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"content": "\u003cp>In December 2020, \u003ca href=\"https://www.kqed.org/forum/2010101881066/california-healthcare-workers-share-experiences-from-covids-frontline\">KQED’s Forum interviewed four health workers\u003c/a> experiencing the front lines of the COVID crisis in California. At the time, cases were surging in California, and no coronavirus vaccines were yet available.\u003c/p>\n\u003cp>Nine months later, \u003ca href=\"https://www.kqed.org/forum/2010101885622/california-health-workers-reflect-on-covid-care-eighteen-months-into-the-pandemic\">Forum’s Mina Kim spoke with the same four health workers\u003c/a> about the changes they have seen, and the challenges they have faced in the last year.\u003c/p>\n\u003cp>Read on for the highlights of their conversation.\u003c/p>\n\u003ch3>A glimpse inside our hospitals\u003c/h3>\n\u003cp>Amy Arlund, a registered nurse at Kaiser Permanente Fresno Medical Center, noted that the dire capacity levels in her facility’s ICU experienced in the winter of 2020 had only gotten worse.\u003c/p>\n\u003cp>In December of 2020, said Arlund, “my ICU was at 100% capacity. I have a 12-bed ICU.”\u003c/p>\n\u003cp>“Here we are nine months later, my ICU is at 200% capacity. We’ve tried to divert patients to other hospitals, but unfortunately, there are no ICU beds available in the Central Valley for about a four-hour drive radius from here,” she said.\u003c/p>\n\u003cp>The overflow of patients in the Kaiser Permanente Fresno Medical Center has led to holding patients in the emergency room for days, and “patients who are in cardiac arrest on the regular floors,” said \u003ca href=\"https://www.kqed.org/news/11867734/we-spent-a-day-inside-a-hospital-heres-how-things-will-never-be-the-same-after-covid\">Dr. Parimal Bharucha\u003c/a>, a pulmonary critical care specialist for Dignity Health in the Sacramento area.\u003c/p>\n\u003cp>Dr. Alex McDonald, a family medicine specialist at Kaiser Permanente Fontana Medical Center in San Bernardino County, emphasized the importance of \u003ca href=\"https://www.kqed.org/news/11887909/when-to-get-your-2021-flu-shot-and-how-it-works-with-covid-vaccines\">getting a flu shot to prevent a flu surge\u003c/a> “on top of our already covered [COVID] surge.”\u003c/p>\n\u003cp>“For the first surge, people [had] a fear of COVID,” said Mawata Kamara, a registered nurse at Alameda Health System’s San Leandro Hospital. “But now it seems like everybody’s out, everybody is over the pandemic.” However, there are still patients who come into medical centers and ERs with symptoms of COVID and refuse to get vaccinated, she said.\u003c/p>\n\u003ch3>‘We are the targets’\u003c/h3>\n\u003cp>Conversations with patients about COVID have not gotten easier in the past nine months, say the health care workers who spoke with Forum.\u003c/p>\n\u003cp>Medical and health professionals are “contending with misinformation about the vaccine” being spread online and through social media, said Kaiser Permanente Fresno Medical Center’s Arlund, who noted that she lives and works “in a conservative part of the central San Joaquin Valley.”\u003cspan style=\"font-weight: 400;\">[aside postID=news_11867734 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2021/04/Bharucha-featured-1020x765.jpg']\u003c/span>\u003c/p>\n\u003cp>Arlund said she’s had to make difficult decisions in the ICU throughout the pandemic — and continue to have hard conversations with her patients.\u003c/p>\n\u003cp>“I was having to face dealing with these patients who were needing to compete for an ICU bed,” she said. “It has become more and more difficult to get through to people when they are lacking on oxygen to their brain for very prolonged periods of time.”\u003c/p>\n\u003cp>The amount of misinformation patients are encountering, said Arlund, is “voluminous.”\u003c/p>\n\u003cp>The health care workers who spoke with Forum emphasized the growth in threats and violence against medical professionals — although such workplace violence is something “we have always had to deal with,” said Arlund.\u003c/p>\n\u003cp>It is, she said, “sometimes very hard to put your own feelings and your emotions aside” when violence occurs. “It may not be personal, but … your own survival instincts kick in,” Arlund said.\u003c/p>\n\u003cp>“We had to go on lockdown about two weeks ago when we had a family member come into the ER,” said Kamara of Alameda Health System’s San Leandro Hospital. She related how a family member became agitated, was removed from the hospital and threatened to bring a firearm.\u003c/p>\n\u003cfigure id=\"attachment_11891806\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11891806 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/10/RS46498_GettyImages-1292815576-800x533.jpg\" alt=\"A medical professional wearing protective gear and a clear face shield is standing in a patient's room looking up at a monitor.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS46498_GettyImages-1292815576-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS46498_GettyImages-1292815576-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS46498_GettyImages-1292815576-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS46498_GettyImages-1292815576-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS46498_GettyImages-1292815576-2048x1365.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS46498_GettyImages-1292815576-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A clinician cares for a COVID-19 patient in the intensive care unit (ICU) at Providence St. Mary Medical Center amid a surge in COVID-19 patients in Southern California on Dec. 23, 2020, in Apple Valley, California. \u003ccite>(Mario Tama/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“It was really scary. It’s one of those things that you never believe that is going to happen at your facility. But then it does,” said Kamara.\u003c/p>\n\u003cp>“In December last year we were heroes,” said Sacramento’s Bharucha. Now, he said, “we are no longer heroes. We are actually villains. We are the targets.”\u003c/p>\n\u003cp>According to Bharucha, the conflict with patients and patients’ family members starts when there is initial mistrust. “It’s mind-boggling to me that patients and public out in the community are not ready to believe science, including the vaccine,” he said.\u003cspan style=\"font-weight: 400;\">[pullquote size='medium' align='right' citation=\"Dr. Alex McDonald, family medicine specialist\"]‘When it comes to COVID, or the vaccine, there’s like this alternate reality in some of these patients’ minds.’[/pullquote]\u003c/span>\u003c/p>\n\u003cp>“We do treat all the patients with the same empathy,” stressed Bharucha. “We are here to serve them. Except that we do ask for a little bit of dignity — a little bit of trust and respect.”\u003c/p>\n\u003cp>Family medicine specialist McDonald offered his perspective of COVID in an outpatient care setting, and spoke about the importance of establishing a relationship with his patients over many years.\u003c/p>\n\u003cp>“But when it comes to COVID, or the vaccine, there’s like this alternate reality in some of these patients’ minds — and they completely disregard [me], and they don’t want to hear anything.” said McDonald.\u003c/p>\n\u003cp>“It’s really insulting that they want to sort of pick and choose what pieces of information they want,” said McDonald. He recalled a recent patient who demanded to be prescribed ivermectin and hydroxychloroquine: “Both of which have been proven not to be effective at all to treat COVID,” and are \u003ca href=\"https://www.fda.gov/consumers/consumer-updates/why-you-should-not-use-ivermectin-treat-or-prevent-covid-19\">not approved by the FDA for COVID treatment\u003c/a>.\u003c/p>\n\u003cp>After the last eight months, McDonald said that his work has become “emotionally draining.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003ch3>Looking to the future\u003c/h3>\n\u003cp>When asked about the efficacy of new COVID treatment options, Bharucha emphasized that current studies show “it is not a magic bullet.”\u003c/p>\n\u003cp>These treatment options work in the first five to 10 days, he said, “by reducing the amount of symptoms and by reducing the amount of time that you will share the virus with other people.” But the available evidence has “never shown that it will improve the rate of mortality.”\u003cspan style=\"font-weight: 400;\">[pullquote size='medium' align='right' citation=\"Dr. Parimal Bharucha, pulmonologist\"]‘We are here to serve [patients]. Except that we do ask for a little bit of dignity — a little bit of trust and respect.’[/pullquote]\u003c/span>\u003c/p>\n\u003cp>Bharucha said that \u003ca href=\"https://www.houstonmethodist.org/blog/articles/2021/jan/what-is-monoclonal-antibody-therapy-and-who-is-eligible-to-receive-it/\">monoclonal antibodies\u003c/a> are “a whole different set of treatment options, which we give to patients who come to urgent care or [the] emergency room in the very beginning phases of COVID, and who are at risk of progressing to the level that they can end up in the ICU.”\u003c/p>\n\u003cp>Bharucha stressed \u003ca href=\"https://www.kqed.org/news/11855623/where-can-i-get-a-covid-19-vaccine-in-the-bay-area-your-questions-answered\">the importance of getting vaccinated\u003c/a>. “If you have a vaccine, you can still get infected with COVID, but your risk is 1 in 11,000 versus 1 in 8 [if you’re unvaccinated],” he said.\u003c/p>\n\u003ch3>COVID patients are getting younger\u003c/h3>\n\u003cp>Arlund has noticed an increase in younger COVID patients in hospitals.\u003c/p>\n\u003cp>“I have had to watch patients that are the same age as me in their mid-forties leave their children orphaned, because neither of the parents were vaccinated,” said Arlund. “Ninety percent of the patients that I see are unvaccinated.”\u003c/p>\n\u003cp>Kamara said that she sees her young COVID patients “apologizing for not getting the vaccine. They realize that we’re risking our lives to take care of them.”\u003c/p>\n\u003cp>However, this is not the time to judge patients, she said, but rather a time to provide emotional and medical support. And health care workers are telling these stories “over and over again,” she said, out of a desire to motivate unvaccinated people to get their COVID shot. “Do it now. Don’t wait until you’re with us in the hospital,” said Kamara.\u003c/p>\n\u003cp>“We offer the vaccine to absolutely everyone that comes through the [hospital] doors,” echoed Arlund.\u003c/p>\n\u003cfigure id=\"attachment_11891807\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11891807 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/10/RS47378_GettyImages-1230161194-800x516.jpg\" alt=\"A gloved hand holding a covered syringe is prepping a patient's arm with an alcohol pad.\" width=\"800\" height=\"516\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS47378_GettyImages-1230161194-800x516.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS47378_GettyImages-1230161194-1020x658.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS47378_GettyImages-1230161194-160x103.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS47378_GettyImages-1230161194-1536x990.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS47378_GettyImages-1230161194-2048x1320.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS47378_GettyImages-1230161194-1920x1238.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Nurse Eunice Lee prepares to give UCLA physician Russell Johnson an injection of the COVID-19 vaccine at Ronald Reagan UCLA Medical Center on Dec. 16, 2020, in Westwood, California. (Photo by Brian van der Brug-Pool/Getty Images) \u003ccite>(Brian van der Brug-Pool/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Mental health on the front line\u003c/h3>\n\u003cp>The health care workers who shared their thoughts with Forum all spoke to the toll COVID — and the misinformation around it — has taken on medical and health professionals.\u003c/p>\n\u003cp>“Having refrigerated trucks and a three-month backup at the morgue have never let up,” said Arlund. “Suicides are on the rise. I’ve had co-workers who have killed themselves because of the stress and the isolation.”\u003c/p>\n\u003cp>Bharucha speaks of the “mental exhaustion seeing patients suffer, day in and day out.”\u003c/p>\n\u003cp>“How long can one keep on doing this?” he asked.\u003c/p>\n\u003cp>Arlund stressed how the long-term emotional, mental and physical toll of the pandemic is prompting medical and health professionals to quit. “They are retiring much earlier than they had planned on,” she said.\u003c/p>\n\u003cp>There is “no way” she said, “for us to replace these nurses that have had 20, 30 years of experience.\u003c/p>\n\u003cp>As for the help available to health care workers, McDonald particularly praised \u003ca href=\"https://lookinside.kaiserpermanente.org/our-promise-to-mental-health/\">Kaiser Permanente’s Rise and Renew program\u003c/a>, which provides mental health services for frontline health care workers. Arlund’s union encouraged her to seek mental health services. “I was given the opportunity to step back” she said, and “that’s what I’ve had to do for my own mental health.”\u003c/p>\n\u003cp>Bharucha told Forum about \u003ca href=\"https://www.dignityhealth.org/sacramento/medical-group/mercy-medical-group/employer-resources/occupational-medicine/employee-assistance-program\">Dignity Health’s employee assistance program\u003c/a> for its health care workers, whose services include confidential counseling.\u003c/p>\n\u003cp>“We are human beings at the end of the day,” he said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In December 2020, \u003ca href=\"https://www.kqed.org/forum/2010101881066/california-healthcare-workers-share-experiences-from-covids-frontline\">KQED’s Forum interviewed four health workers\u003c/a> experiencing the front lines of the COVID crisis in California. At the time, cases were surging in California, and no coronavirus vaccines were yet available.\u003c/p>\n\u003cp>Nine months later, \u003ca href=\"https://www.kqed.org/forum/2010101885622/california-health-workers-reflect-on-covid-care-eighteen-months-into-the-pandemic\">Forum’s Mina Kim spoke with the same four health workers\u003c/a> about the changes they have seen, and the challenges they have faced in the last year.\u003c/p>\n\u003cp>Read on for the highlights of their conversation.\u003c/p>\n\u003ch3>A glimpse inside our hospitals\u003c/h3>\n\u003cp>Amy Arlund, a registered nurse at Kaiser Permanente Fresno Medical Center, noted that the dire capacity levels in her facility’s ICU experienced in the winter of 2020 had only gotten worse.\u003c/p>\n\u003cp>In December of 2020, said Arlund, “my ICU was at 100% capacity. I have a 12-bed ICU.”\u003c/p>\n\u003cp>“Here we are nine months later, my ICU is at 200% capacity. We’ve tried to divert patients to other hospitals, but unfortunately, there are no ICU beds available in the Central Valley for about a four-hour drive radius from here,” she said.\u003c/p>\n\u003cp>The overflow of patients in the Kaiser Permanente Fresno Medical Center has led to holding patients in the emergency room for days, and “patients who are in cardiac arrest on the regular floors,” said \u003ca href=\"https://www.kqed.org/news/11867734/we-spent-a-day-inside-a-hospital-heres-how-things-will-never-be-the-same-after-covid\">Dr. Parimal Bharucha\u003c/a>, a pulmonary critical care specialist for Dignity Health in the Sacramento area.\u003c/p>\n\u003cp>Dr. Alex McDonald, a family medicine specialist at Kaiser Permanente Fontana Medical Center in San Bernardino County, emphasized the importance of \u003ca href=\"https://www.kqed.org/news/11887909/when-to-get-your-2021-flu-shot-and-how-it-works-with-covid-vaccines\">getting a flu shot to prevent a flu surge\u003c/a> “on top of our already covered [COVID] surge.”\u003c/p>\n\u003cp>“For the first surge, people [had] a fear of COVID,” said Mawata Kamara, a registered nurse at Alameda Health System’s San Leandro Hospital. “But now it seems like everybody’s out, everybody is over the pandemic.” However, there are still patients who come into medical centers and ERs with symptoms of COVID and refuse to get vaccinated, she said.\u003c/p>\n\u003ch3>‘We are the targets’\u003c/h3>\n\u003cp>Conversations with patients about COVID have not gotten easier in the past nine months, say the health care workers who spoke with Forum.\u003c/p>\n\u003cp>Medical and health professionals are “contending with misinformation about the vaccine” being spread online and through social media, said Kaiser Permanente Fresno Medical Center’s Arlund, who noted that she lives and works “in a conservative part of the central San Joaquin Valley.”\u003cspan style=\"font-weight: 400;\">\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>\u003c/p>\n\u003cp>Arlund said she’s had to make difficult decisions in the ICU throughout the pandemic — and continue to have hard conversations with her patients.\u003c/p>\n\u003cp>“I was having to face dealing with these patients who were needing to compete for an ICU bed,” she said. “It has become more and more difficult to get through to people when they are lacking on oxygen to their brain for very prolonged periods of time.”\u003c/p>\n\u003cp>The amount of misinformation patients are encountering, said Arlund, is “voluminous.”\u003c/p>\n\u003cp>The health care workers who spoke with Forum emphasized the growth in threats and violence against medical professionals — although such workplace violence is something “we have always had to deal with,” said Arlund.\u003c/p>\n\u003cp>It is, she said, “sometimes very hard to put your own feelings and your emotions aside” when violence occurs. “It may not be personal, but … your own survival instincts kick in,” Arlund said.\u003c/p>\n\u003cp>“We had to go on lockdown about two weeks ago when we had a family member come into the ER,” said Kamara of Alameda Health System’s San Leandro Hospital. She related how a family member became agitated, was removed from the hospital and threatened to bring a firearm.\u003c/p>\n\u003cfigure id=\"attachment_11891806\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11891806 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/10/RS46498_GettyImages-1292815576-800x533.jpg\" alt=\"A medical professional wearing protective gear and a clear face shield is standing in a patient's room looking up at a monitor.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS46498_GettyImages-1292815576-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS46498_GettyImages-1292815576-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS46498_GettyImages-1292815576-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS46498_GettyImages-1292815576-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS46498_GettyImages-1292815576-2048x1365.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS46498_GettyImages-1292815576-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A clinician cares for a COVID-19 patient in the intensive care unit (ICU) at Providence St. Mary Medical Center amid a surge in COVID-19 patients in Southern California on Dec. 23, 2020, in Apple Valley, California. \u003ccite>(Mario Tama/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“It was really scary. It’s one of those things that you never believe that is going to happen at your facility. But then it does,” said Kamara.\u003c/p>\n\u003cp>“In December last year we were heroes,” said Sacramento’s Bharucha. Now, he said, “we are no longer heroes. We are actually villains. We are the targets.”\u003c/p>\n\u003cp>According to Bharucha, the conflict with patients and patients’ family members starts when there is initial mistrust. “It’s mind-boggling to me that patients and public out in the community are not ready to believe science, including the vaccine,” he said.\u003cspan style=\"font-weight: 400;\">\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>\u003c/p>\n\u003cp>“We do treat all the patients with the same empathy,” stressed Bharucha. “We are here to serve them. Except that we do ask for a little bit of dignity — a little bit of trust and respect.”\u003c/p>\n\u003cp>Family medicine specialist McDonald offered his perspective of COVID in an outpatient care setting, and spoke about the importance of establishing a relationship with his patients over many years.\u003c/p>\n\u003cp>“But when it comes to COVID, or the vaccine, there’s like this alternate reality in some of these patients’ minds — and they completely disregard [me], and they don’t want to hear anything.” said McDonald.\u003c/p>\n\u003cp>“It’s really insulting that they want to sort of pick and choose what pieces of information they want,” said McDonald. He recalled a recent patient who demanded to be prescribed ivermectin and hydroxychloroquine: “Both of which have been proven not to be effective at all to treat COVID,” and are \u003ca href=\"https://www.fda.gov/consumers/consumer-updates/why-you-should-not-use-ivermectin-treat-or-prevent-covid-19\">not approved by the FDA for COVID treatment\u003c/a>.\u003c/p>\n\u003cp>After the last eight months, McDonald said that his work has become “emotionally draining.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>\u003c/p>\n\u003cp>Bharucha said that \u003ca href=\"https://www.houstonmethodist.org/blog/articles/2021/jan/what-is-monoclonal-antibody-therapy-and-who-is-eligible-to-receive-it/\">monoclonal antibodies\u003c/a> are “a whole different set of treatment options, which we give to patients who come to urgent care or [the] emergency room in the very beginning phases of COVID, and who are at risk of progressing to the level that they can end up in the ICU.”\u003c/p>\n\u003cp>Bharucha stressed \u003ca href=\"https://www.kqed.org/news/11855623/where-can-i-get-a-covid-19-vaccine-in-the-bay-area-your-questions-answered\">the importance of getting vaccinated\u003c/a>. “If you have a vaccine, you can still get infected with COVID, but your risk is 1 in 11,000 versus 1 in 8 [if you’re unvaccinated],” he said.\u003c/p>\n\u003ch3>COVID patients are getting younger\u003c/h3>\n\u003cp>Arlund has noticed an increase in younger COVID patients in hospitals.\u003c/p>\n\u003cp>“I have had to watch patients that are the same age as me in their mid-forties leave their children orphaned, because neither of the parents were vaccinated,” said Arlund. “Ninety percent of the patients that I see are unvaccinated.”\u003c/p>\n\u003cp>Kamara said that she sees her young COVID patients “apologizing for not getting the vaccine. They realize that we’re risking our lives to take care of them.”\u003c/p>\n\u003cp>However, this is not the time to judge patients, she said, but rather a time to provide emotional and medical support. And health care workers are telling these stories “over and over again,” she said, out of a desire to motivate unvaccinated people to get their COVID shot. “Do it now. Don’t wait until you’re with us in the hospital,” said Kamara.\u003c/p>\n\u003cp>“We offer the vaccine to absolutely everyone that comes through the [hospital] doors,” echoed Arlund.\u003c/p>\n\u003cfigure id=\"attachment_11891807\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11891807 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/10/RS47378_GettyImages-1230161194-800x516.jpg\" alt=\"A gloved hand holding a covered syringe is prepping a patient's arm with an alcohol pad.\" width=\"800\" height=\"516\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS47378_GettyImages-1230161194-800x516.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS47378_GettyImages-1230161194-1020x658.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS47378_GettyImages-1230161194-160x103.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS47378_GettyImages-1230161194-1536x990.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS47378_GettyImages-1230161194-2048x1320.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS47378_GettyImages-1230161194-1920x1238.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Nurse Eunice Lee prepares to give UCLA physician Russell Johnson an injection of the COVID-19 vaccine at Ronald Reagan UCLA Medical Center on Dec. 16, 2020, in Westwood, California. (Photo by Brian van der Brug-Pool/Getty Images) \u003ccite>(Brian van der Brug-Pool/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Mental health on the front line\u003c/h3>\n\u003cp>The health care workers who shared their thoughts with Forum all spoke to the toll COVID — and the misinformation around it — has taken on medical and health professionals.\u003c/p>\n\u003cp>“Having refrigerated trucks and a three-month backup at the morgue have never let up,” said Arlund. “Suicides are on the rise. I’ve had co-workers who have killed themselves because of the stress and the isolation.”\u003c/p>\n\u003cp>Bharucha speaks of the “mental exhaustion seeing patients suffer, day in and day out.”\u003c/p>\n\u003cp>“How long can one keep on doing this?” he asked.\u003c/p>\n\u003cp>Arlund stressed how the long-term emotional, mental and physical toll of the pandemic is prompting medical and health professionals to quit. “They are retiring much earlier than they had planned on,” she said.\u003c/p>\n\u003cp>There is “no way” she said, “for us to replace these nurses that have had 20, 30 years of experience.\u003c/p>\n\u003cp>As for the help available to health care workers, McDonald particularly praised \u003ca href=\"https://lookinside.kaiserpermanente.org/our-promise-to-mental-health/\">Kaiser Permanente’s Rise and Renew program\u003c/a>, which provides mental health services for frontline health care workers. Arlund’s union encouraged her to seek mental health services. “I was given the opportunity to step back” she said, and “that’s what I’ve had to do for my own mental health.”\u003c/p>\n\u003cp>Bharucha told Forum about \u003ca href=\"https://www.dignityhealth.org/sacramento/medical-group/mercy-medical-group/employer-resources/occupational-medicine/employee-assistance-program\">Dignity Health’s employee assistance program\u003c/a> for its health care workers, whose services include confidential counseling.\u003c/p>\n\u003cp>“We are human beings at the end of the day,” he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Gov. Gavin Newsom approved a slew of new legislation in recent weeks, ahead of Sunday’s deadline. That hefty stack of bills — among the hundreds that crossed his desk — touches nearly every policy area, including housing, health, education and wildfire mitigation. The measures stand to affect millions of California residents.\u003c/p>\n\u003cp>The many noteworthy ones in the pile include \u003ca href=\"https://www.gov.ca.gov/2021/10/05/governor-newsom-signs-legislation-to-strengthen-state-unemployment-insurance-delivery-system/\">legislation to boost identity theft protection\u003c/a> at the state Employment Development Department, which may have paid out \u003ca href=\"https://calmatters.org/explainers/california-edd-unemployment-crisis-explained/\">up to $31 billion in fraudulent unemployment claims\u003c/a> since the beginning of the coronavirus pandemic. The governor also recently inked a bill adopting a universal \u003ca href=\"https://www.kqed.org/news/11890023/california-adopts-vote-by-mail-system-for-all-future-elections\">vote-by-mail\u003c/a> ballot system for all future elections, as well as a \u003ca href=\"https://www.kqed.org/news/11888891/bill-regulating-computer-driven-productivity-quotas-at-california-warehouses-lands-on-gov-newsoms-desk\">first-in-the-nation law aimed at protecting California workers in retail warehouses\u003c/a> like those run by Amazon.\u003c/p>\n\u003cp style=\"text-align: left\">Newsom also has vetoed a number of bills, including one that would have, among other things, \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2021/10/AB-990-PDF.pdf\">established visitation as a civil right\u003c/a> to people who are incarcerated. Perhaps the biggest veto shocker so far this year has been \u003ca href=\"https://calmatters.org/politics/2021/07/california-paid-family-leave/\">his recent rejection of a bill that sought to increase pay rates during paid family leave\u003c/a>.\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"california-legislature\"]Below is a rundown of just some of the headline-grabbing legislation Newsom has recently signed.\u003c/p>\n\u003ch3>Education\u003c/h3>\n\u003cp>\u003cstrong>Universal pre-K, dual-immersion language programs, college savings accounts, ethnic studies\u003cbr>\n\u003c/strong>\u003cbr>\nOn Tuesday, Newsom \u003ca href=\"https://www.fresnobee.com/news/local/education-lab/article254772347.html\">signed a trio of bills\u003c/a>, part of a record-setting $124 billion investment in public schools. It includes about $2.7 billion to help create a universal pre-K program for 4-year-olds by 2025 and directs roughly $10 million to expand dual-immersion language programs. The package, a key part of Newsom’s long-touted California Comeback Plan, also includes $1.9 billion to help create college savings accounts of up to $1,500 for some students, as well as $170 million in ongoing funding.\u003c/p>\n\u003cp>\u003cstrong>Transferring to state universities and affordable student housing\u003cbr>\n\u003c/strong>\u003cbr>\nThe following day, the governor also signed a \u003ca href=\"https://edsource.org/2021/newsom-signs-bills-to-ease-college-transfer-and-improve-student-housing/662048\">$47.1 billion higher education package of bills\u003c/a>, including one making it easier for community college students to transfer to the California State University and University of California systems. The legislation also includes $2 billion in funds to increase affordable housing for students.\u003c/p>\n\u003cp>\u003cstrong>Ethnic studies curriculum\u003c/strong>\u003c/p>\n\u003cp>Newsom on Friday signed the aptly numbered \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220AB101\">Assembly Bill 101\u003c/a>, making a one-semester ethnic studies class a graduation requirement for all California public high school students, beginning with the class of 2030. Newsom \u003ca href=\"https://edsource.org/2020/gov-newsom-vetoes-requirement-for-ethnic-studies-course-in-high-school/640877\">unexpectedly vetoed an initial version\u003c/a> of the bill last year, saying the model curriculum needed to be more inclusive. The bill was reintroduced in December after the curriculum had been thoroughly — and painstakingly — revised.\u003c/p>\n\u003ch3>Health\u003c/h3>\n\u003cp>\u003cstrong>Reducing wait times for mental health appointments\u003c/strong>\u003c/p>\n\u003cp>On Friday, Newsom signed \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB221\">SB 221\u003c/a>, a bill to require health insurers across the state to reduce wait times for mental health appointments to no more than 10 business days. While current state law requires insurers to provide initial mental health appointments in 10 days, there is no clear regulation around follow-up appointments, resulting in what state Sen. Scott Wiener, D-San Francisco, the bill’s author, called “obscene delays.”\u003c/p>\n\u003cp>Half of Californians say they have to wait too long to see a mental health provider when they need one, \u003ca href=\"https://www.chcf.org/blog/californians-want-action-health-care-costs-mental-health-treatment/\">according to a survey by the California Health Care Foundation\u003c/a>. At Kaiser Permanente specifically, 87% of therapists said weekly appointments were not available to patients who needed them, according to a survey by the \u003ca href=\"https://nuhw.org/\">National Union of Healthcare Workers\u003c/a>, which represents Kaiser’s therapists and was the main sponsor of the bill. The bill passed both houses of the Legislature in a near-unanimous vote.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11891049/california-bill-would-reduce-wait-times-for-mental-health-appointments\">Read KQED’s coverage of SB 221.\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>VETOED: Incentives for people to not use drugs\u003cbr>\n\u003c/strong>\u003cbr>\nNewsom on Friday vetoed \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB110\">SB 110\u003c/a>, a controversial bill which would have allowed Medi-Cal, the state’s Medicaid program, to provide money or gift cards as incentives for people struggling with drug addiction to stay off drugs — with the goal of encouraging more treatment centers to offer them.\u003c/p>\n\u003cp>“We need to embrace this proven, effective approach to meth addiction, make it clearly legal and start reimbursing for it, so we can address this health epidemic,” said state Sen. Scott Wiener, D-San Francisco, who sponsored the bill.\u003c/p>\n\u003cp style=\"text-align: left\">While suggesting he was open to the bill’s novel drug treatment approach, \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2021/10/SB-110-1082021.pdf\">Newsom in his veto message said it was “premature,”\u003c/a> and called for further study.\u003c/p>\n\u003cp style=\"text-align: left\">\u003ca href=\"https://www.kqed.org/news/11854373/state-lawmakers-move-to-expand-effective-but-controversial-treatment-for-meth-addiction\">Read KQED’s coverage of SB 110.\u003c/a>\u003c/p>\n\u003ch3>Housing\u003c/h3>\n\u003cp>\u003cstrong>Streamlining housing approvals\u003c/strong>\u003c/p>\n\u003cp>Newsom approved three major housing bills in September, including \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB8\">SB 8\u003c/a>, introduced by state Sen. Nancy Skinner, D-Berkeley, which extends through 2030 an existing law that expedites the approval process for housing projects and reduces fee increases on local housing applications.\u003c/p>\n\u003cp>The governor also signed \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB9\">SB 9\u003c/a>, introduced by state Senate President Pro Tempore Toni Atkins, D-San Diego, which allows the development of up to two duplexes without local reviews or hearings, in neighborhoods in most cities that are currently zoned for single-family homes.\u003c/p>\n\u003cp>Lastly, Newsom signed \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB10\">SB 10\u003c/a>, introduced by state Sen. Scott Wiener, D-San Francisco, which offers cities the option to rezone certain land for the construction of as many as 10 units while bypassing an initial review under the California Environmental Quality Act.\u003c/p>\n\u003cp>Read more about these three laws from \u003ca href=\"https://www.kqed.org/news/11889113/in-one-week-newsom-signed-three-major-housing-bills-heres-what-they-mean\">CalMatters\u003c/a>.\u003c/p>\n\u003ch3>Police reform\u003c/h3>\n\u003cp>Newsom signed a slate of new police reform bills into law on Sept. 30, including creating higher education standards for officers, requiring officers to intervene if they see a colleague using excessive force, banning certain physical holds that cause asphyxiation and laying out a process that will decertify officers who are found guilty of serious policy or criminal violations. The bills include:\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB2\">SB 2\u003c/a>, authored by state Sen. Steven Bradford, D-Gardena, which lays out a process that will decertify officers who are found guilty of serious policy or criminal violations, including using excessive force, committing sexual assault, intimidating witnesses, making a false arrest or report or participating in a law enforcement gang. Other grounds include “demonstrating bias” based on race, religion, gender identity, sexual orientation or mental disability, among other criteria.\u003c/li>\n\u003cli>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB16\">SB 16\u003c/a>, which expands state Sen. Nancy Skinner’s 2018 landmark police transparency law, SB 1421, or “The Right to Know Act,” which opened up three narrow categories of police records: investigations into deadly or serious use of force by police, investigations that found officers committed sexual assault on duty or told official lies. SB 16 opens up three more categories of records: investigations into officers who were found to have engaged in bias or discrimination, made unlawful arrests or searches, or used excessive or unreasonable force.\u003c/li>\n\u003cli>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220AB89\">AB 89\u003c/a>, authored by Assemblymember Reggie Jones-Sawyer, D-Los Angeles, which raises the minimum age of eligibility to become a cop from 18 to 21 and expands education requirements for officers.\u003c/li>\n\u003cli>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220AB26\">AB 26\u003c/a>, authored by Assemblymember Chris Holden, D-Pasadena, requires officers to intervene if they see a fellow officer using excessive force and protects them from retaliation if they report another officer for violating policy.\u003c/li>\n\u003c/ul>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11890615/newsom-signs-law-to-strip-badges-from-bad-officers\">Read KQED’s coverage of this slate of police reforms.\u003c/a>\u003c/p>\n\u003ch3>Climate change, drought, wildfires\u003c/h3>\n\u003cp>\u003cstrong>Climate change\u003c/strong>\u003c/p>\n\u003cp>Newsom on Sept. 23 signed a major \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2021/09/NATION-LEADING-15B-CLIMATE-PACKAGE.pdf\">$15 billion climate change package\u003c/a>, as part of the state’s record-high budget. It directs $3.9 billion over the next three years to expand use of electric vehicles in the state, in accordance with \u003ca href=\"https://www.cnn.com/2020/10/03/cars/california-2035-zev-mandate/index.html\">Newsom’s mandate that only zero-emission new passenger cars and trucks be sold in California by 2035\u003c/a>. \u003ca href=\"https://www.kqed.org/science/1976869/heres-whats-inside-newsoms-whopping-15-billion-climate-spending-plan\">That pot\u003c/a> includes funding for new consumer rebates, the production of thousands of buses and heavy-duty trucks, and incentives for Californians with lower incomes to trade in their gas cars.\u003c/p>\n\u003cp>California also will spend $3.7 billion to: prepare communities to deal with sea-level rise, fund energy-efficient homes, and invest in lower-income communities and communities of color, with the goal of improving air quality and reducing heat disparities.\u003c/p>\n\u003cp>\u003cstrong>Drought\u003c/strong>\u003c/p>\n\u003cp>The same package allots about $5.2 billion to immediate drought relief and water measures, including money for projects to boost water recycling, reduce flooding risks and clean up contaminated groundwater.\u003c/p>\n\u003cp>\u003cstrong>Wildfires\u003c/strong>\u003c/p>\n\u003cp>The package also \u003ca href=\"https://apnews.com/article/climate-change-science-business-california-gavin-newsom-f867c179fa49f32c0ed7098e98e33aeb\">earmarks about $1 billion\u003c/a> in new spending for fire breaks, tree thinning and other measures meant to prevent fires from burning out of control.\u003c/p>\n\u003cp>And it includes $19 million for the state to work with tribes on prescribed burns — up from just $1 million last year — as well as training for firefighters. The state also plans to invest in micro-lumber mills and other businesses that reuse old wood from overgrown forests.\u003c/p>\n\u003cp>Less than a week later, Newsom signed \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220AB642\">AB 642\u003c/a>, which requires the state to increase the workforce that can perform prescribed burns in an effort to eliminate fuels that have contributed to extremely destructive fires in the state. The bill, introduced by Assemblymember Laura Friedman, D-Glendale, also requires that Cal Fire create a cultural burning liaison position within the agency who will work with tribes and cultural practitioners to ensure the agency is respecting tribal sovereignty and enabling cultural fire traditions and practices to carry on.\u003c/p>\n\u003cp>“This speaks to the importance of communities, private landowners and private citizens in being part of the fire solutions,” said Lenya Quinn-Davidson, a fire adviser with the University of California Cooperative Extension who helped draft the legislation. “And you know that the agencies can’t do it on their own anymore. We have to work together.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/science/1973196/the-karuk-used-fire-to-manage-the-forest-for-centuries-now-they-want-to-do-that-again\">Read KQED’s coverage of Native American fire techniques to manage forests.\u003c/a>\u003c/p>\n\u003cp>\u003cem>Reporting from KQED’s April Dembosky, Emily Hung, Sukey Lewis, Guy Marzorati and Danielle Venton was used in this post. Additional reporting from The Associated Press, CalMatters and NPR also was included.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Gov. Gavin Newsom approved a slew of new legislation in recent weeks, ahead of Sunday’s deadline. That hefty stack of bills — among the hundreds that crossed his desk — touches nearly every policy area, including housing, health, education and wildfire mitigation. The measures stand to affect millions of California residents.\u003c/p>\n\u003cp>The many noteworthy ones in the pile include \u003ca href=\"https://www.gov.ca.gov/2021/10/05/governor-newsom-signs-legislation-to-strengthen-state-unemployment-insurance-delivery-system/\">legislation to boost identity theft protection\u003c/a> at the state Employment Development Department, which may have paid out \u003ca href=\"https://calmatters.org/explainers/california-edd-unemployment-crisis-explained/\">up to $31 billion in fraudulent unemployment claims\u003c/a> since the beginning of the coronavirus pandemic. The governor also recently inked a bill adopting a universal \u003ca href=\"https://www.kqed.org/news/11890023/california-adopts-vote-by-mail-system-for-all-future-elections\">vote-by-mail\u003c/a> ballot system for all future elections, as well as a \u003ca href=\"https://www.kqed.org/news/11888891/bill-regulating-computer-driven-productivity-quotas-at-california-warehouses-lands-on-gov-newsoms-desk\">first-in-the-nation law aimed at protecting California workers in retail warehouses\u003c/a> like those run by Amazon.\u003c/p>\n\u003cp style=\"text-align: left\">Newsom also has vetoed a number of bills, including one that would have, among other things, \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2021/10/AB-990-PDF.pdf\">established visitation as a civil right\u003c/a> to people who are incarcerated. Perhaps the biggest veto shocker so far this year has been \u003ca href=\"https://calmatters.org/politics/2021/07/california-paid-family-leave/\">his recent rejection of a bill that sought to increase pay rates during paid family leave\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Below is a rundown of just some of the headline-grabbing legislation Newsom has recently signed.\u003c/p>\n\u003ch3>Education\u003c/h3>\n\u003cp>\u003cstrong>Universal pre-K, dual-immersion language programs, college savings accounts, ethnic studies\u003cbr>\n\u003c/strong>\u003cbr>\nOn Tuesday, Newsom \u003ca href=\"https://www.fresnobee.com/news/local/education-lab/article254772347.html\">signed a trio of bills\u003c/a>, part of a record-setting $124 billion investment in public schools. It includes about $2.7 billion to help create a universal pre-K program for 4-year-olds by 2025 and directs roughly $10 million to expand dual-immersion language programs. The package, a key part of Newsom’s long-touted California Comeback Plan, also includes $1.9 billion to help create college savings accounts of up to $1,500 for some students, as well as $170 million in ongoing funding.\u003c/p>\n\u003cp>\u003cstrong>Transferring to state universities and affordable student housing\u003cbr>\n\u003c/strong>\u003cbr>\nThe following day, the governor also signed a \u003ca href=\"https://edsource.org/2021/newsom-signs-bills-to-ease-college-transfer-and-improve-student-housing/662048\">$47.1 billion higher education package of bills\u003c/a>, including one making it easier for community college students to transfer to the California State University and University of California systems. The legislation also includes $2 billion in funds to increase affordable housing for students.\u003c/p>\n\u003cp>\u003cstrong>Ethnic studies curriculum\u003c/strong>\u003c/p>\n\u003cp>Newsom on Friday signed the aptly numbered \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220AB101\">Assembly Bill 101\u003c/a>, making a one-semester ethnic studies class a graduation requirement for all California public high school students, beginning with the class of 2030. Newsom \u003ca href=\"https://edsource.org/2020/gov-newsom-vetoes-requirement-for-ethnic-studies-course-in-high-school/640877\">unexpectedly vetoed an initial version\u003c/a> of the bill last year, saying the model curriculum needed to be more inclusive. The bill was reintroduced in December after the curriculum had been thoroughly — and painstakingly — revised.\u003c/p>\n\u003ch3>Health\u003c/h3>\n\u003cp>\u003cstrong>Reducing wait times for mental health appointments\u003c/strong>\u003c/p>\n\u003cp>On Friday, Newsom signed \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB221\">SB 221\u003c/a>, a bill to require health insurers across the state to reduce wait times for mental health appointments to no more than 10 business days. While current state law requires insurers to provide initial mental health appointments in 10 days, there is no clear regulation around follow-up appointments, resulting in what state Sen. Scott Wiener, D-San Francisco, the bill’s author, called “obscene delays.”\u003c/p>\n\u003cp>Half of Californians say they have to wait too long to see a mental health provider when they need one, \u003ca href=\"https://www.chcf.org/blog/californians-want-action-health-care-costs-mental-health-treatment/\">according to a survey by the California Health Care Foundation\u003c/a>. At Kaiser Permanente specifically, 87% of therapists said weekly appointments were not available to patients who needed them, according to a survey by the \u003ca href=\"https://nuhw.org/\">National Union of Healthcare Workers\u003c/a>, which represents Kaiser’s therapists and was the main sponsor of the bill. The bill passed both houses of the Legislature in a near-unanimous vote.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11891049/california-bill-would-reduce-wait-times-for-mental-health-appointments\">Read KQED’s coverage of SB 221.\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>VETOED: Incentives for people to not use drugs\u003cbr>\n\u003c/strong>\u003cbr>\nNewsom on Friday vetoed \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB110\">SB 110\u003c/a>, a controversial bill which would have allowed Medi-Cal, the state’s Medicaid program, to provide money or gift cards as incentives for people struggling with drug addiction to stay off drugs — with the goal of encouraging more treatment centers to offer them.\u003c/p>\n\u003cp>“We need to embrace this proven, effective approach to meth addiction, make it clearly legal and start reimbursing for it, so we can address this health epidemic,” said state Sen. Scott Wiener, D-San Francisco, who sponsored the bill.\u003c/p>\n\u003cp style=\"text-align: left\">While suggesting he was open to the bill’s novel drug treatment approach, \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2021/10/SB-110-1082021.pdf\">Newsom in his veto message said it was “premature,”\u003c/a> and called for further study.\u003c/p>\n\u003cp style=\"text-align: left\">\u003ca href=\"https://www.kqed.org/news/11854373/state-lawmakers-move-to-expand-effective-but-controversial-treatment-for-meth-addiction\">Read KQED’s coverage of SB 110.\u003c/a>\u003c/p>\n\u003ch3>Housing\u003c/h3>\n\u003cp>\u003cstrong>Streamlining housing approvals\u003c/strong>\u003c/p>\n\u003cp>Newsom approved three major housing bills in September, including \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB8\">SB 8\u003c/a>, introduced by state Sen. Nancy Skinner, D-Berkeley, which extends through 2030 an existing law that expedites the approval process for housing projects and reduces fee increases on local housing applications.\u003c/p>\n\u003cp>The governor also signed \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB9\">SB 9\u003c/a>, introduced by state Senate President Pro Tempore Toni Atkins, D-San Diego, which allows the development of up to two duplexes without local reviews or hearings, in neighborhoods in most cities that are currently zoned for single-family homes.\u003c/p>\n\u003cp>Lastly, Newsom signed \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB10\">SB 10\u003c/a>, introduced by state Sen. Scott Wiener, D-San Francisco, which offers cities the option to rezone certain land for the construction of as many as 10 units while bypassing an initial review under the California Environmental Quality Act.\u003c/p>\n\u003cp>Read more about these three laws from \u003ca href=\"https://www.kqed.org/news/11889113/in-one-week-newsom-signed-three-major-housing-bills-heres-what-they-mean\">CalMatters\u003c/a>.\u003c/p>\n\u003ch3>Police reform\u003c/h3>\n\u003cp>Newsom signed a slate of new police reform bills into law on Sept. 30, including creating higher education standards for officers, requiring officers to intervene if they see a colleague using excessive force, banning certain physical holds that cause asphyxiation and laying out a process that will decertify officers who are found guilty of serious policy or criminal violations. The bills include:\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB2\">SB 2\u003c/a>, authored by state Sen. Steven Bradford, D-Gardena, which lays out a process that will decertify officers who are found guilty of serious policy or criminal violations, including using excessive force, committing sexual assault, intimidating witnesses, making a false arrest or report or participating in a law enforcement gang. Other grounds include “demonstrating bias” based on race, religion, gender identity, sexual orientation or mental disability, among other criteria.\u003c/li>\n\u003cli>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB16\">SB 16\u003c/a>, which expands state Sen. Nancy Skinner’s 2018 landmark police transparency law, SB 1421, or “The Right to Know Act,” which opened up three narrow categories of police records: investigations into deadly or serious use of force by police, investigations that found officers committed sexual assault on duty or told official lies. SB 16 opens up three more categories of records: investigations into officers who were found to have engaged in bias or discrimination, made unlawful arrests or searches, or used excessive or unreasonable force.\u003c/li>\n\u003cli>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220AB89\">AB 89\u003c/a>, authored by Assemblymember Reggie Jones-Sawyer, D-Los Angeles, which raises the minimum age of eligibility to become a cop from 18 to 21 and expands education requirements for officers.\u003c/li>\n\u003cli>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220AB26\">AB 26\u003c/a>, authored by Assemblymember Chris Holden, D-Pasadena, requires officers to intervene if they see a fellow officer using excessive force and protects them from retaliation if they report another officer for violating policy.\u003c/li>\n\u003c/ul>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11890615/newsom-signs-law-to-strip-badges-from-bad-officers\">Read KQED’s coverage of this slate of police reforms.\u003c/a>\u003c/p>\n\u003ch3>Climate change, drought, wildfires\u003c/h3>\n\u003cp>\u003cstrong>Climate change\u003c/strong>\u003c/p>\n\u003cp>Newsom on Sept. 23 signed a major \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2021/09/NATION-LEADING-15B-CLIMATE-PACKAGE.pdf\">$15 billion climate change package\u003c/a>, as part of the state’s record-high budget. It directs $3.9 billion over the next three years to expand use of electric vehicles in the state, in accordance with \u003ca href=\"https://www.cnn.com/2020/10/03/cars/california-2035-zev-mandate/index.html\">Newsom’s mandate that only zero-emission new passenger cars and trucks be sold in California by 2035\u003c/a>. \u003ca href=\"https://www.kqed.org/science/1976869/heres-whats-inside-newsoms-whopping-15-billion-climate-spending-plan\">That pot\u003c/a> includes funding for new consumer rebates, the production of thousands of buses and heavy-duty trucks, and incentives for Californians with lower incomes to trade in their gas cars.\u003c/p>\n\u003cp>California also will spend $3.7 billion to: prepare communities to deal with sea-level rise, fund energy-efficient homes, and invest in lower-income communities and communities of color, with the goal of improving air quality and reducing heat disparities.\u003c/p>\n\u003cp>\u003cstrong>Drought\u003c/strong>\u003c/p>\n\u003cp>The same package allots about $5.2 billion to immediate drought relief and water measures, including money for projects to boost water recycling, reduce flooding risks and clean up contaminated groundwater.\u003c/p>\n\u003cp>\u003cstrong>Wildfires\u003c/strong>\u003c/p>\n\u003cp>The package also \u003ca href=\"https://apnews.com/article/climate-change-science-business-california-gavin-newsom-f867c179fa49f32c0ed7098e98e33aeb\">earmarks about $1 billion\u003c/a> in new spending for fire breaks, tree thinning and other measures meant to prevent fires from burning out of control.\u003c/p>\n\u003cp>And it includes $19 million for the state to work with tribes on prescribed burns — up from just $1 million last year — as well as training for firefighters. The state also plans to invest in micro-lumber mills and other businesses that reuse old wood from overgrown forests.\u003c/p>\n\u003cp>Less than a week later, Newsom signed \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220AB642\">AB 642\u003c/a>, which requires the state to increase the workforce that can perform prescribed burns in an effort to eliminate fuels that have contributed to extremely destructive fires in the state. The bill, introduced by Assemblymember Laura Friedman, D-Glendale, also requires that Cal Fire create a cultural burning liaison position within the agency who will work with tribes and cultural practitioners to ensure the agency is respecting tribal sovereignty and enabling cultural fire traditions and practices to carry on.\u003c/p>\n\u003cp>“This speaks to the importance of communities, private landowners and private citizens in being part of the fire solutions,” said Lenya Quinn-Davidson, a fire adviser with the University of California Cooperative Extension who helped draft the legislation. “And you know that the agencies can’t do it on their own anymore. We have to work together.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/science/1973196/the-karuk-used-fire-to-manage-the-forest-for-centuries-now-they-want-to-do-that-again\">Read KQED’s coverage of Native American fire techniques to manage forests.\u003c/a>\u003c/p>\n\u003cp>\u003cem>Reporting from KQED’s April Dembosky, Emily Hung, Sukey Lewis, Guy Marzorati and Danielle Venton was used in this post. Additional reporting from The Associated Press, CalMatters and NPR also was included.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "what-do-you-need-from-us-california-caregivers-trailblaze-solutions-for-people-who-use-deadly-drugs",
"title": "Asking People What They Need: California Caregivers Trailblaze Solutions for Those Dealing with Addiction",
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"headTitle": "Asking People What They Need: California Caregivers Trailblaze Solutions for Those Dealing with Addiction | KQED",
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"content": "\u003cp>\u003cem>Jump to resources:\u003c/em>\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"#support\">\u003cstrong>Where to find support for substance abuse disorder\u003c/strong>\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cem>In this episode of The California Report Magazine, health reporters Lesley McClurg and April Dembosky take us inside hospitals and clinics to meet people dealing with substance addiction who are getting help in new ways. For the first time, doctors and caregivers are asking: What do you need from us?\u003c/em>\u003c/p>\n\u003cp>Last year more than 93,000 people died of drug overdoses nationwide, more than 10,000 of them in California. The public health crisis, which has spiked during COVID, is taking a horrific toll on communities and cities across the state.\u003c/p>\n\u003cp>For decades the state’s approach has been to punish people who do drugs. But it hasn’t worked.\u003c/p>\n\u003cp>“It’s more than a failure, it has been incredibly harmful,” said Dr. Monish Ullal, internal medicine physician and associate medical director of the Bridge clinic at Highland Hospital. “I think the war on drugs is one of the most disappointing things that our country has done in the last 30 years.”\u003c/p>\n\u003cp>Now policymakers are switching gears by recognizing addiction as a disease needing medical attention. California is investing large amounts of money in new models of treatment for those dealing with substance addiction. Two new programs are showing promise, and becoming models for the rest of the country.\u003c/p>\n\u003cfigure id=\"attachment_11891410\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11891410\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/10/RS51782_024_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51782_024_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51782_024_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51782_024_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51782_024_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51782_024_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">California Bridge Founding Member and Director of Harm Reduction Services Joshua Luftig speaks with a patient about Narcan at the Bridge substance use program at Highland Hospital in Oakland on Oct. 6, 2021 . \u003ccite>(Beth LeBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>\u003cb>Emergency rooms anchor recovery efforts\u003c/b>\u003c/h3>\n\u003cp>The first initiative is called \u003ca href=\"https://cabridge.org/\">CA Bridge\u003c/a>, and its goal is to initiate treatment for patients with a substance use disorder in the emergency department. It may be hard to believe, but treating substance addiction within a hospital is fairly recent strategy.\u003c/p>\n\u003cp>The program has a two-pronged approach. First, emergency medical physicians are trained to dispense medication to treat opioid use. Once a patient is stable, they are assigned a counselor or “substance use navigator” to ensure a strong hand-off to long-term treatment once they leave the ER.\u003c/p>\n\u003cfigure id=\"attachment_11891415\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11891415 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/10/RS51209_005_SanFrancisco_StFrancisER_08262021-qut-800x533.jpg\" alt=\"A woman with long hair, glasses, a mask, and a floral shirt points at a clipboard, which a doctor in blue scrubs and a mask looks at.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51209_005_SanFrancisco_StFrancisER_08262021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51209_005_SanFrancisco_StFrancisER_08262021-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51209_005_SanFrancisco_StFrancisER_08262021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51209_005_SanFrancisco_StFrancisER_08262021-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51209_005_SanFrancisco_StFrancisER_08262021-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Substance Use Manager Monique Randolph speaks with a doctor at the Saint Francis Emergency Department in San Francisco on Aug. 26, 2021. \u003ccite>(Beth LeBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Just letting them know it’s OK. We got you,” explained Christian Hailozian, a substance use navigator at Highland Hospital. “That extra kind of hand-holding that these patients need to really start that journey of recovery.”\u003c/p>\n\u003cp>[aside postID=\"news_11854373\" hero=\"https://ww2.kqed.org/app/uploads/sites/10/2019/02/Rick-Andrews-at-SF-AIDS-Foundation-1020x678.jpg\"]The pilot program, which started at eight California hospitals, worked so well that the state invested another $20 million last fall to expand the California Bridge model. Now 144, or about 40% of hospitals across the state, have staffed a substance use navigator. The goal is to enroll all remaining hospitals by 2025.\u003c/p>\n\u003cp>The other big initiative is a new treatment for addiction to methamphetamine or cocaine. While there are three FDA-approved medications available to treat opioid use disorder — the cornerstone of the Bridge program — there are none for stimulants.\u003c/p>\n\u003cp>“There’s a lot of hopelessness in the community using stimulants, a lot less belief that treatment will help them,” said Dr. Kelly Pfeifer, deputy director of behavioral health at the California Department of Health Care Services.\u003c/p>\n\u003cfigure id=\"attachment_11890594\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11890594\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/01/rs46611_009_sanfrancisco_billylemon_01142021-qut-1536x1024-2-93d1d0b27c5ab9ae1460333fecf87ea21095e212-s1200-800x600.jpg\" alt=\"A man in sunglasses and a hat stands beneath a Pride flag outside a Victorian with a sign that says Castro Country Club.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/01/rs46611_009_sanfrancisco_billylemon_01142021-qut-1536x1024-2-93d1d0b27c5ab9ae1460333fecf87ea21095e212-s1200-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/01/rs46611_009_sanfrancisco_billylemon_01142021-qut-1536x1024-2-93d1d0b27c5ab9ae1460333fecf87ea21095e212-s1200-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/01/rs46611_009_sanfrancisco_billylemon_01142021-qut-1536x1024-2-93d1d0b27c5ab9ae1460333fecf87ea21095e212-s1200-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/01/rs46611_009_sanfrancisco_billylemon_01142021-qut-1536x1024-2-93d1d0b27c5ab9ae1460333fecf87ea21095e212-s1200.jpg 1200w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Billy Lemon, 50, kicked his meth habit more than nine years ago after taking part in a ‘contingency management’ program for meth and cocaine users at the San Francisco AIDS Foundation. For every negative drug test, he earned a small amount of money. Lemon now runs the Castro Country Club, a recovery center in San Francisco. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ca href=\"https://www.drugabuse.gov/news-events/news-releases/2021/09/methamphetamine-involved-overdose-deaths-nearly-tripled-between-2015-to-2019-nih-study-finds\">Meth-related overdoses have tripled nationwide\u003c/a> in recent years, and treatment providers are desperate to find something that works.\u003c/p>\n\u003cp>Providers have landed on a behavioral treatment that studies show is highly effective, but has been only narrowly deployed: \u003ca href=\"https://www.kqed.org/news/11854373/state-lawmakers-move-to-expand-effective-but-controversial-treatment-for-meth-addiction\">contingency management\u003c/a>, an incentive therapy that uses money or prizes to encourage people who use drugs not to use them.\u003c/p>\n\u003cp>California is betting big on contingency management. Lawmakers passed a bill that would authorize the state’s Medi-Cal program to offer the treatment. It’s awaiting Gov. Gavin Newsom’s signature, and state health officials also have requested permission from the federal government to provide the therapy to hundreds of thousands of Californians in lower-income households.\u003c/p>\n\u003cfigure id=\"attachment_11891417\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11891417 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/10/RS51766_007_Oakland_HighlandHospitalBridgeProgram_10062021-qut.jpg\" alt='A person wearing scrubs and a face mask moves through a door, next to a letterboard sign saying \"Welcome to the Bridge.\"' width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51766_007_Oakland_HighlandHospitalBridgeProgram_10062021-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51766_007_Oakland_HighlandHospitalBridgeProgram_10062021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51766_007_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51766_007_Oakland_HighlandHospitalBridgeProgram_10062021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51766_007_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Christian Hailozian, substance use navigator and program coordinator, walks out of the Bridge substance use program office at Highland Hospital in Oakland on Oct. 6, 2021. \u003ccite>(Beth LeBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>\u003ca id=\"support\">\u003c/a>Where to find support for substance abuse disorder\u003c/h3>\n\u003cul>\n\u003cli>If you are insured through Medi-Cal, you can access your county’s \u003cstrong>substance abuse disorder county access line\u003c/strong>. The resources offered vary by county. \u003ca href=\"https://www.dhcs.ca.gov/individuals/Pages/SUD_County_Access_Lines.aspx\">Find the list of phone numbers here.\u003c/a>\u003c/li>\n\u003cli>Most California counties participate in the \u003cstrong>Drug Medi-Cal Organized Delivery System\u003c/strong>, a 2015 expansion that provides more alcohol and drug use services to people in need. \u003ca href=\"https://choosechangeca.org/?campaign=print\">Get more information on how to access treatment for an opioid addiction here.\u003c/a>\u003c/li>\n\u003cli>The \u003ca href=\"https://www.sfaf.org/services/substance-use-treatment/\">\u003cstrong>San Francisco AIDS Foundation\u003c/strong>\u003c/a> offers a variety of initiatives that center harm reduction to support those dealing with substance addiction. This includes support for \u003ca href=\"https://www.sfaf.org/services/substance-use-treatment/cocaine-crack-use-support/\">cocaine and crack use\u003c/a>, \u003ca href=\"https://www.sfaf.org/services/substance-use-treatment/meth-use-support/\">meth use\u003c/a> and \u003ca href=\"https://www.sfaf.org/services/syringe-access-disposal/\">safe syringe disposal sites\u003c/a>.\u003c/li>\n\u003cli>Finding support for mental illness can sometimes be part of dealing with substance abuse. NAMI is the \u003cstrong>National Alliance on Mental Illness\u003c/strong>, and several counties have their own chapter. \u003ca href=\"https://namica.org/find-your-local-nami\">Find the closest one to you here.\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://cabridge.org/tools/resources/\">Providers wanting to learn how to make \u003cstrong>CA Bridge\u003c/strong> part of your work can learn more here.\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "Across the state, providers are now expanding efforts to offer one-stop help at the ER and pay people to not consume drugs. ",
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"title": "Asking People What They Need: California Caregivers Trailblaze Solutions for Those Dealing with Addiction | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Jump to resources:\u003c/em>\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"#support\">\u003cstrong>Where to find support for substance abuse disorder\u003c/strong>\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cem>In this episode of The California Report Magazine, health reporters Lesley McClurg and April Dembosky take us inside hospitals and clinics to meet people dealing with substance addiction who are getting help in new ways. For the first time, doctors and caregivers are asking: What do you need from us?\u003c/em>\u003c/p>\n\u003cp>Last year more than 93,000 people died of drug overdoses nationwide, more than 10,000 of them in California. The public health crisis, which has spiked during COVID, is taking a horrific toll on communities and cities across the state.\u003c/p>\n\u003cp>For decades the state’s approach has been to punish people who do drugs. But it hasn’t worked.\u003c/p>\n\u003cp>“It’s more than a failure, it has been incredibly harmful,” said Dr. Monish Ullal, internal medicine physician and associate medical director of the Bridge clinic at Highland Hospital. “I think the war on drugs is one of the most disappointing things that our country has done in the last 30 years.”\u003c/p>\n\u003cp>Now policymakers are switching gears by recognizing addiction as a disease needing medical attention. California is investing large amounts of money in new models of treatment for those dealing with substance addiction. Two new programs are showing promise, and becoming models for the rest of the country.\u003c/p>\n\u003cfigure id=\"attachment_11891410\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11891410\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/10/RS51782_024_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51782_024_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51782_024_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51782_024_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51782_024_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51782_024_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">California Bridge Founding Member and Director of Harm Reduction Services Joshua Luftig speaks with a patient about Narcan at the Bridge substance use program at Highland Hospital in Oakland on Oct. 6, 2021 . \u003ccite>(Beth LeBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>\u003cb>Emergency rooms anchor recovery efforts\u003c/b>\u003c/h3>\n\u003cp>The first initiative is called \u003ca href=\"https://cabridge.org/\">CA Bridge\u003c/a>, and its goal is to initiate treatment for patients with a substance use disorder in the emergency department. It may be hard to believe, but treating substance addiction within a hospital is fairly recent strategy.\u003c/p>\n\u003cp>The program has a two-pronged approach. First, emergency medical physicians are trained to dispense medication to treat opioid use. Once a patient is stable, they are assigned a counselor or “substance use navigator” to ensure a strong hand-off to long-term treatment once they leave the ER.\u003c/p>\n\u003cfigure id=\"attachment_11891415\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11891415 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/10/RS51209_005_SanFrancisco_StFrancisER_08262021-qut-800x533.jpg\" alt=\"A woman with long hair, glasses, a mask, and a floral shirt points at a clipboard, which a doctor in blue scrubs and a mask looks at.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51209_005_SanFrancisco_StFrancisER_08262021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51209_005_SanFrancisco_StFrancisER_08262021-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51209_005_SanFrancisco_StFrancisER_08262021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51209_005_SanFrancisco_StFrancisER_08262021-qut-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51209_005_SanFrancisco_StFrancisER_08262021-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Substance Use Manager Monique Randolph speaks with a doctor at the Saint Francis Emergency Department in San Francisco on Aug. 26, 2021. \u003ccite>(Beth LeBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Just letting them know it’s OK. We got you,” explained Christian Hailozian, a substance use navigator at Highland Hospital. “That extra kind of hand-holding that these patients need to really start that journey of recovery.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The pilot program, which started at eight California hospitals, worked so well that the state invested another $20 million last fall to expand the California Bridge model. Now 144, or about 40% of hospitals across the state, have staffed a substance use navigator. The goal is to enroll all remaining hospitals by 2025.\u003c/p>\n\u003cp>The other big initiative is a new treatment for addiction to methamphetamine or cocaine. While there are three FDA-approved medications available to treat opioid use disorder — the cornerstone of the Bridge program — there are none for stimulants.\u003c/p>\n\u003cp>“There’s a lot of hopelessness in the community using stimulants, a lot less belief that treatment will help them,” said Dr. Kelly Pfeifer, deputy director of behavioral health at the California Department of Health Care Services.\u003c/p>\n\u003cfigure id=\"attachment_11890594\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11890594\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/01/rs46611_009_sanfrancisco_billylemon_01142021-qut-1536x1024-2-93d1d0b27c5ab9ae1460333fecf87ea21095e212-s1200-800x600.jpg\" alt=\"A man in sunglasses and a hat stands beneath a Pride flag outside a Victorian with a sign that says Castro Country Club.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/01/rs46611_009_sanfrancisco_billylemon_01142021-qut-1536x1024-2-93d1d0b27c5ab9ae1460333fecf87ea21095e212-s1200-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/01/rs46611_009_sanfrancisco_billylemon_01142021-qut-1536x1024-2-93d1d0b27c5ab9ae1460333fecf87ea21095e212-s1200-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/01/rs46611_009_sanfrancisco_billylemon_01142021-qut-1536x1024-2-93d1d0b27c5ab9ae1460333fecf87ea21095e212-s1200-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/01/rs46611_009_sanfrancisco_billylemon_01142021-qut-1536x1024-2-93d1d0b27c5ab9ae1460333fecf87ea21095e212-s1200.jpg 1200w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Billy Lemon, 50, kicked his meth habit more than nine years ago after taking part in a ‘contingency management’ program for meth and cocaine users at the San Francisco AIDS Foundation. For every negative drug test, he earned a small amount of money. Lemon now runs the Castro Country Club, a recovery center in San Francisco. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ca href=\"https://www.drugabuse.gov/news-events/news-releases/2021/09/methamphetamine-involved-overdose-deaths-nearly-tripled-between-2015-to-2019-nih-study-finds\">Meth-related overdoses have tripled nationwide\u003c/a> in recent years, and treatment providers are desperate to find something that works.\u003c/p>\n\u003cp>Providers have landed on a behavioral treatment that studies show is highly effective, but has been only narrowly deployed: \u003ca href=\"https://www.kqed.org/news/11854373/state-lawmakers-move-to-expand-effective-but-controversial-treatment-for-meth-addiction\">contingency management\u003c/a>, an incentive therapy that uses money or prizes to encourage people who use drugs not to use them.\u003c/p>\n\u003cp>California is betting big on contingency management. Lawmakers passed a bill that would authorize the state’s Medi-Cal program to offer the treatment. It’s awaiting Gov. Gavin Newsom’s signature, and state health officials also have requested permission from the federal government to provide the therapy to hundreds of thousands of Californians in lower-income households.\u003c/p>\n\u003cfigure id=\"attachment_11891417\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11891417 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/10/RS51766_007_Oakland_HighlandHospitalBridgeProgram_10062021-qut.jpg\" alt='A person wearing scrubs and a face mask moves through a door, next to a letterboard sign saying \"Welcome to the Bridge.\"' width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51766_007_Oakland_HighlandHospitalBridgeProgram_10062021-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51766_007_Oakland_HighlandHospitalBridgeProgram_10062021-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51766_007_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51766_007_Oakland_HighlandHospitalBridgeProgram_10062021-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/RS51766_007_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Christian Hailozian, substance use navigator and program coordinator, walks out of the Bridge substance use program office at Highland Hospital in Oakland on Oct. 6, 2021. \u003ccite>(Beth LeBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>\u003ca id=\"support\">\u003c/a>Where to find support for substance abuse disorder\u003c/h3>\n\u003cul>\n\u003cli>If you are insured through Medi-Cal, you can access your county’s \u003cstrong>substance abuse disorder county access line\u003c/strong>. The resources offered vary by county. \u003ca href=\"https://www.dhcs.ca.gov/individuals/Pages/SUD_County_Access_Lines.aspx\">Find the list of phone numbers here.\u003c/a>\u003c/li>\n\u003cli>Most California counties participate in the \u003cstrong>Drug Medi-Cal Organized Delivery System\u003c/strong>, a 2015 expansion that provides more alcohol and drug use services to people in need. \u003ca href=\"https://choosechangeca.org/?campaign=print\">Get more information on how to access treatment for an opioid addiction here.\u003c/a>\u003c/li>\n\u003cli>The \u003ca href=\"https://www.sfaf.org/services/substance-use-treatment/\">\u003cstrong>San Francisco AIDS Foundation\u003c/strong>\u003c/a> offers a variety of initiatives that center harm reduction to support those dealing with substance addiction. This includes support for \u003ca href=\"https://www.sfaf.org/services/substance-use-treatment/cocaine-crack-use-support/\">cocaine and crack use\u003c/a>, \u003ca href=\"https://www.sfaf.org/services/substance-use-treatment/meth-use-support/\">meth use\u003c/a> and \u003ca href=\"https://www.sfaf.org/services/syringe-access-disposal/\">safe syringe disposal sites\u003c/a>.\u003c/li>\n\u003cli>Finding support for mental illness can sometimes be part of dealing with substance abuse. NAMI is the \u003cstrong>National Alliance on Mental Illness\u003c/strong>, and several counties have their own chapter. \u003ca href=\"https://namica.org/find-your-local-nami\">Find the closest one to you here.\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://cabridge.org/tools/resources/\">Providers wanting to learn how to make \u003cstrong>CA Bridge\u003c/strong> part of your work can learn more here.\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Most Bay Area counties on Thursday announced criteria for eventually lifting mask mandates for indoor public spaces, including in bars, gyms and entertainment venues.\u003c/p>\n\u003cp>Health officers in Alameda, Contra Costa, Marin, Napa, San Francisco, San Mateo, Santa Clara and Sonoma counties and the city of Berkeley (which has its own health department) said they would lift masking requirements when their respective jurisdictions have reached three key benchmarks:\u003c/p>\n\u003cul>\n\u003cli>When that jurisdiction has moved into the yellow or “moderate” COVID-19 transmission tier — as established by the Centers for Disease Control and Prevention (CDC) — and remained there for a least three straight weeks.\u003c/li>\n\u003cli>When COVID-19 hospitalizations are “low and stable,” as determined by local health officials.\u003c/li>\n\u003cli>When 80% of each jurisdiction’s total population is fully vaccinated (two doses of either the Pfizer or Moderna vaccine, or one dose of the Johnson & Johnson vaccine), or when eight weeks have passed since federal emergency authorization of the COVID-19 vaccine for children age 5 to 11.\u003c/li>\n\u003c/ul>\n\u003cp>But getting there will likely take some time.\u003c/p>\n\u003cp>\u003ca href=\"https://covid.cdc.gov/covid-data-tracker/#county-view%7CCalifornia%7CRisk%7Ccommunity_transmission_level\">Most Bay Area counties are currently in the orange\u003c/a> — or “substantial” — transmission tier, according to the latest CDC reporting, and none are yet in the yellow.\u003c/p>\n\u003cp>Additionally, none have reached 80% vaccination among their full populations — which includes kids — although all but two of the eight counties have topped 70%.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>\u003ca href=\"https://www.kqed.org/news/11859829/see-how-many-people-got-the-covid-19-vaccine-in-your-county-so-far\">See a map of vaccination rates by county.\u003c/a>\u003c/em>\u003c/strong>\u003c/p>\n\u003cp>But local officials say COVID-19 rates have dropped significantly throughout the region, following this summer’s spike brought on by the highly contagious delta variant.\u003c/p>\n\u003cp>“Our regional data is showing that the surge is now receding, and the Bay Area is one of the most vaccinated regions in the country,” Dr. Chris Farnitano, Contra Costa County’s health officer, said on Thursday. “So it is time to really plan for our next phase and an easing of some of these requirements.”\u003c/p>\n\u003cp>He said meeting the third metric — reaching an 80% vaccination rate or being able to give the vaccines to younger kids — is especially important.\u003c/p>\n\u003cp>It will “ensure that enough of the community is vaccinated to give us a fair degree of confidence that removing the mask requirement will not trigger another severe surge of cases and hospitalizations like we saw that began in late June and July with the arrival of the delta strain,” he said.\u003c/p>\n\u003cp>Some 72% of all residents in Contra Costa County are now fully vaccinated, and Farnitano predicted that, at the current pace, the county would crest 80% in the next two to three months.\u003c/p>\n\u003cp>[aside label ='More COVID-19 Coverage' tag='coronavirus']San Francisco Mayor London Breed said Thursday that, despite not yet meeting the criteria, the city — where more than 75% of residents are fully vaccinated — will forge ahead next week in easing its indoor mask requirements for some settings. Beginning Oct. 15, San Francisco will allow those in indoor settings with fewer than 100 people, like small offices, gyms and indoor college classes, to forgo face coverings if everyone can verify they are fully vaccinated.\u003c/p>\n\u003cp>“This is an important step forward for San Francisco, particularly for our downtown, because when I talk to office workers and business leaders, one of the things I continue to hear is that they’re anxious to get back to a more normal routine at work where they can interact with their colleagues,” Breed said in a statement.\u003c/p>\n\u003cp>The new guidelines do not pertain to Solano County, which is the only Bay Area county that did not issue a mask mandate in early August, amid the new wave of COVID-19 cases and hospitalizations.\u003c/p>\n\u003cp>Dr. Sara Cody, the health officer for Santa Clara County, where 75% of all residents are now fully vaccinated, stressed the importance of meeting all three benchmarks before lifting mask mandates.\u003c/p>\n\u003cp>“Essentially, we want to ensure that we have many layers of prevention,” she said. “We want to make sure that the vaccination layer is really robust before we peel back the masking layer.\u003c/p>\n\u003cp>There are roughly 175,000 kids age 5-11 in her county, Cody said, and making the vaccine available to them once federal officials give the green light will be a top priority.\u003c/p>\n\u003cp>“So that’s the size of the population that we anticipate will become newly eligible for vaccination,” she said. “And that’s the population that we’re going to be working very hard to ensure that there’s easy, accessible vaccinations available.”\u003c/p>\n\u003cp>The new guidelines come as \u003ca href=\"https://www.kqed.org/news/11891383/pfizer-asks-us-to-allow-covid-shots-for-kids-ages-5-to-11\">Pfizer on Thursday asked federal officials to allow use of its vaccine for kids age 5 to 11\u003c/a>. However, there is no clear timeline yet on when the shot will be approved for this age group.\u003c/p>\n\u003cp>https://twitter.com/TedrickG/status/1446138118067814408\u003c/p>\n\u003cp>When counties meet all three criteria and lift their mask mandates, residents will still be required to observe state and federal indoor mask rules, which include wearing a face covering when using public transportation and in state and federal buildings.\u003c/p>\n\u003cp>Individual businesses and places of worship also can still require people to wear masks even after their county’s mask order has been lifted.\u003c/p>\n\u003cp>Dr. Peter Chin-Hong, professor of medicine and an infectious disease specialist at UCSF, shared with KQED that it’s very likely that each county will fulfill all three requirements at different times. But he believes that the criteria provides a clear path that a county needs to take to move past mask mandates.\u003c/p>\n\u003cp>“It gives us some guideposts, instead of operating in a fog,” he said. “The criteria are transparent, so people know what we are looking at.”\u003c/p>\n\u003cp>\u003cem>This post includes reporting from KQED’s Ted Goldberg, Matthew Green and Tara Siler.\u003c/em>\u003cbr>\n[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Most Bay Area counties on Thursday announced criteria for eventually lifting mask mandates for indoor public spaces, including in bars, gyms and entertainment venues.\u003c/p>\n\u003cp>Health officers in Alameda, Contra Costa, Marin, Napa, San Francisco, San Mateo, Santa Clara and Sonoma counties and the city of Berkeley (which has its own health department) said they would lift masking requirements when their respective jurisdictions have reached three key benchmarks:\u003c/p>\n\u003cul>\n\u003cli>When that jurisdiction has moved into the yellow or “moderate” COVID-19 transmission tier — as established by the Centers for Disease Control and Prevention (CDC) — and remained there for a least three straight weeks.\u003c/li>\n\u003cli>When COVID-19 hospitalizations are “low and stable,” as determined by local health officials.\u003c/li>\n\u003cli>When 80% of each jurisdiction’s total population is fully vaccinated (two doses of either the Pfizer or Moderna vaccine, or one dose of the Johnson & Johnson vaccine), or when eight weeks have passed since federal emergency authorization of the COVID-19 vaccine for children age 5 to 11.\u003c/li>\n\u003c/ul>\n\u003cp>But getting there will likely take some time.\u003c/p>\n\u003cp>\u003ca href=\"https://covid.cdc.gov/covid-data-tracker/#county-view%7CCalifornia%7CRisk%7Ccommunity_transmission_level\">Most Bay Area counties are currently in the orange\u003c/a> — or “substantial” — transmission tier, according to the latest CDC reporting, and none are yet in the yellow.\u003c/p>\n\u003cp>Additionally, none have reached 80% vaccination among their full populations — which includes kids — although all but two of the eight counties have topped 70%.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>\u003ca href=\"https://www.kqed.org/news/11859829/see-how-many-people-got-the-covid-19-vaccine-in-your-county-so-far\">See a map of vaccination rates by county.\u003c/a>\u003c/em>\u003c/strong>\u003c/p>\n\u003cp>But local officials say COVID-19 rates have dropped significantly throughout the region, following this summer’s spike brought on by the highly contagious delta variant.\u003c/p>\n\u003cp>“Our regional data is showing that the surge is now receding, and the Bay Area is one of the most vaccinated regions in the country,” Dr. Chris Farnitano, Contra Costa County’s health officer, said on Thursday. “So it is time to really plan for our next phase and an easing of some of these requirements.”\u003c/p>\n\u003cp>He said meeting the third metric — reaching an 80% vaccination rate or being able to give the vaccines to younger kids — is especially important.\u003c/p>\n\u003cp>It will “ensure that enough of the community is vaccinated to give us a fair degree of confidence that removing the mask requirement will not trigger another severe surge of cases and hospitalizations like we saw that began in late June and July with the arrival of the delta strain,” he said.\u003c/p>\n\u003cp>Some 72% of all residents in Contra Costa County are now fully vaccinated, and Farnitano predicted that, at the current pace, the county would crest 80% in the next two to three months.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>San Francisco Mayor London Breed said Thursday that, despite not yet meeting the criteria, the city — where more than 75% of residents are fully vaccinated — will forge ahead next week in easing its indoor mask requirements for some settings. Beginning Oct. 15, San Francisco will allow those in indoor settings with fewer than 100 people, like small offices, gyms and indoor college classes, to forgo face coverings if everyone can verify they are fully vaccinated.\u003c/p>\n\u003cp>“This is an important step forward for San Francisco, particularly for our downtown, because when I talk to office workers and business leaders, one of the things I continue to hear is that they’re anxious to get back to a more normal routine at work where they can interact with their colleagues,” Breed said in a statement.\u003c/p>\n\u003cp>The new guidelines do not pertain to Solano County, which is the only Bay Area county that did not issue a mask mandate in early August, amid the new wave of COVID-19 cases and hospitalizations.\u003c/p>\n\u003cp>Dr. Sara Cody, the health officer for Santa Clara County, where 75% of all residents are now fully vaccinated, stressed the importance of meeting all three benchmarks before lifting mask mandates.\u003c/p>\n\u003cp>“Essentially, we want to ensure that we have many layers of prevention,” she said. “We want to make sure that the vaccination layer is really robust before we peel back the masking layer.\u003c/p>\n\u003cp>There are roughly 175,000 kids age 5-11 in her county, Cody said, and making the vaccine available to them once federal officials give the green light will be a top priority.\u003c/p>\n\u003cp>“So that’s the size of the population that we anticipate will become newly eligible for vaccination,” she said. “And that’s the population that we’re going to be working very hard to ensure that there’s easy, accessible vaccinations available.”\u003c/p>\n\u003cp>The new guidelines come as \u003ca href=\"https://www.kqed.org/news/11891383/pfizer-asks-us-to-allow-covid-shots-for-kids-ages-5-to-11\">Pfizer on Thursday asked federal officials to allow use of its vaccine for kids age 5 to 11\u003c/a>. However, there is no clear timeline yet on when the shot will be approved for this age group.\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>When counties meet all three criteria and lift their mask mandates, residents will still be required to observe state and federal indoor mask rules, which include wearing a face covering when using public transportation and in state and federal buildings.\u003c/p>\n\u003cp>Individual businesses and places of worship also can still require people to wear masks even after their county’s mask order has been lifted.\u003c/p>\n\u003cp>Dr. Peter Chin-Hong, professor of medicine and an infectious disease specialist at UCSF, shared with KQED that it’s very likely that each county will fulfill all three requirements at different times. But he believes that the criteria provides a clear path that a county needs to take to move past mask mandates.\u003c/p>\n\u003cp>“It gives us some guideposts, instead of operating in a fog,” he said. “The criteria are transparent, so people know what we are looking at.”\u003c/p>\n\u003cp>\u003cem>This post includes reporting from KQED’s Ted Goldberg, Matthew Green and Tara Siler.\u003c/em>\u003cbr>\n\u003c/p>\u003c/div>",
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"slug": "informed-consent-to-reduce-harm-some-bay-area-venues-are-providing-fentanyl-testing-strips-to-patrons",
"title": "'Informed Consent': To Reduce Harm, Some Bay Area Venues Are Providing Fentanyl Testing Strips to Patrons",
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"content": "\u003cp>\u003cem>Jump to resources:\u003c/em>\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#help\">Where to find fentanyl testing strips in the Bay Area\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#prevention\">How to spot and prevent a fentanyl overdose\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>Almost a year has passed since Crisis Club Gallery, a community space in Oakland, opened its doors, something that makes co-owner Niko Nada very proud.\u003c/p>\n\u003cp>“It took a few months of getting a bunch of kids who didn’t know about construction to do construction,” Nada said. “We built all these walls, we laid everything.”\u003c/p>\n\u003cp>Among other things, the group set up a shelf in the bathroom with a supply of fentanyl testing strips — small pieces of paper that can be used to identify whether a substance contains fentanyl. Anyone who comes into the gallery can take as many strips as they need.\u003c/p>\n\u003cp>On the shelf are also safe snorting and injection kits, and other products meant to help people who use drugs do so in the safest way possible.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Having this available at the gallery was nonnegotiable, said Nada, who uses “they/them” pronouns.\u003c/p>\n\u003cp>“Some places don’t want to stock these things because they think that is promoting drug use in their establishment,” they explained.\u003c/p>\n\u003cp>But Nada acknowledges that drug use is a part of many people’s lives, and has seen how lack of access to clean supplies or information can make the experience much more dangerous.\u003c/p>\n\u003cfigure id=\"attachment_11890996\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11890996\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/10/Image-from-iOS-10-scaled.jpg\" alt=\"A person stands leaning their shoulder against the plate-glass storefront of an art gallery, ankles crossed.\" width=\"1920\" height=\"1440\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/Image-from-iOS-10-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/Image-from-iOS-10-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/Image-from-iOS-10-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/Image-from-iOS-10-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/Image-from-iOS-10-1536x1152.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/Image-from-iOS-10-2048x1536.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/Image-from-iOS-10-1920x1440.jpg 1920w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Niko Nada stands outside Crisis Club Gallery in Oakland. Nada believes in a harm-reduction approach to help those who use drugs stay as safe as possible. \u003ccite>(Annelise Finney/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The highly addictive synthetic opioid fentanyl is about 50 to 100 times more potent than morphine. It is often mixed with other drugs, like ketamine, ecstasy, cocaine and heroin to increase potency.\u003c/p>\n\u003cp>Nada also knows there is now much more fentanyl circulating throughout the Bay Area and the country than there used to be, resulting in an exponential spike in overdoses in recent years.\u003c/p>\n\u003cp>NPR recently \u003ca href=\"https://www.npr.org/2021/07/05/1013203805/party-drugs-are-being-increasingly-laced-with-fentanyl\">reported a rise in the use of drugs that are mixed with fentanyl\u003c/a>, with users often consuming it unknowingly, creating a serious health risk. The spike in availability is particularly pronounced in Northern California, where local \u003ca href=\"https://www.npr.org/2021/09/27/1040899776/dea-public-safety-alert-fake-prescription-drugs-fentanyl\">Drug Enforcement Administration agents already have seized roughly 163 pounds of fentanyl\u003c/a> in pill and powder form so far this year — a 155% increase over last year, the agency said.\u003c/p>\n\u003cp>The Bay Area, in particular, has been hit hard by the drug. In Alameda County, fentanyl overdoses jumped from 14 to 62 in just two years. Santa Clara County saw the region’s biggest fentanyl overdose rate increase, from just 11 cases in 2018 to 72 in 2020.\u003c/p>\n\u003cp>[aside postID=\"news_11874651\" hero=\"https://ww2.kqed.org/app/uploads/sites/10/2021/05/RS48996_006_MountainView_RobinDosskey_05122021-qut.jpg\"]\u003c/p>\n\u003cp>And in San Francisco, 396 overdoses from the drug were reported in 2020, a sixfold increase over those reported two years earlier. According to the county’s medical examiner, just over two-thirds of the city’s total overdose deaths this year have involved fentanyl.\u003c/p>\n\u003cp>Fentanyl testing strips are easy to use and effective, explained Dr. Hannah Snyder, an assistant professor at UCSF and director of the California Bridge program, which focuses on providing health care for people who use drugs.\u003c/p>\n\u003cp>When people want to use fentanyl testing strips, she said, “they can take a tiny amount out of whatever their drug is. Maybe it’s the edge off of a pill or residue.” That residue can then be mixed with a small amount of water and dipped in the testing strip. After a few minutes of drying, if two lines appear, that signifies a negative result. Just one line, however, means there is likely some trace of fentanyl in the other drug.\u003c/p>\n\u003cp>“It’s not a perfect test,” Snyder said, “but that’s really important so a person can say, ‘This is a drug that I think is too high-risk for me to take,’ or ‘This is a drug that I want to take with other people around me to make sure I’m safe.'”\u003c/p>\n\u003cp>Testing also allows people to make the decisions that can help reduce harm, she added.\u003c/p>\n\u003cp>Hospitals, health clinics and emergency departments are making these supplies available, too. But according to Nada, venues like galleries and bars can play a big role in increasing the rate of testing.\u003c/p>\n\u003cp>“[Business owners] have the resources to have a space that can be an influence,” said Nada, whose gallery receives testing supplies through a network of friends.\u003c/p>\n\u003cp>“In places like bars or clubs where drugs are around, whether we are acknowledging [it] or not, [we can be] the nudge in someone’s mental shoulder to be like, ‘Hey, take care of this.'”\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Alison Heller, co-founder of FentCheck\"]‘We’re trying to normalize. If you’re going to do drugs, test them first so you can have some informed consent before you ingest.’[/pullquote]Along with helping to run the gallery, Nada works a few days a week at Telegraph Beer Garden in Oakland, which also offers fentanyl testing strips. The bar receives the strips from FentCheck, an organization run by volunteers that supplies them to around 30 establishments in San Francisco and the East Bay.\u003c/p>\n\u003cp>“We’re trying to normalize. If you’re going to do drugs, test them first so you can have some informed consent before you ingest, and then you can make a plan,” said \u003ca href=\"https://oaklandside.org/2021/07/06/fentanyl-test-fentcheck-will-make-drug-use-safer/\">Alison Heller\u003c/a>, an Oakland resident who launched the project last year after months of extensive community outreach.\u003c/p>\n\u003cp>Heller said people who occasionally use party drugs like ecstasy or ketamine “don’t think this applies to them. Fentanyl feels to them very much like a heroin issue or cocaine issue.”\u003c/p>\n\u003cp>But those occasional users are especially vulnerable to unknowingly consuming fentanyl, she said.\u003c/p>\n\u003cp>And although fentanyl testing strips are usually available at harm-reduction clinics, not everybody knows about those sites, or feels comfortable going to them, Heller added. Providing them at clubs, bars and other nighttime venues, she said, is a way of offering them “where the community goes, and destigmatizing the process.”\u003c/p>\n\u003cp>Heller said she hopes making test strips easily accessible in social venues will have as much of a positive impact as did offering condoms in bars during the AIDS crisis in the 1980s.\u003c/p>\n\u003cp>“[Condoms do] not incentivize having sex in the bar bathroom, nor do fentanyl tests incentivize drug use in the venue,” she said.\u003c/p>\n\u003ch3>\u003cb>Available resources\u003c/b>\u003c/h3>\n\u003cp>\u003ca id=\"help\">\u003c/a>\u003cstrong>Where can you find testing strips in the Bay Area?\u003c/strong>\u003c/p>\n\u003cp>\u003cem>The following is a list of some of the establishments that offer fentanyl testing strips through FentCheck. The complete list \u003ca href=\"https://fentcheck.org/get-strips\">is available on the FentCheck website\u003c/a>:\u003c/em>\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Beauty Bar\u003c/strong>: 2299 Mission Street, San Francisco\u003c/li>\n\u003cli>\u003cstrong>The Sycamore\u003c/strong>: 2140 Mission Street, San Francisco\u003c/li>\n\u003cli>\u003cstrong>Royal Cuckoo Market\u003c/strong>: 3368 19th Street, San Francisco\u003c/li>\n\u003cli>\u003cstrong>Bender’s Bar & Grill\u003c/strong>: 806 South Van Ness Avenue, San Francisco\u003c/li>\n\u003cli>\u003cstrong>Crisis Club Gallery\u003c/strong>: 5887 San Pablo Avenue, Oakland\u003c/li>\n\u003cli>\u003cstrong>Telegraph Beer Garden\u003c/strong>: 2318 Telegraph Avenue, Oakland\u003c/li>\n\u003cli>\u003cstrong>Ghost Town\u003c/strong>: 1960 Adeline Street, Oakland\u003c/li>\n\u003cli>\u003cstrong>King Kog Bicycle Shop\u003c/strong>: 327 17th Street, Oakland\u003c/li>\n\u003cli>\u003cstrong>Oakland Glow Studio\u003c/strong>: 4454 Piedmont Avenue, Unit A, Oakland\u003c/li>\n\u003cli>\u003cstrong>The Avenue\u003c/strong>: 4822 Telegraph Avenue, Oakland\u003c/li>\n\u003c/ul>\n\u003cp>\u003ca id=\"prevention\">\u003c/a>\u003cstrong>What can be done to prevent an overdose from turning fatal?\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"https://www.facebook.com/SCCOverdosePrevention/\">Fatal opioid overdoses can be prevented\u003c/a> with a drug called \u003ca href=\"https://www.drugabuse.gov/publications/drugfacts/naloxone\">naloxone\u003c/a> (also known by the brand name Narcan), which temporarily attaches to opioid receptors and reverses and blocks the effects of other opioids. According to the \u003ca href=\"https://www.nih.gov/\">National Institutes of Health\u003c/a>, naloxone very rarely causes any serious side effects.\u003c/p>\n\u003cp>A number of Bay Area counties, including San Francisco and Santa Clara, provide \u003ca href=\"https://bhsd.sccgov.org/information-resources/opioid-overdose-prevention-project/rescue-and-training\">free naloxone/Narcan kits and training for how to use them\u003c/a> and for how \u003ca href=\"https://harmreduction.org/our-work/action/dope-project-san-francisco/\">to recognize signs of an overdose\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"https://nabp.pharmacy/news/news-releases/california-pharmacists-may-now-dispense-naloxone-without-prescription/\">Pharmacists in California also are permitted to provide naloxone\u003c/a> without a doctor’s prescription.\u003c/p>\n\u003cp>Additionally, medication-assisted treatment for opioid addiction is widely available. Emergency doctors can prescribe FDA-approved drugs that treat opioid dependence and can arrange for patients to follow up at outpatient centers.\u003c/p>\n\u003cp>\u003cstrong>What are common signs of an overdose?\u003c/strong>\u003c/p>\n\u003cp>Someone may be overdosing if they’re acting groggy and lethargic or are barely able to stand, and if slow breathing grows irregular or even stops altogether. Very constricted pupils in someone’s eyes — known as “pinpoint pupils” — that don’t expand when exposed to light also are a common sign of an overdose.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This post includes reporting from Mohar Chatterjee and KQED’s Julie Small.\u003c/em>\u003c/p>\n\n",
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"excerpt": "As more fentanyl overdoses are reported in the Bay Area and beyond, a growing number of venues are offering fentanyl testing strips that can help patrons find out what's in the drugs they consume.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Jump to resources:\u003c/em>\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#help\">Where to find fentanyl testing strips in the Bay Area\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#prevention\">How to spot and prevent a fentanyl overdose\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>Almost a year has passed since Crisis Club Gallery, a community space in Oakland, opened its doors, something that makes co-owner Niko Nada very proud.\u003c/p>\n\u003cp>“It took a few months of getting a bunch of kids who didn’t know about construction to do construction,” Nada said. “We built all these walls, we laid everything.”\u003c/p>\n\u003cp>Among other things, the group set up a shelf in the bathroom with a supply of fentanyl testing strips — small pieces of paper that can be used to identify whether a substance contains fentanyl. Anyone who comes into the gallery can take as many strips as they need.\u003c/p>\n\u003cp>On the shelf are also safe snorting and injection kits, and other products meant to help people who use drugs do so in the safest way possible.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Having this available at the gallery was nonnegotiable, said Nada, who uses “they/them” pronouns.\u003c/p>\n\u003cp>“Some places don’t want to stock these things because they think that is promoting drug use in their establishment,” they explained.\u003c/p>\n\u003cp>But Nada acknowledges that drug use is a part of many people’s lives, and has seen how lack of access to clean supplies or information can make the experience much more dangerous.\u003c/p>\n\u003cfigure id=\"attachment_11890996\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11890996\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/10/Image-from-iOS-10-scaled.jpg\" alt=\"A person stands leaning their shoulder against the plate-glass storefront of an art gallery, ankles crossed.\" width=\"1920\" height=\"1440\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/Image-from-iOS-10-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/Image-from-iOS-10-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/Image-from-iOS-10-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/Image-from-iOS-10-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/Image-from-iOS-10-1536x1152.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/Image-from-iOS-10-2048x1536.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/Image-from-iOS-10-1920x1440.jpg 1920w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Niko Nada stands outside Crisis Club Gallery in Oakland. Nada believes in a harm-reduction approach to help those who use drugs stay as safe as possible. \u003ccite>(Annelise Finney/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The highly addictive synthetic opioid fentanyl is about 50 to 100 times more potent than morphine. It is often mixed with other drugs, like ketamine, ecstasy, cocaine and heroin to increase potency.\u003c/p>\n\u003cp>Nada also knows there is now much more fentanyl circulating throughout the Bay Area and the country than there used to be, resulting in an exponential spike in overdoses in recent years.\u003c/p>\n\u003cp>NPR recently \u003ca href=\"https://www.npr.org/2021/07/05/1013203805/party-drugs-are-being-increasingly-laced-with-fentanyl\">reported a rise in the use of drugs that are mixed with fentanyl\u003c/a>, with users often consuming it unknowingly, creating a serious health risk. The spike in availability is particularly pronounced in Northern California, where local \u003ca href=\"https://www.npr.org/2021/09/27/1040899776/dea-public-safety-alert-fake-prescription-drugs-fentanyl\">Drug Enforcement Administration agents already have seized roughly 163 pounds of fentanyl\u003c/a> in pill and powder form so far this year — a 155% increase over last year, the agency said.\u003c/p>\n\u003cp>The Bay Area, in particular, has been hit hard by the drug. In Alameda County, fentanyl overdoses jumped from 14 to 62 in just two years. Santa Clara County saw the region’s biggest fentanyl overdose rate increase, from just 11 cases in 2018 to 72 in 2020.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And in San Francisco, 396 overdoses from the drug were reported in 2020, a sixfold increase over those reported two years earlier. According to the county’s medical examiner, just over two-thirds of the city’s total overdose deaths this year have involved fentanyl.\u003c/p>\n\u003cp>Fentanyl testing strips are easy to use and effective, explained Dr. Hannah Snyder, an assistant professor at UCSF and director of the California Bridge program, which focuses on providing health care for people who use drugs.\u003c/p>\n\u003cp>When people want to use fentanyl testing strips, she said, “they can take a tiny amount out of whatever their drug is. Maybe it’s the edge off of a pill or residue.” That residue can then be mixed with a small amount of water and dipped in the testing strip. After a few minutes of drying, if two lines appear, that signifies a negative result. Just one line, however, means there is likely some trace of fentanyl in the other drug.\u003c/p>\n\u003cp>“It’s not a perfect test,” Snyder said, “but that’s really important so a person can say, ‘This is a drug that I think is too high-risk for me to take,’ or ‘This is a drug that I want to take with other people around me to make sure I’m safe.'”\u003c/p>\n\u003cp>Testing also allows people to make the decisions that can help reduce harm, she added.\u003c/p>\n\u003cp>Hospitals, health clinics and emergency departments are making these supplies available, too. But according to Nada, venues like galleries and bars can play a big role in increasing the rate of testing.\u003c/p>\n\u003cp>“[Business owners] have the resources to have a space that can be an influence,” said Nada, whose gallery receives testing supplies through a network of friends.\u003c/p>\n\u003cp>“In places like bars or clubs where drugs are around, whether we are acknowledging [it] or not, [we can be] the nudge in someone’s mental shoulder to be like, ‘Hey, take care of this.'”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘We’re trying to normalize. If you’re going to do drugs, test them first so you can have some informed consent before you ingest.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Along with helping to run the gallery, Nada works a few days a week at Telegraph Beer Garden in Oakland, which also offers fentanyl testing strips. The bar receives the strips from FentCheck, an organization run by volunteers that supplies them to around 30 establishments in San Francisco and the East Bay.\u003c/p>\n\u003cp>“We’re trying to normalize. If you’re going to do drugs, test them first so you can have some informed consent before you ingest, and then you can make a plan,” said \u003ca href=\"https://oaklandside.org/2021/07/06/fentanyl-test-fentcheck-will-make-drug-use-safer/\">Alison Heller\u003c/a>, an Oakland resident who launched the project last year after months of extensive community outreach.\u003c/p>\n\u003cp>Heller said people who occasionally use party drugs like ecstasy or ketamine “don’t think this applies to them. Fentanyl feels to them very much like a heroin issue or cocaine issue.”\u003c/p>\n\u003cp>But those occasional users are especially vulnerable to unknowingly consuming fentanyl, she said.\u003c/p>\n\u003cp>And although fentanyl testing strips are usually available at harm-reduction clinics, not everybody knows about those sites, or feels comfortable going to them, Heller added. Providing them at clubs, bars and other nighttime venues, she said, is a way of offering them “where the community goes, and destigmatizing the process.”\u003c/p>\n\u003cp>Heller said she hopes making test strips easily accessible in social venues will have as much of a positive impact as did offering condoms in bars during the AIDS crisis in the 1980s.\u003c/p>\n\u003cp>“[Condoms do] not incentivize having sex in the bar bathroom, nor do fentanyl tests incentivize drug use in the venue,” she said.\u003c/p>\n\u003ch3>\u003cb>Available resources\u003c/b>\u003c/h3>\n\u003cp>\u003ca id=\"help\">\u003c/a>\u003cstrong>Where can you find testing strips in the Bay Area?\u003c/strong>\u003c/p>\n\u003cp>\u003cem>The following is a list of some of the establishments that offer fentanyl testing strips through FentCheck. The complete list \u003ca href=\"https://fentcheck.org/get-strips\">is available on the FentCheck website\u003c/a>:\u003c/em>\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Beauty Bar\u003c/strong>: 2299 Mission Street, San Francisco\u003c/li>\n\u003cli>\u003cstrong>The Sycamore\u003c/strong>: 2140 Mission Street, San Francisco\u003c/li>\n\u003cli>\u003cstrong>Royal Cuckoo Market\u003c/strong>: 3368 19th Street, San Francisco\u003c/li>\n\u003cli>\u003cstrong>Bender’s Bar & Grill\u003c/strong>: 806 South Van Ness Avenue, San Francisco\u003c/li>\n\u003cli>\u003cstrong>Crisis Club Gallery\u003c/strong>: 5887 San Pablo Avenue, Oakland\u003c/li>\n\u003cli>\u003cstrong>Telegraph Beer Garden\u003c/strong>: 2318 Telegraph Avenue, Oakland\u003c/li>\n\u003cli>\u003cstrong>Ghost Town\u003c/strong>: 1960 Adeline Street, Oakland\u003c/li>\n\u003cli>\u003cstrong>King Kog Bicycle Shop\u003c/strong>: 327 17th Street, Oakland\u003c/li>\n\u003cli>\u003cstrong>Oakland Glow Studio\u003c/strong>: 4454 Piedmont Avenue, Unit A, Oakland\u003c/li>\n\u003cli>\u003cstrong>The Avenue\u003c/strong>: 4822 Telegraph Avenue, Oakland\u003c/li>\n\u003c/ul>\n\u003cp>\u003ca id=\"prevention\">\u003c/a>\u003cstrong>What can be done to prevent an overdose from turning fatal?\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"https://www.facebook.com/SCCOverdosePrevention/\">Fatal opioid overdoses can be prevented\u003c/a> with a drug called \u003ca href=\"https://www.drugabuse.gov/publications/drugfacts/naloxone\">naloxone\u003c/a> (also known by the brand name Narcan), which temporarily attaches to opioid receptors and reverses and blocks the effects of other opioids. According to the \u003ca href=\"https://www.nih.gov/\">National Institutes of Health\u003c/a>, naloxone very rarely causes any serious side effects.\u003c/p>\n\u003cp>A number of Bay Area counties, including San Francisco and Santa Clara, provide \u003ca href=\"https://bhsd.sccgov.org/information-resources/opioid-overdose-prevention-project/rescue-and-training\">free naloxone/Narcan kits and training for how to use them\u003c/a> and for how \u003ca href=\"https://harmreduction.org/our-work/action/dope-project-san-francisco/\">to recognize signs of an overdose\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"https://nabp.pharmacy/news/news-releases/california-pharmacists-may-now-dispense-naloxone-without-prescription/\">Pharmacists in California also are permitted to provide naloxone\u003c/a> without a doctor’s prescription.\u003c/p>\n\u003cp>Additionally, medication-assisted treatment for opioid addiction is widely available. Emergency doctors can prescribe FDA-approved drugs that treat opioid dependence and can arrange for patients to follow up at outpatient centers.\u003c/p>\n\u003cp>\u003cstrong>What are common signs of an overdose?\u003c/strong>\u003c/p>\n\u003cp>Someone may be overdosing if they’re acting groggy and lethargic or are barely able to stand, and if slow breathing grows irregular or even stops altogether. Very constricted pupils in someone’s eyes — known as “pinpoint pupils” — that don’t expand when exposed to light also are a common sign of an overdose.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>When Greta Christina fell into a deep depression five years ago, she called up her therapist — someone she’d had a great connection with when she needed therapy in the past. And she was delighted to find out that he was now on staff at Kaiser Permanente, her insurer, meaning she wouldn’t have to pay out of pocket anymore to see him.\u003c/p>\n\u003cp>But the excitement was short-lived. Over time, her appointments went from every two weeks to every four and then to every five or six.\u003c/p>\n\u003cp>“To tell somebody with serious, chronic, disabling depression that they can only see their therapist every five or six weeks is like telling somebody with a broken leg that they can only see their physical therapist every five or six weeks,” she said. “It’s not enough. It’s not even close to enough.”\u003c/p>\n\u003cp>Then, this summer, Christina was diagnosed with breast cancer. Everything related to her cancer care — her mammogram, biopsy, surgery appointments — happened promptly, like a “well-oiled machine,” she said, while her depression care stumbles along.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Greta Christina\"]‘To tell somebody with serious, chronic, disabling depression that they can only see their therapist every five or six weeks is like telling somebody with a broken leg that they can only see their physical therapist every five or six weeks. It’s not enough. It’s not even close to enough.’[/pullquote]\u003c/p>\n\u003cp>“It is a hot mess,” she said. “I need to be in therapy — I have cancer! And still nothing has changed.”\u003c/p>\n\u003cp>A bill sitting on Gov. Gavin Newsom’s desk aims to fix this problem for all Californians. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB221\">Senate Bill 221\u003c/a>, which passed both houses of the Legislature in a near unanimous vote, would require health insurers across the state to reduce those wait times to no more than 10 business days. While current state law requires insurers to provide initial mental health appointments in 10 days, there is no clear regulation around follow-up appointments, resulting in what state Sen. Scott Wiener, D-San Francisco, the bill’s author, calls “obscene delays.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.chcf.org/blog/californians-want-action-health-care-costs-mental-health-treatment/\">Half of Californians say they have to wait too long to see a mental health provider when they need one\u003c/a>, according to a survey by the California Health Care Foundation. At Kaiser Permanente specifically, 87% of therapists said weekly appointments were not available to patients who needed it, according to a survey by the \u003ca href=\"https://nuhw.org/\">National Union of Healthcare Workers\u003c/a>, which represents Kaiser’s therapists and was the main sponsor of the bill.\u003c/p>\n\u003cp>“It just feels so unethical,” said triage therapist Brandi Plumley, referring to the typical two-month wait time she sees at Kaiser’s mental health clinic in Vallejo.\u003c/p>\n\u003cp>Every day she takes multiple crisis calls from patients who have a therapist assigned to them already, but can’t get in to see them, she said, adding the providers’ caseloads are “enormous.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It’s heartbreaking. And it eats on me day after day after day,” Plumley said. “What Kaiser simply needs to do is hire more clinicians.”\u003c/p>\n\u003cp>But Kaiser says there just aren’t enough out there. The integrated health system currently has 300 open clinical positions it is trying to fill, according to a statement from Yener Balan, Kaiser’s Northern California vice president of behavioral health. Even hiring more clinicians won’t solve the problem, Balan said, adding, “We all must reimagine our approach to the existing national model of care.”\u003c/p>\n\u003cp>Kaiser lodged formal concerns about the bill when it was first introduced, and the trade group representing insurers throughout the state, the California Association of Health Plans (CAHP), formally opposed the bill, saying a shortage of therapists would make it too difficult to meet the two-week mandate.\u003c/p>\n\u003cp>“The COVID-19 pandemic has only exacerbated this workforce shortage, and demand for these services [has] significantly increased,” said CAHP lobbyist Jedd Hampton at a state Senate hearing for the bill last spring, citing \u003ca href=\"https://healthforce.ucsf.edu/sites/healthforce.ucsf.edu/files/publication-pdf/California%E2%80%99s%20Current%20and%20Future%20Behavioral%20Health%20Workforce.pdf\">a UCLA study that predicted California would have nearly 30% fewer therapists than needed to meet demand by 2028\u003c/a>. “Simply put, mandating increased frequency of appointments without addressing the underlying workforce shortage will not lead to increased quality of care.”\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch4 style=\"text-align: center\">\u003ca href=\"https://www.kqed.org/stateofhealth/series/state-of-mind\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan style=\"color: #000000\">Special Series: State of Mind\u003c/span>\u003c/a>\u003c/h4>\n\u003cfigure>\u003ca href=\"https://www.kqed.org/stateofhealth/series/state-of-mind\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cimg decoding=\"async\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2016/08/RS20817_State-of-Mind-qut.jpg\" alt=\"\">\u003c/a>\u003c/figure>\n\u003cp style=\"text-align: left\">State of Mind: In this \u003ca href=\"https://www.kqed.org/stateofhealth/series/state-of-mind\">2016 special series by KQED’s The California Report and State of Health\u003c/a>, we traveled across the state to find out why it’s so difficult to get mental health care.\u003c/p>\n\u003c/aside>\n\u003cp>But lawmakers pushed back and \u003ca href=\"https://www.kqed.org/stateofhealth/185843/just-like-patients-therapists-also-battle-insurance-red-tape\">accused insurers of overstating the shortage\u003c/a>. If insurers want to attract more therapists to their networks, the responsibility is on them to pay better rates and reduce administrative burdens, said state Sen. Connie Leyva, D-Chino. And if insurers want more young people to enter the mental health care profession, they have to improve the salaries and working conditions of the field now, said state Sen. Richard Pan, D-Sacramento.\u003c/p>\n\u003cp>As bipartisan support for the bill grew, insurers withdrew their opposition. The bill passed the Legislature with 111 lawmakers voting for it and one voting against.\u003c/p>\n\u003cp>“COVID, and the fact that every single one of us has been impacted significantly in terms of our isolation, I believe, has made legislators’ focus, and their understanding of the importance of treatment, almost universal,” said Julie Snyder, government affairs director for the \u003ca href=\"https://steinberginstitute.org/\">Steinberg Institute\u003c/a>, a supporter of the bill.\u003c/p>\n\u003cp>The bill itself, which would take effect in July 2022 if signed by the governor, is a solid step forward toward improving access to mental health care, with communities of color standing to benefit the most, said Lonnie Snowden, professor of health policy and management at UC Berkeley.\u003c/p>\n\u003cp>African Americans, Asian Americans and Latinos face the most barriers getting into care, he said, and when people of color do come in for treatment, there is a high discontinuation rate.\u003c/p>\n\u003cp>“So anything you can do to speed up people’s future appointments is probably going to disproportionately benefit people who are already staying away because of barriers,” Snowden said. “If you can remove one of the barriers, they’re the ones who stand to benefit.”\u003c/p>\n\u003cp>But there has to be some form of oversight and enforcement for the new rules to work, said Keith Humphreys, a psychiatry professor at Stanford University. Kaiser has data systems that can track the time between appointments, but other insurers contract with therapists in private practice, who manage their own caseloads and schedules.\u003c/p>\n\u003cp>“Who would keep track of whether people who’ve been seen once were seen again in 10 days when \u003ca href=\"https://www.kqed.org/stateofhealth/185796/single-moms-search-for-therapist-foiled-by-insurance-companies\">it’s hard enough just to keep track of how many providers we have\u003c/a> and who they are seeing?” he said. “And if someone wasn’t seen again in 10 days, how do we tell the cases when they were denied care they wanted versus the cases where they decided one appointment is all they wanted?”\u003c/p>\n\u003cp>These are questions that will fall to state regulators, the California Department of Managed Health Care and the Department of Insurance.\u003c/p>\n\u003cp>Regardless, Greta Christina says she is desperate for the bill to become law. She’s thought about looking for a new therapist outside Kaiser so she can be seen more frequently. But she really likes her therapist. She says it’s too hard to think of starting over with someone new while she’s in the middle of a cancer crisis. So she has decided to wait.\u003c/p>\n\u003cp>“Knowing that this bill is on the horizon has been helping me hang on,” she said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Senate Bill 221, which passed both houses of the Legislature with a near unanimous vote, would require health insurers across the state to reduce wait times for mental health appointments to no more than 10 business days. The bill is currently on the governor's desk.",
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"title": "California Bill Would Reduce Wait Times for Mental Health Appointments | KQED",
"description": "Senate Bill 221, which passed both houses of the Legislature with a near unanimous vote, would require health insurers across the state to reduce wait times for mental health appointments to no more than 10 business days. The bill is currently on the governor's desk.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When Greta Christina fell into a deep depression five years ago, she called up her therapist — someone she’d had a great connection with when she needed therapy in the past. And she was delighted to find out that he was now on staff at Kaiser Permanente, her insurer, meaning she wouldn’t have to pay out of pocket anymore to see him.\u003c/p>\n\u003cp>But the excitement was short-lived. Over time, her appointments went from every two weeks to every four and then to every five or six.\u003c/p>\n\u003cp>“To tell somebody with serious, chronic, disabling depression that they can only see their therapist every five or six weeks is like telling somebody with a broken leg that they can only see their physical therapist every five or six weeks,” she said. “It’s not enough. It’s not even close to enough.”\u003c/p>\n\u003cp>Then, this summer, Christina was diagnosed with breast cancer. Everything related to her cancer care — her mammogram, biopsy, surgery appointments — happened promptly, like a “well-oiled machine,” she said, while her depression care stumbles along.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘To tell somebody with serious, chronic, disabling depression that they can only see their therapist every five or six weeks is like telling somebody with a broken leg that they can only see their physical therapist every five or six weeks. It’s not enough. It’s not even close to enough.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It is a hot mess,” she said. “I need to be in therapy — I have cancer! And still nothing has changed.”\u003c/p>\n\u003cp>A bill sitting on Gov. Gavin Newsom’s desk aims to fix this problem for all Californians. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB221\">Senate Bill 221\u003c/a>, which passed both houses of the Legislature in a near unanimous vote, would require health insurers across the state to reduce those wait times to no more than 10 business days. While current state law requires insurers to provide initial mental health appointments in 10 days, there is no clear regulation around follow-up appointments, resulting in what state Sen. Scott Wiener, D-San Francisco, the bill’s author, calls “obscene delays.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.chcf.org/blog/californians-want-action-health-care-costs-mental-health-treatment/\">Half of Californians say they have to wait too long to see a mental health provider when they need one\u003c/a>, according to a survey by the California Health Care Foundation. At Kaiser Permanente specifically, 87% of therapists said weekly appointments were not available to patients who needed it, according to a survey by the \u003ca href=\"https://nuhw.org/\">National Union of Healthcare Workers\u003c/a>, which represents Kaiser’s therapists and was the main sponsor of the bill.\u003c/p>\n\u003cp>“It just feels so unethical,” said triage therapist Brandi Plumley, referring to the typical two-month wait time she sees at Kaiser’s mental health clinic in Vallejo.\u003c/p>\n\u003cp>Every day she takes multiple crisis calls from patients who have a therapist assigned to them already, but can’t get in to see them, she said, adding the providers’ caseloads are “enormous.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It’s heartbreaking. And it eats on me day after day after day,” Plumley said. “What Kaiser simply needs to do is hire more clinicians.”\u003c/p>\n\u003cp>But Kaiser says there just aren’t enough out there. The integrated health system currently has 300 open clinical positions it is trying to fill, according to a statement from Yener Balan, Kaiser’s Northern California vice president of behavioral health. Even hiring more clinicians won’t solve the problem, Balan said, adding, “We all must reimagine our approach to the existing national model of care.”\u003c/p>\n\u003cp>Kaiser lodged formal concerns about the bill when it was first introduced, and the trade group representing insurers throughout the state, the California Association of Health Plans (CAHP), formally opposed the bill, saying a shortage of therapists would make it too difficult to meet the two-week mandate.\u003c/p>\n\u003cp>“The COVID-19 pandemic has only exacerbated this workforce shortage, and demand for these services [has] significantly increased,” said CAHP lobbyist Jedd Hampton at a state Senate hearing for the bill last spring, citing \u003ca href=\"https://healthforce.ucsf.edu/sites/healthforce.ucsf.edu/files/publication-pdf/California%E2%80%99s%20Current%20and%20Future%20Behavioral%20Health%20Workforce.pdf\">a UCLA study that predicted California would have nearly 30% fewer therapists than needed to meet demand by 2028\u003c/a>. “Simply put, mandating increased frequency of appointments without addressing the underlying workforce shortage will not lead to increased quality of care.”\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch4 style=\"text-align: center\">\u003ca href=\"https://www.kqed.org/stateofhealth/series/state-of-mind\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan style=\"color: #000000\">Special Series: State of Mind\u003c/span>\u003c/a>\u003c/h4>\n\u003cfigure>\u003ca href=\"https://www.kqed.org/stateofhealth/series/state-of-mind\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cimg decoding=\"async\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2016/08/RS20817_State-of-Mind-qut.jpg\" alt=\"\">\u003c/a>\u003c/figure>\n\u003cp style=\"text-align: left\">State of Mind: In this \u003ca href=\"https://www.kqed.org/stateofhealth/series/state-of-mind\">2016 special series by KQED’s The California Report and State of Health\u003c/a>, we traveled across the state to find out why it’s so difficult to get mental health care.\u003c/p>\n\u003c/aside>\n\u003cp>But lawmakers pushed back and \u003ca href=\"https://www.kqed.org/stateofhealth/185843/just-like-patients-therapists-also-battle-insurance-red-tape\">accused insurers of overstating the shortage\u003c/a>. If insurers want to attract more therapists to their networks, the responsibility is on them to pay better rates and reduce administrative burdens, said state Sen. Connie Leyva, D-Chino. And if insurers want more young people to enter the mental health care profession, they have to improve the salaries and working conditions of the field now, said state Sen. Richard Pan, D-Sacramento.\u003c/p>\n\u003cp>As bipartisan support for the bill grew, insurers withdrew their opposition. The bill passed the Legislature with 111 lawmakers voting for it and one voting against.\u003c/p>\n\u003cp>“COVID, and the fact that every single one of us has been impacted significantly in terms of our isolation, I believe, has made legislators’ focus, and their understanding of the importance of treatment, almost universal,” said Julie Snyder, government affairs director for the \u003ca href=\"https://steinberginstitute.org/\">Steinberg Institute\u003c/a>, a supporter of the bill.\u003c/p>\n\u003cp>The bill itself, which would take effect in July 2022 if signed by the governor, is a solid step forward toward improving access to mental health care, with communities of color standing to benefit the most, said Lonnie Snowden, professor of health policy and management at UC Berkeley.\u003c/p>\n\u003cp>African Americans, Asian Americans and Latinos face the most barriers getting into care, he said, and when people of color do come in for treatment, there is a high discontinuation rate.\u003c/p>\n\u003cp>“So anything you can do to speed up people’s future appointments is probably going to disproportionately benefit people who are already staying away because of barriers,” Snowden said. “If you can remove one of the barriers, they’re the ones who stand to benefit.”\u003c/p>\n\u003cp>But there has to be some form of oversight and enforcement for the new rules to work, said Keith Humphreys, a psychiatry professor at Stanford University. Kaiser has data systems that can track the time between appointments, but other insurers contract with therapists in private practice, who manage their own caseloads and schedules.\u003c/p>\n\u003cp>“Who would keep track of whether people who’ve been seen once were seen again in 10 days when \u003ca href=\"https://www.kqed.org/stateofhealth/185796/single-moms-search-for-therapist-foiled-by-insurance-companies\">it’s hard enough just to keep track of how many providers we have\u003c/a> and who they are seeing?” he said. “And if someone wasn’t seen again in 10 days, how do we tell the cases when they were denied care they wanted versus the cases where they decided one appointment is all they wanted?”\u003c/p>\n\u003cp>These are questions that will fall to state regulators, the California Department of Managed Health Care and the Department of Insurance.\u003c/p>\n\u003cp>Regardless, Greta Christina says she is desperate for the bill to become law. She’s thought about looking for a new therapist outside Kaiser so she can be seen more frequently. But she really likes her therapist. She says it’s too hard to think of starting over with someone new while she’s in the middle of a cancer crisis. So she has decided to wait.\u003c/p>\n\u003cp>“Knowing that this bill is on the horizon has been helping me hang on,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "new-momnibus-bill-wants-to-help-more-black-moms-survive-childbirth",
"title": "New California Law Aims to Help More Black and Indigenous People Survive Childbirth",
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"headTitle": "New California Law Aims to Help More Black and Indigenous People Survive Childbirth | KQED",
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"content": "\u003cp>\u003cem>Updated Oct. 4, 2021, 2:30 p.m.\u003c/em>\u003c/p>\n\u003cp>Gov. Gavin Newsom signed a bill into law on Monday that aims to improve the survival rates of Black and Indigenous people and their babies during childbirth in California.\u003c/p>\n\u003cp>Black people were six times more likely to die within a year of pregnancy than white women from 2014 to 2016 and had a higher rate of death than Black women nationally from 2014 to 2017.\u003c/p>\n\u003cp>In California, Black and Native American babies die at a rate \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB65\">more than double the state average\u003c/a>. Black birthing people die at more than three times the state average.\u003c/p>\n\u003cp>Senate Bill 65, also known as the California Momnibus Act, will collect more details about pregnancy-related deaths, diversify the experts looking at that data and require them to recommend ways to reduce racial and socioeconomic gaps. It also would expand access to doulas and midwives, whose presence can drive better care.\u003c/p>\n\u003cp>“Every individual deserves to have a healthy pregnancy and birth, and this bill will help make this a reality for more California families,” Newsom said in a press release. “It is unacceptable that the maternal and infant mortality rate among Black and Indigenous communities remains significantly higher than the state average.”\u003c/p>\n\u003cp>SB 65, co-authored by Democratic state Sen. Nancy Skinner, D-Berkeley, formalizes a committee that is tasked with investigating every death of a birthing person and allows for voluntary interviews of family members to better understand what happened. It also looks into pregnancy-related deaths among members of the LGBTQ+ community.\u003c/p>\n\u003cp>“Gov. Newsom’s signing SB 65, the California Momnibus Act, represents a significant victory for Black maternal and infant health. Despite our medical advances, more U.S. babies and mothers die during birth than in all other high-income countries, and these preventable deaths are disproportionately higher for Black families,” said Skinner, who is also vice chair of the Legislative Women’s Caucus. “With the enactment of SB 65, California will help close racial disparities in maternal and infant deaths and save lives.”\u003c/p>\n\u003cp>The bill also increases Medi-Cal coverage to a full year postpartum. Previously, birthing people in lower-income families were kicked off Medi-Cal, California’s version of the federal Medicaid program, two months after giving birth.\u003c/p>\n\u003cp>“This bill affirms here in California these kinds of disparities in our maternal and infant outcomes will no longer be tolerated,” said state Assemblymember Dr. Akilah Weber, D-San Diego, another co-author of SB 65.\u003c/p>\n\u003cp>\u003cem>See the signing below:\u003c/em>\u003c/p>\n\u003cp>https://youtu.be/mTDSMNyUNrQ\u003c/p>\n\u003cp>\u003cstrong>Original post: Sept. 27, 2021\u003c/strong>\u003c/p>\n\u003cp>California has among the lowest death rates nationally among pregnant and birthing people, but the numbers for Black people in those populations tell a different story.\u003c/p>\n\u003cp>They were six times more likely to die within a year of pregnancy than white women from 2014 to 2016 and had a higher rate of death than Black women nationally from 2014 to 2017, the most recent time frame for which data is available.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Jen Flory, Western Center on Law and Poverty\"]‘It is going to take a serious investment and resources, whether that means providing every Black mother a doula or really investigating what’s happening when Black mothers die.’[/pullquote]A bill before Gov. Gavin Newsom aims to change that. Nicknamed the “Momnibus” bill, it would collect more details about pregnancy-related deaths, diversify the experts looking at that data and require them to recommend ways to reduce racial gaps. It also would expand access to doulas and midwives, whose presence can drive better care.\u003c/p>\n\u003cp>“If you really want to address the issue, it is going to take a serious investment and resources, whether that means providing every Black mother a doula or really investigating what’s happening when Black mothers die,” said Jen Flory, policy advocate for the Western Center on Law and Poverty, which supports the bill.\u003c/p>\n\u003cp>Newsom backed past efforts to improve care for Black pregnant people by requiring implicit bias training for health care workers involved in perinatal care, and he’s made support for women and new birthing people a priority for his administration. But his Department of Finance opposes the bill because the $6.7 million price tag for expanded data collection wasn’t included in the state budget. Newsom hasn’t said whether he’ll sign it.\u003c/p>\n\u003cp>Among wealthy nations, the United States ranks poorly in death rates of birthing people, and California’s effort is part of a national push to improve outcomes. Back in 2020, Democratic legislators on Capitol Hill introduced the Black Maternal Health Momnibus Act, which received the support of then-Senator Kamala Harris. But the bill never got a vote.\u003c/p>\n\u003cp>During his campaign, President Joe Biden lauded California’s efforts to reduce deaths, and in April he recognized Black Maternal Health Week.\u003cbr>\n[ad fullwidth]\u003cbr>\nThere are two ways to track deaths: The mortality rate for birthing people, used globally, counts deaths during pregnancy and within 42 days of giving birth. The pregnancy-related mortality rate, used in California and some other states, tracks deaths within a year of giving birth. The Centers for Disease Control and Prevention looks at both, though data lags and isn’t available to compare across states for the latter measure.\u003c/p>\n\u003cp>Earlier this month, the California Department of Public Health released a report tracking California’s outcomes from 2008 to 2016. Deaths of birthing people within a year of pregnancy hit a low in 2012, with fewer than 10 per 100,000 live births. It ticked up to about 14 deaths in 2016, slightly behind the national rate of almost 17 deaths. Using the mortality rate of birthing people, California ranked only behind Illinois for lowest death rates in 2019.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Kimberly D. Gregory, Cedars-Sinai Medical Center\"]‘There is a disparity between Black and white women and it’s not getting better.’[/pullquote]But the rate for Black birthing people was far higher. From 2014 to 2016 in California, about 56 Black birthing people died per 100,000 live births, compared to 13 Asian, 11 Latina and fewer than 10 white birthing people. Nationally, Black birthing people died at a rate of nearly 42 per 100,000 live births from 2014 to 2017. California’s Black birthing people died at six times the rate of white birthing people, up from three times the rate in 2008.\u003c/p>\n\u003cp>“The reality is there is a disparity between Black and white women and it’s not getting better,” said Kimberly D. Gregory, director of maternal fetal medicine at Cedars-Sinai Medical Center in Los Angeles and a former member of California’s pregnancy surveillance committee.\u003c/p>\n\u003cp>The committee plans to release data on pregnancy-related deaths through 2020 by next year. It relies on grant funding.\u003c/p>\n\u003cp>SB 65, authored by Democratic state Sen. Nancy Skinner, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB65\">aims to write the committee into state law\u003c/a> and strengthen its data collection and duties. It would require the committee to have 13 members, including doctors, midwives, doulas and community advocates and would include a tribal representative. According to the bill’s text, California’s Native American infant mortality rate is 11.7 deaths per 1,000 live births, which is far above the state’s average of 4.2 deaths per 1,000 live births.\u003c/p>\n\u003cp>Most of the committee’s current members are doctors.\u003c/p>\n\u003cp>The committee would investigate every death of a birthing person and allow for voluntary interviews of family members to better understand what happened. The committee would have to publish its findings and recommendations every three years. It would also look into pregnancy-related deaths among members of the LGBTQ+ community.\u003c/p>\n\u003cp>“We can make better decisions about prevention, intervention, systems changes, not only at the hospital level but at the community level,” said Mashariki Kudumu, director of maternal and infant health initiatives for the \u003ca href=\"https://www.marchofdimes.org/news/march-of-dimes-greater-los-angeles-division-board.aspx\">March of Dimes, Greater Los Angeles\u003c/a>, which is a co-sponsor of the bill. “What comes with diverse and different perspectives are better changes to systems that improve care.”\u003c/p>\n\u003cp>Kudumu is also trained as a doula. Newsom in his state budget made doulas a covered benefit under Medi-Cal, the state’s health insurance program for lower-income people, following states including New York and Illinois. Doulas are trained to assist and advocate for birthing people in pregnancy and during and after birth. Research shows their presence reduces pregnancy complications and low birthweight in babies.\u003c/p>\n\u003cp>[aside label ='Related Coverage' tag='health-equity']The benefit takes effect next year, and the bill before Newsom would establish a group to study its use. The proposal also expands training for midwives.\u003c/p>\n\u003cp>Kudumu said she’s helped birthing people stick to their birthing plans in the face of pressure from doctors and provided them with nursing and lactation support.\u003c/p>\n\u003cp>She knows the value from personal experience. When Kudumu delivered her son prematurely, she felt disrespected by the doctor because she’s a Black woman who was on Medi-Cal at the time while she was in graduate school.\u003c/p>\n\u003cp>Kudumu had to fight to ensure her son got breastmilk instead of formula while he was in the newborn intensive care unit. She remembers the doctor’s attitude changing when another doula at the hospital came up to greet her.\u003c/p>\n\u003cp>“We want to make sure that this resource, that evidence shows improves health outcomes, is more accessible to people,” she said.\u003c/p>\n\u003cp>\u003cem>Original reporting for this post was from Kathleen Ronayne of the The Associated Press. KQED’s April Dembosky contributed reporting to the updates.\u003c/em>\u003cbr>\n[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Updated Oct. 4, 2021, 2:30 p.m.\u003c/em>\u003c/p>\n\u003cp>Gov. Gavin Newsom signed a bill into law on Monday that aims to improve the survival rates of Black and Indigenous people and their babies during childbirth in California.\u003c/p>\n\u003cp>Black people were six times more likely to die within a year of pregnancy than white women from 2014 to 2016 and had a higher rate of death than Black women nationally from 2014 to 2017.\u003c/p>\n\u003cp>In California, Black and Native American babies die at a rate \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB65\">more than double the state average\u003c/a>. Black birthing people die at more than three times the state average.\u003c/p>\n\u003cp>Senate Bill 65, also known as the California Momnibus Act, will collect more details about pregnancy-related deaths, diversify the experts looking at that data and require them to recommend ways to reduce racial and socioeconomic gaps. It also would expand access to doulas and midwives, whose presence can drive better care.\u003c/p>\n\u003cp>“Every individual deserves to have a healthy pregnancy and birth, and this bill will help make this a reality for more California families,” Newsom said in a press release. “It is unacceptable that the maternal and infant mortality rate among Black and Indigenous communities remains significantly higher than the state average.”\u003c/p>\n\u003cp>SB 65, co-authored by Democratic state Sen. Nancy Skinner, D-Berkeley, formalizes a committee that is tasked with investigating every death of a birthing person and allows for voluntary interviews of family members to better understand what happened. It also looks into pregnancy-related deaths among members of the LGBTQ+ community.\u003c/p>\n\u003cp>“Gov. Newsom’s signing SB 65, the California Momnibus Act, represents a significant victory for Black maternal and infant health. Despite our medical advances, more U.S. babies and mothers die during birth than in all other high-income countries, and these preventable deaths are disproportionately higher for Black families,” said Skinner, who is also vice chair of the Legislative Women’s Caucus. “With the enactment of SB 65, California will help close racial disparities in maternal and infant deaths and save lives.”\u003c/p>\n\u003cp>The bill also increases Medi-Cal coverage to a full year postpartum. Previously, birthing people in lower-income families were kicked off Medi-Cal, California’s version of the federal Medicaid program, two months after giving birth.\u003c/p>\n\u003cp>“This bill affirms here in California these kinds of disparities in our maternal and infant outcomes will no longer be tolerated,” said state Assemblymember Dr. Akilah Weber, D-San Diego, another co-author of SB 65.\u003c/p>\n\u003cp>\u003cem>See the signing below:\u003c/em>\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/mTDSMNyUNrQ'\n title='//www.youtube.com/embed/mTDSMNyUNrQ'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>\u003cstrong>Original post: Sept. 27, 2021\u003c/strong>\u003c/p>\n\u003cp>California has among the lowest death rates nationally among pregnant and birthing people, but the numbers for Black people in those populations tell a different story.\u003c/p>\n\u003cp>They were six times more likely to die within a year of pregnancy than white women from 2014 to 2016 and had a higher rate of death than Black women nationally from 2014 to 2017, the most recent time frame for which data is available.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘It is going to take a serious investment and resources, whether that means providing every Black mother a doula or really investigating what’s happening when Black mothers die.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>A bill before Gov. Gavin Newsom aims to change that. Nicknamed the “Momnibus” bill, it would collect more details about pregnancy-related deaths, diversify the experts looking at that data and require them to recommend ways to reduce racial gaps. It also would expand access to doulas and midwives, whose presence can drive better care.\u003c/p>\n\u003cp>“If you really want to address the issue, it is going to take a serious investment and resources, whether that means providing every Black mother a doula or really investigating what’s happening when Black mothers die,” said Jen Flory, policy advocate for the Western Center on Law and Poverty, which supports the bill.\u003c/p>\n\u003cp>Newsom backed past efforts to improve care for Black pregnant people by requiring implicit bias training for health care workers involved in perinatal care, and he’s made support for women and new birthing people a priority for his administration. But his Department of Finance opposes the bill because the $6.7 million price tag for expanded data collection wasn’t included in the state budget. Newsom hasn’t said whether he’ll sign it.\u003c/p>\n\u003cp>Among wealthy nations, the United States ranks poorly in death rates of birthing people, and California’s effort is part of a national push to improve outcomes. Back in 2020, Democratic legislators on Capitol Hill introduced the Black Maternal Health Momnibus Act, which received the support of then-Senator Kamala Harris. But the bill never got a vote.\u003c/p>\n\u003cp>During his campaign, President Joe Biden lauded California’s efforts to reduce deaths, and in April he recognized Black Maternal Health Week.\u003cbr>\n\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cbr>\nThere are two ways to track deaths: The mortality rate for birthing people, used globally, counts deaths during pregnancy and within 42 days of giving birth. The pregnancy-related mortality rate, used in California and some other states, tracks deaths within a year of giving birth. The Centers for Disease Control and Prevention looks at both, though data lags and isn’t available to compare across states for the latter measure.\u003c/p>\n\u003cp>Earlier this month, the California Department of Public Health released a report tracking California’s outcomes from 2008 to 2016. Deaths of birthing people within a year of pregnancy hit a low in 2012, with fewer than 10 per 100,000 live births. It ticked up to about 14 deaths in 2016, slightly behind the national rate of almost 17 deaths. Using the mortality rate of birthing people, California ranked only behind Illinois for lowest death rates in 2019.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>But the rate for Black birthing people was far higher. From 2014 to 2016 in California, about 56 Black birthing people died per 100,000 live births, compared to 13 Asian, 11 Latina and fewer than 10 white birthing people. Nationally, Black birthing people died at a rate of nearly 42 per 100,000 live births from 2014 to 2017. California’s Black birthing people died at six times the rate of white birthing people, up from three times the rate in 2008.\u003c/p>\n\u003cp>“The reality is there is a disparity between Black and white women and it’s not getting better,” said Kimberly D. Gregory, director of maternal fetal medicine at Cedars-Sinai Medical Center in Los Angeles and a former member of California’s pregnancy surveillance committee.\u003c/p>\n\u003cp>The committee plans to release data on pregnancy-related deaths through 2020 by next year. It relies on grant funding.\u003c/p>\n\u003cp>SB 65, authored by Democratic state Sen. Nancy Skinner, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB65\">aims to write the committee into state law\u003c/a> and strengthen its data collection and duties. It would require the committee to have 13 members, including doctors, midwives, doulas and community advocates and would include a tribal representative. According to the bill’s text, California’s Native American infant mortality rate is 11.7 deaths per 1,000 live births, which is far above the state’s average of 4.2 deaths per 1,000 live births.\u003c/p>\n\u003cp>Most of the committee’s current members are doctors.\u003c/p>\n\u003cp>The committee would investigate every death of a birthing person and allow for voluntary interviews of family members to better understand what happened. The committee would have to publish its findings and recommendations every three years. It would also look into pregnancy-related deaths among members of the LGBTQ+ community.\u003c/p>\n\u003cp>“We can make better decisions about prevention, intervention, systems changes, not only at the hospital level but at the community level,” said Mashariki Kudumu, director of maternal and infant health initiatives for the \u003ca href=\"https://www.marchofdimes.org/news/march-of-dimes-greater-los-angeles-division-board.aspx\">March of Dimes, Greater Los Angeles\u003c/a>, which is a co-sponsor of the bill. “What comes with diverse and different perspectives are better changes to systems that improve care.”\u003c/p>\n\u003cp>Kudumu is also trained as a doula. Newsom in his state budget made doulas a covered benefit under Medi-Cal, the state’s health insurance program for lower-income people, following states including New York and Illinois. Doulas are trained to assist and advocate for birthing people in pregnancy and during and after birth. Research shows their presence reduces pregnancy complications and low birthweight in babies.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The benefit takes effect next year, and the bill before Newsom would establish a group to study its use. The proposal also expands training for midwives.\u003c/p>\n\u003cp>Kudumu said she’s helped birthing people stick to their birthing plans in the face of pressure from doctors and provided them with nursing and lactation support.\u003c/p>\n\u003cp>She knows the value from personal experience. When Kudumu delivered her son prematurely, she felt disrespected by the doctor because she’s a Black woman who was on Medi-Cal at the time while she was in graduate school.\u003c/p>\n\u003cp>Kudumu had to fight to ensure her son got breastmilk instead of formula while he was in the newborn intensive care unit. She remembers the doctor’s attitude changing when another doula at the hospital came up to greet her.\u003c/p>\n\u003cp>“We want to make sure that this resource, that evidence shows improves health outcomes, is more accessible to people,” she said.\u003c/p>\n\u003cp>\u003cem>Original reporting for this post was from Kathleen Ronayne of the The Associated Press. KQED’s April Dembosky contributed reporting to the updates.\u003c/em>\u003cbr>\n\u003c/p>\u003c/div>",
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"title": "SF Scientist Among Pair of California Researchers Awarded Nobel Prize for Work on How Humans Perceive Heat and Touch",
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"content": "\u003cp>Two scientists based in California won the Nobel Prize in medicine on Monday for their discoveries into how the human body perceives temperature and touch, revelations that could lead to new ways of treating pain or even heart disease.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Thomas Perlmann, secretary-general of the Nobel Committee\"]‘This really unlocks one of the secrets of nature … It’s actually something that is crucial for our survival.’[/pullquote]One of the researchers is \u003ca href=\"https://www.ucsf.edu/news/2021/09/421481/david-julius-wins-nobel-prize-work-pain-sensation\">David Julius, a biochemist and molecular biologist at UCSF\u003c/a>. A few hundred miles south, Ardem Patapoutian at Scripps Research Institute in La Jolla also separately identified receptors in the skin that respond to heat and pressure.\u003c/p>\n\u003cp>Some hope the discoveries could eventually lead to pain treatments that reduce dependence on highly addictive opioids. But the breakthroughs, which happened decades ago, have not yet yielded many effective new therapies.\u003c/p>\n\u003cp>Julius used capsaicin, the active component in chili peppers, to help pinpoint the nerve sensors that respond to heat, the Nobel Committee said. Patapoutian found pressure-sensitive sensors in cells that respond to mechanical stimulation.\u003c/p>\n\u003cp>“This really unlocks one of the secrets of nature,” said Thomas Perlmann, secretary-general of the committee, in announcing the winners. “It’s actually something that is crucial for our survival, so it’s a very important and profound discovery.”\u003c/p>\n\u003cp>In keeping with a long tradition of difficulties in alerting Nobel winners, Julius, 65, said he was awakened by what he thought was a prank phone call shortly before the prize was announced.\u003c/p>\n\u003cp>“My phone sort of bleeped, and it was from a relative who had been contacted by somebody on the Nobel Committee trying to find my phone number,” he said from his home in San Francisco, where it was the middle of the night.\u003c/p>\n\u003cp>It was only when his wife heard Perlmann’s voice — his wife worked with Perlmann years ago, Julius said — and confirmed it was indeed the secretary-general of the committee who was calling, that he realized it wasn’t a joke.\u003c/p>\n\u003cp>Julius later said he hoped his work would lead to the development of new pain drugs, explaining that the biology behind even everyday activities can have enormous significance.\u003c/p>\n\u003cp>“We eat chili peppers and menthol, but oftentimes, you don’t think about how that works,” he said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The Nobel Committee said their discoveries get at “one of the great mysteries facing humanity”: how we sense our environment.\u003c/p>\n\u003cp>The choice of winners underscored how little scientists knew about that question before the discoveries — and how much there still is to learn, said Oscar Marin, director of the MRC Centre for Neurodevelopmental Disorders at King’s College London.\u003c/p>\n\u003cp>“While we understood the physiology of the senses, what we didn’t understand was how we sensed differences in temperature or pressure,” Marin said. “Knowing how our body senses these changes is fundamental because once we know those molecules, they can be targeted. It’s like finding a lock, and now we know the precise keys that will be necessary to unlock it.”\u003c/p>\n\u003cp>Marin predicted that new treatments for pain would likely come first, but that understanding how the body detects changes in pressure could eventually lead to drugs for heart disease, if scientists can figure out how to alleviate pressure on blood vessels and other organs.\u003c/p>\n\u003cp>Richard Harris, of the Chronic Pain and Fatigue Research Center at the University of Michigan, also said the new laureates’ work might help design new pain medications, but noted the field has long been stalled.\u003c/p>\n\u003cp>He said that because pain also includes a psychological component, simply identifying how it is triggered in the body isn’t necessarily enough to address it. Still, he said Julius’s and Patapoutian’s work likely would help doctors better treat pain that is caused by things like extreme temperatures and chemical burns.\u003c/p>\n\u003cp>“Their discoveries are giving us the first inkling of how this type of pain starts, but whether it’s involved in many chronic pain patients remains to be seen,” he said.\u003c/p>\n\u003cp>Still, Fiona Boissonade, a pain specialist at the University of Sheffield in the U.K., said the Nobel laureates’ work was especially relevant for the one in five people globally who suffer from chronic pain.\u003c/p>\n\u003cp>Such pain — including from arthritis, migraines and chronic back problems — “is a huge medical problem, and it’s quite poorly treated across the board,” she said. “Their research may lead us to identify new compounds that are effective in treating pain that don’t come with the devastating impact of opioids,” which have spawned a crisis of addiction in the U.S.\u003c/p>\n\u003cp>[aside label ='Related Coverage' tag='science']The Nobel Committee tweeted a photo of Patapoutian in bed with his son while he watched the announcement on his computer.\u003c/p>\n\u003cp>“A day to be thankful: this country gave me a chance with a great education and support for basic research. And for my labbies and collaborators for partnering with me,” Patapoutian, who was born in Lebanon, tweeted.\u003c/p>\n\u003cp>The prestigious award comes with a gold medal and 10 million Swedish kronor (over $1.14 million). The prize money comes from a bequest left by the prize’s creator, Swedish inventor Alfred Nobel, who died in 1896.\u003c/p>\n\u003cp>The prize is the first to be awarded this year. The other prizes are for outstanding work in the fields of physics, chemistry, literature, peace and economics.\u003cbr>\n[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Two scientists based in California won the Nobel Prize in medicine on Monday for their discoveries into how the human body perceives temperature and touch, revelations that could lead to new ways of treating pain or even heart disease.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘This really unlocks one of the secrets of nature … It’s actually something that is crucial for our survival.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>One of the researchers is \u003ca href=\"https://www.ucsf.edu/news/2021/09/421481/david-julius-wins-nobel-prize-work-pain-sensation\">David Julius, a biochemist and molecular biologist at UCSF\u003c/a>. A few hundred miles south, Ardem Patapoutian at Scripps Research Institute in La Jolla also separately identified receptors in the skin that respond to heat and pressure.\u003c/p>\n\u003cp>Some hope the discoveries could eventually lead to pain treatments that reduce dependence on highly addictive opioids. But the breakthroughs, which happened decades ago, have not yet yielded many effective new therapies.\u003c/p>\n\u003cp>Julius used capsaicin, the active component in chili peppers, to help pinpoint the nerve sensors that respond to heat, the Nobel Committee said. Patapoutian found pressure-sensitive sensors in cells that respond to mechanical stimulation.\u003c/p>\n\u003cp>“This really unlocks one of the secrets of nature,” said Thomas Perlmann, secretary-general of the committee, in announcing the winners. “It’s actually something that is crucial for our survival, so it’s a very important and profound discovery.”\u003c/p>\n\u003cp>In keeping with a long tradition of difficulties in alerting Nobel winners, Julius, 65, said he was awakened by what he thought was a prank phone call shortly before the prize was announced.\u003c/p>\n\u003cp>“My phone sort of bleeped, and it was from a relative who had been contacted by somebody on the Nobel Committee trying to find my phone number,” he said from his home in San Francisco, where it was the middle of the night.\u003c/p>\n\u003cp>It was only when his wife heard Perlmann’s voice — his wife worked with Perlmann years ago, Julius said — and confirmed it was indeed the secretary-general of the committee who was calling, that he realized it wasn’t a joke.\u003c/p>\n\u003cp>Julius later said he hoped his work would lead to the development of new pain drugs, explaining that the biology behind even everyday activities can have enormous significance.\u003c/p>\n\u003cp>“We eat chili peppers and menthol, but oftentimes, you don’t think about how that works,” he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The Nobel Committee said their discoveries get at “one of the great mysteries facing humanity”: how we sense our environment.\u003c/p>\n\u003cp>The choice of winners underscored how little scientists knew about that question before the discoveries — and how much there still is to learn, said Oscar Marin, director of the MRC Centre for Neurodevelopmental Disorders at King’s College London.\u003c/p>\n\u003cp>“While we understood the physiology of the senses, what we didn’t understand was how we sensed differences in temperature or pressure,” Marin said. “Knowing how our body senses these changes is fundamental because once we know those molecules, they can be targeted. It’s like finding a lock, and now we know the precise keys that will be necessary to unlock it.”\u003c/p>\n\u003cp>Marin predicted that new treatments for pain would likely come first, but that understanding how the body detects changes in pressure could eventually lead to drugs for heart disease, if scientists can figure out how to alleviate pressure on blood vessels and other organs.\u003c/p>\n\u003cp>Richard Harris, of the Chronic Pain and Fatigue Research Center at the University of Michigan, also said the new laureates’ work might help design new pain medications, but noted the field has long been stalled.\u003c/p>\n\u003cp>He said that because pain also includes a psychological component, simply identifying how it is triggered in the body isn’t necessarily enough to address it. Still, he said Julius’s and Patapoutian’s work likely would help doctors better treat pain that is caused by things like extreme temperatures and chemical burns.\u003c/p>\n\u003cp>“Their discoveries are giving us the first inkling of how this type of pain starts, but whether it’s involved in many chronic pain patients remains to be seen,” he said.\u003c/p>\n\u003cp>Still, Fiona Boissonade, a pain specialist at the University of Sheffield in the U.K., said the Nobel laureates’ work was especially relevant for the one in five people globally who suffer from chronic pain.\u003c/p>\n\u003cp>Such pain — including from arthritis, migraines and chronic back problems — “is a huge medical problem, and it’s quite poorly treated across the board,” she said. “Their research may lead us to identify new compounds that are effective in treating pain that don’t come with the devastating impact of opioids,” which have spawned a crisis of addiction in the U.S.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The Nobel Committee tweeted a photo of Patapoutian in bed with his son while he watched the announcement on his computer.\u003c/p>\n\u003cp>“A day to be thankful: this country gave me a chance with a great education and support for basic research. And for my labbies and collaborators for partnering with me,” Patapoutian, who was born in Lebanon, tweeted.\u003c/p>\n\u003cp>The prestigious award comes with a gold medal and 10 million Swedish kronor (over $1.14 million). The prize money comes from a bequest left by the prize’s creator, Swedish inventor Alfred Nobel, who died in 1896.\u003c/p>\n\u003cp>The prize is the first to be awarded this year. The other prizes are for outstanding work in the fields of physics, chemistry, literature, peace and economics.\u003cbr>\n\u003c/p>\u003c/div>",
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"content": "\u003cp>Recipients of the \u003ca href=\"https://www.cdss.ca.gov/inforesources/calfresh\">CalFresh\u003c/a> food program will see a significant jump in payments starting Friday — just as some of California’s major coronavirus-related benefit programs end.\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Jump to: \u003c/strong>\u003ca href=\"#apply\">\u003cstrong>How to apply for CalFresh benefits\u003c/strong>\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>CalFresh benefits will go up permanently by about 22% over pre-pandemic levels, the first major increase in nearly 50 years.\u003c/p>\n\u003cp>That amounts to \u003ca href=\"https://news.sccgov.org/news-release/calfresh-benefits-increase-first-time-nearly-50-years\">roughly $155 more per month for a family of four with the maximum benefit\u003c/a> — or about $53 more than the benefits offered through temporary pandemic relief, according to a statement from Santa Clara County.\u003c/p>\n\u003cp>CalFresh is the state’s version of the federal Supplemental Nutrition Assistance Program, or SNAP, which provides food benefits — also known as food stamps — to lower-income families.\u003c/p>\n\u003cp>In July 2021, more than \u003ca href=\"https://public.tableau.com/app/profile/california.department.of.social.services/viz/CFdashboard-PUBLIC/Home\">2.4 million households, or 4.3 million people, used CalFresh\u003c/a>, the largest food assistance program in the state.\u003c/p>\n\u003cp>In Santa Clara County alone, more than 62,000 households received CalFresh benefits in July, an increase of more than 20% over pre-pandemic levels, the county reported.[aside postID='news_11888843,news_11889738,science_1976551' label='Find Out About Other Support Programs']“These are members of our community who, before the pandemic, already faced more obstacles than everyone else,” Angela Shing, director of employment and benefits services for the Santa Clara County Social Services Agency, said in a press release.\u003c/p>\n\u003cp>Children and people 65 and older make up more than half of those receiving assistance in the county, the statement said, noting that groups hardest hit by the pandemic, including Latino, Black, and Vietnamese community members, were also overrepresented in enrollment, according to the statement.\u003c/p>\n\u003cp>“The more resources we have to make life more equitable for all residents, the more resilient we are as a community,” Shing said.\u003c/p>\n\u003cp>CalFresh benefits are distributed on electronic benefit transfer cards, which can be used at grocery stores and farmers markets. Beneficiaries can also purchase groceries online for home delivery through major retailers like Amazon, Walmart, and participating grocery chains.\u003c/p>\n\u003cp>The increase in CalFresh benefits comes just months after the state announced it would \u003ca href=\"https://www.kqed.org/news/11881642/california-launches-the-largest-free-school-lunch-program-in-the-country\">offer all 6.2 million public school students the option to eat school breakfasts and lunches for free this year\u003c/a>, regardless of household income.\u003c/p>\n\u003cp>The Public Policy Institute of California reported Friday that \u003ca href=\"https://www.ppic.org/blog/expansions-to-food-assistance-could-reduce-child-poverty/\">the two expanded benefits together “could lower poverty among school-aged children [in California]\u003c/a> by 1.3 percentage points relative to a pre-pandemic baseline, lifting 90,000 children out of poverty.”\u003c/p>\n\u003cp>According to the U.S. Department of Agriculture, more than 42 million people rely on SNAP to feed their families. The \u003ca href=\"https://www.fns.usda.gov/cnpp/usda-food-plans-cost-food-reports\">USDA recently reevaluated how it sets SNAP benefits\u003c/a>, increasing allotted payments by over 20% for the first time since the program started in in 1975 — resulting in the Oct. 1 increase.\u003c/p>\n\u003cp>That increase starts as other food benefits end, including a temporary 15% boost in SNAP payments that started in January 2021, and expired Thursday. It also comes a month after federal pandemic unemployment assistance dried up, and just a day after \u003ca href=\"https://www.kqed.org/news/11889738/covid-rent-relief-what-renters-and-landlords-need-to-know-as-californias-eviction-moratorium-ends\">California’s eviction moratorium\u003c/a> and extended sick leave rules expired.\u003c/p>\n\u003ch3>\u003ca id=\"apply\">\u003c/a>How to get the CalFresh benefits increase\u003c/h3>\n\u003cp>If you’re already a \u003ca href=\"http://calfresh.dss.ca.gov/food/\" target=\"_blank\" rel=\"noopener noreferrer\">CalFresh\u003c/a> recipient, you should already see an increase in your monthly benefits starting Oct. 1. If you’re experiencing problems or have questions about your current CalFresh benefits, the state recommends that you \u003ca href=\"https://www.cdss.ca.gov/Benefits-Services/Cash-Assistance/CalWORKS/County-Offices\" target=\"_blank\" rel=\"noopener noreferrer\">contact your county’s social services agency\u003c/a>.\u003c/p>\n\u003cp>New CalFresh applicants can \u003ca href=\"https://www.getcalfresh.org/\" target=\"_blank\" rel=\"noopener noreferrer\">start their application online in English, Spanish or Chinese\u003c/a> using the state’s official site, or by calling (877) 847-3663. You can also apply in person at your county’s designated CalFresh Office.\u003c/p>\n\u003cp>\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-large wp-image-11891175\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/10/CalFreshApplicationWebsite-1020x679.png\" alt=\"Screenshot of the states' application website for CalFresh benefits.\" width=\"640\" height=\"426\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/CalFreshApplicationWebsite-1020x679.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/CalFreshApplicationWebsite-800x533.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/CalFreshApplicationWebsite-160x107.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/CalFreshApplicationWebsite.png 1281w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/p>\n\u003cp>\u003cstrong>New CalFresh applicants must:\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>Be 18 years or older to apply for themselves or for their household\u003c/li>\n\u003cli>Meet \u003ca href=\"https://www.cdss.ca.gov/inforesources/cdss-programs/calfresh/eligibility-and-issuance-requirements#income\">federal low-income eligibility rules\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>Remember, public charge rules\u003ca href=\"https://www.cdss.ca.gov/calfreshoutreach/res/4.%20ImmigrationandPublicCharge.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"> do not apply to programs like CalFresh, WIC (California Special Supplemental Nutrition Program for Women, Infants, and Children) and free or reduced-cost lunch programs\u003c/a>, and any immigration information will remain private. The California Department of Social Services ensures that applying for CalFresh will not affect your green card or application for U.S. citizenship.\u003c/p>\n\u003cp>All children born in the U.S. can get CalFresh benefits if they qualify. It does not matter where their parents were born. For details on eligibility requirements for people who immigrated to the U.S., \u003ca href=\"https://www.cdss.ca.gov/inforesources/cdss-programs/calfresh/eligibility-and-issuance-requirements#income\" target=\"_blank\" rel=\"noopener noreferrer\">see the state’s website for complete information\u003c/a>.\u003c/p>\n\u003cp>CalFresh says it should take 10 minutes to apply online. New applicants should receive a call from a county representative for a short interview within a week.\u003c/p>\n\u003cp>As of Sept. 1, the CalFresh application site states that counties are receiving more applications than usual and application processing may be delayed.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Check out more data, including enrollment at the county level, on the \u003ca href=\"https://public.tableau.com/app/profile/california.department.of.social.services/viz/CFdashboard-PUBLIC/Home\">California Department of Social Services’ CalFresh Data Dashboard\u003c/a>.\u003c/em>\u003c/strong>\u003cbr>\n[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Recipients of the \u003ca href=\"https://www.cdss.ca.gov/inforesources/calfresh\">CalFresh\u003c/a> food program will see a significant jump in payments starting Friday — just as some of California’s major coronavirus-related benefit programs end.\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Jump to: \u003c/strong>\u003ca href=\"#apply\">\u003cstrong>How to apply for CalFresh benefits\u003c/strong>\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>CalFresh benefits will go up permanently by about 22% over pre-pandemic levels, the first major increase in nearly 50 years.\u003c/p>\n\u003cp>That amounts to \u003ca href=\"https://news.sccgov.org/news-release/calfresh-benefits-increase-first-time-nearly-50-years\">roughly $155 more per month for a family of four with the maximum benefit\u003c/a> — or about $53 more than the benefits offered through temporary pandemic relief, according to a statement from Santa Clara County.\u003c/p>\n\u003cp>CalFresh is the state’s version of the federal Supplemental Nutrition Assistance Program, or SNAP, which provides food benefits — also known as food stamps — to lower-income families.\u003c/p>\n\u003cp>In July 2021, more than \u003ca href=\"https://public.tableau.com/app/profile/california.department.of.social.services/viz/CFdashboard-PUBLIC/Home\">2.4 million households, or 4.3 million people, used CalFresh\u003c/a>, the largest food assistance program in the state.\u003c/p>\n\u003cp>In Santa Clara County alone, more than 62,000 households received CalFresh benefits in July, an increase of more than 20% over pre-pandemic levels, the county reported.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“These are members of our community who, before the pandemic, already faced more obstacles than everyone else,” Angela Shing, director of employment and benefits services for the Santa Clara County Social Services Agency, said in a press release.\u003c/p>\n\u003cp>Children and people 65 and older make up more than half of those receiving assistance in the county, the statement said, noting that groups hardest hit by the pandemic, including Latino, Black, and Vietnamese community members, were also overrepresented in enrollment, according to the statement.\u003c/p>\n\u003cp>“The more resources we have to make life more equitable for all residents, the more resilient we are as a community,” Shing said.\u003c/p>\n\u003cp>CalFresh benefits are distributed on electronic benefit transfer cards, which can be used at grocery stores and farmers markets. Beneficiaries can also purchase groceries online for home delivery through major retailers like Amazon, Walmart, and participating grocery chains.\u003c/p>\n\u003cp>The increase in CalFresh benefits comes just months after the state announced it would \u003ca href=\"https://www.kqed.org/news/11881642/california-launches-the-largest-free-school-lunch-program-in-the-country\">offer all 6.2 million public school students the option to eat school breakfasts and lunches for free this year\u003c/a>, regardless of household income.\u003c/p>\n\u003cp>The Public Policy Institute of California reported Friday that \u003ca href=\"https://www.ppic.org/blog/expansions-to-food-assistance-could-reduce-child-poverty/\">the two expanded benefits together “could lower poverty among school-aged children [in California]\u003c/a> by 1.3 percentage points relative to a pre-pandemic baseline, lifting 90,000 children out of poverty.”\u003c/p>\n\u003cp>According to the U.S. Department of Agriculture, more than 42 million people rely on SNAP to feed their families. The \u003ca href=\"https://www.fns.usda.gov/cnpp/usda-food-plans-cost-food-reports\">USDA recently reevaluated how it sets SNAP benefits\u003c/a>, increasing allotted payments by over 20% for the first time since the program started in in 1975 — resulting in the Oct. 1 increase.\u003c/p>\n\u003cp>That increase starts as other food benefits end, including a temporary 15% boost in SNAP payments that started in January 2021, and expired Thursday. It also comes a month after federal pandemic unemployment assistance dried up, and just a day after \u003ca href=\"https://www.kqed.org/news/11889738/covid-rent-relief-what-renters-and-landlords-need-to-know-as-californias-eviction-moratorium-ends\">California’s eviction moratorium\u003c/a> and extended sick leave rules expired.\u003c/p>\n\u003ch3>\u003ca id=\"apply\">\u003c/a>How to get the CalFresh benefits increase\u003c/h3>\n\u003cp>If you’re already a \u003ca href=\"http://calfresh.dss.ca.gov/food/\" target=\"_blank\" rel=\"noopener noreferrer\">CalFresh\u003c/a> recipient, you should already see an increase in your monthly benefits starting Oct. 1. If you’re experiencing problems or have questions about your current CalFresh benefits, the state recommends that you \u003ca href=\"https://www.cdss.ca.gov/Benefits-Services/Cash-Assistance/CalWORKS/County-Offices\" target=\"_blank\" rel=\"noopener noreferrer\">contact your county’s social services agency\u003c/a>.\u003c/p>\n\u003cp>New CalFresh applicants can \u003ca href=\"https://www.getcalfresh.org/\" target=\"_blank\" rel=\"noopener noreferrer\">start their application online in English, Spanish or Chinese\u003c/a> using the state’s official site, or by calling (877) 847-3663. You can also apply in person at your county’s designated CalFresh Office.\u003c/p>\n\u003cp>\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-large wp-image-11891175\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/10/CalFreshApplicationWebsite-1020x679.png\" alt=\"Screenshot of the states' application website for CalFresh benefits.\" width=\"640\" height=\"426\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/CalFreshApplicationWebsite-1020x679.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/CalFreshApplicationWebsite-800x533.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/CalFreshApplicationWebsite-160x107.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/10/CalFreshApplicationWebsite.png 1281w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/p>\n\u003cp>\u003cstrong>New CalFresh applicants must:\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>Be 18 years or older to apply for themselves or for their household\u003c/li>\n\u003cli>Meet \u003ca href=\"https://www.cdss.ca.gov/inforesources/cdss-programs/calfresh/eligibility-and-issuance-requirements#income\">federal low-income eligibility rules\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>Remember, public charge rules\u003ca href=\"https://www.cdss.ca.gov/calfreshoutreach/res/4.%20ImmigrationandPublicCharge.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"> do not apply to programs like CalFresh, WIC (California Special Supplemental Nutrition Program for Women, Infants, and Children) and free or reduced-cost lunch programs\u003c/a>, and any immigration information will remain private. The California Department of Social Services ensures that applying for CalFresh will not affect your green card or application for U.S. citizenship.\u003c/p>\n\u003cp>All children born in the U.S. can get CalFresh benefits if they qualify. It does not matter where their parents were born. For details on eligibility requirements for people who immigrated to the U.S., \u003ca href=\"https://www.cdss.ca.gov/inforesources/cdss-programs/calfresh/eligibility-and-issuance-requirements#income\" target=\"_blank\" rel=\"noopener noreferrer\">see the state’s website for complete information\u003c/a>.\u003c/p>\n\u003cp>CalFresh says it should take 10 minutes to apply online. New applicants should receive a call from a county representative for a short interview within a week.\u003c/p>\n\u003cp>As of Sept. 1, the CalFresh application site states that counties are receiving more applications than usual and application processing may be delayed.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Check out more data, including enrollment at the county level, on the \u003ca href=\"https://public.tableau.com/app/profile/california.department.of.social.services/viz/CFdashboard-PUBLIC/Home\">California Department of Social Services’ CalFresh Data Dashboard\u003c/a>.\u003c/em>\u003c/strong>\u003cbr>\n\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003cem>This is an updated version of a post that originally published on Jan. 8, 2021.\u003c/em>\u003c/p>\n\u003cp>When Billy Lemon was trying to kick his methamphetamine addiction, he went to a drug treatment program at the \u003ca href=\"https://www.sfaf.org/programs/stonewall-project/positive-reinforcement-opportunity-project-prop/\">San Francisco AIDS Foundation\u003c/a> three times a week and peed in a cup. If it tested negative for meth, he got paid about $7.\u003c/p>\n\u003cp>“For somebody who had not had any legitimate money — without committing felonies — that seemed like a cool thing,” says Lemon, who was arrested three times for selling meth before starting recovery.\u003c/p>\n\u003cp>The payments were part of an addiction treatment called contingency management, which incentivizes people who use drugs with money or gift cards to stay off drugs. At the end of 12 weeks, after all his drug tests came back negative for meth, Lemon received $330. But for him, it was about more than just the money. It was being told: Good job.\u003c/p>\n\u003cp>“It was the first opportunity where I was like, I have self-worth still. It’s buried. This person sees it and is willing to give me $7, just to take care of myself. That was very motivating,” he says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>As overdoses and public health costs related to meth and cocaine use continue to spiral in California, state officials are desperate for more effective treatment options and are pursuing legislation and appealing to federal regulators to make contingency management more widely available. Washington, Montana and West Virginia also are exploring similar strategies.\u003c/p>\n\u003cp>Studies show that contingency management works. The principles of the treatment — positive reinforcement, primarily — are used widely in weight loss, fitness programs and in families, as parents coax their children into adopting positive behaviors, rather than punishing them for negative ones.\u003c/p>\n\u003cp>Research shows \u003ca href=\"https://storage.googleapis.com/plos-corpus-prod/10.1371/journal.pmed.1002715/1/pmed.1002715.pdf?X-Goog-Algorithm=GOOG4-RSA-SHA256&X-Goog-Credential=wombat-sa%40plos-prod.iam.gserviceaccount.com%2F20210929%2Fauto%2Fstorage%2Fgoog4_request&X-Goog-Date=20210929T232600Z&X-Goog-Expires=86400&X-Goog-SignedHeaders=host&X-Goog-Signature=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\">contingency management is the most effective treatment for meth or cocaine addiction\u003c/a>, especially when combined with other behavioral therapy. At the San Francisco AIDS Foundation, 63% of people who participated in the program in 2019 stopped using meth entirely, and another 19% reduced their use.\u003c/p>\n\u003cfigure id=\"attachment_11890594\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11890594 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/01/rs46611_009_sanfrancisco_billylemon_01142021-qut-1536x1024-2-93d1d0b27c5ab9ae1460333fecf87ea21095e212-s1200-800x600.jpg\" alt=\"A man in sunglasses and a hat stands beneath a Pride flag outside a Victorian with a sign that says Castro Country Club.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/01/rs46611_009_sanfrancisco_billylemon_01142021-qut-1536x1024-2-93d1d0b27c5ab9ae1460333fecf87ea21095e212-s1200-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/01/rs46611_009_sanfrancisco_billylemon_01142021-qut-1536x1024-2-93d1d0b27c5ab9ae1460333fecf87ea21095e212-s1200-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/01/rs46611_009_sanfrancisco_billylemon_01142021-qut-1536x1024-2-93d1d0b27c5ab9ae1460333fecf87ea21095e212-s1200-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/01/rs46611_009_sanfrancisco_billylemon_01142021-qut-1536x1024-2-93d1d0b27c5ab9ae1460333fecf87ea21095e212-s1200.jpg 1200w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Billy Lemon, 50, kicked his meth habit more than nine years ago after taking part in a ‘contingency management’ program for people who use meth and cocaine at the San Francisco AIDS Foundation. For every negative drug test, he earned a small amount of money. Lemon now runs the Castro Country Club, a recovery center in San Francisco. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Department of Veterans Affairs has relied on the therapy to treat 5,600 vets over the last 10 years. Of the 73,000 urine samples collected in the VA program, 92% tested negative for drugs, according to \u003ca href=\"https://blogs.va.gov/VAntage/64870/how-va-uses-contingency-management-help-veterans-stay-drug-free/\">Dominick DePhilippis\u003c/a>, a clinical psychologist at the Philadelphia Center of Excellence for Substance Abuse Treatment and Education who helped launch the VA’s program.\u003c/p>\n\u003cp>“Patients often come to treatment ambivalent about change. Why? Because substance use is so seductive. It provides powerful, immediate reinforcement,” DePhilippis says. “Whereas recovery, its immediate consequences, are often unpleasant: withdrawal symptoms, a clear-eyed view of the devastated landscape that is one’s life.”\u003c/p>\n\u003cp>Contingency management embraces this challenge head on, he adds, by offering immediate rewards and reinforcement for abstinence. The small payments or prizes aim to rewire the brain’s reward system, so the person seeks the money or gift card to get a dopamine release, instead of meth or coke.\u003c/p>\n\u003cp>“You’re like, ‘Oh! Oh! I can feel good without the daily use of that substance. Let me try and go one more week,'” says Lemon. “And then all of a sudden, you’re at 90 days and you’ve actually made a change.”\u003c/p>\n\u003cp>Despite its effectiveness, the treatment is controversial. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3049167/\">Critics have scoffed at the idea of paying people who use drugs not to use drugs\u003c/a>, calling it unethical or a bribe. Most insurers don’t cover it. Neither do state Medicaid programs. The \u003ca href=\"https://www.healthaffairs.org/do/10.1377/hblog20200305.965186/full/\">feds generally forbid them from offering financial incentives to patients\u003c/a>, as a protection against fraud and waste, and state officials have interpreted that rule as prohibiting reimbursement for contingency management.\u003c/p>\n\u003ch3>California will try to scale up an effective treatment for stimulant addiction\u003c/h3>\n\u003cp>But as the drug epidemic continues to worsen throughout California and the nation, with \u003ca href=\"https://www.drugabuse.gov/news-events/news-releases/2021/09/methamphetamine-involved-overdose-deaths-nearly-tripled-between-2015-to-2019-nih-study-finds\">overdoses from stimulants like meth tripling in recent years\u003c/a>, state officials are questioning those policies and pushing for changes. Critics are softening their stance. A bill now on the governor’s desk — \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB110\">Senate Bill 110\u003c/a> — would allow the state’s Medicaid program to pay for contingency management services, with the goal of encouraging more drug treatment centers to offer it.\u003c/p>\n\u003cp>“We need to embrace this proven, effective approach to meth addiction, make it clearly legal and start reimbursing for it, so we can address this health epidemic,” says state Sen. Scott Wiener, D-San Francisco, who sponsored the bill.\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"drug-addiction\"]\u003c/p>\n\u003cp>Wiener says he was surprised to see the bill pass the California Legislature with near unanimous, bipartisan support.\u003c/p>\n\u003cp>“The Republicans love it,” he says. “I didn’t think they would, but they actually like it because there’s an abstinence component to it: We pay you money and you abstain from using.”\u003c/p>\n\u003cp>The state’s Department of Health Care Services, which runs California’s Medicaid program, known as Medi-Cal, also is on board. Department leaders have already asked federal regulators for explicit permission to offer contingency management through a statewide pilot project, and the feds appear poised to grant it.\u003c/p>\n\u003cp>Until quite recently, the federal government has been reluctant to relax rules that bar public health programs from offering contingency management. In 2020, during the Trump administration, treatment experts asked the U.S. Department of Health and Human Services to waive the rules for two years, but \u003ca href=\"https://www.nytimes.com/2020/10/27/health/meth-addiction-treatment.html\">the agency refused\u003c/a>.\u003c/p>\n\u003cp>“It’s clear the [Trump] administration had minimal interest in looking at evidence or science, on a wide variety of topics,” says Laura Thomas, director of harm reduction policy at the San Francisco AIDS Foundation, which helped sponsor the bill.\u003c/p>\n\u003cp>The Biden administration, on the other hand, specifically stated in its \u003ca href=\"https://www.whitehouse.gov/wp-content/uploads/2021/03/BidenHarris-Statement-of-Drug-Policy-Priorities-April-1.pdf\">2021 drug control policy\u003c/a> that one of its main priorities is to “identify and address policy barriers related to contingency management.”\u003c/p>\n\u003ch3>As stimulant overdoses soar, California looks to a proven behavioral intervention\u003c/h3>\n\u003cp>The need is urgent, explains \u003ca href=\"https://www.chcf.org/person/kelly-pfeifer/\">Dr. Kelly Pfeifer\u003c/a>, deputy director of behavioral health at the California Department of Health Care Services. In 2020, \u003ca href=\"https://www.dhcs.ca.gov/services/Documents/CA-Overdose-Increases-2020.pdf\">more Californians died from meth and cocaine overdoses than from fentanyl overdoses\u003c/a>, and stimulant abuse is wreaking havoc on California’s jails and courts, foster care and hospitals.\u003c/p>\n\u003cp>“Which are obviously not only devastating to the person and the family, but very expensive for our health care system,” Pfiefer says.\u003c/p>\n\u003cp>There’s also an increasing sense of hopelessness among people who use stimulants, she adds, because of the lack of effective, available treatments. For opioid addiction, there are now three FDA-approved medication therapies: methadone, buprenorphine and naltrexone. For meth and coke, there are no such medications.\u003c/p>\n\u003cp>Making contingency management more widely available would make more people willing to seek treatment, Pfiefer says.\u003c/p>\n\u003cp>“Because people will see success stories,” she says. “They’ll see friends and family getting treatment and getting help and getting better.”\u003c/p>\n\u003cp>One drawback of contingency management is that the \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/24750232/\">benefits may dwindle once the active treatment ends\u003c/a>. For that reason, some doctors believe the incentive treatment should be delivered continuously, in the same way that medication therapies for opioid use disorder are sometimes prescribed indefinitely. But new research indicates the benefits may last longer than previously thought. In a review of 23 previously published trials, researchers at the University of Connecticut found that people who participated in contingency management were \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/33507776/\">22% more likely to be abstinent six months after treatment ended\u003c/a> than people who received other treatments.\u003c/p>\n\u003cp>For Billy Lemon, contingency management was just what he needed to jumpstart his recovery, and to stay the course in residential rehab. When he cashed out all his incentive payments, he used the $330 to buy himself a new cellphone.\u003c/p>\n\u003cp>“Because up until then, ‘Breaking Bad’-style is burner phones,” he says, referring to the prepaid disposable phones that people who sell drugs use, then discard, to avoid detection by the police. “My number was never the same.”\u003c/p>\n\u003cp>Now, nine years later, \u003ca href=\"https://www.kqed.org/news/11855841/kamala-harris-is-my-fairy-godmother-a-vp-super-fan-says-she-saved-his-life\">he’s still sober\u003c/a> — he runs the Castro Country Club, a recovery space in San Francisco — and the number he got with his new phone is still his number.\u003c/p>\n\u003cp>“It’s a nice reminder of what making good decisions for yourself can turn into,” he says.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story comes from NPR’s health reporting partnership with KQED and Kaiser Health News.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>This is an updated version of a post that originally published on Jan. 8, 2021.\u003c/em>\u003c/p>\n\u003cp>When Billy Lemon was trying to kick his methamphetamine addiction, he went to a drug treatment program at the \u003ca href=\"https://www.sfaf.org/programs/stonewall-project/positive-reinforcement-opportunity-project-prop/\">San Francisco AIDS Foundation\u003c/a> three times a week and peed in a cup. If it tested negative for meth, he got paid about $7.\u003c/p>\n\u003cp>“For somebody who had not had any legitimate money — without committing felonies — that seemed like a cool thing,” says Lemon, who was arrested three times for selling meth before starting recovery.\u003c/p>\n\u003cp>The payments were part of an addiction treatment called contingency management, which incentivizes people who use drugs with money or gift cards to stay off drugs. At the end of 12 weeks, after all his drug tests came back negative for meth, Lemon received $330. But for him, it was about more than just the money. It was being told: Good job.\u003c/p>\n\u003cp>“It was the first opportunity where I was like, I have self-worth still. It’s buried. This person sees it and is willing to give me $7, just to take care of myself. That was very motivating,” he says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>As overdoses and public health costs related to meth and cocaine use continue to spiral in California, state officials are desperate for more effective treatment options and are pursuing legislation and appealing to federal regulators to make contingency management more widely available. Washington, Montana and West Virginia also are exploring similar strategies.\u003c/p>\n\u003cp>Studies show that contingency management works. The principles of the treatment — positive reinforcement, primarily — are used widely in weight loss, fitness programs and in families, as parents coax their children into adopting positive behaviors, rather than punishing them for negative ones.\u003c/p>\n\u003cp>Research shows \u003ca href=\"https://storage.googleapis.com/plos-corpus-prod/10.1371/journal.pmed.1002715/1/pmed.1002715.pdf?X-Goog-Algorithm=GOOG4-RSA-SHA256&X-Goog-Credential=wombat-sa%40plos-prod.iam.gserviceaccount.com%2F20210929%2Fauto%2Fstorage%2Fgoog4_request&X-Goog-Date=20210929T232600Z&X-Goog-Expires=86400&X-Goog-SignedHeaders=host&X-Goog-Signature=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\">contingency management is the most effective treatment for meth or cocaine addiction\u003c/a>, especially when combined with other behavioral therapy. At the San Francisco AIDS Foundation, 63% of people who participated in the program in 2019 stopped using meth entirely, and another 19% reduced their use.\u003c/p>\n\u003cfigure id=\"attachment_11890594\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11890594 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/01/rs46611_009_sanfrancisco_billylemon_01142021-qut-1536x1024-2-93d1d0b27c5ab9ae1460333fecf87ea21095e212-s1200-800x600.jpg\" alt=\"A man in sunglasses and a hat stands beneath a Pride flag outside a Victorian with a sign that says Castro Country Club.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/01/rs46611_009_sanfrancisco_billylemon_01142021-qut-1536x1024-2-93d1d0b27c5ab9ae1460333fecf87ea21095e212-s1200-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/01/rs46611_009_sanfrancisco_billylemon_01142021-qut-1536x1024-2-93d1d0b27c5ab9ae1460333fecf87ea21095e212-s1200-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/01/rs46611_009_sanfrancisco_billylemon_01142021-qut-1536x1024-2-93d1d0b27c5ab9ae1460333fecf87ea21095e212-s1200-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/01/rs46611_009_sanfrancisco_billylemon_01142021-qut-1536x1024-2-93d1d0b27c5ab9ae1460333fecf87ea21095e212-s1200.jpg 1200w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Billy Lemon, 50, kicked his meth habit more than nine years ago after taking part in a ‘contingency management’ program for people who use meth and cocaine at the San Francisco AIDS Foundation. For every negative drug test, he earned a small amount of money. Lemon now runs the Castro Country Club, a recovery center in San Francisco. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Department of Veterans Affairs has relied on the therapy to treat 5,600 vets over the last 10 years. Of the 73,000 urine samples collected in the VA program, 92% tested negative for drugs, according to \u003ca href=\"https://blogs.va.gov/VAntage/64870/how-va-uses-contingency-management-help-veterans-stay-drug-free/\">Dominick DePhilippis\u003c/a>, a clinical psychologist at the Philadelphia Center of Excellence for Substance Abuse Treatment and Education who helped launch the VA’s program.\u003c/p>\n\u003cp>“Patients often come to treatment ambivalent about change. Why? Because substance use is so seductive. It provides powerful, immediate reinforcement,” DePhilippis says. “Whereas recovery, its immediate consequences, are often unpleasant: withdrawal symptoms, a clear-eyed view of the devastated landscape that is one’s life.”\u003c/p>\n\u003cp>Contingency management embraces this challenge head on, he adds, by offering immediate rewards and reinforcement for abstinence. The small payments or prizes aim to rewire the brain’s reward system, so the person seeks the money or gift card to get a dopamine release, instead of meth or coke.\u003c/p>\n\u003cp>“You’re like, ‘Oh! Oh! I can feel good without the daily use of that substance. Let me try and go one more week,'” says Lemon. “And then all of a sudden, you’re at 90 days and you’ve actually made a change.”\u003c/p>\n\u003cp>Despite its effectiveness, the treatment is controversial. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3049167/\">Critics have scoffed at the idea of paying people who use drugs not to use drugs\u003c/a>, calling it unethical or a bribe. Most insurers don’t cover it. Neither do state Medicaid programs. The \u003ca href=\"https://www.healthaffairs.org/do/10.1377/hblog20200305.965186/full/\">feds generally forbid them from offering financial incentives to patients\u003c/a>, as a protection against fraud and waste, and state officials have interpreted that rule as prohibiting reimbursement for contingency management.\u003c/p>\n\u003ch3>California will try to scale up an effective treatment for stimulant addiction\u003c/h3>\n\u003cp>But as the drug epidemic continues to worsen throughout California and the nation, with \u003ca href=\"https://www.drugabuse.gov/news-events/news-releases/2021/09/methamphetamine-involved-overdose-deaths-nearly-tripled-between-2015-to-2019-nih-study-finds\">overdoses from stimulants like meth tripling in recent years\u003c/a>, state officials are questioning those policies and pushing for changes. Critics are softening their stance. A bill now on the governor’s desk — \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB110\">Senate Bill 110\u003c/a> — would allow the state’s Medicaid program to pay for contingency management services, with the goal of encouraging more drug treatment centers to offer it.\u003c/p>\n\u003cp>“We need to embrace this proven, effective approach to meth addiction, make it clearly legal and start reimbursing for it, so we can address this health epidemic,” says state Sen. Scott Wiener, D-San Francisco, who sponsored the bill.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Wiener says he was surprised to see the bill pass the California Legislature with near unanimous, bipartisan support.\u003c/p>\n\u003cp>“The Republicans love it,” he says. “I didn’t think they would, but they actually like it because there’s an abstinence component to it: We pay you money and you abstain from using.”\u003c/p>\n\u003cp>The state’s Department of Health Care Services, which runs California’s Medicaid program, known as Medi-Cal, also is on board. Department leaders have already asked federal regulators for explicit permission to offer contingency management through a statewide pilot project, and the feds appear poised to grant it.\u003c/p>\n\u003cp>Until quite recently, the federal government has been reluctant to relax rules that bar public health programs from offering contingency management. In 2020, during the Trump administration, treatment experts asked the U.S. Department of Health and Human Services to waive the rules for two years, but \u003ca href=\"https://www.nytimes.com/2020/10/27/health/meth-addiction-treatment.html\">the agency refused\u003c/a>.\u003c/p>\n\u003cp>“It’s clear the [Trump] administration had minimal interest in looking at evidence or science, on a wide variety of topics,” says Laura Thomas, director of harm reduction policy at the San Francisco AIDS Foundation, which helped sponsor the bill.\u003c/p>\n\u003cp>The Biden administration, on the other hand, specifically stated in its \u003ca href=\"https://www.whitehouse.gov/wp-content/uploads/2021/03/BidenHarris-Statement-of-Drug-Policy-Priorities-April-1.pdf\">2021 drug control policy\u003c/a> that one of its main priorities is to “identify and address policy barriers related to contingency management.”\u003c/p>\n\u003ch3>As stimulant overdoses soar, California looks to a proven behavioral intervention\u003c/h3>\n\u003cp>The need is urgent, explains \u003ca href=\"https://www.chcf.org/person/kelly-pfeifer/\">Dr. Kelly Pfeifer\u003c/a>, deputy director of behavioral health at the California Department of Health Care Services. In 2020, \u003ca href=\"https://www.dhcs.ca.gov/services/Documents/CA-Overdose-Increases-2020.pdf\">more Californians died from meth and cocaine overdoses than from fentanyl overdoses\u003c/a>, and stimulant abuse is wreaking havoc on California’s jails and courts, foster care and hospitals.\u003c/p>\n\u003cp>“Which are obviously not only devastating to the person and the family, but very expensive for our health care system,” Pfiefer says.\u003c/p>\n\u003cp>There’s also an increasing sense of hopelessness among people who use stimulants, she adds, because of the lack of effective, available treatments. For opioid addiction, there are now three FDA-approved medication therapies: methadone, buprenorphine and naltrexone. For meth and coke, there are no such medications.\u003c/p>\n\u003cp>Making contingency management more widely available would make more people willing to seek treatment, Pfiefer says.\u003c/p>\n\u003cp>“Because people will see success stories,” she says. “They’ll see friends and family getting treatment and getting help and getting better.”\u003c/p>\n\u003cp>One drawback of contingency management is that the \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/24750232/\">benefits may dwindle once the active treatment ends\u003c/a>. For that reason, some doctors believe the incentive treatment should be delivered continuously, in the same way that medication therapies for opioid use disorder are sometimes prescribed indefinitely. But new research indicates the benefits may last longer than previously thought. In a review of 23 previously published trials, researchers at the University of Connecticut found that people who participated in contingency management were \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/33507776/\">22% more likely to be abstinent six months after treatment ended\u003c/a> than people who received other treatments.\u003c/p>\n\u003cp>For Billy Lemon, contingency management was just what he needed to jumpstart his recovery, and to stay the course in residential rehab. When he cashed out all his incentive payments, he used the $330 to buy himself a new cellphone.\u003c/p>\n\u003cp>“Because up until then, ‘Breaking Bad’-style is burner phones,” he says, referring to the prepaid disposable phones that people who sell drugs use, then discard, to avoid detection by the police. “My number was never the same.”\u003c/p>\n\u003cp>Now, nine years later, \u003ca href=\"https://www.kqed.org/news/11855841/kamala-harris-is-my-fairy-godmother-a-vp-super-fan-says-she-saved-his-life\">he’s still sober\u003c/a> — he runs the Castro Country Club, a recovery space in San Francisco — and the number he got with his new phone is still his number.\u003c/p>\n\u003cp>“It’s a nice reminder of what making good decisions for yourself can turn into,” he says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story comes from NPR’s health reporting partnership with KQED and Kaiser Health News.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "dangerous-air-as-california-burns-america-breathes-toxic-smoke",
"title": "Dangerous Air: As California Burns, America Breathes Toxic Smoke",
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"headTitle": "Dangerous Air: As California Burns, America Breathes Toxic Smoke | KQED",
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"content": "\u003cp>\u003cem>This story was written and produced by Alison Saldanha, Farida Jhabvala Romero, Caleigh Wells and Aaron Glantz.\u003c/em>\u003c/p>\n\u003cp>Western wildfires pose a much broader threat to human health than to just those forced to evacuate the path of the blazes.\u003c/p>\n\u003cp>Smoke from these fires, which have burned millions of acres in California alone, is choking vast swaths of the country, an analysis of federal satellite imagery by NPR’s California Newsroom and Stanford University’s \u003ca href=\"https://www.stanfordecholab.com/\">Environmental Change and Human Outcomes Lab \u003c/a>found.\u003c/p>\n\u003cp>The monthslong analysis, based on more than 10 years of data collected by the National Oceanic and Atmospheric Administration, and analyzed down to the ZIP code level, reveals a startling increase in the number of days residents are breathing smoke across California and the Pacific Northwest, to Denver and Salt Lake City in the Rocky Mountains and rural Kentucky and West Virginia in Appalachia.\u003c/p>\n\u003cp>When looking at major U.S. cities, the analysis found the starkest increase in San Jose, California, where smoke days were up more than 400%. San Jose residents breathed smoke 45 days a year on average between 2016 and 2020. In Los Angeles and San Diego, the number of days with wildfire smoke increased 230% to 32 days a year in Los Angeles and 23 days in San Diego. Even the East Coast was not immune as prevailing winds carried smoke plumes from the Western United States and Canada thousands of miles away. In Philadelphia and Washington, D.C., our analysis found the number of days residents breathed wildfire smoke increased approximately 40% to over 20 days of smoke on average in a year.\u003c/p>\n\u003cdiv style=\"width: 100%;\">\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://projects.capradio.org/us-wildfire-smoke-exposure/\" style=\"border: 0px #ffffff none;\" name=\"myiFrame\" scrolling=\"no\" frameborder=\"1\" marginheight=\"0px\" marginwidth=\"0px\" height=\"650px\" width=\"1200\" class=\"iframe-class\">\u003c/iframe>\n\u003c/div>\n\u003cp> \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Literally no amount of exposure is safe,” said Marshall Burke, an associate professor of earth system science who led the project for Stanford University. Emerging research shows wildfire smoke exposure not only \u003ca href=\"https://www.epa.gov/pm-pollution/how-smoke-fires-can-affect-your-health\">negatively impact\u003c/a>s the heart and lungs but also the brain. Smoke exposure also poses pregnancy risks. Children and older people are most vulnerable. “There’s no magic threshold under which we’re OK and beyond which we’re in trouble. The lesson is that any amount is bad. And the more you get the worse it is.”\u003c/p>\n\u003cp>Experts say the scale of smoke inundation requires dramatic steps to curb the risk of wildfire and mitigate the impacts of climate change. But investigations from NPR’s California Newsroom have found the state and federal government have not done enough to manage forests, including using prescribed burns. Both have performed mitigation work on far fewer acres than promised to address the state’s wildfire crisis.\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/5.-major-cities.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-11890259 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/5.-major-cities.png\" alt=\"\" width=\"1240\" height=\"1274\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/5.-major-cities.png 1240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/5.-major-cities-800x822.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/5.-major-cities-1020x1048.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/5.-major-cities-160x164.png 160w\" sizes=\"(max-width: 1240px) 100vw, 1240px\">\u003c/a>The deluge of smoke was particularly acute in California, where people in some fire-prone areas are exposed to smoke an average of three months a year. An analysis of state hospitalization records by NPR’s California Newsroom found 30,000 additional admissions for respiratory and cardiac conditions in 2018, at the time a record fire year, compared to two years before.\u003c/p>\n\u003cp>Federally funded prescriptions for the asthma medication albuterol also spiked in the state, with 240,000 more claims for the drug in California in 2018 than 2013, according to an analysis of data provided by the Centers for Medicare & Medicaid Services. The annual cost to taxpayers for the extra albuterol: $34 million.\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/6.-Albuterol.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-11890242\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/6.-Albuterol.png\" alt=\"\" width=\"1240\" height=\"640\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/6.-Albuterol.png 1240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/6.-Albuterol-800x413.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/6.-Albuterol-1020x526.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/6.-Albuterol-160x83.png 160w\" sizes=\"(max-width: 1240px) 100vw, 1240px\">\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Living with smoke\u003c/strong>\u003c/p>\n\u003cp>Residents of the most smoke-stricken areas told us the relentless poor air quality had diminished their health and quality of life.\u003c/p>\n\u003cp>“We’re exhausted from having to go through so many years of smoke,” said 61-year-old Tim Pedrozo, a third-generation dairy farmer in Orland, a small Northern California town of 7,800 that’s famous for breeding queen honey bees.\u003c/p>\n\u003cp>Pedrozo is worried about his lungs. He suffers from dull headaches when smoke is in the air. “It’s just getting harder and harder to want to stay here,” he said.\u003c/p>\n\u003cfigure id=\"attachment_11890244\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/IMG_2226-Pedrozo-scaled-e1632861834817.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11890244\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/IMG_2226-Pedrozo-scaled-e1632861834817.jpg\" alt=\"A man stands on a field with cows.\" width=\"1920\" height=\"1280\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dairy farmer Tim Pedrozo, 61, stands on one of the pastures at his 20-acre dairy farm in Orland, California, on Sept. 3, 2021. Persistent wildfire smoke “is one of the main reasons” he and his wife are considering moving out of state, he said. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Our analysis found Orland residents breathed smoke an average of 82 days a year between 2016 and 2020. Last year, when more acres burned than any in California’s modern history, smoke filled the air for nearly four months.\u003c/p>\n\u003cp>Beyond his health, Pedrozo said his business has taken a hit. The farmer with glasses and a gray beard said he has tasted a smoky taint in the traditional aged cheese he produces. The persistent smoke keeps customers away from outdoor farmers markets, where he sells his cheese rounds.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Listen to part 2 of the radio story:\u003c/em>\u003c/strong>\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://omny.fm/shows/kqed-segmented-audio/californias-smoky-unhealthy-air-causing-problems-f/embed?style=cover\" frameborder=\"0\" width=\"100%\" height=\"180\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>Pedrozo’s cows, which graze on the 20-acre farm year-round, have also gotten sick. Last year, they suffered an outbreak of pink eye infections, he said, which Pedrozo attributes to a combination of smoke and dust. One cow lost an eye. Scientific research has \u003ca href=\"https://extension.sdstate.edu/wildfire-aftermath-beef-cattle-health-considerations\">linked\u003c/a> wildfire smoke to both pink eye and permanent blindness in livestock.\u003c/p>\n\u003cp>“I don’t want to stick around and get worse,” he said. So he is planning to sell his farm of 22 years and move with his wife to Missouri, where their son has already relocated.\u003c/p>\n\u003cfigure id=\"attachment_11890246\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/IMG_4106-Pedrozo-scaled-e1632861923734.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11890246\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/IMG_4106-Pedrozo-scaled-e1632861923734.jpg\" alt=\"\" width=\"1920\" height=\"1440\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Tim Pedrozo checks on one of his cows at the farm he has owned for 22 years in Orland, California. The third-generation dairy farmer said poor air quality, in large part due to wildfire smoke, is a “main reason” he and his wife are considering moving out of state. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But the analysis by NPR’s California Newsroom and Stanford University found that even if worried Californians like Pedrozo flee the state, it will be hard to escape the smoke.\u003c/p>\n\u003cp>“The impacts of wildfire smoke could be one of the largest climate-related impacts across the Western U.S. And as we’re seeing increasingly, it’s not just limited to the Western U.S.,” Burke said.\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"wildfire-smoke\"]Burke’s lab used advanced computer modeling to examine the presence of smoke plumes overhead every day, in every community, from Hawaii to Florida. Reporters from the California Newsroom then compared the average annual number of days with smoke in the air between 2009 to 2013, when extremely destructive wildfires were less common, with the smoke days occurring between 2016 to 2020, when hotter, drier conditions fueled by climate change sparked record fire years.\u003c/p>\n\u003cp>How far smoke can move through the air depends on the intensity of the fire and weather conditions. But the satellite images reviewed by NPR’s California Newsroom and Burke’s lab at Stanford show that as winds carry wildfire smoke plumes from the West and central Canada across the continent, they spread farther and higher. \u003ca href=\"https://earthobservatory.nasa.gov/images/148610/smoke-across-north-america\">According to NASA, these smoke plumes\u003c/a> often go unnoticed, providing the illusion of cleaner air even as they inundate parts of the East Coast and the Midwest, including Missouri where Pedrozo wants to move.\u003c/p>\n\u003cp>Our analysis found the Midwest experienced a slight drop in the number of days with smoke overhead since 2009. But Burke’s modeling of the satellite imagery shows the smoke there is now thicker, suggesting “wildfires are also worsening overall air quality in the Midwest, just as they are in the West.”\u003c/p>\n\u003cp>“This is no longer just a West Coast story. This is a U.S.-wide story,” he said.\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/1.-US-before.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-11890248\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/1.-US-before.png\" alt=\"\" width=\"1240\" height=\"1088\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/1.-US-before.png 1240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/1.-US-before-800x702.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/1.-US-before-1020x895.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/1.-US-before-160x140.png 160w\" sizes=\"(max-width: 1240px) 100vw, 1240px\">\u003c/a>\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/2.-US-after.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-11890249\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/2.-US-after.png\" alt=\"\" width=\"1240\" height=\"1088\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/2.-US-after.png 1240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/2.-US-after-800x702.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/2.-US-after-1020x895.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/2.-US-after-160x140.png 160w\" sizes=\"(max-width: 1240px) 100vw, 1240px\">\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>The kids are not alright\u003c/strong>\u003c/p>\n\u003cp>Our analysis found the smokiest place in the West was Willows, California, a small town about 80 miles north of Sacramento. Last year, the August Complex Fire, then the largest in modern California history, burned more than 1 million acres, or more than 1,500 square miles, to its west in Mendocino National Forest. Two years earlier, the Camp Fire destroyed the Butte County town of Paradise, a 45-minute drive to the east, killing 85 people.\u003c/p>\n\u003cp>On the Friday in September we visited, a thick haze covered nearby mountains, but the sky had cleared up and the air quality was better than it had been earlier in the week. Cheerleaders for the local high school shook their gold and purple pompoms for a junior varsity football game as hundreds of students and parents caught up with each other in between bites of steak sandwiches and cotton candy.\u003c/p>\n\u003cp>For Willows High School Athletic Director Greg Kitchen, the day’s relatively clean air was a huge relief.\u003c/p>\n\u003cp>“I feel like I can breathe easy for a change. It’s nice,” said Kitchen as he watched the game from the sidelines. “It seems like the last five years or so air quality has just been something that we constantly have to monitor.”\u003c/p>\n\u003cp>Already this school year, Kitchen and other school administrators in the region have canceled outdoor sports practices and recess because of decidedly unhealthy air in order to protect students’ health.\u003c/p>\n\u003cfigure id=\"attachment_11890251\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/IMG_2282-Players-scaled-e1632862082813.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11890251\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/IMG_2282-Players-scaled-e1632862082813.jpg\" alt=\"\" width=\"1920\" height=\"1280\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Willows High School football players and coaches stand for the national anthem before the start of a game on Sept. 3, 2021 in Willows, California. But unhealthy air quality has led school administrators to cancel sports practices, recess and other outdoor activities to protect students’ health. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Stacy Lanzi, a third grade teacher at Murdock Elementary School, said she sees her students and her own two teen sons struggle with runny noses, tiredness and itchy eyes during days with haze or thick smoke.\u003c/p>\n\u003cp>“Kids will say, ‘I have a headache, I have a headache.’ You hear it all the time,” said Lanzi, who was born and raised in Willows. “And I’ll say, ‘Well, did you drink some water? Drink some more.’ There’s not too many alternatives, you know?”\u003c/p>\n\u003cp>Our analysis found Willows averaged 91 days of wildfire smoke a year on average between 2016 and 2020. Last year, smoke plumes inundated Willows for 122 days, or four out of twelve months.\u003c/p>\n\u003cfigure id=\"attachment_11890252\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/IMG_2223-Brett-Brown-scaled-e1632862178793.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11890252\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/IMG_2223-Brett-Brown-scaled-e1632862178793.jpg\" alt=\"Man in white lab coat with stethoscope around his neck.\" width=\"1920\" height=\"1280\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Physician Assistant Brett Brown stands at Glenn Medical Center, a small hospital in Willows, Calif on Sept. 2, 2021. Brown said he regularly treats patients who suffer from more asthma attacks, migraines and stress during smoke periods. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Without fail, there’s always somebody who says something about, ‘Well, because of the smoke’ insert problem here,” said 27-year-old Brett Brown, a physician’s assistant who regularly treats patients at Glenn Medical Center, the small hospital in Willows. “Whether it’s ‘I haven’t been exercising, so my diabetes is a little bit worse.’ Or ‘I haven’t been able to breathe as well because my allergies are so bad.’”\u003c/p>\n\u003cp>Brown, who suffers from asthma himself, said he has experienced firsthand how smoke can exacerbate his symptoms. Last year, he said, asthma flare-ups lengthened a case of bronchitis he developed.\u003c/p>\n\u003cp>\u003cstrong>The smoky reality of climate change\u003c/strong>\u003c/p>\n\u003cp>Climate change is at the root of this new reality, with rising temperatures and scant precipitation contributing to conditions that lead fires that burn hotter, faster and more frequently than ever before. Eight of the 10 largest fires in California history \u003ca href=\"https://www.fire.ca.gov/media/4jandlhh/top20_acres.pdf\">sparked\u003c/a> since 2017.\u003c/p>\n\u003cp>Last year was the most active wildfire season in the state’s modern history. More than \u003ca href=\"https://www.fire.ca.gov/incidents/2020/\">4 million acres \u003c/a>burned, nearly 10,500 structures were damaged or destroyed and 33 people died. This year could be even more destructive. \u003ca href=\"https://droughtmonitor.unl.edu/CurrentMap/StateDroughtMonitor.aspx?CA\">Most of \u003c/a>California is in “extreme drought” or “exceptional drought,” which means there is an abundance of dry vegetation ready to catch fire.[pullquote align=\"right\" size=\"medium\" citation=\"Char Miller, director of environmental analysis at Pomona College\"]‘What we’ve got at the state and federal level is a reactive policy — we’re going to respond to the fires. God that’s problematic, because it means you never get ahead of the curve.’[/pullquote]But experts say there are steps government officials and individuals can take to better respond to the growing risk.\u003c/p>\n\u003cp>Decades of poor forest management have led to a dangerous buildup of undergrowth in California’s forests, providing the fuel for recent major blazes. Fire scientists say the state and federal government both need to significantly scale up their efforts to help reduce the potential of devastating wildfires.\u003c/p>\n\u003cp>“What we’ve got at the state and federal level is a reactive policy — we’re going to respond to the fires,” said Char Miller, director of environmental analysis at Pomona College. “God that’s problematic, because it means you never get ahead of the curve.”\u003c/p>\n\u003cp>Last August, California Gov. Gavin Newsom \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2020/08/8.12.20-CA-Shared-Stewardship-MOU.pdf\">announced\u003c/a> an agreement with the U.S. Forest Service that promised each would perform fire prevention work on 500,000 acres annually here by 2025. Today, however, the Forest Service remains far short of that goal. The agency told us they’d completed about 120,000 acres of treatment in California during the fiscal year ending Sept. 30. As for the state, Cal Fire was unable to detail its progress, even after multiple email requests.\u003c/p>\n\u003cp>Prescribed burns are another potential path forward in California. In much of the Southeastern United States, where academic research shows prescribed burns are f\u003ca href=\"https://www.mdpi.com/2571-6255/2/2/30/htm?dom=prime&src=syn\">ar more common\u003c/a>, our investigation shows a substantial decline in wildfire smoke over the past decade.\u003c/p>\n\u003cp>Fire is a natural part of the ecosystem; without it, wildlands become overgrown with brush and small trees. That causes destructive conflagrations to replace the natural, low-intensity fires that serve as an ecological reset. Many state lawmakers support their broader use, and in recent weeks the California legislature has passed bills that would \u003ca href=\"https://www.capradio.org/articles/2021/09/16/prescribed-burns-could-help-reduce-californias-wildfires-a-new-bill-could-help-make-planned-fires-more-frequent/\">change liability laws\u003c/a> and \u003ca href=\"https://sd03.senate.ca.gov/news/20210910-sen-dodd-lauds-passage-controlled-burn-insurance-fund\">create a $20 million insurance liability fund\u003c/a>.\u003c/p>\n\u003cp>“We have to get people to understand that they may have to get exposed to a little smoke from prescribed burns to prevent catastrophic fires,” said John Balmes, a pulmonologist and professor at UCSF who serves on the California Air Resources Board.\u003c/p>\n\u003cp>Meanwhile, Pacific Gas and Electric — the state’s largest utility — continues to face scrutiny over its role in sparking wildfires. Earlier this year, the California Public Utilities Commission placed the company under “\u003ca href=\"https://www.cpuc.ca.gov/industries-and-topics/pge/pge-oversight-and-enforcement\">enhanced oversight\u003c/a>” for failing to prioritize vegetation clearing around its most high-risk power lines. The company, which a federal judge \u003ca href=\"https://www.kqed.org/news/11873113/help-us-investigate-pges-power-lines\">called\u003c/a> “a terror — T-E-R-R-O-R to the people of California,” last year pleaded guilty to 84 counts of involuntary manslaughter in connection with the 2018 Camp Fire. In July, the utility \u003ca href=\"https://www.capradio.org/articles/2021/07/19/dixie-fire-may-be-linked-to-pge-equipment-utility-says/\">told\u003c/a> the CPUC that a fallen branch may have started this year’s Dixie Fire, which has burned more than 960,000 acres, or 1,500 square miles, to date.\u003c/p>\n\u003cp>There are also changes individuals can make to reduce the health impacts of wildfire smoke, including installing indoor air filtration systems. “There are good data to show that these kinds of efforts can make a difference in protecting homes and saving lives,” said Balmes. But these devices can be costly. Balmes recommends the government do more to provide low-cost or free air filters. “But all this requires investment.”\u003c/p>\n\u003cp>\u003cstrong>Erasing progress on air pollution\u003c/strong>\u003c/p>\n\u003cp>The sharp rise in wildfire smoke is reversing decades of hard-won gains in air quality improvement made as a result of environmental legislation like the Clean Air Act, Burke said. “We had actually been having a lot of success in cleaning up our air,” he added, but the rapid rise in smoke is “threatening to undo decades of improvement and undoing them very quickly.”\u003c/p>\n\u003cp>One dangerous pollutant in wildfire smoke is PM2.5, tiny bits of airborne ash that are 30 times smaller than the width of a single strand of human hair. This particulate matter can be inhaled deep into the lungs, and even enter the bloodstream. The Environmental Protection Agency says they pose “the \u003ca href=\"https://www3.epa.gov/region1/airquality/pm-human-health.html\">greatest health risk\u003c/a>,” even causing premature death.\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/8.-West-PM2.5.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-11890253\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/8.-West-PM2.5.png\" alt=\"\" width=\"1240\" height=\"840\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/8.-West-PM2.5.png 1240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/8.-West-PM2.5-800x542.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/8.-West-PM2.5-1020x691.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/8.-West-PM2.5-160x108.png 160w\" sizes=\"(max-width: 1240px) 100vw, 1240px\">\u003c/a>\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/7.-Northwest-PM2.5.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-11890254\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/7.-Northwest-PM2.5.png\" alt=\"\" width=\"1240\" height=\"840\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/7.-Northwest-PM2.5.png 1240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/7.-Northwest-PM2.5-800x542.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/7.-Northwest-PM2.5-1020x691.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/7.-Northwest-PM2.5-160x108.png 160w\" sizes=\"(max-width: 1240px) 100vw, 1240px\">\u003c/a>\u003c/p>\n\u003cp>These tiny particles in wildfire smoke are known to aggravate heart and lung diseases, like cardiac arrhythmias, heart attacks, bronchitis and asthma, with young children and older people especially vulnerable to its harmful effects. Researchers have also linked wildfire smoke to thousands of \u003ca href=\"https://www.kqed.org/news/11884731/poor-air-quality-from-wildfire-smoke-worsens-covid-19-cases-deaths-study-finds\">excess COVID-19 deaths\u003c/a> and are now exploring the links between exposure to wildfire smoke and strokes, pregnancy risks like \u003ca href=\"https://www.sciencedirect.com/science/article/abs/pii/S001393512101166X?via%3Dihub\">preterm births\u003c/a> and neurological disorders such as strokes and \u003ca href=\"https://sanfrancisco.cbslocal.com/2020/11/30/ucsf-study-reveals-link-between-wildfire-smoke-and-alzheimers-disease/\">Alzheimer’s\u003c/a> disease.\u003c/p>\n\u003cp>Smoke plumes may blanket an entire region, impacting every resident irrespective of their income, but limited research suggests the health risks fall disproportionately on older people, and especially poorer people, who are more often than not from Black, brown and indigenous communities.\u003c/p>\n\u003cp>People of color who live in low-income communities often have “increased vulnerability to the effects of air pollution,” Balmes said. “They often have other stressors that contribute to ill health, like a lack of diet filled with fresh vegetables and fruits, which is actually protective in terms of the health effects of air pollution, and just their housing stock, which is often older, may be less protective as the bad outdoor air from wildfires penetrates more easily.”\u003c/p>\n\u003cp>Our analysis focused on the presence of smoke plumes in the air, rather than PM2.5 particles, because the network of EPA air quality sensors varies widely. Many urban communities lack monitors. So do rural areas, often those areas closest to the wildfires. And the sensors that are in place don’t report on all days. But \u003ca href=\"https://www.epa.gov/wildfire-smoke-course/why-wildfire-smoke-health-concern\">EPA scientists say\u003c/a> the presence of smoke plumes from wildfires tracks closely with the presence of fine particulates.\u003c/p>\n\u003cp>Between 2000 and 2010, the annual average PM 2.5 concentration levels in California and Nevada declined 35%, according to an analysis of EPA data by NPR’s California Newsroom. By 2020, however, almost all those gains had been erased, with particulate levels nearly as high as they were two decades earlier. In the Pacific Northwest, PM2.5 levels last year surged higher than they were at the beginning of the century, thanks largely to an increase in wildfire smoke.\u003c/p>\n\u003cp>Indeed, with other sources of PM2.5, such as auto exhaust, in decline because of better emission standards, wildfire smoke represents an increasing share of particulates people are breathing. Burke’s team \u003ca href=\"https://www.pnas.org/content/pnas/118/2/e2011048118.full.pdf\">found\u003c/a> that in the West, wildfire PM2.5 now accounts for up to half of all PM2.5 exposure, compared to less than 20% a decade ago.\u003c/p>\n\u003cp>These tiny particles aren’t the only pollutants to worry about. When the Camp Fire incinerated the town of Paradise in 2018, it destroyed nearly 19,000 buildings, including gas stations, two grocery stores, eight schools and a hotel. Everything inside those buildings went up in smoke — from paint thinner and Drano to plastics, oil and pesticides. A \u003ca href=\"https://ww2.arb.ca.gov/sites/default/files/2021-07/Camp_Fire_report_July2021.pdf\">report\u003c/a> on the Camp Fire released this July by the California Air Resources Board found toxic metals, including lead, traveled more than 150 miles and were picked up in air monitoring stations in Silicon Valley.\u003c/p>\n\u003cp>\u003cstrong>Stuck inside, alone\u003c/strong>\u003c/p>\n\u003cp>Brown, one of a handful of medical staffers at the family care clinic in Willows, says all the smoke days are affecting his patients’ mental health. The recommendation that people stay indoors on bad air quality days intensifies feelings of isolation during the pandemic.\u003c/p>\n\u003cp>“Say you are quarantined and then all of a sudden you can’t even go in your own backyard without getting a major headache or having an asthma attack or worried that your kid is going to have \u003ca href=\"https://www.nature.com/articles/s41370-020-00267-4\">long-term problems\u003c/a> because of \u003ca href=\"https://pediatrics.aappublications.org/content/147/4/e2020027128\">wildfire smoke\u003c/a>,” he said.\u003c/p>\n\u003cfigure id=\"attachment_11890255\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/IMG_2200-Larry-George-scaled-e1632862358321.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11890255\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/IMG_2200-Larry-George-scaled-e1632862358321.jpg\" alt=\"A man at his home pointing to animal-shaped cookie jars on a shelf.\" width=\"1920\" height=\"1280\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Larry George, 74, points to his late wife’s collection of cookie jars at the house he rents in Willows, California, on Sept. 2, 2021. The retired truck driver, who suffers from a chronic lung condition, said he must stay inside on smoky days to protect his health. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>That isolation has been getting to Larry George, who lives alone a block away from the hospital in a gray, two-bedroom house. The 74-year-old Vietnam veteran and retired truck driver suffers from chronic obstructive pulmonary disease, or COPD. On hazy days, George almost never leaves his home.\u003c/p>\n\u003cp>When he has to go to the doctor’s office or grocery store, even walking a few steps to his white pickup truck is difficult.\u003c/p>\n\u003cp>“It just feels like you’re not allowed to go out,” he said, wheezing in his living room, where he keeps an oxygen machine and a large TV screen tuned to Fox News. “You don’t have the freedom you had before.”\u003c/p>\n\u003cp>Like Pedrozo, he is thinking of moving to someplace with cleaner air.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://modules.wearehearken.com/kcrw/embed/8715/share\" width=\"800\" height=\"530\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>\u003cem>Alison Saldanha is a data journalist who led this investigation for NPR’s California Newsroom, where Aaron Glantz is senior investigations editor. Farida Jhabvala Romero is a reporter for KQED in San Francisco. Caleigh Wells is a reporter and producer at KCRW in Los Angeles. \u003c/em>\u003c/p>\n\u003cp>\u003cem>George LeVines and Molly Peterson from the California Newsroom contributed reporting. Glantz edited this story together with the newsroom’s managing editor, Adriene Hill. The story was copy edited by Don Clyde. Scott Rodd, state government reporter at CapRadio in Sacramento, also contributed reporting along with Lily Jamali from KQED.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>The California Newsroom is a collaboration of NPR and 17 public radio stations across the state, from San Diego to the Oregon border.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>This story was written and produced by Alison Saldanha, Farida Jhabvala Romero, Caleigh Wells and Aaron Glantz.\u003c/em>\u003c/p>\n\u003cp>Western wildfires pose a much broader threat to human health than to just those forced to evacuate the path of the blazes.\u003c/p>\n\u003cp>Smoke from these fires, which have burned millions of acres in California alone, is choking vast swaths of the country, an analysis of federal satellite imagery by NPR’s California Newsroom and Stanford University’s \u003ca href=\"https://www.stanfordecholab.com/\">Environmental Change and Human Outcomes Lab \u003c/a>found.\u003c/p>\n\u003cp>The monthslong analysis, based on more than 10 years of data collected by the National Oceanic and Atmospheric Administration, and analyzed down to the ZIP code level, reveals a startling increase in the number of days residents are breathing smoke across California and the Pacific Northwest, to Denver and Salt Lake City in the Rocky Mountains and rural Kentucky and West Virginia in Appalachia.\u003c/p>\n\u003cp>When looking at major U.S. cities, the analysis found the starkest increase in San Jose, California, where smoke days were up more than 400%. San Jose residents breathed smoke 45 days a year on average between 2016 and 2020. In Los Angeles and San Diego, the number of days with wildfire smoke increased 230% to 32 days a year in Los Angeles and 23 days in San Diego. Even the East Coast was not immune as prevailing winds carried smoke plumes from the Western United States and Canada thousands of miles away. In Philadelphia and Washington, D.C., our analysis found the number of days residents breathed wildfire smoke increased approximately 40% to over 20 days of smoke on average in a year.\u003c/p>\n\u003cdiv style=\"width: 100%;\">\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://projects.capradio.org/us-wildfire-smoke-exposure/\" style=\"border: 0px #ffffff none;\" name=\"myiFrame\" scrolling=\"no\" frameborder=\"1\" marginheight=\"0px\" marginwidth=\"0px\" height=\"650px\" width=\"1200\" class=\"iframe-class\">\u003c/iframe>\n\u003c/div>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Literally no amount of exposure is safe,” said Marshall Burke, an associate professor of earth system science who led the project for Stanford University. Emerging research shows wildfire smoke exposure not only \u003ca href=\"https://www.epa.gov/pm-pollution/how-smoke-fires-can-affect-your-health\">negatively impact\u003c/a>s the heart and lungs but also the brain. Smoke exposure also poses pregnancy risks. Children and older people are most vulnerable. “There’s no magic threshold under which we’re OK and beyond which we’re in trouble. The lesson is that any amount is bad. And the more you get the worse it is.”\u003c/p>\n\u003cp>Experts say the scale of smoke inundation requires dramatic steps to curb the risk of wildfire and mitigate the impacts of climate change. But investigations from NPR’s California Newsroom have found the state and federal government have not done enough to manage forests, including using prescribed burns. Both have performed mitigation work on far fewer acres than promised to address the state’s wildfire crisis.\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/5.-major-cities.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-11890259 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/5.-major-cities.png\" alt=\"\" width=\"1240\" height=\"1274\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/5.-major-cities.png 1240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/5.-major-cities-800x822.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/5.-major-cities-1020x1048.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/5.-major-cities-160x164.png 160w\" sizes=\"(max-width: 1240px) 100vw, 1240px\">\u003c/a>The deluge of smoke was particularly acute in California, where people in some fire-prone areas are exposed to smoke an average of three months a year. An analysis of state hospitalization records by NPR’s California Newsroom found 30,000 additional admissions for respiratory and cardiac conditions in 2018, at the time a record fire year, compared to two years before.\u003c/p>\n\u003cp>Federally funded prescriptions for the asthma medication albuterol also spiked in the state, with 240,000 more claims for the drug in California in 2018 than 2013, according to an analysis of data provided by the Centers for Medicare & Medicaid Services. The annual cost to taxpayers for the extra albuterol: $34 million.\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/6.-Albuterol.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-11890242\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/6.-Albuterol.png\" alt=\"\" width=\"1240\" height=\"640\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/6.-Albuterol.png 1240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/6.-Albuterol-800x413.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/6.-Albuterol-1020x526.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/6.-Albuterol-160x83.png 160w\" sizes=\"(max-width: 1240px) 100vw, 1240px\">\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Living with smoke\u003c/strong>\u003c/p>\n\u003cp>Residents of the most smoke-stricken areas told us the relentless poor air quality had diminished their health and quality of life.\u003c/p>\n\u003cp>“We’re exhausted from having to go through so many years of smoke,” said 61-year-old Tim Pedrozo, a third-generation dairy farmer in Orland, a small Northern California town of 7,800 that’s famous for breeding queen honey bees.\u003c/p>\n\u003cp>Pedrozo is worried about his lungs. He suffers from dull headaches when smoke is in the air. “It’s just getting harder and harder to want to stay here,” he said.\u003c/p>\n\u003cfigure id=\"attachment_11890244\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/IMG_2226-Pedrozo-scaled-e1632861834817.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11890244\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/IMG_2226-Pedrozo-scaled-e1632861834817.jpg\" alt=\"A man stands on a field with cows.\" width=\"1920\" height=\"1280\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dairy farmer Tim Pedrozo, 61, stands on one of the pastures at his 20-acre dairy farm in Orland, California, on Sept. 3, 2021. Persistent wildfire smoke “is one of the main reasons” he and his wife are considering moving out of state, he said. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Our analysis found Orland residents breathed smoke an average of 82 days a year between 2016 and 2020. Last year, when more acres burned than any in California’s modern history, smoke filled the air for nearly four months.\u003c/p>\n\u003cp>Beyond his health, Pedrozo said his business has taken a hit. The farmer with glasses and a gray beard said he has tasted a smoky taint in the traditional aged cheese he produces. The persistent smoke keeps customers away from outdoor farmers markets, where he sells his cheese rounds.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Listen to part 2 of the radio story:\u003c/em>\u003c/strong>\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://omny.fm/shows/kqed-segmented-audio/californias-smoky-unhealthy-air-causing-problems-f/embed?style=cover\" frameborder=\"0\" width=\"100%\" height=\"180\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>Pedrozo’s cows, which graze on the 20-acre farm year-round, have also gotten sick. Last year, they suffered an outbreak of pink eye infections, he said, which Pedrozo attributes to a combination of smoke and dust. One cow lost an eye. Scientific research has \u003ca href=\"https://extension.sdstate.edu/wildfire-aftermath-beef-cattle-health-considerations\">linked\u003c/a> wildfire smoke to both pink eye and permanent blindness in livestock.\u003c/p>\n\u003cp>“I don’t want to stick around and get worse,” he said. So he is planning to sell his farm of 22 years and move with his wife to Missouri, where their son has already relocated.\u003c/p>\n\u003cfigure id=\"attachment_11890246\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/IMG_4106-Pedrozo-scaled-e1632861923734.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11890246\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/IMG_4106-Pedrozo-scaled-e1632861923734.jpg\" alt=\"\" width=\"1920\" height=\"1440\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Tim Pedrozo checks on one of his cows at the farm he has owned for 22 years in Orland, California. The third-generation dairy farmer said poor air quality, in large part due to wildfire smoke, is a “main reason” he and his wife are considering moving out of state. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But the analysis by NPR’s California Newsroom and Stanford University found that even if worried Californians like Pedrozo flee the state, it will be hard to escape the smoke.\u003c/p>\n\u003cp>“The impacts of wildfire smoke could be one of the largest climate-related impacts across the Western U.S. And as we’re seeing increasingly, it’s not just limited to the Western U.S.,” Burke said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Burke’s lab used advanced computer modeling to examine the presence of smoke plumes overhead every day, in every community, from Hawaii to Florida. Reporters from the California Newsroom then compared the average annual number of days with smoke in the air between 2009 to 2013, when extremely destructive wildfires were less common, with the smoke days occurring between 2016 to 2020, when hotter, drier conditions fueled by climate change sparked record fire years.\u003c/p>\n\u003cp>How far smoke can move through the air depends on the intensity of the fire and weather conditions. But the satellite images reviewed by NPR’s California Newsroom and Burke’s lab at Stanford show that as winds carry wildfire smoke plumes from the West and central Canada across the continent, they spread farther and higher. \u003ca href=\"https://earthobservatory.nasa.gov/images/148610/smoke-across-north-america\">According to NASA, these smoke plumes\u003c/a> often go unnoticed, providing the illusion of cleaner air even as they inundate parts of the East Coast and the Midwest, including Missouri where Pedrozo wants to move.\u003c/p>\n\u003cp>Our analysis found the Midwest experienced a slight drop in the number of days with smoke overhead since 2009. But Burke’s modeling of the satellite imagery shows the smoke there is now thicker, suggesting “wildfires are also worsening overall air quality in the Midwest, just as they are in the West.”\u003c/p>\n\u003cp>“This is no longer just a West Coast story. This is a U.S.-wide story,” he said.\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/1.-US-before.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-11890248\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/1.-US-before.png\" alt=\"\" width=\"1240\" height=\"1088\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/1.-US-before.png 1240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/1.-US-before-800x702.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/1.-US-before-1020x895.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/1.-US-before-160x140.png 160w\" sizes=\"(max-width: 1240px) 100vw, 1240px\">\u003c/a>\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/2.-US-after.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-11890249\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/2.-US-after.png\" alt=\"\" width=\"1240\" height=\"1088\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/2.-US-after.png 1240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/2.-US-after-800x702.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/2.-US-after-1020x895.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/2.-US-after-160x140.png 160w\" sizes=\"(max-width: 1240px) 100vw, 1240px\">\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>The kids are not alright\u003c/strong>\u003c/p>\n\u003cp>Our analysis found the smokiest place in the West was Willows, California, a small town about 80 miles north of Sacramento. Last year, the August Complex Fire, then the largest in modern California history, burned more than 1 million acres, or more than 1,500 square miles, to its west in Mendocino National Forest. Two years earlier, the Camp Fire destroyed the Butte County town of Paradise, a 45-minute drive to the east, killing 85 people.\u003c/p>\n\u003cp>On the Friday in September we visited, a thick haze covered nearby mountains, but the sky had cleared up and the air quality was better than it had been earlier in the week. Cheerleaders for the local high school shook their gold and purple pompoms for a junior varsity football game as hundreds of students and parents caught up with each other in between bites of steak sandwiches and cotton candy.\u003c/p>\n\u003cp>For Willows High School Athletic Director Greg Kitchen, the day’s relatively clean air was a huge relief.\u003c/p>\n\u003cp>“I feel like I can breathe easy for a change. It’s nice,” said Kitchen as he watched the game from the sidelines. “It seems like the last five years or so air quality has just been something that we constantly have to monitor.”\u003c/p>\n\u003cp>Already this school year, Kitchen and other school administrators in the region have canceled outdoor sports practices and recess because of decidedly unhealthy air in order to protect students’ health.\u003c/p>\n\u003cfigure id=\"attachment_11890251\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/IMG_2282-Players-scaled-e1632862082813.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11890251\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/IMG_2282-Players-scaled-e1632862082813.jpg\" alt=\"\" width=\"1920\" height=\"1280\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Willows High School football players and coaches stand for the national anthem before the start of a game on Sept. 3, 2021 in Willows, California. But unhealthy air quality has led school administrators to cancel sports practices, recess and other outdoor activities to protect students’ health. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Stacy Lanzi, a third grade teacher at Murdock Elementary School, said she sees her students and her own two teen sons struggle with runny noses, tiredness and itchy eyes during days with haze or thick smoke.\u003c/p>\n\u003cp>“Kids will say, ‘I have a headache, I have a headache.’ You hear it all the time,” said Lanzi, who was born and raised in Willows. “And I’ll say, ‘Well, did you drink some water? Drink some more.’ There’s not too many alternatives, you know?”\u003c/p>\n\u003cp>Our analysis found Willows averaged 91 days of wildfire smoke a year on average between 2016 and 2020. Last year, smoke plumes inundated Willows for 122 days, or four out of twelve months.\u003c/p>\n\u003cfigure id=\"attachment_11890252\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/IMG_2223-Brett-Brown-scaled-e1632862178793.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11890252\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/IMG_2223-Brett-Brown-scaled-e1632862178793.jpg\" alt=\"Man in white lab coat with stethoscope around his neck.\" width=\"1920\" height=\"1280\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Physician Assistant Brett Brown stands at Glenn Medical Center, a small hospital in Willows, Calif on Sept. 2, 2021. Brown said he regularly treats patients who suffer from more asthma attacks, migraines and stress during smoke periods. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Without fail, there’s always somebody who says something about, ‘Well, because of the smoke’ insert problem here,” said 27-year-old Brett Brown, a physician’s assistant who regularly treats patients at Glenn Medical Center, the small hospital in Willows. “Whether it’s ‘I haven’t been exercising, so my diabetes is a little bit worse.’ Or ‘I haven’t been able to breathe as well because my allergies are so bad.’”\u003c/p>\n\u003cp>Brown, who suffers from asthma himself, said he has experienced firsthand how smoke can exacerbate his symptoms. Last year, he said, asthma flare-ups lengthened a case of bronchitis he developed.\u003c/p>\n\u003cp>\u003cstrong>The smoky reality of climate change\u003c/strong>\u003c/p>\n\u003cp>Climate change is at the root of this new reality, with rising temperatures and scant precipitation contributing to conditions that lead fires that burn hotter, faster and more frequently than ever before. Eight of the 10 largest fires in California history \u003ca href=\"https://www.fire.ca.gov/media/4jandlhh/top20_acres.pdf\">sparked\u003c/a> since 2017.\u003c/p>\n\u003cp>Last year was the most active wildfire season in the state’s modern history. More than \u003ca href=\"https://www.fire.ca.gov/incidents/2020/\">4 million acres \u003c/a>burned, nearly 10,500 structures were damaged or destroyed and 33 people died. This year could be even more destructive. \u003ca href=\"https://droughtmonitor.unl.edu/CurrentMap/StateDroughtMonitor.aspx?CA\">Most of \u003c/a>California is in “extreme drought” or “exceptional drought,” which means there is an abundance of dry vegetation ready to catch fire.\u003c/p>\u003c/div>",
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"content": "‘What we’ve got at the state and federal level is a reactive policy — we’re going to respond to the fires. God that’s problematic, because it means you never get ahead of the curve.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>But experts say there are steps government officials and individuals can take to better respond to the growing risk.\u003c/p>\n\u003cp>Decades of poor forest management have led to a dangerous buildup of undergrowth in California’s forests, providing the fuel for recent major blazes. Fire scientists say the state and federal government both need to significantly scale up their efforts to help reduce the potential of devastating wildfires.\u003c/p>\n\u003cp>“What we’ve got at the state and federal level is a reactive policy — we’re going to respond to the fires,” said Char Miller, director of environmental analysis at Pomona College. “God that’s problematic, because it means you never get ahead of the curve.”\u003c/p>\n\u003cp>Last August, California Gov. Gavin Newsom \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2020/08/8.12.20-CA-Shared-Stewardship-MOU.pdf\">announced\u003c/a> an agreement with the U.S. Forest Service that promised each would perform fire prevention work on 500,000 acres annually here by 2025. Today, however, the Forest Service remains far short of that goal. The agency told us they’d completed about 120,000 acres of treatment in California during the fiscal year ending Sept. 30. As for the state, Cal Fire was unable to detail its progress, even after multiple email requests.\u003c/p>\n\u003cp>Prescribed burns are another potential path forward in California. In much of the Southeastern United States, where academic research shows prescribed burns are f\u003ca href=\"https://www.mdpi.com/2571-6255/2/2/30/htm?dom=prime&src=syn\">ar more common\u003c/a>, our investigation shows a substantial decline in wildfire smoke over the past decade.\u003c/p>\n\u003cp>Fire is a natural part of the ecosystem; without it, wildlands become overgrown with brush and small trees. That causes destructive conflagrations to replace the natural, low-intensity fires that serve as an ecological reset. Many state lawmakers support their broader use, and in recent weeks the California legislature has passed bills that would \u003ca href=\"https://www.capradio.org/articles/2021/09/16/prescribed-burns-could-help-reduce-californias-wildfires-a-new-bill-could-help-make-planned-fires-more-frequent/\">change liability laws\u003c/a> and \u003ca href=\"https://sd03.senate.ca.gov/news/20210910-sen-dodd-lauds-passage-controlled-burn-insurance-fund\">create a $20 million insurance liability fund\u003c/a>.\u003c/p>\n\u003cp>“We have to get people to understand that they may have to get exposed to a little smoke from prescribed burns to prevent catastrophic fires,” said John Balmes, a pulmonologist and professor at UCSF who serves on the California Air Resources Board.\u003c/p>\n\u003cp>Meanwhile, Pacific Gas and Electric — the state’s largest utility — continues to face scrutiny over its role in sparking wildfires. Earlier this year, the California Public Utilities Commission placed the company under “\u003ca href=\"https://www.cpuc.ca.gov/industries-and-topics/pge/pge-oversight-and-enforcement\">enhanced oversight\u003c/a>” for failing to prioritize vegetation clearing around its most high-risk power lines. The company, which a federal judge \u003ca href=\"https://www.kqed.org/news/11873113/help-us-investigate-pges-power-lines\">called\u003c/a> “a terror — T-E-R-R-O-R to the people of California,” last year pleaded guilty to 84 counts of involuntary manslaughter in connection with the 2018 Camp Fire. In July, the utility \u003ca href=\"https://www.capradio.org/articles/2021/07/19/dixie-fire-may-be-linked-to-pge-equipment-utility-says/\">told\u003c/a> the CPUC that a fallen branch may have started this year’s Dixie Fire, which has burned more than 960,000 acres, or 1,500 square miles, to date.\u003c/p>\n\u003cp>There are also changes individuals can make to reduce the health impacts of wildfire smoke, including installing indoor air filtration systems. “There are good data to show that these kinds of efforts can make a difference in protecting homes and saving lives,” said Balmes. But these devices can be costly. Balmes recommends the government do more to provide low-cost or free air filters. “But all this requires investment.”\u003c/p>\n\u003cp>\u003cstrong>Erasing progress on air pollution\u003c/strong>\u003c/p>\n\u003cp>The sharp rise in wildfire smoke is reversing decades of hard-won gains in air quality improvement made as a result of environmental legislation like the Clean Air Act, Burke said. “We had actually been having a lot of success in cleaning up our air,” he added, but the rapid rise in smoke is “threatening to undo decades of improvement and undoing them very quickly.”\u003c/p>\n\u003cp>One dangerous pollutant in wildfire smoke is PM2.5, tiny bits of airborne ash that are 30 times smaller than the width of a single strand of human hair. This particulate matter can be inhaled deep into the lungs, and even enter the bloodstream. The Environmental Protection Agency says they pose “the \u003ca href=\"https://www3.epa.gov/region1/airquality/pm-human-health.html\">greatest health risk\u003c/a>,” even causing premature death.\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/8.-West-PM2.5.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-11890253\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/8.-West-PM2.5.png\" alt=\"\" width=\"1240\" height=\"840\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/8.-West-PM2.5.png 1240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/8.-West-PM2.5-800x542.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/8.-West-PM2.5-1020x691.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/8.-West-PM2.5-160x108.png 160w\" sizes=\"(max-width: 1240px) 100vw, 1240px\">\u003c/a>\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/7.-Northwest-PM2.5.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-11890254\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/7.-Northwest-PM2.5.png\" alt=\"\" width=\"1240\" height=\"840\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/7.-Northwest-PM2.5.png 1240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/7.-Northwest-PM2.5-800x542.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/7.-Northwest-PM2.5-1020x691.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2021/09/7.-Northwest-PM2.5-160x108.png 160w\" sizes=\"(max-width: 1240px) 100vw, 1240px\">\u003c/a>\u003c/p>\n\u003cp>These tiny particles in wildfire smoke are known to aggravate heart and lung diseases, like cardiac arrhythmias, heart attacks, bronchitis and asthma, with young children and older people especially vulnerable to its harmful effects. Researchers have also linked wildfire smoke to thousands of \u003ca href=\"https://www.kqed.org/news/11884731/poor-air-quality-from-wildfire-smoke-worsens-covid-19-cases-deaths-study-finds\">excess COVID-19 deaths\u003c/a> and are now exploring the links between exposure to wildfire smoke and strokes, pregnancy risks like \u003ca href=\"https://www.sciencedirect.com/science/article/abs/pii/S001393512101166X?via%3Dihub\">preterm births\u003c/a> and neurological disorders such as strokes and \u003ca href=\"https://sanfrancisco.cbslocal.com/2020/11/30/ucsf-study-reveals-link-between-wildfire-smoke-and-alzheimers-disease/\">Alzheimer’s\u003c/a> disease.\u003c/p>\n\u003cp>Smoke plumes may blanket an entire region, impacting every resident irrespective of their income, but limited research suggests the health risks fall disproportionately on older people, and especially poorer people, who are more often than not from Black, brown and indigenous communities.\u003c/p>\n\u003cp>People of color who live in low-income communities often have “increased vulnerability to the effects of air pollution,” Balmes said. “They often have other stressors that contribute to ill health, like a lack of diet filled with fresh vegetables and fruits, which is actually protective in terms of the health effects of air pollution, and just their housing stock, which is often older, may be less protective as the bad outdoor air from wildfires penetrates more easily.”\u003c/p>\n\u003cp>Our analysis focused on the presence of smoke plumes in the air, rather than PM2.5 particles, because the network of EPA air quality sensors varies widely. Many urban communities lack monitors. So do rural areas, often those areas closest to the wildfires. And the sensors that are in place don’t report on all days. But \u003ca href=\"https://www.epa.gov/wildfire-smoke-course/why-wildfire-smoke-health-concern\">EPA scientists say\u003c/a> the presence of smoke plumes from wildfires tracks closely with the presence of fine particulates.\u003c/p>\n\u003cp>Between 2000 and 2010, the annual average PM 2.5 concentration levels in California and Nevada declined 35%, according to an analysis of EPA data by NPR’s California Newsroom. By 2020, however, almost all those gains had been erased, with particulate levels nearly as high as they were two decades earlier. In the Pacific Northwest, PM2.5 levels last year surged higher than they were at the beginning of the century, thanks largely to an increase in wildfire smoke.\u003c/p>\n\u003cp>Indeed, with other sources of PM2.5, such as auto exhaust, in decline because of better emission standards, wildfire smoke represents an increasing share of particulates people are breathing. Burke’s team \u003ca href=\"https://www.pnas.org/content/pnas/118/2/e2011048118.full.pdf\">found\u003c/a> that in the West, wildfire PM2.5 now accounts for up to half of all PM2.5 exposure, compared to less than 20% a decade ago.\u003c/p>\n\u003cp>These tiny particles aren’t the only pollutants to worry about. When the Camp Fire incinerated the town of Paradise in 2018, it destroyed nearly 19,000 buildings, including gas stations, two grocery stores, eight schools and a hotel. Everything inside those buildings went up in smoke — from paint thinner and Drano to plastics, oil and pesticides. A \u003ca href=\"https://ww2.arb.ca.gov/sites/default/files/2021-07/Camp_Fire_report_July2021.pdf\">report\u003c/a> on the Camp Fire released this July by the California Air Resources Board found toxic metals, including lead, traveled more than 150 miles and were picked up in air monitoring stations in Silicon Valley.\u003c/p>\n\u003cp>\u003cstrong>Stuck inside, alone\u003c/strong>\u003c/p>\n\u003cp>Brown, one of a handful of medical staffers at the family care clinic in Willows, says all the smoke days are affecting his patients’ mental health. The recommendation that people stay indoors on bad air quality days intensifies feelings of isolation during the pandemic.\u003c/p>\n\u003cp>“Say you are quarantined and then all of a sudden you can’t even go in your own backyard without getting a major headache or having an asthma attack or worried that your kid is going to have \u003ca href=\"https://www.nature.com/articles/s41370-020-00267-4\">long-term problems\u003c/a> because of \u003ca href=\"https://pediatrics.aappublications.org/content/147/4/e2020027128\">wildfire smoke\u003c/a>,” he said.\u003c/p>\n\u003cfigure id=\"attachment_11890255\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/IMG_2200-Larry-George-scaled-e1632862358321.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11890255\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2021/09/IMG_2200-Larry-George-scaled-e1632862358321.jpg\" alt=\"A man at his home pointing to animal-shaped cookie jars on a shelf.\" width=\"1920\" height=\"1280\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Larry George, 74, points to his late wife’s collection of cookie jars at the house he rents in Willows, California, on Sept. 2, 2021. The retired truck driver, who suffers from a chronic lung condition, said he must stay inside on smoky days to protect his health. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>That isolation has been getting to Larry George, who lives alone a block away from the hospital in a gray, two-bedroom house. The 74-year-old Vietnam veteran and retired truck driver suffers from chronic obstructive pulmonary disease, or COPD. On hazy days, George almost never leaves his home.\u003c/p>\n\u003cp>When he has to go to the doctor’s office or grocery store, even walking a few steps to his white pickup truck is difficult.\u003c/p>\n\u003cp>“It just feels like you’re not allowed to go out,” he said, wheezing in his living room, where he keeps an oxygen machine and a large TV screen tuned to Fox News. “You don’t have the freedom you had before.”\u003c/p>\n\u003cp>Like Pedrozo, he is thinking of moving to someplace with cleaner air.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://modules.wearehearken.com/kcrw/embed/8715/share\" width=\"800\" height=\"530\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>\u003cem>Alison Saldanha is a data journalist who led this investigation for NPR’s California Newsroom, where Aaron Glantz is senior investigations editor. Farida Jhabvala Romero is a reporter for KQED in San Francisco. Caleigh Wells is a reporter and producer at KCRW in Los Angeles. \u003c/em>\u003c/p>\n\u003cp>\u003cem>George LeVines and Molly Peterson from the California Newsroom contributed reporting. Glantz edited this story together with the newsroom’s managing editor, Adriene Hill. The story was copy edited by Don Clyde. Scott Rodd, state government reporter at CapRadio in Sacramento, also contributed reporting along with Lily Jamali from KQED.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "Oakland Unified to Require Coronavirus Vaccine for Students 12 and Up",
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"content": "\u003cp>The Oakland Board of Education voted late Wednesday to require district students 12 and older to be vaccinated against the coronavirus as a prerequisite for attending in-person school.\u003c/p>\n\u003cp>The move makes Oakland Unified the first school district in Northern California to adopt a student vaccine requirement. It follows similar mandates imposed earlier this month by Los Angeles Unified, the state’s largest school district, and the smaller Southern California district of Culver City.\u003c/p>\n\u003cp>Several other school boards in the Bay Area are considering similar measures, including West Contra Costa County Unified and Berkeley Unified, as schools try to navigate in-person instruction amid ongoing concerns over the highly contagious delta variant.\u003c/p>\n\u003cp>[aside postID=news_11889297 hero='https://ww2.kqed.org/app/uploads/sites/10/2021/03/RS42264_006_KQED_Pittsburg_MaliaJohnson_03242020-qut-1020x680.jpg']The plan in Oakland, which serves about 50,000 students, will require all students age 12 and older to be fully vaccinated against COVID-19 unless they are granted medical or “personal belief” exemptions.\u003c/p>\n\u003cp>The resolution does not specify a timeline or say how students’ vaccination status will be tracked. It requires OUSD Superintendent Kyla Johnson-Trammell to “develop recommendations for enforcement of this vaccine requirement” and report them to the board by October.\u003c/p>\n\u003cp>Sam Davis, the school board vice president who \u003ca href=\"https://ousd.legistar.com/LegislationDetail.aspx?ID=5126010&GUID=8D190D58-237F-4085-8620-499EFCBB54FC&Options=&Search=\">introduced the vaccine resolution\u003c/a>, cited district data showing that 40% of the \u003ca href=\"https://dashboards.ousd.org/views/COVIDCaseDashboard/SchoolLevelData?%3Aembed=y\" target=\"_blank\" rel=\"noopener noreferrer\">positive cases \u003c/a>have involved students in middle and high schools, who are old enough to be vaccinated.\u003c/p>\n\u003cp>“We know that if more students were vaccinated, those numbers would go down really sharply,” he said. “That’s what’s creating the urgency around this.”\u003c/p>\n\u003cp>There is no data on how many students are already vaccinated in Oakland Unified, but in the city of Oakland, 54% of 12- to 17-year-olds are fully vaccinated, and 71% have received at least one dose, according to data cited in the school board’s proposal.\u003c/p>\n\u003cp>Davis says the district’s efforts to reach more high school students, including mobile vaccine clinics and free donuts, simply aren’t getting enough traction.\u003c/p>\n\u003cp>He says he sees the resolution as a starting point. “It just feels like this is an urgent conversation that we need to have,” he said. “And I know it’s a hard conversation, but I don’t want to shy away from it.”\u003c/p>\n\u003cp>Vocal critics of the vaccine mandate — including the school board president, Shanthi Gonzales — say the plan could easily backfire, exposing the district to major litigation and driving a significant number of students out of the classroom.\u003c/p>\n\u003cp>“It will push more students to distance learning, where we don’t have space for more students,” she said in a statement. “Or worse, to charters or other districts.”\u003c/p>\n\u003cp>School board member Mike Hutchinson, who also opposes the new requirement, says any such mandate should come from the state.\u003c/p>\n\u003cp>“We’re talking about potentially thousands of students being told that you can’t attend school until you get this vaccination,” said Hutchinson. “That makes me nervous that some families will respond by not attending school.”\u003c/p>\n\u003cp>Some education officials also have questioned the legality of mandating the coronavirus vaccine for students under 16 while it’s still under emergency use authorization. Currently, only the Pfizer-BioNTech vaccine has been granted full FDA authorization, and only for those 16 and older.\u003c/p>\n\u003cp>California currently requires public school staff to either be vaccinated or submit to weekly testing starting Oct. 15, but there is no similar statewide rule regarding students.\u003c/p>\n\u003cp>Asked at a Thursday media briefing if the state is considering requiring eligible schoolchildren to be vaccinated to attend in-person classes, Dr. Mark Ghaly, California’s secretary of health and human services, said there is “no definitive action or decision” right now. But he left open the possibility of such a mandate, noting that students have \u003ca href=\"https://www.shotsforschool.org/k-12/\">long been required\u003c/a> to receive vaccinations against other viruses — including polio, hepatitis B, measles and diphtheria — to attend school in person.[aside tag=\"education\" label=\"Related Coverage\"]“We’re watching the experience in Los Angeles, understanding what it means for students and families alike, staff as well, and watching as other counties consider the same,” he said. “So that conversation is happening.”\u003c/p>\n\u003cp>California State Superintendent of Public Instruction Tony Thurmond has \u003ca href=\"https://edsource.org/2021/culver-city-unified-mandates-covid-vaccine-for-students-possibly-the-states-first/659929\" target=\"_blank\" rel=\"noopener noreferrer\">expressed support\u003c/a> for mandatory student vaccination, \u003ca href=\"https://www.reuters.com/world/us/fauci-backs-covid-19-vaccine-mandate-us-school-children-2021-08-29/\" target=\"_blank\" rel=\"noopener noreferrer\">as has Dr. Anthony Fauci\u003c/a>. A \u003ca href=\"https://apnews.com/article/lifestyle-health-education-coronavirus-pandemic-only-on-ap-0440d83602da918c571d506a3de9f44b\" target=\"_blank\" rel=\"noopener noreferrer\">poll by the Associated Press\u003c/a> found that 6 out of 10 Americans support requiring vaccines for eligible students.\u003c/p>\n\u003cp>Still, Oakland’s new requirement is likely to face significant backlash among students and families who are already on the fence about the vaccine.\u003c/p>\n\u003cp>McClymonds High School student L’Shawna Fletcher, 14, says she thinks a vaccine mandate will keep more students out of class.\u003c/p>\n\u003cp>“Everybody’s just gonna choose to go home instead of getting the vaccine,” she said. “My mom don’t even want me with the vaccine. I would have to do distance learning.”\u003c/p>\n\u003cp>For parent advocate Lakisha Young, the resolution also raises equity concerns. “Looking at the data, our families would probably have the most challenges meeting the requirement,” said Young, who runs The Oakland REACH, an organization that helps support the needs of many of the district’s families.\u003c/p>\n\u003cp>California’s Black, Latino, and lower-income residents are \u003ca href=\"https://www.latimes.com/projects/california-coronavirus-cases-tracking-outbreak/covid-19-vaccines-distribution/\" target=\"_blank\" rel=\"noopener noreferrer\">significantly less likely\u003c/a> to be vaccinated than white residents, data shows.\u003c/p>\n\u003cp>“If I was a board member and I knew these communities were less likely to be vaccinated, I’d be going to them to say, ‘How does this impact you?'” she said. “Why not make sure that you understand and hear from them?”\u003c/p>\n\u003cp>\u003cem>This post includes additional reporting from the Associated Press.\u003c/em>\u003cbr>\n[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Oakland Board of Education voted late Wednesday to require district students 12 and older to be vaccinated against the coronavirus as a prerequisite for attending in-person school.\u003c/p>\n\u003cp>The move makes Oakland Unified the first school district in Northern California to adopt a student vaccine requirement. It follows similar mandates imposed earlier this month by Los Angeles Unified, the state’s largest school district, and the smaller Southern California district of Culver City.\u003c/p>\n\u003cp>Several other school boards in the Bay Area are considering similar measures, including West Contra Costa County Unified and Berkeley Unified, as schools try to navigate in-person instruction amid ongoing concerns over the highly contagious delta variant.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The plan in Oakland, which serves about 50,000 students, will require all students age 12 and older to be fully vaccinated against COVID-19 unless they are granted medical or “personal belief” exemptions.\u003c/p>\n\u003cp>The resolution does not specify a timeline or say how students’ vaccination status will be tracked. It requires OUSD Superintendent Kyla Johnson-Trammell to “develop recommendations for enforcement of this vaccine requirement” and report them to the board by October.\u003c/p>\n\u003cp>Sam Davis, the school board vice president who \u003ca href=\"https://ousd.legistar.com/LegislationDetail.aspx?ID=5126010&GUID=8D190D58-237F-4085-8620-499EFCBB54FC&Options=&Search=\">introduced the vaccine resolution\u003c/a>, cited district data showing that 40% of the \u003ca href=\"https://dashboards.ousd.org/views/COVIDCaseDashboard/SchoolLevelData?%3Aembed=y\" target=\"_blank\" rel=\"noopener noreferrer\">positive cases \u003c/a>have involved students in middle and high schools, who are old enough to be vaccinated.\u003c/p>\n\u003cp>“We know that if more students were vaccinated, those numbers would go down really sharply,” he said. “That’s what’s creating the urgency around this.”\u003c/p>\n\u003cp>There is no data on how many students are already vaccinated in Oakland Unified, but in the city of Oakland, 54% of 12- to 17-year-olds are fully vaccinated, and 71% have received at least one dose, according to data cited in the school board’s proposal.\u003c/p>\n\u003cp>Davis says the district’s efforts to reach more high school students, including mobile vaccine clinics and free donuts, simply aren’t getting enough traction.\u003c/p>\n\u003cp>He says he sees the resolution as a starting point. “It just feels like this is an urgent conversation that we need to have,” he said. “And I know it’s a hard conversation, but I don’t want to shy away from it.”\u003c/p>\n\u003cp>Vocal critics of the vaccine mandate — including the school board president, Shanthi Gonzales — say the plan could easily backfire, exposing the district to major litigation and driving a significant number of students out of the classroom.\u003c/p>\n\u003cp>“It will push more students to distance learning, where we don’t have space for more students,” she said in a statement. “Or worse, to charters or other districts.”\u003c/p>\n\u003cp>School board member Mike Hutchinson, who also opposes the new requirement, says any such mandate should come from the state.\u003c/p>\n\u003cp>“We’re talking about potentially thousands of students being told that you can’t attend school until you get this vaccination,” said Hutchinson. “That makes me nervous that some families will respond by not attending school.”\u003c/p>\n\u003cp>Some education officials also have questioned the legality of mandating the coronavirus vaccine for students under 16 while it’s still under emergency use authorization. Currently, only the Pfizer-BioNTech vaccine has been granted full FDA authorization, and only for those 16 and older.\u003c/p>\n\u003cp>California currently requires public school staff to either be vaccinated or submit to weekly testing starting Oct. 15, but there is no similar statewide rule regarding students.\u003c/p>\n\u003cp>Asked at a Thursday media briefing if the state is considering requiring eligible schoolchildren to be vaccinated to attend in-person classes, Dr. Mark Ghaly, California’s secretary of health and human services, said there is “no definitive action or decision” right now. But he left open the possibility of such a mandate, noting that students have \u003ca href=\"https://www.shotsforschool.org/k-12/\">long been required\u003c/a> to receive vaccinations against other viruses — including polio, hepatitis B, measles and diphtheria — to attend school in person.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“We’re watching the experience in Los Angeles, understanding what it means for students and families alike, staff as well, and watching as other counties consider the same,” he said. “So that conversation is happening.”\u003c/p>\n\u003cp>California State Superintendent of Public Instruction Tony Thurmond has \u003ca href=\"https://edsource.org/2021/culver-city-unified-mandates-covid-vaccine-for-students-possibly-the-states-first/659929\" target=\"_blank\" rel=\"noopener noreferrer\">expressed support\u003c/a> for mandatory student vaccination, \u003ca href=\"https://www.reuters.com/world/us/fauci-backs-covid-19-vaccine-mandate-us-school-children-2021-08-29/\" target=\"_blank\" rel=\"noopener noreferrer\">as has Dr. Anthony Fauci\u003c/a>. A \u003ca href=\"https://apnews.com/article/lifestyle-health-education-coronavirus-pandemic-only-on-ap-0440d83602da918c571d506a3de9f44b\" target=\"_blank\" rel=\"noopener noreferrer\">poll by the Associated Press\u003c/a> found that 6 out of 10 Americans support requiring vaccines for eligible students.\u003c/p>\n\u003cp>Still, Oakland’s new requirement is likely to face significant backlash among students and families who are already on the fence about the vaccine.\u003c/p>\n\u003cp>McClymonds High School student L’Shawna Fletcher, 14, says she thinks a vaccine mandate will keep more students out of class.\u003c/p>\n\u003cp>“Everybody’s just gonna choose to go home instead of getting the vaccine,” she said. “My mom don’t even want me with the vaccine. I would have to do distance learning.”\u003c/p>\n\u003cp>For parent advocate Lakisha Young, the resolution also raises equity concerns. “Looking at the data, our families would probably have the most challenges meeting the requirement,” said Young, who runs The Oakland REACH, an organization that helps support the needs of many of the district’s families.\u003c/p>\n\u003cp>California’s Black, Latino, and lower-income residents are \u003ca href=\"https://www.latimes.com/projects/california-coronavirus-cases-tracking-outbreak/covid-19-vaccines-distribution/\" target=\"_blank\" rel=\"noopener noreferrer\">significantly less likely\u003c/a> to be vaccinated than white residents, data shows.\u003c/p>\n\u003cp>“If I was a board member and I knew these communities were less likely to be vaccinated, I’d be going to them to say, ‘How does this impact you?'” she said. “Why not make sure that you understand and hear from them?”\u003c/p>\n\u003cp>\u003cem>This post includes additional reporting from the Associated Press.\u003c/em>\u003cbr>\n\u003c/p>\u003c/div>",
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"tagline": "Art is where you find it",
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"soldout": {
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