Sonoma, Contra Costa Counties Still Waiting to Qualify for Fewer Restrictions

Sonoma and Contra Costa counties are the only two Bay Area counties still stuck at purple, which is the most restrictive tier of California's coronavirus risk assessment system. The categories dictate the level of limitations imposed on businesses and activities. The other seven counties have all moved up a level, to the red tier.

Health officials in Contra Costa anticipate the county will move into the red tier next week, if case numbers and test positivity rates remain steady.

The move would mean the resumption of indoor dining and the opening of movie theaters, gyms and museums, subject to attendance occupancy limitations.

Sonoma County, however, may have to wait. To loosen restrictions, counties need to meet the red tier criteria for two weeks straight. Counties must log fewer than seven coronavirus cases per 100,000 people daily, and a test positivity rate below 8% both generally and specifically in disadvantaged neighborhoods.

While Sonoma County meets two out of three of the criteria, its case rate is still too high, at 8.2.

“Hang in there, we are so close,” the Santa Rosa Press Democrat reported county Health Officer Dr. Sundari Mase telling county residents.

Counties lagging in the measures the state has used to graduate areas to a less restrictive level may see some relief when the state hits 2 million vaccines administered to people in designated disadvantaged communities. That could happen as soon as this week.

At that point, the case threshold for moving out of the purple tier will be 10 new daily cases per 100,000 residents, up from the current seven.

Laura Klivans and Jon Brooks

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

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