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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>La Clínica de La Raza has cared for generations of Bay Area patients since its inception nearly 50 years ago. With dozens of clinics in Alameda, Contra Costa and Solano counties, the nonprofit sees roughly 90,000 mostly low-income patients per year.\u003c/p>\n\u003cp>But many people are no longer seeking routine care since local stay-at-home orders began in mid-March, and La Clínica is losing $3 million in revenue per month, said its chief executive Jane Garcia.\u003c/p>\n\u003cp>Patient visits have plunged by 40 percent, and the organization has closed non-emergency dental services and downsized optometry as well. Garcia said she has had to furlough about 300 employees.\u003c/p>\n\u003cp>“This is unlike anything we’ve experienced before,” said Garcia, who has led La Clínica for 38 years. “Not being able to provide the services is a big problem for communities who are already underserved.”\u003c/p>\n\u003cp>Nonprofit community clinics and health centers care for patients regardless of their ability to pay or their immigration status. However, during the coronavirus public health emergency, many clinics across California are struggling to keep their doors open. \u003c/p>\u003c/div>",
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"content": "“Our community health centers and clinics are an essential part of the overall health care delivered in our country, they are the backbone.”",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Statewide, federally qualified health centers are hemorrhaging nearly $90 million per week because patient visits — and reimbursements from Medi-Cal insurance — have dropped by half as people hunker down at home, according to Carmela Castellano-Garcia, president and chief executive of the California Primary Care Association, a lobbying group that represents 1,300 community clinics and health centers.\u003c/p>\n\u003cp>“This is unsustainable,” Castellano-Garcia said. “We are the leading providers of care for California’s most vulnerable populations and community health centers’ future is very much threatened by the COVID-19 pandemic.”\u003c/p>\n\u003cp>Last week, 180 health centers in California were awarded $193 million in federal emergency aid to ramp up COVID-19 testing and respond to the pandemic, according to the U.S. Department of Health and Human Services.\u003c/p>\n\u003cp>But Castellano-Garcia said those funds are not enough to keep nonprofit health care providers afloat, and 200 clinic sites have temporarily shut down across the state.\u003c/p>\n\u003cp>“Community health centers are absolutely at risk of closing and losing services permanently if more federal and state relief is not forthcoming,” she said.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In Southern California, Borrego Health has shuttered nine of its 27 clinics, including weekend operations serving migrant farmworkers in the rural Coachella Valley, where there are few other service providers.\u003c/p>\n\u003cp>The organization has laid off 65 employees and eliminated or reduced hours for 250 others since the pandemic began. That represents nearly 30 percent of the nonprofit’s staff, said Mikia Wallis, Borrego Health’s chief executive.\u003c/p>\n\u003cp>“We need the federal and state government to do what they’ve promised — to make us whole, and help keep us operational,” said Wallis, in a statement. “Without immediate financial support from the government, we will be forced to lay off frontline healthcare providers — those providing care directly to our patients — next.” \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The California Primary Care Association has joined other community health providers nationally in asking HHS Secretary Alex Azar for an $8 billion share of the coronavirus stimulus aid package that President Donald Trump signed last month. The association is also lobbying Congress for more financial help as the pandemic continues.\u003c/p>\n\u003cp>HHS is working to ensure all funds appropriated by Congress are made available to support the nearly 1,400 health centers and over 236,000 providers on the frontlines of this pandemic, according to an agency spokesperson.\u003c/p>\n\u003cp>“Secretary Azar is leading an administration-wide policy process to determine how to distribute relief funds in a way that is fast, fair, transparent and simple,” the spokesperson said.\u003c/p>\n\u003cp>Congresswoman Anna Eshoo (D-Palo Alto) said that while lawmakers are currently drafting an upcoming COVID-19 stimulus bill, there is broad bipartisan support for community health providers.\u003c/p>\n\u003cp>“Our community health centers and clinics are an essential part of the overall health care delivered in our country, they are the backbone,” said Eshoo.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>In the midst of the COVID-19 pandemic, the Centers for Medicare and Medicaid Services have\u003ca href=\"https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet\"> expanded access to telemedicine appointments\u003c/a> for their beneficiaries. Thanks to a new waiver, more elderly and low-income people can now receive care from practitioners virtually — and doctors and patients across California are taking advantage of this new leeway.\u003c/p>\n\u003cp>Gabriela Hernandez, who is 38 weeks pregnant, is one of those patients. Normally, she would go to LifeLong Medical Care in Berkeley every few weeks for a check-up with Kim Cardoso, her certified nurse-midwife. But for the past few weeks, their appointments have been over the phone.\u003c/p>\n\u003cp>LifeLong is one of more than 1,000 community health centers in California. Many of these centers have dramatically cut back services under the shelter-in-place order to slow the spread of the novel coronavirus.\u003c/p>\n\u003cp>LifeLong closed all but five of its 14 clinics for in-person visits. Providers still see patients in person for the most urgent cases, but the majority are now virtual.\u003c/p>\n\u003cp>Community health centers like LifeLong depend on partial reimbursements from the Medi-Cal program to provide low-cost or free services. Typically, doctors and nurses have to see their patients in person for the clinic to qualify for those funds — but the recent waiver changed that. Now providers like LifeLong get to care for their patients over the phone, and get reimbursed.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Patients and doctors alike are adapting quickly. Hernandez learned how to take her own blood pressure using a wrist cuff she bought at CVS. She reports the numbers back to Cardoso, who records them into a digital chart.\u003c/p>\n\u003cp>“I think it’s a little high,” Hernandez told Cardoso. “It’s at 150 over 106.”\u003c/p>\n\u003cp>“Oh, I don’t like that,” Cardoso said. She asked Hernandez how she’s been eating and if she’s been exercising. Hernandez said she’s been walking around the backyard every day to stay active.\u003c/p>\n\u003cp>She told Cardoso she dropped off samples she took at a nearby lab, which is the kind of thing a medical assistant would normally do at a clinic.\u003c/p>\n\u003cfigure id=\"attachment_11813263\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11813263\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42853_KimCardoso-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42853_KimCardoso-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42853_KimCardoso-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42853_KimCardoso-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42853_KimCardoso-qut.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Kim Cardoso meets with patients at the Ashby health center before the coronavirus pandemic. \u003ccite>(Courtesy of LifeLong Medical Care)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The learning curve has been steep for everyone at LifeLong, said Chief Medical Officer Michael Stacey.\u003c/p>\n\u003cp>The ability to provide telemedicine services has been an essential lifeline for clinics like LifeLong, said Carmela Castellano-Garcia, president and CEO of the California Primary Care Association, a group that lobbies on behalf of community health centers.\u003c/p>\n\u003cp>“We’ve completely shifted our model of care,” Stacey said.\u003c/p>\n\u003cp>When Bay Area counties began issuing shelter-in-place orders in mid-March, LifeLong had to provide secure digital access to medical charts for many of its 61,000 patients in a matter of days. The clinic had to make sure its doctors and nurses had access to appropriate technology to spend their days sitting in front of a computer, instead of going from exam room to exam room.\u003c/p>\n\u003cp>The rapid change has put LifeLong and other facilities under financial pressure. The clinic has seen about a 35% reduction in visits, even with the switch to telemedicine. The implications of that are troubling, according to LifeLong Deputy Director Lucinda Bazile.\u003c/p>\n\u003cp>So far, LifeLong has reduced hours or furloughed 100 of its employees.\u003c/p>\n\u003cp>“It’s really stressful,” she said. “This is the work that we all chose and we want to make sure that this population gets the care that we need.”\u003c/p>\n\u003cp>[aside tag=\"coronavirus\" label=\"related coverage\"]\u003c/p>\n\u003cp>The clinic where Cardoso works was one of the sites to transition entirely to telemedicine. She has been adapting to new ways to provide that care, including finding the corners of her house with the best cellphone reception and explaining to patients that they might hear her dogs, chickens or kids in the background.\u003c/p>\n\u003cp>But she said that telemedicine isn’t a long-term or complete solution, particularly when it comes to the violence and depression screenings that are part of the routine care she provides. She can’t be certain that her patients are alone and able to speak freely when she asks them about interpersonal violence.\u003c/p>\n\u003cp>“Can they answer truthfully when I ask them if they’re safe?” Cardoso said.\u003c/p>\n\u003cp>Cardoso relies on visual cues and body language to read patients’ responses to sensitive questions about their mental health, something that’s more difficult to do over the phone.\u003c/p>\n\u003cp>Patients like Hernandez are relieved to have that support from a distance, even if it means a different kind of care.\u003c/p>\n\u003cp>“I really like it,” she said. “But I do miss going to the doctor and feeling the baby’s heartbeat.”\u003c/p>\n\u003ch3>How to Get the Most Out of Your Virtual Visit\u003c/h3>\n\u003cp>Here are some tips to help you know when to call your doctor and how to get the most out of your telemedicine appointment:\u003c/p>\n\u003cul>\n\u003cli>If you don’t have a primary care provider already, now is a good time to find one. Community health clinics like LifeLong Medical Care are still doing patient intake over the phone.\u003c/li>\n\u003cli>Prepare for your appointment. Make a list of what you want to talk about during the phone call or video visit to get the most out of it and help your doctors understand your needs. If you have a thermometer, scale or home blood pressure monitor, have it nearby in case your doctor asks you to use it.\u003c/li>\n\u003cli>Track your symptoms as they occur — write them down in your phone or on a sheet of paper. Pay attention to when the symptoms occur, when they get worse and if anything seems to trigger them.\u003c/li>\n\u003cli>Take pictures. If your symptoms include rashes, bites or moles, your doctor wants to see that. It can be helpful to circle the affected area with a pen.\u003c/li>\n\u003cli>Emergencies are still emergencies, so if you’re experiencing chest pain, weakness in one side of the face or body or a sudden thunder-clap headache, call 911 to speak with a professional who can evaluate you over the phone. Be prepared to describe your symptoms in a few sentences.\u003c/li>\n\u003c/ul>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>NPR’s Mara Gordon contributed to this report.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In the midst of the COVID-19 pandemic, the Centers for Medicare and Medicaid Services have\u003ca href=\"https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet\"> expanded access to telemedicine appointments\u003c/a> for their beneficiaries. Thanks to a new waiver, more elderly and low-income people can now receive care from practitioners virtually — and doctors and patients across California are taking advantage of this new leeway.\u003c/p>\n\u003cp>Gabriela Hernandez, who is 38 weeks pregnant, is one of those patients. Normally, she would go to LifeLong Medical Care in Berkeley every few weeks for a check-up with Kim Cardoso, her certified nurse-midwife. But for the past few weeks, their appointments have been over the phone.\u003c/p>\n\u003cp>LifeLong is one of more than 1,000 community health centers in California. Many of these centers have dramatically cut back services under the shelter-in-place order to slow the spread of the novel coronavirus.\u003c/p>\n\u003cp>LifeLong closed all but five of its 14 clinics for in-person visits. Providers still see patients in person for the most urgent cases, but the majority are now virtual.\u003c/p>\n\u003cp>Community health centers like LifeLong depend on partial reimbursements from the Medi-Cal program to provide low-cost or free services. Typically, doctors and nurses have to see their patients in person for the clinic to qualify for those funds — but the recent waiver changed that. Now providers like LifeLong get to care for their patients over the phone, and get reimbursed.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Patients and doctors alike are adapting quickly. Hernandez learned how to take her own blood pressure using a wrist cuff she bought at CVS. She reports the numbers back to Cardoso, who records them into a digital chart.\u003c/p>\n\u003cp>“I think it’s a little high,” Hernandez told Cardoso. “It’s at 150 over 106.”\u003c/p>\n\u003cp>“Oh, I don’t like that,” Cardoso said. She asked Hernandez how she’s been eating and if she’s been exercising. Hernandez said she’s been walking around the backyard every day to stay active.\u003c/p>\n\u003cp>She told Cardoso she dropped off samples she took at a nearby lab, which is the kind of thing a medical assistant would normally do at a clinic.\u003c/p>\n\u003cfigure id=\"attachment_11813263\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11813263\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42853_KimCardoso-qut-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42853_KimCardoso-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42853_KimCardoso-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42853_KimCardoso-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42853_KimCardoso-qut.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Kim Cardoso meets with patients at the Ashby health center before the coronavirus pandemic. \u003ccite>(Courtesy of LifeLong Medical Care)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The learning curve has been steep for everyone at LifeLong, said Chief Medical Officer Michael Stacey.\u003c/p>\n\u003cp>The ability to provide telemedicine services has been an essential lifeline for clinics like LifeLong, said Carmela Castellano-Garcia, president and CEO of the California Primary Care Association, a group that lobbies on behalf of community health centers.\u003c/p>\n\u003cp>“We’ve completely shifted our model of care,” Stacey said.\u003c/p>\n\u003cp>When Bay Area counties began issuing shelter-in-place orders in mid-March, LifeLong had to provide secure digital access to medical charts for many of its 61,000 patients in a matter of days. The clinic had to make sure its doctors and nurses had access to appropriate technology to spend their days sitting in front of a computer, instead of going from exam room to exam room.\u003c/p>\n\u003cp>The rapid change has put LifeLong and other facilities under financial pressure. The clinic has seen about a 35% reduction in visits, even with the switch to telemedicine. The implications of that are troubling, according to LifeLong Deputy Director Lucinda Bazile.\u003c/p>\n\u003cp>So far, LifeLong has reduced hours or furloughed 100 of its employees.\u003c/p>\n\u003cp>“It’s really stressful,” she said. “This is the work that we all chose and we want to make sure that this population gets the care that we need.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The clinic where Cardoso works was one of the sites to transition entirely to telemedicine. She has been adapting to new ways to provide that care, including finding the corners of her house with the best cellphone reception and explaining to patients that they might hear her dogs, chickens or kids in the background.\u003c/p>\n\u003cp>But she said that telemedicine isn’t a long-term or complete solution, particularly when it comes to the violence and depression screenings that are part of the routine care she provides. She can’t be certain that her patients are alone and able to speak freely when she asks them about interpersonal violence.\u003c/p>\n\u003cp>“Can they answer truthfully when I ask them if they’re safe?” Cardoso said.\u003c/p>\n\u003cp>Cardoso relies on visual cues and body language to read patients’ responses to sensitive questions about their mental health, something that’s more difficult to do over the phone.\u003c/p>\n\u003cp>Patients like Hernandez are relieved to have that support from a distance, even if it means a different kind of care.\u003c/p>\n\u003cp>“I really like it,” she said. “But I do miss going to the doctor and feeling the baby’s heartbeat.”\u003c/p>\n\u003ch3>How to Get the Most Out of Your Virtual Visit\u003c/h3>\n\u003cp>Here are some tips to help you know when to call your doctor and how to get the most out of your telemedicine appointment:\u003c/p>\n\u003cul>\n\u003cli>If you don’t have a primary care provider already, now is a good time to find one. Community health clinics like LifeLong Medical Care are still doing patient intake over the phone.\u003c/li>\n\u003cli>Prepare for your appointment. Make a list of what you want to talk about during the phone call or video visit to get the most out of it and help your doctors understand your needs. If you have a thermometer, scale or home blood pressure monitor, have it nearby in case your doctor asks you to use it.\u003c/li>\n\u003cli>Track your symptoms as they occur — write them down in your phone or on a sheet of paper. Pay attention to when the symptoms occur, when they get worse and if anything seems to trigger them.\u003c/li>\n\u003cli>Take pictures. If your symptoms include rashes, bites or moles, your doctor wants to see that. It can be helpful to circle the affected area with a pen.\u003c/li>\n\u003cli>Emergencies are still emergencies, so if you’re experiencing chest pain, weakness in one side of the face or body or a sudden thunder-clap headache, call 911 to speak with a professional who can evaluate you over the phone. Be prepared to describe your symptoms in a few sentences.\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Steve Pantilat was in medical school and residency training in San Francisco at the peak of the AIDS crisis.\u003c/p>\n\u003cp>“While that was a different type of pandemic, there are a lot of echoes of that, of an illness we can’t treat, of people dying, a lot. Young people dying,” he said.\u003c/p>\n\u003cp>Back in the 1980s, health workers knew they could contract HIV from accidental needle sticks. The risk of contagion with coronavirus is very different.\u003c/p>\n\u003cp>“In this situation, anybody can get sick like this,” Pantilat said. “I could get sick like this also.”\u003c/p>\n\u003cp>Pantilat became a pioneer in palliative medicine, shepherding patients through serious illness and the dying process. He founded, and now directs the palliative care program at UCSF, where he’s setting the protocols that are guiding how the first generation of COVID-19 patients dies.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Compared to AIDS, this is much more personal.\u003c/p>\n\u003cp>“My wife and I are both in our 50s,” Pantilat said. “That is a higher risk group for serious complications, including dying of COVID-19. So in our house at least, we think about this a lot because of the work that I do and my wife does, but it’s much more tangible now.” [pullquote size=\"medium\" align=\"right\" citation=\"Dr. Steve Pantilat, chief of palliative care at UCSF\"]“All the clothes go directly in the washing machine. She goes to the shower first thing. We then wipe down every door knob and surface that she touched on the way in the house. And then, we say hello.”[/pullquote]\u003c/p>\n\u003cp>Pantilat’s wife is also a doctor. She’s been on the front lines in the hospital, caring for COVID-19 patients. The concern with carrying the infection home has led to some elaborate routines.\u003c/p>\n\u003cp>“She undresses in the garage, leaves her shoes there, wipes everything down, including the car, her shoes, her stethoscope,” Pantilat said. “She comes into the house, undressed — all the clothes go directly in the washing machine. She goes to the shower first thing. We then wipe down every door knob and surface that she touched on the way in the house. And then, we say hello.”\u003c/p>\n\u003cp>Pantilat, on the other hand, has been protecting himself and his team by working almost exclusively from home, doing his consults over video. While doctors would normally sit on the side of a patient’s bed and hold their hand when delivering bad news, now, all patients have to hold is an iPad.\u003c/p>\n\u003cp>“In order to limit exposure of our staff and to preserve the personal protection equipment, we’ve decided that we will see patients as much as we can by telemedicine, even for patients in the hospital,” he said. \u003c/p>\n\u003cp>Family and visitors are limited to video and phone calls, too. This is hard for doctors like Pantilat, who have made it their life’s work to honor peoples’ last wishes.\u003c/p>\n\u003cp>“I’ve been in rooms where there are 35 family members, people are playing music and holding a vigil and saying prayers and singing,” he said. “They’re even having weddings in the hospital. Just last month, we had another wedding for someone who was dying.”\u003c/p>\n\u003cp>But in the age of coronavirus, all that is out. There’s too much risk of visitors getting sick and there aren’t enough masks to go around. So the new policy at UCSF is one visitor, and only for patients who are actively dying.\u003c/p>\n\u003cp>“We’ve never really faced this before of trying to make these really kind of gut wrenching decisions about visitation and when and who and how many,” he said. “I think that’s really, really, really distressing for everyone involved.”\u003c/p>\n\u003cp>Many of these kinds of decisions are rushed right now. In some cases, COVID-19 can progress so fast, there’s not enough time for a considered conversation with patients about what kind of care they’re willing to have, what’s important to them, and what they want for the end of their lives. Pantilat says we should all be having these conversations with our loved ones now.\u003c/p>\n\u003cp>“Some of us who might not have thought about these issues and thought, ‘Oh, I’ve got a lot of time before I have to worry about this,’ are suddenly facing the reality that you could get suddenly sick and suddenly very, very sick,” he said. \u003c/p>\n\u003cp>Just in case, we should all be saying our goodbyes.\u003c/p>\n\u003cp>“No harm in saying, I love you and thank you and forgive me and I forgive you to the people you care about at any time,” he says. “It’s a really good time to do that now.” [aside tag=\"coronavirus\" label=\"Related Coverage\"]\u003c/p>\n\u003cp>But not all doctors take their own advice. “Good friends of ours sent us a, this sort of letter about, if both of them die, you know, asking us to be sort of official godparents to their three children,” Pantilat said.\u003c/p>\n\u003cp>Pantilat and his wife have two kids. The oldest is grown, but his younger son is 16 and still at home. They don’t have a plan for him. Neither of them have a will. \u003c/p>\n\u003cp>“We’ve talked about it, we have this sort of informal will. We have life insurance, we’ve gone that far,” he says. “But it’s a little embarrassing, as someone who takes care of people who are seriously ill, to say that we don’t have a will, but we don’t have one yet.”\u003c/p>\n\u003cp>Even now, with the haunting pressure of a fatal pandemic, Pantilat wavers. He sighs. He can’t bring himself to write an official plan for his own end. \u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“You know, probably like a lot of people, there’s a little bit of denial, too, like, is this really going to happen to both of us at the same time in the next few months?” he said. “It’s very sobering to get just this very small taste of what I imagine my seriously ill patients must be thinking about all the time.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Steve Pantilat was in medical school and residency training in San Francisco at the peak of the AIDS crisis.\u003c/p>\n\u003cp>“While that was a different type of pandemic, there are a lot of echoes of that, of an illness we can’t treat, of people dying, a lot. Young people dying,” he said.\u003c/p>\n\u003cp>Back in the 1980s, health workers knew they could contract HIV from accidental needle sticks. The risk of contagion with coronavirus is very different.\u003c/p>\n\u003cp>“In this situation, anybody can get sick like this,” Pantilat said. “I could get sick like this also.”\u003c/p>\n\u003cp>Pantilat became a pioneer in palliative medicine, shepherding patients through serious illness and the dying process. He founded, and now directs the palliative care program at UCSF, where he’s setting the protocols that are guiding how the first generation of COVID-19 patients dies.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Compared to AIDS, this is much more personal.\u003c/p>\n\u003cp>“My wife and I are both in our 50s,” Pantilat said. “That is a higher risk group for serious complications, including dying of COVID-19. So in our house at least, we think about this a lot because of the work that I do and my wife does, but it’s much more tangible now.” \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Pantilat’s wife is also a doctor. She’s been on the front lines in the hospital, caring for COVID-19 patients. The concern with carrying the infection home has led to some elaborate routines.\u003c/p>\n\u003cp>“She undresses in the garage, leaves her shoes there, wipes everything down, including the car, her shoes, her stethoscope,” Pantilat said. “She comes into the house, undressed — all the clothes go directly in the washing machine. She goes to the shower first thing. We then wipe down every door knob and surface that she touched on the way in the house. And then, we say hello.”\u003c/p>\n\u003cp>Pantilat, on the other hand, has been protecting himself and his team by working almost exclusively from home, doing his consults over video. While doctors would normally sit on the side of a patient’s bed and hold their hand when delivering bad news, now, all patients have to hold is an iPad.\u003c/p>\n\u003cp>“In order to limit exposure of our staff and to preserve the personal protection equipment, we’ve decided that we will see patients as much as we can by telemedicine, even for patients in the hospital,” he said. \u003c/p>\n\u003cp>Family and visitors are limited to video and phone calls, too. This is hard for doctors like Pantilat, who have made it their life’s work to honor peoples’ last wishes.\u003c/p>\n\u003cp>“I’ve been in rooms where there are 35 family members, people are playing music and holding a vigil and saying prayers and singing,” he said. “They’re even having weddings in the hospital. Just last month, we had another wedding for someone who was dying.”\u003c/p>\n\u003cp>But in the age of coronavirus, all that is out. There’s too much risk of visitors getting sick and there aren’t enough masks to go around. So the new policy at UCSF is one visitor, and only for patients who are actively dying.\u003c/p>\n\u003cp>“We’ve never really faced this before of trying to make these really kind of gut wrenching decisions about visitation and when and who and how many,” he said. “I think that’s really, really, really distressing for everyone involved.”\u003c/p>\n\u003cp>Many of these kinds of decisions are rushed right now. In some cases, COVID-19 can progress so fast, there’s not enough time for a considered conversation with patients about what kind of care they’re willing to have, what’s important to them, and what they want for the end of their lives. Pantilat says we should all be having these conversations with our loved ones now.\u003c/p>\n\u003cp>“Some of us who might not have thought about these issues and thought, ‘Oh, I’ve got a lot of time before I have to worry about this,’ are suddenly facing the reality that you could get suddenly sick and suddenly very, very sick,” he said. \u003c/p>\n\u003cp>Just in case, we should all be saying our goodbyes.\u003c/p>\n\u003cp>“No harm in saying, I love you and thank you and forgive me and I forgive you to the people you care about at any time,” he says. “It’s a really good time to do that now.” \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But not all doctors take their own advice. “Good friends of ours sent us a, this sort of letter about, if both of them die, you know, asking us to be sort of official godparents to their three children,” Pantilat said.\u003c/p>\n\u003cp>Pantilat and his wife have two kids. The oldest is grown, but his younger son is 16 and still at home. They don’t have a plan for him. Neither of them have a will. \u003c/p>\n\u003cp>“We’ve talked about it, we have this sort of informal will. We have life insurance, we’ve gone that far,” he says. “But it’s a little embarrassing, as someone who takes care of people who are seriously ill, to say that we don’t have a will, but we don’t have one yet.”\u003c/p>\n\u003cp>Even now, with the haunting pressure of a fatal pandemic, Pantilat wavers. He sighs. He can’t bring himself to write an official plan for his own end. \u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“You know, probably like a lot of people, there’s a little bit of denial, too, like, is this really going to happen to both of us at the same time in the next few months?” he said. “It’s very sobering to get just this very small taste of what I imagine my seriously ill patients must be thinking about all the time.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>At a time when doctors are more in demand than ever because of COVID-19, they are also being laid off and struggling to keep their practices open.\u003c/p>\n\u003cp>Since hospitals began canceling non-essential surgeries in mid-March to preserve medical resources, and patients have been too afraid to see their doctor for routine care, physicians are watching their revenues plummet.\u003c/p>\n\u003cp>“We had such a decrease in patient volume, we had to furlough about 75% of our staff,” said Dr. Sean Liston, an ophthalmologist and partner at Chico Eye Center. “So we’re still paying their health insurance, but we’re not paying them for hours they’re not working.”\u003c/p>\n\u003cp>About half the medical care in California is delivered by solo and small practice physicians, according to the California Medical Association. In a recent survey of its members, 50% of doctors said they’ve had to lay off fellow physicians, nurses and office staff because of the downturn, and 11% closed down temporarily.\u003c/p>\n\u003cp>Liston specializes in corneal transplants, but he hasn’t done one in weeks. He shut down his surgery center, furloughing 90% of the surgery staff, and the medical office where he does eye exams is only open in the mornings now. The four doctors who own the business suspended their own salaries for March and are considering the same for April.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We didn’t pay ourselves because we needed to make certain that we have enough cash reserves to be able to weather this,” Liston said.\u003c/p>\n\u003cp>They have had to weather a lot. They shut down their office in Paradise after the \u003ca href=\"https://www.kqed.org/news/tag/camp-fire\">2018 Camp Fire\u003c/a> burned through town, then watched dozens of doctors leave Chico when there was already a shortage.\u003c/p>\n\u003cp>“We had almost the same number of patients and significantly less physicians. So it was even worse,” said Liston, who recently served as the president of the local Butte-Glenn Medical Society.\u003c/p>\n\u003cp>He’s worried that another wave of doctors might close shop if the coronavirus shutdown lasts much longer. That could leave patients scrambling to find a primary care doctor, a pediatrician or a psychiatrist.\u003c/p>\n\u003cp>The California Medical Association is lobbying the governor to direct health insurance companies to give doctors “retention grants.” Patients are paying their premiums, but insurers aren’t paying claims, the association said, so why not share some of that money around to keep the physician network stable.\u003c/p>\n\u003cp>[aside label=\"More Coronavirus Coverage\" tag=\"coronavirus\"]\u003c/p>\n\u003cp>“Three months down the road, we’re going to have high demand for physician services, surgical and primary care, and we’ve got to be able to meet that,” said Dustin Corcoran, CEO of the California Medical Association. “Physician practices operate on very, very thin margins. They don’t have the reserves that payers have to weather the storm.”\u003c/p>\n\u003cp>Blue Shield of California is distributing $200 million to doctors in advance payments and loans, but they will have to be paid back. The federal government is depositing $30 billion in the bank accounts of ailing physician practices, but these grants are based on how many Medicare patients they typically see. So while the grants provided a welcome relief to some doctors, for others they only covered a fraction of their losses.\u003c/p>\n\u003cp>“If only one payer steps up, that’s not going to be enough to sustain physician practices,” Corcoran said. “That requires a state effort and private payers to do their part.”\u003c/p>\n\u003cp>Dr. George Scott, an OB-GYN in Manteca, sees very few patients over 65, so he got virtually nothing from the Medicare payment, according to his wife, Debbie Rood, who manages all the finances for the practice.\u003c/p>\n\u003cp>Their patient load has dropped by half, she said, as women skip their annual exams. Pre-natal visits are all over video now, which takes more time but pays less because there’s no physical contact. On top of everything, their landlord tripled the rent. Rood has been begging her husband and their three employees to conserve medical equipment and even electricity.\u003c/p>\n\u003cp>“For three weeks I have been telling them, ‘We are not going to have any money. ‘We’re not going to have any money’,” she said.\u003c/p>\n\u003cp>Insurance companies are sensitive to doctors’ struggles, but not to the point of handing out grants.\u003c/p>\n\u003cp>“It’s a pretty simple solution to a very complex problem — and we think too simple,” said Charles Bacchi, CEO of the California Association of Health Plans, a trade group for health insurance companies.\u003c/p>\n\u003cp>Insurers have their own financial obligations and government regulations they must abide by, Bacchi said, and they would rather decide on a case-by-case basis who to help and how. Advance payments or loans might make more sense than grants, because, eventually, patients will come back for their cancer screenings and cornea transplants.\u003c/p>\n\u003cp>“You can’t pay dollars now to keep this doctor’s office open and then pay again when someone comes in in four months to have their health care services,” Bacchi said.\u003c/p>\n\u003cp>But doctors like George Scott have to pay rent and salaries now and in four months, as well as the months in between. Scott and his wife really don’t want to lay off any of their staff.\u003c/p>\n\u003cp>“If we have to take out a second mortgage on our house, then we’ll have to take it out, and we just won’t be able to retire,” Scott said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Scott is 66. If he has to, he said, he’ll just keep delivering babies until he’s 80.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We didn’t pay ourselves because we needed to make certain that we have enough cash reserves to be able to weather this,” Liston said.\u003c/p>\n\u003cp>They have had to weather a lot. They shut down their office in Paradise after the \u003ca href=\"https://www.kqed.org/news/tag/camp-fire\">2018 Camp Fire\u003c/a> burned through town, then watched dozens of doctors leave Chico when there was already a shortage.\u003c/p>\n\u003cp>“We had almost the same number of patients and significantly less physicians. So it was even worse,” said Liston, who recently served as the president of the local Butte-Glenn Medical Society.\u003c/p>\n\u003cp>He’s worried that another wave of doctors might close shop if the coronavirus shutdown lasts much longer. That could leave patients scrambling to find a primary care doctor, a pediatrician or a psychiatrist.\u003c/p>\n\u003cp>The California Medical Association is lobbying the governor to direct health insurance companies to give doctors “retention grants.” Patients are paying their premiums, but insurers aren’t paying claims, the association said, so why not share some of that money around to keep the physician network stable.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Three months down the road, we’re going to have high demand for physician services, surgical and primary care, and we’ve got to be able to meet that,” said Dustin Corcoran, CEO of the California Medical Association. “Physician practices operate on very, very thin margins. They don’t have the reserves that payers have to weather the storm.”\u003c/p>\n\u003cp>Blue Shield of California is distributing $200 million to doctors in advance payments and loans, but they will have to be paid back. The federal government is depositing $30 billion in the bank accounts of ailing physician practices, but these grants are based on how many Medicare patients they typically see. So while the grants provided a welcome relief to some doctors, for others they only covered a fraction of their losses.\u003c/p>\n\u003cp>“If only one payer steps up, that’s not going to be enough to sustain physician practices,” Corcoran said. “That requires a state effort and private payers to do their part.”\u003c/p>\n\u003cp>Dr. George Scott, an OB-GYN in Manteca, sees very few patients over 65, so he got virtually nothing from the Medicare payment, according to his wife, Debbie Rood, who manages all the finances for the practice.\u003c/p>\n\u003cp>Their patient load has dropped by half, she said, as women skip their annual exams. Pre-natal visits are all over video now, which takes more time but pays less because there’s no physical contact. On top of everything, their landlord tripled the rent. Rood has been begging her husband and their three employees to conserve medical equipment and even electricity.\u003c/p>\n\u003cp>“For three weeks I have been telling them, ‘We are not going to have any money. ‘We’re not going to have any money’,” she said.\u003c/p>\n\u003cp>Insurance companies are sensitive to doctors’ struggles, but not to the point of handing out grants.\u003c/p>\n\u003cp>“It’s a pretty simple solution to a very complex problem — and we think too simple,” said Charles Bacchi, CEO of the California Association of Health Plans, a trade group for health insurance companies.\u003c/p>\n\u003cp>Insurers have their own financial obligations and government regulations they must abide by, Bacchi said, and they would rather decide on a case-by-case basis who to help and how. Advance payments or loans might make more sense than grants, because, eventually, patients will come back for their cancer screenings and cornea transplants.\u003c/p>\n\u003cp>“You can’t pay dollars now to keep this doctor’s office open and then pay again when someone comes in in four months to have their health care services,” Bacchi said.\u003c/p>\n\u003cp>But doctors like George Scott have to pay rent and salaries now and in four months, as well as the months in between. Scott and his wife really don’t want to lay off any of their staff.\u003c/p>\n\u003cp>“If we have to take out a second mortgage on our house, then we’ll have to take it out, and we just won’t be able to retire,” Scott said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Scott is 66. If he has to, he said, he’ll just keep delivering babies until he’s 80.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Dr. Noah Marco might never have known that he’d unwittingly admitted a \u003ca href=\"https://calmatters.org/health/2020/04/california-hotel-rooms-coronavirus-health-care-workers-covid-19/\">COVID-19\u003c/a> patient into his Los Angeles area nursing home last month if his nursing director wasn’t friends with her counterpart at another nursing home nearby.\u003c/p>\n\u003cp>The elderly man had been transferred to the Los Angeles Jewish Home, where Marco is chief medical officer, from another nursing home just before it experienced \u003ca href=\"https://www.latimes.com/socal/burbank-leader/news/story/2020-03-30/2-residents-of-alameda-care-center-die-from-covid-19\">a severe coronavirus outbreak\u003c/a> that infected 17 and killed two residents.\u003c/p>\n\u003cp>Marco had isolated the man as he began showing symptoms, and tested him right after his nursing director received an apologetic call from her counterpart at the stricken home. The man’s \u003ca href=\"https://www.facebook.com/LosAngelesJewishHome/?__tn__=kC-R&eid=ARAyQ3PATa5zgGkEnTT-sXsnNQ33Q8nm1LVY1u8vrCUlzKo0SkEtfshjDlFmo-J0xKq-nGbV1AV2wNta&hc_ref=ARTSyOfr-oYHlEdkIDCHV6TgLYKHs62o5hfqYeToyuMH02-QcrCnTO2xxAYY0L1oRIQ&fref=nf&__xts__%5b0%5d=68.ARDhfIg4P8pjTzlDOQ_X-McpT8OCygOx_IhzTx0y33qq6685BsOMfCQILWJofNPUvbKn-pjekOQUUMkPE1yOzP8wUS_zbDL6KOIySmDit80v101hGFAhCQI78V5xljqxltBAmh5JIdGEepWb1Yq7nkae2NEbJkj00alEkuFsFZx3RB1_T6adXnsmELXOGgyT156MSbZcwS6edPbzBiq4w9XrBTH-KU-f28fLXLbUgYaH0nDDwyX3ZLH7Y-4eGzji-58tJtGwKlB-oX46MvhtjmUpUIrH2eTTJ0lsbfeclkNLypYSrvODnsFG7sp2BzmbLqxLwVD5izQzXw84cT5H\">positive\u003c/a> results arrived from a commercial lab days later — an hour or two, Marco said, before he died.\u003c/p>\n\u003cp>“They sent him to us not knowing he had COVID,” Marco said. “We found out only because of a happenstance relationship between two nurses in two different buildings.” [ad fullwidth]\u003c/p>\n\u003cp>In California and nationwide, some skilled nursing facilities have gone well beyond the measures recommended by the U.S. Centers for Disease Control and Prevention (CDC) earlier in the pandemic — including closing communal dining rooms and banning outside visitors — to protect their elderly or disabled patients who are at most risk of dying if infected with the novel coronavirus.\u003c/p>\n\u003cp>They’re checking residents, and sometimes workers, for fever each day. Setting up special units for dialysis patients who need to leave the nursing home regularly for care. Requiring new residents to isolate in separate areas for 14 days. In some cases, nursing homes are requiring COVID-19 tests of new patients or returning residents before they can be readmitted, all the while worrying about \u003ca href=\"https://www.propublica.org/article/coronavirus-tests-are-being-fast-tracked-by-the-fda-but-its-unclear-how-accurate-they-are\">false negative results that have been reported\u003c/a> in some tests. Some homes are refusing new patients altogether.\u003c/p>\n\u003cp>[aside label=\"Related Stories\" tag=\"nursing-homes\"]\u003c/p>\n\u003cp>Headline-grabbing outbreaks at nursing homes in Riverside and Orinda underscore how quickly the coronavirus can spread through facilities and just how quickly it can fell patients and staff.\u003c/p>\n\u003cp>In Riverside, 83 patients \u003ca href=\"https://www.pe.com/2020/04/08/riverside-skilled-nursing-facility-with-39-coronavirus-cases-evacuated/\">were evacuated\u003c/a> Wednesday from Magnolia Rehabilitation and Nursing Center in the middle of its outbreak there because so many employees failed to show up for work. One COVID-positive certified nursing assistant, not among the no-shows, \u003ca href=\"https://www.pe.com/2020/04/13/woman-20-who-worked-at-riverside-nursing-home-with-outbreak-dies-from-coronavirus/\">has died\u003c/a>, a relative said Monday. Contra Costa County health officials asked the state to take over management of the Orinda Care Center after nearly a third of its staff members \u003ca href=\"https://www.nbcbayarea.com/news/local/east-bay/county-seeks-state-takeover-of-orinda-nursing-home-with-past-safety-violations/2270654/\">fell ill\u003c/a> along with 27 patients, two of whom died.\u003c/p>\n\u003cp>An estimated 1,266 patients or staff in California’s 1,244 skilled nursing facilities have been infected to date, Gov. Gavin Newsom said Friday in an \u003ca href=\"https://www.facebook.com/CAgovernor/videos/665608347538933/\">online press conference\u003c/a>. California public health officials are monitoring 191 nursing homes with infected patients or staff.\u003c/p>\n\u003cp>But in trying to secure their facilities against viral intrusion, some nursing homes may run afoul of state public health officials, who have said that to free up hospital beds, skilled nursing facilities \u003ca href=\"https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/AFL-20-33.aspx\">may be required\u003c/a> to accept recovering COVID-19 patients — even if they’re still infectious.\u003c/p>\n\u003cp>After an outcry from the nursing home industry, the controversial requirement was loosened so that nursing homes may refuse to accept these patients if the facilities lack adequate protective gear for workers or other ways to prevent transmission.\u003c/p>\n\u003cp>“Nursing homes are NOT the right place for the virus patients,” nursing home resident Dorothea Lack, an 81-year-old retired psychotherapist with chronic obstructive pulmonary disease, wrote in an email to CalMatters. “They are like incubators. These helpless, fragile patients should not be exposed to this virulent disease! Just because they are old and helpless is not an excuse for risking their lives, without their knowledge or consent.”\u003c/p>\n\u003cp>[pullquote size='medium' align='left' citation=\"Dorothea Lack, Nursing Home Resident\"]‘Nursing homes are NOT the right place for the virus patients. They are like incubators.’[/pullquote]\u003c/p>\n\u003cp>Still, the moral equation is grave: save hospital beds for the sickest COVID-19 patients or endanger the elderly, who are most at risk of dying if infected?\u003c/p>\n\u003cp>Los Angeles County’s public health director last week even \u003ca href=\"https://www.latimes.com/california/story/2020-04-07/coronavirus-nursing-homes-residents-remove-la-county\">advised families\u003c/a> to consider pulling their loved ones out of nursing homes. It would be “perfectly appropriate,” said Dr. Barbara Ferrer.\u003c/p>\n\u003cp>But many families cannot properly care for their elderly relatives, some of whom may have severe dementia or chronic medical conditions that require daily nursing care.\u003c/p>\n\u003cp>The federal government does \u003ca href=\"https://www.nbcnews.com/news/us-news/more-2-200-coronavirus-deaths-nursing-homes-federal-government-isn-n1181026\">not track\u003c/a> nursing home deaths specifically. The Centers for Medicare and Medicaid Services has suggested nursing homes should dedicate “if possible” a wing or unit for patients transferred from hospitals. Its only \u003ca href=\"https://www.cms.gov/files/document/qso-20-14-nh-revised.pdf\">guidance\u003c/a> for nursing homes accepting patients from hospitals during the pandemic is that they should admit anyone they’d normally admit to their facility as long as they can follow CDC guidelines to prevent infection.\u003c/p>\n\u003cp>Without more specific federal direction, states are making up their own rules about what role skilled nursing facilities must play in housing recovering COVID-19 patients.\u003c/p>\n\u003cp>New York is requiring nursing homes \u003ca href=\"https://www.justiceinaging.org/wp-content/uploads/2020/04/Nursing-Facilities-and-Assisted-Living-During-the-COVID-19-Outbreak-4.3.20.pdf\">to accept patients\u003c/a> at the request of public health officials, no exceptions. Louisiana takes the opposite approach, \u003ca href=\"https://www.justiceinaging.org/wp-content/uploads/2020/04/Nursing-Facilities-and-Assisted-Living-During-the-COVID-19-Outbreak-4.3.20.pdf\">prohibiting nursing homes\u003c/a> from accepting hospital patients who have tested positive for COVID-19 or have a pending test, or who have respiratory symptoms.\u003c/p>\n\u003cfigure id=\"attachment_11812420\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11812420\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/NURSING-HOMES-photo-2-1.jpg\" alt=\"\" width=\"1920\" height=\"1283\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/NURSING-HOMES-photo-2-1.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/NURSING-HOMES-photo-2-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/NURSING-HOMES-photo-2-1-800x535.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/NURSING-HOMES-photo-2-1-1020x682.jpg 1020w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Noah S. Marco, Jewish Home Chief Medical Officer, at the Grancell Village Campus in Reseda, Calif. \u003ccite>(Nancy Pastor/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At the Los Angeles Jewish Home, Dr. Noah Marco said he simply will refuse any COVID-19 patients from hospitals.\u003c/p>\n\u003cp>“I’m not taking in a COVID-positive patient for the sole purpose of emptying one hospital bed. In two weeks, I’m sending them back 20 new patients,” he said. “No facilities have the kind of personal protective equipment they need. We don’t have isolation gowns, we’re out. We’d ordered as many as we can and we used them. You know what we’re using? We are using patient hospital gowns for our caregivers.”\u003c/p>\n\u003cp>The only approach that makes sense, Marco and other nursing home doctors say, is to use other facilities for recovering patients that don’t already have vulnerable seniors living there. “This is these people’s home and you cannot bring a COVID-positive person into a senior’s home, everyone would agree with that,” Marco said.\u003c/p>\n\u003cp>To date, California’s Public Health Department has not required any nursing homes to accept COVID-positive patients to free up hospital beds, but those orders — if they come — are likely to originate from county health departments. Some nursing homes are trying to prepare for this worst-case scenario, including the Campus for Jewish Living in San Francisco, which has prepared a separate wing where COVID-patients from hospitals could recover, the San Francisco Chronicle \u003ca href=\"https://www.sfchronicle.com/politics/article/Ordered-by-the-state-SF-nursing-home-prepares-to-15185950.php\">reported\u003c/a>.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation=\"Dr. Noah Marco, Chief Medical Officer of Los Angeles Jewish Home\"]‘I’m not taking in a COVID-positive patient for the sole purpose of emptying one hospital bed. In two weeks, I’m sending them back 20 new patients.’[/pullquote]\u003c/p>\n\u003cp>Nursing home officials may find some relief in \u003ca href=\"https://www.gov.ca.gov/2020/04/10/governor-newsom-outlines-steps-to-protect-residents-and-employees-of-california-nursing-home-residential-care-facilities/\">plans announced Friday\u003c/a> by Gov. Newsom to deploy what he called “SWAT teams” of infectious disease experts to assist nursing homes experiencing large outbreaks, and 600 public health nurses more generally to help homes improve infection control. The state also will provide $500 stipends to as many as 50,000 nursing home workers, a consequence of a Facebook donation of up to $25 million. Officials also plan to offer \u003ca href=\"https://calmatters.org/health/2020/04/california-hotel-rooms-coronavirus-health-care-workers-covid-19/\">free or heavily discounted hotel rooms to infected or exposed nursing home workers\u003c/a> who don’t need to be hospitalized.\u003c/p>\n\u003cp>Newsom also said that more non-COVID-19 patients could be treated and recover on the hospital ship Mercy, docked at the Port of Los Angeles to reduce the burden on overloaded hospitals. He added that the state has identified seven additional, as yet undisclosed, sites outside of nursing homes where patients could recover. That could take the pressure off some nursing homes.\u003c/p>\n\u003cp>“This state has a disproportionate number of aging individuals and we have a unique responsibility to take care of them,” he said.\u003c/p>\n\u003cp>Since then, however, at least three sailors on the Mercy have \u003ca href=\"https://www.sandiegouniontribune.com/news/military/story/2020-04-10/2-more-hospital-ship-mercy-sailors-test-positive-for-covid-19\">tested positive\u003c/a> for COVID-19, possibly upending Newsom’s plans. They are isolated and recovering off the ship.\u003c/p>\n\u003cp>\u003cem>CalMatters.org is a nonprofit, nonpartisan media venture explaining California policies and politics.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Dr. Noah Marco might never have known that he’d unwittingly admitted a \u003ca href=\"https://calmatters.org/health/2020/04/california-hotel-rooms-coronavirus-health-care-workers-covid-19/\">COVID-19\u003c/a> patient into his Los Angeles area nursing home last month if his nursing director wasn’t friends with her counterpart at another nursing home nearby.\u003c/p>\n\u003cp>The elderly man had been transferred to the Los Angeles Jewish Home, where Marco is chief medical officer, from another nursing home just before it experienced \u003ca href=\"https://www.latimes.com/socal/burbank-leader/news/story/2020-03-30/2-residents-of-alameda-care-center-die-from-covid-19\">a severe coronavirus outbreak\u003c/a> that infected 17 and killed two residents.\u003c/p>\n\u003cp>Marco had isolated the man as he began showing symptoms, and tested him right after his nursing director received an apologetic call from her counterpart at the stricken home. The man’s \u003ca href=\"https://www.facebook.com/LosAngelesJewishHome/?__tn__=kC-R&eid=ARAyQ3PATa5zgGkEnTT-sXsnNQ33Q8nm1LVY1u8vrCUlzKo0SkEtfshjDlFmo-J0xKq-nGbV1AV2wNta&hc_ref=ARTSyOfr-oYHlEdkIDCHV6TgLYKHs62o5hfqYeToyuMH02-QcrCnTO2xxAYY0L1oRIQ&fref=nf&__xts__%5b0%5d=68.ARDhfIg4P8pjTzlDOQ_X-McpT8OCygOx_IhzTx0y33qq6685BsOMfCQILWJofNPUvbKn-pjekOQUUMkPE1yOzP8wUS_zbDL6KOIySmDit80v101hGFAhCQI78V5xljqxltBAmh5JIdGEepWb1Yq7nkae2NEbJkj00alEkuFsFZx3RB1_T6adXnsmELXOGgyT156MSbZcwS6edPbzBiq4w9XrBTH-KU-f28fLXLbUgYaH0nDDwyX3ZLH7Y-4eGzji-58tJtGwKlB-oX46MvhtjmUpUIrH2eTTJ0lsbfeclkNLypYSrvODnsFG7sp2BzmbLqxLwVD5izQzXw84cT5H\">positive\u003c/a> results arrived from a commercial lab days later — an hour or two, Marco said, before he died.\u003c/p>\n\u003cp>“They sent him to us not knowing he had COVID,” Marco said. “We found out only because of a happenstance relationship between two nurses in two different buildings.” \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In California and nationwide, some skilled nursing facilities have gone well beyond the measures recommended by the U.S. Centers for Disease Control and Prevention (CDC) earlier in the pandemic — including closing communal dining rooms and banning outside visitors — to protect their elderly or disabled patients who are at most risk of dying if infected with the novel coronavirus.\u003c/p>\n\u003cp>They’re checking residents, and sometimes workers, for fever each day. Setting up special units for dialysis patients who need to leave the nursing home regularly for care. Requiring new residents to isolate in separate areas for 14 days. In some cases, nursing homes are requiring COVID-19 tests of new patients or returning residents before they can be readmitted, all the while worrying about \u003ca href=\"https://www.propublica.org/article/coronavirus-tests-are-being-fast-tracked-by-the-fda-but-its-unclear-how-accurate-they-are\">false negative results that have been reported\u003c/a> in some tests. Some homes are refusing new patients altogether.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Headline-grabbing outbreaks at nursing homes in Riverside and Orinda underscore how quickly the coronavirus can spread through facilities and just how quickly it can fell patients and staff.\u003c/p>\n\u003cp>In Riverside, 83 patients \u003ca href=\"https://www.pe.com/2020/04/08/riverside-skilled-nursing-facility-with-39-coronavirus-cases-evacuated/\">were evacuated\u003c/a> Wednesday from Magnolia Rehabilitation and Nursing Center in the middle of its outbreak there because so many employees failed to show up for work. One COVID-positive certified nursing assistant, not among the no-shows, \u003ca href=\"https://www.pe.com/2020/04/13/woman-20-who-worked-at-riverside-nursing-home-with-outbreak-dies-from-coronavirus/\">has died\u003c/a>, a relative said Monday. Contra Costa County health officials asked the state to take over management of the Orinda Care Center after nearly a third of its staff members \u003ca href=\"https://www.nbcbayarea.com/news/local/east-bay/county-seeks-state-takeover-of-orinda-nursing-home-with-past-safety-violations/2270654/\">fell ill\u003c/a> along with 27 patients, two of whom died.\u003c/p>\n\u003cp>An estimated 1,266 patients or staff in California’s 1,244 skilled nursing facilities have been infected to date, Gov. Gavin Newsom said Friday in an \u003ca href=\"https://www.facebook.com/CAgovernor/videos/665608347538933/\">online press conference\u003c/a>. California public health officials are monitoring 191 nursing homes with infected patients or staff.\u003c/p>\n\u003cp>But in trying to secure their facilities against viral intrusion, some nursing homes may run afoul of state public health officials, who have said that to free up hospital beds, skilled nursing facilities \u003ca href=\"https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/AFL-20-33.aspx\">may be required\u003c/a> to accept recovering COVID-19 patients — even if they’re still infectious.\u003c/p>\n\u003cp>After an outcry from the nursing home industry, the controversial requirement was loosened so that nursing homes may refuse to accept these patients if the facilities lack adequate protective gear for workers or other ways to prevent transmission.\u003c/p>\n\u003cp>“Nursing homes are NOT the right place for the virus patients,” nursing home resident Dorothea Lack, an 81-year-old retired psychotherapist with chronic obstructive pulmonary disease, wrote in an email to CalMatters. “They are like incubators. These helpless, fragile patients should not be exposed to this virulent disease! Just because they are old and helpless is not an excuse for risking their lives, without their knowledge or consent.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Still, the moral equation is grave: save hospital beds for the sickest COVID-19 patients or endanger the elderly, who are most at risk of dying if infected?\u003c/p>\n\u003cp>Los Angeles County’s public health director last week even \u003ca href=\"https://www.latimes.com/california/story/2020-04-07/coronavirus-nursing-homes-residents-remove-la-county\">advised families\u003c/a> to consider pulling their loved ones out of nursing homes. It would be “perfectly appropriate,” said Dr. Barbara Ferrer.\u003c/p>\n\u003cp>But many families cannot properly care for their elderly relatives, some of whom may have severe dementia or chronic medical conditions that require daily nursing care.\u003c/p>\n\u003cp>The federal government does \u003ca href=\"https://www.nbcnews.com/news/us-news/more-2-200-coronavirus-deaths-nursing-homes-federal-government-isn-n1181026\">not track\u003c/a> nursing home deaths specifically. The Centers for Medicare and Medicaid Services has suggested nursing homes should dedicate “if possible” a wing or unit for patients transferred from hospitals. Its only \u003ca href=\"https://www.cms.gov/files/document/qso-20-14-nh-revised.pdf\">guidance\u003c/a> for nursing homes accepting patients from hospitals during the pandemic is that they should admit anyone they’d normally admit to their facility as long as they can follow CDC guidelines to prevent infection.\u003c/p>\n\u003cp>Without more specific federal direction, states are making up their own rules about what role skilled nursing facilities must play in housing recovering COVID-19 patients.\u003c/p>\n\u003cp>New York is requiring nursing homes \u003ca href=\"https://www.justiceinaging.org/wp-content/uploads/2020/04/Nursing-Facilities-and-Assisted-Living-During-the-COVID-19-Outbreak-4.3.20.pdf\">to accept patients\u003c/a> at the request of public health officials, no exceptions. Louisiana takes the opposite approach, \u003ca href=\"https://www.justiceinaging.org/wp-content/uploads/2020/04/Nursing-Facilities-and-Assisted-Living-During-the-COVID-19-Outbreak-4.3.20.pdf\">prohibiting nursing homes\u003c/a> from accepting hospital patients who have tested positive for COVID-19 or have a pending test, or who have respiratory symptoms.\u003c/p>\n\u003cfigure id=\"attachment_11812420\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11812420\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/NURSING-HOMES-photo-2-1.jpg\" alt=\"\" width=\"1920\" height=\"1283\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/NURSING-HOMES-photo-2-1.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/NURSING-HOMES-photo-2-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/NURSING-HOMES-photo-2-1-800x535.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/NURSING-HOMES-photo-2-1-1020x682.jpg 1020w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Noah S. Marco, Jewish Home Chief Medical Officer, at the Grancell Village Campus in Reseda, Calif. \u003ccite>(Nancy Pastor/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At the Los Angeles Jewish Home, Dr. Noah Marco said he simply will refuse any COVID-19 patients from hospitals.\u003c/p>\n\u003cp>“I’m not taking in a COVID-positive patient for the sole purpose of emptying one hospital bed. In two weeks, I’m sending them back 20 new patients,” he said. “No facilities have the kind of personal protective equipment they need. We don’t have isolation gowns, we’re out. We’d ordered as many as we can and we used them. You know what we’re using? We are using patient hospital gowns for our caregivers.”\u003c/p>\n\u003cp>The only approach that makes sense, Marco and other nursing home doctors say, is to use other facilities for recovering patients that don’t already have vulnerable seniors living there. “This is these people’s home and you cannot bring a COVID-positive person into a senior’s home, everyone would agree with that,” Marco said.\u003c/p>\n\u003cp>To date, California’s Public Health Department has not required any nursing homes to accept COVID-positive patients to free up hospital beds, but those orders — if they come — are likely to originate from county health departments. Some nursing homes are trying to prepare for this worst-case scenario, including the Campus for Jewish Living in San Francisco, which has prepared a separate wing where COVID-patients from hospitals could recover, the San Francisco Chronicle \u003ca href=\"https://www.sfchronicle.com/politics/article/Ordered-by-the-state-SF-nursing-home-prepares-to-15185950.php\">reported\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Nursing home officials may find some relief in \u003ca href=\"https://www.gov.ca.gov/2020/04/10/governor-newsom-outlines-steps-to-protect-residents-and-employees-of-california-nursing-home-residential-care-facilities/\">plans announced Friday\u003c/a> by Gov. Newsom to deploy what he called “SWAT teams” of infectious disease experts to assist nursing homes experiencing large outbreaks, and 600 public health nurses more generally to help homes improve infection control. The state also will provide $500 stipends to as many as 50,000 nursing home workers, a consequence of a Facebook donation of up to $25 million. Officials also plan to offer \u003ca href=\"https://calmatters.org/health/2020/04/california-hotel-rooms-coronavirus-health-care-workers-covid-19/\">free or heavily discounted hotel rooms to infected or exposed nursing home workers\u003c/a> who don’t need to be hospitalized.\u003c/p>\n\u003cp>Newsom also said that more non-COVID-19 patients could be treated and recover on the hospital ship Mercy, docked at the Port of Los Angeles to reduce the burden on overloaded hospitals. He added that the state has identified seven additional, as yet undisclosed, sites outside of nursing homes where patients could recover. That could take the pressure off some nursing homes.\u003c/p>\n\u003cp>“This state has a disproportionate number of aging individuals and we have a unique responsibility to take care of them,” he said.\u003c/p>\n\u003cp>Since then, however, at least three sailors on the Mercy have \u003ca href=\"https://www.sandiegouniontribune.com/news/military/story/2020-04-10/2-more-hospital-ship-mercy-sailors-test-positive-for-covid-19\">tested positive\u003c/a> for COVID-19, possibly upending Newsom’s plans. They are isolated and recovering off the ship.\u003c/p>\n\u003cp>\u003cem>CalMatters.org is a nonprofit, nonpartisan media venture explaining California policies and politics.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Like many in the Bay Area, Calisa Hildebrand was looking for a local solution to address the lack of protective gear. She ended up starting a collection point at her local market — Gus’s on Haight Street. In addition to coordinating the personal protective equipment drop-off point, she wanted people to be able to contribute in a more personal way. She worked with her friend Paloma Figueroa, who works as a consultant for diversity and inclusion, to coordinate with nurses at UCSF. They have now launched a grassroots letter-writing effort to thank health workers.\u003c/p>\n\u003cfigure id=\"attachment_11812090\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11812090 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42690_1920-IMG_2621-qut-800x1176.jpg\" alt=\"\" width=\"800\" height=\"1176\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42690_1920-IMG_2621-qut-800x1176.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42690_1920-IMG_2621-qut-160x235.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42690_1920-IMG_2621-qut-1020x1500.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42690_1920-IMG_2621-qut.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Calisa Hildebrand writes thank you letters to local health care workers from her home in San Francisco. \u003ccite>(Courtesy of Calisa Hildebrand)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Figueroa and Hildebrand mailed the first round of cards to nurses at UCSF. Since then, they’ve coordinated at least 140 letters in just the past few weeks. “This goes beyond San Francisco … we’ll take names of any health worker, anywhere, and volunteers from anywhere,” Hildebrand said.[ad fullwidth]\u003c/p>\n\u003cp>For Hildebrand, the project is personal because she survived cancer a couple of years ago.\u003c/p>\n\u003cp>“The health system literally saved my life,” she said. “The doctors and the nurses and the oncologists and everybody was just so incredible and so responsive, I will forever be grateful to them.” \u003c/p>\n\u003cp>Now that she’s healthy, she’s doing what she can to let health care workers know they’re appreciated — and encouraging others to do the same.\u003c/p>\n\u003cp>Hildebrand also said that this small act of gratitude is a practice in “collective togetherness.” Many people feel overwhelmed, stressed or scared, but “what is so beautiful about this project is that when we do good things for people, we also feel better about ourselves … with minimal effort — we’re able to make a positive impact.”\u003c/p>\n\u003cp>Even before the first thank you card drop-off, when Figueroa’s friend at UCSF told another nurse that the notes were coming, she started crying. “These are just normal people that want to give back and are appreciative of everything that you [health care workers] are all doing and you’re risking your lives for us and we want to do what we can,” she said.[aside tag=\"coronavirus\" label=\"More Coronavirus Coverage\"]\u003c/p>\n\u003cp>The project has evolved quickly, with friends jumping in to help with a \u003ca href=\"https://www.sfcovid19donations.com/\" target=\"_blank\" rel=\"noopener noreferrer\">website\u003c/a> where all information on donating PPE, as well as letter-writing, can be found. \u003c/p>\n\u003cp>“We just started posting on Instagram and texting friends and asking if people wanted to help us write letters,” Hildebrand said. As the project progressed, more people began to write in with requests — with friends or siblings in various locations.\u003c/p>\n\u003cp>“I collect the names of the health workers that are submitted to us and then I assign out a health worker or multiple health workers for each volunteer.” The volunteer writes a letter, and then the letters are sent out. “It’s pretty simple,” Hildebrand said.\u003c/p>\n\u003cp>A minor challenge so far is that some people don’t have stationary or paper around the house. Hildebrand is working with a graphic designer friend to make postcards for those who do not have card-making supplies readily available.\u003c/p>\n\u003cfigure id=\"attachment_11812086\" class=\"wp-caption alignleft\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11812086\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42689_1920_IMG_8595-qut-800x1028.jpg\" alt=\"\" width=\"800\" height=\"1028\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42689_1920_IMG_8595-qut-800x1028.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42689_1920_IMG_8595-qut-160x206.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42689_1920_IMG_8595-qut-1020x1311.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42689_1920_IMG_8595-qut.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Lindsay McGraw and her daughter, Alice, writing cards together. \u003ccite>(Courtesy of Lindsay McGraw)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>For those without supplies there are some similar campaigns, such as the “Thank a nurse for their service” \u003ca href=\"https://act.medicare4all.org/signup/20200410-thank-a-nurse/?\" target=\"_blank\" rel=\"noopener noreferrer\">email campaign\u003c/a> sponsored by National Nurses United. Hildebrand’s campaign is unique, in part, because it is also something parents can do with kids.\u003c/p>\n\u003cp>She’s also working on ways of figuring out how to best thank others on the front lines, such as farmworkers and essential workers in homeless services or others who may not be categorized as health care workers, but are still essential workers. “We’ll take volunteers and we’ll take names from anyone,” Hildebrand said.\u003c/p>\n\u003cp>For those wondering if writing letters is safe, Hildebrand recommends writers wash hands before beginning their note. She also recommends using a sticker stamp (rather than one you lick) and to seal the envelope, she suggests, using a damp towel to avoid any possible contamination.\u003c/p>\n\u003cp>\u003cem>To sign up to write a letter or suggest a letter be mailed to someone contact: Thankourhealthworkers@gmail.com\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Like many in the Bay Area, Calisa Hildebrand was looking for a local solution to address the lack of protective gear. She ended up starting a collection point at her local market — Gus’s on Haight Street. In addition to coordinating the personal protective equipment drop-off point, she wanted people to be able to contribute in a more personal way. She worked with her friend Paloma Figueroa, who works as a consultant for diversity and inclusion, to coordinate with nurses at UCSF. They have now launched a grassroots letter-writing effort to thank health workers.\u003c/p>\n\u003cfigure id=\"attachment_11812090\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11812090 size-medium\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42690_1920-IMG_2621-qut-800x1176.jpg\" alt=\"\" width=\"800\" height=\"1176\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42690_1920-IMG_2621-qut-800x1176.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42690_1920-IMG_2621-qut-160x235.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42690_1920-IMG_2621-qut-1020x1500.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42690_1920-IMG_2621-qut.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Calisa Hildebrand writes thank you letters to local health care workers from her home in San Francisco. \u003ccite>(Courtesy of Calisa Hildebrand)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Figueroa and Hildebrand mailed the first round of cards to nurses at UCSF. Since then, they’ve coordinated at least 140 letters in just the past few weeks. “This goes beyond San Francisco … we’ll take names of any health worker, anywhere, and volunteers from anywhere,” Hildebrand said.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The project has evolved quickly, with friends jumping in to help with a \u003ca href=\"https://www.sfcovid19donations.com/\" target=\"_blank\" rel=\"noopener noreferrer\">website\u003c/a> where all information on donating PPE, as well as letter-writing, can be found. \u003c/p>\n\u003cp>“We just started posting on Instagram and texting friends and asking if people wanted to help us write letters,” Hildebrand said. As the project progressed, more people began to write in with requests — with friends or siblings in various locations.\u003c/p>\n\u003cp>“I collect the names of the health workers that are submitted to us and then I assign out a health worker or multiple health workers for each volunteer.” The volunteer writes a letter, and then the letters are sent out. “It’s pretty simple,” Hildebrand said.\u003c/p>\n\u003cp>A minor challenge so far is that some people don’t have stationary or paper around the house. Hildebrand is working with a graphic designer friend to make postcards for those who do not have card-making supplies readily available.\u003c/p>\n\u003cfigure id=\"attachment_11812086\" class=\"wp-caption alignleft\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11812086\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42689_1920_IMG_8595-qut-800x1028.jpg\" alt=\"\" width=\"800\" height=\"1028\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42689_1920_IMG_8595-qut-800x1028.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42689_1920_IMG_8595-qut-160x206.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42689_1920_IMG_8595-qut-1020x1311.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42689_1920_IMG_8595-qut.jpg 1920w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Lindsay McGraw and her daughter, Alice, writing cards together. \u003ccite>(Courtesy of Lindsay McGraw)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>For those without supplies there are some similar campaigns, such as the “Thank a nurse for their service” \u003ca href=\"https://act.medicare4all.org/signup/20200410-thank-a-nurse/?\" target=\"_blank\" rel=\"noopener noreferrer\">email campaign\u003c/a> sponsored by National Nurses United. Hildebrand’s campaign is unique, in part, because it is also something parents can do with kids.\u003c/p>\n\u003cp>She’s also working on ways of figuring out how to best thank others on the front lines, such as farmworkers and essential workers in homeless services or others who may not be categorized as health care workers, but are still essential workers. “We’ll take volunteers and we’ll take names from anyone,” Hildebrand said.\u003c/p>\n\u003cp>For those wondering if writing letters is safe, Hildebrand recommends writers wash hands before beginning their note. She also recommends using a sticker stamp (rather than one you lick) and to seal the envelope, she suggests, using a damp towel to avoid any possible contamination.\u003c/p>\n\u003cp>\u003cem>To sign up to write a letter or suggest a letter be mailed to someone contact: Thankourhealthworkers@gmail.com\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Sister Donna Maria Moses, a Catholic nun and hospital chaplain who has seen the coronavirus pandemic firsthand, has adapted her ministry to provide solace to the dying over the phone, instead of the usual in-person visits.\u003c/p>\n\u003cp>She manages three staff chaplains and dozens of volunteers from many faiths at Santa Clara Valley Medical Center, one of the first hospitals to treat coronavirus patients returning from China and ill-fated cruise trips.\u003c/p>\n\u003cp>\u003ca href=\"https://www.scvmc.org/patients-and-visitors/services/Pages/Chaplain-and-Spiritual-Care-Services.aspx\">The chaplains\u003c/a> can’t visit patients, or even the units where COVID-19 patients are being treated. Moses is no longer able to hug or hold hands with someone who’s sick or with grieving family members, but she’s determined to provide other kinds of spiritual and emotional comfort.\u003c/p>\n\u003cp>“Most of our work is listening,” she said. “Asking an open-ended question and continuing to ask questions until we have a sense of what their real prayer is. Are they afraid? Are they grief stricken? Are they angry? Are they in despair? So we can offer the appropriate kind of prayer for them,” Moses added.\u003c/p>\n\u003ch3>Adapting Hospital Ministry to Coronavirus Conditions\u003c/h3>\n\u003cp>At first, she and her colleagues didn’t realize how contagious and dangerous it was to visit COVID-19 patients in their rooms, or how challenging it would be to establish an emotional connection with patients in distress when chaplains must hide behind protective masks, gowns and shields.\u003c/p>\n\u003cfigure id=\"attachment_11812030\" class=\"wp-caption alignnone\" style=\"max-width: 600px\">\u003cimg class=\"size-medium wp-image-11812030\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42654_SrDonna2-qut-800x1083.jpg\" alt=\"\" width=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42654_SrDonna2-qut-800x1083.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42654_SrDonna2-qut-160x217.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42654_SrDonna2-qut-1020x1381.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42654_SrDonna2-qut.jpg 1381w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The desk of Sister Donna Maria Moses — a senior chaplain at the Santa Clara Valley Medical Center. \u003ccite>(Courtesy of Sr. Donna Maria Moses)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We don’t have to touch. Sometimes eye contact is enough,\" Moses said. \"We use a vocal tone that conveys peace and acceptance and compassion.\" But with layers of protective gear, it hasn't felt the same for her or the people she strives to support.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>She suited up to visit two patients one day in early March. But the N95 mask muffled her voice and obscured her eyes.\u003c/p>\n\u003cp>“That's not comforting to see another person in all that gear,” Moses said. “It’s not anything anyone would want to see in their last moment on earth. You could see there’s a person, but you can’t see that you’re looking at them in a loving way.\"\u003c/p>\n\u003ch3>Last Rites in the Time of COVID-19\u003c/h3>\n\u003cp>In early March, Moses ended the volunteer program to protect hospital patients from exposure to outside visitors, and to protect volunteers from the virus. Now they call patients by phone — a mixture of cellphones, hospital phones and Zoom calls.\u003c/p>\n\u003cp>For Catholics like her, the last rites for the dying are more than just a prayer. There are three sacraments performed by a priest. She and her colleagues had to make small adjustments at first, like dispensing holy oil individually for each patient, leaving their Bibles at home and printing verses out because anything brought into the room of a contagious patient had to stay there.\u003c/p>\n\u003cfigure id=\"attachment_11812031\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11812031\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42653_SrDonna-qut-800x484.jpg\" alt=\"\" width=\"800\" height=\"484\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42653_SrDonna-qut-800x484.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42653_SrDonna-qut-160x97.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42653_SrDonna-qut-1020x617.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42653_SrDonna-qut.jpg 1707w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sister Donna Maria Moses is a senior chaplain at the Santa Clara Valley Medical Center. She and her colleagues minister to dying COVID-19 patients by phone. \u003ccite>(Courtesy of Sister Donna Maria Moses)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Eventually, once it was clear that the virus could be transmitted asymptomatically, Moses decided that even staff clergy shouldn’t visit patient rooms anymore, even with the same protective equipment that nurses use.\u003c/p>\n\u003cp>\"It was just about that time that Pope Francis came out with a Plenary Indulgence,\" an order absolving Catholics of their usual duties to perform the required sacraments during the pandemic, she said. \"He’s in Italy so he could see it firsthand. There weren’t enough priests to get to everyone (who was dying). And if they did, and the person was still alive and conscious enough to pray, the sight of a priest in all that gear — it’s distressing.\"\u003c/p>\n\u003ch3>Protecting Elderly Clergy and Supporting Nurses\u003c/h3>\n\u003cp>Many Catholic clergy live together in rectories or convents, so they risk infecting their entire communities. They also tend to be older and therefore are at higher risk. Moses lives with three other nuns at a parish house in Los Altos. The 64-year-old nun has decided to skip events at the Fremont mother house of her order, the Dominican Sisters of Mission San Jose. [aside tag=\"coronavirus\" label=\"More Coronavirus Coverage\"]\u003c/p>\n\u003cp>Moses and her staff have turned their attention to the spiritual and emotional needs of medical workers at the public hospital. \"Oftentimes, the entire unit is experiencing spiritual and emotional distress,\" Moses said. \"The nursing supervisor calls a debrief. We work with a therapist and open it up – it's really just venting. It’s good to talk so they’re not bringing it home and dumping that stress on their families,” she said. Moses added that since many families are \u003ca href=\"https://www.kqed.org/news/11806988/sheltering-in-place-what-you-need-to-know\" target=\"_blank\" rel=\"noopener noreferrer\">sheltering in place\u003c/a>, relationships at home can be particularly strained.\u003c/p>\n\u003cp>Moses said the phone visits are going well. Many of her previous volunteers have signed up. They reflect the South Bay’s demographics with people who speak Spanish, Vietnamese, Tagalog and Punjabi, with a diversity of faiths and spiritual practices.\u003c/p>\n\u003ch3>How to Celebrate Holy Week During Physical Isolation\u003c/h3>\n\u003cp>As Moses planned for Holy Week, the holiest time of the year for Christians, she said she won’t miss Mass on Easter Sunday because she has a wealth of online services to participate in. She can choose from Masses at St. Patrick’s Cathedral in New York, at the Vatican in Rome, or join the other nuns in her parish community who plan to tune in to Masses in their home countries of the Philippines or Vietnam.\u003c/p>\n\u003cp>Moses said she takes comfort in reading from the Bible daily because the text takes on new meaning in a crisis.\u003c/p>\n\u003cp>\"Almost daily I'll find something in the Scripture,\" she said. This week she found an encouraging verse from Isaiah: \"The Lord God has given me a well trained tongue so that I may know how to speak a word to the weary.\"\u003c/p>\n\u003cp>\"That's really what we're trying to do in this phone ministry. We're asking God to give us the words, to speak to the weary,” she said.\u003c/p>\n\u003cp>She’s also recited a version of the Jewish Passover Seder with her fellow nuns this week, and reflected on how the whole world is praying for this plague to ‘pass them over.’\u003c/p>\n\u003cp>\"In the midst of the signs of new hope of Spring, there's bitterness and sorrow and tears,” she said. “And on Good Friday, as Jesus is crying, ‘My God, my God, why have you abandoned me?’ We have so many people isolated at home or in a hospital bed alone, probably praying that prayer with their very last breath.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>She insists that there is hope: \"The one truth is we are not alone. This has united us in a way unlike anything in our lifetime. Just look at all the acts of kindness,” she said. \"This will pass. We will get a vaccine... and we’ll be better prepared next time.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Sister Donna Maria Moses, a Catholic nun and hospital chaplain who has seen the coronavirus pandemic firsthand, has adapted her ministry to provide solace to the dying over the phone, instead of the usual in-person visits.\u003c/p>\n\u003cp>She manages three staff chaplains and dozens of volunteers from many faiths at Santa Clara Valley Medical Center, one of the first hospitals to treat coronavirus patients returning from China and ill-fated cruise trips.\u003c/p>\n\u003cp>\u003ca href=\"https://www.scvmc.org/patients-and-visitors/services/Pages/Chaplain-and-Spiritual-Care-Services.aspx\">The chaplains\u003c/a> can’t visit patients, or even the units where COVID-19 patients are being treated. Moses is no longer able to hug or hold hands with someone who’s sick or with grieving family members, but she’s determined to provide other kinds of spiritual and emotional comfort.\u003c/p>\n\u003cp>“Most of our work is listening,” she said. “Asking an open-ended question and continuing to ask questions until we have a sense of what their real prayer is. Are they afraid? Are they grief stricken? Are they angry? Are they in despair? So we can offer the appropriate kind of prayer for them,” Moses added.\u003c/p>\n\u003ch3>Adapting Hospital Ministry to Coronavirus Conditions\u003c/h3>\n\u003cp>At first, she and her colleagues didn’t realize how contagious and dangerous it was to visit COVID-19 patients in their rooms, or how challenging it would be to establish an emotional connection with patients in distress when chaplains must hide behind protective masks, gowns and shields.\u003c/p>\n\u003cfigure id=\"attachment_11812030\" class=\"wp-caption alignnone\" style=\"max-width: 600px\">\u003cimg class=\"size-medium wp-image-11812030\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42654_SrDonna2-qut-800x1083.jpg\" alt=\"\" width=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42654_SrDonna2-qut-800x1083.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42654_SrDonna2-qut-160x217.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42654_SrDonna2-qut-1020x1381.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42654_SrDonna2-qut.jpg 1381w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The desk of Sister Donna Maria Moses — a senior chaplain at the Santa Clara Valley Medical Center. \u003ccite>(Courtesy of Sr. Donna Maria Moses)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We don’t have to touch. Sometimes eye contact is enough,\" Moses said. \"We use a vocal tone that conveys peace and acceptance and compassion.\" But with layers of protective gear, it hasn't felt the same for her or the people she strives to support.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>She suited up to visit two patients one day in early March. But the N95 mask muffled her voice and obscured her eyes.\u003c/p>\n\u003cp>“That's not comforting to see another person in all that gear,” Moses said. “It’s not anything anyone would want to see in their last moment on earth. You could see there’s a person, but you can’t see that you’re looking at them in a loving way.\"\u003c/p>\n\u003ch3>Last Rites in the Time of COVID-19\u003c/h3>\n\u003cp>In early March, Moses ended the volunteer program to protect hospital patients from exposure to outside visitors, and to protect volunteers from the virus. Now they call patients by phone — a mixture of cellphones, hospital phones and Zoom calls.\u003c/p>\n\u003cp>For Catholics like her, the last rites for the dying are more than just a prayer. There are three sacraments performed by a priest. She and her colleagues had to make small adjustments at first, like dispensing holy oil individually for each patient, leaving their Bibles at home and printing verses out because anything brought into the room of a contagious patient had to stay there.\u003c/p>\n\u003cfigure id=\"attachment_11812031\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11812031\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42653_SrDonna-qut-800x484.jpg\" alt=\"\" width=\"800\" height=\"484\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42653_SrDonna-qut-800x484.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42653_SrDonna-qut-160x97.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42653_SrDonna-qut-1020x617.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42653_SrDonna-qut.jpg 1707w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sister Donna Maria Moses is a senior chaplain at the Santa Clara Valley Medical Center. She and her colleagues minister to dying COVID-19 patients by phone. \u003ccite>(Courtesy of Sister Donna Maria Moses)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Eventually, once it was clear that the virus could be transmitted asymptomatically, Moses decided that even staff clergy shouldn’t visit patient rooms anymore, even with the same protective equipment that nurses use.\u003c/p>\n\u003cp>\"It was just about that time that Pope Francis came out with a Plenary Indulgence,\" an order absolving Catholics of their usual duties to perform the required sacraments during the pandemic, she said. \"He’s in Italy so he could see it firsthand. There weren’t enough priests to get to everyone (who was dying). And if they did, and the person was still alive and conscious enough to pray, the sight of a priest in all that gear — it’s distressing.\"\u003c/p>\n\u003ch3>Protecting Elderly Clergy and Supporting Nurses\u003c/h3>\n\u003cp>Many Catholic clergy live together in rectories or convents, so they risk infecting their entire communities. They also tend to be older and therefore are at higher risk. Moses lives with three other nuns at a parish house in Los Altos. The 64-year-old nun has decided to skip events at the Fremont mother house of her order, the Dominican Sisters of Mission San Jose. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Moses and her staff have turned their attention to the spiritual and emotional needs of medical workers at the public hospital. \"Oftentimes, the entire unit is experiencing spiritual and emotional distress,\" Moses said. \"The nursing supervisor calls a debrief. We work with a therapist and open it up – it's really just venting. It’s good to talk so they’re not bringing it home and dumping that stress on their families,” she said. Moses added that since many families are \u003ca href=\"https://www.kqed.org/news/11806988/sheltering-in-place-what-you-need-to-know\" target=\"_blank\" rel=\"noopener noreferrer\">sheltering in place\u003c/a>, relationships at home can be particularly strained.\u003c/p>\n\u003cp>Moses said the phone visits are going well. Many of her previous volunteers have signed up. They reflect the South Bay’s demographics with people who speak Spanish, Vietnamese, Tagalog and Punjabi, with a diversity of faiths and spiritual practices.\u003c/p>\n\u003ch3>How to Celebrate Holy Week During Physical Isolation\u003c/h3>\n\u003cp>As Moses planned for Holy Week, the holiest time of the year for Christians, she said she won’t miss Mass on Easter Sunday because she has a wealth of online services to participate in. She can choose from Masses at St. Patrick’s Cathedral in New York, at the Vatican in Rome, or join the other nuns in her parish community who plan to tune in to Masses in their home countries of the Philippines or Vietnam.\u003c/p>\n\u003cp>Moses said she takes comfort in reading from the Bible daily because the text takes on new meaning in a crisis.\u003c/p>\n\u003cp>\"Almost daily I'll find something in the Scripture,\" she said. This week she found an encouraging verse from Isaiah: \"The Lord God has given me a well trained tongue so that I may know how to speak a word to the weary.\"\u003c/p>\n\u003cp>\"That's really what we're trying to do in this phone ministry. We're asking God to give us the words, to speak to the weary,” she said.\u003c/p>\n\u003cp>She’s also recited a version of the Jewish Passover Seder with her fellow nuns this week, and reflected on how the whole world is praying for this plague to ‘pass them over.’\u003c/p>\n\u003cp>\"In the midst of the signs of new hope of Spring, there's bitterness and sorrow and tears,” she said. “And on Good Friday, as Jesus is crying, ‘My God, my God, why have you abandoned me?’ We have so many people isolated at home or in a hospital bed alone, probably praying that prayer with their very last breath.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Since the COVID-19 pandemic began sweeping the world, hospitals have been scrambling to acquire enough personal protective equipment (PPE) to allow workers to care for those who’ve contracted the disease, without contracting it themselves.\u003c/p>\n\u003cp>As traditional manufacturers struggle to produce PPE fast enough, tech companies and members of the 3D printing community have stepped up to create the supplies desperately needed by doctors and nurses.\u003c/p>\n\u003cp>For the uninitiated, 3D printers can create objects from a digital file by stacking layers of material on top of each other until the design is finished.\u003c/p>\n\u003cp>In the interest of helping out first responders, small-time manufacturers and at-home printers have been sharing \u003ca href=\"https://m.facebook.com/groups/670932227050506\">open-source designs online\u003c/a> to help meet the need for PPE. But that desire to help isn’t without limitations. Many items that hospitals need — like N95 masks or nasal swabs — have complex designs and have to go through an approvals and sterilization process before they can be shipped out to hospitals.\u003c/p>\n\u003cp>But some items are easier to get through the process than others, like face shields.\u003c/p>\n\u003cfigure id=\"attachment_11811876\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11811876\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42634_014_KQED_SanFrancisco_Moddler3DPrinting_04082020-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42634_014_KQED_SanFrancisco_Moddler3DPrinting_04082020-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42634_014_KQED_SanFrancisco_Moddler3DPrinting_04082020-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42634_014_KQED_SanFrancisco_Moddler3DPrinting_04082020-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42634_014_KQED_SanFrancisco_Moddler3DPrinting_04082020-qut-1020x680.jpg 1020w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Face shields being 3D printed at Moddler in San Francisco on April 8, 2020. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Jared Murnan, director of operations at San Francisco’s Moddler, a service-based 3D printing company, said he was wondering how the company could contribute to the PPE effort when officials with UCSF reached out for help.\u003c/p>\n\u003cp>“One of the people we talked to was almost in tears, explaining the situation and how dire it was,” said Murnan.\u003c/p>\n\u003cp>Since then, Murnan and his colleagues have been working with UCSF to create a face shield design that workers could use. As of April 7, the design has been approved by the hospital, and Murnan said they’re now in contact with Sutter and Kaiser to get the design approved there.\u003c/p>\n\u003cp>One roadblock Murnan said he and his more small-time colleagues encounter is capacity.\u003c/p>\n\u003cfigure id=\"attachment_11811877\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11811877\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42633_013_KQED_SanFrancisco_Moddler3DPrinting_04082020-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42633_013_KQED_SanFrancisco_Moddler3DPrinting_04082020-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42633_013_KQED_SanFrancisco_Moddler3DPrinting_04082020-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42633_013_KQED_SanFrancisco_Moddler3DPrinting_04082020-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42633_013_KQED_SanFrancisco_Moddler3DPrinting_04082020-qut-1020x680.jpg 1020w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Jared Murnan pauses the 3D printing machine at Moddler in San Francisco on April 8, 2020. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Most people have … one to 10 machines. Most people don’t have a fleet bigger than that unless they’re a company that actually makes the printers themselves,” said Murnan. “And so this is going to be a collective thing. Where we’re only going to be one piece of the puzzle.”\u003c/p>\n\u003cp>And some large companies \u003cem>have\u003c/em> stepped up to meet that need.\u003c/p>\n\u003cp>HP, which manufactures the HP Multi Jet Fusion 3D printer, has several 3D printing centers with capacity — more than 100 systems — in Spain, Oregon and California. To meet the global need for PPE, the company has teamed up with its partners and customers to widely manufacture it.\u003c/p>\n\u003cp>“Basically what we’re doing is working with partners and customers, but also internally … to come up with these designs, make them available, use our own capacity, actually reach out to some of our customers and partners and use their capacity for their local areas and provide parts to the medical industry,” said Tim Weber, HP’s global head for 3D metals.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>So far, Weber said HP and its affiliates have delivered tens of thousands of parts to hospitals and service providers across the world.\u003c/p>\n\u003cp>One of those partners is Oakland-based FATHOM, which has been working to create face shields, masks, ventilators and nasal swabs for COVID-19 test kits.\u003c/p>\n\u003cp>Rich Stump, the co-founder of FATHOM, says they’re currently partnering with multiple different stakeholders — including experts at HP, Harvard, Stanford and Lawrence Livermore National Labs — to get the swabs approved by the U.S. Food and Drug Administration, and then put into production.\u003c/p>\n\u003cp>“We’ve been driving the swabs from Livermore to Stanford, getting feedback and changing the design very quickly to try to get this into production,” said Stump.\u003c/p>\n\u003cp>FATHOM is currently leveraging those bigger partners to try to find medical companies who can help get the 3D printed swabs “sterilized, packaged and [then] get them out with their test kits.”\u003c/p>\n\u003cp>Stump said they hope to get the swabs into production over the next week.\u003c/p>\n\u003cp>So far, the PPE printed by FATHOM has been delivered to several different organizations, including the Alameda County Fire Department.\u003c/p>\n\u003cp>And some of the designs they’ve made are rather surprising. Stump said the company has partnered with Dolphin Scuba Center in Sacramento to convert scuba masks into PPE.\u003c/p>\n\u003cfigure id=\"attachment_11811914\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11811914\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42666_FATHOM_ScubaMasksON_50-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42666_FATHOM_ScubaMasksON_50-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42666_FATHOM_ScubaMasksON_50-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42666_FATHOM_ScubaMasksON_50-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42666_FATHOM_ScubaMasksON_50-qut-1020x680.jpg 1020w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">FATHOM, in partnership with Dolphin Scuba, is manufacturing adaptors that attach filters to scuba masks, allowing them to be repurposed by medical personnel who need PPE. \u003ccite>(Courtesy of Dolphin Scuba)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>According to HP’s Weber, that kind of innovation and quick turnaround is one of the highlights of 3D printing.\u003c/p>\n\u003cp>“The power of 3D is you can design and react very quickly and go straight into digital manufacturing,” said Weber. But he also notes that the dynamic nature of the pandemic requires a flexible response. “We will do what we can to help as this thing evolves on us.”\u003c/p>\n\u003cp>For Moddler’s Jared Murnan, he said having a way to contribute and help people get through this pandemic has helped him process what’s happening.\u003c/p>\n\u003cp>“There was a significant call to action and then there’s a little bit of a game plan moving forward,” said Murnan. He said having something to do “feels rewarding and like we’re doing something to help.”\u003c/p>\n\u003cp>\u003ci>If you have a 3D printer and want to get involved, you can find the design for Moddler’s face shield \u003ca href=\"https://www.prusaprinters.org/prints/25857-prusa-face-shield\">here.\u003c/a> They plan to add the updated face shield design to their website once they have approval from Sutter and Kaiser.\u003c/i>\u003c/p>\n\u003cp>\u003ci>You can find HP’s designs \u003c/i>\u003ca style=\"font-style: italic\" href=\"https://enable.hp.com/us-en-3dprint-COVID-19-containment-applications\">here\u003c/a>\u003ci>. Hospitals can also make \u003ca href=\"https://app.smartsheet.com/b/form/86efe6ce7d70463da130e4d6be670d6b\">printing requests\u003c/a> or requests for \u003ca href=\"https://app.smartsheet.com/b/form/0f85fb04e2d44f09a799ba9475fd5d0a\">new designs\u003c/a>.\u003c/i>\u003c/p>\n\u003cp>\u003cem>If you have manufacturing capacity, or would like to request PPE from FATHOM, you can sign up \u003ca href=\"https://studiofathom.com/blog/covid-19-response\">here\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Since the COVID-19 pandemic began sweeping the world, hospitals have been scrambling to acquire enough personal protective equipment (PPE) to allow workers to care for those who’ve contracted the disease, without contracting it themselves.\u003c/p>\n\u003cp>As traditional manufacturers struggle to produce PPE fast enough, tech companies and members of the 3D printing community have stepped up to create the supplies desperately needed by doctors and nurses.\u003c/p>\n\u003cp>For the uninitiated, 3D printers can create objects from a digital file by stacking layers of material on top of each other until the design is finished.\u003c/p>\n\u003cp>In the interest of helping out first responders, small-time manufacturers and at-home printers have been sharing \u003ca href=\"https://m.facebook.com/groups/670932227050506\">open-source designs online\u003c/a> to help meet the need for PPE. But that desire to help isn’t without limitations. Many items that hospitals need — like N95 masks or nasal swabs — have complex designs and have to go through an approvals and sterilization process before they can be shipped out to hospitals.\u003c/p>\n\u003cp>But some items are easier to get through the process than others, like face shields.\u003c/p>\n\u003cfigure id=\"attachment_11811876\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11811876\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42634_014_KQED_SanFrancisco_Moddler3DPrinting_04082020-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42634_014_KQED_SanFrancisco_Moddler3DPrinting_04082020-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42634_014_KQED_SanFrancisco_Moddler3DPrinting_04082020-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42634_014_KQED_SanFrancisco_Moddler3DPrinting_04082020-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42634_014_KQED_SanFrancisco_Moddler3DPrinting_04082020-qut-1020x680.jpg 1020w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Face shields being 3D printed at Moddler in San Francisco on April 8, 2020. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Jared Murnan, director of operations at San Francisco’s Moddler, a service-based 3D printing company, said he was wondering how the company could contribute to the PPE effort when officials with UCSF reached out for help.\u003c/p>\n\u003cp>“One of the people we talked to was almost in tears, explaining the situation and how dire it was,” said Murnan.\u003c/p>\n\u003cp>Since then, Murnan and his colleagues have been working with UCSF to create a face shield design that workers could use. As of April 7, the design has been approved by the hospital, and Murnan said they’re now in contact with Sutter and Kaiser to get the design approved there.\u003c/p>\n\u003cp>One roadblock Murnan said he and his more small-time colleagues encounter is capacity.\u003c/p>\n\u003cfigure id=\"attachment_11811877\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11811877\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42633_013_KQED_SanFrancisco_Moddler3DPrinting_04082020-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42633_013_KQED_SanFrancisco_Moddler3DPrinting_04082020-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42633_013_KQED_SanFrancisco_Moddler3DPrinting_04082020-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42633_013_KQED_SanFrancisco_Moddler3DPrinting_04082020-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42633_013_KQED_SanFrancisco_Moddler3DPrinting_04082020-qut-1020x680.jpg 1020w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Jared Murnan pauses the 3D printing machine at Moddler in San Francisco on April 8, 2020. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Most people have … one to 10 machines. Most people don’t have a fleet bigger than that unless they’re a company that actually makes the printers themselves,” said Murnan. “And so this is going to be a collective thing. Where we’re only going to be one piece of the puzzle.”\u003c/p>\n\u003cp>And some large companies \u003cem>have\u003c/em> stepped up to meet that need.\u003c/p>\n\u003cp>HP, which manufactures the HP Multi Jet Fusion 3D printer, has several 3D printing centers with capacity — more than 100 systems — in Spain, Oregon and California. To meet the global need for PPE, the company has teamed up with its partners and customers to widely manufacture it.\u003c/p>\n\u003cp>“Basically what we’re doing is working with partners and customers, but also internally … to come up with these designs, make them available, use our own capacity, actually reach out to some of our customers and partners and use their capacity for their local areas and provide parts to the medical industry,” said Tim Weber, HP’s global head for 3D metals.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>So far, Weber said HP and its affiliates have delivered tens of thousands of parts to hospitals and service providers across the world.\u003c/p>\n\u003cp>One of those partners is Oakland-based FATHOM, which has been working to create face shields, masks, ventilators and nasal swabs for COVID-19 test kits.\u003c/p>\n\u003cp>Rich Stump, the co-founder of FATHOM, says they’re currently partnering with multiple different stakeholders — including experts at HP, Harvard, Stanford and Lawrence Livermore National Labs — to get the swabs approved by the U.S. Food and Drug Administration, and then put into production.\u003c/p>\n\u003cp>“We’ve been driving the swabs from Livermore to Stanford, getting feedback and changing the design very quickly to try to get this into production,” said Stump.\u003c/p>\n\u003cp>FATHOM is currently leveraging those bigger partners to try to find medical companies who can help get the 3D printed swabs “sterilized, packaged and [then] get them out with their test kits.”\u003c/p>\n\u003cp>Stump said they hope to get the swabs into production over the next week.\u003c/p>\n\u003cp>So far, the PPE printed by FATHOM has been delivered to several different organizations, including the Alameda County Fire Department.\u003c/p>\n\u003cp>And some of the designs they’ve made are rather surprising. Stump said the company has partnered with Dolphin Scuba Center in Sacramento to convert scuba masks into PPE.\u003c/p>\n\u003cfigure id=\"attachment_11811914\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11811914\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42666_FATHOM_ScubaMasksON_50-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42666_FATHOM_ScubaMasksON_50-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42666_FATHOM_ScubaMasksON_50-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42666_FATHOM_ScubaMasksON_50-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42666_FATHOM_ScubaMasksON_50-qut-1020x680.jpg 1020w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">FATHOM, in partnership with Dolphin Scuba, is manufacturing adaptors that attach filters to scuba masks, allowing them to be repurposed by medical personnel who need PPE. \u003ccite>(Courtesy of Dolphin Scuba)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>According to HP’s Weber, that kind of innovation and quick turnaround is one of the highlights of 3D printing.\u003c/p>\n\u003cp>“The power of 3D is you can design and react very quickly and go straight into digital manufacturing,” said Weber. But he also notes that the dynamic nature of the pandemic requires a flexible response. “We will do what we can to help as this thing evolves on us.”\u003c/p>\n\u003cp>For Moddler’s Jared Murnan, he said having a way to contribute and help people get through this pandemic has helped him process what’s happening.\u003c/p>\n\u003cp>“There was a significant call to action and then there’s a little bit of a game plan moving forward,” said Murnan. He said having something to do “feels rewarding and like we’re doing something to help.”\u003c/p>\n\u003cp>\u003ci>If you have a 3D printer and want to get involved, you can find the design for Moddler’s face shield \u003ca href=\"https://www.prusaprinters.org/prints/25857-prusa-face-shield\">here.\u003c/a> They plan to add the updated face shield design to their website once they have approval from Sutter and Kaiser.\u003c/i>\u003c/p>\n\u003cp>\u003ci>You can find HP’s designs \u003c/i>\u003ca style=\"font-style: italic\" href=\"https://enable.hp.com/us-en-3dprint-COVID-19-containment-applications\">here\u003c/a>\u003ci>. Hospitals can also make \u003ca href=\"https://app.smartsheet.com/b/form/86efe6ce7d70463da130e4d6be670d6b\">printing requests\u003c/a> or requests for \u003ca href=\"https://app.smartsheet.com/b/form/0f85fb04e2d44f09a799ba9475fd5d0a\">new designs\u003c/a>.\u003c/i>\u003c/p>\n\u003cp>\u003cem>If you have manufacturing capacity, or would like to request PPE from FATHOM, you can sign up \u003ca href=\"https://studiofathom.com/blog/covid-19-response\">here\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Until recently, Elizabeth Sale wouldn’t have described herself as someone who was serious about meditating.\u003c/p>\n\u003cp>“I mean, I’ve been a patchwork, hit-and-miss, erratic meditator, on and off, forever,” she told KQED via video chat from her home in Vallejo.\u003c/p>\n\u003cp>But over the past few weeks, Sale has started doing breathing exercises and other simple, mind-focusing practices every morning.\u003c/p>\n\u003cp>“It’s the first thing I do when I wake up,” she said. “I treat it like brushing your teeth.”\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Elizabeth Sale\"]‘It reminds me that there’s a tiny, safe place to kind of come back to every day.’[/pullquote]\u003c/p>\n\u003cp>In times of high stress and anxiety, experts say having a mindfulness practice like meditation can be helpful.\u003c/p>\n\u003cp>It’s no surprise that \u003ca href=\"https://trends.google.com/trends/explore?date=all&q=meditation\" target=\"_blank\" rel=\"noopener noreferrer\">Google searches\u003c/a> for the word “meditation” are now at an all-time high thanks to the heightened level of anxiety brought on by the coronavirus.\u003c/p>\n\u003cp>Sale, a video producer, has experienced her fair share of disasters, including the 1989 Loma Prieta earthquake, Hurricane Sandy in New York and several wildfires — so she’s no stranger to stress.\u003c/p>\n\u003cp>But Sale said the COVID-19 pandemic is testing her limits. She’s worried for the safety of close family members working on the frontlines. And she’s grappling with her own health issues that make her particularly vulnerable.\u003c/p>\n\u003cp>“Every time you wake up and leave the house, you have to think about masks and social distancing,” she said. “And do we have, you know, disinfectants?”\u003c/p>\n\u003cp>Sale has come to rely on her daily meditation practice to stay grounded.\u003c/p>\n\u003cp>“It reminds me that there’s a tiny, safe place to kind of come back to every day,” she said.\u003c/p>\n\u003cp>California is a hub for mindfulness traditions.\u003c/p>\n\u003cp>The state is home to some of the country’s best known meditation centers, like the \u003ca href=\"https://www.esalen.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Esalen Institute\u003c/a> in Big Sur and \u003ca href=\"https://www.spiritrock.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Spirit Rock\u003c/a> in Marin County.\u003c/p>\n\u003cp>Californians have a long history of turning to meditation during difficult times, said Craig Chalquist, a professor in the East-West Psychology program at the \u003ca href=\"https://www.ciis.edu/\" target=\"_blank\" rel=\"noopener noreferrer\">California Institute of Integral Studies\u003c/a> (CIIS) in San Francisco, where he teaches classes on psychology, folklore, storytelling and mindfulness practices.\u003c/p>\n\u003cp>Chalquist recalled the aftermath of the 1994 Northridge earthquake that violently shook the San Fernando Valley.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“My clients were asking for mindfulness techniques to help them deal with not only the emotional aftereffects of the earthquake, but aftershocks as well,” Chalquist said.\u003c/p>\n\u003cp>Mindfulness apps like \u003ca href=\"https://www.headspace.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Headspace\u003c/a> and \u003ca href=\"https://www.calm.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Calm\u003c/a>, both headquartered in California, have seen a surge in user signups over the past month.\u003c/p>\n\u003cp>“Since mid-March, as news of the global health crisis steadily increased, Headspace saw, in comparison to the previous 30 days of usage, more than double spike in new users installing and signing up,” said Headspace spokeswoman Olivia DeJesse.\u003c/p>\n\u003cp>And meditation coaches and centers across the state are also reporting an uptick in interest.\u003c/p>\n\u003cp>“I’ve never been busier,” \u003ca href=\"https://www.youtube.com/watch?v=n_ZZqJ-vZWE\">Los Angeles meditation teacher Laurie Cousins\u003c/a> said.\u003c/p>\n\u003cp>Cousins said she’s glad people are considering meditation at this volatile time, whether it’s through individual coaching, group classes, online videos or apps.\u003c/p>\n\u003cp>“It’s becoming more accessible, which is wonderful,” she said.\u003c/p>\n\u003cp>Cousins said individuals should explore different offerings to find what works best for them.\u003c/p>\n\u003cp>“Maybe it’s formal or maybe it’s informal. \u003cb>\u003c/b>Maybe it’s a concentration practice, maybe it’s an open awareness practice, maybe it’s a compassionate practice,” she said. “There are many ways you can meditate.”\u003c/p>\n\u003cp>\u003cem>Interested in exploring the world of mindfulness? Here are some useful resources suggested by the people featured in this story:\u003c/em>\u003c/p>\n\u003ch3>\u003cstrong>Craig Chalquist’s Suggestions\u003c/strong>\u003c/h3>\n\u003cp>\u003cem>A five-minute meditation break\u003c/em>\u003c/p>\n\u003cp>https://youtu.be/inpok4MKVLM\u003c/p>\n\u003cp>\u003cem>On the power of mindfulness\u003c/em>\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=IeblJdB2-Vo&feature=youtu.be\u003c/p>\n\u003cp>\u003cem>Breathing techniques\u003c/em>\u003c/p>\n\u003cp>https://youtu.be/4Lb5L-VEm34\u003c/p>\n\u003cp>\u003cem>A nice, little visual meditation from CIIS\u003c/em>\u003c/p>\n\u003cp>https://www.instagram.com/p/B-F-LwphJYi/?utm_source=ig_web_button_share_sheet\u003c/p>\n\u003cp>\u003cem>A short video by Chalquist on “staying sane during the coronavirus” \u003c/em>\u003c/p>\n\u003cp>https://youtu.be/Bg5pY1SynZU\u003c/p>\n\u003ch3>\u003cstrong>Elizabeth Sales’ suggestions\u003c/strong>\u003c/h3>\n\u003cp>“\u003ca href=\"https://www.rickhanson.net\">Rick Hanson\u003c/a> is one of the most trusted psychologists, Buddhists and neuroscientists in the Bay Area. He has great meditations, exercises, lectures and talks (podcasts) on mindfulness and the power of meditation to help rewire the brain for resilience, steadiness, strength and courage during tough times.”\u003c/p>\n\u003cp>“\u003ca href=\"https://www.tarabrach.com/guided-meditations/\">Tara Brach’s guided meditations\u003c/a> are good for relaxing and soothing through deep triggers, emotional stress and finding loving kindness in ourselves. Her exercise ‘RAIN’ is exceptionally helpful for calming emotional stress and paying attention to calming breath and bodies when we feel flooded.”\u003c/p>\n\u003cp>“\u003ca href=\"https://self-compassion.org\">Kristen Neff\u003c/a> is one of the pioneers in the self-compassion movement. Her meditations, in particular, connect us with soothing ourselves through self-kindness.”\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"mindfulness\"]“\u003ca href=\"https://zivameditation.com\">Ziva Meditation\u003c/a> is the practice I’ve been sticking with during the COVID shelter in place. It’s got a basic and easy foundational framework for busy people who want something steady that’s fairly easy to commit to everyday. There is a cost involved in the training after a 15-day trial, so that may not be as appealing to some people.”\u003c/p>\n\u003ch3>Laurie Cousins’ suggestions\u003c/h3>\n\u003cp>“\u003ca href=\"https://www.uclahealth.org/marc/\">UCLA Mindful Awareness Research Center \u003c/a>offers a secular approach to mindful awareness through education, research and training for students and the public to promote well-being and a more compassionate society.”\u003c/p>\n\u003cp>“\u003ca href=\"https://medschool.ucsd.edu/som/fmph/research/mindfulness/Pages/default.aspx\">University of California, San Diego Center of Mindfulness\u003c/a> is a multifaceted program of professional training, education, research and outreach intended to further the practice and integration of mindfulness and compassion into all aspects of society.\u003c/p>\n\u003cp>“\u003ca href=\"https://insightla.org/\">Insight LA\u003c/a> is a nonprofit meditation center teaching the highest quality mindfulness practices in locations throughout the greater Los Angeles area as well as online. They offer practices of inner peace, compassion and mindfulness to all people, and no one is turned away for a lack of funds.”\u003c/p>\n\u003cp>“The \u003ca href=\"https://denmeditation.com/\">Den Meditation\u003c/a> offers guided meditations led by teachers in a variety of contemplative disciplines and other non-traditional styles.”\u003c/p>\n\u003cp>“\u003ca href=\"https://insighttimer.com/\">Insight Timer\u003c/a> is a top-rated free app for guided meditations. The app is helpful for dealing with anxiety, stress and sleep issues.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Until recently, Elizabeth Sale wouldn’t have described herself as someone who was serious about meditating.\u003c/p>\n\u003cp>“I mean, I’ve been a patchwork, hit-and-miss, erratic meditator, on and off, forever,” she told KQED via video chat from her home in Vallejo.\u003c/p>\n\u003cp>But over the past few weeks, Sale has started doing breathing exercises and other simple, mind-focusing practices every morning.\u003c/p>\n\u003cp>“It’s the first thing I do when I wake up,” she said. “I treat it like brushing your teeth.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In times of high stress and anxiety, experts say having a mindfulness practice like meditation can be helpful.\u003c/p>\n\u003cp>It’s no surprise that \u003ca href=\"https://trends.google.com/trends/explore?date=all&q=meditation\" target=\"_blank\" rel=\"noopener noreferrer\">Google searches\u003c/a> for the word “meditation” are now at an all-time high thanks to the heightened level of anxiety brought on by the coronavirus.\u003c/p>\n\u003cp>Sale, a video producer, has experienced her fair share of disasters, including the 1989 Loma Prieta earthquake, Hurricane Sandy in New York and several wildfires — so she’s no stranger to stress.\u003c/p>\n\u003cp>But Sale said the COVID-19 pandemic is testing her limits. She’s worried for the safety of close family members working on the frontlines. And she’s grappling with her own health issues that make her particularly vulnerable.\u003c/p>\n\u003cp>“Every time you wake up and leave the house, you have to think about masks and social distancing,” she said. “And do we have, you know, disinfectants?”\u003c/p>\n\u003cp>Sale has come to rely on her daily meditation practice to stay grounded.\u003c/p>\n\u003cp>“It reminds me that there’s a tiny, safe place to kind of come back to every day,” she said.\u003c/p>\n\u003cp>California is a hub for mindfulness traditions.\u003c/p>\n\u003cp>The state is home to some of the country’s best known meditation centers, like the \u003ca href=\"https://www.esalen.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Esalen Institute\u003c/a> in Big Sur and \u003ca href=\"https://www.spiritrock.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Spirit Rock\u003c/a> in Marin County.\u003c/p>\n\u003cp>Californians have a long history of turning to meditation during difficult times, said Craig Chalquist, a professor in the East-West Psychology program at the \u003ca href=\"https://www.ciis.edu/\" target=\"_blank\" rel=\"noopener noreferrer\">California Institute of Integral Studies\u003c/a> (CIIS) in San Francisco, where he teaches classes on psychology, folklore, storytelling and mindfulness practices.\u003c/p>\n\u003cp>Chalquist recalled the aftermath of the 1994 Northridge earthquake that violently shook the San Fernando Valley.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“My clients were asking for mindfulness techniques to help them deal with not only the emotional aftereffects of the earthquake, but aftershocks as well,” Chalquist said.\u003c/p>\n\u003cp>Mindfulness apps like \u003ca href=\"https://www.headspace.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Headspace\u003c/a> and \u003ca href=\"https://www.calm.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Calm\u003c/a>, both headquartered in California, have seen a surge in user signups over the past month.\u003c/p>\n\u003cp>“Since mid-March, as news of the global health crisis steadily increased, Headspace saw, in comparison to the previous 30 days of usage, more than double spike in new users installing and signing up,” said Headspace spokeswoman Olivia DeJesse.\u003c/p>\n\u003cp>And meditation coaches and centers across the state are also reporting an uptick in interest.\u003c/p>\n\u003cp>“I’ve never been busier,” \u003ca href=\"https://www.youtube.com/watch?v=n_ZZqJ-vZWE\">Los Angeles meditation teacher Laurie Cousins\u003c/a> said.\u003c/p>\n\u003cp>Cousins said she’s glad people are considering meditation at this volatile time, whether it’s through individual coaching, group classes, online videos or apps.\u003c/p>\n\u003cp>“It’s becoming more accessible, which is wonderful,” she said.\u003c/p>\n\u003cp>Cousins said individuals should explore different offerings to find what works best for them.\u003c/p>\n\u003cp>“Maybe it’s formal or maybe it’s informal. \u003cb>\u003c/b>Maybe it’s a concentration practice, maybe it’s an open awareness practice, maybe it’s a compassionate practice,” she said. “There are many ways you can meditate.”\u003c/p>\n\u003cp>\u003cem>Interested in exploring the world of mindfulness? Here are some useful resources suggested by the people featured in this story:\u003c/em>\u003c/p>\n\u003ch3>\u003cstrong>Craig Chalquist’s Suggestions\u003c/strong>\u003c/h3>\n\u003cp>\u003cem>A five-minute meditation break\u003c/em>\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/inpok4MKVLM'\n title='//www.youtube.com/embed/inpok4MKVLM'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>\u003cem>On the power of mindfulness\u003c/em>\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/IeblJdB2-Vo'\n title='//www.youtube.com/embed/IeblJdB2-Vo'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>\u003cem>Breathing techniques\u003c/em>\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/4Lb5L-VEm34'\n title='//www.youtube.com/embed/4Lb5L-VEm34'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>\u003cem>A nice, little visual meditation from CIIS\u003c/em>\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>A short video by Chalquist on “staying sane during the coronavirus” \u003c/em>\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/Bg5pY1SynZU'\n title='//www.youtube.com/embed/Bg5pY1SynZU'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003ch3>\u003cstrong>Elizabeth Sales’ suggestions\u003c/strong>\u003c/h3>\n\u003cp>“\u003ca href=\"https://www.rickhanson.net\">Rick Hanson\u003c/a> is one of the most trusted psychologists, Buddhists and neuroscientists in the Bay Area. He has great meditations, exercises, lectures and talks (podcasts) on mindfulness and the power of meditation to help rewire the brain for resilience, steadiness, strength and courage during tough times.”\u003c/p>\n\u003cp>“\u003ca href=\"https://www.tarabrach.com/guided-meditations/\">Tara Brach’s guided meditations\u003c/a> are good for relaxing and soothing through deep triggers, emotional stress and finding loving kindness in ourselves. Her exercise ‘RAIN’ is exceptionally helpful for calming emotional stress and paying attention to calming breath and bodies when we feel flooded.”\u003c/p>\n\u003cp>“\u003ca href=\"https://self-compassion.org\">Kristen Neff\u003c/a> is one of the pioneers in the self-compassion movement. Her meditations, in particular, connect us with soothing ourselves through self-kindness.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“\u003ca href=\"https://zivameditation.com\">Ziva Meditation\u003c/a> is the practice I’ve been sticking with during the COVID shelter in place. It’s got a basic and easy foundational framework for busy people who want something steady that’s fairly easy to commit to everyday. There is a cost involved in the training after a 15-day trial, so that may not be as appealing to some people.”\u003c/p>\n\u003ch3>Laurie Cousins’ suggestions\u003c/h3>\n\u003cp>“\u003ca href=\"https://www.uclahealth.org/marc/\">UCLA Mindful Awareness Research Center \u003c/a>offers a secular approach to mindful awareness through education, research and training for students and the public to promote well-being and a more compassionate society.”\u003c/p>\n\u003cp>“\u003ca href=\"https://medschool.ucsd.edu/som/fmph/research/mindfulness/Pages/default.aspx\">University of California, San Diego Center of Mindfulness\u003c/a> is a multifaceted program of professional training, education, research and outreach intended to further the practice and integration of mindfulness and compassion into all aspects of society.\u003c/p>\n\u003cp>“\u003ca href=\"https://insightla.org/\">Insight LA\u003c/a> is a nonprofit meditation center teaching the highest quality mindfulness practices in locations throughout the greater Los Angeles area as well as online. They offer practices of inner peace, compassion and mindfulness to all people, and no one is turned away for a lack of funds.”\u003c/p>\n\u003cp>“The \u003ca href=\"https://denmeditation.com/\">Den Meditation\u003c/a> offers guided meditations led by teachers in a variety of contemplative disciplines and other non-traditional styles.”\u003c/p>\n\u003cp>“\u003ca href=\"https://insighttimer.com/\">Insight Timer\u003c/a> is a top-rated free app for guided meditations. The app is helpful for dealing with anxiety, stress and sleep issues.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>By now, you’ve heard of “Zoom bombing,” where trolls hijack an online video conference. \u003ca href=\"https://zoom.us\" target=\"_blank\" rel=\"noopener noreferrer\">Zoom\u003c/a> has quickly become the most popular software for group meetings in recent weeks. Another word to add to the coronavirus pandemic lexicon: Zoom bouncer.\u003c/p>\n\u003cp>Meet Liza P: “clean and sober for seven years,” as she puts it. We’re not sharing her last name or location because she’s a member of \u003ca href=\"https://www.aa.org/p\" target=\"_blank\" rel=\"noopener noreferrer\">Alcoholics Anonymous\u003c/a>. Privacy is paramount in AA.\u003c/p>\n\u003cp>[aside tag=\"zoom\" label=\"More Related Stories\"]Many local AA chapters pivoted online when shelter-in-place orders took hold a few weeks ago. P co-hosts two Zoom meetings, publicly listed, of course — which is how Zoom bombers get access. As a co-host, her role includes serving as a digital bouncer, “to make sure that nothing funny is going on in the background.”\u003c/p>\n\u003cp>Already, she’s had to tackle a group of male zoom bombers spewing obscenities in a women-only meeting. It started with the ostensible husband of a woman attendee getting into an argument during the meeting.\u003c/p>\n\u003cp>“I think it was rehearsed,” P said. “So I’m watching the photo gallery like a hawk and saying OK, where is the sound coming from. One by one deleting them.” This was just the first in a series of steps Zoom recommends taking to regain control of a meeting from those seeking to disrupt it. “Then I went in and I locked the meeting down,” she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Within the Zoom settings a host can “lock” the meeting to prevent anyone else from joining, even if they have the ID and password. Zoom has recently publicized a\u003ca href=\"https://aasfmarin.org/handling-meeting-disruptions-in-the-moment\" target=\"_blank\" rel=\"noopener noreferrer\"> suite of options\u003c/a> to handle trolls, and the Electronic Frontier Foundation, a nonprofit focused in privacy and civil liberties, has compiled a \u003ca href=\"https://www.eff.org/deeplinks/2020/04/harden-your-zoom-settings-protect-your-privacy-and-avoid-trolls\" target=\"_blank\" rel=\"noopener noreferrer\">list of tips\u003c/a> to safeguard privacy.\u003c/p>\n\u003cp>As Zoom states on their \u003ca href=\"https://blog.zoom.us/wordpress/2020/03/20/keep-uninvited-guests-out-of-your-zoom-event/\" target=\"_blank\" rel=\"noopener noreferrer\">website\u003c/a>, “You do not want random people in your public event taking control of the screen and sharing unwanted content with the group.” Zoom suggests restricting this — before the meeting and during the meeting in the host control bar — so the host is the only one who can screen-share.\u003c/p>\n\u003cp>P has no problem using all the tools available to her in the software. She also takes advantage of a “waiting room” feature, that requires would-be participants to linger in digital purgatory until the host lets them in — or not. There’s also a default setting to limit screen sharing to only the host.\u003c/p>\n\u003cp>[youtube https://www.youtube.com/watch?v=ySas2Rgi6yA]P doesn’t know if the same trolls will attempt to disrupt future meetings. “I don’t know who they were, why they were doing it. I can only guess, and my guess is [they were doing it] to create theater, to create fear,” she said.\u003c/p>\n\u003cp>P worries the newcomers in her women’s groups could be put off. “Just the fact of knowing that someone can do such a thing scares some women to begin with. It’s one more barrier,” she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>She’s not intimidated though. P will be monitoring the digital doors in weeks to come — a Zoom bouncer on a mission to keep her AA groups open to the public.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By now, you’ve heard of “Zoom bombing,” where trolls hijack an online video conference. \u003ca href=\"https://zoom.us\" target=\"_blank\" rel=\"noopener noreferrer\">Zoom\u003c/a> has quickly become the most popular software for group meetings in recent weeks. Another word to add to the coronavirus pandemic lexicon: Zoom bouncer.\u003c/p>\n\u003cp>Meet Liza P: “clean and sober for seven years,” as she puts it. We’re not sharing her last name or location because she’s a member of \u003ca href=\"https://www.aa.org/p\" target=\"_blank\" rel=\"noopener noreferrer\">Alcoholics Anonymous\u003c/a>. Privacy is paramount in AA.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Many local AA chapters pivoted online when shelter-in-place orders took hold a few weeks ago. P co-hosts two Zoom meetings, publicly listed, of course — which is how Zoom bombers get access. As a co-host, her role includes serving as a digital bouncer, “to make sure that nothing funny is going on in the background.”\u003c/p>\n\u003cp>Already, she’s had to tackle a group of male zoom bombers spewing obscenities in a women-only meeting. It started with the ostensible husband of a woman attendee getting into an argument during the meeting.\u003c/p>\n\u003cp>“I think it was rehearsed,” P said. “So I’m watching the photo gallery like a hawk and saying OK, where is the sound coming from. One by one deleting them.” This was just the first in a series of steps Zoom recommends taking to regain control of a meeting from those seeking to disrupt it. “Then I went in and I locked the meeting down,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Within the Zoom settings a host can “lock” the meeting to prevent anyone else from joining, even if they have the ID and password. Zoom has recently publicized a\u003ca href=\"https://aasfmarin.org/handling-meeting-disruptions-in-the-moment\" target=\"_blank\" rel=\"noopener noreferrer\"> suite of options\u003c/a> to handle trolls, and the Electronic Frontier Foundation, a nonprofit focused in privacy and civil liberties, has compiled a \u003ca href=\"https://www.eff.org/deeplinks/2020/04/harden-your-zoom-settings-protect-your-privacy-and-avoid-trolls\" target=\"_blank\" rel=\"noopener noreferrer\">list of tips\u003c/a> to safeguard privacy.\u003c/p>\n\u003cp>As Zoom states on their \u003ca href=\"https://blog.zoom.us/wordpress/2020/03/20/keep-uninvited-guests-out-of-your-zoom-event/\" target=\"_blank\" rel=\"noopener noreferrer\">website\u003c/a>, “You do not want random people in your public event taking control of the screen and sharing unwanted content with the group.” Zoom suggests restricting this — before the meeting and during the meeting in the host control bar — so the host is the only one who can screen-share.\u003c/p>\n\u003cp>P has no problem using all the tools available to her in the software. She also takes advantage of a “waiting room” feature, that requires would-be participants to linger in digital purgatory until the host lets them in — or not. There’s also a default setting to limit screen sharing to only the host.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/ySas2Rgi6yA'\n title='//www.youtube.com/embed/ySas2Rgi6yA'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>P doesn’t know if the same trolls will attempt to disrupt future meetings. “I don’t know who they were, why they were doing it. I can only guess, and my guess is [they were doing it] to create theater, to create fear,” she said.\u003c/p>\n\u003cp>P worries the newcomers in her women’s groups could be put off. “Just the fact of knowing that someone can do such a thing scares some women to begin with. It’s one more barrier,” she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>She’s not intimidated though. P will be monitoring the digital doors in weeks to come — a Zoom bouncer on a mission to keep her AA groups open to the public.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Palliative Care Doctors Turn to Technology to Help Those Dying Alone",
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"content": "\u003cp>When Dr. Steve Pantilat asks his patients what they want most at the end of life, the answer is almost always the same: To be comfortable and surrounded by people they love.\u003c/p>\n\u003cp>“I’ve been in rooms where there are 35 family members, people are playing music and holding a vigil, saying prayers and singing,” said Pantilat, chief of palliative medicine at UCSF and author of \u003ca href=\"https://www.stevepantilat.com/latdbook\">Life After the Diagnosis\u003c/a>. “They’re even having weddings in the hospital. Just last month, we had another wedding for someone who was dying.”\u003c/p>\n\u003cp>But in the age of coronavirus, none of this is happening. There’s too much risk of visitors getting sick or infecting critical frontline staff, and there’s not enough protective equipment to go around. So the new policy at UCSF and hospitals across the country is: One visitor, and only for patients who are actively dying.\u003c/p>\n\u003cp>“I think that’s really, really, really distressing for everyone involved,” Pantilat said. “We’ve never really faced this before, trying to make these really gut wrenching decisions about visitation of when and who and how many. It’s a very sacred time, and yet, for this pandemic, it’s really important to limit spread.”\u003c/p>\n\u003cp>Between 100,000 and 240,000 Americans are expected to die from COVID-19, according to the latest projections from the Trump administration’s pandemic scientists. Palliative care specialists, whose expertise is managing pain and disease symptoms as well as having difficult conversations about the end of life, are already feeling overstretched.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Dr. Steve Pantilat, chief of palliative care at UCSF\"]“No harm in saying, I love you and thank you and forgive me and I forgive you to the people you care about at any time. It’s a really good time to do that now.”[/pullquote]\u003c/p>\n\u003cp>Dozens of hospitals in the Bay Area and beyond are racing to move their palliative care services online, using video visits and phone calls to keep patients connected with their families and their doctors. Apple donated 140 iPads to UCSF to use in their telemedicine program, and the Stupski Foundation gave $275,000 to Highland Hospital in Oakland to fast-track the building of their telemedicine program so it can be operational for the pandemic.\u003c/p>\n\u003cp>“Is a remote visit from a palliative care service as effective as an in-person visit where we’re sitting on the side of a bed and holding someone’s hand? I would say no,” said Jessica Zitter, a palliative care doctor at Highland and author of the book \u003ca href=\"https://jessicazitter.com/extreme-measures/\" target=\"_blank\" rel=\"noopener noreferrer\">Extreme Measures\u003c/a>.\u003c/p>\n\u003cp>But the technology will have to do. Her team is small, she said, and if one or two doctors get sick, the whole service would be wiped out.\u003c/p>\n\u003cp>“If we want to stay in the game here and offer our services as I think we’ll need to, I think we’re going to do better if we are working from a remote virtual platform,” she said.\u003c/p>\n\u003cfigure id=\"attachment_11810595\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11810595\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42538_005_KQED_Oakland_JessicaZitter_04032020-qut-800x533.jpg\" alt=\"Dr. Jessica Zitter, a palliative care specialist at Highland Hospital in Oakland, is working from home during coronavirus shelter-in-place orders.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42538_005_KQED_Oakland_JessicaZitter_04032020-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42538_005_KQED_Oakland_JessicaZitter_04032020-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42538_005_KQED_Oakland_JessicaZitter_04032020-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42538_005_KQED_Oakland_JessicaZitter_04032020-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Jessica Zitter, a palliative care specialist at Highland Hospital in Oakland, is working from home during coronavirus shelter-in-place orders. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Palliative care doctors have been fighting for permission to use telemedicine for years. Especially in rural areas, they’ve wanted the ease of video visits so patients who are ill and in pain don’t have to go to the trouble of coming in to a doctor’s office. But the federal government has refused to pay doctors for most video visits and insisted on various rules and restrictions, including making patients in rural areas drive to local clinics for a telemedicine appointment rather than doing it from their own home.\u003c/p>\n\u003cp>The coronavirus has forced some changes, and just two weeks ago, the feds abruptly shifted policy. At a White House press briefing on March 17, Seema Verma, administrator of the Centers for Medicare and Medicaid Services, said the agency was dropping the restrictions, as well as the fines doctors faced for using unapproved technology. She encouraged doctors to go digital.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Doctors can provide telehealth with their own phones,” Verma said. “In an emergency, those on the frontlines shouldn’t have to worry about federal rules and red tape hamstringing them when they need flexibility above all else.”\u003c/p>\n\u003cp>Doctors can now get reimbursed for a video visit at the same rate as an in-person office visit, whether the patient or the doctor is at home.\u003c/p>\n\u003cp>“We’re in a system where the only way physicians’ practices keep the lights on is through what they’re able to bill,” said Chris Acevedo, who runs Acevedo Consulting, a health care billing firm in Delray Beach, Florida. “Without the changes that the government put in place, there would really be zero access to telehealth because the doctors wouldn’t have any remuneration for it.”\u003c/p>\n\u003cp>[aside tag=\"coronavirus\" label=\"Related Coverage\"]\u003c/p>\n\u003cp>The policy changes will encourage the uptake of telemedicine, Acevedo said, and by extension, increase access to palliative care for patients. That includes people who are sick and dying from COVID-19, but also patients who are sick at home with other serious illnesses, some of whom are dying and some who will recover.\u003c/p>\n\u003cp>Rae Anne McLaughlin was one of those patients a few years ago. After she went through 12 rounds of chemotherapy and 35 radiation treatments to treat her stage four head and neck cancer, the last thing she wanted was to drive 70 miles from her home on Long Island to the hospital in the city. She had a palliative care team that would call her up and have normal conversations — not science jargon — about how she was feeling, what she could do about the tingling in her hands and feet and how to manage the opioids she was taking for pain. All of this was over the phone.\u003c/p>\n\u003cp>“It was fabulous,” McLaughlin recalled. “I didn’t have to shower if I didn’t feel like it. Imagine just feeling really, really crummy and then having to get in a car and drive an hour and a half. I didn’t want to do it.”\u003c/p>\n\u003cp>She had private insurance that covered the telephone calls. She’s fully recovered now, three years later, but she can still email her palliative care team. And she did recently to ask whether she was more at risk for becoming ill from coronavirus and to get advice about how to protect herself. They told her to stay home and get her exercise in her house and backyard.\u003c/p>\n\u003cp>Even before the coronavirus pandemic, palliative care specialists — including doctors, nurses and social workers — were in short supply. The subspecialty “didn’t get formal approval until 2007, and we didn’t start training palliative care specialists in any kind of serious numbers until recently,” said Dr. Diane Meier, director of the national Center to Advance Palliative Care and a gerontologist at Mount Sinai Health Systems in New York.\u003c/p>\n\u003cp>Meier knew they wouldn’t have enough palliative care specialists at her hospital to meet the demand of COVID-19 patients needing pain and symptom relief, especially shortness of breath. Her plan was to train frontline emergency department doctors and nurses how to do this themselves, but patients overwhelmed the hospital so fast, they didn’t have time.\u003c/p>\n\u003cp>“They’re getting a new patient in the door of the ED (emergency department) every 30 seconds,” she said. “So we’re creating things like pocket cards and 24/7 hotline numbers that a clinician can call at any hour of the day or night to get very specific advice: ‘What dose do I use? What do I do if it doesn’t work? How long do I wait before I give more?’”\u003c/p>\n\u003cp>But delivering bad news and having tough conversations is a skill they can’t easily delegate. And because COVID-19 can progress so quickly — with patients going from okay to barely able to breathe in an hour — there’s so little time to talk with patients about what kind of care they’re willing to have, what’s important to them and what they want for the end of their lives.\u003c/p>\n\u003cfigure id=\"attachment_11810593\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11810593\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42522_001_KQED_SanFrancisco_StevePantilatMD_04032020-qut-800x533.jpg\" alt=\"Dr. Steve Pantilat, chief of palliative care at University of California, San Francisco (UCSF) is working to provide care remotely during coronavirus shelter-in-place orders.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42522_001_KQED_SanFrancisco_StevePantilatMD_04032020-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42522_001_KQED_SanFrancisco_StevePantilatMD_04032020-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42522_001_KQED_SanFrancisco_StevePantilatMD_04032020-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42522_001_KQED_SanFrancisco_StevePantilatMD_04032020-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Steve Pantilat, chief of palliative care at University of California, San Francisco (UCSF) is working to provide care remotely during coronavirus shelter-in-place orders. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>UCSF’s Pantilat says everyone should be having these conversations with their loved ones now. Some older people who have had a few tours of the medical system already may not want to be intubated and sedated on a ventilator, he said. They may not want to be in the hospital at all, especially if it means they will be separated from their families.\u003c/p>\n\u003cp>But younger people are dying, too, he added, and should think about where they stand on advanced directives for medical care and do-not-resuscitate orders. They should be thinking about how to say goodbye.\u003c/p>\n\u003cp>“Some of us who might not have thought about these issues and thought, ‘Oh, I’ve got a lot of time before I have to worry about this,’ are suddenly facing the reality that you could get suddenly sick and suddenly very, very sick,” he said. “No harm in saying, I love you and thank you and forgive me and I forgive you to the people you care about at any time. It’s a really good time to do that now.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When Dr. Steve Pantilat asks his patients what they want most at the end of life, the answer is almost always the same: To be comfortable and surrounded by people they love.\u003c/p>\n\u003cp>“I’ve been in rooms where there are 35 family members, people are playing music and holding a vigil, saying prayers and singing,” said Pantilat, chief of palliative medicine at UCSF and author of \u003ca href=\"https://www.stevepantilat.com/latdbook\">Life After the Diagnosis\u003c/a>. “They’re even having weddings in the hospital. Just last month, we had another wedding for someone who was dying.”\u003c/p>\n\u003cp>But in the age of coronavirus, none of this is happening. There’s too much risk of visitors getting sick or infecting critical frontline staff, and there’s not enough protective equipment to go around. So the new policy at UCSF and hospitals across the country is: One visitor, and only for patients who are actively dying.\u003c/p>\n\u003cp>“I think that’s really, really, really distressing for everyone involved,” Pantilat said. “We’ve never really faced this before, trying to make these really gut wrenching decisions about visitation of when and who and how many. It’s a very sacred time, and yet, for this pandemic, it’s really important to limit spread.”\u003c/p>\n\u003cp>Between 100,000 and 240,000 Americans are expected to die from COVID-19, according to the latest projections from the Trump administration’s pandemic scientists. Palliative care specialists, whose expertise is managing pain and disease symptoms as well as having difficult conversations about the end of life, are already feeling overstretched.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "“No harm in saying, I love you and thank you and forgive me and I forgive you to the people you care about at any time. It’s a really good time to do that now.”",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Dozens of hospitals in the Bay Area and beyond are racing to move their palliative care services online, using video visits and phone calls to keep patients connected with their families and their doctors. Apple donated 140 iPads to UCSF to use in their telemedicine program, and the Stupski Foundation gave $275,000 to Highland Hospital in Oakland to fast-track the building of their telemedicine program so it can be operational for the pandemic.\u003c/p>\n\u003cp>“Is a remote visit from a palliative care service as effective as an in-person visit where we’re sitting on the side of a bed and holding someone’s hand? I would say no,” said Jessica Zitter, a palliative care doctor at Highland and author of the book \u003ca href=\"https://jessicazitter.com/extreme-measures/\" target=\"_blank\" rel=\"noopener noreferrer\">Extreme Measures\u003c/a>.\u003c/p>\n\u003cp>But the technology will have to do. Her team is small, she said, and if one or two doctors get sick, the whole service would be wiped out.\u003c/p>\n\u003cp>“If we want to stay in the game here and offer our services as I think we’ll need to, I think we’re going to do better if we are working from a remote virtual platform,” she said.\u003c/p>\n\u003cfigure id=\"attachment_11810595\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11810595\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42538_005_KQED_Oakland_JessicaZitter_04032020-qut-800x533.jpg\" alt=\"Dr. Jessica Zitter, a palliative care specialist at Highland Hospital in Oakland, is working from home during coronavirus shelter-in-place orders.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42538_005_KQED_Oakland_JessicaZitter_04032020-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42538_005_KQED_Oakland_JessicaZitter_04032020-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42538_005_KQED_Oakland_JessicaZitter_04032020-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42538_005_KQED_Oakland_JessicaZitter_04032020-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Jessica Zitter, a palliative care specialist at Highland Hospital in Oakland, is working from home during coronavirus shelter-in-place orders. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Palliative care doctors have been fighting for permission to use telemedicine for years. Especially in rural areas, they’ve wanted the ease of video visits so patients who are ill and in pain don’t have to go to the trouble of coming in to a doctor’s office. But the federal government has refused to pay doctors for most video visits and insisted on various rules and restrictions, including making patients in rural areas drive to local clinics for a telemedicine appointment rather than doing it from their own home.\u003c/p>\n\u003cp>The coronavirus has forced some changes, and just two weeks ago, the feds abruptly shifted policy. At a White House press briefing on March 17, Seema Verma, administrator of the Centers for Medicare and Medicaid Services, said the agency was dropping the restrictions, as well as the fines doctors faced for using unapproved technology. She encouraged doctors to go digital.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Doctors can provide telehealth with their own phones,” Verma said. “In an emergency, those on the frontlines shouldn’t have to worry about federal rules and red tape hamstringing them when they need flexibility above all else.”\u003c/p>\n\u003cp>Doctors can now get reimbursed for a video visit at the same rate as an in-person office visit, whether the patient or the doctor is at home.\u003c/p>\n\u003cp>“We’re in a system where the only way physicians’ practices keep the lights on is through what they’re able to bill,” said Chris Acevedo, who runs Acevedo Consulting, a health care billing firm in Delray Beach, Florida. “Without the changes that the government put in place, there would really be zero access to telehealth because the doctors wouldn’t have any remuneration for it.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The policy changes will encourage the uptake of telemedicine, Acevedo said, and by extension, increase access to palliative care for patients. That includes people who are sick and dying from COVID-19, but also patients who are sick at home with other serious illnesses, some of whom are dying and some who will recover.\u003c/p>\n\u003cp>Rae Anne McLaughlin was one of those patients a few years ago. After she went through 12 rounds of chemotherapy and 35 radiation treatments to treat her stage four head and neck cancer, the last thing she wanted was to drive 70 miles from her home on Long Island to the hospital in the city. She had a palliative care team that would call her up and have normal conversations — not science jargon — about how she was feeling, what she could do about the tingling in her hands and feet and how to manage the opioids she was taking for pain. All of this was over the phone.\u003c/p>\n\u003cp>“It was fabulous,” McLaughlin recalled. “I didn’t have to shower if I didn’t feel like it. Imagine just feeling really, really crummy and then having to get in a car and drive an hour and a half. I didn’t want to do it.”\u003c/p>\n\u003cp>She had private insurance that covered the telephone calls. She’s fully recovered now, three years later, but she can still email her palliative care team. And she did recently to ask whether she was more at risk for becoming ill from coronavirus and to get advice about how to protect herself. They told her to stay home and get her exercise in her house and backyard.\u003c/p>\n\u003cp>Even before the coronavirus pandemic, palliative care specialists — including doctors, nurses and social workers — were in short supply. The subspecialty “didn’t get formal approval until 2007, and we didn’t start training palliative care specialists in any kind of serious numbers until recently,” said Dr. Diane Meier, director of the national Center to Advance Palliative Care and a gerontologist at Mount Sinai Health Systems in New York.\u003c/p>\n\u003cp>Meier knew they wouldn’t have enough palliative care specialists at her hospital to meet the demand of COVID-19 patients needing pain and symptom relief, especially shortness of breath. Her plan was to train frontline emergency department doctors and nurses how to do this themselves, but patients overwhelmed the hospital so fast, they didn’t have time.\u003c/p>\n\u003cp>“They’re getting a new patient in the door of the ED (emergency department) every 30 seconds,” she said. “So we’re creating things like pocket cards and 24/7 hotline numbers that a clinician can call at any hour of the day or night to get very specific advice: ‘What dose do I use? What do I do if it doesn’t work? How long do I wait before I give more?’”\u003c/p>\n\u003cp>But delivering bad news and having tough conversations is a skill they can’t easily delegate. And because COVID-19 can progress so quickly — with patients going from okay to barely able to breathe in an hour — there’s so little time to talk with patients about what kind of care they’re willing to have, what’s important to them and what they want for the end of their lives.\u003c/p>\n\u003cfigure id=\"attachment_11810593\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11810593\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/RS42522_001_KQED_SanFrancisco_StevePantilatMD_04032020-qut-800x533.jpg\" alt=\"Dr. Steve Pantilat, chief of palliative care at University of California, San Francisco (UCSF) is working to provide care remotely during coronavirus shelter-in-place orders.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42522_001_KQED_SanFrancisco_StevePantilatMD_04032020-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42522_001_KQED_SanFrancisco_StevePantilatMD_04032020-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42522_001_KQED_SanFrancisco_StevePantilatMD_04032020-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/RS42522_001_KQED_SanFrancisco_StevePantilatMD_04032020-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Steve Pantilat, chief of palliative care at University of California, San Francisco (UCSF) is working to provide care remotely during coronavirus shelter-in-place orders. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>UCSF’s Pantilat says everyone should be having these conversations with their loved ones now. Some older people who have had a few tours of the medical system already may not want to be intubated and sedated on a ventilator, he said. They may not want to be in the hospital at all, especially if it means they will be separated from their families.\u003c/p>\n\u003cp>But younger people are dying, too, he added, and should think about where they stand on advanced directives for medical care and do-not-resuscitate orders. They should be thinking about how to say goodbye.\u003c/p>\n\u003cp>“Some of us who might not have thought about these issues and thought, ‘Oh, I’ve got a lot of time before I have to worry about this,’ are suddenly facing the reality that you could get suddenly sick and suddenly very, very sick,” he said. “No harm in saying, I love you and thank you and forgive me and I forgive you to the people you care about at any time. It’s a really good time to do that now.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "Nurses at Daly City Coronavirus Hospital Sound Alarm Over Shortage of N95 Masks, Medical Supplies",
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"content": "\u003cp>Two weeks after Daly City’s Seton Medical Center was designated a COVID-19 hospital and \u003ca href=\"https://www.sfexaminer.com/news/emergency-coronavirus-funding-keeps-embattled-seton-hospital-open/\">saved from closure\u003c/a>, nurses are sounding the alarm that they are ill-prepared to take in a projected wave of coronavirus patients.\u003c/p>\n\u003cp>The hospital is setting aside 177 beds to receive patients as part of a state-funded move to keep all hospitals open during the current public health crisis. But nurses said the state also needs to provide them with the necessary equipment to do their jobs.\u003c/p>\n\u003cp>“We have not received any PPE (personal protective equipment) from the state of California,” said intensive care nurse Phoebe Minkler at a press conference Thursday. “As we prepare for this surge, we are critically low and we are already utilizing our emergency stockpile here at Seton Medical Center.”\u003c/p>\n\u003cfigure id=\"attachment_11810381\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11810381\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/007_KQED_DalyCity_SetonMedicalCenter_04022020-800x533.jpg\" alt=\"Phoebe Minkler, a registered nurse in the intensive care unit at Seton Medical Center, speaks during a press conference at the hospital on April, 2, 2020. \" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/007_KQED_DalyCity_SetonMedicalCenter_04022020-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/007_KQED_DalyCity_SetonMedicalCenter_04022020-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/007_KQED_DalyCity_SetonMedicalCenter_04022020-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/007_KQED_DalyCity_SetonMedicalCenter_04022020.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Phoebe Minkler, a registered nurse in the intensive care unit at Seton Medical Center, speaks during a press conference at the hospital on April, 2, 2020. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Minkler said each nurse is now being issued only one N95 mask for each 12-hour shift, to help conserve supplies.\u003c/p>\n\u003cp>“Nurses and frontline healthcare providers, we want to work, we want to be able to take care of patients. But we also have to be able to take care of ourselves and stay safe,” said Minkler.\u003c/p>\n\u003cp>“We’re losing healthcare providers, we’re losing nurses, physicians all over the country are falling ill to this disease,” she added. “In some places like New York they’re having to wear bandannas, they’re having to wear trash bags and things like that. We are hoping that we do not have to resort to that.”\u003c/p>\n\u003cp>[aside label=\"More Resources\" postID=news_11807823]\u003c/p>\n\u003cp>Seton Medical Center President Anthony Armada said that a recent delivery of N95 masks from San Mateo County’s supplies will last the hospital another 26 to 30 days, at the current rate of issuing one mask per shift.\u003c/p>\n\u003cp>Armada said the hospital is following \u003ca href=\"https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html\">guidance\u003c/a> from the Centers for Disease Control and Prevention (CDC) about extending the use of N95 masks.\u003c/p>\n\u003cp>“All of us are being responsible to make sure we are following their guidelines,” he said.\u003c/p>\n\u003cp>The hospital is currently treating 15 COVID-19 patients, according to Armada.\u003c/p>\n\u003cfigure id=\"attachment_11810382\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11810382\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/018_KQED_DalyCity_SetonMedicalCenter_04022020-800x533.jpg\" alt=\"Debra Amour, a 62-year-old intensive care nurse at Seton Medical Center participates in a rally at the hospital on April 2, 2020.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/018_KQED_DalyCity_SetonMedicalCenter_04022020-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/018_KQED_DalyCity_SetonMedicalCenter_04022020-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/018_KQED_DalyCity_SetonMedicalCenter_04022020-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/018_KQED_DalyCity_SetonMedicalCenter_04022020.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Debra Amour, a 62-year-old intensive care nurse at Seton Medical Center participates in a rally at the hospital on April 2, 2020. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But many nurses are concerned about using the same masks to see multiple patients. ICU nurse Debra Amour pointed out the importance of protective equipment to slow transmission of the virus to healthy people.\u003c/p>\n\u003cp>“If you don’t have the right equipment, our choice is not to go into a room or go into a room and become part of the problem. We ourselves will get sick, and we can spread it into the community,” she said. “We have open heart patients. We have really sick, fragile patients. So for me to be in a room without a mask, without a gown, you’re just spreading the germs around.”\u003c/p>\n\u003cp>The California Nurses Association represents about 400 nurses at Seton, according to labor representative Julie Tran.\u003c/p>\n\u003cfigure id=\"attachment_11810383\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11810383\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/009_KQED_DalyCity_SetonMedicalCenter_04022020-800x533.jpg\" alt=\"John Avalos, former San Francisco Supervisor and an organizer for the National Union of Healthcare Workers, speaks at a press conference at Seton Medical Center on April 2, 2020. \" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/009_KQED_DalyCity_SetonMedicalCenter_04022020-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/009_KQED_DalyCity_SetonMedicalCenter_04022020-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/009_KQED_DalyCity_SetonMedicalCenter_04022020-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/009_KQED_DalyCity_SetonMedicalCenter_04022020.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">John Avalos, former San Francisco Supervisor and an organizer for the National Union of Healthcare Workers, speaks at a press conference at Seton Medical Center on April 2, 2020. \u003ccite>(Beth LaBerge/KQEd)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Former San Francisco supervisor John Avalos, who is now an organizer for the National Union of Healthcare Workers which represents clerks and janitorial staff at Seton, said the union has been in touch with state and county officials about the need for more medical supplies like masks and gowns.\u003c/p>\n\u003cp>“You can’t just designate this hospital as a facility to receive lots of patients and not have the protective equipment that workers are going to need to know they’re safe when they’re saving lives,” Avalos said.\u003c/p>\n\u003cfigure id=\"attachment_11810384\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11810384\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/005_KQED_DalyCity_SetonMedicalCenter_04022020-800x533.jpg\" alt=\"Medical workers and supporters rally to raise awareness of the lack of N95 masks and other medical supplies at Seton Medical Center at a demonstration organized by the California Nurses Union on April 2, 2020.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/005_KQED_DalyCity_SetonMedicalCenter_04022020-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/005_KQED_DalyCity_SetonMedicalCenter_04022020-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/005_KQED_DalyCity_SetonMedicalCenter_04022020-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/005_KQED_DalyCity_SetonMedicalCenter_04022020.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Medical workers and supporters rally to raise awareness of the lack of N95 masks and other medical supplies at Seton Medical Center at a demonstration organized by the California Nurses Union on April 2, 2020. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As of Saturday, March 28, the California Department of Public Health released data that \u003ca href=\"https://www.cdph.ca.gov/Programs/OPA/Pages/NR20-036.aspx\">73 healthcare workers statewide\u003c/a> had tested positive for COVID-19. That number was up from just \u003ca href=\"https://www.cdph.ca.gov/Programs/OPA/Pages/NR20-035.aspx\">48 the day before\u003c/a>. This week, the state stopped releasing data on the number of healthcare workers infected by coronavirus, saying it wanted to better focus its resources.\u003c/p>\n\u003cp>On Wednesday, April 8, Seton Medical Center will be holding a donation drive to collect N95 masks, sanitizing wipes, and gloves. Items can be dropped off at Holy Child & St. Martin Episcopal Church at 777 Southgate Avenue in Daly City from 10 a.m. to 1 p.m.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Two weeks after Daly City’s Seton Medical Center was designated a COVID-19 hospital and \u003ca href=\"https://www.sfexaminer.com/news/emergency-coronavirus-funding-keeps-embattled-seton-hospital-open/\">saved from closure\u003c/a>, nurses are sounding the alarm that they are ill-prepared to take in a projected wave of coronavirus patients.\u003c/p>\n\u003cp>The hospital is setting aside 177 beds to receive patients as part of a state-funded move to keep all hospitals open during the current public health crisis. But nurses said the state also needs to provide them with the necessary equipment to do their jobs.\u003c/p>\n\u003cp>“We have not received any PPE (personal protective equipment) from the state of California,” said intensive care nurse Phoebe Minkler at a press conference Thursday. “As we prepare for this surge, we are critically low and we are already utilizing our emergency stockpile here at Seton Medical Center.”\u003c/p>\n\u003cfigure id=\"attachment_11810381\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11810381\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/007_KQED_DalyCity_SetonMedicalCenter_04022020-800x533.jpg\" alt=\"Phoebe Minkler, a registered nurse in the intensive care unit at Seton Medical Center, speaks during a press conference at the hospital on April, 2, 2020. \" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/007_KQED_DalyCity_SetonMedicalCenter_04022020-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/007_KQED_DalyCity_SetonMedicalCenter_04022020-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/007_KQED_DalyCity_SetonMedicalCenter_04022020-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/007_KQED_DalyCity_SetonMedicalCenter_04022020.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Phoebe Minkler, a registered nurse in the intensive care unit at Seton Medical Center, speaks during a press conference at the hospital on April, 2, 2020. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Minkler said each nurse is now being issued only one N95 mask for each 12-hour shift, to help conserve supplies.\u003c/p>\n\u003cp>“Nurses and frontline healthcare providers, we want to work, we want to be able to take care of patients. But we also have to be able to take care of ourselves and stay safe,” said Minkler.\u003c/p>\n\u003cp>“We’re losing healthcare providers, we’re losing nurses, physicians all over the country are falling ill to this disease,” she added. “In some places like New York they’re having to wear bandannas, they’re having to wear trash bags and things like that. We are hoping that we do not have to resort to that.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Seton Medical Center President Anthony Armada said that a recent delivery of N95 masks from San Mateo County’s supplies will last the hospital another 26 to 30 days, at the current rate of issuing one mask per shift.\u003c/p>\n\u003cp>Armada said the hospital is following \u003ca href=\"https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html\">guidance\u003c/a> from the Centers for Disease Control and Prevention (CDC) about extending the use of N95 masks.\u003c/p>\n\u003cp>“All of us are being responsible to make sure we are following their guidelines,” he said.\u003c/p>\n\u003cp>The hospital is currently treating 15 COVID-19 patients, according to Armada.\u003c/p>\n\u003cfigure id=\"attachment_11810382\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11810382\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/018_KQED_DalyCity_SetonMedicalCenter_04022020-800x533.jpg\" alt=\"Debra Amour, a 62-year-old intensive care nurse at Seton Medical Center participates in a rally at the hospital on April 2, 2020.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/018_KQED_DalyCity_SetonMedicalCenter_04022020-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/018_KQED_DalyCity_SetonMedicalCenter_04022020-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/018_KQED_DalyCity_SetonMedicalCenter_04022020-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/018_KQED_DalyCity_SetonMedicalCenter_04022020.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Debra Amour, a 62-year-old intensive care nurse at Seton Medical Center participates in a rally at the hospital on April 2, 2020. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But many nurses are concerned about using the same masks to see multiple patients. ICU nurse Debra Amour pointed out the importance of protective equipment to slow transmission of the virus to healthy people.\u003c/p>\n\u003cp>“If you don’t have the right equipment, our choice is not to go into a room or go into a room and become part of the problem. We ourselves will get sick, and we can spread it into the community,” she said. “We have open heart patients. We have really sick, fragile patients. So for me to be in a room without a mask, without a gown, you’re just spreading the germs around.”\u003c/p>\n\u003cp>The California Nurses Association represents about 400 nurses at Seton, according to labor representative Julie Tran.\u003c/p>\n\u003cfigure id=\"attachment_11810383\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11810383\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/009_KQED_DalyCity_SetonMedicalCenter_04022020-800x533.jpg\" alt=\"John Avalos, former San Francisco Supervisor and an organizer for the National Union of Healthcare Workers, speaks at a press conference at Seton Medical Center on April 2, 2020. \" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/009_KQED_DalyCity_SetonMedicalCenter_04022020-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/009_KQED_DalyCity_SetonMedicalCenter_04022020-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/009_KQED_DalyCity_SetonMedicalCenter_04022020-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/009_KQED_DalyCity_SetonMedicalCenter_04022020.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">John Avalos, former San Francisco Supervisor and an organizer for the National Union of Healthcare Workers, speaks at a press conference at Seton Medical Center on April 2, 2020. \u003ccite>(Beth LaBerge/KQEd)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Former San Francisco supervisor John Avalos, who is now an organizer for the National Union of Healthcare Workers which represents clerks and janitorial staff at Seton, said the union has been in touch with state and county officials about the need for more medical supplies like masks and gowns.\u003c/p>\n\u003cp>“You can’t just designate this hospital as a facility to receive lots of patients and not have the protective equipment that workers are going to need to know they’re safe when they’re saving lives,” Avalos said.\u003c/p>\n\u003cfigure id=\"attachment_11810384\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11810384\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/04/005_KQED_DalyCity_SetonMedicalCenter_04022020-800x533.jpg\" alt=\"Medical workers and supporters rally to raise awareness of the lack of N95 masks and other medical supplies at Seton Medical Center at a demonstration organized by the California Nurses Union on April 2, 2020.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/005_KQED_DalyCity_SetonMedicalCenter_04022020-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/005_KQED_DalyCity_SetonMedicalCenter_04022020-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/005_KQED_DalyCity_SetonMedicalCenter_04022020-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2020/04/005_KQED_DalyCity_SetonMedicalCenter_04022020.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Medical workers and supporters rally to raise awareness of the lack of N95 masks and other medical supplies at Seton Medical Center at a demonstration organized by the California Nurses Union on April 2, 2020. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As of Saturday, March 28, the California Department of Public Health released data that \u003ca href=\"https://www.cdph.ca.gov/Programs/OPA/Pages/NR20-036.aspx\">73 healthcare workers statewide\u003c/a> had tested positive for COVID-19. That number was up from just \u003ca href=\"https://www.cdph.ca.gov/Programs/OPA/Pages/NR20-035.aspx\">48 the day before\u003c/a>. This week, the state stopped releasing data on the number of healthcare workers infected by coronavirus, saying it wanted to better focus its resources.\u003c/p>\n\u003cp>On Wednesday, April 8, Seton Medical Center will be holding a donation drive to collect N95 masks, sanitizing wipes, and gloves. Items can be dropped off at Holy Child & St. Martin Episcopal Church at 777 Southgate Avenue in Daly City from 10 a.m. to 1 p.m.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"mindshift": {
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 12
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"onourwatch": {
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
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"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"officialWebsiteLink": "https://www.possible.fm/",
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"source": "Possible"
},
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"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
"id": "reveal",
"title": "Reveal",
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