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"content": "\u003cp>Since the coronavirus pandemic took hold in the U.S., Sara Houze has been on the road — going from one hospital to another to care for COVID-19 patients who are on the brink of death.\u003c/p>\n\u003cp>A cardiac intensive care nurse from Washington, D.C., with expertise in heart rhythm, airway and pain management, her skills are in great demand as infections and hospitalizations skyrocket nationwide. Houze is among more than 500 nurses, doctors and other contract medical staff California has deployed to hospitals that are running out of capacity to treat the most severe COVID-19 cases.\u003c/p>\n\u003cp>Her six-week assignment started Monday in San Bernardino, about 60 miles east of Los Angeles, and she anticipates working 14-hour shifts with a higher-than-usual caseload. San Bernardino County has 1,545 people in hospitals, with more than 125 in makeshift “surge” beds, which are being used because regular hospital space isn’t available.\u003c/p>\n\u003cp>“I expect patients to die. That’s been my experience: They die, I put them in body bags, the room gets cleaned and then another patient comes,” Houze said.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Sara Houze, cardiac intensive care nurse\"]‘I expect patients to die. That’s been my experience: They die, I put them in body bags, the room gets cleaned and then another patient comes.’[/pullquote]\u003c/p>\n\u003cp>The staffing shortage comes as shipments of the COVID-19 vaccine trickle out to health care workers and nursing home residents across the country. Most Americans will have access to the injections by mid-summer, according to Dr. Anthony Fauci, the nation’s top infectious disease expert.\u003c/p>\n\u003cp>\u003ca href=\"https://www.goodmorningamerica.com/news/video/fauci-speaks-receiving-1st-dose-covid-19-vaccine-74857182\">Fauci told “Good Morning America” on Tuesday\u003c/a> that he expects to start vaccinating the general population in late March or early April. The process could take up to four months to reach all Americans who want the vaccine, he said.\u003c/p>\n\u003cp>Fauci received the initial dose of the newest vaccine, produced by Moderna, alongside other federal health leaders who helped oversee its development.\u003c/p>\n\u003cp>Much of California has exhausted its usual ability to staff intensive care beds, and the nation’s most populated state is desperately searching for 3,000 temporary medical workers to meet demand. State officials are reaching out to foreign partners in places like Australia and Taiwan amid a shortage of temporary medical workers in the U.S., particularly nurses trained in critical care.\u003c/p>\n\u003cp>Gov. Gavin Newsom said the state has relationships with countries that provide aid during crises such as wildfires.\u003c/p>\n\u003cp>“We’re now in a situation where we have surges all across the country, so nobody has many nurses to spare,” said Dr. Janet Coffman, a professor of health policy at UCSF.\u003c/p>\n\u003cp>California hospitals typically turn to staffing agencies during flu season, when they rely on travel nurses to meet patient care needs. It is the only state in the nation with strict nurse-to-patient ratios requiring hospitals, for example, to provide one nurse for every two patients in intensive care and one nurse for every four patients in emergency rooms.\u003c/p>\n\u003cp>[ad fullwidth]However, those ratio requirements are being waived at many hospitals as virus cases surge.\u003c/p>\n\u003cp>But the pool of available travel nurses is drying up as demand for them jumped 44% over the last month, with California, Texas, Florida, New York and Minnesota requesting the most extra staff, according to San Diego-based health care staffing firm Aya Healthcare — one of two companies contracted by California to fulfill hospitals’ staffing requests.\u003c/p>\n\u003cp>“We are hiring like crazy and working insane hours,” said Sophia Morris, vice president of account management at Aya Healthcare.\u003c/p>\n\u003cp>Dr. Mark Ghaly, California’s Health and Human Services secretary, said the state is “lucky to get two-thirds” of its requests for travel nurses fulfilled right now.\u003c/p>\n\u003cp>It’s a sharp contrast from the spring, when Newsom issued the nation’s first stay-at-home order. As infection rates slowed and hospitals voluntarily suspended elective surgeries for weeks, health care providers from California flew to New York to help their overworked colleagues.\u003c/p>\n\u003cp>[aside label=\"Related Coverage\" postID=\"news_11850757,news_11850155,forum_2010101881272\"]This time, many hospitals are postponing procedures that are not emergencies, said Jan Emerson-Shea, a spokeswoman for the California Hospital Association. California also has opened alternative care facilities for people with less serious illnesses to save hospital beds for the sickest patients.\u003c/p>\n\u003cp>That also means hospitals have fewer nurses to deploy to ICUs from other units, UCSF’s Coffman said. And many health workers became infected or have had to quarantine because they were exposed to someone with COVID-19 during the surge, she said.\u003c/p>\n\u003cp>Another factor is the dip in the number of nurses 60 and older. In a survey of the state’s 320,000 registered nurses, many older nurses told researchers at UCSF’s Healthforce Center that they stopped working out of concern for their or their family’s health, said Joanne Spetz, the center’s associate director of research.\u003c/p>\n\u003cp>On Monday, more than 17,000 people were hospitalized with confirmed COVID-19 infections — more than double the previous peak reached in July — and a state model that uses current data to forecast future trends shows the number could reach nearly 100,000 by January. More than 3,600 COVID-19 patients were in intensive care units.\u003c/p>\n\u003cp>Ghaly said entire areas of California may run out of room even in surge capacity units “by the end of the month and early in January.” The state is trying to avoid that by opening makeshift hospitals in places like gymnasiums, tents and a vacant NBA arena, and sending patients to parts of the state with empty beds.\u003c/p>\n\u003cp>This past spring, Newsom sought to reinforce fatigued medical workers by creating a paid volunteer network, but with cases skyrocketing now, just 28 members are working at 13 facilities despite pleas for more retired medical professionals to sign up.\u003c/p>\n\u003cp>The state is updating its planning guide for how hospitals would ration care if necessary.\u003c/p>\n\u003cp>A document recently circulated among doctors at the four hospitals run by Los Angeles County calls for them to shift strategy: Instead of trying everything to save a life, their goal during the crisis is to save as many patients as possible. Those less likely to survive would not get the same kind of care offered in normal times.\u003c/p>\n\u003cp>Houze, the ICU nurse, said her online community of nurses is offering webinars about moral distress because many of them have had to change the way they care for patients.\u003c/p>\n\u003cp>“The patients that aren’t yet intubated, and even the ones intubated, aren’t getting the kind of nursing care that I want to give them because our resources are so limited and time is taxed,” she said. “It’s really disheartening.”\u003c/p>\n\u003cp>\u003cem>Associated Press reporter Don Thompson in Sacramento contributed to this report.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cp>This summer, while many Californians went to work in their pajamas at their kitchen tables, Vicente Reyes went to work in the grape fields of the Central Valley.\u003c/p>\n\u003cp>“Other Americans have been able to shelter in place at home, we still keep working,” he said. “And without our work, there wouldn’t be any food.”\u003c/p>\n\u003cp>California produce, meat and dairy gets shipped all over the country and the world. This is why Reyes believes agricultural workers should be next to get the COVID-19 vaccine.\u003c/p>\n\u003cp>“If there would be a shortage of food, then there would be more chaos,” he said.\u003c/p>\n\u003cfigure id=\"attachment_11851296\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11851296\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/12/VicenteReyes.jpg\" alt='\"\"' width=\"800\" height=\"545\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/VicenteReyes.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/VicenteReyes-160x109.jpg 160w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Vicente Reyes worked through the summer harvesting table grapes in the fields of California’s Central Valley. \u003ccite>(Courtesy Vicente Reyes)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>While doctors, nurses and other health care workers began to receive the new COVID-19 vaccine this week, the state is still actively debating which essential workers will be next in line. Officials are using a framework of risk, equity and societal impact to decide who should be prioritized — meat packers, teachers, those who manage wastewater or electrical supply — and based on discussions so far, they appear to be giving deep consideration to agricultural workers.\u003c/p>\n\u003cp>\u003ca href=\"https://news.berkeley.edu/2020/12/02/california-farmworkers-hit-hard-by-covid-19-study-finds/\" target=\"_blank\" rel=\"noopener noreferrer\">Studies\u003c/a> \u003ca href=\"https://www.cirsinc.org/phocadownload/userupload/elevated_farmworker_vulnerability_covid-19_infection_research-report_absract_final_villarejo_07-25-2020.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">show\u003c/a> farmworkers are at higher risk of contracting the coronavirus than the average population because they earn lower wages that force them to live in crowded conditions or drive to work sites in crowded trucks. There have been \u003ca href=\"https://www.kqed.org/news/11850332/covid-19-again-sweeps-through-foster-farms-plants-in-central-valley\" target=\"_blank\" rel=\"noopener noreferrer\">multiple outbreaks\u003c/a> at Foster Farms’ poultry processing plants in the state. And when agricultural workers do get sick, Reyes says, they can’t afford to take time off work or go to the doctor.\u003c/p>\n\u003cp>“We try not to, because we would have to pay,” he says. “We just try to walk it out or try to find home remedies to get better.”\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Diana Tellefson Torres, executive director of the United Farm Workers Foundation']‘This is definitely an opportunity to redress a lot of the inequities that farmworkers have experienced, not only for decades, but for centuries.’[/pullquote]\u003c/p>\n\u003cp>\u003ca href=\"https://www.dol.gov/sites/dolgov/files/ETA/naws/pdfs/NAWS_Research_Report_13.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">About 50%\u003c/a> of farmworkers are undocumented, and without legal status they have been systematically left out of U.S. labor protections, like overtime and sick pay. Under the Affordable Care Act, \u003ca href=\"https://www.kqed.org/stateofhealth/142601/farming-industry-chafed-by-obamacare-requirements\" target=\"_blank\" rel=\"noopener noreferrer\">undocumented immigrants\u003c/a> were prohibited from getting health insurance through the state’s Medicaid program or from buying it through the state’s marketplace.\u003c/p>\n\u003cp>Without health coverage, advocates say farmworkers are paying the price with their lives: Latinos are \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-race-ethnicity.html\" target=\"_blank\" rel=\"noopener noreferrer\">almost three times\u003c/a> more likely to die from COVID-19 than white people.\u003c/p>\n\u003cp>“We’re seeing these structural inequities that are now being exacerbated because of a pandemic,” says Diana Tellefson Torres, executive director of the United Farm Workers Foundation, adding that all the barriers they face in getting care is another reason farmworkers should be prioritized for the vaccine.\u003c/p>\n\u003cp>“This is definitely an opportunity to redress a lot of the inequities that farmworkers have experienced, not only for decades, but for centuries,” she says. [ad fullwidth]\u003c/p>\n\u003ch3>\u003cstrong>Different Counties, Different Priorities\u003c/strong>\u003c/h3>\n\u003cp>The state has made clear that it’s taking equity considerations like this very seriously in its vaccine plans. But it will be up to individual counties to implement the state plan, balancing equity concerns with the complicated logistics of shipping vaccines that need to be stored at minus 94 degrees Farenheit to rural areas.\u003c/p>\n\u003cp>Some counties already have a plan.\u003c/p>\n\u003cp>“In Riverside County, we have a large farmworker population,” says Kim Saruwatari, director of public health for Riverside County. “So we know that once you take it out of the deep freeze, it’s good for five days. So, take a smaller amount, take it out to those farmworking communities, administer everything we have, get more, and take it out and keep going until we get everybody covered.”\u003c/p>\n\u003cp>[aside tag=\"covid-vaccines\" label=\"more coverage\"]\u003c/p>\n\u003cp>But smaller counties with less money may find this daunting — even impractical. For Eric Sergienko, public health officer for Mariposa County, it doesn’t make sense to vaccinate farmworkers first because the first vaccines endorsed by the Food and Drug Administration — the \u003ca href=\"https://www.kqed.org/coronavirusliveupdates/news/11850939/fda-authorizes-covid-19-vaccine-for-emergency-use-in-u-s\">Pfizer-BioNTech\u003c/a> and \u003ca href=\"https://www.kqed.org/science/1971735/fda-researchers-endorse-moderna-covid-19-vaccine\">Moderna\u003c/a> vaccines — each require two doses: the primary shot followed by a booster.\u003c/p>\n\u003cp>“So if it were just a single shot, I think we would be able to wrangle with logistics fairly easily,” Sergienko says. “But seeing as we have to find that person either 21 days or 28 days later, that adds a layer of complexity.”\u003c/p>\n\u003cp>Farmworkers are mobile, he adds. They could be working or living in a different place one month later. He says the most effective strategy could be to wait.\u003c/p>\n\u003cp>“Don’t let the perfect be the enemy of the good,” he says. “Hold us as closely to those equitable measures as possible, but recognize that it’s not going to be perfect.”\u003c/p>\n\u003cp>Sergienko is concerned about equity, but he needs to use an equation that works for his region. His county has just one hospital and no intensive care unit. If someone gets really sick and needs an ICU bed, they get flown or taken in an ambulance to a tertiary care facility, usually in Fresno or Modesto.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Eric Sergienko, public health officer for Mariposa County']‘The more people I keep out of the hospital, the better the people that are actually hospitalized will do.’[/pullquote]\u003c/p>\n\u003cp>But hospitals in those regions are running out of beds. The San Joaquin Valley region had less than 2% of its ICU beds available as of Dec. 14, meaning patients have to wait longer, and get care from staff members who are stretched thin. To Sergienko, it makes sense to vaccinate frail, elderly people first because they’re most likely to need critical care.\u003c/p>\n\u003cp>“The more people I keep out of the hospital, the better the people that are actually hospitalized will do,” he says.\u003c/p>\n\u003cp>Inequity cuts across ethnicity, age and geography, Sergienko says. He hopes the state’s final vaccine plan will somehow account for this: Who needs the vaccine most in Mariposa County may be very different from who needs it most in San Diego or San Francisco.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>This summer, while many Californians went to work in their pajamas at their kitchen tables, Vicente Reyes went to work in the grape fields of the Central Valley.\u003c/p>\n\u003cp>“Other Americans have been able to shelter in place at home, we still keep working,” he said. “And without our work, there wouldn’t be any food.”\u003c/p>\n\u003cp>California produce, meat and dairy gets shipped all over the country and the world. This is why Reyes believes agricultural workers should be next to get the COVID-19 vaccine.\u003c/p>\n\u003cp>“If there would be a shortage of food, then there would be more chaos,” he said.\u003c/p>\n\u003cfigure id=\"attachment_11851296\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11851296\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/12/VicenteReyes.jpg\" alt='\"\"' width=\"800\" height=\"545\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/VicenteReyes.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/VicenteReyes-160x109.jpg 160w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Vicente Reyes worked through the summer harvesting table grapes in the fields of California’s Central Valley. \u003ccite>(Courtesy Vicente Reyes)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>While doctors, nurses and other health care workers began to receive the new COVID-19 vaccine this week, the state is still actively debating which essential workers will be next in line. Officials are using a framework of risk, equity and societal impact to decide who should be prioritized — meat packers, teachers, those who manage wastewater or electrical supply — and based on discussions so far, they appear to be giving deep consideration to agricultural workers.\u003c/p>\n\u003cp>\u003ca href=\"https://news.berkeley.edu/2020/12/02/california-farmworkers-hit-hard-by-covid-19-study-finds/\" target=\"_blank\" rel=\"noopener noreferrer\">Studies\u003c/a> \u003ca href=\"https://www.cirsinc.org/phocadownload/userupload/elevated_farmworker_vulnerability_covid-19_infection_research-report_absract_final_villarejo_07-25-2020.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">show\u003c/a> farmworkers are at higher risk of contracting the coronavirus than the average population because they earn lower wages that force them to live in crowded conditions or drive to work sites in crowded trucks. There have been \u003ca href=\"https://www.kqed.org/news/11850332/covid-19-again-sweeps-through-foster-farms-plants-in-central-valley\" target=\"_blank\" rel=\"noopener noreferrer\">multiple outbreaks\u003c/a> at Foster Farms’ poultry processing plants in the state. And when agricultural workers do get sick, Reyes says, they can’t afford to take time off work or go to the doctor.\u003c/p>\n\u003cp>“We try not to, because we would have to pay,” he says. “We just try to walk it out or try to find home remedies to get better.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://www.dol.gov/sites/dolgov/files/ETA/naws/pdfs/NAWS_Research_Report_13.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">About 50%\u003c/a> of farmworkers are undocumented, and without legal status they have been systematically left out of U.S. labor protections, like overtime and sick pay. Under the Affordable Care Act, \u003ca href=\"https://www.kqed.org/stateofhealth/142601/farming-industry-chafed-by-obamacare-requirements\" target=\"_blank\" rel=\"noopener noreferrer\">undocumented immigrants\u003c/a> were prohibited from getting health insurance through the state’s Medicaid program or from buying it through the state’s marketplace.\u003c/p>\n\u003cp>Without health coverage, advocates say farmworkers are paying the price with their lives: Latinos are \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-race-ethnicity.html\" target=\"_blank\" rel=\"noopener noreferrer\">almost three times\u003c/a> more likely to die from COVID-19 than white people.\u003c/p>\n\u003cp>“We’re seeing these structural inequities that are now being exacerbated because of a pandemic,” says Diana Tellefson Torres, executive director of the United Farm Workers Foundation, adding that all the barriers they face in getting care is another reason farmworkers should be prioritized for the vaccine.\u003c/p>\n\u003cp>“This is definitely an opportunity to redress a lot of the inequities that farmworkers have experienced, not only for decades, but for centuries,” she says. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But smaller counties with less money may find this daunting — even impractical. For Eric Sergienko, public health officer for Mariposa County, it doesn’t make sense to vaccinate farmworkers first because the first vaccines endorsed by the Food and Drug Administration — the \u003ca href=\"https://www.kqed.org/coronavirusliveupdates/news/11850939/fda-authorizes-covid-19-vaccine-for-emergency-use-in-u-s\">Pfizer-BioNTech\u003c/a> and \u003ca href=\"https://www.kqed.org/science/1971735/fda-researchers-endorse-moderna-covid-19-vaccine\">Moderna\u003c/a> vaccines — each require two doses: the primary shot followed by a booster.\u003c/p>\n\u003cp>“So if it were just a single shot, I think we would be able to wrangle with logistics fairly easily,” Sergienko says. “But seeing as we have to find that person either 21 days or 28 days later, that adds a layer of complexity.”\u003c/p>\n\u003cp>Farmworkers are mobile, he adds. They could be working or living in a different place one month later. He says the most effective strategy could be to wait.\u003c/p>\n\u003cp>“Don’t let the perfect be the enemy of the good,” he says. “Hold us as closely to those equitable measures as possible, but recognize that it’s not going to be perfect.”\u003c/p>\n\u003cp>Sergienko is concerned about equity, but he needs to use an equation that works for his region. His county has just one hospital and no intensive care unit. If someone gets really sick and needs an ICU bed, they get flown or taken in an ambulance to a tertiary care facility, usually in Fresno or Modesto.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But hospitals in those regions are running out of beds. The San Joaquin Valley region had less than 2% of its ICU beds available as of Dec. 14, meaning patients have to wait longer, and get care from staff members who are stretched thin. To Sergienko, it makes sense to vaccinate frail, elderly people first because they’re most likely to need critical care.\u003c/p>\n\u003cp>“The more people I keep out of the hospital, the better the people that are actually hospitalized will do,” he says.\u003c/p>\n\u003cp>Inequity cuts across ethnicity, age and geography, Sergienko says. He hopes the state’s final vaccine plan will somehow account for this: Who needs the vaccine most in Mariposa County may be very different from who needs it most in San Diego or San Francisco.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003cb>COVID-19 Hospital and Vaccine Update\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">The surge in coronavirus cases continued its steady rise this week, as California’s ICU capacity dropped to 9%. Meanwhile, approval for a potential COVID-19 vaccine may be only days away. But until the vaccine is widely distributed — months from now — hospitals face a long, dark winter.\u003c/span>\u003c/p>\n\u003cp>\u003cb>Guests:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Dr. Robert Wachter, chair, UCSF Department of Medicine\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Carmela Coyle, president and CEO, California Hospital Association\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Child Care System Stressed by the Pandemic\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">California’s Department of Social Services estimates that nearly 2,500 family child care facilities have closed permanently since the pandemic began. Advocates say the child care system, already fragile before the pandemic, is now in crisis, as many essential workers are scrambling to find reliable — and affordable — care so that they can go to work. \u003c/span>\u003c/p>\n\u003cp>\u003cb>Guests: \u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Loira Limbal, filmmaker, “Through the Night”\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Amie Latterman, chief advancement officer, Children’s Council of San Francisco\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Something Beautiful: Cavallo Point\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">We travel to the north end of the Golden Gate Bridge to visit Cavallo Point, which was named in 1775 for the wild horses that once roamed the region.\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"description": "COVID-19 Hospital and Vaccine Update The surge in coronavirus cases continued its steady rise this week, as California’s ICU capacity dropped to 9%. Meanwhile, approval for a potential COVID-19 vaccine may be only days away. But until the vaccine is widely distributed — months from now — hospitals face a long, dark winter. Guests: Dr. Robert Wachter, chair, UCSF Department of Medicine Carmela Coyle, president and CEO, California Hospital Association Child Care System Stressed by the Pandemic California’s Department of Social Services estimates that nearly 2,500 family child care facilities have closed permanently since the pandemic began. Advocates say the",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cb>COVID-19 Hospital and Vaccine Update\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">The surge in coronavirus cases continued its steady rise this week, as California’s ICU capacity dropped to 9%. Meanwhile, approval for a potential COVID-19 vaccine may be only days away. But until the vaccine is widely distributed — months from now — hospitals face a long, dark winter.\u003c/span>\u003c/p>\n\u003cp>\u003cb>Guests:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Dr. Robert Wachter, chair, UCSF Department of Medicine\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Carmela Coyle, president and CEO, California Hospital Association\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Child Care System Stressed by the Pandemic\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">California’s Department of Social Services estimates that nearly 2,500 family child care facilities have closed permanently since the pandemic began. Advocates say the child care system, already fragile before the pandemic, is now in crisis, as many essential workers are scrambling to find reliable — and affordable — care so that they can go to work. \u003c/span>\u003c/p>\n\u003cp>\u003cb>Guests: \u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Loira Limbal, filmmaker, “Through the Night”\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Amie Latterman, chief advancement officer, Children’s Council of San Francisco\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Something Beautiful: Cavallo Point\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">We travel to the north end of the Golden Gate Bridge to visit Cavallo Point, which was named in 1775 for the wild horses that once roamed the region.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "California extiende la fecha límite para solicitar seguro médico por medio del Affordable Care Act",
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"content": "\u003cp>\u003cem>\u003ca href=\"https://www.kqed.org/news/11850458/want-health-insurance-through-the-affordable-care-act-your-last-chance-is-tuesday-dec-15\">Read in English\u003c/a>\u003c/em>\u003c/p>\n\u003cp>\u003cem>Este artículo fue actualizado a las 4 p.m. el 16 de diciembre\u003c/em>\u003c/p>\n\u003cp>¿Planea solicitar seguro médico para 2021 a través del programa federal que provee subsidios para cobertura médica (también conocido como “Obamacare” o “ACA” por sus siglas en inglés)? La fecha límite para solicitar la cobertura ha sido extendida hasta el 30 de diciembre.\u003c/p>\n\u003cp>“Los Californianos necesitar cobertura médica ahora más que nunca y es por eso que decidimos extender la fecha límite para solicitar Covered California”, dijo el Gobernador Gavin Newsom en un video publicado en Twitter anunciando la extensión.\u003c/p>\n\u003cblockquote class=\"twitter-tweet\">\n\u003cp dir=\"ltr\" lang=\"en\">Californians need health care now more than ever. That’s why we just extended our open enrollment period for \u003ca href=\"https://twitter.com/CoveredCA?ref_src=twsrc%5Etfw\">@CoveredCA\u003c/a>.\u003c/p>\n\u003cp>The deadline for coverage starting 1/1/21 is now 12/30. See which discounts you qualify for & enroll today.\u003c/p>\n\u003cp>📲 \u003ca href=\"https://t.co/snHQO7VBnZ\">https://t.co/snHQO7VBnZ\u003c/a> \u003ca href=\"https://t.co/SEJsptA0Z7\">pic.twitter.com/SEJsptA0Z7\u003c/a>\u003c/p>\n\u003cp>— Office of the Governor of California (@CAgovernor) \u003ca href=\"https://twitter.com/CAgovernor/status/1339277586518605824?ref_src=twsrc%5Etfw\">December 16, 2020\u003c/a>\u003c/p>\u003c/blockquote>\n\u003cp>Esta opción, la cual otorga cobertura médica a través del mercado de seguros médicos administrado por el gobierno federal, está disponible para personas que no tendrán cobertura médica para el 1o de enero de 2021. Esto incluye a personas que no recibirán este beneficio de su empleador o que no califican para programas como Medicaid, Medicare o el programa de cobertura médica para niños (‘CHIP’ por sus siglas en inglés). Cualquier cobertura que uno reciba por ACA será vigente a partir del 1o de enero.\u003c/p>\n\u003cp>Para comparar los costos entre diferentes seguros médicos disponibles en este programa, y para comenzar su solicitud, visite el sitio wen www.healthcare.gov/es para comenzar este proceso.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003ch3>\u003cstrong>¿Califico para este tipo de cobertura?\u003c/strong>\u003c/h3>\n\u003cp>Para recibir cobertura a través del mercado de seguros de ACA, uno tiene que ser un residente de los Estados Unidos, lo que incluye a ciudadanos y residentes estadounidenses, o cualquiera que tenga un estatus legal en el país. (Lea más aquí sobre cuáles estatus migratorios califican)\u003c/p>\n\u003cp>Quienes ya tengan cobertura a través de Medicare no son elegibles para seguros de salud o de cobertura dental de ACA. Las personas que actualmente están en la cárcel tampoco califican. Sin embargo, personas que tengan condiciones preexistentes como cáncer o diabetes no serán descalificadas y compañías que formen parte del mercado de ACA no pueden rechazar a alguien por esto, ni cobrar extra.\u003c/p>\n\u003cp>Para más información sobre las fechas claves, cómo funciona el mercado de seguros y otros requisitos para aplicar, el sitio de ACA ofrece un \u003ca href=\"https://www.healthcare.gov/quick-guide/one-page-guide-to-the-marketplace/\">breve resumen\u003c/a> sobre las operaciones de este programa.\u003c/p>\n\u003ch3>\u003cstrong>¿Y si se me pasa la fecha límite el 30 de diciembre?\u003c/strong>\u003c/h3>\n\u003cp>El 30 de diciembre es la fecha límite para inscribirse para la cobertura que comienza a partir del 1 de enero del 2021. Sin embargo, Covered California ofrece un plazo adicional para registrarse, \u003ca href=\"http://coveredca.com/espanol/support/before-you-buy/enrollment-dates-and-deadlines/\">hasta el 31 de enero de 2021\u003c/a>, pero la cobertura que recibas no inciaría hasta el 1 de febrero de ese año.\u003c/p>\n\u003cp>[aside label ='Historias Relacionadas' tag='kqed-en-espanol']\u003c/p>\n\u003cp>Si no se registra a tiempo dentro de las dos fechas límites, es posible que califique para el ‘periodo especial de inscripción’.\u003c/p>\n\u003cp>Esto otorga una segunda oportunidad para registrarse a personas que hayan cambiado algo de su vida personal (como haberse casado, divorciado o si tuvieron un bebé), si se mudaron o si perdieron su cobertura médica a causa de ciertas razones (por ejemplo, si perdió su empleo).\u003c/p>\n\u003cp>Si ya se inscribió para recibir cobertura médica por ACA y desea cambiar o modificar el seguro que compró, la única manera para hacerlo es a través del periodo especial de inscripción. \u003ca href=\"https://www.healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period/\">Lea más\u003c/a> sobre el periodo especial de inscripción.\u003c/p>\n\u003cp>\u003cem>Este artículo fue traducido por el periodista, \u003ca>Carlos Cabrera-Lomelí\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cp class=\"p1\">At the end of DeOnte Taylor’s recent shift, only one bed remained. The respiratory therapist says his hospital in Oakland was lucky that two critically ill patients didn’t arrive at the same time.\u003c/p>\n\u003cfigure id=\"attachment_11850169\" class=\"wp-caption alignright\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2020/12/covidcaliforniasurge-scaled.jpeg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11850169 size-large\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/12/covidcaliforniasurge-1020x1360.jpeg\" alt=\"\" width=\"640\" height=\"853\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/covidcaliforniasurge-1020x1360.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/covidcaliforniasurge-800x1067.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/covidcaliforniasurge-160x213.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/covidcaliforniasurge-1152x1536.jpeg 1152w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/covidcaliforniasurge-1536x2048.jpeg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/covidcaliforniasurge-scaled.jpeg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/covidcaliforniasurge-1122x1496.jpeg 1122w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/covidcaliforniasurge-840x1120.jpeg 840w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/covidcaliforniasurge-687x916.jpeg 687w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/covidcaliforniasurge-414x552.jpeg 414w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/covidcaliforniasurge-354x472.jpeg 354w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Parimal Bharucha and colleague reviewing patient records inside the ICU COVID-19 unit at Dignity Health Mercy Hospital. ‘It’s like post-traumatic stress disorder that we all go through,’ said Bharucha about the current surge. ‘It is a communal sense of grief.’ \u003ccite>(Courtesty Dignity Health Mercy Hospital)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p1\">“We’ve been barely missing capsizing,” Taylor said.\u003c/p>\n\u003cp class=\"p1\">He fears the surge will topple the facility by the end of the week.\u003c/p>\n\u003cp class=\"p1\">“I think it’s going to be chaotic. Only severe patients will be admitted … because we can only take care of the worst,” he said.\u003c/p>\n\u003cp class=\"p1\">That’s also the reality unfolding at Kaiser Permanente’s Fresno Medical Center. Nurses struggle to fit inside rooms where two beds have been shoved inside. Staff are scrambling to convert conference rooms and a cafeteria into care facilities.\u003c/p>\n\u003cp class=\"p1\">“We are at the point where we are having to triage who deserves an ICU bed and who doesn’t,” said registered nurse Amy Arlund at the end of a harrowing night shift. “We have to look at the severity of each patient and evaluate the chances of survival and pick the best candidate for a bed.”\u003c/p>\n\u003cp class=\"p1\">Arlund says many hospitals in Fresno are beyond capacity. Across California, 80% of the intensive care units are full, according to Carmela Coyle, president and CEO of the California Hospital Association. San Diego, Los Angeles, Imperial County and the entire San Joaquin Valley are the worst hot spots, she said. But, she stressed, Northern California is not going to dodge this particular bullet this time.\u003c/p>\n\u003cp class=\"p1\">Sunday’s single-day tally of 30,000 positive COVID-19 tests in California is three times higher than the total any day during the summer peak. A record-breaking 11,000 people across the state are lying in a hospital bed fighting the virus, an \u003ca href=\"https://www.latimes.com/projects/california-coronavirus-cases-tracking-outbreak/#patients\">\u003cspan class=\"s1\">87%\u003c/span>\u003c/a> increase over the last two weeks.\u003c/p>\n\u003cp class=\"p1\">“The most important limiting factor is staff,” said Coyle. “Those critical care nurses, doctors and respiratory therapists that are needed at the bedside to care and to cure.”\u003c/p>\n\u003cp class=\"p1\">The entire country is now suffering a shortage of health care workers with enough training to care for COVID-19 patients. Some who have those skills are at home taking care of children because schools are closed. Others are sick themselves or nursing loved ones. The virus has killed \u003ca href=\"https://covid.cdc.gov/covid-data-tracker/#health-care-personnel\">\u003cspan class=\"s1\">hundreds\u003c/span>\u003c/a>, potentially thousands of health care workers in the U.S.\u003c/p>\n\u003cp class=\"p1\">Because hospitals across the country are running short on trained personnel, it’s making it harder for California to recruit from the same pool of overworked providers.\u003c/p>\n\u003cp class=\"p1\">“We are mentally, emotionally and physically exhausted,” said Dinora Chinchilla, a pulmonologist specializing in critical care at a hospital in Orange County. “There’s only so many words you can use to describe the extreme fatigue.”\u003c/p>\n\u003cp class=\"p1\">Watching the COVID-19 numbers soar is filling Chinchilla with dread. She says she can’t eat.\u003c/p>\n\u003cp class=\"p1\">“Because this is real,” said Chinchilla. “I’ve had patients who’ve told me that they don’t believe that this exists until they’ve ended up in the hospital. Why have people lost faith in physicians? We practice this field because we love what we do. We want to save lives.”\u003c/p>\n\u003cp class=\"p1\">She says it’s brutal taking care of so many patients who don’t make it.\u003c/p>\n\u003cp class=\"p1\">“It’s like post-traumatic stress disorder that we all go through,” said Dr. Parimal Bharucha, a pulmonologist for Dignity Health in Sacramento. “It is a communal sense of grief. ”\u003c/p>\n\u003cp class=\"p1\">He says his ICU is filled with motionless, sedated people kept alive by machines. The floor is strewn with masks and gowns. Nurses race between patients. It’s “like a war zone,” he said.\u003c/p>\n\u003cp class=\"p1\">“Yesterday I was on-call for telemedicine and I had three patients crash within five minutes of each other,” Bharucha said. “At the same time, in another hospital, there were three patients who had cardiac arrest, one after another.”\u003c/p>\n\u003cp class=\"p1\">Often, he can’t honor his patients’ dying requests. There was an older woman who hadn’t seen her estranged son in decades. She called him but he wasn’t allowed to visit his mother during her final moments because pandemic protocols prevent visitors from entering hospitals.\u003c/p>\n\u003cp class=\"p1\">“This lady could not have the son at the bedside, and she treated me as a son and wanted me to hold her hands when she died,” said Bharucha. “And I could not live up to that.”\u003c/p>\n\u003cp class=\"p1\">Just before she died, Bharucha was called away to treat someone else.\u003c/p>\n\u003cp class=\"p1\">“Somewhere in the back of my mind, it is haunting me,” he said, tearing up.\u003c/p>\n\u003cp class=\"p1\">Coyle attributes the current surge to increased virus transmission over Halloween. The sharp spike does not include the additional numbers doctors expect to see from Thanksgiving gatherings and travel.\u003c/p>\n\u003cp class=\"p1\">So the situation is likely to get worse before it gets better. Dr. Bharucha’s hospital hasn’t had to turn anyone away yet, but he says that could change overnight.\u003c/p>\n\u003cp class=\"p3\">“Please help us help you,” he pleaded. “Please help us take care of the people who really need our help. Don’t let hospitals be overwhelmed, because ultimately, at the end of the day, it is somebody’s loved ones who will need us.”\u003c/p>\n\u003cp class=\"p1\">He urges everyone to stay home and sit tight over the holidays.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "Doctors and nurses are already overwhelmed by the numbers of COVID-19 patients they're seeing and the choices they're forced to make. Yet, the surge of patients may become even more extreme by year's end.\r\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"p1\">At the end of DeOnte Taylor’s recent shift, only one bed remained. The respiratory therapist says his hospital in Oakland was lucky that two critically ill patients didn’t arrive at the same time.\u003c/p>\n\u003cfigure id=\"attachment_11850169\" class=\"wp-caption alignright\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2020/12/covidcaliforniasurge-scaled.jpeg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11850169 size-large\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/12/covidcaliforniasurge-1020x1360.jpeg\" alt=\"\" width=\"640\" height=\"853\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/covidcaliforniasurge-1020x1360.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/covidcaliforniasurge-800x1067.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/covidcaliforniasurge-160x213.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/covidcaliforniasurge-1152x1536.jpeg 1152w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/covidcaliforniasurge-1536x2048.jpeg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/covidcaliforniasurge-scaled.jpeg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/covidcaliforniasurge-1122x1496.jpeg 1122w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/covidcaliforniasurge-840x1120.jpeg 840w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/covidcaliforniasurge-687x916.jpeg 687w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/covidcaliforniasurge-414x552.jpeg 414w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/covidcaliforniasurge-354x472.jpeg 354w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Parimal Bharucha and colleague reviewing patient records inside the ICU COVID-19 unit at Dignity Health Mercy Hospital. ‘It’s like post-traumatic stress disorder that we all go through,’ said Bharucha about the current surge. ‘It is a communal sense of grief.’ \u003ccite>(Courtesty Dignity Health Mercy Hospital)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p1\">“We’ve been barely missing capsizing,” Taylor said.\u003c/p>\n\u003cp class=\"p1\">He fears the surge will topple the facility by the end of the week.\u003c/p>\n\u003cp class=\"p1\">“I think it’s going to be chaotic. Only severe patients will be admitted … because we can only take care of the worst,” he said.\u003c/p>\n\u003cp class=\"p1\">That’s also the reality unfolding at Kaiser Permanente’s Fresno Medical Center. Nurses struggle to fit inside rooms where two beds have been shoved inside. Staff are scrambling to convert conference rooms and a cafeteria into care facilities.\u003c/p>\n\u003cp class=\"p1\">“We are at the point where we are having to triage who deserves an ICU bed and who doesn’t,” said registered nurse Amy Arlund at the end of a harrowing night shift. “We have to look at the severity of each patient and evaluate the chances of survival and pick the best candidate for a bed.”\u003c/p>\n\u003cp class=\"p1\">Arlund says many hospitals in Fresno are beyond capacity. Across California, 80% of the intensive care units are full, according to Carmela Coyle, president and CEO of the California Hospital Association. San Diego, Los Angeles, Imperial County and the entire San Joaquin Valley are the worst hot spots, she said. But, she stressed, Northern California is not going to dodge this particular bullet this time.\u003c/p>\n\u003cp class=\"p1\">Sunday’s single-day tally of 30,000 positive COVID-19 tests in California is three times higher than the total any day during the summer peak. A record-breaking 11,000 people across the state are lying in a hospital bed fighting the virus, an \u003ca href=\"https://www.latimes.com/projects/california-coronavirus-cases-tracking-outbreak/#patients\">\u003cspan class=\"s1\">87%\u003c/span>\u003c/a> increase over the last two weeks.\u003c/p>\n\u003cp class=\"p1\">“The most important limiting factor is staff,” said Coyle. “Those critical care nurses, doctors and respiratory therapists that are needed at the bedside to care and to cure.”\u003c/p>\n\u003cp class=\"p1\">The entire country is now suffering a shortage of health care workers with enough training to care for COVID-19 patients. Some who have those skills are at home taking care of children because schools are closed. Others are sick themselves or nursing loved ones. The virus has killed \u003ca href=\"https://covid.cdc.gov/covid-data-tracker/#health-care-personnel\">\u003cspan class=\"s1\">hundreds\u003c/span>\u003c/a>, potentially thousands of health care workers in the U.S.\u003c/p>\n\u003cp class=\"p1\">Because hospitals across the country are running short on trained personnel, it’s making it harder for California to recruit from the same pool of overworked providers.\u003c/p>\n\u003cp class=\"p1\">“We are mentally, emotionally and physically exhausted,” said Dinora Chinchilla, a pulmonologist specializing in critical care at a hospital in Orange County. “There’s only so many words you can use to describe the extreme fatigue.”\u003c/p>\n\u003cp class=\"p1\">Watching the COVID-19 numbers soar is filling Chinchilla with dread. She says she can’t eat.\u003c/p>\n\u003cp class=\"p1\">“Because this is real,” said Chinchilla. “I’ve had patients who’ve told me that they don’t believe that this exists until they’ve ended up in the hospital. Why have people lost faith in physicians? We practice this field because we love what we do. We want to save lives.”\u003c/p>\n\u003cp class=\"p1\">She says it’s brutal taking care of so many patients who don’t make it.\u003c/p>\n\u003cp class=\"p1\">“It’s like post-traumatic stress disorder that we all go through,” said Dr. Parimal Bharucha, a pulmonologist for Dignity Health in Sacramento. “It is a communal sense of grief. ”\u003c/p>\n\u003cp class=\"p1\">He says his ICU is filled with motionless, sedated people kept alive by machines. The floor is strewn with masks and gowns. Nurses race between patients. It’s “like a war zone,” he said.\u003c/p>\n\u003cp class=\"p1\">“Yesterday I was on-call for telemedicine and I had three patients crash within five minutes of each other,” Bharucha said. “At the same time, in another hospital, there were three patients who had cardiac arrest, one after another.”\u003c/p>\n\u003cp class=\"p1\">Often, he can’t honor his patients’ dying requests. There was an older woman who hadn’t seen her estranged son in decades. She called him but he wasn’t allowed to visit his mother during her final moments because pandemic protocols prevent visitors from entering hospitals.\u003c/p>\n\u003cp class=\"p1\">“This lady could not have the son at the bedside, and she treated me as a son and wanted me to hold her hands when she died,” said Bharucha. “And I could not live up to that.”\u003c/p>\n\u003cp class=\"p1\">Just before she died, Bharucha was called away to treat someone else.\u003c/p>\n\u003cp class=\"p1\">“Somewhere in the back of my mind, it is haunting me,” he said, tearing up.\u003c/p>\n\u003cp class=\"p1\">Coyle attributes the current surge to increased virus transmission over Halloween. The sharp spike does not include the additional numbers doctors expect to see from Thanksgiving gatherings and travel.\u003c/p>\n\u003cp class=\"p1\">So the situation is likely to get worse before it gets better. Dr. Bharucha’s hospital hasn’t had to turn anyone away yet, but he says that could change overnight.\u003c/p>\n\u003cp class=\"p3\">“Please help us help you,” he pleaded. “Please help us take care of the people who really need our help. Don’t let hospitals be overwhelmed, because ultimately, at the end of the day, it is somebody’s loved ones who will need us.”\u003c/p>\n\u003cp class=\"p1\">He urges everyone to stay home and sit tight over the holidays.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>That President-elect Joe Biden wants Xavier Becerra to be part of his administration is not surprising, but choosing California’s top law enforcement official to be his health secretary raised a few eyebrows.\u003c/p>\n\u003cp>Becerra, the 62-year-old son of immigrants from Mexico, was rumored to be on Biden’s short list for attorney general. But it wasn’t until recent days that he emerged as a serious contender to head up the Department of Health and Human Services — a massive bureaucracy whose portfolio includes overseeing Medicare, the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Neither Biden nor Becerra have commented on reports that the attorney general is the choice for health secretary, but NPR and many other news organizations have confirmed it, and Gov. Gavin Newsom tweeted his congratulations to Becerra.\u003c/p>\n\u003cp>https://twitter.com/GavinNewsom/status/1335730236562886658?s=20\u003c/p>\n\u003cp>A formal announcement could come any day.\u003c/p>\n\u003cp>“He’s almost ideally suited to lead that department,” said Drew Altman, president and CEO of the Kaiser Family Foundation. “These days, health care is dominated by politics and by money. And you have to know how to navigate those waters to get stuff done.”\u003c/p>\n\u003cp>Altman and others noted Becerra’s 12 terms in Congress where he represented Los Angeles and became a staunch advocate for access to health care before then-Gov. Jerry Brown picked him to replace Attorney General Kamala Harris when she was elected to the U.S. Senate.\u003c/p>\n\u003cp>“He has probably been the number one defender of the Affordable Care Act under the Trump administration, and he’s done it well and articulately,” said Peter Lee, executive director of Covered California, which oversees the state’s implementation of the ACA. “But it doesn’t end there because he … also recognizes that health care in America has problems that need to be addressed, that go beyond what the Affordable Care Act alone.”\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Drew Altman, president and CEO of the Kaiser Family Foundation']‘He’s almost ideally suited to lead that department … These days, health care is dominated by politics and by money. And you have to know how to navigate those waters to get stuff done.’[/pullquote]\u003c/p>\n\u003cp>As California’s attorney general, Becerra has sued the Trump administration more than a hundred times over issues ranging from immigration to the environment and health care.\u003c/p>\n\u003cp>“He’s really been the leading national champion against the Trump administration in order to protect health care for Americans both in California and across the country,” said Mayra Alvarez, president of the Children’s Partnership in Los Angeles. “Reproductive health, health coverage, you name it. He was there front and center, pushing back on regulation changes and other efforts by the Trump administration that would have taken away health care for some 20 million Americans.”\u003c/p>\n\u003cp>But Becerra’s tenure as attorney general has not been met with universal praise. Advocates of releasing personnel and use-of-force records of problematic police officers based on Senate Bill 1421, a law signed by Gov. Jerry Brown, have been extremely critical of Becerra’s unwillingness to fully comply with the law until forced to do so by the courts.\u003c/p>\n\u003cp>“He is no friend of government transparency,” said David Snyder, executive director of the First Amendment Coalition.\u003c/p>\n\u003cp>Snyder said Becerra’s position on SB 1421 was devoid of valid legal arguments. While stopping short of opposing the law, Becerra said the courts should weigh in on various challenges brought by law enforcement unions throughout the state. KQED joined the First Amendment Coalition’s lawsuit last year against the attorney general and state Department of Justice for access to those records. [aside tag=\"health-care\" label=\"more coverage\"]\u003c/p>\n\u003cp>“That’s just not a position that the state’s highest law enforcement officer should be taking if they want to directly oppose the law and they want to take the position that certain records simply don’t have to be released,” Snyder said.\u003c/p>\n\u003cp>Becerra was born in Sacramento in 1958 to parents who came to the U.S. from Mexico. In an interview with KQED’s \u003ca href=\"https://www.kqed.org/news/11680365/attorney-general-xavier-becerra-on-californias-legal-battles-with-the-trump-administration\" target=\"_blank\" rel=\"noopener noreferrer\">Political Breakdown\u003c/a> after he became attorney general, Becerra talked about how his parents influenced him.\u003c/p>\n\u003cp>“My dad couldn’t walk into a restaurant because of the signs that said ‘no dogs or Mexicans allowed’ even though he was a U.S. citizen! This is when he was a younger man. But you know, he never spoke one time in any of the times that I’ve had an opportunity with him ill about this country because it’s offered him so much and it let his four kids go on and have college or serve in the military,” Becerra said.\u003c/p>\n\u003cp>It seems like Becerra’s focus in public life and policymaking is in some ways a response to the injustices he witnessed, and continues to see directed at immigrants.\u003c/p>\n\u003cp>Becerra said he thinks his parents, and immigrant in the state “feel very proud that there’s an attorney general for the state of California that can absorb, learn and punch back.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>If confirmed, Becerra will take over HHS at a time when the coronavirus pandemic is raging and the nation prepares to begin distributing vaccines that hopefully will bring an end to this era of death, despair and disagreement over masks and government shutdowns.\u003c/p>\n\u003cp>“The good news is in a year, the pandemic is going to be behind us and we should be focusing on issues of health disparities, focusing on how the CDC gets ramped up better. What do we do about the FDA? How do Medicare and Medicaid truly meet the needs of all Americans?” said Covered California’s Lee.\u003c/p>\n\u003cp>He’s hopeful that Becerra’s ascension to health secretary will usher in a new era of more equity in the delivery of health care in the United States.\u003c/p>\n\u003cp>“Having someone at the top of Health and Human Services that understands from experience that health care is defined all too often by the color of your skin and your ZIP code. That’s not the America we want to have,” Lee said.\u003c/p>\n\u003cp>If Becerra is confirmed, his replacement will be chosen by Newsom, who already has a plum appointment still to be made for the remainder of Vice President-elect Kamala Harris’s U.S. Senate term.\u003c/p>\n\u003cp>\u003cem>KQED’s Alex Emslie contributed to this report.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>That President-elect Joe Biden wants Xavier Becerra to be part of his administration is not surprising, but choosing California’s top law enforcement official to be his health secretary raised a few eyebrows.\u003c/p>\n\u003cp>Becerra, the 62-year-old son of immigrants from Mexico, was rumored to be on Biden’s short list for attorney general. But it wasn’t until recent days that he emerged as a serious contender to head up the Department of Health and Human Services — a massive bureaucracy whose portfolio includes overseeing Medicare, the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Neither Biden nor Becerra have commented on reports that the attorney general is the choice for health secretary, but NPR and many other news organizations have confirmed it, and Gov. Gavin Newsom tweeted his congratulations to Becerra.\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>A formal announcement could come any day.\u003c/p>\n\u003cp>“He’s almost ideally suited to lead that department,” said Drew Altman, president and CEO of the Kaiser Family Foundation. “These days, health care is dominated by politics and by money. And you have to know how to navigate those waters to get stuff done.”\u003c/p>\n\u003cp>Altman and others noted Becerra’s 12 terms in Congress where he represented Los Angeles and became a staunch advocate for access to health care before then-Gov. Jerry Brown picked him to replace Attorney General Kamala Harris when she was elected to the U.S. Senate.\u003c/p>\n\u003cp>“He has probably been the number one defender of the Affordable Care Act under the Trump administration, and he’s done it well and articulately,” said Peter Lee, executive director of Covered California, which oversees the state’s implementation of the ACA. “But it doesn’t end there because he … also recognizes that health care in America has problems that need to be addressed, that go beyond what the Affordable Care Act alone.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>As California’s attorney general, Becerra has sued the Trump administration more than a hundred times over issues ranging from immigration to the environment and health care.\u003c/p>\n\u003cp>“He’s really been the leading national champion against the Trump administration in order to protect health care for Americans both in California and across the country,” said Mayra Alvarez, president of the Children’s Partnership in Los Angeles. “Reproductive health, health coverage, you name it. He was there front and center, pushing back on regulation changes and other efforts by the Trump administration that would have taken away health care for some 20 million Americans.”\u003c/p>\n\u003cp>But Becerra’s tenure as attorney general has not been met with universal praise. Advocates of releasing personnel and use-of-force records of problematic police officers based on Senate Bill 1421, a law signed by Gov. Jerry Brown, have been extremely critical of Becerra’s unwillingness to fully comply with the law until forced to do so by the courts.\u003c/p>\n\u003cp>“He is no friend of government transparency,” said David Snyder, executive director of the First Amendment Coalition.\u003c/p>\n\u003cp>Snyder said Becerra’s position on SB 1421 was devoid of valid legal arguments. While stopping short of opposing the law, Becerra said the courts should weigh in on various challenges brought by law enforcement unions throughout the state. KQED joined the First Amendment Coalition’s lawsuit last year against the attorney general and state Department of Justice for access to those records. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“That’s just not a position that the state’s highest law enforcement officer should be taking if they want to directly oppose the law and they want to take the position that certain records simply don’t have to be released,” Snyder said.\u003c/p>\n\u003cp>Becerra was born in Sacramento in 1958 to parents who came to the U.S. from Mexico. In an interview with KQED’s \u003ca href=\"https://www.kqed.org/news/11680365/attorney-general-xavier-becerra-on-californias-legal-battles-with-the-trump-administration\" target=\"_blank\" rel=\"noopener noreferrer\">Political Breakdown\u003c/a> after he became attorney general, Becerra talked about how his parents influenced him.\u003c/p>\n\u003cp>“My dad couldn’t walk into a restaurant because of the signs that said ‘no dogs or Mexicans allowed’ even though he was a U.S. citizen! This is when he was a younger man. But you know, he never spoke one time in any of the times that I’ve had an opportunity with him ill about this country because it’s offered him so much and it let his four kids go on and have college or serve in the military,” Becerra said.\u003c/p>\n\u003cp>It seems like Becerra’s focus in public life and policymaking is in some ways a response to the injustices he witnessed, and continues to see directed at immigrants.\u003c/p>\n\u003cp>Becerra said he thinks his parents, and immigrant in the state “feel very proud that there’s an attorney general for the state of California that can absorb, learn and punch back.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>If confirmed, Becerra will take over HHS at a time when the coronavirus pandemic is raging and the nation prepares to begin distributing vaccines that hopefully will bring an end to this era of death, despair and disagreement over masks and government shutdowns.\u003c/p>\n\u003cp>“The good news is in a year, the pandemic is going to be behind us and we should be focusing on issues of health disparities, focusing on how the CDC gets ramped up better. What do we do about the FDA? How do Medicare and Medicaid truly meet the needs of all Americans?” said Covered California’s Lee.\u003c/p>\n\u003cp>He’s hopeful that Becerra’s ascension to health secretary will usher in a new era of more equity in the delivery of health care in the United States.\u003c/p>\n\u003cp>“Having someone at the top of Health and Human Services that understands from experience that health care is defined all too often by the color of your skin and your ZIP code. That’s not the America we want to have,” Lee said.\u003c/p>\n\u003cp>If Becerra is confirmed, his replacement will be chosen by Newsom, who already has a plum appointment still to be made for the remainder of Vice President-elect Kamala Harris’s U.S. Senate term.\u003c/p>\n\u003cp>\u003cem>KQED’s Alex Emslie contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>As the cooler weather takes hold, a viral pandemic is blanketing the U.S. with infection rates like we’ve never seen.\u003c/p>\n\u003cp>As of early December, there are more than 200,000 \u003ca href=\"https://www.npr.org/sections/health-shots/2020/09/01/816707182/map-tracking-the-spread-of-the-coronavirus-in-the-u-s\">new U.S. cases\u003c/a> reported and more than 1,800 deaths from COVID-19 on average every day. And although we know this illness is dangerous, the \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html#:~:text=The%20overall%20cumulative%20COVID%2D19,aged%2065%20years%20and%20older.\">hospitalization rate\u003c/a> is about 243 hospital stays per 100,000 infections, which means masses of people are having to manage less severe cases at home, too.\u003c/p>\n\u003cp>Patients are facing time alone with a notoriously unpredictable virus — and that can feel scary, confusing and overwhelming. Those are all sentiments I’ve heard a lot in my own practice as a family doctor lately.\u003c/p>\n\u003cp>If you’ve gotten a positive test result, here’s advice from doctors about how to handle a mild to moderate, or even asymptomatic, case on your own — and when you need to seek emergency help.\u003c/p>\n\u003ch3>\u003cstrong>Isolate yourself from others, starting as quickly as you can\u003c/strong>\u003c/h3>\n\u003cp>You’ve probably heard this one plenty, but it’s as important as ever: The Centers for Disease Control and Prevention \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/isolation.html\">recommends 10 days of isolation\u003c/a> after a positive coronavirus test if you’re asymptomatic, or at least 10 days of isolation from the start of symptoms if you have them. If your positive test was \u003cem>after\u003c/em> symptoms started, isolation days would still start counting from the first day of symptoms.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>If you’re in this situation and live with other people, it takes a bit of planning to follow that advice. It’s important to stay in separate rooms (including during meals and sleep), and everyone else in the house should wear a mask in common areas. Also, be sure to step up the sanitizing of shared surfaces and avoid sharing things such as cups and towels.\u003c/p>\n\u003ch3>\u003cstrong>Members of your household and your close contacts need to quarantine, too\u003c/strong>\u003c/h3>\n\u003cp>If you’ve tested positive for the virus, everyone you live with has been exposed, so they, too, \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/quarantine.html#:~:text=Stay%20home%20for%2014%20days,from%20COVID%2D19.\">will need to quarantine\u003c/a> as well as anyone you had close contact with in the two days leading up to your positive test being collected or the start of symptoms.\u003c/p>\n\u003cp>So what’s close contact? The CDC says 15 \u003cem>cumulative\u003c/em> minutes of exposure to the sick person and within 6 feet of them — even with masks on. It’s fair to assume anyone who has been gathering with you, especially indoors, was exposed, so plan to reach out to close contacts and ask them to quarantine.\u003c/p>\n\u003cp>But there’s \u003ca href=\"https://www.npr.org/2020/12/02/941355347/cdc-shortens-its-covid-19-quarantine-recommendations\">new recommendations\u003c/a> for how many days they need to quarantine. The CDC still maintains a full 14 days of quarantine after being exposed is the best method to keep from spreading COVID-19, but it now offers alternatives if that’s not possible. Exposed people can quarantine 10 days from the exposure if there’s no testing and symptoms don’t develop, or as few as seven days if there are no symptoms \u003cem>and\u003c/em> they get a negative test.\u003c/p>\n\u003cp>If the shorter quarantine schedule is followed, exposed people should keep watching closely for symptoms for a full 14 days since an infection can \u003ca href=\"https://www.who.int/news-room/q-a-detail/coronavirus-disease-covid-19\">take that long to develop\u003c/a>. But keep in mind, these are general recommendations and may differ from state to state depending on the number of cases, so be sure to look up local guidance.\u003c/p>\n\u003ch3>\u003cstrong>Assess your symptom severity and know when to seek emergency care\u003c/strong>\u003c/h3>\n\u003cp>If your symptoms are the common nasal congestion, dry cough, body aches, loss of taste or smell or headache, it’s suitable to stay home and treat yourself with rest and plenty of liquids. But be alert to changing symptoms, says \u003ca href=\"https://doctors.umiamihealth.org/provider/Roger+Argelio+Alvarez/525365\">Roger Alvarez\u003c/a>, a pulmonologist and professor of clinical medicine at the University of Miami’s Miller School of Medicine. He says that although mild to moderate COVID-19 cases can be managed at home, symptoms that start out mild can wax, wane and evolve into severe symptoms that need treatment at a hospital.\u003c/p>\n\u003cp>Red flag symptoms that suggest you need to call 911 no matter how many days you’ve been sick include (but aren’t limited to): trouble breathing, chest pain, blue lips, confusion, being unable to tolerate food or drink, weakness or feeling like you can’t stay awake.\u003c/p>\n\u003cp>Consider getting a basic oxygen monitor — \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2020/05/01/848400469/coronavirus-faqs-whats-a-pulse-oximeter-is-it-a-good-idea-to-buy-one\">a pulse oximeter\u003c/a> — for your finger at home, watching for a drop in your oxygen levels down to 94% or below. When levels drop below this, it’s time to call your doctor immediately. If you don’t have a primary care provider, go to an urgent care or emergency room — or, if you feel like you can’t breathe, call 911. Similarly, a high fever (above 103 F) that doesn’t get lower with fever-reducing medicines is another reason to call, or visit, a doctor.\u003c/p>\n\u003cp>But don’t get too caught up in the numbers: If you get a feeling that “something’s not right,” don’t delay medical care.\u003c/p>\n\u003ch3>\u003cstrong>Reach out to your doctor, but know there’s no magic pill\u003c/strong>\u003c/h3>\n\u003cp>If you’ve just tested positive and started isolating, it’s a good time to reach out to your primary care doctor or other health care provider (if you haven’t already) and get advice tailored to your symptoms and medical history. This is especially important for patients with any chronic illnesses such as lung disease or diabetes, but also for healthy people.\u003c/p>\n\u003cp>The good news? Doctors are easier to reach than ever with the popularity of \u003ca href=\"https://www.npr.org/2020/03/16/816344287/during-coronavirus-outbreak-virtual-doctor-visits-are-encouraged\">telephone and video visits\u003c/a>, so no need to leave your home to talk to them. The bad news is that the coronavirus is a virus, just like the flu, which means \u003ca href=\"https://www.cdc.gov/patientsafety/features/be-antibiotics-aware.html#:~:text=Antibiotics%20do%20not%20work%20on,infections%20get%20better%20without%20antibiotics.\">an antibiotic won’t stop the illness or the symptoms\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"https://www.uwhealth.org/findadoctor/profile/matthew-c-anderson-md/10003\">Dr. Matthew Anderson\u003c/a>, senior medical director of primary care at the University of Wisconsin, tells NPR that he sometimes gives oral steroids to patients with chronic lung disease who get COVID-19 and are wheezing. But he says steroids or other drugs you may have heard about — including one of the \u003ca href=\"https://www.npr.org/sections/health-shots/2020/11/10/933444237/fda-oks-eli-lilly-covid-19-drug-but-supplies-will-be-limited\">monoclonal antibody cocktails\u003c/a> or \u003ca href=\"https://www.npr.org/sections/latest-updates-trump-covid-19-results/2020/10/03/919883050/trump-is-taking-remdesivir-heres-how-it-works-to-control-the-coronavirus\">remdesivir\u003c/a> — “aren’t the standard of care” for mild or moderate COVID-19, and might do more harm than good in those cases. While there’s been lots of talk about those drugs given to patients with severe illness who are hospitalized – maybe most famously, \u003ca href=\"https://www.npr.org/2020/10/03/919831018/how-president-trump-is-treating-covid-19\">President Trump\u003c/a> – these treatments aren’t currently recommended for milder cases that are best managed at home.\u003c/p>\n\u003ch3>\u003cstrong>Make an isolation and care plan early, and ask for help \u003c/strong>\u003c/h3>\n\u003cp>Doctors and health care teams that include nurses and care navigators can also be a good resource for figuring out and lining up the sort of logistical help you’ll need to isolate yourself. You won’t want to run out of your routine medications, so ask your health team about how to get them via mail order or from pharmacies that deliver.\u003c/p>\n\u003cp>Also important: How will you and your quarantining housemates get and keep groceries, toilet paper and other goods in the house? Most cities now have grocery delivery services you can access online; typically health care systems also have social workers that can connect you with other food services if you need them. Make a list of your needs and ask friends for help. If you’re isolated and sick, pets will still need to be walked, snow shoveled and bills paid.\u003c/p>\n\u003ch3>\u003cstrong>Rest and rehydrate but try to avoid lingering in bed\u003c/strong>\u003c/h3>\n\u003cp>It can feel frustrating if you’ve got a positive coronavirus test with mild symptoms such as a runny nose or sore throat for which there’s no definitive treatment. But that just means you should stick to the well-worn advice for healing from any viral infection: Get extra rest, drink plenty of fluids and take an over-the-counter fever-reducing medicine such as acetaminophen if you need it.\u003c/p>\n\u003cp>Fluids may also be hard to gulp down when you’re feeling bad, but dehydration can land people in the hospital on its own. That’s especially true for children and older folks, so try to sip plenty of water, juice, soup or electrolyte drinks throughout the day. Non-caffeinated tea with \u003ca href=\"https://www.npr.org/sections/health-shots/2020/02/08/802750225/for-kids-coughs-swap-the-over-the-counter-syrups-for-honey\">honey might soothe your sore throat\u003c/a>, but avoid drinks with lots of sugar or caffeine.\u003c/p>\n\u003cp>Rest is also important to recovery, but be wary of the urge to stay in bed. “You don’t want to overwork yourself but avoid strict bed rest – we don’t want patients to be totally sedentary because we know that patients who move around seem to do better,” says Alvarez, who has recovered from a case of COVID-19 himself. He encourages patients to walk around their homes as they’re able or sit upright on the couch – all things that help expand the lungs and improve the movement of air.\u003c/p>\n\u003ch3>\u003cstrong>Don’t forget your mental health\u003c/strong>\u003c/h3>\n\u003cp>Whether or not you’ve got symptoms, getting a positive test for the coronavirus can be stressful, and isolating alone can make that even worse. When it comes to isolation, adding structure to your days can help a lot, says \u003ca href=\"https://ubhc.rutgers.edu/about-us/leadership/frank-ghinassi.xml\">Dr. Frank Ghinassi\u003c/a>, president and CEO of Rutgers University Behavioral Health Care and senior vice president at RWJBarnabas Health. Ghinassi recommends scheduling sleep and meals at the same time every day and penciling in at least one thing that provides pleasure daily — even if it’s as simple as streaming a movie.\u003c/p>\n\u003cp>The most important part is “actually making the schedule,” Ghinassi says. And be sure to include some socializing — virtual socializing, that is. Also put a bit of simple exercise on the calendar if you’re \u003ca href=\"https://newsnetwork.mayoclinic.org/discussion/covid-19-exercise-when-ill-whats-okay-and-whats-not/\">feeling up to it\u003c/a> — 30 minutes of light physical activity several times a week will help lift your mood. Maybe take a video exercise class or, if you’re asymptomatic or have mild symptoms, climbing stairs will get your heart rate up in a good way. And if you’re unwell and stairs are too much, try taking a room-to-room stroll within your home. Every little bit counts.\u003c/p>\n\u003ch3>\u003cstrong>If your symptoms linger longer than 10 days, keep isolating\u003c/strong>\u003c/h3>\n\u003cp>Unfortunately, you can’t schedule how long symptoms might last when it comes to the coronavirus. Doctors have been studying the nitty-gritty of statistics and numbers for months, and although the \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html\">CDC recommends\u003c/a> isolating at least 10 days from when mild or moderate symptoms started (or 10 days from a positive test if you never had symptoms), there’s no definite number of days to isolate if you’ve still got symptoms after that.\u003c/p>\n\u003cp>The CDC says you can stop isolating if you’ve been free of fever without fever-reducing medicines for 24 hours and your symptoms are “improving.” But if you’re fever-free and still feeling bad with symptoms such as cough, headache or body aches, it’s best to keep staying away from people longer – at least until symptoms have continued to improve significantly for a few days.\u003c/p>\n\u003cp>For otherwise healthy people who test positive for the coronavirus, there’s no need to retest before stopping isolation with or without symptoms. But it \u003cem>is\u003c/em> important to go right back to your mask-wearing, hand-washing and social-distancing routines after that isolation period. And be sure to follow up with your primary care providers – they can help counsel you about your health needs after COVID-19 and about becoming a part of clinical trials that can help researchers learn more about the virus and its treatment.\u003c/p>\n\u003ch3>\u003cstrong>Tell your cautionary tale\u003c/strong>\u003c/h3>\n\u003cp>If you’re out of the woods after a positive coronavirus test, you might consider passing along your experience to friends and family — especially any words of cautious wisdom if you traced your own case back to a pandemic-fatigued moment of weakness, such as going to a gathering or forgoing your mask. But let’s not make it a shame game: We are all human, and talking openly about your story might encourage others to keep their guard up.\u003c/p>\n\u003cp>And be sure to consider sharing acts of kindness and lending a virtual ear or hand to family, friends and neighbors you hear about who test positive later on. The best treatment for all of us to give and get right now may be looking out for each other – no prescription needed.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Kristen Kendrick is a board-certified family physician in Washington, D.C., and a health and media fellow at NPR and Georgetown University School of Medicine.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2020 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=What+To+Do+If+You+Test+Positive+For+The+Coronavirus+This+Winter&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>As the cooler weather takes hold, a viral pandemic is blanketing the U.S. with infection rates like we’ve never seen.\u003c/p>\n\u003cp>As of early December, there are more than 200,000 \u003ca href=\"https://www.npr.org/sections/health-shots/2020/09/01/816707182/map-tracking-the-spread-of-the-coronavirus-in-the-u-s\">new U.S. cases\u003c/a> reported and more than 1,800 deaths from COVID-19 on average every day. And although we know this illness is dangerous, the \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html#:~:text=The%20overall%20cumulative%20COVID%2D19,aged%2065%20years%20and%20older.\">hospitalization rate\u003c/a> is about 243 hospital stays per 100,000 infections, which means masses of people are having to manage less severe cases at home, too.\u003c/p>\n\u003cp>Patients are facing time alone with a notoriously unpredictable virus — and that can feel scary, confusing and overwhelming. Those are all sentiments I’ve heard a lot in my own practice as a family doctor lately.\u003c/p>\n\u003cp>If you’ve gotten a positive test result, here’s advice from doctors about how to handle a mild to moderate, or even asymptomatic, case on your own — and when you need to seek emergency help.\u003c/p>\n\u003ch3>\u003cstrong>Isolate yourself from others, starting as quickly as you can\u003c/strong>\u003c/h3>\n\u003cp>You’ve probably heard this one plenty, but it’s as important as ever: The Centers for Disease Control and Prevention \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/isolation.html\">recommends 10 days of isolation\u003c/a> after a positive coronavirus test if you’re asymptomatic, or at least 10 days of isolation from the start of symptoms if you have them. If your positive test was \u003cem>after\u003c/em> symptoms started, isolation days would still start counting from the first day of symptoms.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>If you’re in this situation and live with other people, it takes a bit of planning to follow that advice. It’s important to stay in separate rooms (including during meals and sleep), and everyone else in the house should wear a mask in common areas. Also, be sure to step up the sanitizing of shared surfaces and avoid sharing things such as cups and towels.\u003c/p>\n\u003ch3>\u003cstrong>Members of your household and your close contacts need to quarantine, too\u003c/strong>\u003c/h3>\n\u003cp>If you’ve tested positive for the virus, everyone you live with has been exposed, so they, too, \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/quarantine.html#:~:text=Stay%20home%20for%2014%20days,from%20COVID%2D19.\">will need to quarantine\u003c/a> as well as anyone you had close contact with in the two days leading up to your positive test being collected or the start of symptoms.\u003c/p>\n\u003cp>So what’s close contact? The CDC says 15 \u003cem>cumulative\u003c/em> minutes of exposure to the sick person and within 6 feet of them — even with masks on. It’s fair to assume anyone who has been gathering with you, especially indoors, was exposed, so plan to reach out to close contacts and ask them to quarantine.\u003c/p>\n\u003cp>But there’s \u003ca href=\"https://www.npr.org/2020/12/02/941355347/cdc-shortens-its-covid-19-quarantine-recommendations\">new recommendations\u003c/a> for how many days they need to quarantine. The CDC still maintains a full 14 days of quarantine after being exposed is the best method to keep from spreading COVID-19, but it now offers alternatives if that’s not possible. Exposed people can quarantine 10 days from the exposure if there’s no testing and symptoms don’t develop, or as few as seven days if there are no symptoms \u003cem>and\u003c/em> they get a negative test.\u003c/p>\n\u003cp>If the shorter quarantine schedule is followed, exposed people should keep watching closely for symptoms for a full 14 days since an infection can \u003ca href=\"https://www.who.int/news-room/q-a-detail/coronavirus-disease-covid-19\">take that long to develop\u003c/a>. But keep in mind, these are general recommendations and may differ from state to state depending on the number of cases, so be sure to look up local guidance.\u003c/p>\n\u003ch3>\u003cstrong>Assess your symptom severity and know when to seek emergency care\u003c/strong>\u003c/h3>\n\u003cp>If your symptoms are the common nasal congestion, dry cough, body aches, loss of taste or smell or headache, it’s suitable to stay home and treat yourself with rest and plenty of liquids. But be alert to changing symptoms, says \u003ca href=\"https://doctors.umiamihealth.org/provider/Roger+Argelio+Alvarez/525365\">Roger Alvarez\u003c/a>, a pulmonologist and professor of clinical medicine at the University of Miami’s Miller School of Medicine. He says that although mild to moderate COVID-19 cases can be managed at home, symptoms that start out mild can wax, wane and evolve into severe symptoms that need treatment at a hospital.\u003c/p>\n\u003cp>Red flag symptoms that suggest you need to call 911 no matter how many days you’ve been sick include (but aren’t limited to): trouble breathing, chest pain, blue lips, confusion, being unable to tolerate food or drink, weakness or feeling like you can’t stay awake.\u003c/p>\n\u003cp>Consider getting a basic oxygen monitor — \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2020/05/01/848400469/coronavirus-faqs-whats-a-pulse-oximeter-is-it-a-good-idea-to-buy-one\">a pulse oximeter\u003c/a> — for your finger at home, watching for a drop in your oxygen levels down to 94% or below. When levels drop below this, it’s time to call your doctor immediately. If you don’t have a primary care provider, go to an urgent care or emergency room — or, if you feel like you can’t breathe, call 911. Similarly, a high fever (above 103 F) that doesn’t get lower with fever-reducing medicines is another reason to call, or visit, a doctor.\u003c/p>\n\u003cp>But don’t get too caught up in the numbers: If you get a feeling that “something’s not right,” don’t delay medical care.\u003c/p>\n\u003ch3>\u003cstrong>Reach out to your doctor, but know there’s no magic pill\u003c/strong>\u003c/h3>\n\u003cp>If you’ve just tested positive and started isolating, it’s a good time to reach out to your primary care doctor or other health care provider (if you haven’t already) and get advice tailored to your symptoms and medical history. This is especially important for patients with any chronic illnesses such as lung disease or diabetes, but also for healthy people.\u003c/p>\n\u003cp>The good news? Doctors are easier to reach than ever with the popularity of \u003ca href=\"https://www.npr.org/2020/03/16/816344287/during-coronavirus-outbreak-virtual-doctor-visits-are-encouraged\">telephone and video visits\u003c/a>, so no need to leave your home to talk to them. The bad news is that the coronavirus is a virus, just like the flu, which means \u003ca href=\"https://www.cdc.gov/patientsafety/features/be-antibiotics-aware.html#:~:text=Antibiotics%20do%20not%20work%20on,infections%20get%20better%20without%20antibiotics.\">an antibiotic won’t stop the illness or the symptoms\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"https://www.uwhealth.org/findadoctor/profile/matthew-c-anderson-md/10003\">Dr. Matthew Anderson\u003c/a>, senior medical director of primary care at the University of Wisconsin, tells NPR that he sometimes gives oral steroids to patients with chronic lung disease who get COVID-19 and are wheezing. But he says steroids or other drugs you may have heard about — including one of the \u003ca href=\"https://www.npr.org/sections/health-shots/2020/11/10/933444237/fda-oks-eli-lilly-covid-19-drug-but-supplies-will-be-limited\">monoclonal antibody cocktails\u003c/a> or \u003ca href=\"https://www.npr.org/sections/latest-updates-trump-covid-19-results/2020/10/03/919883050/trump-is-taking-remdesivir-heres-how-it-works-to-control-the-coronavirus\">remdesivir\u003c/a> — “aren’t the standard of care” for mild or moderate COVID-19, and might do more harm than good in those cases. While there’s been lots of talk about those drugs given to patients with severe illness who are hospitalized – maybe most famously, \u003ca href=\"https://www.npr.org/2020/10/03/919831018/how-president-trump-is-treating-covid-19\">President Trump\u003c/a> – these treatments aren’t currently recommended for milder cases that are best managed at home.\u003c/p>\n\u003ch3>\u003cstrong>Make an isolation and care plan early, and ask for help \u003c/strong>\u003c/h3>\n\u003cp>Doctors and health care teams that include nurses and care navigators can also be a good resource for figuring out and lining up the sort of logistical help you’ll need to isolate yourself. You won’t want to run out of your routine medications, so ask your health team about how to get them via mail order or from pharmacies that deliver.\u003c/p>\n\u003cp>Also important: How will you and your quarantining housemates get and keep groceries, toilet paper and other goods in the house? Most cities now have grocery delivery services you can access online; typically health care systems also have social workers that can connect you with other food services if you need them. Make a list of your needs and ask friends for help. If you’re isolated and sick, pets will still need to be walked, snow shoveled and bills paid.\u003c/p>\n\u003ch3>\u003cstrong>Rest and rehydrate but try to avoid lingering in bed\u003c/strong>\u003c/h3>\n\u003cp>It can feel frustrating if you’ve got a positive coronavirus test with mild symptoms such as a runny nose or sore throat for which there’s no definitive treatment. But that just means you should stick to the well-worn advice for healing from any viral infection: Get extra rest, drink plenty of fluids and take an over-the-counter fever-reducing medicine such as acetaminophen if you need it.\u003c/p>\n\u003cp>Fluids may also be hard to gulp down when you’re feeling bad, but dehydration can land people in the hospital on its own. That’s especially true for children and older folks, so try to sip plenty of water, juice, soup or electrolyte drinks throughout the day. Non-caffeinated tea with \u003ca href=\"https://www.npr.org/sections/health-shots/2020/02/08/802750225/for-kids-coughs-swap-the-over-the-counter-syrups-for-honey\">honey might soothe your sore throat\u003c/a>, but avoid drinks with lots of sugar or caffeine.\u003c/p>\n\u003cp>Rest is also important to recovery, but be wary of the urge to stay in bed. “You don’t want to overwork yourself but avoid strict bed rest – we don’t want patients to be totally sedentary because we know that patients who move around seem to do better,” says Alvarez, who has recovered from a case of COVID-19 himself. He encourages patients to walk around their homes as they’re able or sit upright on the couch – all things that help expand the lungs and improve the movement of air.\u003c/p>\n\u003ch3>\u003cstrong>Don’t forget your mental health\u003c/strong>\u003c/h3>\n\u003cp>Whether or not you’ve got symptoms, getting a positive test for the coronavirus can be stressful, and isolating alone can make that even worse. When it comes to isolation, adding structure to your days can help a lot, says \u003ca href=\"https://ubhc.rutgers.edu/about-us/leadership/frank-ghinassi.xml\">Dr. Frank Ghinassi\u003c/a>, president and CEO of Rutgers University Behavioral Health Care and senior vice president at RWJBarnabas Health. Ghinassi recommends scheduling sleep and meals at the same time every day and penciling in at least one thing that provides pleasure daily — even if it’s as simple as streaming a movie.\u003c/p>\n\u003cp>The most important part is “actually making the schedule,” Ghinassi says. And be sure to include some socializing — virtual socializing, that is. Also put a bit of simple exercise on the calendar if you’re \u003ca href=\"https://newsnetwork.mayoclinic.org/discussion/covid-19-exercise-when-ill-whats-okay-and-whats-not/\">feeling up to it\u003c/a> — 30 minutes of light physical activity several times a week will help lift your mood. Maybe take a video exercise class or, if you’re asymptomatic or have mild symptoms, climbing stairs will get your heart rate up in a good way. And if you’re unwell and stairs are too much, try taking a room-to-room stroll within your home. Every little bit counts.\u003c/p>\n\u003ch3>\u003cstrong>If your symptoms linger longer than 10 days, keep isolating\u003c/strong>\u003c/h3>\n\u003cp>Unfortunately, you can’t schedule how long symptoms might last when it comes to the coronavirus. Doctors have been studying the nitty-gritty of statistics and numbers for months, and although the \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html\">CDC recommends\u003c/a> isolating at least 10 days from when mild or moderate symptoms started (or 10 days from a positive test if you never had symptoms), there’s no definite number of days to isolate if you’ve still got symptoms after that.\u003c/p>\n\u003cp>The CDC says you can stop isolating if you’ve been free of fever without fever-reducing medicines for 24 hours and your symptoms are “improving.” But if you’re fever-free and still feeling bad with symptoms such as cough, headache or body aches, it’s best to keep staying away from people longer – at least until symptoms have continued to improve significantly for a few days.\u003c/p>\n\u003cp>For otherwise healthy people who test positive for the coronavirus, there’s no need to retest before stopping isolation with or without symptoms. But it \u003cem>is\u003c/em> important to go right back to your mask-wearing, hand-washing and social-distancing routines after that isolation period. And be sure to follow up with your primary care providers – they can help counsel you about your health needs after COVID-19 and about becoming a part of clinical trials that can help researchers learn more about the virus and its treatment.\u003c/p>\n\u003ch3>\u003cstrong>Tell your cautionary tale\u003c/strong>\u003c/h3>\n\u003cp>If you’re out of the woods after a positive coronavirus test, you might consider passing along your experience to friends and family — especially any words of cautious wisdom if you traced your own case back to a pandemic-fatigued moment of weakness, such as going to a gathering or forgoing your mask. But let’s not make it a shame game: We are all human, and talking openly about your story might encourage others to keep their guard up.\u003c/p>\n\u003cp>And be sure to consider sharing acts of kindness and lending a virtual ear or hand to family, friends and neighbors you hear about who test positive later on. The best treatment for all of us to give and get right now may be looking out for each other – no prescription needed.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Kristen Kendrick is a board-certified family physician in Washington, D.C., and a health and media fellow at NPR and Georgetown University School of Medicine.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2020 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=What+To+Do+If+You+Test+Positive+For+The+Coronavirus+This+Winter&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"slug": "surging-coronavirus-more-dangerous-for-nursing-homes-with-black-latino-residents",
"title": "Surging Coronavirus More Dangerous for Nursing Homes With Black, Latino Residents",
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"headTitle": "Surging Coronavirus More Dangerous for Nursing Homes With Black, Latino Residents | KQED",
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"content": "\u003cp>\u003ca href=\"https://www.kqed.org/news/11850234/creciente-covid-19-podria-afectar-mas-a-hogares-para-adultos-mayores-con-residentes-afroamericanos-y-latinos\">\u003cem>Leer en espa\u003cspan style=\"font-weight: 400\">ñol\u003c/span>\u003c/em>\u003c/a>\u003c/p>\n\u003cp>As the coronavirus surges again, it is especially dangerous for people in nursing homes caring for more Black and Latino residents, according to a new analysis from the California Health Care Foundation.\u003c/p>\n\u003cp>Researchers found that skilled nursing facilities with a greater share of Black and Latino residents had higher rates of COVID-19 cases and deaths — and that disparity is growing.\u003c/p>\n\u003cp>“We asked [our] advisory group, how do you explain this disparity?” said Dr. Bruce Spurlock, executive director of \u003ca href=\"https://calhospitalcompare.org/about/\">Cal Hospital Compare\u003c/a>, and a study co-author. “And nobody really knows. And that’s kind of the part that we really need to figure out.”\u003c/p>\n\u003cp>\u003cb>A Shift Over Time\u003c/b>\u003c/p>\n\u003cp>Skilled nursing facilities have borne much of the weight of the pandemic. More than one quarter of reported COVID-related deaths in California have happened in nursing homes, even though their residents make up less than half a percent of the state’s population.\u003c/p>\n\u003cfigure id=\"attachment_11849674\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2020/12/RS42756_RS42754_alt_1003-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11849674\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/12/RS42756_RS42754_alt_1003-qut-800x581.jpg\" alt=\"Costell Akrie holds a small baby in his room.\" width=\"800\" height=\"581\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/RS42756_RS42754_alt_1003-qut-800x581.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/RS42756_RS42754_alt_1003-qut-1020x741.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/RS42756_RS42754_alt_1003-qut-160x116.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/RS42756_RS42754_alt_1003-qut-1536x1115.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/RS42756_RS42754_alt_1003-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Costell Akrie died after contracting coronavirus in corporate-owned Gateway Care and Rehabilitation Center in Alameda County. A new study has found that staffing levels worsened outbreaks in facilities like his. \u003ccite>(Courtesy of John Burris Law Offices)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Beyond demographics, the new study analyzed state and federal data about ownership status, size, type of patient, staffing levels and geography to identify factors associated with the hardest-hit nursing homes.\u003c/p>\n\u003cp>And those factors changed as the pandemic wore on. Back in May, “you could tell that the larger the facility, the for-profit facilities, were doing worse than the smaller and nonprofit facilities,” Spurlock said.\u003c/p>\n\u003cp>By late summer, he said, facilities struggling to control the virus were in counties with high COVID-19 rates.\u003c/p>\n\u003cp>“Age, gender, race and ethnicity were a much bigger predictor of who was doing worse in the August time frame,” Spurlock said.\u003c/p>\n\u003cp>Nursing home residents over 85, and men, have been more vulnerable to the virus throughout California. And while Latinos account for about \u003ca href=\"https://covid19.ca.gov/state-dashboard/\">60% of California’s positive coronavirus tests\u003c/a>, they represent less than 40% of the state’s population. But across the state, COVID-positive tests for Blacks have been a disproportionately small part of the total.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" title=\"Nursing Homes With More Latino Residents Have More COVID-19 Cases\" aria-label=\"Interactive line chart\" id=\"datawrapper-chart-3Mtcb\" src=\"https://datawrapper.dwcdn.net/3Mtcb/8/\" scrolling=\"no\" frameborder=\"0\" style=\"width: 0; min-width: 100% !important; border: none;\" height=\"400\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\u003cbr>\n[datawrapper]\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" title=\"Nursing Homes With More Black Residents Have More COVID-19 Cases\" aria-label=\"Interactive line chart\" id=\"datawrapper-chart-HxpFR\" src=\"https://datawrapper.dwcdn.net/HxpFR/3/\" scrolling=\"no\" frameborder=\"0\" style=\"width: 0; min-width: 100% !important; border: none;\" height=\"400\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\u003cbr>\n[datawrapper]\u003c/p>\n\u003cp>\u003cb>Lower Risk in Bay Area Nursing Homes\u003c/b>\u003c/p>\n\u003cp>All together, the research suggests a story of how the coronavirus has moved through skilled nursing facilities statewide. That story is slightly different in the Bay Area.\u003c/p>\n\u003cp>Outbreaks the region experienced during late spring and summer tracks with the study’s overall conclusions about nursing homes. Windsor Vallejo, a Contra Costa County care home operated by a limited liability corporation, saw 100 cases of the coronavirus in May. A month earlier, corporate-owned Gateway Care and Rehabilitation Center in Hayward saw \u003ca href=\"https://www.kqed.org/science/1962559/state-lists-dont-reveal-all-the-senior-care-homes-with-covid-19-outbreaks\">at least 65 cases\u003c/a> of COVID-19. Complaints from family members have so far prompted a lawsuit and an investigation by the Alameda County district attorney.\u003c/p>\n\u003cp>But Bay Area nursing homes have fewer Latino residents than the rest of the state. The region’s nursing homes are generally smaller than the state average, and fewer are run by corporations for profit. About a third of Marin County nursing homes are nonprofit, for example.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" title=\"Percent of Investor-owned and Non-profit Nursing Homes \" aria-label=\"chart\" id=\"datawrapper-chart-5Bj0h\" src=\"https://datawrapper.dwcdn.net/5Bj0h/3/\" scrolling=\"no\" frameborder=\"0\" style=\"width: 0; min-width: 100% !important; border: none;\" height=\"400\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\u003cbr>\n[datawrapper]\u003c/p>\n\u003cp>“The report is great. My response to it is ‘duh,’ ” said Scott Akrie, whose father Costell tested positive for coronavirus while at Gateway and died within weeks. Akrie, who is suing Gateway, points out that the facility has been repeatedly cited by state regulators and sued, so far with little consequence. “Just because these people are elderly, they are not forgotten souls that can be taken for granted.”\u003c/p>\n\u003cp>County by county, as the coronavirus surges, health officers are now are modifying orders related to long-term care homes. In Santa Clara County, \u003ca href=\"https://www.sccgov.org/sites/covid19/Pages/mandatory-directives-long-care-facilities.aspx\">the latest guidelines\u003c/a> keep visitors to care home residents outside as much as possible, and require visitors present a negative test within 72 hours of a socially distanced visit indoors.\u003c/p>\n\u003cp>In Alameda County, where the Centers for Disease Control and Prevention reports the case rate per capita has risen 24% in the last week, seven nursing homes report COVID-19 outbreaks as of Dec. 2. Nine facilities currently report outbreaks in Santa Clara County, where the case rate has risen more than 50% in the last week.\u003c/p>\n\u003cp>[ad fullwidth]\u003cbr>\n\u003cb>Some Recommendations Easier Than Others\u003c/b>\u003c/p>\n\u003cp>Researchers make several recommendations to stanch the spread of the virus in nursing homes. Some are tactical; actions that could be taken immediately, like asking the Department of Public Health to enforce testing and training requirements week after week. Some are more complex: The authors suggest that the Department of Health Care Services should demand more financial transparency from all related entities controlling nursing homes, which would require amending law and regulation.\u003c/p>\n\u003cp>[aside postID=\"news_11849594,news_11813696,science_1968093\" label=\"More Coronavirus Coverage\"]The California Department of Public Health says it has used predictive analysis to identify facilities that seem to be headed for trouble, and follows up with facilities in outbreak to address urgent needs. In a statement, CDPH says it has prioritized mitigation and infection control, as well as the investigation of complaints and incidents that nursing homes themselves report, over routine inspections and enforcement.\u003c/p>\n\u003cp>Nursing homes with higher levels of staffing have fared better throughout the pandemic, but staffing levels remain “a very controversial area,” according to Spurlock. Federal and state rules set minimum hour requirements for nurses, assistants and other staffers at skilled nursing facilities. In the Bay Area, patient advocates allege that understaffing has contributed to outbreaks, especially in Alameda County.\u003c/p>\n\u003cp>In a statement, the California Association of Health Facilities calls staffing a “critical” problem for the nursing homes it represents, pointing out that when a worker tests positive and must quarantine, other workers must often work double shifts.\u003c/p>\n\u003cp>“It’s incredibly difficult to find staff right now and require them to work in a dangerous environment,” said California Association of Health Facilities spokeswoman Deborah Pacyna.\u003c/p>\n\u003cp>Researchers recommend that regulators require facilities to meet the staffing standards they’re supposed to. They also suggest designating family members as “essential workers” as the pandemic continues. Doing that would permit relatives into facilities, which could boost care and minimize isolation and anxiety in a time of crisis.\u003c/p>\n\u003cp>[pullquote align=\"right\" citation=\"Scott Akrie\"]“Just because these people are elderly, they are not forgotten souls that can be taken for granted.”[/pullquote]The authors also put forward a more involved proposal to restructure the state’s low-income health subsidy, to boost nursing home salaries and staffing even further than it does now. Such a move would prompt debate and require litigation.\u003c/p>\n\u003cp>“Any suggestion that staff levels should be increased needs to be coupled with additional state reimbursement for wages,” said Pacyna.\u003c/p>\n\u003cp>“With staffing, we know the changes to make” that would help, said Spurlock. “With health equity, we still are unsure about what actions that we need to take to reduce the disparity.”\u003c/p>\n\u003cp>Among the researchers’ health equity-related recommendations is that vaccines should be directed toward skilled nursing facilities most at-risk, which right now means facilities with higher numbers of Black and Latino residents.\u003c/p>\n\u003cp>As of now, federal and state guidelines prioritize vaccines for health care workers on the front lines most at risk of contracting COVID-19. California counties are still developing their specific plans for distributing vaccines that are sure to be in short supply. And Spurlock acknowledges that this recommendation is a controversial one. But he says that the evidence points toward a need for change, and for multiple, large-scale solutions being enacted simultaneously.\u003c/p>\n\u003cp>“The pandemic has really ripped open some vulnerabilities in a population that’s extremely dangerous, that something like this can go through very rapidly and ravage people that are near and dear to our hearts,” Spurlock said. “I don’t think we’re going back.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"https://www.kqed.org/news/11850234/creciente-covid-19-podria-afectar-mas-a-hogares-para-adultos-mayores-con-residentes-afroamericanos-y-latinos\">\u003cem>Leer en espa\u003cspan style=\"font-weight: 400\">ñol\u003c/span>\u003c/em>\u003c/a>\u003c/p>\n\u003cp>As the coronavirus surges again, it is especially dangerous for people in nursing homes caring for more Black and Latino residents, according to a new analysis from the California Health Care Foundation.\u003c/p>\n\u003cp>Researchers found that skilled nursing facilities with a greater share of Black and Latino residents had higher rates of COVID-19 cases and deaths — and that disparity is growing.\u003c/p>\n\u003cp>“We asked [our] advisory group, how do you explain this disparity?” said Dr. Bruce Spurlock, executive director of \u003ca href=\"https://calhospitalcompare.org/about/\">Cal Hospital Compare\u003c/a>, and a study co-author. “And nobody really knows. And that’s kind of the part that we really need to figure out.”\u003c/p>\n\u003cp>\u003cb>A Shift Over Time\u003c/b>\u003c/p>\n\u003cp>Skilled nursing facilities have borne much of the weight of the pandemic. More than one quarter of reported COVID-related deaths in California have happened in nursing homes, even though their residents make up less than half a percent of the state’s population.\u003c/p>\n\u003cfigure id=\"attachment_11849674\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2020/12/RS42756_RS42754_alt_1003-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11849674\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/12/RS42756_RS42754_alt_1003-qut-800x581.jpg\" alt=\"Costell Akrie holds a small baby in his room.\" width=\"800\" height=\"581\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/RS42756_RS42754_alt_1003-qut-800x581.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/RS42756_RS42754_alt_1003-qut-1020x741.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/RS42756_RS42754_alt_1003-qut-160x116.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/RS42756_RS42754_alt_1003-qut-1536x1115.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/12/RS42756_RS42754_alt_1003-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Costell Akrie died after contracting coronavirus in corporate-owned Gateway Care and Rehabilitation Center in Alameda County. A new study has found that staffing levels worsened outbreaks in facilities like his. \u003ccite>(Courtesy of John Burris Law Offices)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Beyond demographics, the new study analyzed state and federal data about ownership status, size, type of patient, staffing levels and geography to identify factors associated with the hardest-hit nursing homes.\u003c/p>\n\u003cp>And those factors changed as the pandemic wore on. Back in May, “you could tell that the larger the facility, the for-profit facilities, were doing worse than the smaller and nonprofit facilities,” Spurlock said.\u003c/p>\n\u003cp>By late summer, he said, facilities struggling to control the virus were in counties with high COVID-19 rates.\u003c/p>\n\u003cp>“Age, gender, race and ethnicity were a much bigger predictor of who was doing worse in the August time frame,” Spurlock said.\u003c/p>\n\u003cp>Nursing home residents over 85, and men, have been more vulnerable to the virus throughout California. And while Latinos account for about \u003ca href=\"https://covid19.ca.gov/state-dashboard/\">60% of California’s positive coronavirus tests\u003c/a>, they represent less than 40% of the state’s population. But across the state, COVID-positive tests for Blacks have been a disproportionately small part of the total.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" title=\"Nursing Homes With More Latino Residents Have More COVID-19 Cases\" aria-label=\"Interactive line chart\" id=\"datawrapper-chart-3Mtcb\" src=\"https://datawrapper.dwcdn.net/3Mtcb/8/\" scrolling=\"no\" frameborder=\"0\" style=\"width: 0; min-width: 100% !important; border: none;\" height=\"400\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\u003cbr>\n\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cb>Lower Risk in Bay Area Nursing Homes\u003c/b>\u003c/p>\n\u003cp>All together, the research suggests a story of how the coronavirus has moved through skilled nursing facilities statewide. That story is slightly different in the Bay Area.\u003c/p>\n\u003cp>Outbreaks the region experienced during late spring and summer tracks with the study’s overall conclusions about nursing homes. Windsor Vallejo, a Contra Costa County care home operated by a limited liability corporation, saw 100 cases of the coronavirus in May. A month earlier, corporate-owned Gateway Care and Rehabilitation Center in Hayward saw \u003ca href=\"https://www.kqed.org/science/1962559/state-lists-dont-reveal-all-the-senior-care-homes-with-covid-19-outbreaks\">at least 65 cases\u003c/a> of COVID-19. Complaints from family members have so far prompted a lawsuit and an investigation by the Alameda County district attorney.\u003c/p>\n\u003cp>But Bay Area nursing homes have fewer Latino residents than the rest of the state. The region’s nursing homes are generally smaller than the state average, and fewer are run by corporations for profit. About a third of Marin County nursing homes are nonprofit, for example.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" title=\"Percent of Investor-owned and Non-profit Nursing Homes \" aria-label=\"chart\" id=\"datawrapper-chart-5Bj0h\" src=\"https://datawrapper.dwcdn.net/5Bj0h/3/\" scrolling=\"no\" frameborder=\"0\" style=\"width: 0; min-width: 100% !important; border: none;\" height=\"400\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\u003cbr>\n\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“The report is great. My response to it is ‘duh,’ ” said Scott Akrie, whose father Costell tested positive for coronavirus while at Gateway and died within weeks. Akrie, who is suing Gateway, points out that the facility has been repeatedly cited by state regulators and sued, so far with little consequence. “Just because these people are elderly, they are not forgotten souls that can be taken for granted.”\u003c/p>\n\u003cp>County by county, as the coronavirus surges, health officers are now are modifying orders related to long-term care homes. In Santa Clara County, \u003ca href=\"https://www.sccgov.org/sites/covid19/Pages/mandatory-directives-long-care-facilities.aspx\">the latest guidelines\u003c/a> keep visitors to care home residents outside as much as possible, and require visitors present a negative test within 72 hours of a socially distanced visit indoors.\u003c/p>\n\u003cp>In Alameda County, where the Centers for Disease Control and Prevention reports the case rate per capita has risen 24% in the last week, seven nursing homes report COVID-19 outbreaks as of Dec. 2. Nine facilities currently report outbreaks in Santa Clara County, where the case rate has risen more than 50% in the last week.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cbr>\n\u003cb>Some Recommendations Easier Than Others\u003c/b>\u003c/p>\n\u003cp>Researchers make several recommendations to stanch the spread of the virus in nursing homes. Some are tactical; actions that could be taken immediately, like asking the Department of Public Health to enforce testing and training requirements week after week. Some are more complex: The authors suggest that the Department of Health Care Services should demand more financial transparency from all related entities controlling nursing homes, which would require amending law and regulation.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The California Department of Public Health says it has used predictive analysis to identify facilities that seem to be headed for trouble, and follows up with facilities in outbreak to address urgent needs. In a statement, CDPH says it has prioritized mitigation and infection control, as well as the investigation of complaints and incidents that nursing homes themselves report, over routine inspections and enforcement.\u003c/p>\n\u003cp>Nursing homes with higher levels of staffing have fared better throughout the pandemic, but staffing levels remain “a very controversial area,” according to Spurlock. Federal and state rules set minimum hour requirements for nurses, assistants and other staffers at skilled nursing facilities. In the Bay Area, patient advocates allege that understaffing has contributed to outbreaks, especially in Alameda County.\u003c/p>\n\u003cp>In a statement, the California Association of Health Facilities calls staffing a “critical” problem for the nursing homes it represents, pointing out that when a worker tests positive and must quarantine, other workers must often work double shifts.\u003c/p>\n\u003cp>“It’s incredibly difficult to find staff right now and require them to work in a dangerous environment,” said California Association of Health Facilities spokeswoman Deborah Pacyna.\u003c/p>\n\u003cp>Researchers recommend that regulators require facilities to meet the staffing standards they’re supposed to. They also suggest designating family members as “essential workers” as the pandemic continues. Doing that would permit relatives into facilities, which could boost care and minimize isolation and anxiety in a time of crisis.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The authors also put forward a more involved proposal to restructure the state’s low-income health subsidy, to boost nursing home salaries and staffing even further than it does now. Such a move would prompt debate and require litigation.\u003c/p>\n\u003cp>“Any suggestion that staff levels should be increased needs to be coupled with additional state reimbursement for wages,” said Pacyna.\u003c/p>\n\u003cp>“With staffing, we know the changes to make” that would help, said Spurlock. “With health equity, we still are unsure about what actions that we need to take to reduce the disparity.”\u003c/p>\n\u003cp>Among the researchers’ health equity-related recommendations is that vaccines should be directed toward skilled nursing facilities most at-risk, which right now means facilities with higher numbers of Black and Latino residents.\u003c/p>\n\u003cp>As of now, federal and state guidelines prioritize vaccines for health care workers on the front lines most at risk of contracting COVID-19. California counties are still developing their specific plans for distributing vaccines that are sure to be in short supply. And Spurlock acknowledges that this recommendation is a controversial one. But he says that the evidence points toward a need for change, and for multiple, large-scale solutions being enacted simultaneously.\u003c/p>\n\u003cp>“The pandemic has really ripped open some vulnerabilities in a population that’s extremely dangerous, that something like this can go through very rapidly and ravage people that are near and dear to our hearts,” Spurlock said. “I don’t think we’re going back.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, joins Marisa Lagos and Scott Shafer to discuss California’s new regional stay-at-home order, the politicization of vaccines and the “spectacular” advances in their development, and lessons he learned from fighting the HIV/AIDS epidemic. Then, San Francisco Chronicle health reporter Erin Allday joins to discuss the new statewide order and how public health guidance has evolved since the spring.\u003c/p>\n\u003cp>Here are some highlights from our interview with Dr. Fauci:\u003c/p>\n\u003ch3>On California’s new shelter-in-place order\u003c/h3>\n\u003cp>Fauci, the nation’s leading infectious disease specialist, enthusiastically supports Gov. Gavin Newsom’s new order, which calls for \u003ca href=\"https://www.kqed.org/news/11849487/newsom-to-impose-sweeping-new-stay-at-home-order-as-covid-19-rates-soar\">regional shutdowns of some businesses and other activities\u003c/a> once ICU hospital bed capacity drops to 15%.\u003c/p>\n\u003cp>Fauci said he consulted with California health authorities ahead of the announcement, and called it “a prudent and correct decision.”\u003c/p>\n\u003cp>“The reason is that you are all on a brink, literally on the threshold of getting the almost unimaginable situation of getting the health care system overrun. You just can’t let that happen. That is unimaginable and unacceptable,” Fauci said. “I spoke to some of his health people and I said I would back them in that decision. So I certainly back what the governor’s doing.”\u003c/p>\n\u003cp>[aside postID=\"news_11849487\" label=\"California's New Shelter-in-Place Order\"]\u003c/p>\n\u003cp>Fauci warned that while hospitals across the nation are already filling up, we have not “seen the full brunt of what we expect to be yet again, another surge, hopefully a mini surge, as opposed to a major one.”\u003c/p>\n\u003cp>“There almost invariably will be a surge associated with what went on last week, with Thanksgiving, with the travel … and the congregate settings of dinners,” he said. “The trouble is, the spike won’t come for about two and a half to three weeks after the Thanksgiving holiday, which would put it right before the Christmas and Hanukkah holiday, which is kind of a double whammy. So we are in a really precarious situation. And because of the stress on the health care system, I think what the governor did was both prudent and advisable.”\u003c/p>\n\u003ch3>On the nation’s inconsistent approach and mixed messaging\u003c/h3>\n\u003cp>Fauci, who’s careful not to get too political, said this: “Mixed messages are bad. One of the problems inherent in mixed messages is that [it] provides license for people to do things according to their own preconceived notions. Because if they hear that going left is right, going right is right, then they say: ‘I’m going to go wherever I want to go because it’s a 50-50 chance.’ that’s not good. We need consistent messages at all levels.”\u003c/p>\n\u003cp>Asked where we stand now as compared to where he thought we would be when the pandemic started, Fauci was blunt.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Dr. Anthony Fauci']‘There’s no doubt in my mind that … uniform mask wearing, distancing, avoiding crowds or the kinds of shutdowns that you’re talking about, it does make a difference and you should be assured of that.’[/pullquote]\u003c/p>\n\u003cp>“I think I would have to say honestly, worse,” he said. “I thought that we were going to have a uniform public health response that would not have allowed us to never get below a precarious baseline. And every time we try to do something like open up the economy, we’d slip up and then come down. And then we do this, we slip up, and now we’re going into winter, we’re going into the holidays and we’re seeing the same thing.”\u003c/p>\n\u003cp>He also acknowledged that governing a large state like California — and ensuring a consistent message across its diverse 58 counties — is difficult. But, he said, even though the entire nation is seeing a surge in cases right now, places like California are in a better position to tackle the increase because of our stricter state guidelines around mask wearing and social distancing.\u003c/p>\n\u003cp>“I think initially you may think you’re seeing the same result, but when it really plays out, there’s no doubt in my mind that … uniform mask wearing, distancing, avoiding crowds or the kinds of shutdowns that you’re talking about, it does make a difference and you should be assured of that,” he said.\u003c/p>\n\u003ch3>On the vaccine and his hope for the coming months\u003c/h3>\n\u003cp>Fauci encouraged Americans not to lose hope, saying we need to hang on for just a few more months.\u003c/p>\n\u003cp>[aside tag=\"covid-vaccines\" label=\"more vaccine coverage\"]\u003c/p>\n\u003cp>“Help is on the way because we have extraordinarily efficacious vaccines, plural, more than one vaccine that will start to be implemented and distributed in the middle and end of December. And then as we get into January, February, March, more and more and more people will be vaccinated so that by the time we get to April, it will be available for the general public,” he said.\u003c/p>\n\u003cp>Fauci said he’s confident we will “crush this outbreak” and urged the nation to double down, to make difficult sacrifices as we head into the holidays — knowing that there’s light at the end of the tunnel.\u003c/p>\n\u003cp>“Once we get a substantial proportion of the population vaccinated, we’ll get that umbrella of herd immunity and that will ultimately crush this outbreak,” he said. “That to me is an incentive … to double down even more and say [that] although things like the lockdown, things that the governor is trying to do are difficult and straining your comfort, your economy and all those things, the fact is that at the end of the day it will get us through. And then when a vaccine comes in full blast, we’re going to be out of this.” [ad fullwidth]\u003c/p>\n\u003ch3>On vaccine skepticism\u003c/h3>\n\u003cp>With regular Americans as well as health care workers expressing concern about the safety of a vaccine created in record time, Fauci urged everyone to examine the scientific record and consider the independence of our regulators.\u003c/p>\n\u003cp>“These skepticisms are understandable when there are mixed messages,” he said, noting that people have concern about both how quickly the vaccines were developed and whether they are safe and effective.\u003c/p>\n\u003cp>“The fact that we were able to go from the recognition of a brand new virus in January to a vaccine that’s able to be distributed by December is a completely unprecedented accomplishment,” he said. “It is spectacular not because it was rushed by compromising safety or scientific integrity, because of the extraordinary scientific advances that have been made in vaccine platform technologies, which is the fruit of basic and applied research that’s been going on for decades.”\u003c/p>\n\u003cp>Fauci said it’s not as if the underlying science and technology “just popped up.”\u003c/p>\n\u003cp>“This is people who have been working throughout the country, in the world, for decades on exquisite technologies that have allowed us to do things in weeks to months that a decade ago would have taken several years. So the speed does not compromise anything,” he said.\u003c/p>\n\u003cp>What about the safety and the efficacy? Fauci said he knows some people are skeptical that the Trump administration may be trying to prove something, or that the vaccine manufacturers are just trying to make money.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Dr. Anthony Fauci']‘We’ve got to be able to communicate that to the American public, that even though there’s a lot of skepticism, the [vaccine] process is independent and transparent, period’[/pullquote]\u003c/p>\n\u003cp>“It’s neither of the two, and here’s why,” he said. “Because the determination of safety and efficacy is made by an independent data and safety monitoring board that has allegiance, not to the president, not to the administration and not to the company. It has an allegiance to the American public.”\u003c/p>\n\u003cp>Fauci noted that the process starts with a group of independent scientists, statisticians, ethicists and vaccinology experts who examine the data for safety and efficacy.\u003c/p>\n\u003cp>“They then, and only then, release it to the company, which then examines it and gives it to the [Food and Drug Administration], where career scientists — not politicians but career scientists who do this every day for decades — examine the data and then in accordance with their advisory committee, which is another independent committee, determine if it’s safe and able to be given to the American public. So you have a process that is not only independent, it’s completely transparent.”\u003c/p>\n\u003cp>Fauci noted that “nobody can hide anything,” because the data will ultimately be published in a peer-reviewed journal.\u003c/p>\n\u003cp>“So we’ve got to be able to communicate that to the American public, that even though there’s a lot of skepticism, the process is independent and transparent, period,” he said.\u003c/p>\n\u003ch3>On his own personal journey\u003c/h3>\n\u003cp>Fauci also discussed his remarkable career — he has been at the National Institute of Allergy and Infectious Diseases since 1972 and was appointed director in 1984.\u003c/p>\n\u003cp>While this pandemic has made Fauci a household name, many in the public health community first got to know him in the 1980s as the nation struggled with another new, mysterious, deadly and terrifying virus: HIV.\u003c/p>\n\u003cp>Fauci recognized the threat before many of his colleagues and began researching the virus. But by 1988, he and other government scientists were also becoming the subject of protests by AIDS activists — mostly young, gay men — who felt the government wasn’t doing enough to let infected Americans try new treatments and that they didn’t have a seat at the table.\u003c/p>\n\u003cp>Fauci invited them in, and ended up traveling the country to talk to gay communities stricken by AIDS. Their inclusion and input helped change the way the government approached experimental HIV and AIDS treatments — and more broadly, how we approach medicine in the U.S.\u003c/p>\n\u003cp>We asked Fauci what he learned from that experience.\u003c/p>\n\u003cp>“Well, that was really one of the more transforming periods in my own professional career, in my own life, in which I made a decision — which retrospectively it really turned out to be a good decision — to reach out to the community,” he said.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Dr. Anthony Fauci']‘Once you start getting involved in ideology and political things, you just lose any credibility. So I have stayed completely away from the politics and focused on what my job is, which is public health and the safety and the health of the American public. You do that, you’re in good shape’[/pullquote]\u003c/p>\n\u003cp>“In this case, it was dominated by young gay men in San Francisco and in New York and in Los Angeles. Because they had some very valid points that the government, the scientific and regulatory community just did not fully appreciate the situation they were in, and they excluded the constituents from participation in important decision making that had a great impact on their lives and their deaths. And yet no one was listening to them.”\u003c/p>\n\u003cp>The activists’ exclusion, Fauci said, made them “iconoclastic, theatrical, confrontative, which unfortunately turned off the government and the scientific and regulatory community even more.”\u003c/p>\n\u003cp>What he did — putting aside the theatrical protests and sitting down with them — “was one of the better things I’ve ever done in my career.”\u003c/p>\n\u003cp>“It became eminently clear to me that what they were saying really made sense, and if I were in their shoes, I would have been doing exactly what they were doing. And that’s when I said I need to sit down and start talking to these people. And once we did that, we found out that we had a lot in common. And that’s when the bonds of collaboration began decades ago to the point now that is a very productive component of what we do,” he said.\u003c/p>\n\u003cp>Fauci, who will be serving his seventh presidential administration as NIAID director when Joe Biden is sworn in next month, has survived Republicans and Democrats, as well as numerous outbreaks: HIV/AIDS, Ebola, Zika, H1N1 and now the coronavirus. What has he learned?\u003c/p>\n\u003cp>“As a scientist and as a public health person, it’s absolutely essential that I stay above and beyond the politics and focus completely on the public health, the scientific issues, because that’s what I’m supposed to be doing,” he said. “Once you start getting involved in ideology and political things, you just lose any credibility. So I have stayed completely away from the politics and focused on what my job is, which is public health and the safety and the health of the American public. You do that, you’re in good shape.”\u003c/p>\n\u003cp>\u003cem>This interview has been lightly edited for clarity.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, joins Marisa Lagos and Scott Shafer to discuss California’s new regional stay-at-home order, the politicization of vaccines and the “spectacular” advances in their development, and lessons he learned from fighting the HIV/AIDS epidemic. Then, San Francisco Chronicle health reporter Erin Allday joins to discuss the new statewide order and how public health guidance has evolved since the spring.\u003c/p>\n\u003cp>Here are some highlights from our interview with Dr. Fauci:\u003c/p>\n\u003ch3>On California’s new shelter-in-place order\u003c/h3>\n\u003cp>Fauci, the nation’s leading infectious disease specialist, enthusiastically supports Gov. Gavin Newsom’s new order, which calls for \u003ca href=\"https://www.kqed.org/news/11849487/newsom-to-impose-sweeping-new-stay-at-home-order-as-covid-19-rates-soar\">regional shutdowns of some businesses and other activities\u003c/a> once ICU hospital bed capacity drops to 15%.\u003c/p>\n\u003cp>Fauci said he consulted with California health authorities ahead of the announcement, and called it “a prudent and correct decision.”\u003c/p>\n\u003cp>“The reason is that you are all on a brink, literally on the threshold of getting the almost unimaginable situation of getting the health care system overrun. You just can’t let that happen. That is unimaginable and unacceptable,” Fauci said. “I spoke to some of his health people and I said I would back them in that decision. So I certainly back what the governor’s doing.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Fauci warned that while hospitals across the nation are already filling up, we have not “seen the full brunt of what we expect to be yet again, another surge, hopefully a mini surge, as opposed to a major one.”\u003c/p>\n\u003cp>“There almost invariably will be a surge associated with what went on last week, with Thanksgiving, with the travel … and the congregate settings of dinners,” he said. “The trouble is, the spike won’t come for about two and a half to three weeks after the Thanksgiving holiday, which would put it right before the Christmas and Hanukkah holiday, which is kind of a double whammy. So we are in a really precarious situation. And because of the stress on the health care system, I think what the governor did was both prudent and advisable.”\u003c/p>\n\u003ch3>On the nation’s inconsistent approach and mixed messaging\u003c/h3>\n\u003cp>Fauci, who’s careful not to get too political, said this: “Mixed messages are bad. One of the problems inherent in mixed messages is that [it] provides license for people to do things according to their own preconceived notions. Because if they hear that going left is right, going right is right, then they say: ‘I’m going to go wherever I want to go because it’s a 50-50 chance.’ that’s not good. We need consistent messages at all levels.”\u003c/p>\n\u003cp>Asked where we stand now as compared to where he thought we would be when the pandemic started, Fauci was blunt.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I think I would have to say honestly, worse,” he said. “I thought that we were going to have a uniform public health response that would not have allowed us to never get below a precarious baseline. And every time we try to do something like open up the economy, we’d slip up and then come down. And then we do this, we slip up, and now we’re going into winter, we’re going into the holidays and we’re seeing the same thing.”\u003c/p>\n\u003cp>He also acknowledged that governing a large state like California — and ensuring a consistent message across its diverse 58 counties — is difficult. But, he said, even though the entire nation is seeing a surge in cases right now, places like California are in a better position to tackle the increase because of our stricter state guidelines around mask wearing and social distancing.\u003c/p>\n\u003cp>“I think initially you may think you’re seeing the same result, but when it really plays out, there’s no doubt in my mind that … uniform mask wearing, distancing, avoiding crowds or the kinds of shutdowns that you’re talking about, it does make a difference and you should be assured of that,” he said.\u003c/p>\n\u003ch3>On the vaccine and his hope for the coming months\u003c/h3>\n\u003cp>Fauci encouraged Americans not to lose hope, saying we need to hang on for just a few more months.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Help is on the way because we have extraordinarily efficacious vaccines, plural, more than one vaccine that will start to be implemented and distributed in the middle and end of December. And then as we get into January, February, March, more and more and more people will be vaccinated so that by the time we get to April, it will be available for the general public,” he said.\u003c/p>\n\u003cp>Fauci said he’s confident we will “crush this outbreak” and urged the nation to double down, to make difficult sacrifices as we head into the holidays — knowing that there’s light at the end of the tunnel.\u003c/p>\n\u003cp>“Once we get a substantial proportion of the population vaccinated, we’ll get that umbrella of herd immunity and that will ultimately crush this outbreak,” he said. “That to me is an incentive … to double down even more and say [that] although things like the lockdown, things that the governor is trying to do are difficult and straining your comfort, your economy and all those things, the fact is that at the end of the day it will get us through. And then when a vaccine comes in full blast, we’re going to be out of this.” \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch3>On vaccine skepticism\u003c/h3>\n\u003cp>With regular Americans as well as health care workers expressing concern about the safety of a vaccine created in record time, Fauci urged everyone to examine the scientific record and consider the independence of our regulators.\u003c/p>\n\u003cp>“These skepticisms are understandable when there are mixed messages,” he said, noting that people have concern about both how quickly the vaccines were developed and whether they are safe and effective.\u003c/p>\n\u003cp>“The fact that we were able to go from the recognition of a brand new virus in January to a vaccine that’s able to be distributed by December is a completely unprecedented accomplishment,” he said. “It is spectacular not because it was rushed by compromising safety or scientific integrity, because of the extraordinary scientific advances that have been made in vaccine platform technologies, which is the fruit of basic and applied research that’s been going on for decades.”\u003c/p>\n\u003cp>Fauci said it’s not as if the underlying science and technology “just popped up.”\u003c/p>\n\u003cp>“This is people who have been working throughout the country, in the world, for decades on exquisite technologies that have allowed us to do things in weeks to months that a decade ago would have taken several years. So the speed does not compromise anything,” he said.\u003c/p>\n\u003cp>What about the safety and the efficacy? Fauci said he knows some people are skeptical that the Trump administration may be trying to prove something, or that the vaccine manufacturers are just trying to make money.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It’s neither of the two, and here’s why,” he said. “Because the determination of safety and efficacy is made by an independent data and safety monitoring board that has allegiance, not to the president, not to the administration and not to the company. It has an allegiance to the American public.”\u003c/p>\n\u003cp>Fauci noted that the process starts with a group of independent scientists, statisticians, ethicists and vaccinology experts who examine the data for safety and efficacy.\u003c/p>\n\u003cp>“They then, and only then, release it to the company, which then examines it and gives it to the [Food and Drug Administration], where career scientists — not politicians but career scientists who do this every day for decades — examine the data and then in accordance with their advisory committee, which is another independent committee, determine if it’s safe and able to be given to the American public. So you have a process that is not only independent, it’s completely transparent.”\u003c/p>\n\u003cp>Fauci noted that “nobody can hide anything,” because the data will ultimately be published in a peer-reviewed journal.\u003c/p>\n\u003cp>“So we’ve got to be able to communicate that to the American public, that even though there’s a lot of skepticism, the process is independent and transparent, period,” he said.\u003c/p>\n\u003ch3>On his own personal journey\u003c/h3>\n\u003cp>Fauci also discussed his remarkable career — he has been at the National Institute of Allergy and Infectious Diseases since 1972 and was appointed director in 1984.\u003c/p>\n\u003cp>While this pandemic has made Fauci a household name, many in the public health community first got to know him in the 1980s as the nation struggled with another new, mysterious, deadly and terrifying virus: HIV.\u003c/p>\n\u003cp>Fauci recognized the threat before many of his colleagues and began researching the virus. But by 1988, he and other government scientists were also becoming the subject of protests by AIDS activists — mostly young, gay men — who felt the government wasn’t doing enough to let infected Americans try new treatments and that they didn’t have a seat at the table.\u003c/p>\n\u003cp>Fauci invited them in, and ended up traveling the country to talk to gay communities stricken by AIDS. Their inclusion and input helped change the way the government approached experimental HIV and AIDS treatments — and more broadly, how we approach medicine in the U.S.\u003c/p>\n\u003cp>We asked Fauci what he learned from that experience.\u003c/p>\n\u003cp>“Well, that was really one of the more transforming periods in my own professional career, in my own life, in which I made a decision — which retrospectively it really turned out to be a good decision — to reach out to the community,” he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“In this case, it was dominated by young gay men in San Francisco and in New York and in Los Angeles. Because they had some very valid points that the government, the scientific and regulatory community just did not fully appreciate the situation they were in, and they excluded the constituents from participation in important decision making that had a great impact on their lives and their deaths. And yet no one was listening to them.”\u003c/p>\n\u003cp>The activists’ exclusion, Fauci said, made them “iconoclastic, theatrical, confrontative, which unfortunately turned off the government and the scientific and regulatory community even more.”\u003c/p>\n\u003cp>What he did — putting aside the theatrical protests and sitting down with them — “was one of the better things I’ve ever done in my career.”\u003c/p>\n\u003cp>“It became eminently clear to me that what they were saying really made sense, and if I were in their shoes, I would have been doing exactly what they were doing. And that’s when I said I need to sit down and start talking to these people. And once we did that, we found out that we had a lot in common. And that’s when the bonds of collaboration began decades ago to the point now that is a very productive component of what we do,” he said.\u003c/p>\n\u003cp>Fauci, who will be serving his seventh presidential administration as NIAID director when Joe Biden is sworn in next month, has survived Republicans and Democrats, as well as numerous outbreaks: HIV/AIDS, Ebola, Zika, H1N1 and now the coronavirus. What has he learned?\u003c/p>\n\u003cp>“As a scientist and as a public health person, it’s absolutely essential that I stay above and beyond the politics and focus completely on the public health, the scientific issues, because that’s what I’m supposed to be doing,” he said. “Once you start getting involved in ideology and political things, you just lose any credibility. So I have stayed completely away from the politics and focused on what my job is, which is public health and the safety and the health of the American public. You do that, you’re in good shape.”\u003c/p>\n\u003cp>\u003cem>This interview has been lightly edited for clarity.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>When California receives its first shipment of COVID-19 vaccines in early December, experts agree \u003ca href=\"https://www.kqed.org/news/11848790/covid-19-vaccine-plans-in-california-what-we-know-so-far\">health care workers will be the first to get it\u003c/a>.\u003c/p>\n\u003cp>But while the state’s medical workforce includes 2.4 million people, officials say the first vaccine shipment is expected to contain just 1 or 2 million doses — forcing the state to “sub-prioritze.” So who moves to the front of the line: a 65-year-old emergency room nurse or a 30-year-old home health aide?\u003c/p>\n\u003cp>“These are the difficult decisions that we are wrestling with,” said Dr. Oliver Brooks, chief medical officer at Watts Healthcare Corporation in Los Angeles and co-chair of the group charged with writing the state’s vaccine allocation guidelines.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Dr. Erica Pan']‘All of our preparations for the vaccine are guided by the need for safety, equity and transparency in the process.’[/pullquote]\u003c/p>\n\u003cp>Those guidelines are in draft form right now and will be refined over the next several months as scarce vaccine supplies trickle out. The Food and Drug Administration is expected to authorize the first vaccines in the coming weeks, and federal officials have said states will begin receiving doses 24 hours after they’re approved.\u003c/p>\n\u003cp>The state is drawing guidance for its overall distribution plan from the National Academy of Sciences, which recommends prioritizing people according to three main criteria: those who are at high risk of getting the virus; those most likely to suffer complications or to die if they become sick; those whose illness could have a negative impact on society.\u003c/p>\n\u003cp>This third principle — societal impact — is what puts health care workers in the top tier: If a doctor or paramedic is out sick for three or four weeks, their absence impacts the well-being of the community in a much more profound way than, say, a sick video game designer.\u003c/p>\n\u003cp>The details of these distribution plans are left to individual states to decide and implement, and California officials have emphasized that fairness and equity are top goals. They’ve established an advisory group comprised of 70 community organizations and medical associations to provide input.\u003c/p>\n\u003cp>“We must work together to ensure that vulnerable Californians, those most at risk, have equitable access to the vaccine,” said Dr. Erica Pan, acting state public health officer. “All of our preparations for the vaccine are guided by the need for safety, equity and transparency in the process.” [ad fullwidth]\u003c/p>\n\u003ch3>\u003cstrong>Which Health Care Workers Get Priority?\u003c/strong>\u003c/h3>\n\u003cp>The state is applying the same principles to deciding which health care workers should be prioritized over others — chance of getting it, chance of a bad outcome, societal impact of getting it — and adding three additional criteria to the consideration: the type of health care facility, the location of the facility and the characteristics of the people who work there.\u003c/p>\n\u003cp>For example, California’s draft plan puts acute care hospitals and congregate care facilities, like nursing homes and assisted living, at the top of its list since those workers are most at risk of contracting the disease. Primary care clinics and dental offices are lower down.\u003c/p>\n\u003cp>But the state has more than 1 million staff working at acute care hospitals alone, so the first shipment of vaccine may not cover everyone even in the state’s top tier of medical providers.\u003c/p>\n\u003cfigure id=\"attachment_11848982\" class=\"wp-caption aligncenter\" style=\"max-width: 1632px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11848982 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/11/Screen-Shot-2020-11-27-at-6.30.04-PM.png\" alt=\"\" width=\"1632\" height=\"1164\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/Screen-Shot-2020-11-27-at-6.30.04-PM.png 1632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/Screen-Shot-2020-11-27-at-6.30.04-PM-800x571.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/Screen-Shot-2020-11-27-at-6.30.04-PM-1020x728.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/Screen-Shot-2020-11-27-at-6.30.04-PM-160x114.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/Screen-Shot-2020-11-27-at-6.30.04-PM-1536x1096.png 1536w\" sizes=\"auto, (max-width: 1632px) 100vw, 1632px\">\u003cfigcaption class=\"wp-caption-text\">A chart of health care workers by facility type. \u003ccite>(California Department of Public Health)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>From there, the state might consider the location of the facility using principles of equity and the state’s “vulnerability index,” which measures social determinants of health in neighborhoods, like access to housing, education and transportation.\u003c/p>\n\u003cp>“Let’s say we say acute care hospitals get first pass,” Brooks said. “There are five in L.A. County. So should it go to the three that are in a low- to moderate-income area, versus somewhere that’s a higher income?”\u003c/p>\n\u003cp>If the state decides hospitals in low-income areas get priority, then officials further narrow the decision by looking at which employees in those hospitals should get it.\u003c/p>\n\u003cp>“What personal characteristics would we look at?” Brooks asked, at a recent meeting of the community advisory committee. “Occupation, age, gender, race and ethnicity, co-morbid conditions?”\u003c/p>\n\u003cp>Occupation and age are the most likely, he added, since the state has more reliable, actionable data on those categories. This suggests nurses and EMTs would get the vaccine before hospital janitors or drivers, and older nurses might get priority over younger nurses. [aside tag=\"vaccine, covid-19\" label=\"more coverage\"]\u003c/p>\n\u003cp>None of this has actually been decided yet. The state gathered feedback from community stakeholders at an advisory committee meeting on Nov. 25, and Gov. Gavin Newsom indicated a more formal plan for health care workers could be presented as early as Dec. 1.\u003c/p>\n\u003cp>But this is just the beginning. Once health care workers are vaccinated, the state will have to decide how to allocate the next shipments of vaccines among the elderly, essential workers, prison inmates, teachers, children and everyone else. The majority of Californians will not be vaccinated until spring or summer 2021.\u003c/p>\n\u003cp>“We’re having this discussion because there won’t be enough vaccine for everyone,” Brooks told the committee. “What I want the community vaccine advisory to focus on is ensuring that we have a process in place to allocate accordingly and ensure that that process is fair.”\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When California receives its first shipment of COVID-19 vaccines in early December, experts agree \u003ca href=\"https://www.kqed.org/news/11848790/covid-19-vaccine-plans-in-california-what-we-know-so-far\">health care workers will be the first to get it\u003c/a>.\u003c/p>\n\u003cp>But while the state’s medical workforce includes 2.4 million people, officials say the first vaccine shipment is expected to contain just 1 or 2 million doses — forcing the state to “sub-prioritze.” So who moves to the front of the line: a 65-year-old emergency room nurse or a 30-year-old home health aide?\u003c/p>\n\u003cp>“These are the difficult decisions that we are wrestling with,” said Dr. Oliver Brooks, chief medical officer at Watts Healthcare Corporation in Los Angeles and co-chair of the group charged with writing the state’s vaccine allocation guidelines.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Those guidelines are in draft form right now and will be refined over the next several months as scarce vaccine supplies trickle out. The Food and Drug Administration is expected to authorize the first vaccines in the coming weeks, and federal officials have said states will begin receiving doses 24 hours after they’re approved.\u003c/p>\n\u003cp>The state is drawing guidance for its overall distribution plan from the National Academy of Sciences, which recommends prioritizing people according to three main criteria: those who are at high risk of getting the virus; those most likely to suffer complications or to die if they become sick; those whose illness could have a negative impact on society.\u003c/p>\n\u003cp>This third principle — societal impact — is what puts health care workers in the top tier: If a doctor or paramedic is out sick for three or four weeks, their absence impacts the well-being of the community in a much more profound way than, say, a sick video game designer.\u003c/p>\n\u003cp>The details of these distribution plans are left to individual states to decide and implement, and California officials have emphasized that fairness and equity are top goals. They’ve established an advisory group comprised of 70 community organizations and medical associations to provide input.\u003c/p>\n\u003cp>“We must work together to ensure that vulnerable Californians, those most at risk, have equitable access to the vaccine,” said Dr. Erica Pan, acting state public health officer. “All of our preparations for the vaccine are guided by the need for safety, equity and transparency in the process.” \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch3>\u003cstrong>Which Health Care Workers Get Priority?\u003c/strong>\u003c/h3>\n\u003cp>The state is applying the same principles to deciding which health care workers should be prioritized over others — chance of getting it, chance of a bad outcome, societal impact of getting it — and adding three additional criteria to the consideration: the type of health care facility, the location of the facility and the characteristics of the people who work there.\u003c/p>\n\u003cp>For example, California’s draft plan puts acute care hospitals and congregate care facilities, like nursing homes and assisted living, at the top of its list since those workers are most at risk of contracting the disease. Primary care clinics and dental offices are lower down.\u003c/p>\n\u003cp>But the state has more than 1 million staff working at acute care hospitals alone, so the first shipment of vaccine may not cover everyone even in the state’s top tier of medical providers.\u003c/p>\n\u003cfigure id=\"attachment_11848982\" class=\"wp-caption aligncenter\" style=\"max-width: 1632px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11848982 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/11/Screen-Shot-2020-11-27-at-6.30.04-PM.png\" alt=\"\" width=\"1632\" height=\"1164\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/Screen-Shot-2020-11-27-at-6.30.04-PM.png 1632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/Screen-Shot-2020-11-27-at-6.30.04-PM-800x571.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/Screen-Shot-2020-11-27-at-6.30.04-PM-1020x728.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/Screen-Shot-2020-11-27-at-6.30.04-PM-160x114.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/Screen-Shot-2020-11-27-at-6.30.04-PM-1536x1096.png 1536w\" sizes=\"auto, (max-width: 1632px) 100vw, 1632px\">\u003cfigcaption class=\"wp-caption-text\">A chart of health care workers by facility type. \u003ccite>(California Department of Public Health)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>From there, the state might consider the location of the facility using principles of equity and the state’s “vulnerability index,” which measures social determinants of health in neighborhoods, like access to housing, education and transportation.\u003c/p>\n\u003cp>“Let’s say we say acute care hospitals get first pass,” Brooks said. “There are five in L.A. County. So should it go to the three that are in a low- to moderate-income area, versus somewhere that’s a higher income?”\u003c/p>\n\u003cp>If the state decides hospitals in low-income areas get priority, then officials further narrow the decision by looking at which employees in those hospitals should get it.\u003c/p>\n\u003cp>“What personal characteristics would we look at?” Brooks asked, at a recent meeting of the community advisory committee. “Occupation, age, gender, race and ethnicity, co-morbid conditions?”\u003c/p>\n\u003cp>Occupation and age are the most likely, he added, since the state has more reliable, actionable data on those categories. This suggests nurses and EMTs would get the vaccine before hospital janitors or drivers, and older nurses might get priority over younger nurses. \u003c/p>\u003c/div>",
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"content": "\u003cp>\u003cb>Staying Safe This Thanksgiving\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">The Centers for Disease Control and Prevention has advised Americans not to travel for the Thanksgiving holiday, as the country logged more than 1 million new cases of COVID-19 in the past week alone. Still, with a vaccine likely to be approved in the coming weeks, there may be light at the end of the tunnel. Public health expert Dr. Robert Wachter likens the situation to watching a split-screen movie with horror on one side and hope on the other. \u003c/span>\u003c/p>\n\u003cp>\u003cb>Guests:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Dr. Robert Wachter, chair, UCSF Department of Medicine\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>COVID-19 Updates From Santa Clara and Fresno\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">This week, Gov. Gavin Newsom said he was pulling the “emergency brake” and imposing a curfew prohibiting most nonessential work and activities between 10 p.m. and 5 a.m. The curfew applies to 41 counties in the “purple tier,” the state’s most restrictive category indicating “widespread risk” of COVID-19 transmission. We get reaction from the mayors of San Jose and Fresno.\u003c/span>\u003c/p>\n\u003cp>\u003cb>Guests:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Sam Liccardo, mayor of San Jose\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Lee Brand, mayor of Fresno\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Something Beautiful: Mosaic Steps of San Francisco\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">Take a walk with us up some of San Francisco’s tiled staircases, including one boasting a mosaic of the sea and the stars.\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"description": "Staying Safe This Thanksgiving The Centers for Disease Control and Prevention has advised Americans not to travel for the Thanksgiving holiday, as the country logged more than 1 million new cases of COVID-19 in the past week alone. Still, with a vaccine likely to be approved in the coming weeks, there may be light at the end of the tunnel. Public health expert Dr. Robert Wachter likens the situation to watching a split-screen movie with horror on one side and hope on the other. Guests: Dr. Robert Wachter, chair, UCSF Department of Medicine COVID-19 Updates From Santa Clara and Fresno",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cb>Staying Safe This Thanksgiving\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">The Centers for Disease Control and Prevention has advised Americans not to travel for the Thanksgiving holiday, as the country logged more than 1 million new cases of COVID-19 in the past week alone. Still, with a vaccine likely to be approved in the coming weeks, there may be light at the end of the tunnel. Public health expert Dr. Robert Wachter likens the situation to watching a split-screen movie with horror on one side and hope on the other. \u003c/span>\u003c/p>\n\u003cp>\u003cb>Guests:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Dr. Robert Wachter, chair, UCSF Department of Medicine\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>COVID-19 Updates From Santa Clara and Fresno\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">This week, Gov. Gavin Newsom said he was pulling the “emergency brake” and imposing a curfew prohibiting most nonessential work and activities between 10 p.m. and 5 a.m. The curfew applies to 41 counties in the “purple tier,” the state’s most restrictive category indicating “widespread risk” of COVID-19 transmission. We get reaction from the mayors of San Jose and Fresno.\u003c/span>\u003c/p>\n\u003cp>\u003cb>Guests:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Sam Liccardo, mayor of San Jose\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Lee Brand, mayor of Fresno\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Something Beautiful: Mosaic Steps of San Francisco\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">Take a walk with us up some of San Francisco’s tiled staircases, including one boasting a mosaic of the sea and the stars.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp class=\"p2\">On the rare occasion she leaves her room, Diane Evans uses a walker to gingerly navigate San Francisco’s Tenderloin neighborhood. Most days, the 74-year-old wears a multicolored head wrap, extra large T-shirt and plaid pajama pants.\u003c/p>\n\u003cp class=\"p2\">Deprived of classes and shared meals at the senior center she calls home, she is alone most of the time, beset by numerous health problems and severe clinical depression.\u003c/p>\n\u003cp class=\"p2\">She is, in fact, a prime candidate during this pandemic to be crushed by loneliness.\u003c/p>\n\u003cp>[pullquote]‘You get to be 85 years old, you know you got a foot on the banana peel.’[/pullquote]\u003c/p>\n\u003cp class=\"p2\">Yet, she is making it through OK.\u003c/p>\n\u003cp class=\"p3\">“If adverse situations beat you down, there wouldn’t be an African American in this country,” said Evans, who is Black. “You do what you have to do to survive.\u003c/p>\n\u003cp class=\"p2\">Recent research reveals older populations are less consumed by pandemic depression than those who are younger. According to a recent \u003ca href=\"https://www.apa.org/pubs/journals/releases/amp-amp0000690.pdf\">\u003cspan class=\"s1\">study\u003c/span>\u003c/a>, some seniors have even expanded their social support network during the lockdown.\u003c/p>\n\u003cp class=\"p2\">“They’ve been finding ways to adapt and cope,” said Ashwin Kotwal, a UCSF geriatrician. “They’re finding creative ways to interact with family members through Zoom, taking dance classes online or joining virtual book clubs.”\u003c/p>\n\u003cp class=\"p2\">Kotwal led a \u003ca href=\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.16865\">\u003cspan class=\"s1\">study\u003c/span>\u003c/a> that tracked 150 older adults in the Bay Area over six months, beginning in April. Measures of loneliness peaked in the first few months of the outbreak, but decreased as time passed.\u003c/p>\n\u003cfigure id=\"attachment_11847725\" class=\"wp-caption aligncenter\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11847725\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/11/IMG_5840-scaled.jpeg\" alt=\"\" width=\"2560\" height=\"1920\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/IMG_5840-scaled.jpeg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/IMG_5840-800x600.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/IMG_5840-1020x765.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/IMG_5840-160x120.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/IMG_5840-1536x1152.jpeg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/IMG_5840-2048x1536.jpeg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/IMG_5840-1920x1440.jpeg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/IMG_5840-1832x1374.jpeg 1832w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/IMG_5840-1376x1032.jpeg 1376w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/IMG_5840-1044x783.jpeg 1044w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/IMG_5840-632x474.jpeg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/IMG_5840-536x402.jpeg 536w\" sizes=\"(max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">Diane Evans steps outside for a brief stroll through the Tenderloin neighborhood in San Francisco. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p2\">Evans credits a lot of her positive attitude to technology. Grinning, she reached for a purple cellphone and said, “I learned how to text!’ She now Zooms regularly with her daughter in Chicago. When she’s not chatting online, she streams the radio or Hulu Live.\u003c/p>\n\u003cp class=\"p2\">She keeps solvent by buying very little, subsisting on about $1,000 a month from Social Security. The room she lives in is federally subsidized. Medicare covers doctor bills, and Meals on Wheels delivers food. Her biggest expense is laundry.\u003c/p>\n\u003cp class=\"p2\">On gloomy days inside her room, she reminds herself, “This too shall pass.”\u003c/p>\n\u003cp class=\"p2\">She’s eager for the virus to retreat enough for her to join protests for racial equality.\u003c/p>\n\u003cp class=\"p2\">“I want to be alive at the end of this,” she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003ch3>Connection Is Key\u003c/h3>\n\u003cp class=\"p2\">Evans’ story is not uncommon. At the Curry Senior Center, where she lives, older adults who connect virtually with friends and family are doing well, says Angela Di Martino, the facility’s wellness program manager.\u003c/p>\n\u003cp>Technology, though, is not a panacea.\u003c/p>\n\u003cp class=\"p2\">“Video calls cannot replace personal contact,” she said.\u003c/p>\n\u003cp class=\"p2\">Di Martino is among the experts who fear virtual interaction won’t offer a meaningful substitute for live conversation in the long run. Zoom fatigue is a real thing.\u003c/p>\n\u003cp class=\"p2\">Unsurprisingly, those seniors who are still engaging with people in person are faring the best. UCSF geriatrician Louise Aronson says she’s been hearing from older people who actually feel less isolated now than prior to the pandemic, because they live in multigenerational households, with family members who no longer rush off to work or school. Some are finding new purpose by helping their grandkids with distance learning.\u003c/p>\n\u003ch3>1 in 4 Lonely\u003c/h3>\n\u003cp class=\"p2\">To be sure, not all seniors\u003cb> \u003c/b>are riding out the storm smoothly. About 1 in 4 older adults say they’re anxious or depressed, according to a Kaiser Family Foundation \u003ca href=\"https://www.kff.org/medicare/issue-brief/one-in-four-older-adults-report-anxiety-or-depression-amid-the-covid-19-pandemic/#:~:text=Amid%20the%20ongoing%20coronavirus%20pandemic,older%20adults%20who%20reported%20anxiety\">\u003cspan class=\"s1\">poll\u003c/span>\u003c/a>, a rate that has more than doubled during the pandemic.\u003c/p>\n\u003cp class=\"p2\">The isolation is especially acute in nursing homes that prohibit visitors. Aronson says she’s seen patients who are refusing to eat, or who cry alone in their rooms for long stretches. \u003cspan class=\"s2\">One \u003ca href=\"https://www.jamda.com/article/S1525-8610(20)30738-6/fulltext?rss=yes\">\u003cspan class=\"s3\">recent study\u003c/span>\u003c/a>\u003c/span> of 111 residents in a Chicago-area nursing home found the group had shed an average of about four-and-a-half pounds from December through April. The researchers attribute the changes to fewer social interactions, a halt to family visits, and shifts in schedule, driven by the pandemic\u003cspan class=\"s2\">.\u003c/span>\u003c/p>\n\u003cp class=\"p2\">“Because they haven’t touched another human being or been touched by another human being since March,” said Aronson, “there is isolation. There is depression. There is battle fatigue.”\u003c/p>\n\u003cp class=\"p2\">Aronson points to a former patient of hers, Shirley Drexler, who died at an assisted living facility in San Francisco two months into the coronavirus outbreak. Though 102 years old, prior to the pandemic she was highly social, bright-eyed and steady on her feet. She used to dash from table to table to share lewd jokes during group meals, Aronson said.\u003c/p>\n\u003cp class=\"p2\">“But after a few weeks, when it became clear that the coronavirus wasn’t going to go away, she basically took to bed and died. Because at 102, she wasn’t going to live long enough to see the end of it. And so she figured that was it.\u003c/p>\n\u003cp class=\"p2\">“We’ve heard many other stories like that.”\u003c/p>\n\u003cp class=\"p2\">A growing body of \u003ca href=\"https://journals.sagepub.com/doi/10.1177/1745691614568352\">\u003cspan class=\"s4\">literature\u003c/span>\u003c/a> shows persistent loneliness has a number of consequences, such as depression, physical pain, increased disabilities and even death. Some \u003ca href=\"https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1188033\">\u003cspan class=\"s4\">research\u003c/span>\u003c/a> has shown a link between loneliness and the development of dementia, heart disease and stroke. A recent \u003ca href=\"https://link.springer.com/article/10.1007/s00125-020-05258-6\">\u003cspan class=\"s1\">study\u003c/span>\u003c/a> for the first time showed an association between loneliness and diabetes risk.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" frameborder=\"0\" height=\"200\" scrolling=\"“no”\" src=\"https://playlist.megaphone.fm?e=KQINC2415600030&light=true\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003ch3>One Day at a Time\u003c/h3>\n\u003cp class=\"p2\">Sukari Addison is one of the lucky ones. Dressed in a stylish pair of silver earrings and gold glasses, she says her motto is not to worry about things she can’t control.\u003c/p>\n\u003cp class=\"p2\">“We are in a really big change now,” Addison said. “But I’ve been through changes before. A lot of them as an African American.”\u003c/p>\n\u003cp class=\"p2\">She suffers from congestive heart failure and high blood pressure, both of which are risk factors for COVID-19. But Addison is not living in fear.\u003c/p>\n\u003cp class=\"p3\">“You get to be 85 years old, you know you got a foot on the banana peel,” she said.\u003c/p>\n\u003cp class=\"p2\">On a hot summer night in August, after collapsing on her bed from fatigue, she tried not to panic. Within days she tested positive for COVID-19 and landed in the hospital with pneumonia. The hardest part, she says, was the no-visitor policy. After two dire weeks, her physician sent her home, and she credits her recovery to the kindness of the nurses and doctors.\u003c/p>\n\u003cp class=\"p3\">She’s still moving slowly and spends most days alone in the room she rents near Union Square. But she says she’s not lonely, as her devices keep her connected.\u003c/p>\n\u003cp class=\"p2\">“I learn so much because of technology,” she said. “All I have to do is turn on my iPhone or my iPad or my computer. And there is a new subject for me to learn.”\u003c/p>\n\u003cp class=\"p2\">She often showcases her new skills over FaceTime with her six great-grandchildren on the East Coast. In the evenings, her sweetheart visits. They make dinner in her instant pot.\u003c/p>\n\u003cp class=\"p2\">On difficult days she pulls on her gloves, tightens her mask and strolls the city, chatting with folks on the street. She looks forward to a lot more social interaction when the pandemic ends.\u003c/p>\n\u003cp class=\"p2\">“I’m a professional volunteer!” proclaimed Addison. Until that’s safe, she’s taking it one day at a time.\u003c/p>\n\u003cp class=\"p2\">“The good news overall is that older adults are adapting. They’re resilient,” Kotwal said. “They’re finding ways to continue to cope despite these really prolonged restrictions. On the other hand, I think there is that subgroup that has had persistent loneliness that hasn’t been able to adopt new technologies or has had trouble coping.”\u003c/p>\n\u003cp class=\"p2\">Kotwal says it’s critical that doctors and social service agencies track older adults who may not have access to or feel comfortable navigating technology. He and his UCSF colleagues plan to check back with their original study cohort in a few months. He worries colder weather and a very different holiday season may lead to increased loneliness, and he suggests calling seniors more often this fall and winter.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"p2\">On the rare occasion she leaves her room, Diane Evans uses a walker to gingerly navigate San Francisco’s Tenderloin neighborhood. Most days, the 74-year-old wears a multicolored head wrap, extra large T-shirt and plaid pajama pants.\u003c/p>\n\u003cp class=\"p2\">Deprived of classes and shared meals at the senior center she calls home, she is alone most of the time, beset by numerous health problems and severe clinical depression.\u003c/p>\n\u003cp class=\"p2\">She is, in fact, a prime candidate during this pandemic to be crushed by loneliness.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp class=\"p2\">Yet, she is making it through OK.\u003c/p>\n\u003cp class=\"p3\">“If adverse situations beat you down, there wouldn’t be an African American in this country,” said Evans, who is Black. “You do what you have to do to survive.\u003c/p>\n\u003cp class=\"p2\">Recent research reveals older populations are less consumed by pandemic depression than those who are younger. According to a recent \u003ca href=\"https://www.apa.org/pubs/journals/releases/amp-amp0000690.pdf\">\u003cspan class=\"s1\">study\u003c/span>\u003c/a>, some seniors have even expanded their social support network during the lockdown.\u003c/p>\n\u003cp class=\"p2\">“They’ve been finding ways to adapt and cope,” said Ashwin Kotwal, a UCSF geriatrician. “They’re finding creative ways to interact with family members through Zoom, taking dance classes online or joining virtual book clubs.”\u003c/p>\n\u003cp class=\"p2\">Kotwal led a \u003ca href=\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.16865\">\u003cspan class=\"s1\">study\u003c/span>\u003c/a> that tracked 150 older adults in the Bay Area over six months, beginning in April. Measures of loneliness peaked in the first few months of the outbreak, but decreased as time passed.\u003c/p>\n\u003cfigure id=\"attachment_11847725\" class=\"wp-caption aligncenter\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11847725\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/11/IMG_5840-scaled.jpeg\" alt=\"\" width=\"2560\" height=\"1920\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/IMG_5840-scaled.jpeg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/IMG_5840-800x600.jpeg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/IMG_5840-1020x765.jpeg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/IMG_5840-160x120.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/IMG_5840-1536x1152.jpeg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/IMG_5840-2048x1536.jpeg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/IMG_5840-1920x1440.jpeg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/IMG_5840-1832x1374.jpeg 1832w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/IMG_5840-1376x1032.jpeg 1376w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/IMG_5840-1044x783.jpeg 1044w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/IMG_5840-632x474.jpeg 632w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/11/IMG_5840-536x402.jpeg 536w\" sizes=\"(max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">Diane Evans steps outside for a brief stroll through the Tenderloin neighborhood in San Francisco. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p2\">Evans credits a lot of her positive attitude to technology. Grinning, she reached for a purple cellphone and said, “I learned how to text!’ She now Zooms regularly with her daughter in Chicago. When she’s not chatting online, she streams the radio or Hulu Live.\u003c/p>\n\u003cp class=\"p2\">She keeps solvent by buying very little, subsisting on about $1,000 a month from Social Security. The room she lives in is federally subsidized. Medicare covers doctor bills, and Meals on Wheels delivers food. Her biggest expense is laundry.\u003c/p>\n\u003cp class=\"p2\">On gloomy days inside her room, she reminds herself, “This too shall pass.”\u003c/p>\n\u003cp class=\"p2\">She’s eager for the virus to retreat enough for her to join protests for racial equality.\u003c/p>\n\u003cp class=\"p2\">“I want to be alive at the end of this,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch3>Connection Is Key\u003c/h3>\n\u003cp class=\"p2\">Evans’ story is not uncommon. At the Curry Senior Center, where she lives, older adults who connect virtually with friends and family are doing well, says Angela Di Martino, the facility’s wellness program manager.\u003c/p>\n\u003cp>Technology, though, is not a panacea.\u003c/p>\n\u003cp class=\"p2\">“Video calls cannot replace personal contact,” she said.\u003c/p>\n\u003cp class=\"p2\">Di Martino is among the experts who fear virtual interaction won’t offer a meaningful substitute for live conversation in the long run. Zoom fatigue is a real thing.\u003c/p>\n\u003cp class=\"p2\">Unsurprisingly, those seniors who are still engaging with people in person are faring the best. UCSF geriatrician Louise Aronson says she’s been hearing from older people who actually feel less isolated now than prior to the pandemic, because they live in multigenerational households, with family members who no longer rush off to work or school. Some are finding new purpose by helping their grandkids with distance learning.\u003c/p>\n\u003ch3>1 in 4 Lonely\u003c/h3>\n\u003cp class=\"p2\">To be sure, not all seniors\u003cb> \u003c/b>are riding out the storm smoothly. About 1 in 4 older adults say they’re anxious or depressed, according to a Kaiser Family Foundation \u003ca href=\"https://www.kff.org/medicare/issue-brief/one-in-four-older-adults-report-anxiety-or-depression-amid-the-covid-19-pandemic/#:~:text=Amid%20the%20ongoing%20coronavirus%20pandemic,older%20adults%20who%20reported%20anxiety\">\u003cspan class=\"s1\">poll\u003c/span>\u003c/a>, a rate that has more than doubled during the pandemic.\u003c/p>\n\u003cp class=\"p2\">The isolation is especially acute in nursing homes that prohibit visitors. Aronson says she’s seen patients who are refusing to eat, or who cry alone in their rooms for long stretches. \u003cspan class=\"s2\">One \u003ca href=\"https://www.jamda.com/article/S1525-8610(20)30738-6/fulltext?rss=yes\">\u003cspan class=\"s3\">recent study\u003c/span>\u003c/a>\u003c/span> of 111 residents in a Chicago-area nursing home found the group had shed an average of about four-and-a-half pounds from December through April. The researchers attribute the changes to fewer social interactions, a halt to family visits, and shifts in schedule, driven by the pandemic\u003cspan class=\"s2\">.\u003c/span>\u003c/p>\n\u003cp class=\"p2\">“Because they haven’t touched another human being or been touched by another human being since March,” said Aronson, “there is isolation. There is depression. There is battle fatigue.”\u003c/p>\n\u003cp class=\"p2\">Aronson points to a former patient of hers, Shirley Drexler, who died at an assisted living facility in San Francisco two months into the coronavirus outbreak. Though 102 years old, prior to the pandemic she was highly social, bright-eyed and steady on her feet. She used to dash from table to table to share lewd jokes during group meals, Aronson said.\u003c/p>\n\u003cp class=\"p2\">“But after a few weeks, when it became clear that the coronavirus wasn’t going to go away, she basically took to bed and died. Because at 102, she wasn’t going to live long enough to see the end of it. And so she figured that was it.\u003c/p>\n\u003cp class=\"p2\">“We’ve heard many other stories like that.”\u003c/p>\n\u003cp class=\"p2\">A growing body of \u003ca href=\"https://journals.sagepub.com/doi/10.1177/1745691614568352\">\u003cspan class=\"s4\">literature\u003c/span>\u003c/a> shows persistent loneliness has a number of consequences, such as depression, physical pain, increased disabilities and even death. Some \u003ca href=\"https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1188033\">\u003cspan class=\"s4\">research\u003c/span>\u003c/a> has shown a link between loneliness and the development of dementia, heart disease and stroke. A recent \u003ca href=\"https://link.springer.com/article/10.1007/s00125-020-05258-6\">\u003cspan class=\"s1\">study\u003c/span>\u003c/a> for the first time showed an association between loneliness and diabetes risk.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" frameborder=\"0\" height=\"200\" scrolling=\"“no”\" src=\"https://playlist.megaphone.fm?e=KQINC2415600030&light=true\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003ch3>One Day at a Time\u003c/h3>\n\u003cp class=\"p2\">Sukari Addison is one of the lucky ones. Dressed in a stylish pair of silver earrings and gold glasses, she says her motto is not to worry about things she can’t control.\u003c/p>\n\u003cp class=\"p2\">“We are in a really big change now,” Addison said. “But I’ve been through changes before. A lot of them as an African American.”\u003c/p>\n\u003cp class=\"p2\">She suffers from congestive heart failure and high blood pressure, both of which are risk factors for COVID-19. But Addison is not living in fear.\u003c/p>\n\u003cp class=\"p3\">“You get to be 85 years old, you know you got a foot on the banana peel,” she said.\u003c/p>\n\u003cp class=\"p2\">On a hot summer night in August, after collapsing on her bed from fatigue, she tried not to panic. Within days she tested positive for COVID-19 and landed in the hospital with pneumonia. The hardest part, she says, was the no-visitor policy. After two dire weeks, her physician sent her home, and she credits her recovery to the kindness of the nurses and doctors.\u003c/p>\n\u003cp class=\"p3\">She’s still moving slowly and spends most days alone in the room she rents near Union Square. But she says she’s not lonely, as her devices keep her connected.\u003c/p>\n\u003cp class=\"p2\">“I learn so much because of technology,” she said. “All I have to do is turn on my iPhone or my iPad or my computer. And there is a new subject for me to learn.”\u003c/p>\n\u003cp class=\"p2\">She often showcases her new skills over FaceTime with her six great-grandchildren on the East Coast. In the evenings, her sweetheart visits. They make dinner in her instant pot.\u003c/p>\n\u003cp class=\"p2\">On difficult days she pulls on her gloves, tightens her mask and strolls the city, chatting with folks on the street. She looks forward to a lot more social interaction when the pandemic ends.\u003c/p>\n\u003cp class=\"p2\">“I’m a professional volunteer!” proclaimed Addison. Until that’s safe, she’s taking it one day at a time.\u003c/p>\n\u003cp class=\"p2\">“The good news overall is that older adults are adapting. They’re resilient,” Kotwal said. “They’re finding ways to continue to cope despite these really prolonged restrictions. On the other hand, I think there is that subgroup that has had persistent loneliness that hasn’t been able to adopt new technologies or has had trouble coping.”\u003c/p>\n\u003cp class=\"p2\">Kotwal says it’s critical that doctors and social service agencies track older adults who may not have access to or feel comfortable navigating technology. He and his UCSF colleagues plan to check back with their original study cohort in a few months. He worries colder weather and a very different holiday season may lead to increased loneliness, and he suggests calling seniors more often this fall and winter.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"soldout": {
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"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
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