Public Health Officials Say Harassment Is Compounding Already Difficult Job

Harassment and limited resources are leading to an exodus of local and state public health officials, experts at the Johns Hopkins Bloomberg School of Public Health said Wednesday at a panel convened by the school.

The conversation addressed challenges that public health officials have faced since the start of the pandemic, including the frequent problem of harassment by the public.

The most common forms of abuse faced by health officials, said Dr. Beth Resnick of the Hopkins school of public health, include threats against themselves, their families and staff; and protests at their homes. Other problems include backlash against public health protections and a lack of support from state and local elected officials. Much of the harassment has targeted women and minorities, Resnick said.

She and her colleagues assembled the data based on reports from the Associated Press, Kaiser Health News and their own research.

Santa Clara County Health Officer Dr. Sara Cody is familiar with these forms of attempted intimidation.

"I’m still experiencing rather regular harassment," said Cody, a panel member. "That comes in the form of people coming to protest at my home, letters written in the paper, emails or other letters that are way outside the norms of what we would consider normal discourse and differences of opinion.

"I actually had a 24-7 protective detail for almost a year because of concerns about my safety and the safety of my family."

In addition, health officials face efforts to reduce their authority.

"As noted by a former local health officer, political disagreements and gamesmanship have contributed to increased disrespect and disdain for public health leaders, as well as calls for retraction of evidence-based public health guidance," researcher Paulani Mui said.

She noted that as of December, at least 24 states have introduced bills that would restrict the powers of government or public health officials at both the state and local level, including limits on quarantines, contact tracing, vaccine requirements and emergency executive powers. Some of those bills have failed, she said, while others are currently under consideration.

"Should these efforts succeed, health departments can lose legal authority that is essential for the protection of communities from disease and illness," Mui said.

Resnick and Mui said 190 local and state public health leaders resigned, retired or were fired from their positions from March 2020 to January 2021, and they believe that number is an undercount.

Dr. Joneigh Khaldun, chief deputy director for health at the Michigan Department of Health and Human Services, said these compounding difficulties have led to fatigue.

"Its frustration at doing the job with the meager resources that are available, plus this incredible new challenge of harassment, threats and other dangers," Khaldun said.

Panelists suggested a variety of solutions, such as creating a harassment monitoring system connected to the Centers for Disease Control and Prevention, using existing laws or creating new ones to protect public health workers, and supporting investment in public health infrastructure with more staffing and modernization of data systems.

Laura Klivans

Latino Task Force Partners With SF on a New Vaccination Site in the Mission

The city of San Francisco is opening up a second vaccine center in the Mission District at a union headquarters at 18th and Capp streets. The site will provide about 200 shots per day.

It’s the city’s fourth neighborhood vaccination site and will be operated in partnership with the Latino Task Force, a coalition made up of dozens of community-based organizations.

“To have a local community-run-and-implemented site means that you will have that extra touch if you have questions, if you're scared, if you speak Spanish, and we're local,” said Valerie Tulier-Laiwa of the Latino Task Force.

She says the Mission sites have become models for other community groups who want to reach essential workers.

The new site is planned to be open Thursday through Saturday, 11 a.m. - 6 p.m, by appointment and with limited drop-in availability.

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From the city’s release:

“Mission residents and residents in eligible ZIP codes can sign up for an appointment in person at 24th and Mission Wednesday through Sunday, 9 a.m. - 2 p.m. or at 701 Alabama Street Monday, Wednesday, Thursday and Friday, 10 a.m. - 3 p.m.  Mission neighborhood residents and workers can email LatinoTaskForceSF@gmail.com to request an appointment.”

Raquel Maria Dillon and Kevin Stark

Contra Costa County Begins Offering Walk-in COVID Vaccinations

Contra Costa County will begin offering walk-in COVID-19 vaccinations to eligible people who live and work in the county, officials announced Thursday.

The county will operate multiple pop-up sites over the next several weeks in partnership with the California Governor's Office of Emergency Services. The sites will be able to collectively administer 500 to 700 vaccines per day.

The first walk-in clinics will be placed in parts of the county that have been hardest hit by the pandemic, like Richmond, Concord's Monument Boulevard corridor and parts of East County, officials said.

"We want everyone to get vaccinated as quickly and conveniently as possible," Contra Costa County Supervisor John Gioia said in a statement. "That's why we are opening walk-in vaccination clinics in our hardest hit communities, especially communities of color. This effort helps us close the vaccine equity gap."

Previously, vaccine-eligible people in Contra Costa County had to request an appointment, and would only be able to schedule a vaccination appointment after county officials manually reviewed the request.

The county opened vaccine eligibility to all residents 16 and older on March 30. As of Wednesday, 858,878 vaccine doses had been administered countywide.

About six to 10 volunteers are needed to help with shifts from 9 a.m. to 12:30 p.m. and 12:30 p.m. to 4 p.m. People who volunteer don't have to be fully vaccinated and may receive the vaccine as well. People interested should email Dawn.Morrow@bos.cccounty.us to sign up.

These temporary walk-in clinics will be available on the following dates:

April 15-25; 9 a.m. to 4 p.m.:

  • Veterans Memorial Hall in Richmond
  • Antioch Community Center

April 26-May 2; 9 a.m. to 4 p.m.:

  • Albert D. Seeno Jr. Pittsburg Youth Development Center
  • St. John Missionary Baptist Church North Campus in Richmond

May 3-6; 9 a.m. to 4 p.m.:

  • Meadow Homes Elementary School in Concord
  • St. John Missionary Baptist Church South Campus in Richmond.

County residents and people who work in the county can visit https://covidvaccine.cchealth.org/COVIDVaccine to schedule a vaccine appointment.

Eli Walsh, Bay City News

As Vaccines Open Up, California Is Still Struggling With Equity

California expanded vaccine eligibility late Wednesday, allowing everyone ages 16 and older to sign up for an appointment. But the state is still struggling to vaccinate communities that have been hit hardest during the pandemic.

According to the latest data from the California Department of Public Health, out of the total number of vaccine doses administered, only 3.2% have gone to Black people and 22.4% to people who identify as Latino. Nearly 31% of the shots have gone to white people.

Of the total number of COVID-19 cases in the state, 44% of the positive results have occurred in the Latino community and more than 7% in the Black community.

Kiran Savage-Sangwan, executive director of the California Pan-Ethnic Health Network, a statewide multicultural health advocacy organization, told KQED the state needs to continue to push forward in getting the vaccine to communities of color.

“We need to double down on the equity strategies that we’re using in California,” she said. “We need to make sure that we continue that 40% allocation to the most vulnerable neighborhoods.”

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Savage-Sangwan said the biggest challenge for these communities has been access — access to accurate information and nearby distribution sites located in easy-to-get-to places, as well as ensuring that vaccine sites remain open beyond the typical 9 a.m. to 5 p.m. workday.

Without expanded hours, she said, it can be difficult for some folks who work long days and can't take time off to get a shot.

Keith Mizuguchi

Kaiser Says Vaccine Appointments Will Be Harder to Book for the Next Few Weeks

California’s pause in the use of Johnson & Johnson coronavirus shots will decrease Kaiser Permanente’s vaccine supply and the number of appointments the health giant can offer, the company told patients late Tuesday.

The Oakland-based health system says they’ll be able to administer shots at 69% of their capacity in California. That means roughly 500,000 doses each week, compared to the 720,000 doses the company could administer if supplies allowed.

The reduction comes as Kaiser is set to expand vaccine eligibility to people 16 and older Thursday.

In an email to patients, Kaiser leaders wrote that not everyone will be able to make vaccine appointments immediately and that appointments will be limited through April. Kaiser leadership said they will only cancel existing appointments if no other COVID-19 vaccine is available.

The constraints come not only from the Johnson & Johnson pause following reports of the extremely rare but serious blood clots experienced by six women who received the shot, but also, the company says, due to other vaccine supply limitations that have reduced the number of doses coming to the state from the federal government.

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Kaiser has played a significant role in vaccinating Californians, including people outside of their network. The company reports having administered more than 3.2 million vaccine doses in California as of April 13.

Laura Klivans

'A Tough Week': Alameda County Shifts Course to Make Do Without J&J Vaccine

California officials directed counties and other providers on Tuesday to pause use of the single-dose Johnson & Johnson vaccine following recommendations by federal agencies, which are examining potential side effects after six recipients, among millions, developed blood clots.

The sudden shortage of millions of vaccine doses has left some health providers scrambling to meet growing demand, as vaccine eligibility expands Thursday to everyone in the state ages 16 and older.

Alameda County says it may have to cancel some appointments due to supply shortfall.

"This week was kind of a blow. We had a reduction of about 35% overall [vaccine supplies]. And now this news about our inability to use the J&J [Johnson & Johnson] is making this a tough week," said Dr. Kathleen Clanon, medical director of the Alameda County Health Care Services Agency, who oversees vaccination efforts.

The county has not had to cancel many appointments yet, she said, because it had already made fewer than usual, expecting a drop in supply.

"But we have thousands of people who are expecting to get vaccinated this week who will not be," she said.

Clanon said the county is scrambling to redistribute as much of the two-dose Moderna and Pfizer vaccines as it can to clinics that have been using the J&J vaccine.

"We've been able to patch a lot of our appointments that way," she said. "Where we have to just outright cancel, we are letting people know by email and other mechanisms that this is not a 'No,' it's a 'Not yet,' and that we will be back to them with more information."

Because it only requires a single shot, the J&J vaccine has been particularly useful for inoculating certain vulnerable populations that are often hard to reach, like those who are homeless, incarcerated or homebound.

One clinic that had planned this week to give the J&J vaccine to transgender women of color will now be using the two-shot Moderna vaccine instead, Clanon said. Another effort to administer the vaccine to homebound seniors is now being put on hold.

"It's really breaking my heart that we have to change [those clinics]," Clanon said. "It's really hard. When you see people get vaccinated, they have really deep emotional responses of joy and relaxation. It's a huge deal, and then to have it delayed is really tough on them."

Clanon said it's important for people to "keep an open mind" and try to be patient, as the risks of the vaccine are assessed.

"Trying to get people to hold in their uncertainty and wait until we get more information is the toughest part of all," she said.

Raquel Maria Dillon and Matthew Green

San Francisco Reopens for Indoor Live Events, Other Activities Thursday

Starting Thursday at 8 a.m., San Francisco will allow the return of indoor live-audience events and performances, as well as private events like conferences and receptions.

Under the new health order, the city will open indoor ticketed and seated events with up to 35% capacity for venues with an approved health and safety plan. Participants will be required to keep their masks on except when eating or drinking in designated concession areas, maintain distancing requirements and show proof of vaccination or a negative COVID-19 test before entering the venue. Venues can create vaccinated-only sections with relaxed distancing requirements.

For indoor venues operating at 15% capacity or less, with no more than 200 people, proof of vaccination or a negative test may not be required. Outdoor ticketed venues may expand capacity up to 50%.

“San Francisco is continuing to reopen and this latest round of activities and events that can start to resume is an exciting step for our city,” said Mayor London Breed in a statement Wednesday. “Throughout our response to COVID-19 and our reopening efforts, we’ve focused on moving forward in a way that protects public health, and we’re going to need everyone to keep doing their part to keep our community safe."

San Francisco's expanded reopenings largely following the state's updated guidance for activities permitted under the orange tier of the color-coded plan for navigating the COVID-19 pandemic.

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The city will also allow meetings, conventions and other private events with up to 150 participants indoors and up to 300 people outdoors, as long as safety requirements have been met.

The updated health order also loosens some restrictions on indoor and outdoor social gatherings, indoor and outdoor dining, recreation and hotels.

Community centers serving seniors and adult day care will also be able to reopen to 25% capacity beginning Thursday.

In a statement, the city said it will post the full updated directive on its website later on Wednesday.

Peter Arcuni

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