California Getting 40% Fewer Pfizer Vaccine Doses Than Expected Next Week

As an explosion of COVID-19 cases strains California’s intensive care units to the breaking point, the state learned it will receive 160,000 fewer vaccine doses than officials had anticipated next week — a roughly 40% reduction.

California hospitals began vaccinations this week from the first Pfizer shipment of 327,000 doses, and the state was expecting 393,000 more to arrive next week.

Instead, officials have been told they will receive about 233,000 doses next week, said Erin Mellon, a spokeswoman for Gov. Gavin Newsom.

The state was expecting more than 2 million doses to be delivered by the end of year, based on the shipments California has already received and projections of more from Pfizer and Moderna.

“Right now, we know that we’ll be below that estimate because of the latest change communicated by the CDC,” Mellon said. “There may be additional changes from the federal government in projected shipments through the end of the year.”

In Washington, D.C., two senior Trump administration officials who spoke to The Associated Press on condition of anonymity in order to discuss internal planning said states will receive their full allocations, but misunderstandings about vaccine supply and changes to the delivery schedule may be creating confusion.

One official said the initial numbers of available doses that were provided to states were projections based on information from the manufacturers, not fixed allocations. Some state officials may have misunderstood that, the official said.

The two officials also said that changes the federal government made to the delivery schedule, at the request of governors, may be contributing to a mistaken impression that fewer doses are coming.

The key change involves spacing out delivery of states’ weekly allocations over several days to make distribution more manageable.

“They will get their weekly allocation, it just won’t come to them on one day,” one official said.

Pfizer made it clear that as far as production goes, nothing has changed.

“Pfizer has not had any production issues with our COVID-19 vaccine, and no shipments containing the vaccine are on hold or delayed,” spokesman Eamonn Nolan said in an email. “We are continuing to dispatch our orders to the locations specified by the U.S. government."

The company said in a written statement that this week it “successfully shipped all 2.9 million doses that we were asked to ship by the U.S. Government to the locations specified by them. We have millions more doses sitting in our warehouse but, as of now, we have not received any shipment instructions for additional doses.”

The senior administration officials said Pfizer’s statement about doses awaiting shipping instructions, while technically accurate, conveniently omits the explanation: It was planned that way.

California is also expecting 672,000 doses of the Moderna vaccine, which was approved by the Food and Drug Administration on Friday.

Associated Press and KQED's Kevin Stark (@starkkev)

Another Coronavirus Strain Gaining Ground in California

Another variant of the coronavirus, known as 452R, is being detected more and more in California.

That's according to the California Department of Public Health and the University of California San Francisco, who on Sunday evening announced this new strain of COVID-19 has been detected in Nothern California, in San Francisco, Humboldt,  Lake, Monterey and Santa Clara counties more frequently.

This is not the same, more-infectious strain of COVID-19 first seen in the United Kingdom, which is known as B 1. 1. 7.

Instead, 452R was linked in several large outbreaks in Santa Clara County, and whether or not it is more easily spread than the first COVID-19 strain is not yet clear, officials said.

“The fact that this variant was identified in several large outbreaks in our county is a red flag and must be investigated further,” said Santa Clara County Health Officer Dr. Sara Cody, in a statement. “This virus continues to mutate and adapt, and we cannot let down our guard. This news underscores the need for everyone to follow all prevention measures and get vaccinated as soon as they are offered the vaccine.”

It has also been detected in Los Angeles, Riverside, San Diego, San Bernadino and San Luis Obispo counties.

The health department and UCSF said they are working with the Centers for Disease Control and PRevention to learn more about the variant and how it spreads.

— Joe Fitzgerald Rodriguez (@FitztheReporter)

Santa Clara County Jail Inmates Start Hunger Strike In Wake of COVID Outbreaks

Inmates in Santa Clara County's main jail went on a hunger strike this week to protest the jail's largest COVID-19 outbreak since the pandemic's start in March.

On Wednesday afternoon, the sheriff's office reported 109 new COVID-19 cases. That same night, the hunger strike began in the main jail's 7B wing to protest unsanitary living conditions and lack of policy that prisoners believe have led to the outbreaks.

One of the 40 -plus inmates participating in the hunger strike in 7B, Ceaser Torres, said the hunger strike is the only way to get the change inmates so desperately need.

"It seems that the jail and the facility to the sheriff's office doesn't really take us seriously unless we do something extreme," Torres said.

The 7B unit was the site of a COVID-19 outbreak in December, which coincided with an indoor private party of multiple unmasked correctional deputies and supervisors that surfaced on Facebook.

"I think the outbreak is the result of utter negligence of jail administration and staff. That or just institutional ineptitude to do the basic responsibilities," Raj Jayadev, co-founder of grassroots community organization Silicon Valley De-Bug said. "And the thing I'll point to is these photos of correctional officers throwing a party."

Jayadev said all the jail outbreaks likely originate with staff since they are the only ones leaving and entering the jails.

Valle said the latest December outbreak in 7B was the second outbreak in that housing unit since March.  Wednesday's new report showing 109 active positive cases is comprised of all the county's jails.

By Friday, the active case count jumped to 127 new cases in the county since Jan. 5 -- accounting for a quarter of the 501 cumulative jail infections since March.

In response to the significant outbreaks the Santa Clara County District Attorney's office has been working with public defenders to facilitate additional releases that could start as early as next week.

"When COVID first happened in March, we put together a team that actually really quickly ended up with about a one-third reduction in the jail population," Assistant District Attorney David Angel said. "So we've kind of pulled the same team together again now."

Angel said the releases were a success because they were able to significantly reduce the jail capacity without seeing an increase in recidivism rates or spikes in crime.

— Bay City News

California Scrambles to Open Vaccine Sites, as Newsom Blames Empty Promise by Feds for Shortfall

California officials are scrambling to open coronavirus vaccine “super sites” at places like Disneyland and the Moscone Center in San Francisco in an effort to speed up the distribution of shots in a state with one of the lowest vaccination rates in the country.

Speaking to reporters at one of the sites, Dodger Stadium in Los Angeles, Gov. Gavin Newsom said the federal government further complicated the effort to accelerate distribution this week by promising the state hundreds of thousands of doses from a stockpile held in reserve for second shots that The Washington Post reported is actually empty.

Newsom said he participated in an “all-governors” call with Vice President Mike Pence and Health and Human Services Secretary Alex Azar this week in which federal officials said they would be releasing more than 50 million additional doses to the states.

“Then we read as everybody else that they have reneged on that or for whatever reason, are unable to deliver on that,” Newsom said, adding that he’s asked for clarification from the Trump administration and the incoming Biden administration.

For now, Newsom said he is now unsure when the doses will arrive in California.

“Our resolve is to get all of the existing doses that are in this state administered as quickly and efficiently as possible and we still have a lot of work to do in that space,” he said.

The state has received just over 3 million doses so far.

Californians are growing increasingly frustrated with the sluggish vaccine rollout as the state averages more than 40,000 new cases of COVID-19 each day.

Newsom also pushed back on criticism that the state created confusion this week when it prematurely offered vaccines to people who are 65 or older.

“The purpose was crystal clear, and that is to make sure the guidelines were not barriers and to provide the flexibility with a sense of urgency that's needed in this moment,” he said.

Kevin Stark

San Francisco Plans to Open Three Mass Vaccination Sites

When the coronavirus vaccine is more widely available, San Francisco plans to open three locations for mass distribution, along with smaller satellite facilities across the city, Mayor London Breed said Friday.

The vaccine hubs will be located at the Moscone Center in the South of Market neighborhood, the City College of San Francisco Ocean Campus in Ingleside, and the San Francisco Produce Market in Bayview — all neighborhoods with high rates of COVID-19 transmission.

The sites could deliver as many as 10,000 doses per day, provided that many were available. Breed said the city is waiting to receive more doses.

“The locations are not the problem, it’s the supply,” she said during a livestreamed press conference.

"We're ready for more doses. We need more doses. We're asking for more doses," Breed said. "We can ramp up and open these sites the minute we have the vaccines."

The mayor said one of the sites could be open by the end of next week, and the others when the city receives a sufficient supply.

Supervisor Matt Haney welcomed the move. He and others have been critical of the city's distribution plans. The two had a back and forth Friday over Twitter:

The mayor also announced a text message service to notify city residents when it is their turn to get the vaccine. Beginning Tuesday, Jan. 19, city residents can sign up here to receive a text message notification.

— Kevin Stark (@starkkev)

Older People Rush to Make Vaccine Appointments, But the Wait Times Are Brutal

Now that people 65 and older are eligible for vaccination, large health care providers are receiving a flurry of calls about when and where.

One of those callers was Ron Shalita, 70, who called the Kaiser appointment line around 6 a.m. on Thursday.

He says he waited about 45 minutes to speak to someone, who told him to contact his primary care doctor, who in turn sent him back to the appointment line, which by then had a wait time of four to six hours.

When he called back later, the wait time had narrowed ... to three to five hours.

On the phone with a reporter, he said, "I have a private line, and I’m actually on hold on that line. And I’m going to check in at 4:30, which would mark about three hours, [to] see if I’m still on hold."

Three hours did the trick. Shalita was able to schedule an appointment for Jan. 28.

Pam Hatayama is a Kaiser member in the same age group.

She knows someone who got an appointment at a different location than they usually visit.

Something like that would be fine with her.

"I would gladly go anywhere to go and get the vaccination," she said Thursday.

She waited on hold two hours and 45 minutes before giving up. Friday morning, she tried again at 7 a.m. and it took an hour and 45 minutes before a nurse answered.

And then ...

"Bingo!" Hatayma wrote in a text.

She and her husband both landed slots at their regular Oakland facility. The best part: The appointments are for Saturday.

In a statement, a Kaiser spokesperson acknowledged the long wait times and said not everyone who is eligible will be able to make an appointment right away because of limited vaccine supplies. An online scheduling system should be working sometime next week, he said.

Meanwhile, the San Francisco Chronicle is reporting similarly frustrating experiences for patients at Sutter Health and Stanford Health Care. Sutter told the paper it would be staffing an appointment line over the Martin Luther King Jr. holiday weekend and that an online portal would be available soon.

Polly Stryker and Jon Brooks

California Hospitals Warn They May Have to Ration Care

The California Hospital Association is warning that some hospitals are getting so stretched by the pandemic, they may have to begin rationing care.

While new infections may be leveling off at the moment, there are still about 40,000 people testing positive for COVID-19 every day, and with 12% of them expected to need hospital care, hospital executives want to prepare the public for what “crisis care” might look like.

“There is nothing comfortable about this conversation,” Carmela Coyle, CEO of the California Hospital Association, said Thursday. “But those numbers are already cooked. The viral spread has already occurred.”

While no hospital has yet declared the need for crisis care, Coyle says some facilities, especially in Southern California and the San Joaquin Valley regions, are on the cusp of another peak where demand for treatment could outstrip supply.

The state has guidelines in place to help hospitals decide who gets care and who doesn’t should that occur, with decisions falling to a triage team charged with making those decisions, rather than putting the burden on the treating physician.

“They're not the ones who are having to make the very hard call of telling a patient or family, ‘We simply don't have the ventilator or the oxygen or the bed space to meet your health care needs,’ ” said Christopher Meyers, a philosophy professor at CSU Bakersfield who consults with hospitals on ethics policies.

Generally, hospitals rely on a numerical score in determining allocation of resources, with priority usually given to patients who are both most likely to benefit from treatment and survive once they’re discharged.

April Dembosky

Attorneys for California Inmates Call for Accelerated Vaccinations as Prisons See Huge Case Rates

Attorneys representing California inmates are urging state and federal officials to advance about 1 of every 10 prisoners to the front of the line for vaccinations, saying it would help ease the burden on hospitals while helping control outbreaks inside state lockups.

They're asking Gov. Gavin Newsom and U.S. District Judge Jon Tigar to order the swift vaccinations of every inmate who hasn't already been infected, starting with those who are most vulnerable.

More than 4,400 of the state's 95,000 inmates currently have active infections, including 1 of every 3 at a Central Coast men’s prison and 1 of every 10 at the state’s largest women’s facility, where, an advocacy group says officials bungled the response. California prisons have an aggregate rate of 468 cases per 1,000 people, more than seven times the rate of California's population.

CDCR COVID-19 trends screenshot from Jan. 15, 2021. (Courtesy California Department of Corrections and Rehabilitation)

And that's not the worst of it, said Steve Fama, an attorney with the nonprofit Prison Law Office, which represents inmates in the largest class-action settlement over prison medical conditions.

There have been about a dozen bigger outbreaks in the last month, accounting for about a third of the 167 inmate coronavirus deaths, he said. Corrections officials said active cases peaked Dec. 20 at 10,721 systemwide.

"As much of a disaster as it was the first nine months of the pandemic, the last 30 days have far exceeded in terms of the statewide number of cases,” Fama said.

The California Department of Corrections and Rehabilitation said Thursday at a hearing for the class action that it has started to vaccinate all inmates 65 years and older, and that it expects to complete administering shots to the group by the weekend.   

CDCR hopes to begin vaccinating the entire prison population as early as next week, which it said will prevent a highly vulnerable population from overwhelming hospitals.

Officials said they'll prioritize additional inmates who are high risk after the 65-and-over group.

As of Wednesday, officials said, approximately 90% of the 2,945 incarcerated patients who have been offered vaccinations have opted to receive them. 

Additionally, 19,351 staff members, about a third of the total workforce, have been vaccinated, according to Clark Kelso, the federal receiver in charge of prison medical care.

Prisoner advocates say that while the vaccines are good news, it’s still unclear if they prevent transmission, so continued testing, physical distancing and face covering remain essential to preventing the spread of the virus.

 “While plaintiffs welcome the vaccinations and the small number of additional cells identified for quarantine and isolation at some prisons, these efforts do not go nearly far enough,” the lawsuit asserts. “Defendants have consistently refused to take the most effective step to protect the people in these prisons from severe illness or death: population reduction sufficient to allow for social distancing and cell-based quarantine.”

 Of the 1,690 medically vulnerable people eligible for early-release review recorded last December, only 15 have been approved, according to the lawsuit.

Sara Norman with the Prison Law Office, representing plaintiffs, emphasized that the state knows how to keep inmates “truly safe” but hasn’t done it.

“This is not a litigation about vaccination,” she said. “Vaccination is a remedy. This is litigation about quarantine. These outbreaks are significant, are dangerous, and the prisons are helpless in the face of them, in large part because, as the court has already alluded, they have far too many people to safely house.”

Advocates also want people who haven't previously tested positive for the virus and are unvaccinated to be quarantined only in solid-door cells starting Feb. 1.

Julie Chang and Associated Press