COVID in Nursing Homes Is Way Down, But Life Inside Remains Very Different

Cases of COVID-19 in California nursing homes are down 98% since the winter surge. But after a year of outbreaks, life inside these facilities has changed, perhaps permanently.

A year ago, Bethany Murray was on a call with nursing home managers on the East Coast. Their warning was stark: This virus will sneak into your building, and it will threaten your residents. Murray is now the administrator of Cedar Crest Nursing and Rehabilitation Center in Sunnyvale, where a bad outbreak came early.

"I can remember one time walking down the hallway and watching four or five nurses within the span of two to three minutes get a call from the county that they were positive," she said. "They had to leave. They had to walk out."

Even before the pandemic, nursing homes experienced a lot of staff turnover. When COVID hit, suddenly it was much harder to find people to do the work. So state officials loosened work rules, and Murray offered hazard pay.

"One of our doctors was pushing beds as we did a room change. And I'm unclogging toilets, and we had a pipe break in the COVID unit and the plumbers wouldn't come," she recalled.

Eventually hospitals started discharging people more quickly, including those who need post-operative care or rehab. These short-term residents take up about half the beds in Murray’s nursing home. She says they require isolation and testing, and usually more care and attention.

"It's a drain on resources that I don't think will go away until we as a larger community have kind of moved past COVID," Murray said.

Almost half a million nursing home residents in California have received one dose of vaccine. But many pandemic protocols, such as isolating new residents and testing everyone frequently, are still followed. And state rules now permit vaccinated residents to see visitors indoors.

"Even if we're 100% vaccinated, we're still going to have to follow these protocols ... until we're told not to, but also until we're reasonably confident that people coming in do not have COVID," Murray said. "And it's hard to say how long that's going to be."

Nearly 13,000 Californians died from COVID in nursing homes, a smaller percentage of the state’s total than the national average. Murray says she’s optimistic.

"The hospitals are starting the process of vaccinating our residents before they even get to us," she said. "We've taken care of our staff. All of our long-term residents are vaccinated. We're starting to see that light."

And Murray says if care homes are seeing the light, the rest of us can, too.

Molly Peterson

All Bay Area Counties Confirm They Have Paused Using Johnson & Johnson Vaccine

All nine Bay Area counties announced Tuesday that they are momentarily halting the use of the Johnson and Johnson coronavirus vaccine after reports of six women in the U.S. experiencing a rare and severe type of blood clot.

Early Tuesday, the Centers for Disease Control and Prevention and the Food and Drug Administration recommended health providers pause using the vaccine pending a review of the cases expected on Wednesday. The California Department of Public Health followed suit.

The six cases were reported out of the approximate 6.8 million doses of the J&J vaccine that have been administered in the U.S.

KQED reached out to all nine counties in the Bay Area to ask how they are responding to this recommendation. Alameda, Contra Costa, Marin, Napa, San Francisco, San Mateo, Santa Clara, Solano and Sonoma counties all have confirmed that they have paused using the Johnson & Johnson vaccine.

Some have already specified that they will switch over to Moderna and Pfizer vaccines to make up for the gap left behind by J&J.

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The San Francisco COVID Command Center released a statement saying that out of the 33,000 doses of the J&J vaccine that the city has administered so far, there are no reported cases of blood clotting.

"As this adverse event is reported to be extremely rare with just over six reported cases nationwide, we do not believe there is cause for immediate alarm," city officials said.

They added that anyone who has received the J&J vaccine should contact their care provider if they experience severe headache, abdominal pain, leg pain or shortness of breath within three weeks after vaccination.

However, some public health experts worry that this may impact counties' efforts to vaccinate communities that are the hardest to reach.

In Marin County, the J&J vaccine made up less than 3% of the doses allotted for this week. But many of those single-dose shots were intended for the county’s homeless population through mobile vaccination sites.

"We'll be using Pfizer instead, which just means that we'll have to be revisiting those sites in a few weeks. And we hope that the same people will be present when we revisit them," said Dr. Matt Willis, public health officer for Marin County.

Peter Arcuni

San Francisco, Santa Clara Counties Open Vaccine Appointments to Everyone 16 and Up

Less than two days before all Californians 16 and older become eligible to receive a COVID-19 vaccine, San Francisco and Santa Clara county officials announced that anyone 16 and older who lives or works in their counties is now eligible to make a vaccine appointment.

In a press release, San Francisco Mayor London Breed's office directed newly eligible people to the city's website to schedule an appointment at different vaccination sites. The state's My Turn tool is also showing eligibility for 16+ San Franciscans.

Santa Clara County has also fully opened vaccine eligibility to all county residents and workers 16 and older, although the county was not yet showing that eligibility through My Turn. Newly eligible Santa Clara County residents and workers may instead make appointments through the county website. An increase in vaccine supply allowed county officials to "release tens of thousands of additional vaccine appointments over the remainder of this week," according to a Tuesday press release.

The state on Tuesday directed all counties to pause using the Johnson & Johnson vaccine based on guidance from the Centers for Disease Control and Prevention and the Food and Drug Administration, which are examining a possible and rare side effect associated with only that vaccine.

State health officials said vaccine supply levels would not be affected by the pause because "less than 4% of our vaccine allocation this week is the Johnson & Johnson vaccine."

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-David Marks

CDC and FDA Recommend Pausing Use of Johnson & Johnson Vaccine Over Blood Clot Concerns

The U.S. Centers for Disease Control and Prevention and the Food and Drug Administration said on Tuesday they are recommending a "pause" in the use of the single-dose Johnson & Johnson COVID-19 vaccine out of an "abundance of caution" while a review of reports of rare, potentially dangerous blood clots is conducted.

In a joint statement on Tuesday, the two agencies said they are "reviewing data involving six reported U.S. cases of a rare and severe type of blood clot in individuals after receiving the J&J vaccine."

"In these cases, a type of blood clot called cerebral venous sinus thrombosis (CVST) was seen in combination with low levels of blood platelets (thrombocytopenia)," said Dr. Anne Schuchat, principal deputy director of the CDC, and Dr. Peter Marks, director of the Food and Drug Administration's Center for Biologics Evaluation and Research.

"All six cases occurred among women between the ages of 18 and 48, and symptoms occurred 6 to 13 days after vaccination," the statement added. "Right now, these adverse events appear to be extremely rare."

Speaking at a virtual news briefing after the announcement, Marks said that symptoms averaged about a week to nine days after vaccination, but not longer than three weeks.

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Schuchat and Marks recommended that individuals who had already received the Johnson & Johnson vaccine who experience severe headache, abdominal pain, leg pain or shortness of breath within three weeks of getting the shot contact their health care provider.

Following the recommended pause in vaccination with the Johnson & Johnson vaccine, Jeffrey Zients, the White House coronavirus coordinator, said, "we are working now with our state and federal partners to get anyone scheduled for a J&J vaccine quickly rescheduled for a Pfizer or Moderna vaccine."

In a statement sent to NPR, Johnson & Johnson said it was "aware of an extremely rare disorder involving people with blood clots in combination with low platelets in a small number of individuals who have received our COVID-19 vaccine."

"We have been working closely with medical experts and health authorities, and we strongly support the open communication of this information to healthcare professionals and the public," the company said.

Scott Neuman, NPR

FEMA Opens Application for COVID-19 Funeral Cost Assistance

Starting Monday, families who’ve lost a loved one to COVID-19 may apply for a reimbursement from the federal government for funeral expenses, which can add up to thousands of dollars.

The Federal Emergency Management Agency is now offering assistance of up to $9,000 per funeral for a death in the U.S. attributed to COVID-19.

U.S. citizens and some categories of immigrants with a lawful immigration status may apply for FEMA funds by providing proof of funeral expenses, an official certificate linking the death to COVID and other documents. There are no income limits for applicants, according to the agency.

“This is the kind of program that we need in this community,” said Antonio López, a City Council member in East Palo Alto, where a majority low-income and Latino population has suffered one of the county’s highest COVID-19 case rates. “You don’t know how many times I’ve seen on Facebook and social media a GoFundMe for a funeral.”

In California, FEMA’s new funeral assistance program could help ease some of the financial stress for tens of thousands of families grieving loved ones during the pandemic, particularly in Latino communities that have been disproportionately impacted.

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Statewide, 47% of those who’ve died due to COVID are Latino, even though Latinos make up only 39% of the population, according to California Department of Public Health figures.

The disparity is even greater among working-age Californians, as Latinos under 65 were four times more likely to die compared to white Californians in that age group.

For FEMA’s funeral assistance program to be effective and reach the neediest families, the federal government must also invest in outreach and help to apply, said López.

“You need to make it as easy as possible for the community to access those services,” López said. “If not, it is going to create a situation where the people who are relatively privileged are going to know about it and the ones who need it most are not going to apply.”

For more information on this aid, visit the COVID-19 FEMA Funeral Assistance website. To apply, call 1-844-684-6333 (TTY 1-800-462-7585). The phone line is open Monday through Friday, from 6 a.m. to 6 p.m. PST.

Farida Jhabvala Romero

San Francisco Plans to Reopen All Public Pools by Mid-June

The San Francisco Recreation and Parks Department announced Monday that it expects to reopen all of the city's public pools by the start of summer, and that two indoor pools would open as soon as next week.

The Martin Luther King Jr. Pool in the Bayview District and Sava Pool in the Sunset District will become the first indoor public pools to reopen on April 20.

The agency hopes that by mid-June all nine pools in the city are ready to welcome back swimmers. So far, only Mission Pool has reopened due to the fact it's outdoors.

To reduce COVID-19 transmission, all locker rooms will remain closed. Swimmers will have to sign up ahead of time to reserve 60-minute lap times. At indoor pools, only one swimmer will be allowed per lane.

These rules meet CDC guidelines for pool safety, which ask swimmers to stay at least 6 feet apart while both outside and inside the water.

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Recreation and Parks officials clarified in a press release that "Temperature checks will be performed before entering the building and masks are required outside of the water."

The next pools to reopen will be: Garfield Pool on May 1; North Beach and Coffman Pool on May 17; Balboa Pool on June 1; Hamilton Pool on June 7. The exact date for the reopening of Rossi Pool is not yet known, but city officials expect the date to be around mid-June.

Starting April 16, swimmers interested in signing up for a slot at Martin Luther King, Jr. Pool and Sava Pool can do so here.

Carlos Cabrera-Lomelí

Santa Clara, Alameda and Fresno Counties Expand Vaccine Eligibility to 16 and Up

More California counties are opening up vaccines to younger adults, a week ahead of the state broadening eligibility to everyone 16 and older.

Still, California public health officials warned on Thursday of decreases in supply because of a national reduction of the one-shot Johnson & Johnson vaccine in coming weeks.

Santa Clara, Alameda, Contra Costa and Fresno counties are the latest to open up vaccinations to everyone 16 and older ahead of the state.

Alameda County has now opened vaccine eligibility for county residents ages 16 and older, although the state's My Turn tool shows that people who work (not live) in Alameda County are eligible, too. Santa Clara, however, has only opened the ability to schedule an appointment now for April 15 or later.

Contra Costa County was the first Bay Area county to widen vaccine eligibility to residents 16 and older. Previously, residents could only make 16+ appointments through the county itself, but those people can now book appointments at locations including Oakland Coliseum through My Turn, or by calling the state's vaccine hotline at (833) 422-4255.

People age 16 and older can get the Pfizer vaccine, while the Moderna and Johnson & Johnson vaccines are for those 18 and older.

On Friday, Facebook announced that it would convert part of its Menlo Park headquarters into a vaccination site and hoped to vaccinate as many as 10,000 people in coming weeks.

Vaccine supplies could shrink when eligibility expands next week.

Associated Press, Bay City News

San Francisco Expects to Allow Indoor Concerts, Performances Starting April 15

A return to indoor live events may come sooner than previously expected for San Francisco residents. San Francisco Director of Health Dr. Grant Colfax and Mayor London Breed expect to officially issue guidelines next Wednesday, April 14, that will allow indoor live events to return with some limited capacity on Thursday, April 15.

According to Mayor Breed's office, indoor ticketed and seated events will currently be allowed to operate at a maximum capacity of 35%, with attendees required to show proof of a negative COVID test or vaccination for entry. All participants must keep their masks on except when eating and drinking while seated, and social distancing will be required according to state guidelines. Venues operating at up to 35% capacity must also have an approved Health and Safety Plan.

Should a venue choose to operate at only 15% capacity or with less with 200 people, proof of a negative test or vaccination, as well as a Health and Safety Plan, will not be required.

Read the full post.

Samuel Getachew