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"content": "\u003cp>Two scientists based in California won the Nobel Prize in medicine on Monday for their discoveries into how the human body perceives temperature and touch, revelations that could lead to new ways of treating pain or even heart disease.\u003c/p>\n\u003cp>[pullquote align=\"right\" size=\"medium\" citation=\"Thomas Perlmann, secretary-general of the Nobel Committee\"]‘This really unlocks one of the secrets of nature … It’s actually something that is crucial for our survival.’[/pullquote]One of the researchers is \u003ca href=\"https://www.ucsf.edu/news/2021/09/421481/david-julius-wins-nobel-prize-work-pain-sensation\">David Julius, a biochemist and molecular biologist at UCSF\u003c/a>. A few hundred miles south, Ardem Patapoutian at Scripps Research Institute in La Jolla also separately identified receptors in the skin that respond to heat and pressure.\u003c/p>\n\u003cp>Some hope the discoveries could eventually lead to pain treatments that reduce dependence on highly addictive opioids. But the breakthroughs, which happened decades ago, have not yet yielded many effective new therapies.\u003c/p>\n\u003cp>Julius used capsaicin, the active component in chili peppers, to help pinpoint the nerve sensors that respond to heat, the Nobel Committee said. Patapoutian found pressure-sensitive sensors in cells that respond to mechanical stimulation.\u003c/p>\n\u003cp>“This really unlocks one of the secrets of nature,” said Thomas Perlmann, secretary-general of the committee, in announcing the winners. “It’s actually something that is crucial for our survival, so it’s a very important and profound discovery.”\u003c/p>\n\u003cp>In keeping with a long tradition of difficulties in alerting Nobel winners, Julius, 65, said he was awakened by what he thought was a prank phone call shortly before the prize was announced.\u003c/p>\n\u003cp>“My phone sort of bleeped, and it was from a relative who had been contacted by somebody on the Nobel Committee trying to find my phone number,” he said from his home in San Francisco, where it was the middle of the night.\u003c/p>\n\u003cp>It was only when his wife heard Perlmann’s voice — his wife worked with Perlmann years ago, Julius said — and confirmed it was indeed the secretary-general of the committee who was calling, that he realized it wasn’t a joke.\u003c/p>\n\u003cp>Julius later said he hoped his work would lead to the development of new pain drugs, explaining that the biology behind even everyday activities can have enormous significance.\u003c/p>\n\u003cp>“We eat chili peppers and menthol, but oftentimes, you don’t think about how that works,” he said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The Nobel Committee said their discoveries get at “one of the great mysteries facing humanity”: how we sense our environment.\u003c/p>\n\u003cp>The choice of winners underscored how little scientists knew about that question before the discoveries — and how much there still is to learn, said Oscar Marin, director of the MRC Centre for Neurodevelopmental Disorders at King’s College London.\u003c/p>\n\u003cp>“While we understood the physiology of the senses, what we didn’t understand was how we sensed differences in temperature or pressure,” Marin said. “Knowing how our body senses these changes is fundamental because once we know those molecules, they can be targeted. It’s like finding a lock, and now we know the precise keys that will be necessary to unlock it.”\u003c/p>\n\u003cp>Marin predicted that new treatments for pain would likely come first, but that understanding how the body detects changes in pressure could eventually lead to drugs for heart disease, if scientists can figure out how to alleviate pressure on blood vessels and other organs.\u003c/p>\n\u003cp>Richard Harris, of the Chronic Pain and Fatigue Research Center at the University of Michigan, also said the new laureates’ work might help design new pain medications, but noted the field has long been stalled.\u003c/p>\n\u003cp>He said that because pain also includes a psychological component, simply identifying how it is triggered in the body isn’t necessarily enough to address it. Still, he said Julius’s and Patapoutian’s work likely would help doctors better treat pain that is caused by things like extreme temperatures and chemical burns.\u003c/p>\n\u003cp>“Their discoveries are giving us the first inkling of how this type of pain starts, but whether it’s involved in many chronic pain patients remains to be seen,” he said.\u003c/p>\n\u003cp>Still, Fiona Boissonade, a pain specialist at the University of Sheffield in the U.K., said the Nobel laureates’ work was especially relevant for the one in five people globally who suffer from chronic pain.\u003c/p>\n\u003cp>Such pain — including from arthritis, migraines and chronic back problems — “is a huge medical problem, and it’s quite poorly treated across the board,” she said. “Their research may lead us to identify new compounds that are effective in treating pain that don’t come with the devastating impact of opioids,” which have spawned a crisis of addiction in the U.S.\u003c/p>\n\u003cp>[aside label ='Related Coverage' tag='science']The Nobel Committee tweeted a photo of Patapoutian in bed with his son while he watched the announcement on his computer.\u003c/p>\n\u003cp>“A day to be thankful: this country gave me a chance with a great education and support for basic research. And for my labbies and collaborators for partnering with me,” Patapoutian, who was born in Lebanon, tweeted.\u003c/p>\n\u003cp>The prestigious award comes with a gold medal and 10 million Swedish kronor (over $1.14 million). The prize money comes from a bequest left by the prize’s creator, Swedish inventor Alfred Nobel, who died in 1896.\u003c/p>\n\u003cp>The prize is the first to be awarded this year. The other prizes are for outstanding work in the fields of physics, chemistry, literature, peace and economics.\u003cbr>\n[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cp>On Tuesday, Dr. Jeanne Noble devoted time between patient visits to hanging clear 2-gallon plastic bags at each of her colleagues’ workstations. Noble is a professor of emergency medicine and director of the UCSF Medical Center response to the novel coronavirus that has permeated California and reached into every U.S. state.\u003c/p>\n\u003cp>The bags were there to hold personal protective equipment (PPE) — the masks, face shields, gowns and other items that health care providers rely on every day to protect themselves from the viruses shed by patients, largely through coughs and sneezes. In normal times, safety protocols would require these items be disposed of after one use. But just weeks into the COVID-19 pandemic, supplies of protective gear at UCSF are already so low that doctors and nurses are wiping down and reusing almost everything except gloves.\u003c/p>\n\u003cp>“It is not a foolproof strategy at all; we all realize the risk we are taking,” Noble said. But as supplies dwindle, she increasingly finds herself asking the folks in charge of infection control at the hospital if they can make changes to protocols. “As days go by, one regulation after the other goes out,” she said.\u003c/p>\n\u003cp>Noble is among the Bay Area physicians applauding the decision this week by seven Bay Area counties and multiple others across California to order residents to \u003ca href=\"https://www.kqed.org/news/11806988/sheltering-in-place-what-you-need-to-know\" target=\"_blank\" rel=\"noopener noreferrer\">shelter in place\u003c/a> for the foreseeable future, directives that are upending life for millions of people and shuttering schools and businesses across the state. Without swift and dramatic changes to curb transmission of the virus, hospital officials say, it is just a matter of time before their health systems are overwhelmed.\u003c/p>\n\u003cp>\"My prediction is that we will get a wave of patients, but that it will be less than it would have been had we not put these shelter-in-place orders out there,\" Jahan Fahimi, the director of the emergency department at UCSF, told KQED. \"But it's still going to be challenging.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Interviews with California physicians on the front lines of COVID-19 offer a sobering portrait of a health care system preparing for the worst of a pandemic that could be months from peaking. In the Bay Area, the battle is being waged hospital by hospital, with wide variations in resources.\u003c/p>\n\u003cp>The tent where Noble tended to patients this week was set up to deal with a recent rise in people showing up with respiratory illness. Even without the coronavirus threat, UCSF’s emergency room is a busy one, and doctors frequently see patients in hallways and other spaces. But the current outbreak makes that close contact unsafe. So instead, everyone who comes to the hospital is being triaged. Most people with fever, cough or shortness of breath are diverted to the tent, which is heated and has negative air pressure to prevent the spread of infection. For now, the pace is manageable, but Noble fears what’s ahead.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Jahan Fahimi, the director of the emergency department at UCSF\"]'With the supply chain being disrupted, we are frantically trying to figure out how we're going to meet the needs of our workforce.'[/pullquote]\u003c/p>\n\u003cp>Farther south, in Palo Alto, Stanford Medical Center was testing patients with respiratory problems in its parking garage. The private university hospital has more protective gear than the public one in San Francisco; a global scavenger hunt several weeks ago bolstered supplies, though Stanford, too, has adapted protocols to be more sparing with some items.\u003c/p>\n\u003cp>“We don’t have an unlimited supply,” said Dr. Andra Blomkalns, professor and chair of the Stanford School of Medicine’s Department of Emergency Medicine. “But at least we’re not looking at our last box.”\u003c/p>\n\u003cp>The entire country is short on protective gear, a result of both the surging demand for such equipment as the virus spreads and the implosion of supply chains from China, where much of the equipment is manufactured.\u003c/p>\n\u003cp>\"We're really trying to make sure that we use the right kind of PPE in the right scenarios and conserve the more critical PPE for what we expect to be kind of a long couple of months,\" Fahimi told KQED. \"And with the supply chain being disrupted, we are frantically trying to figure out how we're going to meet the needs of our workforce.\"\u003c/p>\n\u003cp>Noble believes some equipment will need to be made locally. “If the [federal] government doesn’t step in and force manufacturing of these products here now, we are going to run out,” she said.\u003c/p>\n\u003cp>Empty supply closets affect everyone who needs care, including heart attack victims and people in need of emergency surgery, said Dr. Vivian Reyes, president of the California chapter of the American College of Emergency Physicians and a practicing emergency physician in the Bay Area.\u003c/p>\n\u003cp>“I know it’s really hard for us Americans because we’re never told no,” she said of the shortfall of supplies. “But we’re not in normal times right now.”\u003c/p>\n\u003cp>And protective equipment isn’t the only thing in short supply.\u003c/p>\n\u003cp>Until a few days ago, UCSF had to rely on the San Francisco Department of Public Health for coronavirus testing, and a shortage of test kits meant clinicians could test only the most critically ill. The situation improved March 9, when the university started running tests created in its own lab. First, there were 40 tests a day. By Tuesday, there were 60 to 80. But a new shortage looms: The hospital has just \u003ca href=\"https://khn.org/news/as-coronavirus-testing-gears-up-specialized-swabs-running-out/\">500 testing swabs\u003c/a> left.\u003cbr>\n[aside postID=\"news_11807416\" label=\"Coronavirus Testing in California\" hero=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/03/RS42027_011_KQED_SanFrancisco_Coronavirus_03132020_7054-qut-1020x680.jpg\"]\u003c/p>\n\u003cp>Stanford pathologist Benjamin Pinsky built an in-house test that has been approved for use by the federal Food and Drug Administration. Since March 3, Stanford has used it to test more than 500 patients, 12% of whom had tested positive as of Tuesday. The university has been running tests for other hospitals as well, including UCSF. It’s a dramatic improvement from a few weeks ago, when Stanford relied on its county lab.\u003c/p>\n\u003cp>\"If we had no supply issues, we are ready to sort of ramp up testing at UCSF and could probably serve all of our internal needs and probably reach out to our fellow hospitals in San Francisco in the Bay Area ... but we're faced with a shortage of some of these supplies,\" Fahimi told KQED.\u003c/p>\n\u003cp>Blomkalns saw a sick patient in mid-February, before the hospital had its own test kits, who had symptoms of COVID-19 but didn’t qualify for testing under the narrow federal guidelines in place at the time. He went home, only to return to the hospital after his condition deteriorated. This time, he was tested and it came back positive.\u003c/p>\n\u003cp>In Santa Clara County, home to Stanford, 175 people have tested positive for COVID-19 and six have died. Late last week, the medical center’s emergency department saw the highest number of patients in one day in its history. Blomkalns doubts it’s because there are more cases in her area. “If you don’t test, you don’t have any cases,” she said.\u003c/p>\n\u003cp>Blomkalns worries about staffing shortages as health care workers are inevitably exposed to the virus. As of Tuesday, one doctor in the Stanford ER had tested positive. At UCSF, six health care providers had.\u003c/p>\n\u003cp>Not all Bay Area hospitals are seeing a flood of patients. In fact, some have fewer patients than usual, as they have canceled elective surgeries in anticipation of a COVID-19 surge.\u003c/p>\n\u003cp>The doctors treating COVID-19 patients say nearly all who test positive have a cough. They complain of fatigue, body aches, headaches, runny noses and sore throats. While most people are well enough to recover at home, those who get critically ill tend to do so in their second week of symptoms, and can deteriorate very quickly, several doctors noted. “We are recommending that patients get intubated a little earlier than they might otherwise,” said Reyes.\u003c/p>\n\u003cp>[aside postID=\"news_11806966\" label=\"Look Up Local Food Banks That Need Your Help\" hero=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2020/03/RS42178_012_KQED_SanFranciscoMarinFoodBank_03182020_-qut-1020x680.jpg\"]\u003c/p>\n\u003cp>In general, officials are asking people who have mild cases of COVID-19 to treat their symptoms at home, as they would a cold or flu, and refrain from seeking care at hospitals. People experiencing shortness of breath, however, should definitely go to the emergency room, said Blomkalns.\u003c/p>\n\u003cp>For children, the criteria may be a bit different. Shortness of breath should trigger a visit, as should altered mental state, excessive irritability, or an inability to eat or drink, said Dr. Nicolaus Glomb, a pediatric emergency care physician at UCSF Benioff Children’s Hospital.\u003c/p>\n\u003cp>Gov. Gavin Newsom said Tuesday that rough projections suggest the state could need anywhere from 4,000 to 20,000 additional beds to treat patients with serious cases of COVID-19.\u003c/p>\n\u003cp>The testing problems worry Noble, as do the equipment shortages, but not nearly as much as the potential for a lot of sick people. “I’m mostly worried about a tsunami of very ill patients that we’re not equipped to take care of,” said Noble.\u003c/p>\n\u003cp>Blomkalns isn’t sure whether or when Stanford might exceed capacity, saying the caseload trajectory may hinge on how aggressively state and national authorities move to cut off routes of community transmission. “It all depends on what happens in the coming weeks and days,” she said. “We know what we need to do, and we’re doing the job.”\u003c/p>\n\u003cp>\u003cem>KQED's Alice Woelfle and KHN Senior Correspondents JoNel Aleccia and Jenny Gold contributed to this report.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://khn.org/\">KHN\u003c/a> story first published on \u003ca href=\"http://www.californiahealthline.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Healthline\u003c/a>, a service of the \u003ca href=\"http://www.chcf.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Health Care Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>On Tuesday, Dr. Jeanne Noble devoted time between patient visits to hanging clear 2-gallon plastic bags at each of her colleagues’ workstations. Noble is a professor of emergency medicine and director of the UCSF Medical Center response to the novel coronavirus that has permeated California and reached into every U.S. state.\u003c/p>\n\u003cp>The bags were there to hold personal protective equipment (PPE) — the masks, face shields, gowns and other items that health care providers rely on every day to protect themselves from the viruses shed by patients, largely through coughs and sneezes. In normal times, safety protocols would require these items be disposed of after one use. But just weeks into the COVID-19 pandemic, supplies of protective gear at UCSF are already so low that doctors and nurses are wiping down and reusing almost everything except gloves.\u003c/p>\n\u003cp>“It is not a foolproof strategy at all; we all realize the risk we are taking,” Noble said. But as supplies dwindle, she increasingly finds herself asking the folks in charge of infection control at the hospital if they can make changes to protocols. “As days go by, one regulation after the other goes out,” she said.\u003c/p>\n\u003cp>Noble is among the Bay Area physicians applauding the decision this week by seven Bay Area counties and multiple others across California to order residents to \u003ca href=\"https://www.kqed.org/news/11806988/sheltering-in-place-what-you-need-to-know\" target=\"_blank\" rel=\"noopener noreferrer\">shelter in place\u003c/a> for the foreseeable future, directives that are upending life for millions of people and shuttering schools and businesses across the state. Without swift and dramatic changes to curb transmission of the virus, hospital officials say, it is just a matter of time before their health systems are overwhelmed.\u003c/p>\n\u003cp>\"My prediction is that we will get a wave of patients, but that it will be less than it would have been had we not put these shelter-in-place orders out there,\" Jahan Fahimi, the director of the emergency department at UCSF, told KQED. \"But it's still going to be challenging.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Interviews with California physicians on the front lines of COVID-19 offer a sobering portrait of a health care system preparing for the worst of a pandemic that could be months from peaking. In the Bay Area, the battle is being waged hospital by hospital, with wide variations in resources.\u003c/p>\n\u003cp>The tent where Noble tended to patients this week was set up to deal with a recent rise in people showing up with respiratory illness. Even without the coronavirus threat, UCSF’s emergency room is a busy one, and doctors frequently see patients in hallways and other spaces. But the current outbreak makes that close contact unsafe. So instead, everyone who comes to the hospital is being triaged. Most people with fever, cough or shortness of breath are diverted to the tent, which is heated and has negative air pressure to prevent the spread of infection. For now, the pace is manageable, but Noble fears what’s ahead.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Farther south, in Palo Alto, Stanford Medical Center was testing patients with respiratory problems in its parking garage. The private university hospital has more protective gear than the public one in San Francisco; a global scavenger hunt several weeks ago bolstered supplies, though Stanford, too, has adapted protocols to be more sparing with some items.\u003c/p>\n\u003cp>“We don’t have an unlimited supply,” said Dr. Andra Blomkalns, professor and chair of the Stanford School of Medicine’s Department of Emergency Medicine. “But at least we’re not looking at our last box.”\u003c/p>\n\u003cp>The entire country is short on protective gear, a result of both the surging demand for such equipment as the virus spreads and the implosion of supply chains from China, where much of the equipment is manufactured.\u003c/p>\n\u003cp>\"We're really trying to make sure that we use the right kind of PPE in the right scenarios and conserve the more critical PPE for what we expect to be kind of a long couple of months,\" Fahimi told KQED. \"And with the supply chain being disrupted, we are frantically trying to figure out how we're going to meet the needs of our workforce.\"\u003c/p>\n\u003cp>Noble believes some equipment will need to be made locally. “If the [federal] government doesn’t step in and force manufacturing of these products here now, we are going to run out,” she said.\u003c/p>\n\u003cp>Empty supply closets affect everyone who needs care, including heart attack victims and people in need of emergency surgery, said Dr. Vivian Reyes, president of the California chapter of the American College of Emergency Physicians and a practicing emergency physician in the Bay Area.\u003c/p>\n\u003cp>“I know it’s really hard for us Americans because we’re never told no,” she said of the shortfall of supplies. “But we’re not in normal times right now.”\u003c/p>\n\u003cp>And protective equipment isn’t the only thing in short supply.\u003c/p>\n\u003cp>Until a few days ago, UCSF had to rely on the San Francisco Department of Public Health for coronavirus testing, and a shortage of test kits meant clinicians could test only the most critically ill. The situation improved March 9, when the university started running tests created in its own lab. First, there were 40 tests a day. By Tuesday, there were 60 to 80. But a new shortage looms: The hospital has just \u003ca href=\"https://khn.org/news/as-coronavirus-testing-gears-up-specialized-swabs-running-out/\">500 testing swabs\u003c/a> left.\u003cbr>\n\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Stanford pathologist Benjamin Pinsky built an in-house test that has been approved for use by the federal Food and Drug Administration. Since March 3, Stanford has used it to test more than 500 patients, 12% of whom had tested positive as of Tuesday. The university has been running tests for other hospitals as well, including UCSF. It’s a dramatic improvement from a few weeks ago, when Stanford relied on its county lab.\u003c/p>\n\u003cp>\"If we had no supply issues, we are ready to sort of ramp up testing at UCSF and could probably serve all of our internal needs and probably reach out to our fellow hospitals in San Francisco in the Bay Area ... but we're faced with a shortage of some of these supplies,\" Fahimi told KQED.\u003c/p>\n\u003cp>Blomkalns saw a sick patient in mid-February, before the hospital had its own test kits, who had symptoms of COVID-19 but didn’t qualify for testing under the narrow federal guidelines in place at the time. He went home, only to return to the hospital after his condition deteriorated. This time, he was tested and it came back positive.\u003c/p>\n\u003cp>In Santa Clara County, home to Stanford, 175 people have tested positive for COVID-19 and six have died. Late last week, the medical center’s emergency department saw the highest number of patients in one day in its history. Blomkalns doubts it’s because there are more cases in her area. “If you don’t test, you don’t have any cases,” she said.\u003c/p>\n\u003cp>Blomkalns worries about staffing shortages as health care workers are inevitably exposed to the virus. As of Tuesday, one doctor in the Stanford ER had tested positive. At UCSF, six health care providers had.\u003c/p>\n\u003cp>Not all Bay Area hospitals are seeing a flood of patients. In fact, some have fewer patients than usual, as they have canceled elective surgeries in anticipation of a COVID-19 surge.\u003c/p>\n\u003cp>The doctors treating COVID-19 patients say nearly all who test positive have a cough. They complain of fatigue, body aches, headaches, runny noses and sore throats. While most people are well enough to recover at home, those who get critically ill tend to do so in their second week of symptoms, and can deteriorate very quickly, several doctors noted. “We are recommending that patients get intubated a little earlier than they might otherwise,” said Reyes.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In general, officials are asking people who have mild cases of COVID-19 to treat their symptoms at home, as they would a cold or flu, and refrain from seeking care at hospitals. People experiencing shortness of breath, however, should definitely go to the emergency room, said Blomkalns.\u003c/p>\n\u003cp>For children, the criteria may be a bit different. Shortness of breath should trigger a visit, as should altered mental state, excessive irritability, or an inability to eat or drink, said Dr. Nicolaus Glomb, a pediatric emergency care physician at UCSF Benioff Children’s Hospital.\u003c/p>\n\u003cp>Gov. Gavin Newsom said Tuesday that rough projections suggest the state could need anywhere from 4,000 to 20,000 additional beds to treat patients with serious cases of COVID-19.\u003c/p>\n\u003cp>The testing problems worry Noble, as do the equipment shortages, but not nearly as much as the potential for a lot of sick people. “I’m mostly worried about a tsunami of very ill patients that we’re not equipped to take care of,” said Noble.\u003c/p>\n\u003cp>Blomkalns isn’t sure whether or when Stanford might exceed capacity, saying the caseload trajectory may hinge on how aggressively state and national authorities move to cut off routes of community transmission. “It all depends on what happens in the coming weeks and days,” she said. “We know what we need to do, and we’re doing the job.”\u003c/p>\n\u003cp>\u003cem>KQED's Alice Woelfle and KHN Senior Correspondents JoNel Aleccia and Jenny Gold contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://khn.org/\">KHN\u003c/a> story first published on \u003ca href=\"http://www.californiahealthline.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Healthline\u003c/a>, a service of the \u003ca href=\"http://www.chcf.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Health Care Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Bay Area Hospitals Gear Up for Potential Surge in Coronavirus Cases",
"title": "Bay Area Hospitals Gear Up for Potential Surge in Coronavirus Cases",
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"content": "\u003cp>Canceling or postponing non-urgent appointments, seeing patients through remote tools like telehealth and, in some cases, locking up face masks so they don't go missing: These are just some of the ways that local hospitals are preparing for an influx of coronavirus cases in the Bay Area.\u003c/p>\n\u003cp>This comes as the Centers for Disease Control and Prevention (CDC) announced that \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/summary.html\">more cases of COVID-19\u003c/a> are likely to be identified and that widespread transmission could occur, which \"would translate into large numbers of people needing medical care at the same time.\"\u003c/p>\n\u003cp>\"I think what’s a little tricky now is it’s just not at all clear whether it’s going to be medium bad or quite terrible,\" said Dr. Robert Wachter, chair of the UCSF Department of Medicine. \"We don’t want to panic anyone and we don’t want to overreact, but we feel that under-reacting could be the greater sin.\"\u003c/p>\n\u003cp>On Wednesday, the World Health Organization (WHO) said that the COVID-19 viral disease is now officially considered a \u003ca href=\"https://www.kqed.org/science/1958628/coronavirus-covid-19-is-now-officially-a-pandemic-who-says\">pandemic\u003c/a>. [ad fullwidth]\u003c/p>\n\u003ch3>Zuckerberg San Francisco General Hospital\u003c/h3>\n\u003cp>At Zuckerberg San Francisco General Hospital (SFGH), officials said they're working to ensure that patients are routed to the right part of the hospital.\u003c/p>\n\u003cp>\"It's critically important that people aren't in the emergency department unless they absolutely need to be there,\" said SFGH CEO Susan Ehrlich. \"We have other resources for them on campus, including an urgent care clinic and a number of different primary care clinics and specialty clinics.\"\u003c/p>\n\u003cp>They're also canceling non-urgent medical appointments and conducting many appointments and evaluations over the phone.\u003c/p>\n\u003cp>Additionally, because California has declared a state of emergency over the coronavirus outbreak, Ehrlich said that the state Department of Public Health is now allowing the hospital more discretion over how the building can be used to better meet patient needs.\u003c/p>\n\u003cp>\"Each space in the hospital is licensed for a very particular use — for example, labor and delivery, medical surgical floors or critical care floors,\" Ehrlich explained. \"We have to use those spaces in those ways unless we have this special dispensation from the state to use them in different ways.\"\u003c/p>\n\u003cp>[aside tag=\"coronavirus\" label=\"more coverage\"]\u003c/p>\n\u003ch3>Stanford Health Care\u003c/h3>\n\u003cp>At Stanford Health Care systems, which are located in Santa Clara County — where most of the Bay Area's confirmed cases of COVID-19 have been located — staff have confined those patients to particular sections at each hospital.\u003c/p>\n\u003cp>Dr. Yvonne Maldonado, a professor of pediatrics and an infectious disease epidemiologist at Stanford University School of Medicine, said that selecting one particular location in each hospital for these patients has logistical advantages.\u003c/p>\n\u003cp>\"You can have one team that's going to clean those areas. One team is going to take care of those patients,\" she said.\u003c/p>\n\u003cp>Stanford hospitals' staff is currently conducting daily morning meetings, virtually or in-person, and having subcommittee meetings throughout the day to ensure that all their facilities are adequately staffed and have enough equipment.\u003c/p>\n\u003cp>Maldonado said they've also taken to locking away some of their protective gear, including N95 face masks, after some started going missing.\u003c/p>\n\u003cp>Maldonado said that people did not initially understand that N95 masks are not required for every patient, but only for a specific set of patients. \u003c/p>\n\u003cp>\"We're doing a lot of training about what kinds of isolation equipment should be used for what kinds of patients and restricting the use to just those patients,\" Maldonado said.\u003c/p>\n\u003cp>As for seeing patients through remote video connections or over the phone, Maldonado said Stanford had already been using some telemedicine before the outbreak and are working on building out those systems.\u003c/p>\n\u003cp>\"Obviously, you need to make sure that the facilities are sufficient on both ends,\" said Maldonado, referring as well to the ability of providers to work remotely. \"Some people may not need to come in, and can see patients from off-site as well. But, again, that all needs to be set up so it's compliant with all of our hospital and regulatory requirements.\"\u003c/p>\n\u003cfigure id=\"attachment_11806325\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-11806325\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/03/Image_from_iOS-4_1920x.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2020/03/Image_from_iOS-4_1920x.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2020/03/Image_from_iOS-4_1920x-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2020/03/Image_from_iOS-4_1920x-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2020/03/Image_from_iOS-4_1920x-1020x680.jpg 1020w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">UCSF has set up a tent outside one of their main hospitals to triage patients with respiratory illness. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>UCSF\u003c/h3>\n\u003cp>While there haven't been as many confirmed cases of COVID-19 in San Francisco County as in places like Santa Clara County, officials at UCSF are also working on getting ready for the potential influx.\u003c/p>\n\u003cp>\"We have a hotline that patients are calling in on and we are trying to get the patients in who need to get in, but also giving information, advice to those who don't,\" said UCSF's Dr. Wachter. \"We're also markedly ramping up our telemedicine capabilities.\"\u003c/p>\n\u003cp>UCSF has set up a tent outside one of their main hospitals to triage patients with respiratory illness. Wachter said that under a worst-case scenario, they could limit staff vacation time and delay elective surgeries.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Canceling or postponing non-urgent appointments, seeing patients through remote tools like telehealth and, in some cases, locking up face masks so they don't go missing: These are just some of the ways that local hospitals are preparing for an influx of coronavirus cases in the Bay Area.\u003c/p>\n\u003cp>This comes as the Centers for Disease Control and Prevention (CDC) announced that \u003ca href=\"https://www.cdc.gov/coronavirus/2019-ncov/summary.html\">more cases of COVID-19\u003c/a> are likely to be identified and that widespread transmission could occur, which \"would translate into large numbers of people needing medical care at the same time.\"\u003c/p>\n\u003cp>\"I think what’s a little tricky now is it’s just not at all clear whether it’s going to be medium bad or quite terrible,\" said Dr. Robert Wachter, chair of the UCSF Department of Medicine. \"We don’t want to panic anyone and we don’t want to overreact, but we feel that under-reacting could be the greater sin.\"\u003c/p>\n\u003cp>On Wednesday, the World Health Organization (WHO) said that the COVID-19 viral disease is now officially considered a \u003ca href=\"https://www.kqed.org/science/1958628/coronavirus-covid-19-is-now-officially-a-pandemic-who-says\">pandemic\u003c/a>. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch3>Zuckerberg San Francisco General Hospital\u003c/h3>\n\u003cp>At Zuckerberg San Francisco General Hospital (SFGH), officials said they're working to ensure that patients are routed to the right part of the hospital.\u003c/p>\n\u003cp>\"It's critically important that people aren't in the emergency department unless they absolutely need to be there,\" said SFGH CEO Susan Ehrlich. \"We have other resources for them on campus, including an urgent care clinic and a number of different primary care clinics and specialty clinics.\"\u003c/p>\n\u003cp>They're also canceling non-urgent medical appointments and conducting many appointments and evaluations over the phone.\u003c/p>\n\u003cp>Additionally, because California has declared a state of emergency over the coronavirus outbreak, Ehrlich said that the state Department of Public Health is now allowing the hospital more discretion over how the building can be used to better meet patient needs.\u003c/p>\n\u003cp>\"Each space in the hospital is licensed for a very particular use — for example, labor and delivery, medical surgical floors or critical care floors,\" Ehrlich explained. \"We have to use those spaces in those ways unless we have this special dispensation from the state to use them in different ways.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch3>Stanford Health Care\u003c/h3>\n\u003cp>At Stanford Health Care systems, which are located in Santa Clara County — where most of the Bay Area's confirmed cases of COVID-19 have been located — staff have confined those patients to particular sections at each hospital.\u003c/p>\n\u003cp>Dr. Yvonne Maldonado, a professor of pediatrics and an infectious disease epidemiologist at Stanford University School of Medicine, said that selecting one particular location in each hospital for these patients has logistical advantages.\u003c/p>\n\u003cp>\"You can have one team that's going to clean those areas. One team is going to take care of those patients,\" she said.\u003c/p>\n\u003cp>Stanford hospitals' staff is currently conducting daily morning meetings, virtually or in-person, and having subcommittee meetings throughout the day to ensure that all their facilities are adequately staffed and have enough equipment.\u003c/p>\n\u003cp>Maldonado said they've also taken to locking away some of their protective gear, including N95 face masks, after some started going missing.\u003c/p>\n\u003cp>Maldonado said that people did not initially understand that N95 masks are not required for every patient, but only for a specific set of patients. \u003c/p>\n\u003cp>\"We're doing a lot of training about what kinds of isolation equipment should be used for what kinds of patients and restricting the use to just those patients,\" Maldonado said.\u003c/p>\n\u003cp>As for seeing patients through remote video connections or over the phone, Maldonado said Stanford had already been using some telemedicine before the outbreak and are working on building out those systems.\u003c/p>\n\u003cp>\"Obviously, you need to make sure that the facilities are sufficient on both ends,\" said Maldonado, referring as well to the ability of providers to work remotely. \"Some people may not need to come in, and can see patients from off-site as well. But, again, that all needs to be set up so it's compliant with all of our hospital and regulatory requirements.\"\u003c/p>\n\u003cfigure id=\"attachment_11806325\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-11806325\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/03/Image_from_iOS-4_1920x.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2020/03/Image_from_iOS-4_1920x.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2020/03/Image_from_iOS-4_1920x-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2020/03/Image_from_iOS-4_1920x-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2020/03/Image_from_iOS-4_1920x-1020x680.jpg 1020w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">UCSF has set up a tent outside one of their main hospitals to triage patients with respiratory illness. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>UCSF\u003c/h3>\n\u003cp>While there haven't been as many confirmed cases of COVID-19 in San Francisco County as in places like Santa Clara County, officials at UCSF are also working on getting ready for the potential influx.\u003c/p>\n\u003cp>\"We have a hotline that patients are calling in on and we are trying to get the patients in who need to get in, but also giving information, advice to those who don't,\" said UCSF's Dr. Wachter. \"We're also markedly ramping up our telemedicine capabilities.\"\u003c/p>\n\u003cp>UCSF has set up a tent outside one of their main hospitals to triage patients with respiratory illness. Wachter said that under a worst-case scenario, they could limit staff vacation time and delay elective surgeries.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Starting this year, routine pediatric visits for millions of California children could involve questions about touchy family topics, such as divorce, unstable housing or a parent who struggles with alcoholism.\u003c/p>\n\u003cp>California now will pay doctors to screen patients for traumatic events known as adverse childhood experiences, or ACEs, if the patient is covered by Medi-Cal.\u003c/p>\n\u003cp>The screening program is rooted in \u003ca href=\"https://californiahealthline.org/news/california-looks-to-lead-nation-aces-screening-childhood-trauma/\" target=\"_blank\" rel=\"noopener noreferrer\">decades of research\u003c/a> that suggests children who endure sustained stress in their day-to-day lives undergo biochemical changes to their brains and bodies that can dramatically increase their risk of developing serious health problems, including heart disease, asthma, depression and cancer.\u003c/p>\n\u003cp>Health and welfare advocates hope that widespread screening of children for ACEs, accompanied by early intervention, will help reduce the ongoing stresses and skirt the onset of physical illness, or at least ensure an illness is treated.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Dr. Dayna Long, a pediatrician at UCSF\"]‘We’re not going to make all the hard things go away, but we can help families build resilience and reduce stress.’[/pullquote]\u003c/p>\n\u003cp>The higher the number of such adverse events — and so, the higher a child’s ACEs “score” — the higher the risk of chronic illness and premature death. About 63% of Californians have experienced at least one adverse childhood event, and nearly 18% have faced four or more, according to state health officials.\u003c/p>\n\u003cp>California is the first state to create a formal reimbursement strategy for ACEs screening, and the program will be open to both children and adults enrolled in Medi-Cal. The initiative is part of a larger \u003ca href=\"https://www.dhcs.ca.gov/Documents/ACEs-AWARE-INITIATIVE.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">ACEs awareness campaign\u003c/a> championed by the state’s first surgeon general, \u003ca href=\"https://www.ted.com/talks/nadine_burke_harris_how_childhood_trauma_affects_health_across_a_lifetime/discussion?CMP\" target=\"_blank\" rel=\"noopener noreferrer\">Dr. Nadine Burke Harris\u003c/a>, who is a national leader in the ACEs movement.\u003c/p>\n\u003cp>The public health impact could be significant as Medi-Cal covers 5.3 million kids — roughly 40% of all California children — and 6.3 million adults.\u003c/p>\n\u003cp>“It is a profound shift that’s going to change the type of prevention and management we do with families,” said Dr. Dayna Long, a pediatrician who is director of the Center for Child and Community Health at UCSF Benioff Children’s Hospital Oakland and helped develop the state-approved screening tool for children and teens. “We’re not going to make all the hard things go away, but we can help families build resilience and reduce stress.”\u003c/p>\n\u003cp>Here are five key things to know about ACEs and the state’s new screening program:\u003c/p>\n\u003ch4>1. How it Works\u003c/h4>\n\u003cp>At a typical well-child visit, parents or caregivers will be asked to fill out a state-approved \u003ca href=\"https://www.acesaware.org/wp-content/uploads/2019/12/PEARLS-Tool-Child-Parent-Caregiver-Report-De-Identified-English.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">questionnaire\u003c/a> about potentially stressful experiences in their children’s lives. For children under age 12, caregivers fill out the survey. Young people ages 12-19 will complete their own questionnaire in addition to their caregivers’ questionnaire.\u003c/p>\n\u003cp>The questions will touch on 10 categories of adversity spanning the first 18 years of life: physical, emotional or sexual abuse; physical or emotional neglect; and experiences that could indicate household dysfunction, such as a parent who has a serious mental illness or addiction, having parents who are incarcerated or living in a home with domestic violence.\u003c/p>\n\u003cp>[aside postID=mindshift_54373 label='Does every moment matter?' hero=\"https://cdn.kqed.org/wp-content/uploads/sites/23/2019/09/happy-childhood-photos-de61f9ac60f2b9d24a1196c86e0d47be30eebaea-1020x765.jpg\"]The screening will measure for experiences that could regularly trigger fear and anxiety, including homelessness, not having enough food or the right kinds of food, and growing up in a neighborhood marred by drugs and violence.\u003c/p>\n\u003cp>Dr. Long acknowledged some caregivers and children might be reluctant or unwilling to disclose sensitive information, particularly if they fear shame or repercussions. “We acknowledge it takes time to build trust,” she said. “But we want to encourage families to have hard conversations with their doctors and to understand how stressful events over the life of the child are impacting that child’s health.”\u003c/p>\n\u003cp>Physicians will review the responses and discuss them with caregivers during the visit. Doctors will have access to free online training on how to communicate with families and connect them to community resources. Physicians will be eligible for a $29 reimbursement for each Medi-Cal patient screened.\u003c/p>\n\u003cp>The responses are considered confidential patient information and won’t be shared with state officials. But researchers hope that aggregated information will be studied to improve care for patients with high ACEs scores.\u003c/p>\n\u003ch4>2. Screenings Are Voluntary\u003c/h4>\n\u003cp>Doctors do not need to offer them, and patients and their caregivers do not have to participate. Doctors will need to complete online training before they can be paid for screening patients. The state will cover the costs of screening once a year for children and once in a lifetime for adults. But children are the main focus of the screening campaign.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003ch4>3. What Happens After the Screening Is Less Clear\u003c/h4>\n\u003cp>Community clinics often have social workers or “navigators” available to connect families to aid like food stamps or counseling. Doctors in private practice, however, are less likely to have those resources, said Dr. Eric Ball, an Orange County pediatrician who served on a committee advising the surgeon general on the ACEs campaign. Ball said local chapters of the American Academy of Pediatrics will work to educate doctors on how to help children who register high ACEs scores, because social services vary so much by county.\u003c/p>\n\u003cp>Doctors “are not going to get rich doing ACEs screenings, that’s not the point,” Ball said. “If we can pick up kids at higher risk for these issues down the road and mitigate it, that’s really exciting to me.”\u003c/p>\n\u003ch4>4. Researchers Aren’t Yet Sure Which Interventions Will Best Help Kids With High ACEs Scores\u003c/h4>\n\u003cp>Long and her UCSF Benioff colleagues are \u003ca href=\"https://clinicaltrials.ucsf.edu/trial/NCT04182906\" target=\"_blank\" rel=\"noopener noreferrer\">continuing to study\u003c/a> how well the ACEs screening works and what interventions might be most effective. It’s one thing to help hungry families sign up for food stamps and free school lunches. It’s less clear how to help a child whose parent is in prison. Researchers have identified protective factors that can help children better resist the effects of toxic stress, including nurturing relationships with trusted adults, such as grandparents or teachers.\u003c/p>\n\u003cp>“The fact of screening is also an intervention,” Long said. “Being able to sit in a room with a pediatrician is not going to make those hard experiences go away, but it creates a freedom to talk about some things that are solvable. That’s therapeutic in and of itself.”\u003c/p>\n\u003ch4>5. Not Everyone Agrees That Widespread ACEs Screening Is a Good Idea\u003c/h4>\n\u003cp>Sociologist David Finkelhor, director of the Crimes against Children Research Center at the University of New Hampshire, is among those who caution that universal screening for ACEs is premature, given there is little consensus about the potential negative effects of screening or the best interventions.\u003c/p>\n\u003cp>[aside postID=\"science_1938819,news_11724781,futureofyou_439851\" label=\"Related Coverage\"]“The good news is that we are focusing on these adversities that are clearly the source of so many downstream health and mental health problems,” Finkelhor said. “But the bad news is we’re moving way too fast, before we know how to best conduct this kind of screening and intervention, and we could get it wrong with pretty disastrous consequences.”\u003c/p>\n\u003cp>“Mostly, we don’t know what to do with somebody who has a high ACE score,” he said. “There are already long waits to get into family counseling or child mental health programs.”\u003c/p>\n\u003cp>For example, a doctor might be legally required to report previous abuse to authorities, upending a family even if the child no longer is exposed to the abuser, Finkelhor said.\u003c/p>\n\u003cp>“These are tough questions,” Long of UCSF acknowledged. Still, she said, screening is important, because it encourages physicians to engage in difficult conversations they might not otherwise have and pushes clinics to create links to supportive services and resources.\u003c/p>\n\u003cp>“That is the next phase, and that is important,” Long said. “We’re doing this because we care about your child and want them to grow into healthy adults.”\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://khn.org/\" target=\"_blank\" rel=\"noopener noreferrer\">KHN\u003c/a> story first published on \u003ca href=\"http://www.californiahealthline.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Healthline\u003c/a>, a service of the \u003ca href=\"http://www.chcf.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Health Care Foundation\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://www.kaiserhealthnews.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Kaiser Health News\u003c/a> (KHN) is a national health policy news service. It is an editorially independent program of the \u003ca href=\"http://www.kff.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Henry J. Kaiser Family Foundation\u003c/a> which is not affiliated with Kaiser Permanente.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Starting this year, routine pediatric visits for millions of California children could involve questions about touchy family topics, such as divorce, unstable housing or a parent who struggles with alcoholism.\u003c/p>\n\u003cp>California now will pay doctors to screen patients for traumatic events known as adverse childhood experiences, or ACEs, if the patient is covered by Medi-Cal.\u003c/p>\n\u003cp>The screening program is rooted in \u003ca href=\"https://californiahealthline.org/news/california-looks-to-lead-nation-aces-screening-childhood-trauma/\" target=\"_blank\" rel=\"noopener noreferrer\">decades of research\u003c/a> that suggests children who endure sustained stress in their day-to-day lives undergo biochemical changes to their brains and bodies that can dramatically increase their risk of developing serious health problems, including heart disease, asthma, depression and cancer.\u003c/p>\n\u003cp>Health and welfare advocates hope that widespread screening of children for ACEs, accompanied by early intervention, will help reduce the ongoing stresses and skirt the onset of physical illness, or at least ensure an illness is treated.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The higher the number of such adverse events — and so, the higher a child’s ACEs “score” — the higher the risk of chronic illness and premature death. About 63% of Californians have experienced at least one adverse childhood event, and nearly 18% have faced four or more, according to state health officials.\u003c/p>\n\u003cp>California is the first state to create a formal reimbursement strategy for ACEs screening, and the program will be open to both children and adults enrolled in Medi-Cal. The initiative is part of a larger \u003ca href=\"https://www.dhcs.ca.gov/Documents/ACEs-AWARE-INITIATIVE.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">ACEs awareness campaign\u003c/a> championed by the state’s first surgeon general, \u003ca href=\"https://www.ted.com/talks/nadine_burke_harris_how_childhood_trauma_affects_health_across_a_lifetime/discussion?CMP\" target=\"_blank\" rel=\"noopener noreferrer\">Dr. Nadine Burke Harris\u003c/a>, who is a national leader in the ACEs movement.\u003c/p>\n\u003cp>The public health impact could be significant as Medi-Cal covers 5.3 million kids — roughly 40% of all California children — and 6.3 million adults.\u003c/p>\n\u003cp>“It is a profound shift that’s going to change the type of prevention and management we do with families,” said Dr. Dayna Long, a pediatrician who is director of the Center for Child and Community Health at UCSF Benioff Children’s Hospital Oakland and helped develop the state-approved screening tool for children and teens. “We’re not going to make all the hard things go away, but we can help families build resilience and reduce stress.”\u003c/p>\n\u003cp>Here are five key things to know about ACEs and the state’s new screening program:\u003c/p>\n\u003ch4>1. How it Works\u003c/h4>\n\u003cp>At a typical well-child visit, parents or caregivers will be asked to fill out a state-approved \u003ca href=\"https://www.acesaware.org/wp-content/uploads/2019/12/PEARLS-Tool-Child-Parent-Caregiver-Report-De-Identified-English.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">questionnaire\u003c/a> about potentially stressful experiences in their children’s lives. For children under age 12, caregivers fill out the survey. Young people ages 12-19 will complete their own questionnaire in addition to their caregivers’ questionnaire.\u003c/p>\n\u003cp>The questions will touch on 10 categories of adversity spanning the first 18 years of life: physical, emotional or sexual abuse; physical or emotional neglect; and experiences that could indicate household dysfunction, such as a parent who has a serious mental illness or addiction, having parents who are incarcerated or living in a home with domestic violence.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The screening will measure for experiences that could regularly trigger fear and anxiety, including homelessness, not having enough food or the right kinds of food, and growing up in a neighborhood marred by drugs and violence.\u003c/p>\n\u003cp>Dr. Long acknowledged some caregivers and children might be reluctant or unwilling to disclose sensitive information, particularly if they fear shame or repercussions. “We acknowledge it takes time to build trust,” she said. “But we want to encourage families to have hard conversations with their doctors and to understand how stressful events over the life of the child are impacting that child’s health.”\u003c/p>\n\u003cp>Physicians will review the responses and discuss them with caregivers during the visit. Doctors will have access to free online training on how to communicate with families and connect them to community resources. Physicians will be eligible for a $29 reimbursement for each Medi-Cal patient screened.\u003c/p>\n\u003cp>The responses are considered confidential patient information and won’t be shared with state officials. But researchers hope that aggregated information will be studied to improve care for patients with high ACEs scores.\u003c/p>\n\u003ch4>2. Screenings Are Voluntary\u003c/h4>\n\u003cp>Doctors do not need to offer them, and patients and their caregivers do not have to participate. Doctors will need to complete online training before they can be paid for screening patients. The state will cover the costs of screening once a year for children and once in a lifetime for adults. But children are the main focus of the screening campaign.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch4>3. What Happens After the Screening Is Less Clear\u003c/h4>\n\u003cp>Community clinics often have social workers or “navigators” available to connect families to aid like food stamps or counseling. Doctors in private practice, however, are less likely to have those resources, said Dr. Eric Ball, an Orange County pediatrician who served on a committee advising the surgeon general on the ACEs campaign. Ball said local chapters of the American Academy of Pediatrics will work to educate doctors on how to help children who register high ACEs scores, because social services vary so much by county.\u003c/p>\n\u003cp>Doctors “are not going to get rich doing ACEs screenings, that’s not the point,” Ball said. “If we can pick up kids at higher risk for these issues down the road and mitigate it, that’s really exciting to me.”\u003c/p>\n\u003ch4>4. Researchers Aren’t Yet Sure Which Interventions Will Best Help Kids With High ACEs Scores\u003c/h4>\n\u003cp>Long and her UCSF Benioff colleagues are \u003ca href=\"https://clinicaltrials.ucsf.edu/trial/NCT04182906\" target=\"_blank\" rel=\"noopener noreferrer\">continuing to study\u003c/a> how well the ACEs screening works and what interventions might be most effective. It’s one thing to help hungry families sign up for food stamps and free school lunches. It’s less clear how to help a child whose parent is in prison. Researchers have identified protective factors that can help children better resist the effects of toxic stress, including nurturing relationships with trusted adults, such as grandparents or teachers.\u003c/p>\n\u003cp>“The fact of screening is also an intervention,” Long said. “Being able to sit in a room with a pediatrician is not going to make those hard experiences go away, but it creates a freedom to talk about some things that are solvable. That’s therapeutic in and of itself.”\u003c/p>\n\u003ch4>5. Not Everyone Agrees That Widespread ACEs Screening Is a Good Idea\u003c/h4>\n\u003cp>Sociologist David Finkelhor, director of the Crimes against Children Research Center at the University of New Hampshire, is among those who caution that universal screening for ACEs is premature, given there is little consensus about the potential negative effects of screening or the best interventions.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“The good news is that we are focusing on these adversities that are clearly the source of so many downstream health and mental health problems,” Finkelhor said. “But the bad news is we’re moving way too fast, before we know how to best conduct this kind of screening and intervention, and we could get it wrong with pretty disastrous consequences.”\u003c/p>\n\u003cp>“Mostly, we don’t know what to do with somebody who has a high ACE score,” he said. “There are already long waits to get into family counseling or child mental health programs.”\u003c/p>\n\u003cp>For example, a doctor might be legally required to report previous abuse to authorities, upending a family even if the child no longer is exposed to the abuser, Finkelhor said.\u003c/p>\n\u003cp>“These are tough questions,” Long of UCSF acknowledged. Still, she said, screening is important, because it encourages physicians to engage in difficult conversations they might not otherwise have and pushes clinics to create links to supportive services and resources.\u003c/p>\n\u003cp>“That is the next phase, and that is important,” Long said. “We’re doing this because we care about your child and want them to grow into healthy adults.”\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://khn.org/\" target=\"_blank\" rel=\"noopener noreferrer\">KHN\u003c/a> story first published on \u003ca href=\"http://www.californiahealthline.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Healthline\u003c/a>, a service of the \u003ca href=\"http://www.chcf.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Health Care Foundation\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://www.kaiserhealthnews.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Kaiser Health News\u003c/a> (KHN) is a national health policy news service. It is an editorially independent program of the \u003ca href=\"http://www.kff.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Henry J. Kaiser Family Foundation\u003c/a> which is not affiliated with Kaiser Permanente.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>A 2015 \u003ca href=\"https://www.kqed.org/stateofhealth/222927/californias-new-vaccine-law-expected-to-send-disease-rates-plummeting\" target=\"_blank\" rel=\"noopener noreferrer\">California law\u003c/a> that eliminated personal belief exemptions for childhood vaccines appears to be working, according to new research out Monday, which found a hike in vaccination rates among children statewide.\u003c/p>\n\u003cp>The UC San Francisco \u003ca href=\"https://www.ucsf.edu/news/2019/12/416271/barring-nonmedical-exemptions-increases-vaccination-rates-study-finds\" target=\"_blank\" rel=\"noopener noreferrer\">study,\u003c/a> published in the journal “PLOS Medicine,” concluded that the state’s stricter immunization requirements have resulted in more kids getting vaccinated.\u003c/p>\n\u003cp>Researchers estimated the number of children in California who would have received the vaccine for measles, mumps and rubella (MMR) without the law, and compared that to the number vaccinated after the legislation — \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" target=\"_blank\" rel=\"noopener noreferrer\">SB 277\u003c/a> — went into effect.\u003c/p>\n\u003cp>[aside tag=\"vaccines\" label=\"Related coverage\"]The \u003ca href=\"https://www.latimes.com/science/sciencenow/la-sci-sn-vaccine-medical-exemptions-20181029-story.html\" target=\"_blank\" rel=\"noopener noreferrer\">law requires\u003c/a> every child taught in school classrooms or enrolled in a child care facility — with the exemption of students who receive medical exemptions from doctors — to be fully immunized against 10 communicable diseases: diphtheria, hepatitis B, haemophilus influenzae Type B, measles, mumps, pertussis (whooping cough), poliomyelitis, rubella, tetanus and varicella (chickenpox).\u003c/p>\n\u003cp>Researchers also compared California’s vaccination rates with those of other states that still have personal belief exemptions, factoring in demographic variations.\u003c/p>\n\u003cp>Vaccination rates went up across California, particularly in counties like Sonoma and Santa Cruz, where rates have lingered below the statewide average. the report found. Non-medical exemptions decreased statewide by 2.4%, while medical exemptions increased 0.4%.\u003c/p>\n\u003cp>“When we look at those high-risk counties, we see the largest increases in vaccine coverage. 10-plus percent jumps in those areas,” said UCSF public health researcher Dr. Nathan Lo.\u003c/p>\n\u003cp>These changes brought the vaccination rate to 95% in almost all California counties, enough to provide “herd” immunity, or rates high enough that a contagious disease is less likely to spread.\u003c/p>\n\u003cp>It also means that a significant number of parents who previously received non-medical exemptions ended up complying with the law.\u003c/p>\n\u003cp>“So that nudge is enough to push the majority of these children to get properly vaccinated,” Lo said, adding that other states and countries would be wise to follow California’s lead.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cp>Hank Nguyen is an IT employee at UC San Francisco. Until recently, his daughter wanted to follow in his footsteps and work in information technology. She was accepted at UC Santa Cruz and planned to study computer science.\u003c/p>\n\u003cp>Then, last July, the letters arrived. The first was the tuition bill from Santa Cruz. The second was a layoff notice from UCSF.\u003c/p>\n\u003cp>UCSF has a total of 565 full-time workers focused on core IT services. The research institute and hospital is cutting some 97 IT jobs –– including 49 full-time workers, 30 contractors and 18 unfilled positions. Those jobs are scheduled to end in February. The work is being outsourced to HCL, a multinational information technology firm headquartered in India. This is one of the two firms \u003ca href=\"http://www.nytimes.com/2016/10/14/us/judge-says-disney-didnt-violate-visa-laws-in-layoffs.html?_r=0\" target=\"_blank\" rel=\"noopener noreferrer\">Disney took heat over for partnering with last year\u003c/a> when it outsourced 250 IT jobs.\u003c/p>\n\u003cp>[soundcloud url=”https://api.soundcloud.com/tracks/297913715″ params=”color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false” width=”100%” height=”166″ iframe=”true” /]\u003c/p>\n\u003cp>This is just one example of the kind of globalization and job losses President-elect Donald Trump talked about while campaigning.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Nguyen cannot believe that this is happening to him, a worker in the tech industry. But it is. He and other IT workers at UCSF are now training their replacements, workers from HCL. “I’m speechless,” he says. “How can they do this to us?”\u003c/p>\n\u003caside class=\"pullquote alignright\">‘I’m speechless. How can they do this to us?’ \u003ccite>Hank Nguyen, laid-off IT Worker\u003c/cite>\u003c/aside>\n\u003cp>Nguyen worries he won’t have money to pay for his daughter’s education. She worries her expensive degree won’t lead to a stable career in IT. “I’m unsure about everything now,” Nguyen says. “She’s unsure as well.”\u003c/p>\n\u003cp>Originally from Vietnam, Nguyen says he escaped to America in 1981 and he restarted his life here from scratch. He taught himself about computers so he could get a job in the tech world. He thought it was the surest way for him to have a stable, middle-class life.\u003c/p>\n\u003cfigure id=\"attachment_11219856\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11219856 size-medium\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2016/12/IMG_0925-e1481741203582-800x600.jpg\" alt=\"Hank Nguyen is losing his job because UCSF is working with an outside contractor.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2016/12/IMG_0925-e1481741203582-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2016/12/IMG_0925-e1481741203582-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2016/12/IMG_0925-e1481741203582-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2016/12/IMG_0925-e1481741203582-1920x1440.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2016/12/IMG_0925-e1481741203582-1180x885.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2016/12/IMG_0925-e1481741203582-960x720.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2016/12/IMG_0925-e1481741203582-240x180.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2016/12/IMG_0925-e1481741203582-375x281.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2016/12/IMG_0925-e1481741203582-520x390.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Hank Nguyen is losing his job because UCSF is working with an outside contractor. \u003ccite>(Sam Harnett/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Nguyen thought he had job security. He works with servers, the computers that run company software and handle data. It’s part of a range of back-end IT work that keeps our modern computer-driven world running. But now, much of this IT infrastructure has been shipped overseas, says Ron Hira, a professor of public policy at Howard University.\u003c/p>\n\u003cp>“It’s a silent destruction of really important innovation, high-wage, really the knowledge-based economy jobs that we’re supposed to be moving into,” Hira says.\u003c/p>\n\u003cp>He says what’s really scary is that we don’t know how many IT jobs America has lost. The government doesn’t keep track of it, he says. Hira has studied IT offshoring for over a decade, and he has been gathering numbers to try to get a picture of this job loss.\u003c/p>\n\u003cp>By looking at IT employment abroad in countries like India, and the numbers of workers American companies like IBM now employ overseas, Hira has come up with a rough estimate. He thinks as many as 1.5 million foreign workers could now be doing IT jobs for American companies.\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘It’s huge in scale and scope, and it has long-term ramifications’ \u003ccite>Ron Hira, Howard University public policy professor \u003c/cite>\u003c/aside>\n\u003cp>“It’s huge in scale and scope, and it has long-term ramifications in terms of innovation, but also in terms of spillover jobs and career ladders for folks,” Hira says.\u003c/p>\n\u003cp>Changes in technology like cloud computing have contributed to IT job loss, but Hira says outsourcing has greatly accelerated the trend. And he says the main tool paving the way for outsourcing is the H-1B visa. Hira \u003ca href=\"http://www.epi.org/publication/congressional-testimony-the-impact-of-high-skilled-immigration-on-u-s-workers-4/\" target=\"_blank\" rel=\"noopener noreferrer\">gave this testimony\u003c/a> in front of Congress about how the H-1B visa is used to outsource jobs and undercut U.S. workers. HCL is mentioned as a company that depends on the H-1B visa for business operations in the U.S.\u003c/p>\n\u003cp>Controversy over this visa has been escalating in recent years. There have been numerous bipartisan attempts in Congress to \u003ca href=\"http://www.computerworld.com/article/3094126/it-careers/after-12-years-seeking-h-1b-reform-rep-pascrell-tries-again.html\" target=\"_blank\" rel=\"noopener noreferrer\">reform the visa\u003c/a>. They have all failed. Complaints about the visa range from the offshoring of U.S. jobs to how it can be used to drive down wages and create situations where \u003ca href=\"http://www.pri.org/stories/2013-03-07/h-1b-visas-leave-immigrant-workers-disadvantage-while-some-critics-fume\" target=\"_blank\" rel=\"noopener noreferrer\">companies can abuse H-1B workers\u003c/a>. Companies like Southern California Edison have been criticized for effectively replacing U.S. workers with H-1B workers. The move led to a federal investigation, \u003ca href=\"http://www.scpr.org/news/2015/10/22/55178/feds-conclude-investigation-into-firm-that-provide/\" target=\"_blank\" rel=\"noopener noreferrer\">which did not end\u003c/a> in the workers’ favor.\u003c/p>\n\u003cp>This visa cropped up in the presidential race after Disney shipped out 250 of its IT jobs, in part to HCL, the same company UCSF is working with now. Donald Trump at times criticized Disney and the visa. He drew applause at debates by saying the H-1B program should be dismantled, and he championed a laid-off IT worker at Disney who endorsed him. But it is hard to say what he will do in office, since he flip-flopped on the issue several times when pressed about actual policy decisions.\u003c/p>\n\u003cp>[jwplayer mediaid=”11219854″]\u003c/p>\n\u003cp>Here is the back story on the H-1B. The visa is supposed to allow companies to hire the highest-skilled foreign talent. But in reality, outsourcing companies like HCL scoop up the most H-1B visas for lower-level IT workers. These H-1B workers are sent into U.S. companies to see how their IT systems operate, and then they work with large teams abroad, mostly in India, where labor is cheap.\u003c/p>\n\u003cp>At UCSF, eight of the 27 workers in the transition team that HCL sent in to learn the ropes at the school were on H-1B visas, according to UCSF’s Vice Chancellor of University Relations Barbara French. While the transition team had H-1B workers, French says UCSF has a policy not to replace any of the employees losing their jobs with workers on H-1Bs. But now that the transition team has learned the IT needs at UCSF, much of the work can be done offsite and potentially offshore where labor is cheaper. French says HCL will have only 20 workers on the ground at UCSF.\u003c/p>\n\u003cp>Cutting costs is why UCSF is partnering with HCL, French says.\u003c/p>\n\u003cp>“We can save $30 million over five years by outsourcing,” French said. She also anticipates that as IT needs grow in coming years, working with HCL could help save more money.\u003c/p>\n\u003cp>French says UCSF came up with the outsourcing plan after seeing that the competition had already done a similar thing. French says this decision was not taken lightly and that the school held a job fair to find new IT positions within the UC system for employees being laid off.\u003c/p>\n\u003cp>Many hospitals have already outsourced parts of their IT infrastructure to cut costs, and other universities are starting to look into doing the same. Meanwhile, UCSF is facing rising health costs and cuts in state funding. “We’re feeling the squeeze,” French says.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘We’re feeling the squeeze’ \u003ccite>Barbara French, UCSF spokeswoman \u003c/cite>\u003c/aside>\n\u003cp>French says UCSF provides around $130 million in charity care for the poor. She says to continue that kind of service, UCSF has to focus only on its core IT services, things like data analysis for researchers, cybersecurity and organizing electronic health records. French says while it is laying off some IT workers by outsourcing to HCL, the university continues to hire new IT workers to do more specialized work.\u003c/p>\n\u003cp>“Taking care of patient care IT issues, taking care of research IT issues, that belongs to us,” French says. “We need to be on top of it and grow it.”\u003c/p>\n\u003cp>The contract with HCL would allow all 10 UC campuses to similarly outsource portions of their IT work. Other schools are not yet making moves to do that, but IT workers at UCSF think this is the beginning of a trend that could spread throughout UC.\u003c/p>\n\u003cp>IT worker Hank Nguyen says it doesn’t make any sense that a state university system training the STEM workers of tomorrow would lay off the STEM workers of today. He says his work was once considered core and specialized, but it is now being outsourced. He worries the same will soon happen to the new IT workers UCSF is now hiring.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Nancy Pelosi and state lawmakers are \u003ca href=\"http://www.computerworld.com/article/3144449/it-outsourcing/pelosi-says-uc-it-workers-are-in-untenable-position.html\" target=\"_blank\" rel=\"noopener noreferrer\">calling on UC President Janet Napolitano\u003c/a> to halt the layoffs at UCSF, but there’s no indication she will do that. If she doesn’t, the IT workers will lose their jobs at the end of February.\u003c/p>\n\n",
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"title": "UCSF Lays Off Tech Workers, Stepping Into Jobs Outsourcing Controversy | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Hank Nguyen is an IT employee at UC San Francisco. Until recently, his daughter wanted to follow in his footsteps and work in information technology. She was accepted at UC Santa Cruz and planned to study computer science.\u003c/p>\n\u003cp>Then, last July, the letters arrived. The first was the tuition bill from Santa Cruz. The second was a layoff notice from UCSF.\u003c/p>\n\u003cp>UCSF has a total of 565 full-time workers focused on core IT services. The research institute and hospital is cutting some 97 IT jobs –– including 49 full-time workers, 30 contractors and 18 unfilled positions. Those jobs are scheduled to end in February. The work is being outsourced to HCL, a multinational information technology firm headquartered in India. This is one of the two firms \u003ca href=\"http://www.nytimes.com/2016/10/14/us/judge-says-disney-didnt-violate-visa-laws-in-layoffs.html?_r=0\" target=\"_blank\" rel=\"noopener noreferrer\">Disney took heat over for partnering with last year\u003c/a> when it outsourced 250 IT jobs.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='”100%”' height='”166″'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=”https://api.soundcloud.com/tracks/297913715″&visual=true&”color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false”'\n title='”https://api.soundcloud.com/tracks/297913715″'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>This is just one example of the kind of globalization and job losses President-elect Donald Trump talked about while campaigning.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Nguyen cannot believe that this is happening to him, a worker in the tech industry. But it is. He and other IT workers at UCSF are now training their replacements, workers from HCL. “I’m speechless,” he says. “How can they do this to us?”\u003c/p>\n\u003caside class=\"pullquote alignright\">‘I’m speechless. How can they do this to us?’ \u003ccite>Hank Nguyen, laid-off IT Worker\u003c/cite>\u003c/aside>\n\u003cp>Nguyen worries he won’t have money to pay for his daughter’s education. She worries her expensive degree won’t lead to a stable career in IT. “I’m unsure about everything now,” Nguyen says. “She’s unsure as well.”\u003c/p>\n\u003cp>Originally from Vietnam, Nguyen says he escaped to America in 1981 and he restarted his life here from scratch. He taught himself about computers so he could get a job in the tech world. He thought it was the surest way for him to have a stable, middle-class life.\u003c/p>\n\u003cfigure id=\"attachment_11219856\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11219856 size-medium\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2016/12/IMG_0925-e1481741203582-800x600.jpg\" alt=\"Hank Nguyen is losing his job because UCSF is working with an outside contractor.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2016/12/IMG_0925-e1481741203582-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2016/12/IMG_0925-e1481741203582-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2016/12/IMG_0925-e1481741203582-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2016/12/IMG_0925-e1481741203582-1920x1440.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2016/12/IMG_0925-e1481741203582-1180x885.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2016/12/IMG_0925-e1481741203582-960x720.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2016/12/IMG_0925-e1481741203582-240x180.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2016/12/IMG_0925-e1481741203582-375x281.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2016/12/IMG_0925-e1481741203582-520x390.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Hank Nguyen is losing his job because UCSF is working with an outside contractor. \u003ccite>(Sam Harnett/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Nguyen thought he had job security. He works with servers, the computers that run company software and handle data. It’s part of a range of back-end IT work that keeps our modern computer-driven world running. But now, much of this IT infrastructure has been shipped overseas, says Ron Hira, a professor of public policy at Howard University.\u003c/p>\n\u003cp>“It’s a silent destruction of really important innovation, high-wage, really the knowledge-based economy jobs that we’re supposed to be moving into,” Hira says.\u003c/p>\n\u003cp>He says what’s really scary is that we don’t know how many IT jobs America has lost. The government doesn’t keep track of it, he says. Hira has studied IT offshoring for over a decade, and he has been gathering numbers to try to get a picture of this job loss.\u003c/p>\n\u003cp>By looking at IT employment abroad in countries like India, and the numbers of workers American companies like IBM now employ overseas, Hira has come up with a rough estimate. He thinks as many as 1.5 million foreign workers could now be doing IT jobs for American companies.\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘It’s huge in scale and scope, and it has long-term ramifications’ \u003ccite>Ron Hira, Howard University public policy professor \u003c/cite>\u003c/aside>\n\u003cp>“It’s huge in scale and scope, and it has long-term ramifications in terms of innovation, but also in terms of spillover jobs and career ladders for folks,” Hira says.\u003c/p>\n\u003cp>Changes in technology like cloud computing have contributed to IT job loss, but Hira says outsourcing has greatly accelerated the trend. And he says the main tool paving the way for outsourcing is the H-1B visa. Hira \u003ca href=\"http://www.epi.org/publication/congressional-testimony-the-impact-of-high-skilled-immigration-on-u-s-workers-4/\" target=\"_blank\" rel=\"noopener noreferrer\">gave this testimony\u003c/a> in front of Congress about how the H-1B visa is used to outsource jobs and undercut U.S. workers. HCL is mentioned as a company that depends on the H-1B visa for business operations in the U.S.\u003c/p>\n\u003cp>Controversy over this visa has been escalating in recent years. There have been numerous bipartisan attempts in Congress to \u003ca href=\"http://www.computerworld.com/article/3094126/it-careers/after-12-years-seeking-h-1b-reform-rep-pascrell-tries-again.html\" target=\"_blank\" rel=\"noopener noreferrer\">reform the visa\u003c/a>. They have all failed. Complaints about the visa range from the offshoring of U.S. jobs to how it can be used to drive down wages and create situations where \u003ca href=\"http://www.pri.org/stories/2013-03-07/h-1b-visas-leave-immigrant-workers-disadvantage-while-some-critics-fume\" target=\"_blank\" rel=\"noopener noreferrer\">companies can abuse H-1B workers\u003c/a>. Companies like Southern California Edison have been criticized for effectively replacing U.S. workers with H-1B workers. The move led to a federal investigation, \u003ca href=\"http://www.scpr.org/news/2015/10/22/55178/feds-conclude-investigation-into-firm-that-provide/\" target=\"_blank\" rel=\"noopener noreferrer\">which did not end\u003c/a> in the workers’ favor.\u003c/p>\n\u003cp>This visa cropped up in the presidential race after Disney shipped out 250 of its IT jobs, in part to HCL, the same company UCSF is working with now. Donald Trump at times criticized Disney and the visa. He drew applause at debates by saying the H-1B program should be dismantled, and he championed a laid-off IT worker at Disney who endorsed him. But it is hard to say what he will do in office, since he flip-flopped on the issue several times when pressed about actual policy decisions.\u003c/p>\n\u003cp>[jwplayer mediaid=”11219854″]\u003c/p>\n\u003cp>Here is the back story on the H-1B. The visa is supposed to allow companies to hire the highest-skilled foreign talent. But in reality, outsourcing companies like HCL scoop up the most H-1B visas for lower-level IT workers. These H-1B workers are sent into U.S. companies to see how their IT systems operate, and then they work with large teams abroad, mostly in India, where labor is cheap.\u003c/p>\n\u003cp>At UCSF, eight of the 27 workers in the transition team that HCL sent in to learn the ropes at the school were on H-1B visas, according to UCSF’s Vice Chancellor of University Relations Barbara French. While the transition team had H-1B workers, French says UCSF has a policy not to replace any of the employees losing their jobs with workers on H-1Bs. But now that the transition team has learned the IT needs at UCSF, much of the work can be done offsite and potentially offshore where labor is cheaper. French says HCL will have only 20 workers on the ground at UCSF.\u003c/p>\n\u003cp>Cutting costs is why UCSF is partnering with HCL, French says.\u003c/p>\n\u003cp>“We can save $30 million over five years by outsourcing,” French said. She also anticipates that as IT needs grow in coming years, working with HCL could help save more money.\u003c/p>\n\u003cp>French says UCSF came up with the outsourcing plan after seeing that the competition had already done a similar thing. French says this decision was not taken lightly and that the school held a job fair to find new IT positions within the UC system for employees being laid off.\u003c/p>\n\u003cp>Many hospitals have already outsourced parts of their IT infrastructure to cut costs, and other universities are starting to look into doing the same. Meanwhile, UCSF is facing rising health costs and cuts in state funding. “We’re feeling the squeeze,” French says.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘We’re feeling the squeeze’ \u003ccite>Barbara French, UCSF spokeswoman \u003c/cite>\u003c/aside>\n\u003cp>French says UCSF provides around $130 million in charity care for the poor. She says to continue that kind of service, UCSF has to focus only on its core IT services, things like data analysis for researchers, cybersecurity and organizing electronic health records. French says while it is laying off some IT workers by outsourcing to HCL, the university continues to hire new IT workers to do more specialized work.\u003c/p>\n\u003cp>“Taking care of patient care IT issues, taking care of research IT issues, that belongs to us,” French says. “We need to be on top of it and grow it.”\u003c/p>\n\u003cp>The contract with HCL would allow all 10 UC campuses to similarly outsource portions of their IT work. Other schools are not yet making moves to do that, but IT workers at UCSF think this is the beginning of a trend that could spread throughout UC.\u003c/p>\n\u003cp>IT worker Hank Nguyen says it doesn’t make any sense that a state university system training the STEM workers of tomorrow would lay off the STEM workers of today. He says his work was once considered core and specialized, but it is now being outsourced. He worries the same will soon happen to the new IT workers UCSF is now hiring.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Nancy Pelosi and state lawmakers are \u003ca href=\"http://www.computerworld.com/article/3144449/it-outsourcing/pelosi-says-uc-it-workers-are-in-untenable-position.html\" target=\"_blank\" rel=\"noopener noreferrer\">calling on UC President Janet Napolitano\u003c/a> to halt the layoffs at UCSF, but there’s no indication she will do that. If she doesn’t, the IT workers will lose their jobs at the end of February.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"tagline": "The flip side of gentrification, told through one town",
"info": "Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?",
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"tagline": "Exploring the Bay Area, one question at a time",
"info": "KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.",
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"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
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"order": 8
},
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},
"link": "https://www.cityarts.net",
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"order": 1
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"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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},
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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},
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"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
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"source": "kqed",
"order": 9
},
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"meta": {
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},
"link": "/radio/program/freakonomics-radio",
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},
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"id": "fresh-air",
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"hidden-brain": {
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"airtime": "SUN 7pm-8pm",
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"source": "NPR"
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"how-i-built-this": {
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"airtime": "SUN 7:30pm-8pm",
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"link": "/radio/program/how-i-built-this",
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"hyphenacion": {
"id": "hyphenacion",
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"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"jerrybrown": {
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"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"order": 18
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},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
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},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"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.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
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"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "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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