poli DC, QME 7940 Orangethorpe Ave., Buena Park 90621 Practicing for 30 years, Dr. Poli specializes in non-invasive chiropractic sports medicine and uses state-of-the-art Laser modalities. He is open six days a week, and is seen by appointment only due to limited availability. kiromark.com | 714.883.2693 Priestley Family Chiropractic 3 Corporate Plaza, Ste 200, Newport Beach 92660 Dr. Priestley provides care for families in Orange County who want natural and drug-free health solutions to address pain or improve overall wellness. We focus on allowing your body and brain to communicate, relieving pain and restoring your health. priestleychiropractic.com | 949.640.7030 Lander Chiropractic 1203 West Imperial Hwy., #100, Brea 92821 Our passion is to help patients achieve their health goals. We truly believe that self-care is health care and we strive to be a part of our patient’s wellness team. landerchiropractic.com | 714.626.0074 phone; 714.931.0475 text DiSiena Family Chiropractic Irvine, Nutrition and Brain Wellness 6 Venture, Ste. 115, Irvine 92618 A family practice established in 1984, we provide chiropractic care, functional nutrition, and brain wellness utilizing the latest technologies. We also are the home office for a non-profit called Buds Odyssey, offering free care to veterans and first responders. drdisiena.com | 949.559.6030 Lavinia K. Chong, M.D. Aesthetic & Plastic Surgery 1401 Avocado Ave., Ste. 803, Newport Beach 92660 Board-certified plastic surgeon Dr. Lavinia K. Chong specializes in facial rejuvenation (including face and neck lifts), breast surgery (reduction/augmentation/lift/exchange/explant), and tummy tucks. A vigorous COVID-19 policy is maintained and her private surgical suite is accredited by AAAASF (American Association for Accreditation of Ambulatory Surgery Facilities) to ensure patients receive the highest quality of care and safety. Virtual appointments available. chongmd.com | 949.644.1400 Newport Beach Dermatology and Plastic Surgery 1441 Avocado Ave., Ste. 702, Newport Beach, CA 92660 Newport Beach Dermatology and Plastic Surgery, located in the Fashion Island area of Newport Beach, prides itself on providing individualized comprehensive dermatologic care and plastic surgery to our patients. newportbeachdps.com | 949.706.7886 South Coast Plastic Surgery 4968 Booth Circle, Ste. 105, Irvine 92604 Perfectionists in the art of plastic surgery, we offer an array of aesthetic services to suit your needs. Our expert team focuses on creating results that appear fresh and natural at our state-of-the-art surgery center and medspa. socoplasticsurgery.com I 949.894.4772 Brian P. Dickinson, M.D. 351 Hospital Rd., Ste. 415, Newport Beach 92663 Dr. Dickinson’s practice is focused on rhinoplasty, facelift, nasal airway reconstruction, microsurgical breast reconstruction, oncoplastic reconstruction as well as primary and secondary aesthetic and reconstructive breast procedures. drbriandickinson.com | 949.612.8632 Mark Kramer, DDS, FICOI 1442 Irvine Blvd., #105, Tustin 92780 We are here to help you, not judge you. We treat our patients like family. Our practice is based on safety and predictability. Our decades of dental implant experience allow your dental treatment to be delivered in a comfortable manner, using the most modern technologies and materials, for an extremely reasonable fee. Call now for a free consultation. markkramerdds.com | 714.500.7194 Dr. Craig C. Thiede, DDS 13132 Newport Ave., #230, Tustin 92780 At SoCal Oral Maxillofacial Surgery, we believe in treating people, not cases. Dr. Craig Thiede uses modern technology and minimally invasive techniques to improve the success of procedures and create a positive patient experience. socaloralsurgery.com | 657.231.2880 California Implant Smiles 1920 17th St., #103, Santa Ana 92705 We separate ourselves from other cosmetic dentistry centers by providing our patients with the latest technology and an experienced team. This way, we address any doubts or questions you might have before arriving. californiaimplantsmiles.com | 949.732.1992 Dr. Sanford L. Ratner, DDS 1200 N Tustin Ave., #108, Santa Ana 92705 Dr. Ratner practices the full scope of oral and maxillo-facial surgery, including skeletal deformity correction, cleft surgery, temporo-mandibular joint surgery, facial reconstruction, trauma, as well as dento-alveolar procedures and dental implant placement. orangeoralsurgery.com/meet-us/meet-dr-ratner | 714.835.7771 Advanced Dental Care 3033 Bristol St., Ste. AA, Costa Mesa 92626 At Advanced Dental Care, we’re committed to the health and wellbeing of every patient. When you come to our office, you’ll always experience compassionate, personalized service that targets your specific needs. Dr. Jeremy Jorgenson and his team provide both general and specialized dentistry using minimally invasive, state-of-the-art tools and procedures for your comfort and convenience. Call or visit us online! mycostamesadentist.com | 714.424.9099 OC Healthy Smiles 2900 Bristol St., A205, Costa Mesa 92626 Unlike anything else, OC Healthy Smiles has created an environment around delivering your best possible dental experience. Conveniently open Monday-Saturday, our modern and high-tech office offers you truly one of a kind care. ochealthysmiles.com | 714.294.2229 Ford Dental Group 16511 Goldenwest St., #107, Huntington Beach 92647 Dr. Jonathan Ford creates an exceptional experience for all of his patients through his state-of-the-art family dental practice. His goal is to provide every patient the smile they have always wanted while keeping health and well-being a top priority. forddentalgroup.com | 714.842.7431 Laguna Hills Family Dentistry 24407 Calle De La Louisa, #200, Laguna Hills 92653 We foster patient relationships based on mutual trust, excellent customer service, and the best personalized patient care available. lagunahillsfamilydentistry.net | 949.588.7525 West Coast Pilates 1599 Superior Ave., Ste. A3, Costa Mesa 92627 West Coast Pilates is nestled between Costa Mesa and Newport Beach. Owner Carrie Gauden leaves no stone unturned when it comes to detail. It’s small group setting offers an experience of one-on-one training with state-of-the-art equipment. Specializing in Fascia, Athletic Conditioning and Rehab pilates, the studio is equipped with wall-to-wall accessories. West Coast Pilates is also a Merrithew Host Training Center. wcoastpilates.com | 949.382.5225 24 Hour Fitness 12647 Alcosta Blvd. #500, San Ramon 94583 At 24 Hour Fitness, we’re committed to creating a healthier, happier world with clean, spacious clubs, innovative technology and a team at the ready to support your every move. 24hourfitness.com | 800.432.6348 iHeartYoga 34485 Golden Lantern, Dana Point 92629 iHeartYoga is Orange County’s largest yoga community offering studio and outdoor yoga, Barre, and Sculpt classes with local health and wellness events and yoga retreats to Mexico. iheartyoga.org | 949.577.6634 West Coast School of The Arts 890 Baker St. #100, Costa Mesa 92626 West Coast School of the Arts provides specialized dance training for students of all ages in jazz, contemporary, ballet, tap, hip hop, tumbling and voice. We currently offer both virtual and outdoor classes. wcdance.com | 714.754.419 Best Hearing Aid Clinic Costco Hearing Aid Centers Multiple locations Costco Hearing Aid Centers offer Costco value pricing, premium technology and free perks like product demonstrations, follow-up appointments, hearing aid cleanings, check-ups and loss and damage protection, with multiple locations in Orange County to serve you. costco.com/hearing-aid-center.html Fullerton Hearing Center 1843 N. Euclid St., Fullerton 92835 Fullerton Hearing Center strives to improve patients’ lives through our healthy hearing practice. With many years of experience, our staff is well-educated and ready to provide exceptional care. fullertonhearing.com | 714.871.0632 Miracle-Ear Hearing Aid Centers Multiple locations Since 1948, we’ve strived to bring our customers leading-edge technology and hearing solutions that improve lives, relationships and communities. miracle-ear.com Shohet Ear Associates Medical Group, Inc. 446 Old Newport Blvd., Newport Beach 92663 Shohet Ear Associates provides comprehensive care for patients with medical ear conditions or hearing loss, and a range of hearing aids and implantable devices including cochlear implants, Esteem, and Earlens. eardoctor.org | 949.631.4327 Hoag Memorial Hospital Presbyterian 1 Hoag Dr., Newport Beach 92626 For nearly 70 years, Hoag has delivered a level of personalized care that is unsurpassed among Orange County. Hoag is one of the largest acute care hospitals in OC with two main hospital campuses in Newport Beach and Irvine, 13 urgent care centers and nine health centers. Hoag’s network of more than 1,700 physicians represent 52 different specialties. hoag.org | 800.400.HOAG CHOC Children’s 1201 W. La Veta, Orange 92868 CHOC’s pediatric healthcare system includes two hospitals, several primary and specialty care clinics, and many excellent clinical programs providing the highest levels of care for serious pediatric illnesses and injuries, both physical and mental. choc.org | 714.997.3000 St. Joseph Hospital 1100 Stewart Dr., Orange 92868 For over 90 years, St. Joseph Hospital has provided compassionate care at the forefront of medical innovation and triumph. It is nationally recognized for clinical excellence, family-centered care and a patient experience ranked in the country’s top 5%. providence.org/stjoseph | 714.771.8000 Mission Hospital 27700 Medical Center Rd., Mission Viejo 92691 and 31872 Coast Hwy., Laguna Beach 92651 Nationally recognized for excellence and ranked among the top 5% in the country, Mission Hospital delivers the best in personalized care and precision medicine. Mission cares for our community when they need us most. providence.org/mission | 949.364.1400 Best Medical Group Hoag Medical Group Multiple locations HMG is the multispecialty physician group most closely aligned with Hoag Hospital. HMG has specialties in internal medicine, family medicine, pediatrics, geriatrics, rheumatology, allergy and immunology, endocrinology, sports medicine, HIV medicine and diabetes. hoagmedicalgroup.com | 800.400.HOAG St. Joseph Heritage Group 1100 W. Stewart Dr., Orange 92868 We offer nearly every medical specialty and subspecialty with an unparalleled standard of care. Our dedication to service, compassion and quality healthcare has made us an essential caretaker in Orange County for over 90 years. providence.org | 714.633.9111 Monarch HealthCare 11 Technology, Irvine 92618 Monarch HealthCare, part of Optum, is recognized by health plans and business groups for our “patient-first” approach to care. With more than 2,500 doctors in Orange County and Long Beach, it’s easy to find a Monarch doctor in your neighborhood. monarchhealthcare.com | 949.923.3200 MemorialCare Medical Group MemorialCare Medical Group is made up of more than 200 physicians. In addition to multiple locations throughout Orange County, MemorialCare Medical Group offers Urgent Care Centers that are open 365 days a year memorialcare.org
As the novel coronavirus emerged in the news in January, Sarah Keeley was working as a medical scribe and considering what to do with her biology degree. By February, as the disease crept across the U.S., Keeley found her calling: a career in public health. “This is something that’s going to be necessary,” Keeley remembered thinking. “This is something I can do. This is something I’m interested in.” In August, Keeley began studying at the University of Illinois at Urbana-Champaign to become an epidemiologist. Public health programs in the United States have seen a surge in enrollment as the coronavirus has swept through the country, killing more than 248,000 people. As state and local public health departments struggle with unprecedented challenges — slashed budgets, surging demand, staff departures and even threats to workers’ safety — a new generation is entering the field. Among the more than 100 schools and public health programs that use the common application (a single admissions application form that students can send to multiple schools), there was a 20% increase — to nearly 40,000 — in applications for the current academic year to programs for earning a master’s degree in public health, according to the Association of Schools and Programs of Public Health. Some programs are seeing even bigger jumps. Applications to Brown University’s small master’s in public health program rose 75%, according to Annie Gjelsvik, a professor and director of the program. Demand was so high as the pandemic hit full force in the spring that Brown extended its application deadline by over a month. Seventy students ultimately matriculated this fall, up from 41 last year. “People interested in public health are interested in solving complex problems,” Gjelsvik said. “The COVID pandemic is a complex issue that’s in the forefront every day.”  Science Super-spreading wedding party demonstrates COVID-19 risk posed by holiday gatherings Science Super-spreading wedding party demonstrates COVID-19 risk posed by holiday gatherings A coronavirus outbreak tied to a wedding reception caused 177 infections and 7 COVID-19 deaths. It shows why health officials are nervous about holiday gatherings.  It’s too early to say whether the jump in interest in public health programs is specific to that field or reflects a broader surge of interest in graduate programs in general, according to those who track graduate school admissions. Factors such as pandemic-related deferrals and disruptions in international student admissions make it difficult to compare programs across the board. Magnolia E. Hernández, an assistant dean at Florida International University’s Robert Stempel College of Public Health and Social Work, said new student enrollments in its master’s in public health program grew 63% from last year. The school has especially seen an uptick in interest among Black students, from 21% of newly admitted students last fall to 26.8% this year. Kelsie Campbell is one of them. She’s part Jamaican and part British. When she heard in both the British and American media that Black and ethnic minorities were being disproportionately hurt by the pandemic , she wanted to focus on why. “Why is the Black community being impacted disproportionately by the pandemic? Why is that happening?” Campbell asked. “I want to be able to come to you and say, ‘This is happening. These are the numbers and this is what we’re going to do.’” The biochemistry major at Florida International said she planned to explore that when she began her master’s program at Stempel College in the spring. She said she hoped to eventually put her public health degree to work helping her own community. “There’s power in having people from your community in high places,” she said, “somebody to fight for you, somebody to be your voice.” Public health students are already working on the front lines of the nation’s pandemic response in many locations. Students at Brown’s public health program, for example, are crunching infection data and tracing the spread of the disease for the Rhode Island Department of Health.  California L.A. told to stay at home as much as possible as COVID-19 brings ‘new level of danger’ California L.A. told to stay at home as much as possible as COVID-19 brings ‘new level of danger’ Officials are sounding the alarm about the rapid spread of the coronavirus and have warned that more restrictions could come, even a possible curfew.  More Coverage Some students who had planned to work in public health shifted their focus as they watched the devastation of COVID-19 in their communities. In college, Emilie Saksvig, 23, double-majored in civil engineering and public health. She was supposed to start working this year as a Peace Corps volunteer to help with water infrastructure in Kenya. She had dreamed of working overseas on global public health. The pandemic forced her to cancel those plans, and she decided instead to pursue a master’s degree in public health at Emory University. “The pandemic has made it so that it is apparent that the United States needs a lot of help, too,” she said. “It changed the direction of where I wanted to go.” These students are entering a field that faced serious challenges even before the pandemic exposed the strains on the underfunded patchwork of state and local public health departments. An analysis by the Associated Press and Kaiser Health News found that, since 2010, per capita spending for state public health departments has dropped by 16%, and for local health departments by 18%. At least 38,000 state and local public health jobs have disappeared since the 2008 recession. And the workforce is aging: 42% of governmental public health workers are over 50, according to the De Beaumont Foundation, and the field has high turnover. Before the pandemic, nearly half of public health workers said they planned to retire or leave their organizations for other reasons in the next five years. Poor pay topped the list of reasons. Some public health workers are paid so little that they qualify for public aid. California Young people are spreading coronavirus in L.A., but older and sicker suffer the most California Young people are spreading coronavirus in L.A., but older and sicker suffer the most L.A. County’s adjusted coronavirus case rate has nearly doubled, from 7.6 new cases per 100,000 residents last week to 13.7 this week.  Brian Castrucci, CEO of the De Beaumont Foundation, which advocates for public health, said government public health jobs needed to be a “destination job” for top graduates of public health schools. “If we aren’t going after the best and the brightest,” Castrucci said, “it means that the best and the brightest aren’t protecting our nation from those threats that can, clearly, not only devastate from a human perspective, but from an economic perspective.” The pandemic put that already stressed public health workforce in the middle of what became a pitched political battle over how to contain the disease. As public health officials recommended closing businesses and requiring people to wear masks, many, including Dr. Anthony Fauci, the U.S. government’s top infectious disease expert, faced threats and political reprisals, the AP and Kaiser Health News found. Many were pushed out of their jobs. An ongoing count by the two news organizations has found that more than 100 public health leaders in dozens of states have retired, quit or been fired since April. Those threats have had the effect of crystallizing for students the importance of their work, said Patricia Pittman, a professor of health policy and management at George Washington University’s Milken Institute School of Public Health. “Our students have been both indignant and also energized by what it means to become a public health professional,” Pittman said. “Indignant because many of the local and the national leaders who are trying to make recommendations around public health practices were being mistreated. And proud because they know that they are going to be part of that frontline public health workforce that has not always gotten the respect that it deserves.” Saksvig compared public health workers with law enforcement in the way they both have responsibility for enforcing rules that can alter people’s lives. “I feel like, before the coronavirus, a lot of people didn’t really pay attention to public health,” she said. “Especially now when something like a pandemic is happening, public health people are just on the forefront of everything.”
Southern California counties are reopening their economies at a slower pace than other parts of the state, and officials blame celebrations. Lakers and Dodgers viewing parties and public events are keeping coronavirus infections high enough to hold the region back, officials warn. California has avoided the substantial spike in coronavirus cases seen across the country this fall, but some of the state’s most populated counties — Los Angeles , Riverside and San Bernardino — remain in the most restrictive reopening tier. That means indoor dining rooms are shut, as are indoor operations of gyms and houses of worship. San Diego County , now in the red tier, is teetering on backsliding into the most restrictive category. Public health officials have identified gatherings as a significant source of virus transmission in Southern California, where young adults are driving the spread of the highly contagious disease. There are also troubling signs of a potential increase in coronavirus cases. Even after accounting for a backlog , Los Angeles County has gone from about 940 daily new cases at the beginning of October to nearly 1,200 new cases each day as of last week, based on the date of a positive test or the first onset of symptoms, said Barbara Ferrer, the county’s director of public health. California L.A. County hits new milestones in coronavirus cases, deaths amid troubling increase in infections California L.A. County hits new milestones in coronavirus cases, deaths amid troubling increase in infections Los Angeles County surpassed 300,000 confirmed coronavirus cases and reported its 7,000th death Monday, health officials said.  More Coverage Officials are worried that the post-season success of the Lakers and the Dodgers may be playing a role in the increased coronavirus cases. “Gatherings in large crowds to watch games indoors, people aren’t wearing their face coverings, people are yelling a lot — that’s just not sensible,” Ferrer said.  Even congregating at outdoor restaurants, while shouting and cheering and hugging strangers without wearing masks, makes it “so easy to spread this virus,” she said. About 55% of people who knew of a possible exposure to the virus also attended a gathering where two or more people were sick, the county said, based on interviews with the newly infected or people who were in contact with them over the last three weeks. Other parts of Southern California are seeing similar trends. “We’re seeing more spread at family and friend gatherings,” said Corwin Porter, public health director for San Bernardino County. “It seems to be more prominent in our younger populations — our under-40 crowd, for the most part.” Among newly infected people who said they attended some kind of large gathering in the previous month in San Bernardino County, 61% attended gatherings of friends or family,  according to data from the second full week of October. In Riverside County, public health officer Dr. Cameron Kaiser expressed dismay about a crowd of more than 1,000 people who showed up at the Banning Street Drag Race at the Banning Municipal Airport — a mass gathering that has the potential of becoming a superspreader event. Mass gatherings are generally banned under the state’s public health order. “The more people you get into a place, then the higher the risk that someone is going to be there with a big load of virus,” Kaiser said. “Paradoxically, it’s probably somebody healthier because they can tolerate it. And then those people turn out to be highly efficient in giving it to other folks.” Gatherings take on an outsized importance, Kaiser said, with research showing that superspreader events are responsible for the majority of new infections. Some people can infect others without ever falling sick themselves; others can be contagious for 48 hours before showing symptoms. “We deal with underground parties and house bashes on a regular basis,” Kaiser said. “Sometimes you don’t hear about these on social media until it’s too late.”  Neighborhoods around universities remain a persistent problem. An outbreak has been identified among residents of student housing at Chapman University in Orange County. Since late August, more than 1,200 students at San Diego State University have tested positive for the coronavirus. Large parties among families and friends at private homes are also a problem, with hosts even renting inflatable bounce houses. “We’re talking about multiple families getting together at residences, having even Jolly Jumps up on the front yard or in the backyard; multiple cars lined up in the street. We’ve even had reports of actual live music bands in residences,” said Rigoberto Vargas, director of public health for Ventura County. Officials have resorted to pleading with the public to take the worst global pandemic in a century more seriously. “People are lowering their guards — going back to how they functioned before COVID-19, going to gatherings,” said San Diego County public health officer Dr. Wilma Wooten. San Diego County is at risk of being forced by the state to close indoor dining rooms and indoor gyms and houses of worship if the transmission rate increases. Gatherings are one of several reasons why Southern California remains stuck in a coronavirus limbo, experts say. Transmission is likely occurring at workplaces where employees are closer together. And transmission may be greater in rural agricultural communities where migrant workers live in dense housing arrangements, as well as urban areas where low-income workers live in crowded homes and are less likely to be able to telecommute, said Dr. Robert Kim-Farley, medical epidemiologist and infectious diseases expert at the UCLA Fielding School of Public Health. Long before the pandemic, the Centers for Disease Control and Prevention identified Los Angeles, Riverside and San Bernardino counties, as well as many counties in the Central Valley, Salinas Valley and Imperial Valley, as ranking worse on a social vulnerability index. That means that factors such as poverty, a lack of access to transportation and crowded housing may weaken a community’s ability to prevent human suffering and financial loss in a disaster. L.A. County faces special challenges as a diverse and populous county, with some of the most crowded census tracts in the nation, and with its sheer size of more than 10 million residents, Ferrer said. Those things can make it challenging to manage a complicated reopening strategy. The county also has a fairly high rate of poverty and a large number of Latino residents, communities that have been hit disproportionately hard by the virus. There are also political factors. In some parts of Southern California, there has been an explicit rejection of mask use, Kim-Farley said. In Huntington Beach, workers say they have had their fair share of customers refusing to wear masks , with some even tearing down signs promoting their use.  Which California counties are reopening? Which California counties are reopening? To contain the spread of COVID-19, parks, restaurants and stores are slowly reopening.  Unlike Southern California, the Bay Area has achieved vastly different results. Some contributing factors may be the differing response of local leaders and public sentiment. Some Southern California politicians have been among those pushing the state to more rapidly loosen restrictions on businesses. By contrast, many health officials in the Bay Area have taken a decidedly slower approach, often retaining more restrictive rules even after state officials loosen them. In San Francisco, Mayor London Breed credited residents for driving down the spread of the disease. “I know they were tired of me, over and over, pretty much yelling at everyone and asking people to wear your mask, socially distance, cancel your events, don’t come together,” Breed told a local TV station . “The fact is: People actually listened.” San Francisco is now in the state’s yellow tier, thanks in part to decreasing the disproportionate impact of the virus on the city’s most disadvantaged neighborhoods, state officials said. The yellow tier is the state’s least restrictive on its four-part color-coded reopening plan, allowing wide swaths of businesses to resume operations. Some experts have also speculated that people in the Bay Area tend to adhere to health rules more than in other places. The area’s poorly performing sports teams may have also assisted earlier this year when the pandemic first struck the region. Epidemiologists credited the San Francisco 49ers’ loss at the Super Bowl — and the resulting failure to have a victory parade — as a big reason why the Bay Area may have escaped a worse first wave of the pandemic in the spring.  State officials announced last week they will devote more resources to Los Angeles, Riverside and San Bernardino counties, including increasing mobile testing and helping those infected to isolate themselves while they recover. They said similar strategies helped tamp down a surge in the Central Valley earlier this year. Health officials are worried that Thanksgiving and Christmas could transform into superspreader events if people don’t cancel large gatherings or, at a minimum, take precautions. New state minimum requirements allow for only small outside gatherings of no more than three households, keeping guests six feet apart, wearing masks when not eating or drinking, serving food in single-serve disposable containers and limiting events to no more than two hours. Times staff writers Luke Money, Maura Dolan and Stephanie Lai contributed to this report.
California’s financially battered restaurants filed government claims Monday to recover more than $100 million in fees for liquor and health permits and tourism charges that they say were assessed even though their businesses were shuttered or only partially operating under long-running coronavirus restrictions. Few businesses have been hit as hard during the COVID-19 pandemic as restaurants, which in California were ordered closed, reopened, closed for a second time and then allowed to welcome customers again, though with restrictions, such as takeout only. Thousands of eateries have closed permanently. Owners say one thing has remained constant amid the turmoil: State and county governments have continued to charge fees for liquor licenses, health permits and tourism assessments — even though the restaurants were closed down by government order or permitted to operate with limited capacity and dining . The owners contend that they are being unjustly punished for following the law and are being charged for permits they can’t use. “The irony is they did what they were told and the very entity that told them to close is keeping these fees,” said attorney Brian Kabateck, who is representing restaurants that filed claims against the state and against Los Angeles, Orange, Sacramento, San Diego and Monterey counties,. Additional claims will be filed in coming days for restaurants in San Francisco and in Fresno and Placer counties. The move is supported by the California Restaurant Assn. Food When restaurants suffer, others feel the pain too Food When restaurants suffer, others feel the pain too As the U.S. struggles to rebound from a now-resurgent coronavirus, restaurants seem much less likely to deliver an economic boost.  “Somebody has to tell them this is wrong and to return the money,” Kabateck said.  Kabateck estimated the fees could exceed $100 million statewide. A government claim, filed for individual restaurants and on behalf of other businesses in the sector, is a required initial step before filing a class-action lawsuit against government agencies in California. Officials have 45 days to respond. Walter Schild, who owns the gastropub 33 Taps in Hollywood, said he pays about $7,000 annually in government fees beside property taxes, including for his liquor license and operating a valet service. Business Beloved American restaurants shut down as coronavirus relief falls short Business Beloved American restaurants shut down as coronavirus relief falls short Economic pressure from the coronavirus outbreak is hitting some of the country’s top-tier restaurants, forcing some to close for good.  He said he has been unable to get the fees reduced or delayed and is now being charged with late fees of up to 50% for failing to pay, even though the restaurant has been closed for all but about a month since mid-March. With the restaurant closed, Schild has no income. He was recently forced to shutter another restaurant in Orange County because of the financial strain, and laid off 30 employees. His Hollywood restaurant lost money when he attempted takeout and delivery, and the lack of tourists gutted what would be the eatery’s usual customer base. “We have been pleading with our legislators for fee relief,” Schild said. “It’s been tough.”  Get our free Coronavirus Today newsletter Sign up for the latest news, best stories and what they mean for you, plus answers to your questions. You may occasionally receive promotional content from the Los Angeles Times. The restaurant association previously urged Gov. Gavin Newsom to hold a special legislative session to work on an aid package for their businesses. Under state rules, counties with the highest infection rates are limited to outdoor dining only, along with takeout and delivery. If those rates improve, restaurants can operate with 25% capacity indoors or 100 patrons, whichever is fewer. Even under the least restrictive rules, indoor capacity can only reach 50%. Restaurant industry executives have said the rules will doom many more restaurants. California has nearly 60,000 restaurants that employ approximately 1.5 million workers. “Even when the restrictions are lifted, the devastating impact on the restaurant industry will extend for years,” Jot Condie, who heads the restaurant association, said in a statement. “Easing fees would help enable establishments to stay open and keep vulnerable workers employed.”
President-elect Joe Biden, faced with worsening economic and health crises, on Monday called for action from two political forces beyond his control: Congress, which is deadlocked over economic relief, and President Trump, who refuses to concede the election and share information about the pandemic and national security. “More people may die if we don’t coordinate,” Biden bluntly warned. He welcomed news of progress in developing a second vaccine but emphasized how logistically challenging it will be to distribute — an endeavor further complicated by the Trump administration’s resistance to coordinating with Biden officials, who will be tasked with carrying it out. “The vaccine is important,” Biden said, “but it’s of little importance if you are not vaccinated.” Biden also called on Congress to pass long-stalled legislation to provide economic relief and public health funding during its lame duck session. But he offered no path to breaking the deadlock that pits House Democrats, who passed a scaled-down $2.2-trillion package as a compromise seven weeks ago, against Senate Republicans, who say that’s still far too expensive. “For millions of Americans who’ve lost hours and wages or have lost jobs, we can deliver immediate relief and it needs to be done quickly,” Biden said. “The refusal of Democrats and Republicans to cooperate with one another is not due to a mysterious force beyond our control. If we can decide not to cooperate, we can decide to cooperate.” Get our Essential Politics newsletter The latest news, analysis and insights from our politics teams from Sacramento to D.C. You may occasionally receive promotional content from the Los Angeles Times. Biden expressed a note of optimism after a video conference with a small group of top union and business officials, including AFL-CIO President Richard Trumka; General Motors Chief Executive Mary Barra; Mary Kay Henry, president of the Service Employees International Union; and Target Chief Executive Brian Cornell. He intended the conversation as a symbol of his aspiration to unify the country and bring opposing sides together, and joked that he “deserves a Nobel Peace Prize” for bringing the diverse group together.  “We all agree on the common goals, just have a slightly different perspective,” Biden said, noting that he made a point of telling the business leaders that he is a “union man” who plans to empower labor. “I’m convinced we can all come together around the same table to advance areas of common ground,” he said. Biden as president will immediately have to juggle the competing demands of getting the coronavirus under control and repairing the damage it has inflicted on the economy, though stepped-up public health measures amid the pandemic’s current surge are contributing to a slowed recovery. He has insisted all along that the two policy aims are intertwined, but that the pandemic has to be controlled before the economy can recover. “Once we shut down the virus, then we can start to build back better,” Biden said in his remarks, his first on the economy since he won the election. Biden seemed to acknowledge that as president he will face deeper economic and health crises. Coronavirus cases have been surging and neither Trump nor Congress is acting to address the fallout. “We’re going into a very dark winter,” Biden said. “Things are going to get much tougher before they get easier.” In California, weekly coronavirus case counts have doubled in the last month . Los Angeles County recorded more than 6,800 cases over the weekend, an alarming jump that has officials talking about more restrictions, such as setting a curfew. Other states are reinstating stricter social and economic restrictions, only to draw White House fire in some cases. Trump singled out Ohio Gov. Mike DeWine, a Republican, who reissued a mask-wearing order and said over the weekend that the president should begin the transition to Biden. In a tweet Monday morning, Trump encouraged a Republican primary challenge to DeWine: “Who will be running for Governor of the Great State of Ohio? Will be hotly contested!” In Michigan, Democratic Gov. Gretchen Whitmer announced new rules for the next three weeks to sharply limit indoor gatherings, suspend in-person school and college classes, and close indoor service for bars and restaurants. Whitmer, already a target of right-wing ire — and a foiled kidnapping attempt — for her earlier restrictions, was denounced by Trump advisor Scott Atlas, who urged Michigan residents to resist, tweeting: “The only way this stops is if people rise up.” Biden lambasted Trump and his allies for such attacks. “What the hell’s the matter with these guys? “‘Resist!’” he said. “It’s totally irresponsible.” Biden, who again urged state and local officials to issue mask mandates, offered praise for the handful of Republican leaders who have rejected Trump’s intransigence on the election outcome and have stepped up the fight against the spread of the virus. Asked about Trump’s ongoing refusal to acknowledge his defeat and cooperate in the transition, Biden said, “I find this more embarrassing for the country than debilitating for my ability to get started.” Biden said that his lack of the intelligence briefings usually given to a president-elect was mitigated by one thing: Vice President-elect Kamala Harris, who appeared with Biden, is still a member of the Senate Intelligence Committee, which gives her access to classified material. He continued to hold out hope that Republicans would be more cooperative once Trump has left the scene. The president-elect said his message to them was, “I will work with you. I understand a lot of your reluctance because of the way the president operates.” He added, “I’ve been in contact with, and I will be in contact with, more of them as we move along.” Former First Lady Michelle Obama also made a rare political statement Monday in an Instagram post to denounce Trump’s behavior. “This isn’t a game,” she wrote. “So I want to urge all Americans, especially our nation’s leaders, regardless of party, to honor the electoral process and do your part to encourage a smooth transition of power, just as sitting presidents have done throughout our history.” Looking ahead to the holidays, Biden discussed the coronavirus threat in personal terms when he was asked what advice he would give to families trying to plan celebrations. He noted that he and his wife, Jill, had just been discussing that. For years while he served as vice president, Biden hosted big family dinners on Nantucket. “Jill and I spent this morning figuring out, like many of you, what to do for Thanksgiving,” he said. He consulted his advisors and said he was told to have no more than 10 people, to maintain social distance and wear masks. He did not disclose which 10 members of his extended family would make the cut.
To the editor: David Lazarus writes as if health insurance companies are the problem in healthcare . In fact, the insurance market in California is quite competitive and already has multiple nonprofit companies. The main problem is the lack of provider competition. There are fewer competing hospitals and medical groups in California every year. This results in higher prices that insurance companies must pay for their members. They have no choice but to pay these higher prices if they want to offer products that include most hospitals and doctors. The Medicare option would not address this problem, since Medicare does not have to negotiate prices. Rather, Medicare tells providers how much it will pay to hospitals and doctors. A Medicare option would leverage much lower Medicare prices to offer new insurance products that would be 30% to 40% lower than what commercial insurance companies can negotiate in California’s concentrated provider markets. This is important to understand since, if we do not have a Medicare option in the near future, we need California policymakers to act now. We need policies to restore competition to hospital and physician markets and limit the ability of providers to charge excessive prices when patients need emergency care and access to providers that are not on their plan’s approved list. Glenn Melnick, Manhattan Beach The writer is a professor of public policy at USC who specializes in health economics.
An evangelical megachurch in Los Angeles that has defied L.A. County public health orders and held indoor worship services for the last several weeks has been struck with an outbreak of the coronavirus, public health officials confirmed Thursday. Grace Community Church in Sun Valley has seen three confirmed cases, according to the Los Angeles County Department of Public Health. Public health officials are investigating the outbreak and said they will work closely with the church to help limit transmission of the coronavirus in the church, which has an estimated attendance of 7,000. The county did not provide any further details about whether the cases were confirmed among staff or worshipers. Attorneys for Grace Community Church did not immediately respond to a request for comment. Under the county health officer’s order, places of worship must report to the county Public Health Department when at least three  coronavirus cases are identified among staff or worshipers within a span of 14 days so the agency can determine whether there is an outbreak. The conservative megachurch announced in late July that it would restart indoor services — despite a county public health order barring any house of worship from doing so. Thousands of people have attended services, with most not wearing face coverings as they sit side by side indoors, or close together outside under a tent, according to public health officials. Pastor John MacArthur has repeatedly told the congregation that no one from the church has gotten sick with COVID-19 and claims the pandemic threat is overblown. The church does not screen congregants for symptoms before they enter or require them to follow any protocols, according to court records and interviews with members. MacArthur has been increasingly skeptical of the pandemic, a viewpoint he has shared from the pulpit. He and his attorneys have argued that it is their constitutional right to hold church services and that meeting together in person is a crucial part of how Grace Community Church’s congregants exercise their religion. Since mid-August, when county officials sued the church, the parties have been in a heated court battle over the church’s unwillingness to follow the county public health order.  In early September, an L.A. County Superior Court judge ruled that the church must stop holding indoor worship services and also must require congregants to wear face coverings and adhere to social distancing practices when worshiping outdoors. The church has refused to follow that ruling, and county attorneys have asked a judge to hold the church in contempt. A hearing on the matter is scheduled for Nov. 13. County officials said the vast majority of religious institutions continue to hold services either online or outdoors with public health safeguards in place. “The county went to court only after significant efforts to work with the leaders of Grace Community Church to protect the health of congregants and the surrounding community proved unsuccessful,” county officials said in a statement.
Coast-to-coast and around the world, sighs of relief could be heard after the Trump administration threw in the towel , more or less, on its refusal to allow President-elect Joe Biden to begin the presidential transition. But with 56 days left until Biden can formally take over on Jan. 20, it’s too soon to breathe easy. Trump still has all the powers of federal leadership in his hands. He’s been showing in recent days and weeks that he’s not shy about using them. When it comes to environmental and healthcare policy in particular, he’s been doing so with unparalleled malevolence. The forest service just granted itself a free pass to increase commercial logging and roadbuilding across our national forests. Randi Spivak, Center for Biological Diversity As my colleague Doyle McManus reports , much of Trump’s last-minute policymaking appears aimed at bequeathing Biden a scorched-earth economic landscape. This would be perfectly in character for Trump, whose approach to governing always seemed to be guided by animus toward the Obama-Biden administration. Trump’s broader policymaking seems to be motivated by something else — pure malevolence toward the needy and the natural world. In some respects it evokes Samuel Taylor Coleridge’s perception of the “motiveless malignity” of Shakespeare’s Iago. To be fair, however Iago did have a motive for attacking Othello. Trump also may have a motive for his environmental policies — enriching timber companies and the oil and gas industry, despoliation of the environment being merely collateral damage. Outside those categories, however, Trump’s recent decisions will have the effect of disrupting America’s national security for reasons that are impossible to detect, except perhaps vengefulness.  On Nov. 17 he fired Chris Krebs , the cybersecurity chief of the Department of Homeland Security. Krebs’ assertion that the election had been free of voter fraud contradicted Trump’s claim that “massive improprieties and fraud” had led to his defeat. Business Column: Republicans have destroyed the idea of the ‘loyal opposition’ — and eroded democracy Business Column: Republicans have destroyed the idea of the ‘loyal opposition’ — and eroded democracy The GOP has buried the notion of the ‘loyal opposition’ in the U.S., along with the peaceful transfer of power  Over the weekend, Trump formalized the U.S. withdrawal from the Open Skies Treaty, a 1992 pact between Russia and Western nations designed to keep cooler heads in charge when the two sides conduct reconnaissance flights over each others’ territories. Trump went further than withdrawal — he took steps to mothball two specially-equipped planes that conduct the oversight sorties. That would make it harder for Biden to revive the treaty, though experts say he can cancel the decommissioning upon taking office . Changes in environmental policy, healthcare and the social safety net could have more far-reaching and immediate impact on millions of Americans. Before taking them in turn, let’s recall the history of the lengthy interregnum between outgoing and incoming administrations. Until the 20th Amendment went into effect in 1937, Inauguration Day was March 4 (or March 5 if the official date fell on a Sunday). On two occasions, the gap caused more than inconvenience. The delay in Abraham Lincoln’s inauguration allowed Southern secession  to begin to unfold without a firm hand in the White House (though the attack on Ft. Sumter, generally viewed as the start of the Civil War, did not begin until April 12). In the period between Franklin D. Roosevelt’s election on Nov. 8, 1932, and his swearing-in on March 4, 1933, the Great Depression gathered steam. The financial sector was especially hard-hit, with the lights in banks all over the country blinking out without an effective policy response from the Hoover White House. During that time Hoover repeatedly attempted to get FDR to endorse his own economic policies, many of which would have hamstrung FDR’s efforts. FDR flatly refused, informing Hoover that as long as he remained president, he would have to address the crisis without FDR’s assent. The 20th Amendment, which set the turnover of administrations at noon on Jan. 20, had already been ratified, but wasn’t effective until after Roosevelt’s first inauguration. Business Column: A Biden victory would put an end to Trump appointees vandalizing their own agencies Business Column: A Biden victory would put an end to Trump appointees vandalizing their own agencies Trump appointees aimed to dismantle their own agencies, at the public’s expense.  That leaves Trump with plenty of scope for mischief, or worse. We reported earlier on Trump’s haste to issue leases allowing oil and gas exploration in Alaska’s Arctic National Wildlife Refuge before he leaves office. Biden could make good on his pledge to protect the reserve from development unless the Trump administration has already issued leases, which would be hard to unwind. The administration has also weakened environmental protections across the board in only the last few weeks. On Nov. 16, the Department of Agriculture finalized a rule change that lowers restrictions on commercial activities in national forests. “The forest service just granted itself a free pass to increase commercial logging and roadbuilding across our national forests under the guise of restoration,” as Randi Spivak, public lands director at the Center for Biological Diversity, put it. One day later, the administration released a final environmental impact statement supporting its decision to weaken the Endangered Species Act, which has been a special target of Interior Secretary David Bernhardt, a former lobbyist for natural resources developers often stymied by the act. In this case, the administration sought to invalidate protections for the greater sage grouse so the bird’s habitat can be opened for fracking and oil drilling in California and six other Western states. On healthcare, Trump has continued to steam ahead with regulations that will accomplish nothing but complicating the management of Medicaid, the nation’s most important public health program, and threaten coverage for millions of enrollees. On Nov. 4, the Department of Health and Human Services issued a proposed rule that would cause most HHS regulations to expire automatically without “a time-consuming assessment and review,” as Jessica Schubel of the Center on Budget and Policy Priorities observed . If it’s finalized, Schubel noted, the rule would “divert key resources from responding to COVID-19; wreak havoc on the administration of Medicaid, Medicare, the marketplaces, and other HHS programs; and potentially seriously harm millions of people.”  Business Column: Medicare boss Seema Verma is a threat to public health Business Column: Medicare boss Seema Verma is a threat to public health Seema Verma, the federal official in charge of Medicare, Medicaid and the Affordable Care Act, has blasted into the limelight. And not in a good way.  HHS estimates that anywhere between 2,500 and 12,400 rules would have to be reexamined in the next two years if its proposal is made final, at a cost of some $26 million over a decade. “This would be no simple exercise,” Schubel wrote, calling the proposal “the Trump Administration’s latest attempt to sabotage HHS programs and tie the Biden Administration’s hands.” The administration, which as we’ve reported has avoided no opportunity to undermine Medicaid, has also implemented a rule that effectively overturns a congressional guarantee that COVID-19 testing, immunization and treatment will be covered for Medicaid members. The rule requires state Medicaid programs to reexamine the enrollment eligibility of millions of enrollees. It also excludes thousands of enrollees — those entitled to limited coverage such as some pregnant women — from coverage of COVID-19 testing and treatment costs. That could happen even though that coverage was guaranteed by the Families First Coronavirus Response Act, the first COVID-19 relief act passed by Congress and signed by Trump in March. To have the requalification process “kick in during the middle of a pandemic is insane, and exactly what the FFCRA said can’t happen,” says Sara Rosenbaum, a health policy expert at George Washington University. “They’ve concocted this policy out of whole cloth.” Business Column: Trump unleashes another unhinged rant about California water and wildfires Business Column: Trump unleashes another unhinged rant about California water and wildfires Fact-checking President Trump’s rant about California water and wildfires.  The administration is also moving ahead with a rule reducing eligibility for food stamps that could cut as many as 3 million recipients out of the program, known formally as the Supplemental Nutrition Assistance Program, or SNAP. A federal judge blocked the rule change last year, but that hasn’t stopped Trump from pushing it forward as a parting gift to the nation. That’s just a taste of all the actions that are making this lame-duck administration one of the lamest ducks in history. Trump is moving ahead with federal executions of death-row inmates despite an unwritten tradition that executions are suspended during the pendency of a new administration, and Biden’s expressed intention to abolish the death penalty at the federal level and encourage states to follow suit. He may continue firing government officials who displease him. O"n Wednesday he pardoned  Michael Flynn, his former national security advisor, who pleaded guilty to lying to the FBI but then tried to overturn his conviction. His Treasury secretary, Steven T. Mnuchin, is moving to sequester $455 billion in coronavirus relief funds appropriated by Congress but unspent by Trump in an account that will keep it inaccessible to the Biden administration without further congressional approval. There may be more vandalism in the offing. Without having to face even the modest political consequences that he has faced in the last four years, Trump is showing himself to be massively uninterested in governing at all now, and intent on throwing sand in the gears of good government by whim. The possibilities are endless, and endlessly frightening.
Los Angeles County health officials reported 953 new coronavirus cases Saturday and 10 related deaths, as the rate of the virus’ spread in the region continues to rise. In a statement, Public Health Director Barbara Ferrer warned that the number of new cases might be low because of “several missing reports” from Friday evening. The number of people who have tested positive for the virus in L.A. County now stands at 287,295, and the sickness has claimed 6,856 lives here. Officials said Saturday that 746 people remain hospitalized with COVID-19 in the county, and a quarter of those people are in intensive care units. At least nine of the 10 deaths reported by L.A. County on Saturday involved people who had underlying health conditions. The 10th death was reported by the city of Long Beach, and county health officials did not immediately have information available about their prior medical history. Officials have continued to express concern about large gatherings as the rate of new cases in L.A. County is expected to increase in coming weeks. Halloween also looms as a potential vector for increased spread if families choose to trick-or-treat, which would make social distancing all but impossible. Beverly Hills officials banned trick-or-treating earlier this week, and L.A. County Mayor Eric Garcetti has pleaded residents to modify their candy and costumed revelry this year for their own health. Ferrer urged county residents to continue following social distancing protocols in the hopes of avoiding a holiday surge in cases, similar to the one seen after Memorial Day. “To slow community spread of COVID-19 in our county we must all partner together; businesses and residents must do their part and adopt the infection control measures that we know to be effective,” she said in a statement. “Each of us has the opportunity every single day to make the right choices for our health and the health of those around us.”
With just over 3,000 cases of coronavirus infections, Placer County voted to end its local COVID-19 health emergency this week, prompting the county’s health officer to submit her notice of resignation. Residents will still be expected to follow California’s overall guidance, but the county says it will not enforce the state rules. In a statement, the Board of Supervisors cited concerns that the state framework for measuring COVID-19 mischaracterizes the effects of the disease in the county and “harms the community’s economic, health, mental and social well-being.” The action prompted Public Health Officer Dr. Aimee Sisson to resign, effective Sept. 25. “It is with a heavy heart that I submit this letter of resignation. Today’s action by the Placer County Board of Supervisors made it clear that I can no longer effectively serve in my role as Placer County Health Officer and Public Health Director,” Sisson wrote Tuesday. “I am grateful to have been granted the tremendous privilege and responsibility of protecting and promoting the health of Placer County’s 400,000 residents over the last 10 months.” Sisson is among a handful of health officers throughout the state who have resigned following a clash with local officials. Former Orange County health officer Dr. Nichole Quick resigned in early June following outcry over a face covering mandate. The requirement was lifted when current Health Officer Dr. Clayton Chau took over, but a California mandate — brought on by conversations between Chau and state officials — later superseded the Orange County policy. Placer County issued a local health emergency March 3 after a second patient tested positive for the virus . There have been  36 deaths in the county, among more than 14,000 in the state.  County officials cited a low level of transmission of COVID-19 in their decision to lift the emergency health order and raised concerns about the community’s economy, which like many in the state, suffered during months-long closures. The county is now in Tier 2 of the state’s four-stage color-coded monitoring system, meaning more businesses — including movie theaters, restaurants and places of worship — can ease restrictions and open in limited capacity. “We cannot continue to keep our community shut down for some unknown amount of time as determined by the ever-changing metrics according to the governor,” Supervisor Bonnie Gore said.
Health officials around the world are clashing over the use of certain drugs for COVID-19, leading to different treatment options for patients depending on where they live. On Friday, a World Health Organization guidelines panel advised against using the antiviral remdesivir for hospitalized patients, saying there’s no evidence it improves survival or avoids the need for breathing machines. But in the U.S. and many other countries, the drug has been the standard of care since a major, government-led study found other benefits — it shortened recovery time for hospitalized patients by five days on average, from 15 days to 10. Within the U.S., a federal guidelines panel and some leading medical groups have not endorsed two other therapies the Food and Drug Administration authorized for emergency use — Eli Lilly’s experimental antibody drug and convalescent plasma, which is derived from the blood of COVID-19 survivors. The groups say there isn’t enough evidence to recommend for or against them. Doctors also remain uncertain about when and when not to use the only drugs known to improve survival for the sickest COVID-19 patients: dexamethasone or similar steroids. And things got murkier with Thursday’s news that the anti-inflammatory drug tocilizumab may help. Like the key WHO study on remdesivir, the preliminary results on tocilizumab have not yet been published or fully reviewed by independent scientists, leaving doctors unclear about what to do. “It’s a genuine quandary,” said the University of Pittsburgh’s Dr. Derek Angus, who is involved in a study testing many of these treatments. “We need to see the details.” Dr. Rochelle Walensky, infectious-disease chief at Massachusetts General Hospital, agreed.  “It’s really hard to practice medicine by press release,” she said on a podcast Thursday with a medical journal editor. Until the National Institutes of Health’s guidelines endorse a treatment, “I’m really reluctant … to call that ‘standard of care.’” Angus said there are legitimate questions about all of the drug studies. “It’s not unusual for professional guidelines to disagree with each other, it’s just that it’s all under the microscope with COVID-19,” he said. The rift over remdesivir, sold as Veklury by Gilead Sciences Inc., is the most serious. The WHO guidelines emphasize that the drug does not save lives, based heavily on a WHO-sponsored study that was larger but much less rigorous than the U.S.-led one that found it had other benefits. The drug is administered intravenously  for around five days, and its high cost and lack of “meaningful effect” on mortality make it a poor choice, the WHO panel concluded. Gilead charges $3,120 for a typical treatment course for patients with private insurance and $2,340 for people covered by government health programs in the U.S. and other developed countries. In poor or middle-income countries, much cheaper versions are sold by generic makers.  Price  may be keeping demand for remdesivir low. In October, U.S. health officials said that hospitals had bought only about one-third of the doses  that they were offered over the previous few months, when the drug was in short supply. Between July and September, 500,000 treatment courses were made available to state and local health departments, but only about 161,000 were bought. In a separate development, the FDA gave emergency authorization Thursday to use of another anti-inflammatory drug, baricitinib, to be used with remdesivir. Adding baricitinib shaved an additional day off the average recovery time for severely ill hospitalized patients in one study. Lilly sells baricitinib now as Olumiant to treat rheumatoid arthritis,  which occurs when a patient’s mistaken or overreacting immune system attacks joints, causing inflammation. An overactive immune system also can lead to serious problems in coronavirus patients.
State health officials are advising Californians to skip trick-or-treating this Halloween, though their  new guidelines, released Tuesday,  stop short of prohibiting the activity amid the COVID-19 pandemic. The guidelines come as trick-or-treaters ready their costumes for Oct. 31, which this year falls on a Saturday, increasing the likelihood of gatherings. Health officials voiced concerns that it’s not possible to practice social distancing while trick-or-treating and that Día de los Muertos and Halloween celebrations would lead to interaction with people from outside one’s household. State officials are strongly discouraging trick-or-treating and suggested that some Halloween activities, such as costume contests and pumpkin carving, move online. They recommended that families go on a walk while dressed up but forgo stopping door-to-door for candy. “This is a recommendation,” California Health and Human Services Secretary Dr. Mark Ghaly said Tuesday. “Does that mean that trick-or-treaters will see some enforcement? Absolutely not. We don’t want to turn certainly what is a celebration and a time of joy into something that is difficult or contentious, but we also recognize the need to provide a clear understanding of the risks and why we recommend strongly that we do Halloween differently than we have in the past.” The state on Friday released holiday guidelines prohibiting  gatherings among more than three households  and urging residents who choose to socialize with other families to do so with a consistent group in order to reduce the risk of transmission. The guidelines also note that interacting at multiple gatherings with different households or groups is “strongly discouraged.” The state had previously warned residents against mingling with members of any other households, but those restrictions are likely to become even more difficult to abide by as people look to spend holidays such as Thanksgiving and Christmas together. Ghaly said Tuesday that the state has to be realistic in its expectation that residents will want to gather during the holiday season and added that providing guidance on how to limit exposure in those cases is important. “We want to carry through this difficult time for transmission with flu, colder weather, more potential for gatherings, and that we come out of it with continued reduced cases and that we don’t see that surge that other parts of the country are experiencing,” Ghaly said.  Last month, Los Angeles County public health officials prohibited trick-or-treating; following blowback, they revised the guidance a day later to say the activity was “not recommended.” All Halloween gatherings with people outside of a household, including haunted houses, will be barred in Los Angeles County , regardless of the state’s rules allowing gatherings of up to three households. Ghaly noted Tuesday that counties can implement guidelines that are more restrictive than those of the state, but not less restrictive. California is experiencing a respite from COVID-19; hospitalizations and deaths have dropped to the lowest levels seen in months. In addition, the positivity rate, which measures the percentage of tests for the virus that come back positive, is at an all-time low of 2.7%, according to state data . The declining numbers have allowed more counties to reopen businesses and loosen restrictions on restaurants, movie theaters and gyms. But Gov. Gavin Newsom has warned residents to remain vigilant, emphasizing that the coronavirus, coupled with the upcoming flu season, could create challenges in the state. “We are entering into the holidays, but also we’re entering into the part of the year when things cool down and people are more likely to congregate ... in settings that put their physical proximity and likelihood of transmitting disease at higher risk,” Newsom said Monday. “Don’t be misled that this disease is any less deadly. Quite the contrary — it is as deadly as it’s ever been in the context of those that are high-risk.”
The coronavirus outbreak is surging again worldwide, and hospitals and health systems are scrambling to keep up. More than 56 million people have been infected and more than 1.3 million killed, according to the Coronavirus Resource Center at Johns Hopkins University. The latest surge has prompted the U.S., France, Spain and several other countries to impose curfews and close some nonessential businesses. The good news is that U.S. drug companies Pfizer and Moderna have recently announced promising results of clinical trials of vaccines. But until people are vaccinated, medical experts are urging them to follow safety precautions such as wearing face masks , social distancing of at least six feet and frequent hand washing. Here is an update on the places hardest hit, what worries health officials most and progress toward a vaccine. The United States has reported the most infections and the most deaths, with more than 11 million cases and more than 250,000 fatalities. India has recorded 8.9 million cases and more than 131,000 deaths. Those figures for Brazil are 5.9 million and 167,000. Next are France and Russia, which each have around 2 million cases. France has more than 47,200 deaths and Russia about 34,500.  The reasons are complicated and could include population density, travel patterns, the willingness of governments to impose restrictions and the willingness of people to abide by them. Experts say that one big factor is leadership. In the three countries with the most deaths, leaders have repeatedly downplayed the severity of the coronavirus. The United States doesn’t have a national safety plan. India’s government refuses to acknowledge that it has entered the phase of “community spread” — in which large numbers of infections can not be traced. Brazil’s president recently said it was “ crazy ” that some countries were starting to reimpose restrictions again because of the increase in cases. The coming winter season is the biggest concern. Authorities fear health systems will be overloaded. One reason is the flu, which thrives between October and April. The flu season usually leads to tens of thousands of deaths. According to the U.S. Centers for Disease Control and Prevention, the number of annual hospitalizations has ranged from 140,000 to 810,000 over the last decade. Another reason the health system may be stretched thin is that people will be spending more time indoors, where the coronavirus spreads more easily. Epidemiologists are especially worried about the coming holiday season, when people from different households will gather for hours inside and eat together without masks. “The virus loves indoor, poorly ventilated spaces,” said William Hanage, an epidemiologist at Harvard. “Good ventilators could be helpful, but it is not as good as outside.” Experts say a COVID-19 vaccine probably won’t be available to ordinary Americans until mid- to late next year. Several vaccines are being tested in clinical trials around the world. Pfizer said Wednesday that data showed its vaccine was 95% effective , has no serous side effects and protects older people most. Pfizer’s study enrolled nearly 44,000 people in the U.S. and five other countries. The company said it was preparing to ask U.S. regulators to allow emergency use of the vaccine. If Pfizer is successful, it plans to provide the limited supply to healthcare workers and others on the front line. It estimates 50 million doses — good for 25 million people, since it requires two shots — could be available globally by the end of this year. Moderna said last week that early data showed its vaccine was 90% effective and that it plans to have 20 million doses for the U.S. by the end of this year. Its vaccine is being studied in 30,000 volunteers who received the vaccine or a placebo. Dr. Francis Collins, director of the National Institutes of Health, which helped create the vaccine Moderna is manufacturing, cautioned people to not let their guard down just because a vaccine could soon be approved. That will only mark the beginning of a long road to get it to everyone. The CDC, which will be in charge of distribution, has yet to announce a plan. A committee of public health experts and academics recently suggested a phased approach with healthcare workers and people with underlying conditions at the front of the line. It may take until spring or summer until anyone who is not high risk and wants a shot can get one. Poorer countries will probably be last to get the vaccine. China and Russia are promoting still-unproven vaccines worldwide and are garnering interest from other countries. Vaccine executives predict treating the world could take until 2024.
Harvey Weinstein isn’t battling COVID-19, but he is struggling with a number of health issues in prison — one of which was a 101-degree fever this week, his representatives said Thursday. “We can report that Mr. Weinstein’s fever has dropped but is still being closely monitored,” said Juda Engelmayer, Weinstein’s spokesman, and Craig Rothfeld, his authorized department of corrections representative, in a joint statement to The Times. “We can also report at this time that he does not have COVID-19.” The disgraced movie mogul’s fever spiked Tuesday morning, Rothfeld said. “Mr. Weinstein continues to be very closely monitored due to a plethora of underlying health issues, which are continuing to decline, get worse, and need treatment,” they added. Movies Is it COVID-19? Feverish Harvey Weinstein is being ‘closely monitored’ in prison Movies Is it COVID-19? Feverish Harvey Weinstein is being ‘closely monitored’ in prison Imprisoned movie mogul Harvey Weinstein has a fever and is being closely monitored by prison medical staff. His reps would not say if he has COVID-19.  The 68-year-old, who will likely to remain in prison for the rest of his life, is currently in the care of the medical staff at Wende Correctional Facility, a maximum-security prison in upstate New York, where he is serving a 23-year sentence for rape and sexual assault in  a landmark #MeToo case. Weinstein has not been transferred to a hospital outside of Wende. The facility has a regional medical unit inside the prison, and that’s where  Weinstein has been since he was moved to Wende in March . Rothfeld said the unit is analogous to a hospital inside the prison. The healthcare and medical team at Wende and the New York State Dept. of Corrections and Community Supervision’s Central Office have been working with Weinstein’s representatives “to ensure all his health issues will be addressed in a timely manner.” “We all remain concerned about his health,” said Engelmayer and Rothfeld.  The once-formidable producer’s numerous maladies include a heart condition, high blood pressure and spinal stenosis. At court appearances earlier this year, he used  a walker to assist him during his contentious trial. California Harvey Weinstein faces six more sexual assault charges in L.A. California Harvey Weinstein faces six more sexual assault charges in L.A. Harvey Weinstein faces six additional sexual assault charges in L.A. involving two more accusers.  More Coverage After being found guilty in February, Weinstein left the court in an ambulance and detoured to Bellevue Hospital, complaining of chest pains and high blood pressure.   A stent was later inserted to unblock an artery. After his sentencing, he returned with more chest pains, according to the Associated Press. Later, the former film titan was held in isolation after two inmates at Wende tested positive for the novel coronavirus. The “Shakespeare in Love” producer still faces a looming legal battle in Los Angeles. In October, local prosecutors charged him with six additional sexual assault counts involving two more alleged victims.
The pandemic has been a boon for start-ups selling lab tests to anxious Americans who don’t want to leave home for a doctor’s visit. One of the most successful has been Everlywell, which offers a wide range of at-home tests, including those for COVID-19, cholesterol and cell aging. With just a few clicks on a smartphone, customers can get test kits delivered to their door. Founder Julia Cheek, who first gained wide attention on an episode of ABC’s reality show “Shark Tank,” expects sales of more than $100 million this year — more than double last year. In August, citing the pandemic and a desire to reduce bureaucracy, the Trump administration made an unexpected move to limit the Food and Drug Administration’s already minimal oversight of the type of tests widely used by the industry — products known as lab-developed tests. The decision has heightened worries from some health experts that consumers could be harmed, as few of the tests are backed by scientific studies and most don’t require a doctor’s prescription. “Some of these tests have never been checked for reliability or accuracy,” said Liz Richardson, who studies the regulation of medical products for the Pew Charitable Trusts. “Even very good tests sometimes get it wrong.” Christina Song, an Everlywell spokeswoman, defended the accuracy of the company’s tests, saying the start-up based in Austin, Texas, processes its tests at the same certified labs that doctors and clinics use. “We work closely with independent third parties to ensure our tests meet or exceed the accuracy of traditional laboratory tests where samples are collected by healthcare professionals,” she said. Song said that a physician reviews each test order, including for whether it is appropriate for the person based on medical guidelines — although the review is invisible to the customer. And customers can discuss the results of their tests, priced from $49 to $259, with a physician or other healthcare professional at no extra cost.  Another company advertising tests online is MintRx of North Palm Beach, Fla. “Take your self-care to the next level using at home lab tests,” one of its ads says. Among the MintRx offerings is Harmony, a test for women of hormonal levels that is shipped in a pink package. More on coronavirus’ economic impact California Here are the L.A. County malls, gyms, restaurants and churches cited for COVID-19 violations California Here are the L.A. County malls, gyms, restaurants and churches cited for COVID-19 violations L.A. County inspectors have issued 157 citations to businesses and churches for violating COVID-19 protocols since Dec. 1, some multiple times.  California California suspends payment on 1.4 million unemployment claims while searching for fraud California California suspends payment on 1.4 million unemployment claims while searching for fraud State lawmakers say they’ve been flooded with desperate calls from constituents who don’t understand why their jobless benefits have been cut off by EDD.  California Newsom proposes $600 payments to Californians in need and extending COVID-19 eviction moratorium California Newsom proposes $600 payments to Californians in need and extending COVID-19 eviction moratorium California Gov. Gavin Newsom proposes extending eviction protections and expediting $2.6 billion in federal rental assistance for low-income tenants.  If a test shows that medication is needed, the company makes a prescription easy. A MintRx ad on Groupon explains that customers can “get treated online by one of our participating providers in 5 minutes.” MintRx executives didn’t respond to several messages. The industry says the tests have benefits beyond their convenience, including more transparency of prices. Customers know how much they will pay for the test when they order it — not a common experience in today’s health system where even patients with insurance can be hit with expensive bills they weren’t expecting. In September, a group of researchers led by Louiza Kalokairinou at the University of Pennsylvania’s Perelman School of Medicine published a paper detailing the advantages and risks of at-home lab tests. They noted that an at-home test for COVID-19 allows someone infected with the virus to avoid exposing others. But the minimal involvement of physicians, they wrote, increases the risk that consumers will misinterpret the test’s results. “Amidst the pandemic, the market has been flooded by companies making unsubstantiated and often fraudulent claims,” they wrote. The misleading promotion “capitalizes on widespread anxiety caused by the pandemic and preys on the vulnerability of consumers,” they added, “many of whom are likely concerned about their health.” The start-ups have benefited from loopholes in federal regulations for lab-developed tests. Such tests are designed, manufactured and used by a single laboratory. Decades ago, use of the tests was limited. Sometimes referred to as “home brew tests,” they were often created by hospitals to diagnose their own patients. Now an unknown number of the tests are sold across the country. The tests don’t have to be registered, but experts estimate that 100,000 have been developed. California coronavirus cases: Tracking the outbreak California coronavirus cases: Tracking the outbreak The latest maps and charts on the spread of COVID-19 in California.  In contrast, commercial lab tests that are manufactured in large quantities and sold as kits to multiple labs and healthcare facilities must gain approval from the FDA — a process that can take more than a year. Critics of the lack of rules often point to the flawed lab-developed tests sold by Theranos, the Silicon Valley lab start-up that was once valued at $9 billion. The company ceased operations in 2018, and founder Elizabeth Holmes and the company’s former president were indicted on criminal fraud charges. Their trial has been delayed because of the pandemic. Some lab-developed tests can have serious consequences on a person’s health. The FDA says it has found faulty tests that could have led to patients taking unnecessary and harmful treatments. Other flawed tests created the risk that patients would not get the therapies they needed. The agency has long said it has authority to regulate the tests — a position opposed by many in the industry. The opponents point out that the labs already must follow other federal and state rules that require labs to be inspected and meet certain standards. In August, Trump officials in the Health and Human Services Department said the FDA would no longer be able to review and approve lab-developed tests before they were sold. In a statement, the officials said the move was needed to “keep duplicative regulations and unnecessary policies from interfering” with their efforts at “combating COVID-19.” The decision was swiftly criticized by some experts, including Scott Gottlieb, who served as Trump’s first FDA commissioner until he stepped down in April 2019. “Now, FDA’s ability to protect public health could be challenged,” Gottlieb tweeted soon after the decision. “FDA might not be able to provide critical advice to test developers or take needed enforcement actions against bad tests.” We'll see a plethora of DTC Covid tests enter the market, where tests ship directly to consumers and are processed in a central lab operating outside FDA oversight. CMS oversees lab operations, but there’s no process for  ensuring clinical accuracy prior to coming to market 10/x In October, two top FDA officials, Jeffrey Shuren and Timothy Stenzel, published an article in the New England Journal of Medicine calling for legislation to “ensure that all clinical tests are accurate and reliable.” They noted that before the Trump officials’ decision, agency scientists had found that two-thirds of the 125 proposed COVID-19 tests they had reviewed had problems, including in their design or how their accuracy was validated. With the testing boom, investors have flocked to the lab start-ups. In October, Bloomberg News reported that Everlywell had been valued at $1 billion or more — making it what investors call a unicorn — in its ongoing talks to raise more money. Last year, the company had been valued at $175 million. In September, Everlywell hired Andy Page, the former president of 23andMe, the Google-backed lab start-up. Another health start-up called Truepill announced in September it had obtained $75 million from investors to launch a network of labs that will process at-home tests. Truepill, based in San Mateo, Calif., already operates pharmacies and a telehealth network where patients can get prescriptions from physicians online. Truepill said it doesn’t sell healthcare directly to consumers. Instead, it builds the infrastructure that allows other start-ups to do that. For example, it has created the network that allow Hims Inc., a San Francisco start-up, to offer men and women quick prescriptions for sexual dysfunction and other maladies. “We envision a future where 80% of healthcare is digital,” Sid Viswanathan, a Truepill co-founder, said in a September news release. Richardson at the Pew Charitable Trusts said Congress needs to act to allow the FDA to regulate the lab tests with the most serious risks. “We can’t allow this large and ongoing ambiguity” in the law, she said, “for such a large portion of the healthcare structure.” “I do worry about bad actors who might try to capitalize,” she said.
The World Health Organization has recorded 65 coronavirus cases among staff members based at its headquarters, despite the agency’s public assertions that there has been no transmission at the Geneva site, an internal email obtained by the Associated Press shows. The cases involve at least one cluster of infections. The revelation comes amid a surge of cases in Europe , including WHO host country Switzerland and the city of Geneva in particular. The email said that about half of the infections were in people who had been working from home. But 32 were found in staff who had been working at the headquarters building, suggesting that the health agency’s strict hygiene, screening and other prevention measures were not sufficient to spare it from the pandemic. Farah Dakhlallah, a WHO spokeswoman, confirmed the accuracy of the information about the case count in an email to the AP but said the agency had not yet determined whether the spread happened at its offices. Raul Thomas, who heads business operations at the WHO, emailed staff Friday noting that five people — four on the same team and one who had contact with them — had tested positive for the coronavirus. Although the email did not use the term, a “cluster” is generally defined as two or more cases in the same area, and the five cases indicate that basic infection-control and social-distancing procedures were likely being broken. A previous email Thomas sent Oct. 16 indicated that no clusters had been found at the site. “As per standard protocols, these colleagues are receiving the necessary medical attention and are recovering at home,” Friday’s email said. “These last five cases bring the total reported number of affected members of the Geneva-based workforce to 65 since the beginning of the pandemic.” World & Nation Moderna’s COVID-19 vaccine boasts a nearly 95% effective rate in early data World & Nation Moderna’s COVID-19 vaccine boasts a nearly 95% effective rate in early data There’s more promising news on the COVID-19 vaccine front as Moderna says its shot provides strong protection against the coronavirus.  More Coverage Thomas’ email did not specify who was infected, but a staff member with direct knowledge of the situation, speaking on condition of anonymity because she was not authorized to speak to the media, said the cluster included an infection-control specialist member who serves on Director-General Tedros Adhanom Ghebreyesus’ leadership team.  The senior manager reportedly held several in-person meetings at the WHO in early November before testing positive last week. The person, contacted by the AP, referred all comments to the WHO media office. The agency has faced repeated criticism of its handling of the pandemic. President Trump accused the U.N. agency of “colluding” with China to hide the extent of the initial outbreak. In June, the AP found that WHO publicly lauded China for its speed and transparency even though in private meetings WHO officials were frustrated that the country  delayed release of critical outbreak information. According to Thomas’ email, 49 of the cases had occurred in the last eight weeks, “thus very much in line with the situation being reported in Geneva and the surrounding areas.” He added that “a higher number of cases among those who telework might have gone unreported.” Science 10% of world’s population may have been infected with coronavirus, WHO estimates Science 10% of world’s population may have been infected with coronavirus, WHO estimates A senior World Health Organization official says its ‘best estimates’ indicate that roughly 1 in 10 people worldwide may have had the coronavirus.  Enhanced measures to “reduce our risk profile” were being considered, the email said. “Finally, members of the workforce are reminded that physical meetings, including gatherings in common areas or in the cafeteria, are strongly discouraged and should only take place where absolutely necessary,” the email added. Elsewhere in Geneva, restaurants are among many public venues that have been closed to prevent the spread of the coronavirus. Last month, Thomas told WHO staff that the agency was restricting access to its Geneva headquarters to critical employees, including senior directors, their assistants and management officers. “All members for the workforce are reminded to always keep proper hand hygiene, respect physical distancing standards ... and wear masks, when distancing is not possible,” he wrote.  Politics U.S. will cut ties with World Health Organization over coronavirus response, Trump says Politics U.S. will cut ties with World Health Organization over coronavirus response, Trump says The president said WHO had failed to adequately respond to the coronavirus because China has ‘total control’ over the global health organization.  In normal times, an estimated 2,400 people regularly work at the WHO’s seven-story headquarters. As outbreaks in the area have worsened, staff members have been encouraged to work from home when possible. Non-staff visitors have been required to wear masks , and access to the building has been curtailed. And ahead of the agency’s weeklong meeting of member states last week — which was mostly virtual — the staff was told in an internal email to take extra precautions, including mask-wearing in public places. On Monday, from a vast meeting room at the headquarters, Tedros and other officials participated in a session of the agency’s latest executive board meeting, which was largely conducted by videoconference. Tedros was returning from a two-week self-quarantine after coming into contact with a person who had tested positive. Because Tedros did not show any symptoms himself, he was not tested for the coronavirus but stayed at home as a precaution. On Nov. 2, the WHO’s technical lead for the COVID-19 response, Maria Van Kerkhove, told reporters that there had been no transmission or clusters at headquarters, before adding: “But it is something that we’re monitoring every day.” The WHO press office did not respond to two emails from the AP — on Nov. 2 and Nov. 10 — asking how many staff members based in Geneva had tested positive for the coronavirus.
On the Shelf No Time Like the Future: An Optimist Considers Mortality By Michael J. Fox If you buy books linked on our site, The Times may earn a commission from Bookshop.org , whose fees support independent bookstores. When Michael J. Fox was diagnosed with Parkinson’s disease at age 29, already a major movie and TV star (“Family Ties,” “ Back to the Future ”), a doctor told him he would be lucky to work for 10 more years. Thirty years and eight Emmy nominations (including a 2009 win) later, the joke’s on that guy. But the optimism that carried Fox along even as his body betrayed him — and fueled three hopeful memoirs, beginning with “ Lucky Man ” in 2002 — has given way to a more sober and realistic vision in his latest book, “ No Time Like the Future : An Optimist Considers Mortality.” Part of that realism is the revelation, to himself and his fans, that his acting career is coming to an end. “There is a time for everything, and my time of putting in a twelve-hour workday, and memorizing seven pages of dialogue, is best behind me,” Fox writes in the book, which is out Tuesday. He continues, “At least for now ... I enter a second retirement. That could change, because everything changes. But if this is the end of my acting career, so be it.” Here are some other takeaways from Fox’s fourth memoir. Back to the Future: Hiring Michael J. Fox Back to the Future: Hiring Michael J. Fox   Some Trump digs Among several comments on our slowly departing president , Fox describes his struggle with Parkinson’s in terms of every physical movement being a “negotiation in my mind between Donald Trump and Nancy Pelosi.” His past struggles with sobriety Fox describes the early years with his first son, Sam, as “Miller Time.” Looking back on it, Sam “tells me that his earliest memories include going to the fridge to get me beers.” Fox quit drinking when Sam was 3 and has been sober ever since. Memory loss and delusions Like many Parkinson’s patients, Fox has begun to notice cognitive changes, including memory loss, confusion, delusions and dementia — something he has “rarely contemplated before now, much less spoke of.” He describes looking for his car keys before remembering he can no longer drive; mistaking one of his twin daughters for the other and uttering, “What did you think?” to “the person to my left, who isn’t there.” A missed gig with a Hollywood ending The day Fox was set to film a cameo in the 2019 Spike Lee -produced movie “ See You Yesterday ,” he had a serious fall — only four months after a critical surgery to remove a tumor from his spine (unrelated to Parkinson’s). But Netflix offered a “Hollywood ending,” funding a pick-up day to return to set about six months later, reassembling the cast and crew and belatedly completing Fox’s scene. Keith Richards and more famous friends Even big-shot actors get starstruck. Fox rang in New Year’s Day 2018 next to Keith Richards , “swashbuckling pirate king, immortal rock god, and Rolling freaking Stone ... I’m not worthy.” Adorned with a massive skull ring, cocktail in his hand, Richards and Fox (virgin piña colada in hand) enjoyed the fireworks show together at a Turks and Caicos resort. Unfortunately, Fox was dealing at the time with an excruciatingly painful pinched sciatic nerve and had to cut the trip short. “Oh god, Keith Richards looks better than I feel,” he thought. Fox also writes at length about hitting the links with his golfing buddies, author Harlan Coben and ABC News’ George Stephanopoulos ; hanging out with former Sen. Harry Reid (D-Nev.); and working with the likes of Larry David. Music Keith Richards on catching COVID: ‘I’m impervious ... like Donald Trump’ Music Keith Richards on catching COVID: ‘I’m impervious ... like Donald Trump’ Keith Richards on his X-Pensive Winos reissue, a new Rolling Stones album and living in American during COVID.  His binge-watches may surprise you You can count Fox among the legion of fans who find comfort in “ Great British Baking Show .” The actor also enjoys “ Peaky Blinders ,” “Escape at Dannemora ,” cable news and old game shows he acknowledges are “politically incorrect.” Watching vintage TV, Fox "[slips] into another reality. It’s one of the million iterations of time travel — to visit a world that’s pre-me ... Just like the performers in these old shows, someday I will survive myself in reruns.” Love and family ties Fox is “quietly impressed” that he and Tracy Pollan have passed their 30th anniversary, decades after first meeting on the NBC sitcom “ Family Ties .” “She’s not always a rock, but that’s okay,” he writes. “Rocks are solid, stubborn, and immovable. That’s me. Tracy, on the other hand, has learned to keep the rock rolling.” Not so happy days on ‘The Michael J. Fox Show’ Fox has some choice words for NBC, which picked up one season of “The Michael J. Fox Show” from 2013-2014: “I think Parkinson’s freaked them out, which was problematic, because it was the premise of the show.” He considers it a “grievous mistake” that he did not involve his longtime producing partner Nelle Fortenberry, who helped him write this book by transcribing dictation. Ultimately, he takes responsibility for the show’s failures. He didn’t have “the focus or the bandwidth to administer the life support the show would need to make it. That’s on me, and I’m fine with that.”  Television Michael J. Fox: Can he really come back with new NBC comedy? Television Michael J. Fox: Can he really come back with new NBC comedy? Michael J. Fox: Can he really come back with new NBC comedy?  He took inspiration from Quentin Tarantino When it comes to Fox’s declining health and independence, he feels a connection with Leonardo DiCaprio’s character in Quentin Tarantino’s “ Once Upon a Time ... in Hollywood,” “one of my favorite films by one of my favorite directors.” He writes, “DiCaprio, playing a cowboy actor who’s seen better days, keeps screwing up his lines ... Furious at himself over his chronic inability to remember and deliver the dialogue... [he] berates himself viciously over his abject failure. I feel his pain. I’ve obviously been there. “But weighed against everything else in my life, I don’t find it worthy of self-excoriation ... My work as an actor does not define me.” Despite several setbacks and scares, Fox remains committed to advice his late father-in-law Stephen Pollan gave him, “With gratitude, optimism becomes sustainable.”
The astronomical coronavirus surge in Los Angeles has infected thousands of healthcare workers in recent weeks and exacerbated the strain on hospitals struggling to care for critically ill patients. More than 2,200 people who work at hospitals in L.A. County tested positive for the virus in December alone, constituting roughly a third of all hospital infections reported during the pandemic. Whereas in previous months nursing homes and outpatient clinics suffered the most illnesses, besieged hospitals and their beleaguered workers have been hit hardest by the winter surge. Dr. Anish Mahajan, chief medical officer of Harbor-UCLA Medical Center in Torrance, said that adequately staffing his hospital — where the ICU is stretched to 150% of its normal capacity — is a constant challenge, with staffers out because they are ill with COVID-19 or quarantining due to exposure. Hospitals across California have reported similar trends. “Somebody who wears their PPE perfectly and deals with high-risk patients doesn’t get sick at work. ... When they get home, their teenager might give them COVID. We see that a lot,” Mahajan said. “We end up short-staffed in everything, from nurses to doctors to even the custodial staff that helps us turn over the rooms. And all of that makes it even more difficult to take an onslaught of more and more patients.” The recent explosion of the coronavirus has trapped L.A.'s hospitals in a vicious cycle. The more people who are ill, the more likely others will become infected, both at and away from work. That, in turn, intensifies staffing shortages at hospitals — at the very moment the public needs medical care the most. Outbreaks have also jumped dramatically in recent months among grocery store workers and retail employees and at other workplaces .  But the rise in infections comes at a crucial time for L.A.'s hospitals as they buckle under a deluge of patients and turn away ambulances , line hallways with gurneys and cram bodies into overflowing morgues . California Only 60% of LAPD officers, employees willing to take COVID vaccine, internal survey shows California Only 60% of LAPD officers, employees willing to take COVID vaccine, internal survey shows An informal survey of LAPD employees found significant skepticism about COVID-19 vaccines, with 20% saying they’d opt out.  More Coverage Officials reported Tuesday that a record 7,898 people with COVID-19 were currently admitted to hospitals in L.A. County, a record-breaking total that is expected to grow in the coming weeks.  “We’re going to continue to work with organizations across the county to ensure that healthcare workers at every location are protected,” L.A. County Department of Public Health Director Barbara Ferrer said this week. Since the pandemic began, 28,448 healthcare workers and first responders have tested positive for the coronavirus in L.A. County, and 132 have died from the virus, Ferrer said. Hospitals, nursing homes and outpatient clinics account for the majority of cases. Infections among healthcare workers have swelled as overall cases have grown. In a single week in mid-December, as L.A. County reported more coronavirus infections than ever, 2,363 healthcare workers and first responders fell ill with COVID-19, compared with 360 two months prior. Hospitals are where these problems compound. Nurses and doctors are stretched thin as COVID-19 patients overrun hospitals, and staff are out with the disease themselves, said UCLA emergency room  nurse Marcia Santini. “We have COVID that’s rampant and we have a very sick population — coupled with that we have a staffing crisis,” she said. “All of that combined is putting a real stress on these facilities.” Santini became sick with COVID-19 last month, though she is not certain how she contracted the virus. She cared for COVID-19 patients before becoming ill, but her husband showed symptoms before her, suggesting he got it at work and then passed it on to her. Her illness became so severe that she couldn’t breathe and was admitted to the hospital for days. Nearly three weeks later, she remains easily fatigued. “I’ve never gone through anything like this,” she said. At Kaiser Permanente San Jose Medical Center, at least 43 staff members recently contracted the coronavirus, including one who died, part of an outbreak possibly linked to an employee who wore an inflatable holiday costume in the hospital to lift spirits. In Fresno County, where only 11 ICU beds remained available Tuesday, a recent rash of healthcare workers falling ill or needing to stay home due to exposure to the virus has hampered hospitals’ ability to treat patients, said interim health officer Dr. Rais Vohra. California COVID-19 deaths hit 11,000 in L.A. County, as surge creates ‘a human disaster’ California COVID-19 deaths hit 11,000 in L.A. County, as surge creates ‘a human disaster’ California registered more than 74,000 new coronavirus cases Monday — 11% higher than the previous record for a single day.  More Coverage “We have hundreds of people who are out who could otherwise be working in our hospitals,” Vohra said. “There are so many cases that are happening, whether it’s a healthcare worker who’s sick or a relative who’s ill, that really affects our ability to deliver care because that person then has to take time off.” Unlike in the spring, when a shortage of personal protective gear and ventilators was the most pressing issue, concerns during this latest surge have been largely centered around staffing. The U.S. Department of Defense is lending combat medics and nurses to assist hospitals across California. L.A. County officials have redeployed nearly 800 clinic nurses to work in its public hospitals, while other local hospitals have recruited doctors and nurses from other departments to help out in the ICU, though with varying success. “Quite frankly, you get comfortable in your field of knowledge, and when you’re put somewhere else, you’re a little bit of a fish out of water,” said Dr. Frank Candela, who is on the medical executive committee of West Hills Hospital. “People are spread thin. They’re persevering. They’re adapting, but it puts a big strain on the person doing it, as well as patient care.” Many healthcare workers cited the emotional toll of seeing not just strangers severely ill, but their own colleagues hospitalized with the virus, or even killed by it. Candela said that Ernesto Ruelas, an environmental service worker at the hospital, died of COVID-19 this week. “He is deeply missed,” Candela said. For the most part, staff who are falling sick with COVID-19 are believed to have caught it outside the hospital, he said. But that hasn’t always been the case. California Free Airbnb with your COVID-19 vaccine? Firefighters offered prizes along with priority access California Free Airbnb with your COVID-19 vaccine? Firefighters offered prizes along with priority access Top LAFD brass are using free Lyft rides, Google Nest gear and home security systems to entice firefighters unwilling to get a COVID-19 vaccine.  In an unfortunate incident over the summer, COVID-19 infections were transmitted among staff who spent time together in the break room, often without masks and distancing, he said. That outbreak ultimately spread to patients too, he said. Candela said the hospital has since begun to stagger breaks so people don’t eat lunch at the same time and now prohibits bringing in food to share with others. But he said he hopes his hospital’s experience shows the public that even small lapses can have devastating consequences. “We sort of learned the lesson the hard way: that we can’t let our guard down,” he said. This dark moment of the pandemic is brightened by ongoing vaccinations, healthcare workers say. The first people vaccinated in California will receive their second dose this week, which offers 95% immunity to the coronavirus. With that protection, hospitals eventually won’t be so short-staffed, Mahajan said. “Right now is the worst time because the vaccine hasn’t been out long enough,” he said. “But that’s going to be less and less of an issue as the days and weeks of January go by.” Mahajan has warned his staff that the extreme surge will continue for at least five more weeks. L.A. County officials said this week that they expect the number of people hospitalized with COVID-19 to grow by at least 1,000 within the next two weeks, though only about 20 ICU beds are available. “One of the things I’ve tried to tell our staff as we entered the Christmas holidays is that this is halftime,” Mahajan said. “I’ve asked them to pace themselves over the holidays — take some time for themselves and their families — because we have so much more we have to do.”
After spending the first part of the pandemic in the spotlight for a large COVID-19 outbreak at Otay Mesa Detention Center, Immigration and Customs Enforcement has contracted out medical care at the facility to the private prison company that owns and operates it. Detainees interviewed by the San Diego Union-Tribune say the medical care, which they and their advocates already had  criticized , has grown even worse under the private operator CoreCivic than it was under ICE. Detainees complain of missed and late medications, multiple-day waits for medical attention and a lack of transfer of records that left staff in the dark about what treatment individual detainees were supposed to be receiving. It has also meant that those who had been approved for specialty care, such as oncology and orthopedics, would have to begin the lengthy process anew. “The first couple of days, it was chaos,” said Guillermo Alvarez Mendoza, a detainee with diabetes, hypertension and chronic back pain. “If you were getting your blood sugar checked two or three times a day, it was midnight before they came for the first blood-sugar check.” Both CoreCivic and ICE denied the detainees’ allegations. “Our clinic is staffed with licensed, credentialed doctors, nurses and mental health professionals who contractually meet the highest standards of care,” said Amanda Gilchrist, spokeswoman for CoreCivic. “CoreCivic also maintains several accreditations from nationally recognized industry leaders such as the American Correctional Assn., the National Commission on Correctional Health Care and the Joint Commission on Accreditation of Healthcare Organizations, which ensures we meet the highest standards for healthcare delivery.” She said that detainees with chronic health conditions are regularly monitored and that all detainees are able to sign up for sick call daily. Lauren Mack, aspokeswoman for ICE, called the transition “seamless.”  “The health, safety and welfare of those in our care remain a top priority and concern for the agency, regardless of the medical service provider,” Mack said. The Otay Mesa facility still has a reduced number of ICE detainees because of  the pandemic — currently about 330, the agency said. CoreCivic proposed the switch in the second quarter of 2020,  Gilchrist said, and ICE agreed to it. It was not immediately clear how much ICE is paying CoreCivic for the services, which they took over Sept.10 after a 90-day transition period. An ICE official speaking on background said that the shift was seen as a positive change, and detainees will receive the same level and standard of care.   CoreCivic received medical summaries from ICE and has a way to request additional records on an as-needed basis, Gilchrist said. But detainees tell a different story. “They didn’t know none of our doses, none of our medications, what we actually needed, what was prescribed to us,” Alvarez Mendoza said. “They would ask us, ‘What are you supposed to take right now?’” After several days of not receiving any of the medications he was supposed to get, Alvarez Mendoza said, medical staff showed up with some of his meds. Others, particularly his prescribed pain medications, were missing. In protest, he refused to take what had been brought. ICE maintained that Alvarez Mendoza had access to his medications throughout the transition and said that he had refused his medications eight times. Alvarez Mendoza, who had a green card, was transferred to ICE custody from state prison after serving a couple of decades for a carjacking conviction, according to ICE. He’s waiting on an appeal of his immigration case. “The time that I’ve spent in ICE custody is weighing a lot more than the time I did in prison,” Alvarez Mendoza said. “I’d rather be back in state. That’s how sorry and pitiful they treat you.” Several detainees in another housing unit had similar complaints. Alvarez Mendoza said he’d been diagnosed with a tumor in his testicle about a month ago. He was then supposed to see another specialist to address the issue. But when the changeover happened, the medical staff no longer had records of the referrals, he said. And now he’s being given the same diagnostic tests that he already had, essentially starting the process over again. “Now I have to wait more time,” Mendoza said in Spanish. “I tell them I have a tumor, and it doesn’t seem important to them.” Jose Hernandez had a similar experience. He was injured while being transferred on a bus between ICE facilities, he said, because he was handcuffed and in the bathroom when the vehicle stopped suddenly. He’d been seeing a specialist in orthopedics at an ICE facility in Alabama for the shoulder injury, but when he was sent to Otay Mesa, he had to push for a year before he was taken to a specialist. Now that CoreCivic is in charge of medical care, he’s had to start the process over a second time, he said. He had hoped medical care might get better with the change, he said. “But it’s not,” Hernandez said. “It’s worse.” Jose Antonio Espinoza said that it took the facility five days to see him after he signed up for sick call because he had pus coming out of his ear. He’s also on a blood-pressure medication, which he’s supposed to take right before dinner, he said. Sometimes medical staff bring the medication at 3 a.m., other times at 9 p.m. “They said it’s because there’s no staff,” Espinoza said. Jose Manzo Alvarez said he stopped receiving his blood-pressure medication after the transition happened. Staff told him they had ordered more by mail but that it hadn’t arrived yet, he said. “I’m a very patient person, but I figured it’s time to let somebody know,” Manzo Alvarez said. ICE said it could not comment on these additional individual allegations without having identification numbers for each detainee. CoreCivic deferred to ICE on individual cases. Morrissey writes for the San Diego Union-Tribune.
Twenty-eight more people have died of COVID-19 across Los Angeles County and 1,285 new coronavirus infections have been confirmed, officials said Saturday. The numbers, reported by the Los Angeles County Department of Public Health, bring the countywide pandemic death toll to 6,768 people, with 281,165 confirmed cases. In 72% of the new cases, those who tested positive were under 50 years old, the department said. Of the 28 deaths, the department said, 22 people had underlying health conditions. One of the fatalities involved a person between 18 and 29 years old, while two people were between 30 and 49, seven were between 50 and 64, nine were between 65 and 79, and nine were over 80, the department said. “Please remember that even young people can have serious illness if infected with this virus and have severe outcomes,” county Public Health Director Barbara Ferrer said in a news release. Ferrer recommend the use of masks, social distancing and avoiding nonessential activities. The department said 93% of the fatalities involve people with underlying health problems. The LA County numbers do not include Pasadena, where the reported deaths are now 129, and Long Beach, where the number is 249. The department urged bars and restaurants that might be airing sports not to allow customers to congregate around the televisions.  Experts say it is too soon to characterize the increase in cases in Los Angeles County as a surge, of the kind that accompanied rapid business reopenings over the summer. The state is now relying on a tiered reopening strategy, and in L.A. County, where businesses such as breweries and wineries have been allowed to reopen outdoors, the high case count has kept it at Tier 1. Across the country, some 40,000 new cases of COVID-19 are reported every day. Dr. Anthony Fauci, the U.S. government’s top infectious-diseases expert, said this week that the pandemic could get worse in the winter and persist through much of next year. He warned that a vaccine won’t return the country to pre-pandemic conditions but predicted “some degree of normality” in the second half of 2021.
Health policy specialists questioned White House officials’ claim that federal rules on essential workers allow Vice President Mike Pence to continue to campaign and not quarantine himself after being exposed to the coronavirus. Campaigning is not an official duty that might fall under the guidelines meant to ensure that police, first responders and key transportation and food workers can still perform jobs that cannot be done remotely, the health experts said. A Pence aide said Sunday that the vice president would continue to work and travel, including for campaigning, after his chief of staff and some other close contacts tested positive. Pence tested negative on Sunday and decided to keep traveling after consulting White House medical personnel, his aides said. Politics President Trump and first lady test positive for the coronavirus Politics President Trump and first lady test positive for the coronavirus President Trump and First Lady Melania Trump have tested positive for the coronavirus, the president tweeted early Friday.  More Coverage Pence’s chief of staff, Marc Short, was among those who tested positive. President Trump said early Sunday that Short was quarantining. That usually means isolating oneself for 14 days after exposure in case an infection is developing, to prevent spreading the virus to others. Pence was holding a rally Sunday in North Carolina, events in Minnesota and Pennsylvania on Monday and more events in North Carolina and South Carolina on Tuesday. The most recent numbers show COVID-19 cases are rising in 75% of the country. On Sunday, national security advisor Robert O’Brien told reporters that Pence “is following all the rules” from federal health officials. He called Pence “an essential worker” and said, “essential workers going out and campaigning and voting are about as essential as things we can do as Americans.”  However, the guidelines on essential workers from the U.S. Centers for Disease Control and Prevention are aimed at folks like police, first responders and key transportation and food workers. The Department of Homeland Security spells out 16 categories of critical infrastructure workers, including those at military bases, nuclear power sites, courthouses and public works facilities like dams and water plants. “I don’t see campaigning on the list,” said Dr. Joshua Sharfstein, vice dean for public health practice at Johns Hopkins University and former Maryland state health department chief. “Anything that does not have to be done in person and anything not related to his job as vice president would not be considered essential.” Dr. Thomas Tsai, a health policy specialist at Harvard University, agreed. Helping to maintain the function of the executive branch of government could be considered critical work, but “we’ve always historically separated campaigning from official duties,” he said. Pence also serves as president of the Senate, a largely ceremonial role outlined in the Constitution but one that stands to come into focus Monday. The Senate was expected to vote Monday evening to confirm Trump’s Supreme Court nominee Amy Coney Barrett. Pence’s vote is unlikely to be needed to break a tie, but his presence was expected for the vote. If Pence’s official work as vice president was considered essential, the CDC guidelines say he should be closely monitored for COVID-19 symptoms, stay at least 6 feet from others and wear a mask “at all times while in the workplace.” Lawrence Gostin, a public health expert at Georgetown University school of law, said Pence’s intention to continue campaigning flouts the spirit of the CDC guidelines. Sharfstein said Pence “could be putting people at risk” because he’s at high risk of becoming infected. “He should quarantine in order to protect other people,” Sharfstein said.
Gov. Gavin Newsom signed a law on Friday that for the first time in California defines the term “medical necessity” in a move aimed at requiring private health insurance plans to pay for more mental health and drug addiction treatments. State and federal laws already require health insurance companies to handle mental health treatments the same as physical health treatments. The California Health Benefits Review Program says 99.8% of people enrolled in private health insurance plans have coverage for mental health and substance abuse disorders on par with other medical conditions. But those laws don’t define what is “medically necessary” to determine which treatments get covered. Because of that, advocates say private insurers often deny coverage for some mental health and drug abuse treatments based on their own restrictive definitions. The law requires all private insurers to cover medically necessary mental health and drug addiction treatments. The law requires insurance companies, when deciding whether a treatment is medically necessary, to follow the most recent criteria and guidelines developed by nonprofit professional associations, like the American Society of Addiction Medicine.  California Newsom orders 2035 phaseout of gas-powered vehicles, calls for fracking ban California Newsom orders 2035 phaseout of gas-powered vehicles, calls for fracking ban California would be the first U.S. state to mandate 100% zero-emission vehicles, though 15 countries have committed to phasing out gas-powered cars.  More Coverage State Sen. Scott Wiener (D-San Francisco), the author of the bill, said many insurance companies refuse mental health or drug addiction treatment for people “by saying it’s not serious enough.” He said that’s like telling a State 1 cancer patient they can’t get treated until they are at Stage 4. “We would never tolerate that with physical health. Yet we tolerate it with addiction,” he said. The California Assn. of Health Plans called it a “misconception” that private insurers wait until people are in crisis before they cover their treatment for mental health or drug addiction. They had asked Newsom to veto the bill, arguing it “recklessly defines medical necessity in a way that will undermine the ability of providers to determine what is clinically appropriate for their patients.”  Newsom acknowledged that pressure during a bill-signing ceremony that was streamed online Friday, saying “not everybody is happy with us.” “I got a lot of folks that wanted to pull the plug on this Zoom call today, but we’re doing it because we’re zooming into the future,” Newsom said. The new law takes effect Jan. 1, and it comes as Californians are dealing with a COVID-19 pandemic, a reckoning over racial injustice and massive wildfires that have destroyed homes and businesses while turning the air toxic. Arthur Evans, chief executive of the American Psychological Assn., says the group’s annual “Stress in America” survey has shown the highest stress levels since the survey began in 2007. “All of that really emphasizes the need to have access to not only adequate care but to really have access to excellent care just because we know the need is significant right now,” he said. California Newsom defends his actions to fix California’s troubled unemployment agency California Newsom defends his actions to fix California’s troubled unemployment agency Newsom again blamed payment delays on the crush of claims filed during the pandemic, an influx that overwhelmed the system’s 30-year-old technology.  More Coverage Joe Parks, medical director for the National Council on Behavioral Health, called the law the first comprehensive reform in the country. He said he hoped it would “encourage other states to fill the gaps that they have with this legislation.” The bill was one of more than a dozen health-related measures Newsom signed on Friday. The others included one authored by Sen. Jim Beall (D-San Jose) that sets standards for peer support specialists — people who have suffered from mental health or drug addiction and want to counsel others experiencing the same problems. The bill also authorizes the state’s Medicaid program to seek permission from the federal government to cover peer support specialists. Similar bills have been vetoed twice before by previous governors. It’s one of the final bills authored by Beall to become law as the senator is leaving office this year because of term limits. “The pandemic has really changed the public’s view on this. We now have a pandemic of despair going on,” Beall said, adding that the bill “adds proven mental health resources when we need it most.”
He had directed the first fourth-quarter comeback of his career. Until he hadn’t. When it was over, when a replay review invalidated his last-second touchdown pass, Justin Herbert clutched the collar of his navy-blue jersey and stared up at SoFi Stadium’s video scoreboard in disbelief. The Chargers lost again, this time to the Raiders, 31-26 . Donald Parham Jr.’s catch on the right side of the end zone was a mirage, the resulting euphoria an illusion. There was no reprieve for Herbert and the Chargers, not on Sunday. The Chargers are 2-6 overall, 1-6 with Herbert as their starting quarterback. By now, it’s clear Herbert isn’t the quarterback of a team that’s cursed or an underachieving team that can’t hold leads. He’s the quarterback of a team that’s not very good, if not downright awful.  Chargers Justin Herbert and Chargers lose to Raiders on another final-play heartbreaker Chargers Justin Herbert and Chargers lose to Raiders on another final-play heartbreaker Chargers tight end Donald Parham Jr. can’t hang on to a potential touchdown pass on the final play as the Chargers lose to the Raiders, 31-26.  More Coverage “I know things are going to change here,” Herbert said in the postgame video news conference. He’s probably right. In Herbert, the Chargers have a franchise quarterback. At some point in the relatively near future, they should be able to field a contender, whether it’s under Anthony Lynn or another coach. The question is whether the 22-year-old Herbert can survive until then. His spectacular performances have obscured how he is playing behind a porous offensive line that is jeopardizing his physical well-being and, by extension, his future. Herbert absorbed another pounding while completing 28 of 42 passes for 326 yards on Sunday, as the group’s two major offseason reinforcements were sidelined. All-Pro right guard Trai Turner has played in  one game, in Week 2. Right tackle Bryan Bulaga returned in Week 8, only to reinjure his back on the second play  Sunday. Bulaga was replaced by Trey Pipkins III, who was abused by the Raiders pass rushers. The Raiders entered the game with  just seven sacks, which was tied for 30th in the 32-team league. But they sacked Herbert twice and were credited with seven quarterback hits, not counting the time Maxx Crosby decked Herbert when he pitched the ball to Kalen Ballage on the final drive. Another shot he absorbed from Crosby was particularly costly. With the Chargers down by eight points, Herbert faked a handoff to Ballage and rolled right, only to find Crosby there. Herbert threw back across his body to an open Gabe Nabers for a four-yard touchdown, but was knocked to the turf. Herbert was shaken and required the attention of team trainers. Rules prohibited Herbert from remaining in the game unless Lynn burned a timeout, so Tyrod Taylor replaced him on the ensuing two-point conversion attempt. The attempt failed, which kept the Chargers behind, 28-26. How the Chargers positioned themselves to win this game was a credit to Herbert’s athleticism. Consider the first of his two touchdown passes, a 27-yard strike to Keenan Allen with 19 seconds remaining in the second quarter. Sensing pressure behind him, Herbert stepped up in the pocket. In doing so, he nearly walked into the outstretched arm of a pass rusher. Herbert hopped to his left to avoid the tackle and somehow threw to his right as he landed. The near comeback was also a testament to the rookie’s resilience. “He doesn’t flinch,” Lynn remarked. The Chargers started their final drive on their  25-yard line with four minutes 37 seconds remaining. They drove to the Raiders’ four-yard line, where Herbert spiked the ball to  stop the clock with  six seconds left. That was sufficient time for Herbert to throw a couple of fades to the back-right corner of the end zone. Chargers Chargers’ offense has drive to beat Raiders but drops ball in the end Chargers Chargers’ offense has drive to beat Raiders but drops ball in the end The Chargers put a drive together in attempt to beat the Raiders before time ran out, but two dropped passes in the final six seconds cost them a victory.  The first was to Mike Williams. Then came the near-catch by Parham, who couldn’t hold on to the ball as gravity pulled him to the turf. Afterward, Herbert was stoic. As he addressed reporters over an internet feed, he looked straight ahead. He pursed his lips. He said he would throw to Williams and Parham again, knowing they would make the catches next time. He backed the coaching staff. And he shared why he was confident better days were ahead. Herbert pointed to his freshman year at the University of Oregon, where  he became the Ducks’ starter five games into a 4-8 season. As a senior, he went 12-2 and won the Rose Bowl. He proved his resilience then, just as he’s proving it now. But the Chargers should be mindful of how tough they’re asking him to be. If they demand too much of him, if they require him to take too many hits, he won’t be healthy enough to take advantage of the roster they envision building around him. Chargers Chargers’ 31-26 loss to the Raiders by the numbers Chargers Chargers’ 31-26 loss to the Raiders by the numbers Breaking down the notable numbers behind the Chargers’ 31-26 loss to the Las Vegas Raiders on Sunday.  
Gov. Gavin Newsom on Wednesday allowed health officials to hide their addresses under a California state program designed to protect people from harassment and violence. Newsom’s executive order permits the secretary of state to make the Safe at Home confidentiality program available to local health officers and other public health officials. The order says those officials have been subjected to harassment and threats. Some threats targeted their homes, “which threatens to chill the performance of their critical duties,” the governor’s order stated. The order is designed “to protect local health officers and other public health officials on the front lines of the fight against the virus ,” said a statement from the governor’s office. California Recent rise in COVID-19 cases threatens to slow L.A. reopening, mayor says California Recent rise in COVID-19 cases threatens to slow L.A. reopening, mayor says L.A. County can only enter a new tier on the state’s color-coded reopening blueprint if the positivity rate and number of COVID-19 cases remain low.  More Coverage A California community college instructor was arrested last month and charged with sending two dozen misogynistic and threatening letters to Dr. Sara Cody, Santa Clara County’s top public health official. Alan Viarengo, 55, of Gilroy, is charged with felony counts of stalking and threatening a public official.  He hasn’t entered a plea. The Safe at Home program “provides a substitute mailing address for victims and survivors of sexual assault, domestic violence, stalking, human trafficking, elder/dependent adult abuse, as well as reproductive healthcare workers,” according to the statement. Newsom’s order also contains a series of other actions related to the impact of COVID-19, including extending an authorization through next March 31 for local governments to halt evictions of commercial renters.
Can California address the shortage of life-saving oxygen at some hospitals overwhelmed by coronavirus cases? The demand for oxygen has skyrocketed, as critically ill COVID-19 patients often need high rates of oxygen flowing into their lungs to keep them alive, helping them to overcome a perilous moment when their lungs are inflamed and their oxygen levels in the body become dangerously low. Problems on Dec. 27 with hospital oxygen systems caused five hospitals in L.A. County to declare an “ internal disaster ,” which allows a facility to close its emergency room to all incoming ambulance traffic. That’s a rare situation; traditionally, when emergency rooms are full, only certain types of ambulance traffic are diverted elsewhere. Fully repairing the crippled oxygen distribution systems at aging hospitals throughout Southern California may end up being a complicated endeavor. The U.S. Army Corps of Engineers last week was wrapping up assessing 11 aging Southern California hospitals in urgent need of evaluation, largely focused on oxygen distribution systems that have had significant problems and are essential for critically ill COVID-19 patients gasping for air as their inflamed lungs fail. Some of the oxygen systems evaluated were found to be heavily frosted “just from the constant increased demand for oxygen,” said Mike Petersen, spokesman for the Army Corps of Engineers. Some of the systems were in particularly rough shape, Petersen said, and the accumulation of frost and ice was significant. “We’re doing everything we can to keep them operating.” Compressed oxygen is very cold, and can freeze condensation that builds up around pipes. The freezing can worsen with ever-more increasing amounts of compressed oxygen that flows through the system. Frozen pipes can lead the oxygen distribution system in a hospital to stop working.  But it’s not easy to remove the frost or ice that has built up around the pipes. It wouldn’t be wise, for example, to take a blowtorch to melt the ice around a pipe containing compressed amounts of highly flammable purified oxygen. The Army Corps of Engineers was also asked to evaluate how to address the potential need for greater bed space at hospitals. The teams have begun to send their evaluation reports to the Federal Emergency Management Agency, which asked the Army to undertake the evaluations, and will await further instructions. The Army Corps of Engineers was asked to evaluate the hospitals on Dec. 31 and began evaluating hospitals by Jan. 1. Reports are being written and filed with FEMA. Initially, the Army Corps of Engineers was asked to evaluate six hospitals; that has since been expanded to a total of 11 hospitals. Here is a list of the hospitals. Beverly Hospital, Montebello Mission Community Hospital, Panorama City San Antonio Regional Hospital, Upland Lakewood Regional Medical Center, Lakewood Adventist White Memorial Medical Center, Boyle Heights Good Samaritan Hospital , Westlake Emanate Health Queen of the Valley Hospital, West Covina PIH Health Downey Hospital, Downey Providence Saint Joseph Medical Center, Burbank Providence Holy Cross Medical Center, Mission Hills Providence Little Company of Mary Medical Center, Torrance 
Brianna Davis, a history and government teacher at Rancho Campana High School in Camarillo, was showing a readout of the Declaration of Independence with her students online when she began receiving news alerts about the violent siege on Capitol Hill — live history careening into her government course. “I don’t know what we’re watching. I don’t know what to do right now,” Davis recalled thinking as she struggled to respond to her virtual class, not about the profound 1776 document under study but the 2021 insurrection before their eyes. “There was no way to analyze the grievances of the colonists as things were going down in Washington D.C.” The class ended as questions were just beginning, but Davis said she knew she needed a plan to help her students understand what happened. “I can’t, in good faith, teach government and not teach this,” said Davis, who has taught for 19 years. Some of her students were grateful she chose to address it. “They were ready to talk about it.” With millions of students throughout the country online or connected during class last week, teachers have been confronted with instant tumult in their lesson plans — whether in a history, math or English class — pivoting to discuss the volatile news events with students too young to vote but full of  questions and fears. What led to the riot? What is the electoral process ? How come this is different from the police response to summer Black Lives Matter protests ? What comes next? Some school districts in Southern California are making plans to address the issue. At the Los Angeles Unified School District, teachers are preparing to discuss the insurrection and its aftermath when classes resume Tuesday after winter break. Long Beach Unified sent out guidance to teachers and staff on how to talk to their students about the unrest based on grade level. In a letter titled “A Tumultuous Day for Our Nation,” Supt. Jill Baker said the event, while shocking, presents  an opportunity to discuss civility, equal rights and civic action for social change.  The guidance offered conversation starters to get students to open up and asked teachers to pay attention to their students’ emotional health. The school district also provided key messages to give to students, including how history has shown that hate only causes harm, and that violence is  never the answer to anger. Davis could not afford to wait for guidance. That night, she put together a presentation that began with a timeline of how events unfolded based on news reports. She included statements from former Republican and Democratic presidents George W. Bush and Barack Obama and used a chart so students could express what they felt, heard, saw and thought. She scrapped her plan on the Civil War and instead presented the hastily assembled lesson. She showed images of the mob storming the Capitol. One photo showing a man holding a Confederate flag angered her students, who were quick to point out that the the Capitol was attacked and burned during the War of 1812, which she had previously taught them about. Her class includes students who span the political spectrum, including supporters of President Trump, Davis said. But the conversation in her virtual classroom remained civil, and she focused on the historical context and the importance of democratic processes like free and fair  elections and peaceful transitions of power rather than politics. She shared her presentation online with other teachers, who thanked her for the starting point. “Students respond to history events when they make sense in their own lives,” said Kevin M. Schultz, chair of the history department at the University of Illinois at Chicago. In this case, the riot appeared everywhere on the news and social media, and the political polarization that manifested itself on Capitol Hill was something everyone has felt from fractured families or friendships, he said. At a Long Beach school, one elementary school teacher asked her students if they wanted to talk about their feelings on the insurrection. In a group of about 10 fourth-graders, some said they felt unsafe and scared after seeing and hearing what happened in Washington. “I’m scared because when people break into government houses, that might happen to us,” one student wrote. Another said, “I feel scared to go outside because some people might still be mad.” “I feel uneasy and at a point where I don’t know what to do anymore,” another said. One of her Black students wrote, “I feel scared to go outside and feel unprotected. Sometimes I feel like I’m going to die because of my skin tone.” At the end, the teacher, who declined to give her name to protect her students’ privacy, said she had them listen to a meditation that eased some of their nerves. With the pandemic struggles students are facing, she prioritized their emotional health over lessons. Dr. Linda Drozdowicz, a child and adolescent psychiatrist at Blythedale Children’s Hospital and assistant professor of clinical child psychiatry at Yale University, said it’s important for adults to let young people and children process their feelings. The most important thing, she said, is to remind them that they are safe. “We can process it and talk about it, but in the end, they are OK.” Navigating the issue has been fraught with worries. At one San Gabriel Valley middle school, students began discussing the riot in an online chat in a seventh-grade math class. One student asked the others if they had seen the news. “Yeah and it makes me so mad that they bearly  got a slap on the wrist for it,” one student wrote online. “If they had been Black they would’ve been cleared out with tear gas,” another student said, adding, “the way trump told them to go was ‘i love you go home!’” Vivian Chau let her students chat for a little before she asked them to withhold from talking about politics. Chau said she kept the conversation brief because she did not want to inflame tensions. She worried about  appearing to choose  a political side. On Thursday, Erik Anderson, a high school teacher in Edina, Minn., gave his students time to process their thoughts about the riot while going through photos of the event. On Wednesday, he spent 45 minutes on a virtual meetup with some of his ninth-graders, who had questions about the electoral college process and responsibility of the police in the riot. Anderson, a social studies teacher, said the police killing of George Floyd in Minneapolis, about 10 miles northeast of Edina, was fresh in their minds, and many students noted parallels of the conflicts. “They saw those scenes here in Minneapolis last summer,” Anderson said, when protesters took to the streets as part of the Black Lives Matter movement. Anderson’s students noted that while protesters were met with heavy police force in Minneapolis, rioters on Capitol Hill were not . And the image of the man carrying a confederate flag inside the Capitol stunned his students, who had just studied the Civil War. “There were a lot of questions about what comes next,” Anderson said. Some students wondered if this was the future of the country.   
At a hospital near South Los Angeles, doctors debate whether an elderly patient should be hooked to one of the few remaining ventilators. Meanwhile, nurses at Ronald Reagan UCLA Medical Center in Westwood fear they are treating too many patients to provide them all with the best care. And for emergency medical technicians, racing the sick to hospitals has become an obstacle course, with not enough beds for the hundreds of patients in need. Once an ambulance that has responded to a 911 call finds a hospital, it can take up to 17 hours to offload the patient. These are dark days for Los Angeles County doctors, nurses and EMTs, marked by levels of death once unimaginable in the United States, despite tireless efforts to treat patients. “It’s a war zone,” said one doctor at an L.A. County public hospital. “The way most people leave is by dying.” But amid the exhaustion and anguish of the last several weeks is something worse: fear that the next few weeks will be even more dire. Another COVID-19 surge, fueled by the recent holidays, is beginning to swell, and the looming question is how big an uptick hospitals will face. Officials say even small increases in demand could trigger grim measures that would further compromise care. Already, so many people are dying in L.A. County that hospital morgues and funeral homes are often full. In the last week, 200 people a day were dying of COVID-19 in the county — more than the number of deaths from all other reasons combined, which average 170 a day.  A doctor at one of L.A. County’s public hospitals has heard “families wail on the phone, in agony that their loved one is dying.” “We spend our days calling families to let them know their loved one has exhausted all medical treatment and are going to pass away despite our best efforts,” the physician said. The hospital’s emergency room is packed with patients waiting to get into the intensive care unit, where space typically opens up only when someone dies. Patient care is suffering because ER staffers aren’t trained to care for ICU patients and have many of their own to attend to, the doctor said. But the next phase of the pandemic could be worse. L.A. County hospitals so far have generally avoided having to make the most heart-wrenching decisions: choosing who receives aggressive lifesaving care and the limited time of the best-trained professionals and equipment, and who will be treated only for comfort as they die. Teams of triage officers — usually led by critical care and emergency doctors — would make those calls. At Ronald Reagan UCLA, there are tents outside the ER to triage and treat the patient overflow. Staffers are struggling to keep up as they are assigned more patients than they can handle, said ER nurse Marcia Santini. “We have a real unsafe situation,” she said. “It’s really scary.” The state last month granted waivers permitting hospitals to increase the number of patients nurses can treat at one time. California law typically allows ER nurses to be assigned no more than four patients, but the loosening of regulations has bumped that up to six at some hospitals. “We do not shy away from hard work. We do not shy away from taking care of patients. But what we do not want is to work in an unsafe environment, and that’s what it’s become,” Santini said. “We understand we’re going through unprecedented times, but if we don’t have enough staff in these areas or the equipment, then it’s really hard to take care of somebody.” The once-clear divisions between COVID and non-COVID patients have broken down as the hospital fills up, she added. In the ER, she can treat a COVID patient minutes before seeing someone with another illness. “That makes additional stress: ‘Oh, my God, am I protected correctly? Did I change my gloves? Did I change my mask?’ … You have to think every time before you go into another room,” she said. “You could have a COVID patient, and you could have a patient coming in with complications with cancer … and you have to be really careful not to cross-contaminate.” In response to Santini’s comments, UCLA Health System said in a statement that it follows state-mandated staffing ratios and has adequate supplies of personal protective equipment to keep nurses safe. “The safety and well-being of UCLA Health nurses, our other health care workers and our patients is our overriding priority at all times. We understand the anxiety created by the high volume of COVID-19 patients and associated workload, and we value our staff’s dedication to high-quality, compassionate patient care,” the statement said. Other hospitals are already facing tough decisions about how to distribute limited resources. A nurse at St. Francis Medical Center in Lynwood said providers discuss how to distribute the scant supplies of high-flow oxygen and BiPAP machines, which help COVID-19 patients breathe. A doctor at the hospital described a recent argument about whether to put a critically ill patient on one of the remaining ventilators. The team ultimately decided not to. “This kind of scenario is going to continue happening, and it’s sad and traumatic for medical teams to be put in this position on a daily basis,” the doctor said. At St. Francis, any separation between COVID and non-COVID patients has disappeared, with the ER functioning as “an open-air ICU,” the doctor said. Nurses are assigned more patients than they can handle, and patients “line the hallways, unmonitored.” The problems extend outside hospital walls. Emergency medical technicians who respond to 911 calls are dealing with bottlenecks, extreme wait times and sickened staff. “While we’re trained to deal with crises, something like this has never been seen in anybody’s lifetime that’s in healthcare right now,” said Tom Wagner, chief executive for the Western region of American Medical Response, one of the country’s largest ambulance service providers. AMR and Care Ambulance Service, a provider in Los Angeles, Orange and Riverside counties, are responding to a combined 1,500 emergency calls a day, officials said — roughly 30% more than in the earlier months of the pandemic, when calls decreased during initial stay-at-home orders. The Los Angeles Fire Department, which provides ambulance services within the city, is responding to 800 to 1,000 emergency medical calls each day. The flood of patients, along with increasingly sick healthcare workers and the lack of ICU beds, is resulting in crippling delays when it comes to offloading patients at hospitals. Before the pandemic, an ambulance could be back on the road within minutes of arriving at a hospital. Now, EMTs are regularly waiting four, five or even 10 hours to offload a patient, said Jeff Lucia, Care’s communications director. On Wednesday, “I heard as much as 13,” he said. Wagner said he’s aware of wait times as long as 17 hours. “That’s time that a patient is on an ambulance gurney, which is a little uncomfortable for them, at a hospital waiting to be brought in,” Lucia said, adding that even if Care were to put more ambulances on the road, most would end up just “sitting there.” Ambulance crews are also experiencing a reduction in staffing due to the spread of the coronavirus. More than 170 of the LAFD’s responders are in isolation due to COVID-19, said Dr. Marc Eckstein, the department’s EMS Bureau commander. Meanwhile, “several dozen” of AMR’s 500 L.A. caregivers are in various stages of quarantine on any given day, Wagner said. The L.A. County Emergency Medical Services Agency has issued a directive advising ambulance crews to conserve oxygen for patients whenever possible, but Lucia said the contents of the small tanks within ambulances are being used up during the long delays outside hospitals. Both AMR and Care said they have developed contingency plans to redistribute oxygen and PPE, if necessary, to prevent dangerous shortages. The county’s directive also told ambulance crews not to transport to hospitals patients who no longer have a pulse, can’t be resuscitated at the scene and have an extraordinarily limited chance of survival — a scenario that is increasingly likely as the number of sick patients climbs. Eckstein said cases of cardiac arrest more than doubled in November and December compared with 2019, a reflection of the impact of COVID-19. “It’s really a true nightmare,” Santini said, “because you’re being forced to do things you would never do.”
On the beautiful spring day that her bestie Charles “Chuck” Jackson was laid to rest in South L.A., Clarice Kavanaugh spent most of it restless in her car. Staring at her phone behind rolled-up windows, she watched as the pastor delivered the eulogy online. Then as masked pallbearers carried his coffin from the funeral home. And finally as loved ones came and went from the cemetery. Only a few weeks earlier, Jackson had been living it up in the mountains of Idaho with fellow members of the National Brotherhood of Skiers. And only a few weeks before that, the besties had gone to see the Temptations in concert just like they did every January. But then, in a story of woe that is common now but wasn’t at the time, the healthy and active 64-year-old Black man contracted COVID-19 and died. “I have never in my life visited a grave,” said Kavanaugh, recounting how she waited until everyone left Inglewood Park Cemetery to say her goodbyes that day in April. “Never.” But it felt like the right thing to do. It wasn’t the only thing she could do, though. And so, searching for a more profound way to honor Jackson, she decided to join a clinical trial for the COVID-19 vaccine developed by AstraZeneca and the University of Oxford. Despite being a bit of a hypochondriac, Kavanaugh believes that taking the risk of injecting an unknown substance into her body is the best way to “keep his memory alive.” She also believes that, by setting an example, it’s the best way she can help other Black people.  “People are going to die because they don’t believe in the vaccine,” said Kavanaugh, who spent years working in sales for pharmaceutical companies and now teaches at the Chicago School of Professional Psychology in L.A. “I can have a voice and be an influencer.” Indeed, even as coronavirus cases continue to climb to never-before-seen heights and overwhelm hospitals in Southern California, public health officials have been fretting about the high number of Americans of all races who are refusing to get vaccinated and what that could mean for ending the pandemic through herd immunity. Black Americans are by far the most wary, many of us deeply distrustful of the medical establishment after decades of unequal access to care and unethical research, including the Tuskegee Syphilis Study. Nationally, only about 24% of Black adults say they will probably or definitely take a vaccine when the time comes. In California, the percentage is closer to 30%, according to the Public Policy Institute of California, but that’s still lower than the percentage of Latino, Asian and white adults who plan to get vaccinated. It tracks then that pharmaceutical companies haven’t had the easiest time persuading Black Americans to participate in clinical trials. “They were begging for African Americans,” Kavanaugh said. “Because, of course, we ain’t volunteering. You know, ‘I ain’t being no guinea pig.’” It’s important to have the data, though, because, along with Latinos, we are the most at risk for not only getting COVID-19 but also dying of it. This is what Kavanaugh told her adult children. Still, they were thrilled that she had volunteered for the trial when she fessed up on Christmas Day. “My oldest one didn’t say anything,” Kavanaugh said with a dismissive laugh. “My youngest one, she was like, ‘Well, you should have waited.’” Her bestie probably would’ve  said something similar. But then “he would have been cool,” she insisted. “He would have been bragging.” :: My colleague Angel Jennings first wrote about Jackson after his funeral in April. He was a man who liked to go fishing in the Gulf of Mexico, didn’t miss a party, but who was generous enough to drive kids up to Big Bear or Mountain High to go skiing — and sometimes help foot the bill. When he flew home from Idaho in March, he became sick within days. So sick that he ended up sedated and on a ventilator at the West Los Angeles hospital where his daughter works as a nurse. He died there after seeing his son one last time. It’s a story that stuck with me — and not just because I first read it in my previous role as an editor. It’s because, like Jackson, the last thing I did in the Before Times was board a plane to meet up with some friends for a ski trip. In my case, in Colorado. And like Jackson, two days after arriving home in L.A., I came down with horrible, flu-like symptoms. I went to work on Super Tuesday, feeling fine. Little did I know that would be my last day working in the office. I woke up that Wednesday morning feeling terrible. Tired. Congested. I never had a fever or a cough. Looking back, I’m pretty sure it was just a bad cold. But, also like Jackson, I heard about people who had been at the same resorts where I had been and had come down with COVID-19. Little did anyone know then, but those final days of the 2020 ski season turned out to be super-spreader events. It didn’t take long for Vail Resorts to shut down access to all of its mountain resorts, from Idaho to Colorado to California. I never bought into the social-media-fueled conspiracy theories about Black people not being able to catch the coronavirus. But it was terrifying to understand just how close I had come to actually getting COVID-19. I got lucky. Jackson didn’t. All these months later, essential workers, who are overwhelmingly Black and Latino, remain at the highest risk. But no one is immune. In fact, a recent study out of New York found that biological differences don’t account for the racial and ethnic disparities in coronavirus cases. Rather it is that Latino and Black people are more likely to be poor, live in overcrowded housing and be exposed to the virus in the workplace. Not to mention the likelihood of getting sicker because of preexisting conditions that haven’t been addressed because of a lack of access to healthcare. It’s one reason why race is being considered only indirectly in terms of how to distribute the vaccines “equitably,” as politicians love to say. Instead, public health officials are using a “social vulnerability index” to determine who is most in need. All one has to do is connect the dots, though, to understand that systemic racism meted out against Black and Latino Americans, regardless of income, is exactly why such inequities and social vulnerabilities exist. It’s also why mass vaccination is so hard to do in the U.S.  :: Kavanaugh has already received the first dose of what she suspects is the actual AstraZeneca vaccine, though it could be a placebo. She gets the second dose this month. Then it’s all about following up and getting coronavirus antigen tests. Even before Jackson died, Kavanaugh took the coronavirus seriously, wearing masks long before people were belligerently marching into malls refusing to wear them. She has bedazzled face shields and keeps a stash of gloves and Clorox wipes on hand. She wants people to be safe and has fallen out with neighbors and friends over their refusal to do so. People don’t want to hear it, even though Los Angeles County reported more than 300 COVID-19 deaths Friday — a new single-day record. “My prayer is that African Americans, save yourselves,” Kavanaugh said. “Make the right decisions for yourself. If you feel the vaccine is not right for you, then don’t do it. But what a hell of a thing to die. To leave this Earth when you have help at the touch of your hand, a phone call to your provider.” Jackson, a friend with whom she shared a love of music and church for many years, didn’t have that chance. Normally, at this time in January, they would be planning their night out for the Temptations concert. Instead Kavanaugh will be heading from her home in Long Beach back to Inglewood Park Cemetery to place flowers on his grave — a new annual tradition. “My only picture I have of us is the last picture. We went to the Temptations,” she said. “Chuck normally would say, ‘I ain’t taking no damn selfie.’ But I said, ‘Chuck, come on. Selfie.’ He took it. Right before he died.”
The University of California’s top health executive has told UC officials to prepare to continue online learning and limited access to campus beyond the fall as the COVID-19 pandemic will probably cause at least another year of disruption to university operations. “This is not something that will go away quickly,” Dr. Carrie L. Byington, who heads UC Health, told regents during their two-day online meeting this week. The university’s $13-billion health enterprise includes 19 health professional schools and six health systems, five of them academic medical centers. So far, UC campuses have not announced plans for winter and spring — unlike the California State University system, which said this month that campuses will stay primarily online through the rest of the academic year. But Byington told The Times on Thursday that she has discussed with top UC officials the possible need to continue largely online operations. “Yes, I have discussed the need to prepare for continued distance learning and decreased density on campuses beyond the fall term with the chancellors, president and regents,” Byington said. “Much will depend on the effectiveness of the measures put in place on each campus to control transmission during the fall semester/quarter and on the trajectory of the pandemic in California and the U.S. If we can control transmission on our campuses and the trajectory of the pandemic is improving, it may be possible to increase density.” UC Berkeley reported 61 new cases of the coronavirus between Aug. 26, when fall classes began, and Sept. 16. Only two cases involved students who live in campus dorms, and all transmissions have been traced to off-campus encounters, a spokeswoman said. UC Merced has reported no new cases, Chancellor Juan Sánchez Muñoz told regents. Berkeley and Merced are the only two of UC’s nine undergraduate campuses that have started fall term. The pandemic’s cost to UC campuses and medical centers has been steep. Chief Financial Officer Nathan Brostrom said UC has taken a $2.2-billion hit during the pandemic, including losses in revenue from medical services, housing and dining, and added expenses for online teaching technology and medical and cleaning supplies. UCLA took the greatest hit at $653 million, and UC Merced the smallest at $16 million between March and August, Brostrom said. In the first glimpse of how the pandemic is affecting enrollment, Berkeley and Merced have seen no drop in California students this fall, regents were told.  But Berkeley reported enrollment declines of about 550 out-of-state students, half of them seniors, and more than 200 graduate students, many of them international students in law and engineering programs. Many of them had indicated they planned to enroll but withdrew just before fall classes started, UC officials said. Those numbers represent a tiny fraction of Berkeley’s 43,000 students. But nonresident students are an important source of revenue because they pay three times the tuition and fees that Californian do and are not eligible for need-based financial aid. UC’s seven other undergraduate campuses start fall classes Oct. 1.
Los Angeles plans to turn its massive coronavirus testing site at Dodger Stadium into a vaccination distribution center this week, with officials hoping to vaccinate up to 12,000 people a day when the site is fully operational, city and county officials announced Sunday night. Dodger Stadium is the largest testing site in the country, processing thousands of residents a day. The site has administered more than 1 million tests since May. Tracking the coronavirus in L.A. County Tracking the coronavirus in L.A. County The latest maps and charts on the spread of COVID-19 in Los Angeles County, including cases, deaths, closures and restrictions.  Testing operations at Dodger Stadium will end Monday, according to a release from Mayor Eric Garcetti’s office. City and county officials also plan to end testing at the Veterans Affairs Lot 15 site near Jackie Robinson Stadium to shift personnel, equipment and other resources to vaccine distribution. “Vaccines are the surest route to defeating this virus and charting a course to recovery, so the city, county, and our entire team are putting our best resources on the field to get Angelenos vaccinated as quickly, safely, and efficiently as possible,” Garcetti said in the release. The county’s testing capacity will be reduced temporarily during the transition at the sites, but the change will more than triple the daily number of vaccines available for Angelenos. The city plans to continue providing free testing for residents, with or without symptoms, at eight permanent sites and six mobile sites across L.A. In the coming weeks, testing will increase through existing locations, additional mobile sites and at Pierce College in Woodland Hills, the release said. The transition  toward  vaccine distribution  comes as California and the rest of the country have been slow to administer COVID-19 vaccines. On Friday, Gov. Gavin Newsom set a goal of administering vaccines to 1 million additional people over the following nine days, acknowledging that the state’s effort to distribute the lifesaving supplies has been “not good enough.”  Though California has received more than 2 million doses of vaccine, as of Friday less than a third had been administered to the front-line healthcare workers and residents at nursing homes and other long-term care facilities who are eligible in the first round of inoculations. The vaccine rollout also has been hampered by reluctance from some front-line healthcare workers to take it. Roughly 20% to 40% of L.A. County’s front-line workers who were offered the vaccine as of the end of the year declined to take it, according to county public health officials. California Some healthcare workers refuse to take COVID-19 vaccine, even with priority access California Some healthcare workers refuse to take COVID-19 vaccine, even with priority access Doubts about the vaccine among healthcare workers could have serious implications for public health, say experts.  More Coverage State officials recently broadened who can qualify for vaccination, allowing teachers, child-care workers and people over the age of 75 to be inoculated if there is a risk of doses expiring. In L.A. County, 145,621 of the initial doses of the COVID-19 vaccine had been administered — a little more than a third of those received — as of Jan. 7, according to county public health data. The announcement that Dodger Stadium would transition to a vaccine distribution site was first reported by KNX-AM (1070). California also is facing a continuing surge in COVID-19 deaths. By Saturday night, the state was recording an average of 451 deaths a day for the previous week, a record. On Sunday,  the state eclipsed 30,000 deaths since the pandemic began. L.A. County is now averaging about 211 COVID-19 deaths a day, also a record. Times staff writers Rong-Gong Lin II, Vanessa Martínez, Swetha Kannan and Melody Gutierrez contributed to this report.
Los Angeles County health officials said Sunday they will stop providing a commonly used coronavirus  test after federal regulators raised questions about its accuracy. The decision affects only a small number of county-supported mobile testing sites. County health officials had already discontinued the broad use of oral swab tests produced by Silicon Valley start-up Curative over the summer because of concerns about too many false negatives. California L.A. to turn Dodger Stadium into a COVID-19 vaccine site this week California L.A. to turn Dodger Stadium into a COVID-19 vaccine site this week Testing operations at Dodger Stadium, the largest coronavirus testing site in the U.S., will end Monday, according to the mayor’s office. Officials hope to eventually vaccinate 12,000 people a day there.  More Coverage The use of Curative oral swab tests at the city of Los Angeles’ drive-through testing sites are unaffected by Sunday’s decision, although Mayor Eric Garcetti’s office said separately that the Dodger Stadium site would be turned into a vaccine distribution center this week, ending testing operations there Monday. Garcetti has defended the tests as broadly effective and said that moving away from them could lead to fewer people being diagnosed and greater spread of the virus. Guidance issued last week from the Food and Drug Administration warned healthcare providers and patients that the test made by Curative carries a “risk of false results, particularly false negative results.” To reduce the risk of false negatives, the Curative test should be used only on “symptomatic individuals within 14 days of COVID-19 symptom onset,” and the swab should be observed and directed by a healthcare worker, the FDA said. Los Angeles has been using the tests since April. Responding to the FDA guidance last week, Garcetti strongly  backed the testing. While the Curative test is designed for screening people who are visibly ill, he added that the tests are also effective at catching cases in people who are asymptomatic. He said that about one-third of the positive test results from the city’s program — about 92,000 — were from people without symptoms. In June, L.A. County discontinued its use of Curative’s oral swab testing at its main testing sites. Public Health Director Barbara Ferrer said at the time that nasal tests produced fewer false negatives.  In mid-December, however, Curative began supplying tests at mobile testing sites supported by the county. Between Dec. 13 and Jan. 2, Curative administered 24,241 tests at these county-supported sites, about 10% of all coronavirus tests administered at such sites during that time frame, the County Department of Health and Human Services said in a statement Sunday. County officials said they were discontinuing the use of the Curative tests “as a precaution” and would replace  them with tests by Fulgent Genetics. Tracking the coronavirus in L.A. County Tracking the coronavirus in L.A. County The latest maps and charts on the spread of COVID-19 in Los Angeles County, including cases, deaths, closures and restrictions.  Health officials said that any type of test poses a risk of false negatives, because the results rely on the correct collection of the saliva sample and the viral load that it may contain. “There is no reliable way to detect early infection, meaning that infection often spreads before symptoms develop,” the statement said. Nevertheless, county officials said the Curative tests remain better at detecting  disease than other tests, including rapid tests. Curative, founded by a 25-year-old British businessman a year ago, has administered more than 11 million tests nationwide, including in other major cities such as Chicago, San Francisco, Houston, Atlanta, Miami and Seattle. The company holds a $42-million contract to perform testing in U.S. military treatment facilities and also tests members of Congress, including those who do not have symptoms. Unlike nasal swab tests, which must be administered by a medical professional deep into a patient’s nose, the Curative test is an oral swab that can be self-administered. Patients are required to cough three times, swish the spit in their mouths, then rub a cotton swab around their gums, cheeks and tongue. After  the FDA guidance issued last week, a Curative representative said in a statement that the company’s test “has been validated and is being offered during the pandemic under an Emergency Use Authorization, and is labeled with specific warnings, precautions, and limitations that FDA reiterated in the Safety Communication. The test performance and labeling, however, have not changed, nor has the company observed any changes in test performance.” The study Curative conducted to validate its test excluded patients who were asymptomatic, and the company told the FDA, in its application for emergency authorization, that the test is “limited to patients with symptoms of COVID-19.” When the FDA issued an emergency use authorization for Curative’s test in April, it specifically authorized the test for samples “from individuals suspected of COVID-19 by their healthcare provider.”
TV host Jeannie Mai is the latest celebrity contestant to leave “Dancing With the Stars.” Hers is due to a health scare. In a Monday statement to “Good Morning America,” Mai announced her departure from the ABC program after being diagnosed with a sometimes life-threatening inflammatory condition called epiglottitis, which can restrict airflow to the lungs due to swelling. “My doctors discovered a health concern with my throat which requires immediate attention and surgery,” the “Real” star’s message read. “I’m heartbroken that my ‘DWTS’ journey has to end here. I have pushed myself to new limits physically and mentally, and I am so proud of how far we’ve come.” According to ABC, only one competitor will be sent home on Monday’s forthcoming episode of “DWTS” — which was previously supposed to be a double-elimination show — “in light of the news.” “Jeannie has inspired us, along with millions of fans, with her energy and dedication,” the “DWTS” team told “GMA” upon her exit. Television Broadcast TV is ready for a Latino family. Justina Machado is here to prove it Television Broadcast TV is ready for a Latino family. Justina Machado is here to prove it On “Dancing With the Stars” and “One Day at a Time,” journeywoman Justina Machado may be fall TV’s biggest star. It couldn’t have happened to a nicer person.  More Coverage Shortly after the announcement, “DWTS” pro Brandon Armstrong penned a lengthy and heartfelt Instagram goodbye to his famous dance partner, thanking her for “an amazing season” and wishing her “a speedy recovery.” “JEANNIE! I’m so sorry this happened to you! You don’t deserve it!” he wrote. “Your journey on this show was so special so unique and so inspiring! I loved EVERY SINGLE WEEK that we got to go through this together!  “I hope I helped give you an experience that you’ll remember forever! We share a lot of good times, tough times and all the times in between but mainly, a lot of laughs! Mainly you laughing at me but hey I’ll take it!” JEANNIE! I’m so sorry this happened to you! You don’t deserve it! Your journey on this show was so special so unique and so inspiring! I loved EVERY SINGLE WEEK that we got to go through this together! I hope I helped give you an experience that you’ll remember forever! We share a lot of good times, tough times and all the times in between but mainly, a lot of laughs! Mainly you laughing at me but hey I’ll take it! 😂thank you for giving me such an amazing season! We will all be praying for a speedy recovery! ❤️ #teamdreamofjeannie always! 🙏🏽🔥 A post shared by Brandon Armstrong (@brandonarmstrong) on Nov 2, 2020 at 7:12am PST During last week’s Halloween-themed “Villains” episode, Mai and Armstrong were nearly booted from the competition after ending up in the bottom two. But it was “Cheer” coach Monica Aldama and her partner, Val Chmerkovskiy, who finally got the ax from the judges. Still in the running for the coveted Mirrorball trophy are “Bachelorette” Kaitlyn Bristowe, Disney Channel actress Skai Jackson, “One Day at a Time” star Justina Machado , Backstreet Boys artist AJ McLean, “Hot in Here” rapper Nelly, “Catfish” host Nev Schulman, “Selling Sunset” Realtor Chrishell Stause and Olympic figure skater Johnny Weir. Mai’s withdrawal notwithstanding, six stars — including Aldama, NBA athlete Charles Oakley, NFL player Vernon Davis and “Tiger King” breakout” Carole Baskin — have exited the 29th season so far.
 California continued to see a dramatic surge Sunday in its number of COVID-19 deaths as the state surpassed another milestone: 30,000 fatalities.  The pace of daily COVID-19 deaths has climbed since the most recent surge began in November. On Nov. 3, California was recording about 40 deaths a day; by Thanksgiving, about 70 deaths a day; and by Christmas, about 220 deaths a day. By Sunday night, California was recording an average of 481 deaths a day for the previous week, a record. It took roughly six months for California to record its 10,000th death, which came Aug. 6, and four more months to record its 20,000th death, which was logged Dec. 8. California recorded its 30,003rd death Sunday night, just about one month later, according to a survey of local health jurisdictions conducted by The Times. Five of the highest single-day death tallies for California have been recorded in the last week.  The most recent single-day death record for California occurred Friday, when 685 deaths were recorded, breaking the previous record of 575 deaths tallied on New Year’s Eve. An additional 456 deaths were tallied statewide Saturday, the sixth-highest single-day tally, and 297 on Sunday. California is recording an increasing number of daily coronavirus cases after a post-Christmas lull. From Dec. 16 to Dec. 22, the state had an average of 45,000 coronavirus cases a day, a record; that stabilized to between 35,000 and 40,000 cases a day until Thursday. But the seven-day average of new cases rose to nearly 45,000 by Sunday night, the second-highest such number of the pandemic.  The post-Christmas surge in new coronavirus cases has been growing by the day. L.A. County’s average number of new coronavirus cases Thursday, Friday and Saturday was about 18,000 — significantly above the average of about 14,000 new cases a day over the last week. “This very clearly is the latest surge from the winter holidays and New Year’s — no question about it,” Dr. Paul Simon, the L.A. County Department of Public Health’s chief science officer, said Friday. “It had gradually started earlier in the week, but [definitely] here in the last day or two.” A  survey of local health jurisdictions in L.A. County found 13,247 new coronavirus cases reported Sunday and 162 deaths. The daily tallies for Sundays are generally lower because of reporting delays over the weekend. L.A. County is now averaging about 211 COVID-19 deaths a day, a record. That’s a far more accelerated pace than the number from Christmas, when L.A. County was averaging about 80 deaths a day, and Thanksgiving, when about 30 deaths a day were recorded. There continues to be ongoing pressure on California’s overloaded intensive care units. According to data released Sunday, the number of COVID-19 patients in the state’s ICUs climbed to a record 4,863 on Saturday. That’s about triple the number from Thanksgiving. About 22,000 COVID-19 patients were in California’s hospitals Saturday. That number has remained relatively flat for the last week. Officials expect the number of hospitalizations to start worsening this week, as people who were infected over Christmas start to become ill. What’s still not fully known is how bad the post-holiday surge will be in the hospitals. L.A. County’s COVID-19 hospitalizations have been stable in recent days, hovering between 7,900 and 8,100 patients, including about 1,700 in the ICU. The ICUs in L.A. County are effectively out of available space. There are typically about 2,000 staffed ICU beds in the county, and as of last week, about 400 were occupied by non-COVID patients. In recent days, available ICU beds in the county fell to zero or one in each of the following regions: central L.A., the Westside, southeast L.A. County, the San Gabriel Valley and the Antelope Valley. The South Bay-and-Long Beach region had as few as three available ICU beds in recent days, and the San Fernando Valley as few as six. An increasing percentage of people infected with the coronavirus are now dying of COVID-19 in L.A. County without any underlying health conditions. Earlier in the pandemic, 7% of all COVID-19 deaths in L.A. County occurred among people without underlying medical conditions; now, 14% of cumulative deaths are among people with no underlying medical conditions. Though California’s existing pandemic surge is dire, the state has one of the lower cumulative numbers of COVID-19 deaths on a per capita basis, ranking 38th among the 50 states, probably a result of the early imposition of the stay-at-home order in the spring and summertime closures of certain high-risk businesses. New Jersey’s cumulative COVID-19 death rate is triple that of California’s, Arizona’s is double and Florida’s is 1½ times larger.  Times staff writer Thomas Suh Lauder contributed to this report.
These days, Los Angeles acting teacher Deryn Warren balances her pain with her fear. She’s a bladder cancer patient who broke her wrist in November. She still needs physical therapy for her wrist, and she’s months late for a cancer follow-up. But Warren won’t go near a hospital, even though she says her wrist hurts every day. “If I go back to the hospital, I’ll get COVID. Hospitals are full of COVID people,” says Warren, a former film director and author of the book “How to Make Your Audience Fall in Love With You.” “Doctors say, ‘Come back for therapy,’ and my answer is, ‘No thank you.’” Many, many patients like Warren are shunning hospitals and clinics. The coronavirus has so diminished trust in the U.S. medical system that even people with obstructed bowels, chest pain and stroke symptoms are ignoring danger signs and staying out of the emergency room, with potentially mortal consequences. A study by the Centers for Disease Control and Prevention found that emergency room visits nationwide fell 42% in April, from a mean of 2.1 million a week to 1.2 million, compared with the same time period in 2019. A Harris poll on behalf of the American Heart Assn. found roughly 1 in 4 adults experiencing a heart attack or stroke would rather stay at home than risk getting infected with the coronavirus at the hospital. These concerns are higher in Black (33%) and Latino (41%) populations, said Dr. Mitchell Elkind, president of the American Heart Assn. and a professor of neurology and epidemiology at Columbia University. Perhaps even more worrisome is the drastic falloff of routine screening, especially in regions hit hard by the virus. Models created by the medical research company IQVIA predict delayed diagnoses of an estimated 36,000 breast cancers and 19,000 colorectal cancers due to COVID-19’s scrambling of medical care.  At Hoag Memorial Hospital Presbyterian in Newport Beach, mammograms have dropped as much as 90% during the pandemic. “When you see only 10% of possible patients, you’re not going to spot that woman with early-stage breast cancer who needs a follow-up biopsy,” said Dr. Burton Eisenberg, executive medical director of the Hoag Family Cancer Institute. Lifestyle I went to the doctor for a routine checkup during the pandemic. You should, too Lifestyle I went to the doctor for a routine checkup during the pandemic. You should, too What is it like to get a health exam during the COVID-19 pandemic? It is different, but safe and vitally needed, given how many people are avoiding preventative care out of coronavirus fears.  Before the pandemic, Eisenberg saw five melanoma patients a week. He hasn’t seen any in the last month. “There’s going to be a lag time before we see the results of all this missed care,” he said. “In two or three years, we’re going to see a spike in breast cancer in Orange County, and we’ll know why,” he said. Dr. Farzad Mostashari, former national coordinator for health information technology at the U.S. Department of Health and Human Services, agreed. “There will be consequences for deferring chronic disease management,” he said. “Patients with untreated high blood pressure, heart and lung and kidney diseases are all likely to experience a slow deterioration. Missed mammograms, people keeping up with blood pressure control — there’s no question this will all cause problems.” In addition to fear? Changes in the healthcare system have prevented some from getting needed care. Many medical offices have remained closed during the pandemic, delaying timely patient testing and treatment. Other sick patients lost their company-sponsored health insurance during virus-related job layoffs and are reluctant to seek care, according to a study by the Urban Institute . A study by the American Cancer Society’s Cancer Action Network found that 79% of cancer patients in treatment had experienced delays in care, including 17% who saw delays in chemotherapy or radiation therapy. “Many screening facilities were shuttered, while people were afraid to go to the ones that were open for fear of contracting COVID,” said Dr. William Cance, chief medical and scientific officer for the American Cancer Society. And then there are patients who have fallen through the cracks because of the medical system’s fixation on COVID-19. Dimitri Timm, a 43-year-old loan officer from Watsonville, Calif., began feeling stomach pain in mid-June. He called his doctor, who suspected the coronavirus and directed Timm to an urgent care facility that handled suspected COVID-19 patients. But that office was closed for the day. When he was finally examined the following afternoon, Timm learned his appendix had burst. “If my burst appendix had become septic, I could have died,” he said. The degree to which non-COVID patients are falling through the cracks may vary by region. Doctors in Northern California, where hospitals haven’t yet seen an overwhelming surge of COVID-19 cases, have continued to see other patients, said Dr. Robert Harrington, chairman of the Stanford University Department of Medicine and outgoing president of the American Heart Assn. Non-COVID issues were more likely to have been missed in, say, New York during the April wave, he said. The American College of Cardiology and American Heart Assn. have launched campaigns to get patients to seek urgent care and continue routine appointments. The impact of delayed care might be felt this winter if a renewed crush of COVID-19 cases collides with flu season, overwhelming the system in what CDC Director Robert Redfield has predicted will be “one of the most difficult times that we’ve experienced in American public health.” The healthcare system’s ability to handle it all is “going to be tested,” said Anthony Wright, executive director of Health Access California, an advocacy group. But some patients who stay at home may actually be avoiding doctors because they don’t need care. Yale University cardiologist and researcher Dr. Harlan Krumholz believes the pandemic could be reducing stress for some heart patients, thus reducing heart attacks and strokes. “After the nation shut down, the air was cleaner, the roads were less trafficked. And so, paradoxically, people say they were experiencing less stress in the pandemic, not more,” said Krumholz, who wrote an April op-ed in the New York Times headlined “Where Have All the Heart Attacks Gone?” “While sheltering in place, they were eating healthier, changing lifestyles and bad behaviors,” he said. At least some medical experts agree. “The shutdown may have provided a sabbatical for our bad habits,” said Dr. Jeremy Faust, a physician in the division of health policy and public health at Boston’s Brigham and Women’s Hospital. “We’re making so many changes to our lives, and that includes heart patients. If you go to a restaurant three times a week or more, do you realize how much butter you’re eating?”  Lifestyle Going to the dentist in the coronavirus era like I did? Here’s the drill Lifestyle Going to the dentist in the coronavirus era like I did? Here’s the drill A COVID-era dentist’s appointment means fewer people, more layers and possibly a new tool or two.  While some patients may be benefiting from a COVID-19 regime change, many people have urgent and undeniable medical needs. And some are pressing through their fear of the virus to seek care, after balancing the risks and benefits. In March, when the virus took hold, Kate Stuhr-Mack was undergoing a clinical trial at Hoag for her Stage 4 ovarian cancer, which had recurred after a nine-month relapse. Members of her online support group considered staying away from the facility, afraid of contracting the virus. But Stuhr-Mack, 69, a child psychologist, had no choice: To stay in the trial, she had to keep her regular outpatient chemotherapy appointments. “We all make choices, so you have to be philosophical,” she said. “And I thought it was far more risky not to get my cancer treatment than face the off-chance I’d contract COVID on some elevator.” Glionna is a former national reporter for the Los Angeles Times. This story was produced by KHN (Kaiser Health News), which publishes California Healthline , an editorially independent service of the California Health Care Foundation . KHN is not affiliated with Kaiser Permanente.
The patient needed a ventilator or she would die. The hospital wanted to discharge her, but there was no place she could go. As the surge of coronavirus infections created a terrifying shortage of hospital beds across Southern California, discharge planner Erika Gomez faced a dilemma. She needed to move the woman — a neurology patient — as safely as possible, while also freeing up a critical bed at Rancho Los Amigos National Rehabilitation Center. Over the next two weeks, Gomez reached out to 126 subacute care and congregative living health facilities in Los Angeles County, searching for a bed and a ventilator. Though some considered caring for the woman, they all ultimately said no. Her insurance wouldn’t pay enough. Finally, a residential home with which Gomez had a good relationship agreed to help. It would take the woman in and lend her a ventilator. Days earlier, Rancho Los Amigos — which is taking in patients from the other three county public hospitals to help lighten their load — had nearly reached its capacity. Even with discharges, it was like trying to save the Titanic from sinking with a teacup. The work of discharge planners has never been more critical than in this moment, as they try to free up beds in dangerously full hospitals confronting a deluge of COVID-19 patients. For some patients and their families it can feel like an eviction. But for the people on the other side of the battle against an unrelenting pandemic, it’s about saving lives and keeping the precarious Jenga tower of a healthcare system from crashing down. “We’re working as fast as we can,” Gomez said. “Administration is asking, ‘Well what are your efforts? What are you doing now to discharge patients sooner rather than later?’”  Every day is like a jigsaw puzzle, with discharge planners trying to figure out where patients fit. There are nursing homes suffering staffing shortages or that are in lockdown. Patients who refuse to transfer or whose families are worried they won’t get the care they need elsewhere. Health plans that won’t approve moving a patient to an agency that they don’t contract with. “If there is another place for them to go we need to let that patient go to that other bed … because there’s somebody else who’s dying right now and they need a bed,” said Suzette Shields, a clinical social work supervisor at Harbor-UCLA Medical Center. In L.A. County, hospitalizations have stabilized at a high number, hovering between 7,900 and 8,100 from Monday through Thursday. But officials have warned that the level of hospitalizations is unsustainable, leading to a shortage of available ambulances and forcing patients to wait hours for beds to open. The county’s four public hospitals, which include Rancho Los Amigos, as well as other hospitals across Southern California, may soon ration care because they are so short on resources. At a news conference Friday, California Hospital Assn. Chief Executive Carmela Coyle said that hospitals are struggling to discharge patients to skilled nursing facilities, home health care and other settings outside the hospitals. She cited some counties that passed bans prohibiting skilled nursing facilities from accepting hospital patients because of concern about COVID-19’s spread. Some of those bans still exist in many places, she said. “We really need help. We need a release valve,” she said. “We have ambulances continuing to flow into hospitals, dropping patients off in acute care need. And yet, we have challenges in discharging patients to other parts of the healthcare system when they are no longer in need of that acute care, and it is creating a bottleneck.”  Dr. Christina Ghaly, the L.A. County director of health services, said Tuesday that within the Department of Health Services about 10% of inpatients no longer needed an acute level of hospital care. Charmaine Dorsey, director of the department’s Patient and Social Support Services, said there are close to 100 patients waiting to be discharged in the county’s four public hospitals. But it’s been a frustrating task to move them and free up badly needed beds. Health plans were asked to help reduce administrative barriers, Dorsey said, “yet we are still being denied authorizations and experience increased delays in obtaining authorizations.” “We’re in a crisis now where if we find a place, we need the health plan to say, ‘Go ahead and send the patient, you need to get them out of your bed and put them in the right level of care,’” Dorsey said. “Health plans, help us. Don’t deny.” Last week at Rancho Los Amigos, Gomez’s patient caseload had doubled into the 20s. She spent a day working on a placement for a woman who had been in the hospital for two weeks, only for her family to turn down the transfer. (State law prohibits the movement of a patient unless the person agrees to the placement.) The patient’s family members asked that she be moved to a specific facility they had in mind — which was on lockdown because of COVID-19. They later filed an appeal through Medicare. After the appeal was denied Wednesday, Gomez stayed late to speak with the family, who eventually agreed to the discharge for that evening. Even before the pandemic, discharge planners across the state faced challenges finding placement for patients who were uninsured, homeless or dealing with comorbidities of health — to name a few. The workers spend days making referrals and calling residential homes, skilled nursing facilities and nursing homes to try to find the right place. As of Thursday, the most recent day for which complete data are available, there were 21,855 coronavirus-positive patients hospitalized in California, with 4,812 in intensive care. Coyle called on county and state governments to help hospitals with transitioning patients out of hospitals, especially in the hardest-hit areas of the San Joaquin Valley and Southern California. She said this will be particularly important over the next 10 days, when she anticipates the surge to reach its worst moment. In Orange County, Angelica Rojas, whose husband had spent about a month in the intensive care unit at Providence St. Jude Medical Center, worried when she was told in December that her husband might be transferred. “They told me there’s so many patients, that they’re trying to free up beds,” Rojas said. But she worried that her husband would get sick again and possibly regress. “My husband is still not out of the woods.” She said she was relieved to learn that her husband would be moving to Providence St. Jude’s Inpatient Rehabilitation unit in the next few days, instead of a different hospital. Speaking generally about patient cases, Roslyn Ausina, director of case management at Providence St. Jude, said there is often a lot of discussion with families regarding potential transfers outside the hospital. With a higher volume of patients in the emergency room, there’s always someone ready to go to the next bed. “During this pandemic, we understand the need to create critical surge capacity. At the same time we must address discharge difficulties, always ensuring the right level of care at the right time and place,” Ausina said. “The No. 1 priority is that patients go to a safe place to heal and recover.” It’s a delicate balance and one that Maritza Sandoval, a discharge planner at Harbor-UCLA, is well acquainted with. In a recent case, members of a family did not want their loved one transferred from the hospital and threatened to call their attorney. The children wanted their mother in a specific rehabilitation hospital, but therapists at the hospital didn’t feel she was eligible for that care. On a call with the woman’s son, Sandoval laid it out on the table. “I’m sorry; I’m being honest with you, we need the beds,” she said. “We have many people waiting in our emergency room just for a bed who are really sick. Your mother is no longer sick … we should be thankful for that.” Discharging his mother meant someone who needed to get out of the emergency room could then take her bed. Thankfully, she said, the woman’s son understood. “Sometimes you just have to empathize with them and say, ‘Look, I understand where you’re coming from, I know you’re afraid,’” Sandoval said. “It’s constantly working with families and trying to think of other alternatives that they’re comfortable with and hope that they work.” Sandoval has had cases in which a patient has the coronavirus and families are afraid for them to come home because they feel they can’t care for them. One woman, who was coronavirus-positive and ready to be discharged home with oxygen, told the staff she was too anxious to leave. Sandoval connected her with a clinical social worker who calmed her and got her discharged the next day. In the emergency room, discharge planners described seeing beds by the ambulance entrance of patients just waiting to be seen. Several units in the hospital have been converted to take care of patients. “What if that’s someone’s loved one who just had a heart attack and that has nothing to do with COVID, but now they can’t come into the emergency room because we have no bed?” Shields asked. On Dec. 7, 51 COVID-19 patients were at Harbor-UCLA, with 18 in the ICU. On Thursday, that number stood at 164, with 52 in the ICU. (By Friday, the number of patients with the coronavirus had risen to 171.) Discharge planner Yesica Lopez crossed her fingers Thursday that she’d be able to discharge at least one patient so she could free up a bed. Unfortunately, Sandoval said, she didn’t foresee discharging anyone that day. In the nearly 14 years Sandoval has worked at the hospital, she’s never felt the pressure like she does now. “All eyes are on us,” Sandoval said. “I’m trying my best to constantly discharge, because I know that there’s other people that need the bed that are really sick out there.” Times staff writer Soumya Karlamangla contributed to this report.
How bad will the next few weeks get? The number of COVID-19 deaths in California and Los Angeles County — an epicenter of the pandemic — is setting records or near-records almost daily. There is clear evidence that the post-Christmas holiday surge in cases is worsening, as the numbers continue to spike, particularly in L.A. County. But the big question is whether this new wave of cases will result in a similar increase in hospitalizations as occurred during the post-Thanksgiving surge, which has pushed hospitals to the breaking point, resulting in terrifying shortages of staffing and certain supplies and affecting the quality of medical care given to critically ill patients. Around Thanksgiving, about 300 new COVID-19 patients a day were admitted into hospitals in L.A. County; that number rose precipitously for about a month, finally stabilizing at about 750 to 800 new hospitalizations a day around Christmas Eve. Another doubling or tripling of new hospitalizations per day would be catastrophic. For as dire as the crisis has become, most hospitals have yet to enter a sustained, widespread period of rationed care. But that would probably come if the Christmas surge is dramatically worse. Teams of triage officers — usually led by critical care and emergency doctors — would have to be fully activated. Faced with shortages in staff and supplies, they would be forced to make the most heart-wrenching decisions: determining who receives the most aggressive lifesaving care and the limited time of the best-trained professionals and equipment, and who is given a lesser chance of survival and provided treatment to comfort them as they die. How hospitalizations break this week will give officials a sense of what to expect. “We are all waiting with a certain amount of anxiety in seeing how the hospital admission data unfold over the coming days,” said Dr. Roger Lewis, director of COVID-19 hospital demand modeling for the L.A. County Department of Health Services. “The hospital-based system is literally at the breaking point, where a substantial increase in demand could result in situations where we cannot provide to people the care that we would all expect to be able to provide or to receive when we’re critically ill,” he added.  Science These researchers predicted California’s COVID-19 surge. Here’s when they think it will end Science These researchers predicted California’s COVID-19 surge. Here’s when they think it will end Researchers share which numbers they’re watching to forecast when California’s deadly COVID-19 surge will end.  More Coverage Patients suffering from COVID-19 who are now entering the hospitals were mostly infected in the post-Thanksgiving, pre-Christmas period. The flattening of new hospitalizations probably resulted from the imposition of stay-at-home orders issued by the county and state. But the effect of holiday gatherings over Christmas will soon begin to show up in hospitals. Soon, a certain percentage of people who got infected over Christmas and have tested positive will begin getting so sick they’ll need hospital care. If the number of new daily hospital admissions for COVID-19 patients worsens, that’s a big sign of trouble. Now, it’s possible that the increasing hospitalizations could be moderated if, for instance, it’s mostly younger, otherwise healthier people who got infected over the holiday season, and quarantined or isolated themselves to avoid infecting older family and friends who are at a higher risk of dying. But it’s also plausible the vulnerable and elderly people attended Christmas and New Year’s gatherings or were later infected by younger people who didn’t stay away from them — something that happened over the Thanksgiving holiday. “The fear, or the intuition, of most of the people doing predictive modeling is that it is going to get worse. The uncertainty is in how much worse. And in order to quantify how much worse, that requires the data that will only be available to us next week,” Lewis said. California As COVID-19 rages, an L.A. hospital plans to close its doors, sparking criticism and questions California As COVID-19 rages, an L.A. hospital plans to close its doors, sparking criticism and questions After a sale to UCLA, Olympia Medical Center says it will shut down March 31. Workers and community members said they were blindsided by the decision.  The post-Christmas surge in new coronavirus cases has been growing by the day. L.A. County’s average number of new coronavirus cases on Thursday, Friday and Saturday was about 18,000 — significantly above the average of about 14,000 new cases a day over the last week. “This very clearly is the latest surge from the winter holidays and New Year’s — no question about it,” said the L.A. County Department of Public Health’s chief science officer, Dr. Paul Simon. “It had gradually started earlier in the week, but [definitely] here in the last day or two.” About 1 in 5 coronavirus tests performed daily in Los Angeles County are coming back positive, a huge increase from early November when about 1 in 25 tests confirmed an infection. And when community transmission is this prolific, officials warn that activities that seemed mundane months ago carry a higher risk of infection than ever. Simon said the increase in daily coronavirus cases is likely to continue over the next week or two, which will translate into even worse hospitalizations and more deaths. The number of daily COVID-19 deaths is already breaking records; in early December, about 30 people a day in L.A. County were dying of COVID-19 on average over a seven-day period; now, about 200 people a day are dying. The number of people dying of COVID-19 daily is now exceeding the average number of deaths in L.A. County for all other causes, including heart disease, cancer, stroke, diabetes, car crashes, suicides and homicides, which is about 170 deaths a day.  California L.A. ambulance crews struggle amid bottlenecks, surging call volume California L.A. ambulance crews struggle amid bottlenecks, surging call volume EMTs are waiting four, five and even 10 hours to offload patients at hospitals, officials said.  More Coverage Some veteran epidemiologists suspect higher levels of hospitalizations and deaths will, in fact, materialize and that hospitals will be forced to adopt “crisis standards of care,” in which triage doctors may have to choose who receives lifesaving treatment. “I anticipate that with the increased numbers of cases that we are seeing — which will translate into inevitable increased numbers of hospitalizations and ICU patients — that hospitals will be forced into operating under crisis protocols that may include rationing of care,” said UCLA medical epidemiologist and infectious-diseases expert Dr. Robert Kim-Farley. Kim-Farley said he suspected there will be a renewed increase in hospitalizations soon that will continue rising through the end of January. A fraction of those people won’t survive their illness, and a peak in daily COVID-19 deaths will probably occur in mid-February, Kim-Farley said, due to the lag between initial hospitalization and death. It was wise that state officials are ready to distribute dozens of large refrigerated trailers that can act as temporary morgues for bodies that are being dispatched to counties, Kim-Farley said. Funeral homes across the state are already overwhelmed by the surge in bodies and some have been forced to turn families away. “Unfortunately, the surge capacity being done for morgues will in fact be needed,” Kim-Farley said. L.A. County has now reached new milestones in the pandemic: more than 12,000 dead from COVID-19 and more than 900,000 coronavirus cases. On Saturday, 218 COVID-19 deaths were reported in L.A. County. That came the day after the county set a single-day record of 318. L.A. County officials Saturday confirmed three additional cases of the coronavirus-related inflammatory disease in children known as MIS-C. A total of 54 children in L.A. County have contracted the severe illness, and one has died. The disease can cause fever and inflame the heart, lungs, kidneys, brain, skin, eyes and gastrointestinal organs. The disease is disproportionately affecting Latino children, who account for about 3 of 4 reported cases. In L.A. County in recent days, available ICU beds fell to zero or one in each of the following regions: central L.A., the Westside, southeast L.A. County, the San Gabriel Valley and the Antelope Valley. The South Bay-and-Long Beach region had as few as three available ICU beds in recent days, and the San Fernando Valley as few as six. In Santa Clara County, which has some 2 million residents, about 20 to 25 available ICU beds remained Friday; in Fresno County, with about 1 million residents, only 10 beds were available. Dr. Rais Vohra, Fresno County’s interim health officer, said hospitals are preparing for “a very hard rest of January and possibly February,” including scrambling to find supplies related to providing oxygen treatments and providing ways to perform infusions of antibodies to keep patients from needing hospitalization. Some help has started to arrive: Staffers from the U.S. Department of Defense, as well as ICU nurses recruited by the state, have been deployed around hospitals in the region, said Dan Lynch, director of the Fresno County Emergency Medical Services agency. And one hospital in San Mateo County has offered to take in critically ill patients from Fresno County. But it won’t be easy to do those transfers in practice. “It is a risky move when you’re moving them for a long distance,” Lynch said. Though California’s existing pandemic surge is dire, the state has one of the lower cumulative numbers of COVID-19 deaths on a per capita basis, ranking 38th among the 50 states, probably a result of the early imposition of the stay-at-home order in the spring and summertime closures of certain high-risk businesses. New Jersey’s cumulative COVID-19 death rate is triple that of California’s; Arizona’s is double. Times staff writer Ryan Murphy contributed to this report. 
Blanca Briceno said she wakes up many nights with the images in her head: Several Los Angeles County sheriff’s deputies pinning down and striking her son Eric in his bedroom, his face full of blood. She had called the police one day in March to help her son, who was in the midst of a mental health crisis. But by the end, he’d been beaten and Tasered to death. At one point, she said, deputies grabbed her phone when she tried to film what was happening. “We called them to come and help us, to get some help,” Briceno said, choking up during an interview at her Maywood home. “And instead, they came and killed him, brutally killed him.” Eric Briceno’s death has not made headlines or triggered protests during this moment of unrest across the nation over police brutality. The incident occurred inside the family’s home, and the autopsy wasn’t released to their attorney until last week. In their report, obtained by The Times, coroner’s officials concluded that Briceno, 39, died of cardiopulmonary arrest, resulting from neck compression and restraint with a Taser. The death was ruled a homicide, although the designation doesn’t mean it was intentional or a crime. The Briceno family last month filed a wrongful-death claim, a precursor to a lawsuit, against the Sheriff’s Department and is calling for prosecutors to charge the deputies involved. “He didn’t die a natural death,” said Briceno’s father, Juan. “He died because of police brutality.” The Sheriff’s Department declined to comment, citing an ongoing investigation into the incident. Sheriff’s investigators have not yet presented a case to prosecutors, who will review the materials and decide whether deputies committed a crime, the district attorney’s office said.  According to the autopsy report, investigators told coroner’s officials that when deputies responded to a call that Eric Briceno had assaulted his father, he “attacked the deputies” and resisted arrest. Eric began showing symptoms of mental illness in high school and was diagnosed with mild schizophrenia, the family’s claim says. He self-medicated with street drugs and spent time in jail. Most recently, he was on probation and receiving treatment through the L.A. County Department of Mental Health. On March 16, the claim said, Eric had an altercation with his father and left the home as his parents called 911. Deputies arrived and told the parents to call them back when their son returned, which they did. Eric Briceno — 6 feet tall and weighing nearly 300 pounds, records show — was in his room sleeping when deputies arrived, his mother said. She said she told deputies she would call him out of his bedroom because she didn’t want the deputies to go in. They went in anyway, she said, startling her son. Blanca Briceno said the deputies began beating Eric without provocation, kneeling on his back and hitting him with a baton. “They went, ‘Eric, Eric!’ So he got scared,” his mother said. “He wasn’t doing anything; he wasn’t aggressive, nothing.” One deputy fired a Taser, striking him, and another discharged pepper spray in the room. Meanwhile, Eric cried out that he could not breathe, his mother and the claim said. Blanca Briceno said she pleaded for the deputies to stop. When she took out her phone to record, she said, a deputy took it away, telling her she couldn’t speak to anyone because they might convince her to change her story. She was pushed out of the room and into a cabinet, the claim said. Eric Briceno was punched, pepper-sprayed and shot with a Taser seven or eight times, the autopsy report said. Deputies reported that before being transported to the hospital, Briceno had turned blue, according to the autopsy report. Medical examiners found methamphetamine in his system, which contributed to but was not the immediate cause of his death. Samuel Paz, an attorney representing the Briceno family, said he reviewed hospital records and those of emergency responders,  and it doesn’t appear that members of the sheriff’s Mental Evaluation Team responded to the incident. Members of the team usually roll out in pairs: a deputy and a licensed mental health clinician trained to de-escalate and avoid the use of force. In 2019, the agency’s 33 teams responded to more than half the 10,425 patrol calls involving mentally ill or cognitively impaired people in crises, a Sheriff’s Department report said. The report found that during 431 mental health incidents in 2019, the supervisor at the scene believed it “very likely” that deputies would have used force to subdue patients if not for team members arriving to defuse the situation. Spurred by the police killing of George Floyd in Minneapolis, many are calling for some of these responsibilities to be removed from law enforcement and for other public community and support services to be expanded. In Los Angeles, for example, the City Council is exploring a new emergency response that uses trained specialists, rather than Los Angeles police officers, to render aid to homeless people and those suffering from mental health and substance abuse issues. As Eric Briceno was taken to the hospital, deputies took his parents to the East L.A. station, where they were questioned by investigators; neither knew whether their son was still alive. After the interview, the Bricenos said, investigators returned and told them: We have some bad news — he didn’t make it. Paz said Eric Briceno was declared dead within eight minutes of arriving at the hospital. In a letter dated a month after the incident, the district attorney’s office expressed condolences to the Bricenos for their loss. The letter used language that the Bricenos felt added insult to injury, referencing prosecutors’ review of “the shooting.” “There was no shooting,” Blanca Briceno said. “There’s a lot of people like this … screaming for help. And they deserve to live and get the help they need. My son didn’t deserve this.”
The rebellion that took place inside a government building in rural Northern California happened the day before the violent siege of the U.S. Capitol by supporters of President Trump. The Shasta County Board of Supervisors had planned to meet virtually Jan. 5 because of an uptick in coronavirus cases. The supervisors’ chambers in Redding were closed. Seats had been removed. The public speakers’ microphone was disabled. But, in protest, a newly elected supervisor unlocked the doors. In poured dozens of people, unmasked, to vent their fury. Three supervisors attending virtually watched from afar as threats flew amid the speeches. “When Joe Biden’s long winter sets and the dark night comes in this country, do you think you’re going to get to see the dawn?” Timothy Fairfield, 44, of Shingletown asked the supervisors. “No, you will not. Flee now while you can. Because the days of your tyranny are drawing to a close, and the legitimacy of this government is waning. “When the ballot box is gone,” he added, “there is only the cartridge box. You have made bullets expensive. But luckily for you, ropes are reusable.” In some ways, the rhetoric in that officially closed county government facility carried a hint of the rage that would boil over 2,800 miles away when pro-Trump rioters stormed the U.S. Capitol the next day. Five deaths, including that of a U.S. Capitol Police officer and the police shooting of an Air Force veteran from San Diego County, have been linked to the siege. Politics Read the House article of impeachment against President Trump Politics Read the House article of impeachment against President Trump Three members of the House of Representatives introduced the article of impeachment, citing the president’s role in ‘incitement of insurrection.’  Here in California’s rural, conservative northern counties — where people have long wanted to split from California and form a new state called Jefferson — the kind of anger and distrust of the government that Trump has fomented is on full display.  And it is not likely to go away any time soon, because some residents believe there is great political utility in making government officials believe that potential violence could become all too real. “We have to make politicians scared again,” Carlos Zapata, who attended the supervisors’ meeting, told The Times. “If politicians do not fear the people they govern, that relationship is broken.” That such tension is playing out in liberal California — which voted overwhelmingly for Biden and fought the Trump administration on immigration, climate change and myriad other issues — only signals that it is happening all across the country, locals say. While watching the violence unfolding in Washington, Supervisor Leonard Moty, who attended the county meeting virtually, thought of the threats hurled at him and his colleagues the day before. Moty, a former Redding police chief, texted the Board of Supervisors’ chairman, asking how he planned to keep their meetings safe in the future. “I definitely saw parallels in that,” Moty said in an interview. “I saw the possibility of that kind of behavior erupting in our county.” Moty said residents have become more blatantly threatening toward government employees amid the pandemic. Some announced the home address of the county health officer, prompting police to do extra patrols in her neighborhood. “It’s totally inappropriate,” Moty said. “Conducting the business of the county — the public can tell us we’re doing it wrong. They can tell us how we ought to do it. But they should never make threatening statements. “This is by far the worst it’s been,” he added. “They politicized the virus. The pandemic. You saw a culmination of it by a president who incited a whole group of people to march to the Capitol and do bad things. I think we have a number of people in this county who follow his voice. Who knows what they will do?” Among the president’s supporters in Washington last week were men carrying the yellow-and-green State of Jefferson flag with its pair of Xs, called a “double cross,” that represent a sense of rural abandonment. As Moty watched the news with alarm, Zapata was keeping up with pro-Trump friends in the nation’s capital who, like him, believe the election was stolen. “People say … ‘Oh, man, those people at the Capitol, they were violent. That’s un-American,’” Zapata said. “I’m like, the most American thing they could have done is burn that f— down.” In Shasta County, where Trump beat Biden by 33 percentage points, the supervisors’ meetings have become a prime venue for outrage. Accusations of treason and socialism are commonplace. So, too, is talk of revolution and civil war. In August, Zapata — a 42-year-old Marine Corps combat veteran who served in Iraq and now owns the Palomino Room restaurant and bar in nearby Red Bluff — blasted supervisors for “muzzling” their faces with masks and said the closures and restrictions that have devastated small businesses are making families starve. His unplanned speech, in which he warned that “it’s not going to be peaceful much longer,” went viral. The next month, a man in a Grim Reaper mask tried, unsuccessfully, to light a surgical mask on fire during public comments. Another man announced in October that he was placing all of the supervisors under citizen’s arrest; when his three minutes of speaking time were up, sheriff’s deputies escorted him out. By December, coronavirus cases were climbing in Shasta County. At least three employees in the county administration building, which houses the supervisors’ offices and board chambers, tested positive, Moty said. The supervisors voted 3 to 2 to hold virtual meetings as long as the county was in the most restrictive purple or red tiers in the state’s reopening plan. But when Patrick Jones — a former Redding mayor who defeated an incumbent supervisor in the November election — joined the board this month, the tenor changed. The incumbent had supported virtual meetings. Jones, who campaigned on reopening the county, did not. On Jan. 5, he showed up to his first meeting in person, along with one other supervisor, and welcomed the crowd inside. From behind the counter at Jones’ Fort, the Redding gun store he manages where a giant Jefferson flag hangs on the wall, Jones said last week that facing heated comments was just part of an elected official’s job. There is a growing recall effort, he said, to oust his colleagues who did not come to the meeting in person. “You need to face the public,” he said. “You need to hear their concerns. And, yeah, sometimes they’re angry. Sometimes they’re mean. They have the right to be. We may not like it, but under the Constitution and 1st Amendment, they have those rights.” Jones called the melee in Washington “unfortunate.” “I don’t expect any violence here,” he said. “I know most of these people. They’re venting, getting some frustrations out.” At the Jan. 5 meeting, a bespectacled mother who said her son had struggled amid school closures told supervisors that “civil war is brewing.” Another mom in a MAGA hat — who held up a picture of the yellow Star of David that Nazis forced Jewish people to wear and compared it to pandemic mask orders — said she would fight in that civil war “because I’m not screwing around anymore.” A 12-year-old boy said the restrictions had been “created by the left to scare people” and told the supervisors: “Please open schools, sports. No masks. No social distancing.” Wearing a polo shirt featuring a U.S. flag and the Lincoln Memorial, Terry Rapoza, a leader in the State of Jefferson movement, turned to the crowd, most of whom stood because the seats had been removed. “We’re here, aren’t we?” he said as they cheered. Rapoza read a statement that he helped prepare for the self-proclaimed California State Militia that business owners were starting to place in their windows. The businesses, it says, “are protected” by the militia, and any attempt by the government to interfere “may be met with resistance.” In an interview, Rapoza said that there are still a lot of unanswered questions over what happened in Washington but that “we did it the right way” in Redding. “If a little bit of the rhetoric got rough, big deal,” he said. “They used to beat each other with canes in Congress if someone said something off-color or stupid. For the most part, everyone was pretty level-headed. There’s a lot of disappointment with the people we elected. There will be a recall, and they will be gone.” Three days after his furious speech, Fairfield said in an interview that he sees what happens at the supervisors’ meetings as “a microcosm of what happens at the national level.” A disabled Army veteran who served in Iraq, Fairfield said he believed that the presidential election had been stolen and that elites, including local officials, were profiting off the pandemic while Americans lost their livelihoods. “Democracy doesn’t die because people challenge the results of an election. Democracy dies when people don’t believe the results of the election and don’t believe what they’re being told by the government and the government mouthpieces like you,” he told a Times reporter. “No one believes the media.” Among the groups putting pressure on Shasta County officials — the State of Jefferson movement, the Redding Patriots, the Open Shasta Coalition, the California State Militia — Zapata has become a favored voice since his August speech at the supervisors’ meeting, which has prompted multiple appearances on Alex Jones’ Infowars. Zapata is an active member of the militia and was a longtime Democrat who became a Republican to vote for Trump. He said he is weighing whether he should run for office himself, as a third-party candidate. The son of Peruvian immigrants, he raises rodeo bucking bulls on 10 acres in Palo Cedro, just up the road from the late country legend Merle Haggard’s ranch. At his home last week, he said that politicians should have a “healthy fear” of their constituents and that the line between a threat and a confrontation is a fine one. If county officials lock the buildings in the future, he predicted, people will march in, and they will have armed militia guards outside. “Without the threat of physical violence, our words are empty. We have no teeth to our message,” Zapata said. “By calling for violence, am I saying, ‘Hey, let’s go kill people?’ Absolutely not. And I never have. I’ve been misquoted there. But I am saying that we’re at the point now where we have to consider the threat of violence to protect ourselves.”
As the second major heat wave in weeks bears down on Southern California, experts and authorities are warning the public to take seriously the health dangers of extreme temperatures that are only getting worse due to climate change. Record heat. Raging wildfires. What are the solutions? Get Boiling Point, our newsletter exploring climate change, energy and the environment. You may occasionally receive promotional content from the Los Angeles Times. If the past is any guide, Los Angeles will see a spike in 911 calls, emergency room visits and deaths during a powerful heat spell that’s expected to peak Sunday, with highs between 110 and 120 hitting inland valleys and 95 to 105 degrees along the coast. “Heat of this magnitude is rare, dangerous and very possibly deadly,” the National Weather Service warned. Temperatures will remain unusually warm overnight — in the mid-70s and 80s — “creating a dangerous situation where it will be difficult to cool off without air conditioning.” Wildfires, elevated smog levels and possible power outages may pose additional threats. The pandemic, meanwhile, could make this Labor Day weekend especially deadly , as coronavirus restrictions have closed many of the cooled indoor spaces that usually offer relief. Exacerbating it all is climate change, which researchers say is increasing the frequency and intensity of extreme heat events.  As greenhouse gases continue to rise globally, heat spells of this severity are an unfortunate reality that Californians will increasingly have to get used to, they say. Last month’s heat wave, one of the worst to hit California in years, brought “an increase in health-related emergency room visits in relation to the sustained high temperatures,” the Los Angeles County Department of Public Health said in an email. “We are particularly concerned that these extreme heat events and the health impacts from them have been increasing in recent years due to climate change.” Though extreme heat is a less visible menace than, say, hurricanes or wildfires, it is climate change’s most life-threatening impact, causing more deaths each year in the United States than any other weather-related problem, including all floods and storms combined.  “Of all the climate change exposures we study, heat is the  No. 1 killer,” Rupa Basu, chief of air and climate epidemiology for the California Office of Environmental Health Hazard Assessment, said in an interview last month. People aren’t only dying from conditions  such as heat stroke and dehydration. Extreme heat increases risk of complications and death from an array of other chronic illnesses including kidney disease, cardiovascular disease and diabetes. “Most of the time you won’t see it on a death certificate, because people with underlying conditions are pushed to the edge,” said Dr. Jonathan Fielding, a UCLA professor of public health and medicine and former L.A. County public health director. “They have a cardiac condition, they have a respiratory condition or other conditions, like COVID. So I’m very concerned about it, and I think it’s really important that people take this very, very seriously.” Global warming is already bringing longer-lasting heat waves that don’t cool down  as much overnight, limiting people’s ability to rest and recover. As climate change accelerates, scientists project the number of days topping 95 degrees in Los Angeles to double or even triple within a few decades. “It means that we’re going to have increasingly difficult times in terms of weather events, particularly heat,” said Fielding, who is co-director of a new center at UCLA focused on addressing the near-term health impacts of climate change. This weekend’s heat spell, he said, “is not a one-off that maybe we won’t have for another 20 years. This is going to become more the norm, unfortunately.” A 2012 analysis by the L.A. County Department of Public Health found there were 3.6 times as many emergency department visits on days with temperatures above 100 degrees compared to days with temperatures in the 80s. Across California, heat-related emergency room visits increased by 35% between 2005 and 2015, “with disproportionate increases among African Americans, Asian Americans and Latinx residents due to the inequitable impacts of extreme heat,” according to the department. Helen Chavez, associate director with the L.A. County Office of Emergency Management, said dozens of cooling centers have been activated at libraries, community centers, gymnasiums and other locations throughout the county, but are operating at lower capacity than usual due to coronavirus social distancing restrictions. Still largely closed are movie theaters, malls and other air-conditioned public gathering places that people without air conditioning would normally flock to. “The problem with cooling centers is they’re not all that cool. They’re kind of boring, so people don’t really gravitate to them,” said Bryn Lindblad, deputy director of the Los Angeles nonprofit Climate Resolve, which advocates for reflective roofs and other measures designed to reduce urban temperatures. About one-third of households in Greater Los Angeles lack air conditioning, but that number is higher in neighborhoods near the coast, where roughly half don’t have air conditioning, according to a 2019 study by USC scientists . Much like with the coronavirus, the health damage from heat waves is not distributed evenly. Poorer communities of color tend to have more paved surfaces and less shade, and therefore suffer more from higher temperatures. “We’ve brought this heat on ourselves from our carbon pollution, but the people who have done the least to cause that problem will have the hardest time escaping it now,” Lindblad said. That’s partly because of the urban heat island effect, in which the masses of buildings and paved surfaces that dominate cities make them several degrees hotter than their rural surroundings. Those hard surfaces absorb heat and radiate it overnight, making it even harder for residents in the most urbanized areas to cool down and recuperate. At the same time, some of the populations at greatest risk for heat-related illness have also been hit hard by COVID-19, including residents over 65, those with preexisting health conditions and people working outdoors, such as farmworkers and construction workers. “ Again and again, whether it’s heat, wildfire or COVID, it seems to be the same very high-risk groups that are affected,” Basu said. Many of those same communities have also suffered disproportionately for years from higher exposure to air pollution and other environmental health threats. That’s certainly the case in the northeast San Fernando Valley, where a high of 113 is forecast for Sunday. Andres Ramirez, policy director with the environmental justice group Pacoima Beautiful, said he is worried about how the area’s low-income residents will deal with a dangerous combination of a brutal heat wave and pandemic restrictions that have put cooled public spaces at a greater premium than ever. “Those resources are not as available because we’re still in a pandemic and the mandate is we shouldn’t be congregating,” Ramirez said. “But at the same time, people need to be able to get out of their house when it’s a heat wave and it’s 110 degrees.” Ramirez hopes people find ways to cool down — maybe walk to a park and find some shade, he said. “But I feel like climate change is almost magnified in our communities.” A recent study by the Los Angeles Urban Cooling Collaborative, which is developing strategies to combat urban heat, found that widespread tree planting and retrofitting of roofs and streets with solar-reflective surfaces could cool down Los Angeles enough to reduce heat-related illnesses and deaths by more than 25%. “As scary as it is — and sometimes it feels really doom and gloom — the work that we’ve been doing ... is fundamentally optimistic,” said Edith de Guzman, director of research for the environmental group TreePeople who directs the collaborative. “Because even though we’re in this boat together that’s kind of sinking, we’re like  OK, hang on, we can actually have a positive impact. We can actually save lives.” Even without air conditioning, there are concrete steps you can take to get through an exceptionally hot Labor Day weekend with your health intact. Here are some recommendations from authorities and health experts:  Chavez, with the county emergency management office, urged residents to familiarize themselves with the signs of heat exhaustion and illness and be prepared to keep themselves and their families safe. “Heat-related illnesses can kind of creep up on you,” Chavez said. “So now is the time, when we’re having protracted periods of heat, that it’s really important to be aware of how you’re feeling.”
For weeks, millions of Californians were smothered by smoke from a record explosion of wildfires burning through grass, shrubs, conifer forests, houses and mobile home parks. Eyes watered. Lungs burned. Skies glowed orange. People suffered sore throats, headaches and chest pains. Many cloistered themselves indoors as pollution spiked to “hazardous” levels, or worse, on the Air Quality Index. While most people were not threatened directly by fires burning up and down the West Coast, smoke transported health dangers to nearly every corner of the state. State air quality officials are aware of no precedent for so many people breathing such high levels of wildfire smoke for so long. Even as air quality begins to improve, many remain worried about long-term health impacts.  “Frankly, we don’t really know about the long-term effects of wildfire smoke because community exposures haven’t been long-term before,” said Dr. John Balmes, a professor of medicine at UC San Francisco and a member of the California Air Resources Board. Health experts are fairly certain that such levels of wildfire smoke did significant harm in the immediate term by aggravating chronic lung and heart conditions, triggering asthma attacks, strokes and heart attacks. Scientists also suspect that heavy smoke has lowered people’s defenses against the coronavirus, and put them at greater risk of severe symptoms. But the question of lasting health damage remains hazier. Though the link between chronic exposure to the fine-particle pollution in urban smog and long-term health problems is well-established thanks to thousands of studies and decades of research, there has been relatively little research when it comes to wildfire smoke.  Understanding the long-term consequences is critical, scientists said, because wildfire smoke is a growing health hazard, responsible for an increasing share of the fine-particle pollution across the Western U.S. And with climate change warming and drying out landscapes, helping to fuel bigger, more intense fires , you can expect more smoky days in the future. In just the last month, fires have generated both the highest readings and most widespread unhealthy levels of fine-particle pollution since continuous monitoring began in the late 1990s, California air quality officials said. In the first few weeks of the firestorm, about half  of California’s population — an estimated 19.6 million people — experienced levels of wildfire smoke exceeding health standards, mostly north of the Grapevine, according to the state Air Resources Board. By last weekend, the smoke had spread across Southern California and to nearly every corner of the state, with almost 95 percent of Californians exposed to unhealthy pollution levels, the air quality agency estimated. Monitoring data released this week by the Air Resources Board showed that 15 of the top 20 fine-particle pollution readings on record in California have occurred during the fires over the last month. The highest concentration yet came on Tuesday in Mammoth Lakes, where concentrations of tiny soot particles known as PM2.5 reached 660 micrograms per cubic meter — more than 18 times the federal health standard of 35 and beyond the range of the Air Quality Index. “These are unprecedented levels of air pollution,” said Bonnie Holmes-Gen, chief of the  Air Resources Board’s health and exposure assessment branch. Large areas of California have been hit with heavy smoke in the past. The most widespread episode prior to this year, according to air quality officials, was during the 2018 Camp fire, when unhealthy pollution spread across the entire northern portion of the state. The smoke lasted about 13 days, impacting about 60% of California’s population. Fires in the summer of 2008 also brought weeks of widespread unhealthy smoke to northern and central California. Wildfire smoke is distinct from typical urban smog, and consists of thousands of compounds. Its composition varies widely depending on what type of fuel was burned and when. A big, hot fire burns material more completely, breaking fuels down to their more essential elements. A cooler fire, one that leaves smoldering black and brown wood behind, can release more toxic particulates, experts say. And a fire that burns homes can release a stew of potentially more toxic chemicals from plastics, furniture and building materials. As a product of the combustion of wood, leaves and other material, wildfire smoke is closer to tobacco smoke than diesel exhaust, and consists of carbon-based particles with “nasty, complex hydrocarbons on their surface” and irritant gases that are known carcinogens, said Balmes. “The dose is usually less than inhaling directly from a burning cigarette,” Balmes said. “But the dose makes the poison … and the community is getting a bigger dose than we’ve ever had before because of these multiple days in a row of bad air quality.” Some of the world’s most intense fires produce smoke that lofts into the atmosphere and wraps thousands of miles around the globe , said Barry Lefero, manager of NASA’s Tropospheric Composition Program, which uses a DC-8 jetliner that circles the globe studying wildfire smoke . With big fires “the smoke goes higher in the air, it’s more buoyant, it can travel farther, but at night the fires lay down, the smoke is trapped and it fumigates the valleys that fill up with smoke.” Of all the ingredients in wildfire smoke, the most concerning to scientists are microscopic particles known as PM2.5 because they are less than 2.5 microns in diameter. They can be inhaled deep into the lungs and pass into the bloodstream. In the short term, those tiny specks of pollution can irritate the eyes, nose and throat and cause coughing, tightness in the chest and difficulty breathing, and even flu-like symptoms in otherwise healthy people. But they pose more serious risks to young children, pregnant women, outdoor workers, the elderly and especially people with chronic health conditions such as asthma, lung disease and heart disease. Balmes said that such high levels of wildfire smoke along the West Coast have likely increased the number of patients seeking medical care for asthma attacks, heart attacks, strokes and other health problems aggravated by air pollution. “And the longer we have bad air,” he said, ”the greater the cumulative exposure, and that increases the risk of these adverse outcomes.” Stanford University researchers Marshall Burke and Sam Heft-Neal did a “back-of-envelope” calculation estimating that smoke exposure has likely caused  1,000 to 3,000 excess deaths and an additional 5,000 emergency room visits in California in the last month. Francesca Dominici, a professor of biostatistics at Harvard T.H. Chan School of Public Health, said their estimate is credible and the general approach makes sense. “There is a large epidemiological literature that shows strong evidence of short-term changes in PM2.5 and increased mortality risk,” she said. What are the health consequences of the terrible air quality experienced recently in CA due to wildfires? In a back-of-envelope, we calculate that smoke exposure has likely caused 1000-3000 excess deaths in CA in the last month. Blog+thread https://t.co/5FmhaxGewB  The concerns about increased risk of COVID-19 come from past research showing dirty air makes people more susceptible to contracting similar respiratory infections, such as pneumonia, and of developing more severe symptoms. Scientists suspect that is also happening with the coronavirus. Even if the number of new cases remains the same, there could be more serious health complications because of the way air pollution inflames the lungs and “just doesn’t allow the immune system to respond correctly to this kind of infection,” said Tarik Benmarhnia, a professor of epidemiology at UC San Diego’s Scripps Institution of Oceanography and School of Medicine. “I really hope I’m wrong, but what we may expect to see in the next few weeks is an increase in the fatality rate from COVID-19.”  Scientists have good reasons to expect that chronic exposure to wildfire smoke may inflict some of the same long-term health damage as typical urban fine-particle pollution, or soot. That type of pollution, which in California is generated mainly by motor vehicles, is linked to an array of health problems, including thousands of early deaths each year . Wildfire smoke could even be more harmful, said Benmarhnia, who cited studies showing that the same concentrations of fine particles, when coming from wildfires, “seem to be way more toxic for the respiratory system compared to PM2.5 from other sources.” Scientists don’t know for sure because of a dearth of long-term health research. For all the years of study we’ve devoted to vehicle exhaust and cigarettes, our understanding of this fundamental element in our planet’s existence is in its relative infancy. The few studies that have been completed have usually involved groups like wildland firefighters. There is research suggesting they have increased risk of heart disease and lung cancer, but that is mostly extrapolated from what is already known about exposure to PM2.5 from other sources of pollution, such as traffic. One of the most relevant studies followed not humans, but baby rhesus macaque monkeys at a primate research center on the UC Davis campus who were exposed to high levels of PM2.5 pollution over a 10-day period during the wildfires in the summer of 2008. The study found that the monkeys had reduced function in their lungs and immune systems years later, compared to monkeys that were not exposed to high pollution levels as infants. But even those findings were after shorter exposures, and lower pollution levels than Californians have lived with since August, the Air Resources Board’s Holmes-Gen noted. A flurry of new research into the health effects of the smoke is now underway. Rebecca Schmidt, a professor in the Department of Public Health Sciences at UC Davis, is conducting a long-term study into effects of smoke on pregnant women that began in response to the 2017 fires in Napa and Sonoma. She heard from expecting mothers who were affected by the smoke, dealing with coughs, watery eyes and other symptoms and wanted to know what the science said about the impacts on their developing babies. “There really wasn’t much out there,” Schmidt said. “There were just a couple studies.” Schmidt’s project now includes about 400 women who were pregnant during or shortly after wildfires in Northern California over the past three years. She plans to recruit additional participants this year who may have faced even higher, cumulative smoke exposure due to the recent fires. “What we really are interested in is to see what’s happening long term and whether those early biological responses are going to have long-term impacts, and that we just don’t know yet,” she said. “There’s just very little known about wildfire, specifically smoke exposure, and long-term health impacts.” Meanwhile, another ongoing study in Montana has reported troubling new findings that suggest wildfire smoke impairs people’s lungs long after the smoke clears. Researchers assessed the health of people in the small community of Seeley Lake, outside Missoula, which was blanketed with heavy wildfire smoke for 49 days during devastating wildfires in 2017. Follow-up tests showed they had decreased lung function for two years after the fires, with the percentage of residents who fell below normal levels more than doubling in 2018 and remaining low a year later. As University of Montana immunologist Christopher Migliaccio and colleagues wrote in a study published last month ,"these findings suggest that wildfire smoke can have long-lasting effects on human health.” Though at least some portion of California’s PM2.5 pollution has always come from fires, in years past most of it has been generated by motor vehicles and industrial sources. But as vehicle emissions decline and the climate warms, scientists expect the bulk of that pollution to come from wildfire smoke within the next few decades. “We’ve always been exposed to smoke, but it’s getting worse these days,” said Carsten Warneke, a research scientist with the National Oceanic and Atmospheric Administration. “And we notice it much more as we’re getting all our other air pollution better.” Another team of researchers coined the term “smoke wave” to describe episodes of high air pollution from wildfire that last two or more days. In a 2016 study , they projected a big increase in the frequency and intensity of smoke wave events that will affect tens of millions of people across the western U.S. if greenhouse gases continue to rise moderately. Northern California and Western Oregon are among the areas “likely to suffer the highest exposure to wildfire smoke in the future.” California regulators, who have for decades fought a slow but successful war on smog, are also being forced to confront wildfires as an increasing threat to their work to reduce emissions and slow global warming. “We’re concerned about smoke pollution undercutting all the efforts we’re making to reduce particle pollution and clean up the air,” said Holmes-Gen of the state Air Resources Board. Scientists also worry about what the future holds because of the role wildfire emissions play in what’s called a “climate feedback loop,” in which the global warming begets more warming. “Increased global emissions lead to higher temperatures, which then create drier, more fire-prone conditions,” researchers at the World Resources Institute think tank wrote in a blog post this week . “With more fires comes more emissions, perpetuating the entire cycle.”
For the fourth week in a row, San Diego County is seeing a record-breaking number of coronavirus outbreaks in its skilled nursing facilities. County health officials reported this week that there are 60 active outbreaks. Outbreaks at skilled nursing facilities are deemed active when one resident or healthcare worker from the facility tests positive for the coronavirus. That brings the total number of skilled nursing outbreaks since the beginning of the pandemic to 146. To date, the county reported, a total of 2,548 skilled nursing residents and 1,575 staff have tested positive for the virus and 282 residents and staff have died. Deaths related to skilled nursing facility outbreaks account for about 17% of the the total number of coronavirus-related deaths in the county. And the post-holiday surge continues. This week, the Shores Post-Acute had the greatest number of coronavirus cases among nursing homes countywide. According to California Department of Public Health data, the Birdland area facility has reported 207 resident and 88 staff cases since the beginning of the pandemic. On Wednesday, there were 140 active cases among residents and 38 active cases among healthcare workers, and by Friday those numbers had changed to 73 and 42, respectively. In an email Thursday, administrator Joseph Cruz said preventing the virus’ spread was the top priority at the facility, and that staff was collaborating with San Diego County Public Health to ensure that the best infection control practices were in place. Cruz said residents and staff are tested weekly, and its plan to prevent infections was tested and approved by the California Department of Public Health. With a 305-bed capacity, the Shores is tied with Country Hills Post Acute in El Cajon as the largest skilled nursing facilities in San Diego County and among the largest facilities in the state, California Department of Public Health data show.  “The facility avoided a widespread COVID outbreak throughout the entire the year of 2020 and was complimented by CDPH on several occasions for its COVID prevention interventions,” Cruz wrote about the Shores. “In December 2020, CDPH performed an infection control mitigation survey and the facility had zero deficiencies.” In 2020, there were 69 complaints against the Shores filed with CDPH, compared with the statewide average of 21 for facilities of a similar size and type. Of those, investigations found a total of 10 deficiencies, all of which were the second least severe level, meaning no actual harm was caused but there was a potential for more than minimal harm to occur. During an Oct. 18 inspection, a certified nursing assistant was observed walking in the hallway without a face mask while spraying an air deodorizer, according to the summary statement of deficiencies . When interviewed by the inspector, the nursing assistant said, “I just removed it. Yes, I’m supposed to wear it.” The report also states that according to the Shores May 20 face covering policy, “All staff are required to wear a face mask at all times in the facility.” News of the outbreak at the Shores was not a surprise to Nancy Kral, a Torrey Highlands resident whose 95-year-old mother, Ruth Palmer, stayed there for a week last month. Palmer was admitted to the facility while recovering from a mid-November leg fracture, and soon after her transfer to the facility, Kral received text updates from the Shores reporting a couple of coronavirus cases among staff and residents. During a video chat with her mother, Kral said she appeared to be in poor health. “I was horrified by how bad she looked,” Kral said. Kral asked her brother for help, and they were able to have her transferred to an assisted living facility two days later, where she is receiving home health visits. Although the transfer between facilities went smoothly, Palmer’s dentures were left behind, so Kral had to pick them up from the Shores. Upon arrival, she said she found the front desk receptionist maskless and eating lunch as workers walked in and out of the facility making deliveries, despite the safety protocols for visitors and staff to wear both masks and face shields. Asked to respond to Kral’s experience, Marionne Matusalem, the senior administrator, said the facility strives “to deliver the highest level of dignity and quality of care.” But, she added, “the facility is not immune to an observation of an area that could be enhanced, but it has the highest commitment to ensuring quality of care is upheld.” Palmer has not tested positive for the virus, and Kral said she was doing much better immediately after transferring to the assisted living facility, where she has been able to have social-distanced patio visits. The spike in cases within San Diego County facilities mirrors what nursing homes are experiencing across the state and throughout the nation as the first round of vaccines are administered to staff and residents.  Mapp writes for the San Diego Union-Tribune.
With hospital morgues overwhelmed by soaring numbers of bodies amid a surge in COVID-19 deaths, hard-hit parts of California are struggling to store the bodies of those who have died. The Los Angeles County coroner’s office is accelerating efforts to temporarily store corpses as the local death toll hits  record levels. This week, six members of  the California  National Guard arrived to assist county workers in  transferring bodies from  hospital morgues to  12 refrigerated storage units parked at the coroner’s office, said Sarah Ardalani, spokeswoman for  the office. Additional helpers  from the National Guard are expected to come next week. Last spring, the coroner’s office had anticipated a surge in the dead and quadrupled its storage capacity  to at least 2,000 bodies by bringing in the 12 refrigerated trailers, according to Ardalani. There are also  additional  trailers that can each hold about 25 bodies. As of Monday, the coroner’s office was holding 757 bodies. At the end of November, the beginning of the most recent COVID-19 surge in deaths, the containers held only about 60 bodies . Then the pace of fatalities began rising.  In early December, about 30 people a day were dying; by Saturday, the seven-day average was about 200 people a day. More than 4,400  COVID-19 deaths have been reported since Dec. 1, an astonishing number in just a matter of weeks. The cumulative number of dead in L.A. County from the disease is more than 12,000, a milestone that was crossed Saturday.  In just the last five days alone, an average of about 250 COVID-19 deaths a day have been reported in L.A. County. That’s higher than the average number of daily deaths from all other causes combined, including heart disease, cancer, stroke, diabetes, car crashes, suicides and homicides, which is about 170. Hospital morgues are overcrowded because funeral homes and private mortuaries are so full that they are having to turn families away . Open spots at the hospital morgue are quickly being replaced by new bodies. To prepare for the surge, the California Governor’s Office of Emergency Services has been preparing to dispatch 88 refrigerated trailers around the state to supplement morgue space. Ten have already been dispatched to Los Angeles, San Bernardino, Imperial, Monterey and Sonoma counties. The other 78 trailers, donated by Illinois-based Hub Group, need to be retrofitted with shelving to double their capacity. Cal-OES said there’s a plan to set up an additional temporary morgue at the campus of the county coroner, with at least five trailers supplied by Cal-OES and another five supplied by L.A. County. These resources will help “ensure we don’t get large backups, or, if we do have backups, they’re dealt with [with] respect and dignity [and] that we have the appropriate equipment in place or materials that are required for coroners and medical examiners to effectively deal with the decedents,” Cal-OES director Mark Ghilarducci said in a statement. Funeral homes in Fresno County are also under pressure. Mortuaries have had to figure out ways to maximize storage space for the increasing numbers of dead, Fresno County interim health officer Dr. Rais Vohra said Tuesday, and mobile refrigeration units are being brought in. “This is a mass casualty, a mass fatality event that our county is experiencing. And we’ve had to expand the storage areas for the dead bodies here in Fresno County beyond what’s normal,” Vohra said. How much extra space the county will ultimately need depends on how quickly funeral homes and mortuaries can process bodies, Vohra said. “It’s going to take that whole ecosystem to try to figure out how best to work through this really large number of bodies that they have to get taken care of,” Vohra said. “I’m glad that those two trucks are coming, and I sure hope that we don’t need them.” Times staff writers Phi Do and Maria L. La Ganga contributed to this report.
In a turnaround from recent dire predictions, Gov. Gavin Newsom’s proposed budget boosts next year’s funding for K-12 school districts and includes emergency grants to reopen campuses as soon as possible — part of a sweeping effort to address learning loss and social stresses in children. Higher education also benefited from increased support, and the governor rejected any increase in tuition. The total dollars — about $90 billion for kindergarten through community college — is almost certain to leave education officials wanting more, but also provides much of what they’d asked for. Newsom’s proposal comes in addition to $6.7 billion in recently approved federal education funding for California . “We are proposing to the Legislature a record investment in our public schools,” said Newsom, “to deal with the disproportionate impacts of this pandemic on ... our low-income communities.” For most of the state’s students, campuses have been essentially closed since March, with instruction moving online. Students from low-income families, especially Black and Latino students, have been slower to receive the computers and broadband they need to keep up with schoolwork. Many also have difficult learning environments at home — including higher rates of COVID-19, increased economic instability and added family responsibilities that include supervising younger siblings and jobs. “Distance learning has not met everybody’s needs equally,” Newsom said. “And that’s exactly what this is intended to do.” The budget generally received measured praise. “The governor’s budget is a big step toward meeting the needs of diverse school districts throughout the state,” said Troy Flint, a spokesman for the California School Boards Assn. “But it’s not comprehensive and does not provide the level of transformative money needed to mitigate the effects of learning loss long-term.”  “This is going to be a generational effort,” he added. Newsom has earmarked $4.6 billion to address learning loss, which school districts are expected to use for such purposes as an extended academic year and summer school. He allocated $400 million for school-based mental health services . And the governor wants $2 billion for reopening grants that would be available to every school district and campus-based charter school. Grant applications can be turned in as soon as the beginning of next month. By early February — health conditions permitting — the governor hopes to see campuses open for students in kindergarten through Grade 2, with older elementary grades soon to follow and secondary students coming after. The money available for reopening would range from $337.50 to $800 per student, with larger amounts going to districts that apply more quickly and to districts with high numbers of low-income families or other targeted groups of students with special needs. One concern, raised in a letter to Newsom by superintendents from seven large urban school districts, is whether the grants would be distributed equitably. Many districts might be unable to open under the governor’s timetable because of local health conditions. In his remarks and in documents released with the budget, Newsom sought to ease those concerns. The proposal would reserve funding for all districts that can submit a plan for future reopening “once rates drop and in compliance with state and local health requirements,” according to a state outline. If a school system takes the money, it would have to provide, as soon as health conditions allow, “optional in-person instruction” to students with disabilities, youths in foster care, children who are part of homeless households, students without adequate internet access and all students in transitional kindergarten through sixth grade — at the least. At the college level, Newsom proposed a 3% increase in base funding for the University of California and Cal State, which would help the two public university systems recover somewhat from staggering financial losses and added expenses triggered by the COVID-19 pandemic. Newsom said added funding came with the “expectation” of no increase in tuition or fees — which is something that senior leaders at undergraduate campuses have been considering , calling such hikes difficult to avoid. While education officials praised Newsom for prioritizing education, he was able to do so because of higher tax revenues than recently projected. In contrast, early in the pandemic-induced recession, the budget outlook appeared to be catastrophic, likely to force districts to slash programs and carry out sweeping layoffs. The process of decoding the complex budget proposal has now begun, and already there are concerns. One issue raised by school district officials is whether the governor used money for his COVID-response package that would have gone to education anyway. Those worries were echoed Friday by union leaders. “The budget rightly sets aside money for COVID-19 testing and vaccination, but that funding should come from public health funds” and not from dollars needed “for the regular operation of classrooms,” said Cecily Myart-Cruz, president of United Teachers Los Angeles. Separately, some district leaders don’t like that the grants seem to require a sign-off from unions representing teachers as well as those representing most non-teaching employees. Not surprisingly, union leaders favor such a provision. The governor treaded carefully on the issue Friday, saying that moving forward for the benefit of students would require participation from all parties, but that he would oppose those who refused to collaborate on reopening campuses.
The post-Christmas surge of coronavirus cases is worsening in Los Angeles County, a much-feared scenario that officials say will result in more crowding at already overwhelmed hospitals and an increase in deaths. On Saturday, L.A. County reached new milestones in the pandemic: more than 12,000 dead from COVID-19 and more than 900,000 cases of the coronavirus. The coming days are expected to be critical in determining how bad this surge will get and how much it will affect conditions at hospitals. L.A. County’s average number of new coronavirus cases on Thursday, Friday and Saturday was 17,879 — significantly above last week’s average of 14,000.  “This very clearly is the latest surge from the winter holidays and New Year’s — no question about it,” said Dr. Paul Simon, chief science officer of the L.A. County Department of Public Health, on Friday. “It had gradually started earlier in the week, but [definitely is] here in the last day or two.” On Saturday, there were 218 COVID-19 deaths reported in L.A. County. That came the day after the county set a single-day record, with 318. L.A. County has averaged 200 COVID-19 deaths a day over the past week. The number of people dying from COVID-19 daily now exceeds the average number of deaths in L.A. County from all other causes — including heart disease, cancer, stroke, diabetes, car crashes, suicides and homicides — which is about 170 a day.  “This is another devastating day for Los Angeles County. The speed with which we are reaching grim milestones of COVID-19 deaths and cases is a devastating reflection of the immense spread that is occurring across the county,” L.A. County Public Health Director Barbara Ferrer said in a statement Saturday. “This accelerated spread reflects the many unsafe actions individuals took over holidays. The travel and intermingling with non-household members made it much easier for transmission of the virus,” Ferrer said. “As a result, there is so much more risk when engaging in any activity that has you exposed to people outside your household.”  About 1 in 5 coronavirus tests performed daily in Los Angeles County is coming back positive, a huge spike from November, when about 1 test in 25 confirmed an infection. Ferrer urged residents to pause activities outside the home that aren’t essential. “This is just not the time to go to the shopping mall or to a friend’s house to watch a basketball or football game,” she said.  COVID-19 hospitalizations have leveled off in recent days but remain high — at about 8,000. Intensive care units are effectively stretched beyond capacity across L.A. County; there were a record 1,731 ICU patients on Friday, about triple the number from Dec. 1. There are only about 2,000 staffed ICU beds in L.A. County, and earlier in the week, about 400 were occupied by non-COVID patients.   Meanwhile, officials Saturday confirmed three additional cases of the coronavirus-related multisystem inflammatory syndrome in children known as MIS-C. A total of 54 children in L.A. County have contracted the severe illness, and one has died. The disease can cause fever and inflame the heart, lungs, kidneys, brain, skin, eyes and gastrointestinal organs. The disease is disproportionately affecting Latino children, who account for about 3 of 4 reported cases.       What is particularly frightening about the coronavirus, Simon said, is how unpredictable it is in terms of who becomes severely ill. Earlier in the pandemic, only 7% of COVID-19 deaths in L.A. County occurred among people with no underlying medical conditions, while now, 14% of deaths are among that group. “I know personally someone who is in his late 30s who became very ill,” Simon said. “Everybody needs to recognize that this virus has the potential to wreak tremendous havoc, tremendous damage within the body.” Statewide, Friday was the worst day yet for COVID-19 fatalities, with 676, according to a Times survey of health agencies. That figure easily topped the previous single-day record of 575, set Dec. 31. To prepare for more deaths, the Governor’s Office of Emergency Services has been preparing to dispatch 88 refrigerated trailers around the state that can serve as temporary morgues. Ten have already been designated for Los Angeles, San Bernardino, Imperial, Monterey and Sonoma counties.  On Monday, six men and women from the California National Guard arrived to assist county workers in the loading of bodies from hospital morgues into one of 12 refrigerated storage units at the L.A. County Department of Medical Examiner-Coroner, said Sarah Ardalani, a spokeswoman with the coroner’s office. Additional members of the National Guard are expected to come next week. The leader of a trade group representing California hospitals said Friday that the state’s healthcare system will be swamped starting in about a week. “We do anticipate the worst of this is to hit in another week or 10 days, and may continue into the month of February,” said Carmela Coyle, president and chief executive of the California Hospital Assn. “This has been unprecedented for our state, unprecedented for the nation, unprecedented for the world,” she said during a conference call. “But we find ourselves today, in terms of the numbers, at a point where we are standing on a beach and watching a tsunami approach.”  Simon pointed out symptoms that warrant emergency medical attention, such as a call to 911 or a call ahead to the hospital: • Trouble breathing • Bluish lips or face • Persistent pain or pressure in the chest • New onset of confusion • Inability to wake or stay awake “It is also critically important not to wait till you are sick to identify a regular source of healthcare. If you don’t have a regular healthcare provider, get one today,” Simon said. “The odds are simply too great at this moment that you will be exposed to COVID-19. And if you are, you’re going to need a doctor, a nurse to alert and discuss your symptoms or options and care options.” L.A. County residents who don’t have a healthcare provider can call 211 to get more information. 
No group has suffered more during the COVID-19 pandemic than staff and residents of nursing homes, where high concentrations of elderly people with serious health problems created the perfect killing ground for the virus. Still, the effort to vaccinate people in those homes is rolling out at a frustratingly slow pace, according to experts nationwide. For the record: 6:04 PM, Jan. 09, 2021 A previous version of this story misspelled the last name of Lake Minnetonka Care Center administrator Jeff Sprinkel as Sprinkle. As of Friday, only about 17% of the more than 4 million vaccine doses distributed to long-term care facilities had been injected, according to the federal Centers for Disease Control and Prevention. “Clearly nobody cares if old people die,” said Dr. Michael Wasserman, past president of the California Assn. of Long Term Care Medicine, which represents doctors, nurses and others working in nursing homes. “We could get all of these places vaccinated quickly if we approached it the right way.” Wasserman blames the federal government for failing to set up a streamlined plan and directly oversee delivery of the vaccine. Instead, crucial decisions about who gets the shots first have been left up to state and local governments, and the work of administering the shots has been left to large national pharmacy chains — CVS and Walgreens — that do not have the same relationship with nursing homes as the specialized pharmacies that already serve the industry. Science These researchers predicted California’s COVID-19 surge. Here’s when they think it will end Science These researchers predicted California’s COVID-19 surge. Here’s when they think it will end Researchers share which numbers they’re watching to forecast when California’s deadly COVID-19 surge will end.  More Coverage The slow rollout is “certainly a cause for alarm,” said David Grabowski, professor of healthcare policy at Harvard Medical School. “I think, like a lot of other parts of the pandemic, the federal response was too slow.”  Among the obstacles is bureaucracy: the sheer amount of labor required to fill out forms and upload data to ensure that consent was obtained and that each dose is tracked. “It’s just crazy,” said Jeff Sprinkel, administrator of the Lake Minnetonka Care Center, a home with only about 20 residents in Deephaven, Minn. When a crew showed up to administer the shots in late December, they had six people with them, more than could safely fit in the small break room used for the vaccinations given social distancing requirements. And three of those people were there only to “input information into their database,” Sprinkel said. It took 7½ hours for the team to vaccinate everyone, a task that could have been completed by a single nurse in the same time without all the paperwork, Sprinkel said. And because the vaccines come in batches, about eight doses were left over after everyone who qualified for the first round of shots had been vaccinated. “I contemplated having my family vaccinated, giving it to my wife, but I imagined that hitting the news, it would make us reviled,” Sprinkel said. Instead, the doses went to waste. Another obstacle has been the surprising degree of hesitance among nursing home staff to take the vaccine. A survey last month by the Kaiser Family Foundation found that 29% of healthcare workers nationwide were “vaccine hesitant,” a figure slightly higher than the percentage of the general population, 27%. “We haven’t treated staff very well in this pandemic,” Grabowski said. Roughly 40% of COVID-19 deaths nationwide have been among residents and staff at long-term care facilities, yet workers there have been chronically short of the masks, gloves and gowns needed to keep them safe from the virus, and most have been denied hazard pay even though they have done some of the most dangerous work. “I think they’re pretty distrustful now,” Grabowski said. “I get why they might not be anxious to step forward.” Another factor slowing the rollout is the number of active cases at nursing homes, which has been climbing steadily along with the post-holiday surge of cases in the general public. “If you have a nursing home with 100 residents and 20 had COVID last week, they might elect not to have the vaccine,” said Dr. Christian Bergman, an academic geriatrician at Virginia Commonwealth University. “You wouldn’t be able to monitor for any adverse event, and they likely would have protection for 90 days, so we’re not giving them to those people.” The lifesaving vaccines didn’t begin to be administered in Virginia until Dec. 28, Bergman said, and then the shots stopped abruptly for New Year’s Eve and New Year’s Day, slowing things down from the start. Despite the glitches, most homes in the state hope to have their first doses administered by the middle of January. “That will help a lot in stopping the spread,” Bergman said. So far, data documenting the progress of the vaccine effort in California nursing homes are hard to come by. State and Los Angeles County health officials did not respond Friday afternoon to requests for the numbers. But interviews with local industry experts suggest things aren’t going much quicker in California than elsewhere in the country. Raffaela Meyer, vice president of operations at Skilled Nursing Pharmacy, which specializes in providing medicine to nursing homes in California, said there are problems up and down the state. Her company has so far not been tapped to administer the vaccines, but many of her clients have said they aren’t scheduled to get their first doses until the end of January. In Los Angeles County, where public health officials opted out of the program run through CVS and Walgreens in order to handle vaccinations directly, homes have seen the opposite problem. “A lot of our nursing homes in L.A. County have hundreds of extra doses,” Meyer said. Once opened, those vaccines have a limited shelf life, and the nursing homes don’t know what to do with them. “I am on calls every week with L.A. County; they don’t have any answers. On calls with [state health officials], they don’t know either,” Meyer said. Most of the homes with extra doses are skilled nursing facilities, places for people who need the highest level of medical care. They have been the top priority to get vaccines, along with front-line hospital staff, because of the devastating toll the virus has taken there. One way to use their extra doses, Wasserman said, would be to share them with assisted living facilities, whose residents are just as old and often nearly as sick but haven’t been included in the first group to get vaccinated. “They’re on fire with new cases right now,” Wasserman said. He worries that frustration with the delays will lead to pressure to distribute the vaccine to the general public before states and local governments get around to vaccinating people in assisted living facilities. “And who gets shoved to the back of the bus then? Elderly residents and the poor women of color who take care of them,” Wasserman said.
They are frontline workers with top-priority access to the COVID-19 vaccine, but they are refusing to take it. At St. Elizabeth Community Hospital in Tehama County, fewer than half of the 700 hospital workers eligible for the vaccine were willing to take the shot when it was first offered. At Providence Holy Cross Medical Center in Mission Hills, one in five frontline nurses and doctors have declined the shot. Roughly 20% to 40% of L.A. County’s frontline workers who were offered the vaccine did the same, according to county public health officials. So many frontline workers in Riverside County have refused the vaccine — an estimated 50% — that hospital and public officials met to strategize how best to distribute the unused doses, Public Health Director Kim Saruwatari said. The vaccine doubts swirling among healthcare workers across the country come as a surprise to researchers, who assumed hospital staff would be among those most in tune with the scientific data backing the vaccines.  How race factors into decisions about who should get priority for COVID-19 vaccines How race factors into decisions about who should get priority for COVID-19 vaccines  The scientific evidence is clear regarding the safety and efficacy of the vaccines after trials involving tens of thousands of participants, including elderly people and those with chronic health conditions. The shots are recommended for everyone except those who have had a severe allergic reaction to any of the ingredients. Still, skepticism remains. April Lu, a 31-year-old nurse at Providence Holy Cross Medical Center, said she refused to take the vaccine because she was not convinced it was safe for pregnant women. She is six months pregnant.  Clinical trials have yet to be conducted on pregnant women who take the vaccine, but experts believe the vaccine is unlikely to pose a specific risk, according to the Centers for Disease Control. The agency says pregnant women may choose to be vaccinated. “I’m choosing the risk — the risk of having COVID, or the risk of the unknown of the vaccine,” Lu said. “I think I’m choosing the risk of COVID. I can control that and prevent it a little by wearing masks, although not 100% for sure.” Some of her co-workers have also declined to take the vaccine because they’ve gone months without contracting the virus and believe they have a good chance of surviving it, she said. “I feel people think, ‘I can still make it until this ends without getting the vaccine,’” she said. The extent to which healthcare workers are refusing the vaccine is unclear, but reports of lower-than-expected participation rates are emerging around the country, raising concerns for epidemiologists who say the public health implications could be disastrous. A recent survey by the Kaiser Family Foundation found that 29% of healthcare workers were “vaccine hesitant,” a figure slightly higher than the percentage of the general population, 27%. “Even the name, Operation Warp Speed, draws some concern for people about the rush to push it through,” said Dr. Medell Briggs-Malonson, an emergency medicine physician at UCLA Health who has received the vaccine. Still, she urged her colleagues to do the same. “It’s certainly disappointing,” said Sal Rosselli, the president of the National Union of Healthcare Workers. “But it’s not shocking, given what the federal administration has done over the past 10 months. ... Trust science. It’s about science, and reality, and what’s right.” The consequences are potentially dire: If too few people are vaccinated, the pandemic will stretch on indefinitely, leading to future surges, excessive strain on the healthcare system and ongoing economic fallout. “Our ability as a society to get back to a higher level of functioning depends on having as many people protected as possible,” said Harvard epidemiologist Marc Lipsitch. ‘Aren’t you going to help him?’ L.A. hospitals serving the poor and people of color hit hardest by COVID-19 ‘Aren’t you going to help him?’ L.A. hospitals serving the poor and people of color hit hardest by COVID-19  Respondents to the Kaiser Family Foundation survey who said they probably wouldn’t get the vaccine said they worried about side effects; they lacked trust in the government to ensure the vaccines were safe; they had concerns about the role of politics in the development of the vaccines; or they believed the dangers of COVID-19 had been exaggerated. In online forums, some healthcare workers throughout the country have expressed frustration over going first — a status some have associated with experimentation. Nicholas Ruiz, an office assistant at Natividad Medical Center in Salinas, Calif., said healthcare workers wrestled with the same doubts, fears and misinformation about the disease as the public. Though he interacts with nurses who treat COVID-19 patients, he’s not taking it and knows many others who aren’t. “I feel like the perception of the public with healthcare workers is incorrect. They might think we’re all informed of all of this. They might think that because we work in this environment,” Ruiz said. “But  I know there’s a lot of people that have the same mentality as the public where they’re still afraid of getting it.” In Fresno County, interim  Public Health Officer Dr. Rais Vohra said Tuesday that some “people who are qualified to get the vaccine are not ready to get it.” Such healthcare workers, including those who are pregnant or want to become pregnant, have been hesitant as questions about the long-term effects arise. To persuade reluctant workers, many hospitals are using instructional videos and interactive webinars showing staff getting vaccinated. At an Orange County hospital, Anthony Wilkinson, an intensive care nurse who cares for coronavirus patients, said he had co-workers who had “lost faith in big pharma and even the CDC.” Wilkinson made a Facebook video about the science behind the vaccine and was updating friends and family on his progress after receiving it. “People are scared for me,” he said. “I can understand why. It’s new and no one wants to be the first.” When can I get the COVID-19 vaccine? When can I get the COVID-19 vaccine?  The first allocations of the vaccine made by Pfizer Inc. and BioNTech arrived last week in Tehama County, home to 65,000 people. Dr. Richard Wickenheiser, the Tehama County health officer, said 495 doses were first made available to healthcare workers at St. Elizabeth Community Hospital in Red Bluff, but the hospital “basically returned 200 back to us.” “They gave us those vaccines back, and we quickly started moving it out and using it,” Wickenheiser said. “I don’t want to be accused of having it in the freezer while we wait for people to make up their mind.” At Laguna Honda Hospital in San Francisco, about 10% of the nursing staff has opted out of the vaccine,  said spokeswoman Zoe Harris. As of Tuesday, UCLA Health had vaccinated 7,300 personnel out of more than 37,000, though it wasn’t clear how many people had been offered the vaccine because the hospital didn’t release that information. Officials acknowledged that “there may be vaccine hesitancy in our workforce.” “We are not asking personnel to decide immediately whether to receive the vaccine. We want to give those offered vaccines adequate time to make a decision, and we hope that personnel will continue to understand that the benefits of vaccination clearly outweigh the risks,” the hospital said in a statement. The uncertainty is shared among staff inside nursing homes, which account for roughly 35% of the more than 25,000 COVID-19 deaths in California. But about a quarter of the staffers have voiced reluctance to take the vaccine,  said nursing home administrators and employees interviewed by The Times. “They’re scared of the side effects, they don’t know what is going to happen or if it will really protect them,” said a licensed vocational nurse at a Los Angeles nursing home who asked that her name not be used because she was not authorized to speak to the media. “It has become so political.” She  was reluctant to take the vaccine herself until the 95-bed facility she works in, which had been virus-free for months, was hit by the rapid community spread. “We have 16 new cases in just three days,” she said. “It’s so fast, we don’t even know how it happens.” “Reluctance? No question, there’s a lot of reluctance,” said Dr. Michael Wasserman, medical director of the Eisenberg Village nursing home in Reseda and past president of the California Assn. of Long Term Care Medicine, which represents doctors, nurses and others working in nursing homes. “Because there was no transparency or clarity from the federal government with the rollout, the states and the counties often didn’t know what was happening until the last minute,” he said. “That makes the vaccine reluctance even worse.” A hospital gave a COVID-19 vaccine to a Disney employee. It may be permitted under state guidance A hospital gave a COVID-19 vaccine to a Disney employee. It may be permitted under state guidance  It’s unclear what happens when a hospital ends up with  extra doses. State guidance allows hospitals to offer the vaccine to lower-priority people if frontline workers have already been offered the vaccine. In Tehama County, unused doses at hospitals are being distributed to the next group of people who are eligible: staff and residents of assisted living and skilled nursing facilities. Meanwhile, the county’s health department is fielding daily phone calls about access, said Wickenheiser, the Tehama County health officer, adding, “The public is asking on a daily basis: ‘When are we going to get it?’” Times staff writers Laura Newberry and Jaclyn Cosgrove and staff photojournalist Francine Orr contributed to this report.
Facebook, facing a boycott from advertisers and growing pressure from employees over the posting of material that incites violence, has removed at least four videos targeting public health officials who have called for people to stay home and wear facial coverings to slow the spread of COVID-19. Facebook CEO Mark Zuckerberg has long resisted calls to regulate political content on the popular website, which has more than 221 million users in the U.S. But the stepped-up rhetoric of content on the website and an expanding advertising boycott that added Verizon, Unilever, Hershey and Coca-Cola in the last two days has forced Zuckerberg to back down. Facebook stock fell seven percentage points Friday. “If we determine the content may lead to violence …. we’re going to take that content down no matter who said it,” Zuckerberg told CBS News. The videos Facebook removed Thursday were from a group called the Freedom Angels Foundation, which is known for its opposition to California’s efforts to mandate vaccinations. CNN, which reviewed the videos, said the posts make a number of false claims, including that children are being removed from their homes because of the coronavirus, face masks cause people to pass out, and COVID-19 is not a virus. One video was posted during a protest outside the home of Chris Farnitano, Contra Costa County’s health commissioner. Dozens of health officials across the county — including Barbara Ferrer, the director of the Los Angeles County Department of Public Health, and Dr. Nichole Quick, Orange County’s top health officer — have received death threats after issuing guidelines for dealing with the coronavirus. Ferrer found it “disheartening that an increasing number of public health officials across the country are threatened with violence on a regular basis. In my case, the death threats started last month, during a COVID-19 Facebook Live public briefing when someone very casually suggested that I should be shot.”  Quick, citing threats she received, is one of 10 state or county health officials who resigned over the threats. Several others have been assigned security details.
Along Pacific Coast Highway in Huntington Beach, electronic road signs were programmed to read: CANCELED SATURATE OC. But the evangelical worship event took place on the sand near Lifeguard Tower 20 for the fourth Friday in a row, despite warnings that it was violating public health orders and permitting rules, officials said. Its organizers estimate as many as 1,800 people attended for nearly two hours of musical performances, baptisms and prayers. Days earlier, minister and musician Sean Feucht urged his fellow Christians to join him under the Sundial Bridge in Redding for a night of worship. “Bring a mask (we’ll have some if you need). Spread out. Let’s worship Jesus and love on our city!” he said on Twitter. But videos of the July 22 gathering show people crowded together with no masks , waving their hands in the air and singing songs of praise. It’s been nearly two weeks since Gov. Gavin Newsom ordered the re-closure of churches in much of the state amid a worrying resurgence of new coronavirus cases. Though outdoor worship services are still permitted, participants are supposed to wear face coverings and keep six feet apart, as is required when Californians are around anyone who is not a member of their household. But from Orange County to Northern California, people continue to gather for large outdoor ceremonies without following the rules, prompting stern reprimands from public health officials. The Shasta County Health and Human Services Agency recommended that anyone who attended the Redding service get tested for the coronavirus and self-quarantine for 14 days.  “We truly empathize with all who have had to change the way they worship in the past few months,” the agency said in a news release. “Very sadly, some of our local cases of COVID-19, including hospitalizations, have resulted from faith gatherings, and it’s critical that our faith community leaders continue to offer safe services that follow the state guidelines.” The health agency noted in its statement that “there was much physical touching” at the event, and the crowd was too large to fit in the area around the bridge while maintaining social distancing. As of Friday, Shasta County had 291 confirmed coronavirus cases, with five people hospitalized and eight dead from the virus. The city of Huntington Beach said in a statement that it “firmly supports the right of any religious group to worship,” but that they must follow permitting and safety protocols. “Unfortunately, the Saturate OC event promoters have not instituted safety protocols prescribed by the  state and county, and they have refused to obtain a permit for their event,” the city said. The event’s directors said they thought they were being singled out because of their religion. “I think it’s more of a political statement that anything at this point, for people to actually shut down a worship service when there’s mass protests with hundreds of thousands of people in L.A. and then we’re getting highlighted in the news for spreading the virus,” said Parker Green, 34, who organized the recurring event with his wife Jessi, 35. Huntington Beach Police officers visited the Greens’ home ahead of the 6 p.m. service and cited Parker for promoting an event without a permit. They planned to expand the charge to holding an event without a permit, and officers were also recommending that his wife be cited, Angela Bennett, public information officer for the Huntington Beach Police Department, said Saturday. Each municipal code violation carries a potential fine of $1,000, she said. The Greens had been planning Saturate OC for more than a year and initially planned to host it at the Hyatt hotel, but then the coronavirus pandemic put an indefinite end to large indoor gatherings, they said. They held their first event at Huntington Beach on July 3, and they’ve seen attendance grow every week, surpassing their expectations, they said. “Suicide rates have shot up since COVID and we have people crying on the beach because they’re getting set free from suicidal thoughts and they’re saying this is the thing that they’ve needed,” Jessi Green said. “And I think that’s why there’s so many people coming to the beach.” On Friday, the Greens provided participants with hand sanitizer and gave out hundreds of masks, they said, but they estimated at least 60% of people chose not to wear them. “It’s Orange County,” Parker Green said, referencing the strong resistance to following public health orders that many county residents have become noted for. “Obviously [coronavirus] is a concern that we have in our mind, especially with people that are more vulnerable, but I’m driving through Main Street in Huntington Beach right now, and there are no masks, hundreds of people bumping into each other,” he said Saturday. “When is it enforceable and when is it not?” Public health officials have said there are potential hazards associated with churches — namely, the prevalence of singing and chanting, which can increase the likelihood of transmission through droplet spread. Even in less hard-hit counties where churches have been allowed to remain open for indoor services, the state has required that they not have singing and chanting indoors and limit attendance to either 25% of building capacity or 100 people, whichever is lower. When it comes to outdoor services, state guidelines advise local health authorities to consider appropriate limitations based on local conditions. Orange County has seen a recent surge in coronavirus cases and hospitalizations , reporting more than 33,900 cases and 560 deaths as of Saturday, with 685 COVID-19 patients in county hospitals. Based on the county’s transmission rate, its public health department determined the Saturate OC event should be limited to 100 people or less, the city of Huntington Beach said Friday in a news release. When the organizers declined to limit attendance, the public health department declared the event to be in violation of public health orders, the city said. It wasn’t immediately clear whether the declaration carried any weight. The Greens said they received no communication from county authorities about violating health orders. The health department did not respond to a request for comment. Still, the couple has decided Friday’s Saturate OC was the last one they’ll hold in Huntington Beach. They’re hoping to find somewhere else in Orange County instead. “They kind of put us between a rock and a hard place because they’re saying churches, as a whole, that they can’t meet inside buildings because of the health codes, to go outside,” Jessi Green said. “So we’re just trying to find places to go outside to share the gospel and practice our religion, but then we’re being told the public city beach is not an option.” “So where exactly is it OK, according to California municipalities and the state government, for me to practice my religion?” Parker Green said. Feucht, who could not be reached for comment, is holding “Let Us Worship” events around the country, including in Pasadena and Bakersfield earlier this week and Arkansas, Oklahoma and Texas in the coming weeks. A flier for one of the events, in San Diego on Sunday, urges attendees to “Please bring a mask and practice social distancing between households.” In a video filmed Friday before the Bakersfield event, Feucht appeared in a park with the city’s mayor, Karen Goh. “We’re socially distanced, we want to follow the guidelines, we want to worship,” he said. Pasadena police did not receive any calls about the gathering at 400 W. Claremont St. on Thursday evening, said Lt. Marcia Taglioretti. Officers are not making arrests for social distancing or mask violations, but they attempt to educate the public about the requirements, she said. In a video on Feucht’s Twitter page , labeled “Let Us Worship — Live — Pasadena,” Feucht plays the guitar, accompanied by a drummer. The crowd, closely packed and maskless, sings: “He’s got the whole world in his hands.”
In the weeks after George Floyd was killed by a Minneapolis police officer, dozens of city councils, mayors and governors approved resolutions condemning police violence and calling racism a public health crisis. One of the most strongly worded statements , passed unanimously by the Goleta, Calif., City Council, proclaimed that “Black people in America continue to live in fear of losing their lives at the hands of law enforcement.” But long before these resolutions denounced racist policing practices, the largest organization of public health workers in the world was locked in a multiyear debate over a policy statement titled “ Addressing Law Enforcement Violence as a Public Health Issue .” With more than 130 citations, the 14-page statement is a dense piece of academic work, but in some respects it’s as impassioned as a message scrawled on a protest sign. The story of what it took to get the 25,000-member American Public Health Assn. to explicitly state that systemic racism contributes to bad policing presages the conversations occurring across the country now. “It was that same kind of exposure, awakening and awareness that we’ve seen in the past few months, but at APHA it happened on a slower scale because the times were different,” said Nancy Krieger , a professor of social epidemiology at Harvard T.H. Chan School of Public Health, who contributed research to the statement. Emma Rubin, one of the 12 authors of the statement, put it this way: “People had to go with us on a journey of critical dialogue and interrogating the evidence. It was a process, but we got there.” The origins of the statement technically date to 2015, but public health workers have been thinking about these issues for decades.  The disproportionate impact of policing on Black communities has been documented since at least the 1960s, and there is a long history of public health researchers examining the role racism plays in health differences among whites and Black and Latino communities. More recently, the authors of the statement were inspired by activist groups, including Black Lives Matter, which formed in 2013, and the uprisings in Ferguson, Mo., after police fatally shot Michael Brown in 2014. Also influential was the work by the Guardian newspaper, which compiled the most accurate count to date of killings at the hands of American police . At the same time, growing numbers of academic papers were documenting the psychological and physical health effects of police encounters, especially among Black people. “It was becoming clear to more and more public health workers that policing was a threat, not just because police kill people, but also because of the stress and trauma that is experienced on an individual level and a community level when communities were having more contact with the police,” Rubin said. Science Cause of death: COVID-19, police violence or racism? Science Cause of death: COVID-19, police violence or racism? Some public health experts are bracing for a spike in COVID-19 cases in the wake of protests against police brutality.  In 2015, Rubin was a graduate student in public health at San Francisco State University, where she and other students began writing papers about how police violence undermines the health of Black communities. Any member of the APHA can propose a policy statement, so in early 2016 a small group of grad students from San Francisco State and the University of Illinois at Chicago set to work gathering research for a statement that would declare that current policing creates health risks for communities of color; the statement would point to systemic racism as the root cause. The students cited data that found police in the U.S. killed at least 1,140 people in 2015, that Black people are more than twice as likely to be killed by law enforcement than white people and that police are rarely held accountable when they kill people. The authors called for better reporting of law enforcement violence and urged federal and state governments to decriminalize as many activities as possible, including drug use and sex work. They also called for reallocating funds from policing to efforts that benefit public health, such as education and housing programs. “Yes, we are abolitionist, and yes, we wrote the APHA policy statement with an abolitionist lens,” read a recent tweet from @endpolviolence, a Twitter handle that represents the authors of the statement. “Abolition is public health.” In case anyone missed it when @ohmsbg mentioned it on the webinar this morning: yes, we are abolitionist, and yes, we wrote the APHA policy statement with an abolitionist lens. Abolition is public health. https://t.co/qVsWykxySc The motto of the APHA is “For Science. For Action. For Health.” But the statement declaring police violence a public health issue met with opposition immediately. Dr. Julie Graves , who chaired the science board that reviewed proposed policy statements in 2016, said that while she agreed with the sentiment behind the document, the board decided that it was poorly written, formatted incorrectly and lacked evidence. “When it was first presented to us, we wrote the authors back and said everyone agrees with you, but you have to follow the rules,” she said. The science board recommended that the statement not move forward. The authors disagreed, and that fall, the statement was presented as a “late breaker,” which meant that if approved, it would remain APHA policy for a year while undergoing a demanding process of review and revision. This time, leaders of the governing council tried to use a parliamentary procedure to keep the policy statement from coming to a vote. Graves was disgusted. “I’d rather they’d rewritten it, but you have to let people vote,” she said. Science Getting killed by police is a leading cause of death for young black men in America Science Getting killed by police is a leading cause of death for young black men in America About 1 in 1,000 black men and boys in America can expect to die at the hands of police. That risk is 2.5 times higher than for white men, new research shows.  After a long discussion, the 220-member APHA governing council passed the statement with 55% of the vote. Though some APHA members didn’t actively resist the statement, they didn’t embrace it, either, according to Dr. Camara Jones , an epidemiologist and former APHA president who lectures widely on the health impacts of racism. “There was nobody who would get up and say, ‘We don’t care about police violence,’ but there was what I would characterize as a lack of readiness,” she said. Some APHA members struggled to understand how public safety would be protected if funds were moved away from the police. “It’s not as if the APHA has not dealt with different aspects around racism and health,” Krieger said. “It has. But people needed to understand that the framework is not just about making police disappear; it’s also about determining what investment in community safety is needed that doesn’t involve more force.”  Science Oakland police tend to treat black drivers with less respect than white ones, linguistic analysis shows Science Oakland police tend to treat black drivers with less respect than white ones, linguistic analysis shows After reviewing transcripts of traffic stops involving 981 motorists, Stanford researchers have come up with proof of something that many Americans have believed for a very long time: Police officers tend to treat black citizens with less respect than white citizens.  For example, research shows that access to stable housing, robust mental health services, quality education and living wages all contribute to healthy communities. After the 2016 APHA meeting, the statement’s authors set to work, with more volunteers, both students and veterans, collecting research, writing drafts and trying to draw up support from other APHA members. The group also gave itself a name: the End Police Violence Collective . But at the 2017 annual meeting, the statement failed in a 55% to 45% vote. “We were disappointed but resolute,” Rubin said. “We knew we had to keep pushing.” Leaders of the APHA blamed the quality of the statement, not its perspective, for its failure. “They didn’t strengthen it as the committee felt they needed to,” said Dr. Georges Benjamin , executive director of the APHA. “Our policies are used in Supreme Court briefs and other legal briefs. We want to know when someone says, ‘The APHA says this,’ the data is behind it.” But at the same time, Benjamin was growing increasingly convinced that the APHA needed to address police violence. “You see all these various components of how police violence impacts people’s health in negative ways,” he said. “Quite frankly, it was clear that its time had come.” The End Police Violence Collective resumed work and mostly stuck to the data rather than referencing individual deaths. But the news of Black people dying at the hands of police was inescapable. In 2016, the year the late breaker was approved, two high-profile cases dominated the news: the deaths of Philando Castile in a suburb of St. Paul, Minn., and Alton Sterling in Baton Rouge, La. Rubin thinks APHA members were influenced by what they were hearing in the news as well as by incidents in their own lives. “At hearings and in some conversations, we definitely heard from people who had had personal experiences of police violence — their loved ones or themselves had been affected,” she said. When the APHA convened its annual meeting in November 2018, the collective was ready. The group and its supporters distributed thousands of “End police violence” ribbons and fliers that stated: “Violence by law enforcement officers results in deaths, injuries, trauma and stress that disproportionately affect marginalized populations. ... It’s time the field of public health takes a stand!” They organized a daylong workshop at which APHA members could hear from community organizers, health workers and family members of people who had been harmed by police violence. On the day of the vote, supporters of the statement staged a rally outside the building, then filtered into a large auditorium to watch the balloting. Governing council members used clickers to cast their votes, which were recorded one by one on a big screen at the front of the hall. Silently, the End Police Violence Collective and their supporters watched with growing joy as the votes came in: The statement not only passed but passed by the commanding margin of 87% to 13%. “People were clapping, hugging, crying, all those things,” Rubin said. “It took a lot to get to this point.” Graves was more circumspect. “They did improve it, but it still has some problems,” she said. “Is it the best policy? No. Is it the worst policy? No. But at least we have a policy statement.” Science How your racial biases can change in a heartbeat Science How your racial biases can change in a heartbeat In humans, the distance between the brain and heart can be a foot or more.  The authors said they can’t attribute the passing of the statement to any particular action on their part. “Each year the conversation got more nuanced and was underscored by the injuries and deaths at the hands of law enforcement,” said Omid Bagheri Garakani , a faculty member at the University of Washington school of public health and one of the co-authors. “And it has continued through 2018 all the way to George Floyd and Breonna Taylor now. The data was continuing to come out.” The End Police Violence Collective still meets regularly, and the statement isn’t just sitting on a shelf collecting dust. It has appeared on public health syllabi and been cited in academic papers. Activists have used it to support campaigns on several fronts, such as efforts to end militarized police training exercises in Oakland and to help dismantle a gang database used by police in Chicago. Asantewaa Boykin , an emergency room nurse and co-founder of the Anti Police-Terror Project in Oakland, said that in her own advocacy work, she references the statement at least twice a month. “Even if I’m just saying, ‘The American Public Health Assn. said this was a problem two years ago,’ people are still shocked,” Boykin said. “They say, ‘What? They did? Oh, wow.’”
Gov. Gavin Newsom set an ambitious target of vaccinating an additional 1 million people against COVID-19 over the next nine days, but offered few new details in Friday’s budget proposal indicating how the state would spend the estimated $372 million he says is needed to improve vaccine rates. Newsom said the state is ramping up efforts to ensure those who qualify for a COVID-19 vaccine are able to get them quickly, admitting the state’s effort to distribute the lifesaving supplies has been “not good enough.” Though California has received more than 2 million doses of vaccine, as of Friday less than a third had been administered to the frontline healthcare workers and residents at nursing homes and other long-term care facilities who are eligible in the first round of inoculations. “I would expect — and you should expect — that we are going to see a substantially higher number of vaccines administered in the coming days and coming weeks,” said Newsom, later adding, “Hold me accountable.” The state’s effort to quickly ramp up the number of people vaccinated against the deadly coronavirus comes as the California Hospital Assn. said Friday that the surging infection rates are expected to result in a tsunami of patients needing care at hospitals that are already stretched to their limit. The state eased restrictions on who currently qualifies for vaccinations to help speed up the rate at which local health departments and providers administer the Pfizer-BioNTech and Moderna vaccines, a process that was created to ensure the well-off and well-connected can’t jump to the front of the line. The state’s new guidelines allow for vaccines to be offered to those in other lower-tier groups, such as teachers, child care workers and people over the age of 75, if there is a risk of the vaccine expiring. Despite the immense focus last year on swift development of a vaccine, distribution has been slower than expected across the United States. Regulations at the federal, state and local levels on how to prioritize those who will first be vaccinated have added to delays in California. The state’s rollout has also been hampered in part by technical problems with a software program used to coordinate vaccine distribution,  local and state health officials say. On Friday, Newsom proposed spending $372 million to improve vaccination efforts, with that money loosely earmarked for a new vaccine management system, which is expected to launch next week, increasing distribution supplies and creating a public education campaign to counter vaccine hesitancy. Although those funds are included in the budget proposal that, if approved by legislators, wouldn’t take effect until later this year, state officials said Friday that the governor could more quickly spend funds under emergency operations rules that do not require legislative approval. Newsom defended the state’s regimented prioritization of who can receive the vaccine, saying that a shortage is inevitable amid worldwide demand for vaccines and the focus should remain on ensuring groups with the most pressing needs are first in line.  “There is this false pretense that somehow the vaccines are plentiful when they’re not,” Newsom said. However, Newsom said it’s critical that the state put the supply it has on hand in the arms of those who need it. California is currently facing a massive surge in COVID-19 cases, with hospitals stretched so thin that some are preparing to ration care. Critically ill patients are waiting days for available intensive care beds in Southern California and the San Joaquin Valley. Carmela Coyle, president of the California Hospital Assn., said Friday that there are 23,000 people hospitalized with COVID-19 throughout the state, with another 15,000 expected to be hospitalized over the next 10 days. “Our greatest challenge, as we all know, is the supply of that vaccine,” Coyle said.
Gov. Gavin Newsom on Friday rejected tuition increases this fall at the University of California and California State University but provided more higher education funds in his 2021-22 proposed budget than some campus leaders had expected. “We do not believe it’s time for tuition increases and fee increases,” Newsom said in unveiling his budget proposal at a Sacramento briefing. “And we do believe it’s time to invest more in student aid across the spectrum. And that’s exactly what this budget proposes.” Newsom’s proposal provides a 3% increase in base funding for UC and Cal State, which would help the two public university systems recover from substantial financial losses and added expenses triggered by the COVID-19 pandemic. Both systems were hit with state budget cuts of about $300 million each, massive losses in revenue from housing and dining, added expenses for technology as campuses shifted to online learning, and additional outlays for coronavirus testing and tracing, cleaning and protective equipment. The proposed increase does not cover all of those losses or come close to reaching the level of funding that the systems had asked for. Moreover, Newsom said the increases were being proposed with the “expectation” that the UC and Cal State systems do not raise tuition or fees. At the UC system, senior leaders at the majority of undergraduate campuses told The Times last month that they believed it was time to begin talking about a possible tuition increase to ease their financial straits due to the pandemic, continued rising costs and flat tuition rates for most of the last decade. But Newsom noted that the second stimulus bill passed last month by Congress could provide an additional $2.9 billion to California colleges. An analysis of that legislation by the American Council on Education found that the federal funds could amount to $73 million at Cal State Northridge, for instance, and more than $50 million at UCLA, UC Irvine, UC San Diego and UC Davis. In a statement , UC Board of Regents Chairman John A. Pérez and UC President Michael V. Drake thanked Newsom for what they called “critical investments in UC students and California’s future, especially given the fiscal uncertainty during COVID-19.” Cal State Chancellor Joseph I. Castro, who began his role this week, called Newsom’s budget proposal “a welcome reinvestment” and noted specifically the money for the graduation initiative, which Cal State leaders had been worried could be in jeopardy.  “The state’s investment in the CSU has led to greater access and record-levels of achievement for students under Graduation Initiative 2025 , which in turn produces career-ready graduates in a timely manner,” Castro said in a statement. That gratitude was echoed by Eloy Ortiz Oakley, who serves as both a UC regent and chancellor of the California Community Colleges system. “The biggest issue for us going into this budget was student need,” he said, noting that many students in the system took fewer classes or dropped out altogether because they had to find ways to meet financial obligations at home. Newsom’s proposal gives the UC system an increase of $136.3 million in ongoing general funds to cover core needs plus money for student access to technology and mental health services, medical education, immigrant legal services and firearms violence research. Another $225.3 million in one-time funding would help cover deferred maintenance, energy efficiency projects, emergency financial assistance for students and support for other programs, such as research in science and innovation. The proposal fell far short of UC’s budget request of more than $500 million for ongoing funding — but it could have been worse, budget experts said. “Given that revenues have come in substantially higher than had been originally forecast, it has allowed the state to provide more investments in UC, CSU and the community colleges than many of us had feared would have been the case,” said Hans Johnson, a higher education expert at the Public Policy Institute of California. “And while the total allocations in terms of increases for UC and CSU in particular are not as high as they might have had in their budget requests, they’re pretty substantial still.” George Blumenthal, a former UC Santa Cruz chancellor who now heads the UC Berkeley Center for Studies in Higher Education, said Newsom’s budget does not address the steady decline in per-pupil state support over decades — and is tying UC’s hands to raise more revenue by increasing tuition and fees. Although the UC regents retain the sole authority to determine tuition rates, Newsom — and former Gov. Jerry Brown before him — tied the state funding increases to a maintenance of current tuition rates. “This is not a tragic or horrible budget, but to the extent that it continues a long-term trend … and especially as the governor is saying, no tuition increases going forward, then I think it’s somewhat alarming in terms of the future efficacy of the educational experience,” Blumenthal said. “How can that have any effect other than to decrease the quality of the university?” At the Cal State system, Newsom proposed an additional $144.5 million in recurring funding, including money for the system’s flagship Graduation Initiative, a 10-year campaign to increase graduation rates and close equity gaps, and $30 million to support students’ basic needs of food and housing, access to technology and mental health services. The money represents about half of the $299 million in ongoing funding for the Cal State system that was cut last year because of the recession and state budget deficit. Newsom also proposed $225 million in one-time funding for Cal State. The majority of that will go to deferred maintenance across campuses, but the money also includes $30 million for emergency financial assistance grants to students and $10 million for faculty professional development, including in online instruction. For both university systems, the funding would be granted “with the expectation” that they maintain undergraduate tuition and fee levels for 2021-22 and take steps to reduce equity gaps significantly. Also, the systems would create a new “dual admission” pathway granting a guaranteed UC or Cal State seat to high school graduates who do not gain immediate freshman entry but would move over after they complete prescribed community college coursework needed for a transfer degree. By giving them conditional admission upfront, proponents say, students would be more likely to stay on the path to a four-year degree. At the California Community Colleges, which serve some of the most financially vulnerable students in higher education and where enrollment in fall 2020 dropped by about 8%, Newsom’s proposal focused on emergency financial assistance and efforts to retain students who struggled financially or with online instruction. The budget included $250 million for emergency financial assistance to students, $20 million to bolster retention and enrollment by engaging students who withdrew or who may be hesitant to enroll because of the pandemic, $100 million for food and housing needs, and $30 million for technology access and mental health resources. There was also $35 million to support apprenticeships and other “work-based learning” programs for community college students and $30 million for professional development and distance learning.
Like hospitals, ambulance systems in Los Angeles County are buckling under the surge of COVID-19 cases. Bottlenecks, extreme wait times and sickened staff are among the issues facing the county’s emergency medical technicians, officials said, with at least one EMT waiting as long as 17 hours to offload a critical patient. “While we’re trained to deal with crises, something like this has never been seen in anybody’s lifetime that’s in healthcare right now,” said Tom Wagner, west group president of American Medical Response, one of the largest ambulance service providers in the county. AMR and Care, the county’s other major ambulance service provider, are responding to a combined 1,500 emergency calls a day, officials said — roughly 30% more than in earlier months of the pandemic, when calls decreased  during initial stay-at-home orders. The Los Angeles Fire Department, which provides ambulance services within the city, is responding to  roughly 800 to 1,000 emergency medical calls each day. “It really has been a dramatic surge in the last six weeks,” Wagner said. “The relentlessness of it is really putting a pressure on folks.” The flood of patients, along with increasingly sick healthcare workers and the region’s  lack of intensive care unit beds, are resulting in crippling delays when it comes to offloading patients at hospitals. Before the pandemic, an ambulance could be back on the road within minutes of arriving at a hospital. Now EMTs are regularly waiting four, five and even 10 hours to offload a patient, according to Jeff Lucia, Care’s communications director.  “That’s time that a patient is on an ambulance gurney, which is a little uncomfortable for them, at a hospital waiting to be brought in,” he said, adding that even if Care were to put more ambulances on the road, most would end up just “sitting there.” Dr. Marc Eckstein, EMS bureau commander at the LAFD, said the delays are piling up so quickly that the city is working to implement a new policy that will allow ambulances at over-capacity hospitals to offload patients onto portable cots whereby firefighter EMTs can monitor four or five people awaiting admission at the same time. It’s something they’ve never had to do before. “Desperate times require desperate measures,” Eckstein said. “The goal is to be able to accomplish our mission, which is to respond to 911 calls.... We need to get ambulances back out in the streets.” Ambulance crews are also experiencing a reduction in staffing due to the spread of the coronavirus. More than 170 of the LAFD’s responders are in isolation due to COVID-19, Eckstein said. “Several dozen” of AMR’s 500 L.A. caregivers are in various stages of quarantine on any given day, Wagner said. Officials said ambulance crews now must assume every patient they respond to is COVID-positive — and many are. On Thursday, public health officials announced that 1 in every 5 COVID-19 tests in the county is coming back positive. The L.A. County Emergency Medical Services Agency this week issued a directive advising ambulance crews to conserve oxygen for patients whenever possible, but Lucia said the long waits outside hospitals are using up oxygen from the small portable tanks within ambulances. Both AMR and Care said they have developed contingency plans to redistribute oxygen and PPE supplies, if necessary, to prevent dangerous shortages. The county’s directive also advised ambulance crews to not transport patients who have a limited chance of survival — a scenario that is increasingly likely as the number of sick patients climbs. Eckstein said cases of cardiac arrest more than doubled in November and December compared with 2019, which he called a reflection of the impact of COVID-19. Although people should seek help when they need it, Eckstein said, it is incumbent  on them  to call 911 only when  there is a real or perceived life-threatening emergency. “The system is being really taxed right now, and we want to make sure we have resources for those individuals who truly need our services,” he said. On Friday, nearly 8,000 people were in L.A. County’s hospitals with COVID-19, according to The Times tracker , a 17.7% increase from two weeks ago. As it stands, the flood of sick patients and the delays in turnaround time are proving challenging for even the most ready of responders. “People tend to [become EMTs] because they want a career helping people,” Lucia said. “To be sitting outside a hospital with a stable patient, while you know people are out there calling 911 and waiting for ambulances, and you’re unable to get to them — that’s pretty hard on our crews.” Los Angeles County reported more than 300 new COVID-19 deaths Friday, its highest single-day tally to date.
Los Angeles Mayor Eric Garcetti condemned a group of anti-maskers who descended on Westfield Century City mall on Sunday in protest of COVID-19 health mandates, at times harassing employees and customers. Police made no arrests Sunday but did take two reports of battery. Garcetti said that in the future, police officers will take action and arrest lawbreakers in such situations. “Don’t test us on this because you will find yourself in jail, cited or dealing with prosecution,” the mayor said. Los Angeles Police Chief Michel Moore earlier this week had defended his officers’ handling of such incidents without arrests, saying they had followed guidance from him and other police leaders to focus first on lowering tensions. “Our effort here is not to escalate the situation,” he said. He said officers had been given a specific set of instructions. They were told to first speak with the operator of whatever business was being protested, and then to support the operator in enforcing their mask requirements by informing protesters of the rules and asking them to comply. Moore said officers would prefer not to reach the point of having to use force in such instances but are prepared to physically enforce the rules if violators refuse to comply because  wearing masks is a critical issue. “This is not just an expression of a political view,” he said. “This is a dangerous act that I am very concerned about.”  He said forcing people to obey  health orders is “not a primary responsibility of the Police department,” but when people “start jeopardizing other people’s health and other people’s family members, that’s a bridge too far.” The incident Sunday, which began at a Ralphs grocery store and then continued on to the upscale mall stunned customers and employees. Videos on social media showed the group without masks walking through the grocery store and arguing with customers. In one video , a man can be seen rejecting an offer of a mask, stating, “I don’t need that; I don’t wear masks.” Science These researchers predicted California’s COVID-19 surge. Here’s when they think it will end Science These researchers predicted California’s COVID-19 surge. Here’s when they think it will end Researchers share which numbers they’re watching to forecast when California’s deadly COVID-19 surge will end.  More Coverage Another man said he tested negative for the coronavirus and called a customer at the market a “mask Nazi.” An unmasked woman tried to ram her shopping cart into a masked man, claiming that he hit her, and she was later seen kicking the man in a checkout line. “Come on, patriots, show him what’s up,” she could be heard saying on the video. It was the latest of several anti-mask protests in Los Angeles. Two weeks ago, a group of maskless demonstrators forced its way into an Erewhon market in the Fairfax district in protest of coronavirus restrictions. Video showed at least six police vehicles near the Erewhon on Beverly Boulevard. A crowd of protesters chanted in front of the store, some shouting, “Open up L.A.!” One person yelled, “They want you to wear a mask, they want you to lock down!” Public health officials say mask wearing is essential to prevent the spread of COVID-19. In California, public health mandates require that all residents wear face masks when outside their homes. Los Angeles County on Thursday recorded its fourth-highest total of new coronavirus cases in a single day, according to a Times tally of local health jurisdictions, On Thursday, 18,764 new coronavirus cases were reported, well above the daily average over the last week of about 14,000. There were 205 COVID-19 deaths reported Thursday, according to The Times’ tally, the sixth-highest death toll reported in a single day. L.A. County is now averaging 171 COVID-19 deaths a day over the past week. COVID-19 hospitalizations have stabilized at a high number recently, hovering between 8,000 and 8,100 from Monday through Wednesday — a level that has already plunged L.A. County’s hospitals into crisis and created a shortage of ambulances and increased wait times to drop off patients. Already, hospital morgues and private mortuaries are full, and the National Guard has been asked to help store bodies at the county coroner’s office. But the worst is probably yet to come. Most of the people hospitalized with COVID-19 in L.A. County were infected before Christmas. It won’t be until next week, experts say, that statistics indicate how much worse the post-holiday surge could be. County Supervisor Hilda Solis and public health officials expressed dismay at the anti-mask protests. “Despite what protesters claim, this is not a hoax,” Solis said. “Just take a look at our hospitals — hospitals where care now has to be rationed . And it will only get worse if we give in to demands to reopen at a time when our cases, hospitalizations and deaths continue to skyrocket.” Solis added: “It is actually very counterproductive to end restrictions and let the virus spread even more uncontrollably. Doing so will only further damage the economy and continue to take lives.” A Kaiser Family Foundation tracking poll found that 70% of Americans thought they could follow social distancing guidelines for more than six months or until a vaccine is widely available. About the same proportion say they wear a protective mask every time they leave their house. Times staff writers Iris Lee and Hayley Smith contributed to this report.
When healthcare workers at Olympia Medical Center reported for work on New Year’s Eve, they were prepared for another grueling day of patient care amid L.A.’s worsening COVID-19 surge. What they weren’t prepared for was the laminated paper taped to the front door. “Olympia Medical Center has elected to voluntarily suspend all patient care services, including the emergency department and all emergency medical services, as of 11:59 p.m. on March 31, 2021,” the notice said. Employees were outraged, blindsided and concerned, with one medical staff officer calling it a “terrible public health mistake” to close an L.A. hospital in the midst of the pandemic. “How can we be having an acute-care hospital shut down by March 31 when we need hospital beds, when they’re putting up field hospitals and asking Navy ships to come back?” said the officer, Dr. Don Schiller. Any patients who remain at Olympia on April 1, he noted, will have to be transferred to another hospital because all clinical activity will stop. Yet few answers were immediately available, either for the 450 healthcare workers who will lose their jobs at the 204-bed hospital in Mid-Wilshire, or for the community that relies on it. The owner of Olympia Medical Center, Alecto Healthcare, sold the facility to UCLA Health in recent weeks. In a statement to The Times, UCLA Health confirmed the purchase and said it is planning a “major facility renovation on the former Olympia campus” this year. “UCLA Health regularly considers property purchases and growth opportunities in the region that allow us to expand access to care for patients who need our services,” the statement said. “One such opportunity arose recently with Olympia Medical Center of Los Angeles in mid-Wilshire.” David Sampson, a spokesman for UCLA Health, provided no further details about the purchase or about when the facility will reopen. He declined to say whether the facility will remain a hospital.  “The operators decided to sell the property and will be winding down their services over the next few months before closing the hospital,” the statement said. Michael Sarrao, executive vice president and general counsel for Alecto, declined to comment. The notice on the hospital’s door, which has also been posted on its website , advises patients of three nearby hospitals that provide acute care, including Southern California Hospital at Culver City and Ronald Reagan UCLA Medical Center in Westwood. The closest hospital on the list, Cedars-Sinai, is already struggling with intensive care unit capacity under the surge of COVID-19. The lack of clarity has left the community in the lurch. The impending suspension of services, some beginning as soon as Jan. 31, will probably coincide with a jump in COVID-19 cases tied to the holidays.  California Here’s what the ICU ward looks like with 0% availability California Here’s what the ICU ward looks like with 0% availability ICU availability in Southern California at 0%, and the crisis is expected to get worse, officials warn.  On Monday, healthcare workers at Olympia said the facility was well over capacity with few doctors and nurses left to help. After the announcement, they were all advised to start seeking credentialing elsewhere, and many have already jumped ship. “People are looking for jobs already because they know this place is going to be shutting down,” said one Olympia worker who asked to remain anonymous, “so now the place will die a slow death.” For the remaining uncertain weeks of the facility’s operation, patients who come to Olympia could experience shortfalls in care. Over the weekend, there were only two nurses in the 30-bed emergency room, the worker said, and two patients had to wait 28 hours for an ICU bed. The healthcare workers who still remain, most of whom were already struggling under the weight of countywide staffing shortages , are now caring for up to six patients at a time — far more than state-mandated staffing ratios allow, especially for patients who require intensive care and monitoring. “People are giving all of themselves,” the worker said. “Everyone’s burnt out. They leave work crying every day.” Alecto Healthcare has managed other controversial hospital closings. In September 2019, the company abruptly closed Ohio Valley Medical Center in Wheeling, W.Va., despite Gov. Jim Justice’s efforts to keep it open. In March 2020, the company again closed a hospital in West Virginia , Fairmont Regional Medical Center, with little warning. The state’s attorney general, Patrick Morrisey, is investigating the company’s business practices, his office said, and the investigation has already resulted in Alecto agreeing to pay more than $1 million in lost wages and retirement benefits to employees at the shuttered West Virginia hospitals. But it’s not only the immediate loss of care that is of grave concern to the local community. The hospital opened in 1947 near the corner of Olympic and San Vicente boulevards and was long known as Midway Hospital. It has been a reliable standby for neighborhood healthcare, locals said, for treating sliced fingers, broken bones and other maladies. A post about the hospital’s closure on the neighborhood-based website NextDoor drew dozens of comments bemoaning the decision, according to screenshots obtained by The Times. “They saved my life in August of 2019,” one resident wrote of the facility. “It has always served as an important healthcare resource for our community,” wrote another. Several community members, including Roque Wicker of the Mid City West Community Council and Steven Rosenthal of the Greater Miracle Mile Chamber of Commerce, said the Olympia facility is going to be gutted and turned into a rehabilitation center or long-term care facility, but UCLA Health would not confirm those reports. The loss of an emergency department and ICU, whether temporarily or for good, will have an immediate and resounding impact on the area: The population served by the hospital is primarily Black, Latino and underinsured, according to Wicker, who helps run Olympia’s outpatient wound care and hyperbaric department in addition to serving on the community council. All are groups that have already been disproportionately affected by the pandemic . “What’s going to happen to these patients?” Wicker said. “They won’t be prioritized. I believe it’ll cost lives, the doctors believe it’ll cost lives. It’s definitely devastating to the community.” Olympia was also closely tied to the area’s senior population, providing geriatric and orthopedic care and garnering accolades for its digestive and intestinal disease treatment. “It’s just so concerning if they are doing anything that’s a business transaction, and not taking into consideration the pandemic and the community’s need for this hospital,” said Kari Garcia, vice president of the Miracle Mile Residential Assn., a nonprofit community group in the area. Garcia, who works with the association’s earthquake and disaster arm, said the hospital also played a pivotal role in the area’s emergency preparedness plan. “It unravels our Miracle Mile community and it leaves us very vulnerable,” she said of the impending closure. Both the Miracle Mile community group and the neighborhood council said that they were not consulted about the suspension of services, and that there was never any public comment period, warning or advanced communication about the change. Representatives for Nithya Raman, the newly elected councilwoman for the district that includes the hospital, said it was the first they had heard about the suspension of patient care at Olympia. “At a moment in which COVID-19 is surging and ICU capacity in hospitals is at zero, we agree that any reduction in overall emergency services capacity in Los Angeles is cause for concern,” said Jesse Zwick, a spokesman for Raman. Zwick said the councilwoman’s office has reached out to Olympia and to UCLA Health to discuss the matter. Some, like Wicker, feared Olympia’s closure could create a monopoly on hospital care in the area and lead to longer wait times and higher co-pays for its historically lower-income patients. “This is a huge blow to the community,” he said. “This is just wrong.” The March 31 deadline posted on the door is probably not arbitrary: Hospitals in California are required to provide the public with 90 days notice for elimination of supplementary services, although recent laws mandate greater notice for more extensive closures. Residents and hospital workers said they wished the company had found a better time, and a better way to deliver the message. “The lack of information, even on a non-COVID, non-pandemic day, would still be concerning,” Garcia said, adding that many in the community, herself included, took comfort in having “Olympia down the street.” “It’s crazy that during a pandemic, people will not have it as a resource,” she said. “Now we’re like, ‘Where do we go?’”
