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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cb>COVID-19 Hospital and Vaccine Update\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">The surge in coronavirus cases continued its steady rise this week, as California’s ICU capacity dropped to 9%. Meanwhile, approval for a potential COVID-19 vaccine may be only days away. But until the vaccine is widely distributed — months from now — hospitals face a long, dark winter.\u003c/span>\u003c/p>\n\u003cp>\u003cb>Guests:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Dr. Robert Wachter, chair, UCSF Department of Medicine\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Carmela Coyle, president and CEO, California Hospital Association\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Child Care System Stressed by the Pandemic\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">California’s Department of Social Services estimates that nearly 2,500 family child care facilities have closed permanently since the pandemic began. Advocates say the child care system, already fragile before the pandemic, is now in crisis, as many essential workers are scrambling to find reliable — and affordable — care so that they can go to work. \u003c/span>\u003c/p>\n\u003cp>\u003cb>Guests: \u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Loira Limbal, filmmaker, “Through the Night”\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Amie Latterman, chief advancement officer, Children’s Council of San Francisco\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Something Beautiful: Cavallo Point\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">We travel to the north end of the Golden Gate Bridge to visit Cavallo Point, which was named in 1775 for the wild horses that once roamed the region.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Pfizer and Moderna COVID-19 Vaccines 'Breathtakingly Effective,' Says UCSF's Dr. Robert Wachter",
"title": "Pfizer and Moderna COVID-19 Vaccines 'Breathtakingly Effective,' Says UCSF's Dr. Robert Wachter",
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"content": "\u003cp>\u003cstrong>\u003cem>Skip straight to:\u003c/em>\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#effective\">How effective are Pfizer and Moderna's COVID-19 vaccines?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#distribute\">How might they be distributed?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>For the past several weeks, advances with COVID-19 vaccines have offered hope in what has felt like an endless slog through this pandemic.\u003c/p>\n\u003cp>On Nov. 20, Pfizer \u003ca href=\"https://www.cnn.com/2020/11/20/health/pfizer-vaccine-eua-submission/index.html\">applied for emergency use authorization\u003c/a> for its COVID-19 vaccine from the Food and Drug Administration. On Monday, Moderna announced \u003ca href=\"https://www.cnn.com/2020/11/30/health/moderna-vaccine-fda-eua-application/index.html\">it would also be applying for authorization\u003c/a> for its vaccine, which reportedly has a 94.1% efficacy rate. If approved, doses could start rolling out before the end of the year.\u003c/p>\n\u003cp>But with the possibility of a vaccine in the near future coming into clearer focus, questions are being raised how these vaccine doses might be distributed. In California, state officials have made it clear that health care workers will be the first to receive the vaccine. But since the initial rollout will likely be limited, officials will have to \u003ca href=\"https://www.kqed.org/news/11848963/if-there-arent-enough-vaccines-for-all-health-care-workers-in-california-which-doctors-nurses-or-aides-will-get-it-first\">decide which health care workers\u003c/a> will get the vaccine first.\u003c/p>\n\u003cp>What does that mean, then, for the rest of us?\u003c/p>\n\u003cp>KQED Forum host Michael Krasny spoke with Dr. Robert Wachter, chair of the UCSF Department of Medicine, about the vaccine rollout and when the general public should realistically expect a dose.\u003c/p>\n\u003cp>\u003cem>This interview has been edited for length and clarity. \u003ca href=\"https://www.kqed.org/forum/2010101880963/ucsfs-dr-wachter-on-bay-area-vaccine-distribution\">Hear the full interview\u003c/a>\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>\u003ca id=\"effective\">\u003c/a>Michael Krasny:\u003c/strong> \u003cstrong>There's good news on the horizon with respect to vaccines. And I'm interested in finding out your thoughts about the timing, first of all, but also the distribution of vaccines at this point. \u003c/strong>\u003c/p>\n\u003cp>Robert Wachter: Let's start with the big picture: A month ago, we didn't know for sure that we would get a vaccine that worked. I mean, we've been working on an HIV vaccine for 30 years. We don't have one. So November, really, will go down in history as a remarkable month in the history of science, that now we have three vaccines that we know work — two of them remarkably effective, the AstraZeneca [vaccine] a little bit less so. But the news on the Pfizer and the Moderna vaccine are breathtaking, really beyond anything any of us had anticipated.\u003c/p>\n\u003cp>But even more impressively, the Moderna news that came out this morning in their trial: There were 30 severe cases, 30 patients that were quite sick that had to go to the hospital or to the ICU or had very low oxygen. All of them — all 30 — were people that got the placebo. Zero of them were in people that got the vaccine. So these are breathtakingly effective.\u003cspan style=\"font-weight: 400\">[pullquote size='medium' align='right' citation=\"Dr. Robert Wachter, UCSF\"]'Those of us in the health care business are giddy about this. '[/pullquote]\u003c/span>\u003c/p>\n\u003cp>And I think those of us in the health care business are giddy about this. But now we start the work of trying to get them manufactured, distributed and sorting out who gets it first, because there will not be enough vaccine to go around until probably the middle part of next year. So we have some complicated decisions and logistics to work out in the next month or two.\u003c/p>\n\u003cp>\u003cstrong>There's still a big uncertainty about how long the vaccine can last. And the vaccine is mainly targeting symptoms to a great degree. Does it really help us understand or avert infections, particularly in asymptomatic people?\u003c/strong>\u003c/p>\n\u003cp>Here are the things we know: We know that the vaccine prevents infection 95% of the time — so 19 out of 20 cases are prevented. We know, just as importantly, that it also prevents severe cases. We now know that it is incredibly effective in preventing people from getting very sick and almost certainly from dying.\u003c/p>\n\u003cp>What we don't know for sure is how long it will last. And we care about that, but if it turns out you need to get a booster in a year or two, that's not the worst thing in the universe. And we don't know for 100% sure that it prevents you from getting infected — meaning you're carrying the virus in your your mouth and nose and potentially giving it to someone else. That's going to be important because that may ultimately determine whether we have to still take some precautions, like wearing masks.\u003cspan style=\"font-weight: 400\">[pullquote size='medium' align='right' citation=\"Dr. Robert Wachter, UCSF\"]'We don't know for 100% sure that [the vaccine] prevents you from getting infected.'[/pullquote]\u003c/span>\u003c/p>\n\u003cp>But overall, the news that we now have a vaccine that is incredibly safe, has some moderate side effects that will last for a day and will bring the number of infections — and severe infections — down to close to zero is unbelievably good news.\u003c/p>\n\u003cp>And when we get the vaccine in maybe 70% of people in the United States is when we will reach herd immunity in the right way. You don't want to reach it by people getting sick and dying. You want to reach it through a vaccine. And if you do the math in terms of distribution and manufacturing, we should be able to get there probably by the end of the summer.\u003c/p>\n\u003cfigure id=\"attachment_11848978\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-11848978\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/11/GettyImages-1229759730_1920x.jpg\" alt=\"\" width=\"1920\" height=\"1231\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2020/11/GettyImages-1229759730_1920x.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2020/11/GettyImages-1229759730_1920x-800x513.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2020/11/GettyImages-1229759730_1920x-1020x654.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2020/11/GettyImages-1229759730_1920x-160x103.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2020/11/GettyImages-1229759730_1920x-1536x985.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A sign on the entrance to a pharmacy reads 'COVID-19 Vaccine Not Yet Available' on Nov. 23, 2020 in Burbank, California. \u003ccite>(Robyn Beck/AFP via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>\u003ca id=\"distribute\">\u003c/a>We've got three phases likely with distribution.\u003c/strong> \u003cstrong>Can you outline it for us?\u003c/strong>\u003c/p>\n\u003cp>The first phase is complicated. It's often divided into phase 1A, 1B and 1C. And I don't think we know the order yet.\u003c/p>\n\u003cp>There have been recommendations made by a prestigious national group, the National Academy of Medicine, in October, that had the first group be health care workers — people with direct exposure to patients. The next group being people over 65 or with preexisting conditions.\u003c/p>\n\u003cp>But then, what really matters is what advisory group to the Centers for Disease Control and Prevention says. And it looks like the order is tilting toward the first group being health care workers, the second group likely being essential workers and then the third group of phase one being people over 65, and people with preexisting conditions.\u003c/p>\n\u003cp>The exception there is probably going to be people over 65 who live in nursing homes and other congregate settings, which have had a remarkably high mortality rate. But the devil's in the details. We don't know the order yet, and the numbers get a little daunting.\u003cspan style=\"font-weight: 400\">[pullquote size='medium' align='right' citation=\"Dr. Robert Wachter, UCSF\"]'The amount of vaccine that's available is going to force some tough prioritization decisions.'[/pullquote]\u003c/span>\u003c/p>\n\u003cp>We really want is all of those groups to go to get their vaccine as quickly as possible. But when you do the math, the number of health care workers in the United States is about 20 million. The number of essential workers is close to 90 million. The number of people over 65 is 50 million. And the number of people with preexisting conditions: 150 million.\u003c/p>\n\u003cp>When you add up those groups, you get to 200 million or so people. The amount of vaccine we will have by the end of December is probably about enough for 20 million people.\u003c/p>\n\u003cp>So the amount of vaccine that's available is going to force some tough prioritization decisions. We shouldn't go too crazy over this because eventually there will be enough vaccine for everybody, and when you look at the time that it takes to manufacture it and the speed with which they're ramping up, we're probably going to get through all of those groups by early spring.\u003c/p>\n\u003cp>But, you know, we're talking about when you look at the number of cases, hospitalizations and deaths, it does make a difference whether you got your shot and if your shots were in December and January or March and April. And that's what we're going to be debating for the next week or two.\u003c/p>\n\u003cp>\u003cstrong>There's also some debate about how much race should be considered — how much income and health care access and those kinds of things.\u003c/strong>\u003c/p>\n\u003cp>One of the things that's been exposed by COVID-19 — although it has been well-known in every part of health care — is that there are major disparities in the people and the risk of people for the disease and how they do.\u003cspan style=\"font-weight: 400\">[pullquote size='medium' align='right' citation=\"Dr. Robert Wachter, UCSF\"]'There certainly is a case to be made that people who are the most vulnerable and most at risk get their vaccines early.'[/pullquote]\u003c/span>\u003c/p>\n\u003cp>And it's become quite clear, including in San Francisco — which has had the best experience with COVID-19 of any major city in the country — you see rates of COVID-19 in the Mission District and in other more diverse areas being far higher than in less diverse and more affluent areas. And so there certainly is a case to be made that people who are the most vulnerable and most at risk get their vaccines early.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">[ad fullwidth]\u003c/span>\u003c/p>\n\u003cp>My guess is there will not be a race category of prioritization, which will create its own challenges, but rather the CDC committee will look very carefully at the at the essential worker category and who's in nursing homes and who has preexisting conditions and try to be sure that those groups are being prioritized. And by doing that, to be sure that diverse populations and poor people are getting their vaccines early.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>\u003cem>Skip straight to:\u003c/em>\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"#effective\">How effective are Pfizer and Moderna's COVID-19 vaccines?\u003c/a>\u003c/strong>\u003c/li>\n\u003cli>\u003cstrong>\u003ca href=\"#distribute\">How might they be distributed?\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>For the past several weeks, advances with COVID-19 vaccines have offered hope in what has felt like an endless slog through this pandemic.\u003c/p>\n\u003cp>On Nov. 20, Pfizer \u003ca href=\"https://www.cnn.com/2020/11/20/health/pfizer-vaccine-eua-submission/index.html\">applied for emergency use authorization\u003c/a> for its COVID-19 vaccine from the Food and Drug Administration. On Monday, Moderna announced \u003ca href=\"https://www.cnn.com/2020/11/30/health/moderna-vaccine-fda-eua-application/index.html\">it would also be applying for authorization\u003c/a> for its vaccine, which reportedly has a 94.1% efficacy rate. If approved, doses could start rolling out before the end of the year.\u003c/p>\n\u003cp>But with the possibility of a vaccine in the near future coming into clearer focus, questions are being raised how these vaccine doses might be distributed. In California, state officials have made it clear that health care workers will be the first to receive the vaccine. But since the initial rollout will likely be limited, officials will have to \u003ca href=\"https://www.kqed.org/news/11848963/if-there-arent-enough-vaccines-for-all-health-care-workers-in-california-which-doctors-nurses-or-aides-will-get-it-first\">decide which health care workers\u003c/a> will get the vaccine first.\u003c/p>\n\u003cp>What does that mean, then, for the rest of us?\u003c/p>\n\u003cp>KQED Forum host Michael Krasny spoke with Dr. Robert Wachter, chair of the UCSF Department of Medicine, about the vaccine rollout and when the general public should realistically expect a dose.\u003c/p>\n\u003cp>\u003cem>This interview has been edited for length and clarity. \u003ca href=\"https://www.kqed.org/forum/2010101880963/ucsfs-dr-wachter-on-bay-area-vaccine-distribution\">Hear the full interview\u003c/a>\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>\u003ca id=\"effective\">\u003c/a>Michael Krasny:\u003c/strong> \u003cstrong>There's good news on the horizon with respect to vaccines. And I'm interested in finding out your thoughts about the timing, first of all, but also the distribution of vaccines at this point. \u003c/strong>\u003c/p>\n\u003cp>Robert Wachter: Let's start with the big picture: A month ago, we didn't know for sure that we would get a vaccine that worked. I mean, we've been working on an HIV vaccine for 30 years. We don't have one. So November, really, will go down in history as a remarkable month in the history of science, that now we have three vaccines that we know work — two of them remarkably effective, the AstraZeneca [vaccine] a little bit less so. But the news on the Pfizer and the Moderna vaccine are breathtaking, really beyond anything any of us had anticipated.\u003c/p>\n\u003cp>But even more impressively, the Moderna news that came out this morning in their trial: There were 30 severe cases, 30 patients that were quite sick that had to go to the hospital or to the ICU or had very low oxygen. All of them — all 30 — were people that got the placebo. Zero of them were in people that got the vaccine. So these are breathtakingly effective.\u003cspan style=\"font-weight: 400\">\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>\u003c/p>\n\u003cp>And I think those of us in the health care business are giddy about this. But now we start the work of trying to get them manufactured, distributed and sorting out who gets it first, because there will not be enough vaccine to go around until probably the middle part of next year. So we have some complicated decisions and logistics to work out in the next month or two.\u003c/p>\n\u003cp>\u003cstrong>There's still a big uncertainty about how long the vaccine can last. And the vaccine is mainly targeting symptoms to a great degree. Does it really help us understand or avert infections, particularly in asymptomatic people?\u003c/strong>\u003c/p>\n\u003cp>Here are the things we know: We know that the vaccine prevents infection 95% of the time — so 19 out of 20 cases are prevented. We know, just as importantly, that it also prevents severe cases. We now know that it is incredibly effective in preventing people from getting very sick and almost certainly from dying.\u003c/p>\n\u003cp>What we don't know for sure is how long it will last. And we care about that, but if it turns out you need to get a booster in a year or two, that's not the worst thing in the universe. And we don't know for 100% sure that it prevents you from getting infected — meaning you're carrying the virus in your your mouth and nose and potentially giving it to someone else. That's going to be important because that may ultimately determine whether we have to still take some precautions, like wearing masks.\u003cspan style=\"font-weight: 400\">\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>\u003c/p>\n\u003cp>But overall, the news that we now have a vaccine that is incredibly safe, has some moderate side effects that will last for a day and will bring the number of infections — and severe infections — down to close to zero is unbelievably good news.\u003c/p>\n\u003cp>And when we get the vaccine in maybe 70% of people in the United States is when we will reach herd immunity in the right way. You don't want to reach it by people getting sick and dying. You want to reach it through a vaccine. And if you do the math in terms of distribution and manufacturing, we should be able to get there probably by the end of the summer.\u003c/p>\n\u003cfigure id=\"attachment_11848978\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-11848978\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/11/GettyImages-1229759730_1920x.jpg\" alt=\"\" width=\"1920\" height=\"1231\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2020/11/GettyImages-1229759730_1920x.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2020/11/GettyImages-1229759730_1920x-800x513.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2020/11/GettyImages-1229759730_1920x-1020x654.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2020/11/GettyImages-1229759730_1920x-160x103.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2020/11/GettyImages-1229759730_1920x-1536x985.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A sign on the entrance to a pharmacy reads 'COVID-19 Vaccine Not Yet Available' on Nov. 23, 2020 in Burbank, California. \u003ccite>(Robyn Beck/AFP via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>\u003ca id=\"distribute\">\u003c/a>We've got three phases likely with distribution.\u003c/strong> \u003cstrong>Can you outline it for us?\u003c/strong>\u003c/p>\n\u003cp>The first phase is complicated. It's often divided into phase 1A, 1B and 1C. And I don't think we know the order yet.\u003c/p>\n\u003cp>There have been recommendations made by a prestigious national group, the National Academy of Medicine, in October, that had the first group be health care workers — people with direct exposure to patients. The next group being people over 65 or with preexisting conditions.\u003c/p>\n\u003cp>But then, what really matters is what advisory group to the Centers for Disease Control and Prevention says. And it looks like the order is tilting toward the first group being health care workers, the second group likely being essential workers and then the third group of phase one being people over 65, and people with preexisting conditions.\u003c/p>\n\u003cp>The exception there is probably going to be people over 65 who live in nursing homes and other congregate settings, which have had a remarkably high mortality rate. But the devil's in the details. We don't know the order yet, and the numbers get a little daunting.\u003cspan style=\"font-weight: 400\">\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>\u003c/p>\n\u003cp>We really want is all of those groups to go to get their vaccine as quickly as possible. But when you do the math, the number of health care workers in the United States is about 20 million. The number of essential workers is close to 90 million. The number of people over 65 is 50 million. And the number of people with preexisting conditions: 150 million.\u003c/p>\n\u003cp>When you add up those groups, you get to 200 million or so people. The amount of vaccine we will have by the end of December is probably about enough for 20 million people.\u003c/p>\n\u003cp>So the amount of vaccine that's available is going to force some tough prioritization decisions. We shouldn't go too crazy over this because eventually there will be enough vaccine for everybody, and when you look at the time that it takes to manufacture it and the speed with which they're ramping up, we're probably going to get through all of those groups by early spring.\u003c/p>\n\u003cp>But, you know, we're talking about when you look at the number of cases, hospitalizations and deaths, it does make a difference whether you got your shot and if your shots were in December and January or March and April. And that's what we're going to be debating for the next week or two.\u003c/p>\n\u003cp>\u003cstrong>There's also some debate about how much race should be considered — how much income and health care access and those kinds of things.\u003c/strong>\u003c/p>\n\u003cp>One of the things that's been exposed by COVID-19 — although it has been well-known in every part of health care — is that there are major disparities in the people and the risk of people for the disease and how they do.\u003cspan style=\"font-weight: 400\">\u003c/p>\u003c/div>",
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"content": "'There certainly is a case to be made that people who are the most vulnerable and most at risk get their vaccines early.'",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>\u003c/p>\n\u003cp>And it's become quite clear, including in San Francisco — which has had the best experience with COVID-19 of any major city in the country — you see rates of COVID-19 in the Mission District and in other more diverse areas being far higher than in less diverse and more affluent areas. And so there certainly is a case to be made that people who are the most vulnerable and most at risk get their vaccines early.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>\u003c/p>\n\u003cp>My guess is there will not be a race category of prioritization, which will create its own challenges, but rather the CDC committee will look very carefully at the at the essential worker category and who's in nursing homes and who has preexisting conditions and try to be sure that those groups are being prioritized. And by doing that, to be sure that diverse populations and poor people are getting their vaccines early.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Everyone has bad days, but after the 2016 presidential election, many people living in Democratic states had more of them than usual.\u003c/p>\n\u003cp>That’s according to a \u003ca href=\"https://www.ucsf.edu/news/2020/11/418961/election-angst-states-back-losing-nominee-residents-mental-health-may-falter\">new study\u003c/a> by researchers at UCSF and Duke University, who found that residents in states that supported Hillary Clinton experienced, on average, an additional half a day of poor mental health in the month following the election (December) — a collective uptick of 54.6 million more days — compared to the month preceding it (October).[aside postID=\"arts_13881725,news_11808968,news_11841065\" label=\"Mental Health Resources\"]\u003c/p>\n\u003cp>Researchers also found that depression rates among residents in blue states rose in January 2017, when Trump was inaugurated. Residents 65 and older, women and white people were the groups most impacted overall, the study found.\u003c/p>\n\u003cp>The research team combed through reams of data from the \u003ca href=\"https://www.cdc.gov/brfss/index.html\">Behavioral Risk Factor Surveillance System\u003c/a>, an annual national mental health phone survey of nearly 500,000 participants, to identify the number of poor mental health days people reported experiencing before and after the 2016 election.\u003c/p>\n\u003cp>The study’s findings could help guide mental health providers in the wake of another divisive, emotionally fraught election, its authors say.\u003c/p>\n\u003cp>“I think what’s important about this study is we don’t traditionally think of elections themselves being a public health issue, but our study finds evidence that at least the 2016 election likely worsened mental health in a clinically significant way for voters of the candidate that lost,” said study lead author Brandon Yan, a UCSF researcher.\u003c/p>\n\u003cp>Meanwhile, adults in states that voted for Trump reported no statistically significant change in their mental health — not even an improvement.\u003c/p>\n\u003cp>[ad fullwidth]“My hypothesis for why we don’t see an improvement in mental health in states that voted for Trump is that in general we know from behavioral economics that losses are felt much more heavily than victories,” Yan said. “Especially when you think about the 2016 election, the outcome was rather unexpected.”\u003c/p>\n\u003cp>As has been \u003ca href=\"https://www.kqed.org/forum/2010101878994/pandemic-takes-growing-toll-on-mental-health\">widely reported\u003c/a>, 2020 has already brought about a national mental health crisis. The COVID-19 pandemic has increased social isolation, while reducing the number of physician visits. And that means fewer opportunities for health care providers to help patients facing psychological distress, Yan said.\u003c/p>\n\u003cp>Yan hopes his study will help clinicians take a proactive approach in caring for a population that is already struggling.\u003c/p>\n\u003cp>“The implication, at least from a health care perspective, is that patients could potentially benefit from clinicians and mental health providers screening for election-related stress and offering interventions when appropriate,” he said.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Everyone has bad days, but after the 2016 presidential election, many people living in Democratic states had more of them than usual.\u003c/p>\n\u003cp>That’s according to a \u003ca href=\"https://www.ucsf.edu/news/2020/11/418961/election-angst-states-back-losing-nominee-residents-mental-health-may-falter\">new study\u003c/a> by researchers at UCSF and Duke University, who found that residents in states that supported Hillary Clinton experienced, on average, an additional half a day of poor mental health in the month following the election (December) — a collective uptick of 54.6 million more days — compared to the month preceding it (October).\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Researchers also found that depression rates among residents in blue states rose in January 2017, when Trump was inaugurated. Residents 65 and older, women and white people were the groups most impacted overall, the study found.\u003c/p>\n\u003cp>The research team combed through reams of data from the \u003ca href=\"https://www.cdc.gov/brfss/index.html\">Behavioral Risk Factor Surveillance System\u003c/a>, an annual national mental health phone survey of nearly 500,000 participants, to identify the number of poor mental health days people reported experiencing before and after the 2016 election.\u003c/p>\n\u003cp>The study’s findings could help guide mental health providers in the wake of another divisive, emotionally fraught election, its authors say.\u003c/p>\n\u003cp>“I think what’s important about this study is we don’t traditionally think of elections themselves being a public health issue, but our study finds evidence that at least the 2016 election likely worsened mental health in a clinically significant way for voters of the candidate that lost,” said study lead author Brandon Yan, a UCSF researcher.\u003c/p>\n\u003cp>Meanwhile, adults in states that voted for Trump reported no statistically significant change in their mental health — not even an improvement.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“My hypothesis for why we don’t see an improvement in mental health in states that voted for Trump is that in general we know from behavioral economics that losses are felt much more heavily than victories,” Yan said. “Especially when you think about the 2016 election, the outcome was rather unexpected.”\u003c/p>\n\u003cp>As has been \u003ca href=\"https://www.kqed.org/forum/2010101878994/pandemic-takes-growing-toll-on-mental-health\">widely reported\u003c/a>, 2020 has already brought about a national mental health crisis. The COVID-19 pandemic has increased social isolation, while reducing the number of physician visits. And that means fewer opportunities for health care providers to help patients facing psychological distress, Yan said.\u003c/p>\n\u003cp>Yan hopes his study will help clinicians take a proactive approach in caring for a population that is already struggling.\u003c/p>\n\u003cp>“The implication, at least from a health care perspective, is that patients could potentially benefit from clinicians and mental health providers screening for election-related stress and offering interventions when appropriate,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>President Trump has experienced two drops in his oxygen levels over the course of his COVID-19 diagnosis and is now also being treated with a steroid, but could be discharged from Walter Reed National Military Medical Center as early as Monday, his physicians told reporters during a briefing Sunday.\u003c/p>\n\u003cp>Trump was admitted to Walter Reed on Friday evening after announcing early on Friday morning that he and the first lady had tested positive for the coronavirus.\u003c/p>\n\u003cp>“Since we spoke last [on Saturday], the president has continued to improve,” the president’s physician, Sean Conley, said. “As with any illness, there are frequent ups and downs, particularly when a patient is being so closely watched 24 hours a day.”\u003c/p>\n\u003cp>Conley said that Trump had a high fever and saw his oxygen levels fall while at the White House on Friday morning ahead of being moved to Walter Reed. He did not detail Trump’s high temperature.\u003c/p>\n\u003cp>“Given these two developments, I was concerned for possible progression of the illness,” Conley said. “I recommended [to] the president we try some supplemental oxygen, see how he’d respond. He was fairly adamant that he didn’t need it. He was not short of breath; he was tired, had the fever, and that was about it. After about a minute on only 2 liters, his saturation levels were back over 95%. He stayed on that for about an hour.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>https://twitter.com/Bob_Wachter/status/1312792230860451841\u003c/p>\n\u003cp>In the Bay Area, University of California San Francisco Department of Medicine Chair Bob Wachter tweeted his impressions of Trump’s doctor’s statements, in an effort to unravel what has been described as a confusing back-and-forth between Trump’s doctors and other statements given to reporters by the White House.\u003c/p>\n\u003cp>“It seems like Trump is stable, but remains at high risk, given transient hypoxemia, some findings on chest imaging.,” Wachter said. “The happy talk and evasions are clearly at Trump’s direction, putting the docs in a terrible position. No way he’s ready for discharge tomorrow.”\u003c/p>\n\u003cp>Trump experienced a second episode of falling oxygen levels Saturday, dropping to 93%, Conley said. He said he didn’t know whether Trump received supplemental oxygen at that point. “I’d have to check with the nursing staff,” he said.\u003c/p>\n\u003cp>When asked whether any signs of pneumonia are apparent on the president’s X-rays and scans, Conley said, “There’s some expected findings but nothing of any major clinical concern.”\u003c/p>\n\u003cp>Trump also received his first dose of the steroid dexamethasone on Saturday, with Conley saying the potential benefits of the treatment outweigh the risks.\u003c/p>\n\u003cp>Trump’s care plan includes a five-day treatment course of remdesivir, which Dr. Brian Garibaldi said Trump “tolerated well.”\u003c/p>\n\u003cp>“If he continues to look and feel as well as he does today, our hope is that we can plan for a discharge as early as tomorrow to the White House, where he can continue his treatment course,” Garibaldi said.\u003c/p>\n\u003cp>A similar news conference Saturday led to many questions.\u003c/p>\n\u003cp>The timeline Conley presented to reporters of Trump’s diagnosis was quickly walked back by the White House.\u003c/p>\n\u003cp>And though Conley said that Trump’s symptoms were improving and that he was “extremely happy” with the progress being made, almost immediately after the briefing, a White House official — later identified by The Associated Press as White House Chief of Staff Mark Meadows — contradicted Conley, telling reporters: “The president’s vitals over the last 24 hours were very concerning, and the next 48 hours will be critical in terms of his care. We’re still not on a clear path to a full recovery.”\u003c/p>\n\u003cp>https://twitter.com/Yamiche/status/1312743738939244544?s=19\u003c/p>\n\u003cp>On Sunday, Conley said the chief of staff’s statement was “misconstrued.”\u003c/p>\n\u003cp>“What he meant was that 24 hours ago, when he and I were checking on the president, that there was that momentary episode of the high fever and that temporary drop in the saturation, which prompted us to act expediently to move him up here,” Conley said.\u003c/p>\n\u003cp>When asked why he was reluctant during Saturday’s briefing to disclose that Trump had been administered oxygen, Conley said he was trying to “reflect the upbeat attitude” of the medical team and the president.[pullquote size=\"large\" align=\"right\" citation=\"Bob Wachter, chair of the UCSF Department of Medicine\"]“No way he’s ready for discharge tomorrow.”[/pullquote]\u003c/p>\n\u003cp>“I didn’t want to give any information that might steer the course of illness in another direction,” he said. “And in doing so, you know, it came off that we’re trying to hide something, which wasn’t necessarily true. The matter is, is that [Trump’s] doing really well.”\u003c/p>\n\u003cp>White House communications director Alyssa Farah expanded on Conley’s comments, telling Fox News on Sunday that he was projecting confidence in order to help his patient.\u003c/p>\n\u003cp>“It’s a very, it’s a common medical practice, that you want to convey confidence and you want to raise the spirits of the person you’re treating,” Farah said. “I know this president, I don’t know that he needs his spirits raised. But I think it’s actually a very common medical practice to do that.”\u003c/p>\n\u003cp>The president himself tweeted a video Saturday evening in which he said: “I came here, wasn’t feeling so well. I feel much better now.”\u003c/p>\n\u003cp>But echoing Meadows, Trump added: “You don’t know, over the next period of a few days — I guess that’s the real test, so we’ll be seeing what happens over those … next couple of days.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>KQED staff contributed to this report. \u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cb>New School Year Tests Teachers, Students and Parents Like Never Before\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">As classes resume throughout the state, one thing is clear: This academic year will be unlike any before, as the pandemic shuttered classrooms and forced most of the state’s school districts to instruct more than 6 million K-12 students remotely. Despite a complex waiver process for elementary schools, most students will be getting and completing assignments online. But distance learning is fraught with challenges, as teachers, students and parents learned this past spring when school districts abruptly closed to comply with state and local public health orders. Some of those challenges remain, including technological barriers for low-income students and English learners, along with concerns teachers have about engaging and retaining students in a virtual setting. \u003c/span>\u003c/p>\n\u003cp>\u003cb>Guests:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Julia McEvoy, senior editor of education and equity, KQED\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Elisha Smith Arrillaga, PhD, executive director, The Education Trust-West\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Pandemic Exposes Race and Equity Gaps in Education\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">This week, state education officials announced a plan to purchase up to 1 million internet-connected tablets for public school children. Although the digital divide existed before the pandemic, the public health crisis has exposed growing race and equity disparities between communities in school districts, especially for parents who are essential workers and can’t work remotely. This week, 29 teacher unions representing more than 300,000 students in Alameda and Contra Costa counties wrote a letter urging local health officials to use ZIP code data instead of county-wide averages of coronavirus cases to determine when it would be safe for in-person instruction and that currently “no schools should open until it is safe for all schools in the county to open.”\u003c/span>\u003c/p>\n\u003cp>\u003cb>Guests:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Marissa Glidden, president, United Teachers of Richmond\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Shakira W. Reynolds, co-founder, Parent Leadership Council, West Contra Costa Unified School District\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Mental Health Struggles for Parents and Children\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">We hear from a clinical psychologist about how the pandemic is exacerbating the mental health struggles of parents and students alike as they grapple with uncertainty, upended routines, and for essential workers, the ever-present fear of contracting the virus and spreading it to their families. \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>In mid-March, Karla Monterroso flew home from a hiking trip in Zion National Park through the Las Vegas airport. Four days later she began to develop a bad, dry cough. Her lungs felt sticky.\u003c/p>\n\u003cp>The fevers that persisted for the next nine weeks grew so high — 100.4, 101.2, 101.7, 102.3 — that on the worst night, she was in the shower on all fours, ice cold water running down her back, willing her temperature to go down.\u003c/p>\n\u003cp>“That night I had written down in a journal, letters to everyone I’m close to, the things I wanted them to know in case I died,” she remembers.\u003c/p>\n\u003cp>Then came a new batch of symptoms in the second month, headaches and shooting pains in her legs and abdomen that made her worry she could be at risk for the blood clots and strokes that other COVID-19 patients in their thirties were starting to report.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Karla Monterroso']‘You spend so much of the process not believing yourself, and then to not be believed when you go in? It’s really hard to be questioned in that way.’[/pullquote]But still, she wasn’t sure if she should go to the hospital.\u003c/p>\n\u003cp>“As women of color, you get questioned a lot about your emotions and the truth of your physical state. You get called an exaggerator a lot throughout the course of your life,” said Monterroso, who is Latina. “So there was this weird, ‘I don’t want to go and use resources for nothing’ feeling.”\u003c/p>\n\u003cp>It took four friends to convince her that she needed to call 911.\u003c/p>\n\u003cp>But what happened in the emergency room at Alameda Hospital only confirmed her worst fears.\u003c/p>\n\u003cp>The disrespect and abuse she experienced at the hands of medical professionals confirmed for her that the reason people of color are being disproportionately impacted by the coronavirus is not just because they’re more likely to have front-line jobs that expose them to it and the underlying conditions that make COVID-19 worse.\u003c/p>\n\u003cp>“That is certainly part of it, but the other part is the lack of value people see in our lives,” Monterroso wrote in \u003ca href=\"https://twitter.com/karlitaliliana/status/1260761818558984195\" target=\"_blank\" rel=\"noopener noreferrer\">a Twitter thread\u003c/a> detailing her experience.\u003c/p>\n\u003cp>https://twitter.com/karlitaliliana/status/1260761818558984195\u003c/p>\n\u003cp>Research shows how \u003ca href=\"https://www.kqed.org/stateofhealth/54909/doctors-struggle-with-unconscious-bias-same-as-police\" target=\"_blank\" rel=\"noopener noreferrer\">doctors’ unconscious bias\u003c/a> affects the care people receive, with Latino and Black patients being less likely to receive \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448154/#r3\" target=\"_blank\" rel=\"noopener noreferrer\">pain medications\u003c/a> or get referred for \u003ca href=\"https://www.nejm.org/doi/full/10.1056/NEJM199902253400806#t=articleResults\" target=\"_blank\" rel=\"noopener noreferrer\">advanced care\u003c/a> than white patients with the same complaints or symptoms, and more likely to die in childbirth from preventable complications.\u003c/p>\n\u003cp>At nearly every turn during her emergency room visit, Monterroso said providers dismissed her symptoms and concerns. Her low blood pressure? That’s a false reading. Her cycling oxygen levels? The machine’s wrong. The shooting pains in her leg? Probably just a cyst.\u003c/p>\n\u003cp>“The doctor came in and said, ‘I don’t think that much is happening here. I think we can send you home,’” Monterroso recalls.\u003c/p>\n\u003cp>She was feeling woozy and having trouble communicating, so she had a friend and her friend’s cousin, a cardiac nurse, on the phone to help. They started asking questions: What about Karla’s accelerated heart rate? Her low oxygen levels? Her lips are blue.\u003c/p>\n\u003cp>The doctor walked out of the room. He refused to care for Monterroso while her friends were on the phone, she said, and when he came back, the only thing he wanted to talk about was Monterroso’s tone and her friends’ tone.\u003c/p>\n\u003cp>“The implication was that we were insubordinate,” Monterroso says.\u003c/p>\n\u003cp>She told the doctor she didn’t want to talk about her tone. She wanted to talk about her health care. She was worried about possible blood clots in her leg and she asked for a CT scan.\u003c/p>\n\u003cp>“Well, you know, the CT scan is radiation right next to your breast tissue. Do you want to get breast cancer?” Monterroso recalls the doctor saying to her. “I only feel comfortable giving you that test if you say that you’re fine getting breast cancer.”\u003c/p>\n\u003cp>Monterroso thought to herself, “Swallow it up, Karla. You need to be well.” And so she said to the doctor: “I’m fine getting breast cancer.”\u003c/p>\n\u003cp>He never ordered the test.\u003c/p>\n\u003cfigure id=\"attachment_11826930\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11826930\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/06/Black-Health-Matters-800x600.jpeg\" alt=\"\" width=\"800\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">A vehicle parked in Oakland during the first weeks of the 2020 Black Lives Matter protests \u003ccite>(Courtesy of April Dembosky)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Monterroso asked for a different doctor, for a hospital advocate. No and no, she was told. She began to worry for her safety, for her life. She wanted to get out of there. Her friends, all calling every medical professional they knew to confirm that this treatment was not right, came to pick her up and drove her to UCSF. The team there gave her an EKG, a chest x-ray and a CT scan.\u003c/p>\n\u003cp>“One of the nurses came in and she was like, ‘I heard about your ordeal. I just want you to know that I believe you. And we are not going let you go until we know that you are safe to go,’” Monterroso said. “And I started bawling. Because that’s all you want, is to be believed. You spend so much of the process not believing yourself, and then to not be believed when you go in? It’s really hard to be questioned in that way.”\u003c/p>\n\u003cp>Alameda Health System did not respond to multiple requests for comment. Monterroso filed a grievance with the hospital and they invited her to come talk to their staff and residents, but she declined.\u003c/p>\n\u003cp>She believes her experience is an example of why people of color are faring so badly in the pandemic.\u003c/p>\n\u003cp>“Because when we go and seek care, if we are advocating for ourselves, we can be treated as insubordinate,” she says. “And if we are not advocating for ourselves, we can be treated as invisible.”\u003c/p>\n\u003ch3>Unconscious Bias in Health Care\u003c/h3>\n\u003cp>Experts say this happens routinely, and regardless of the doctor’s intentions or race. Monterroso’s doctor was not white, for example.\u003c/p>\n\u003cp>Research shows that every doctor, every human being, has biases they’re not aware of, says Dr. Rene Salazar, assistant dean for diversity at the University of Texas at Austin medical school.\u003c/p>\n\u003cp>[aside tag=\"coronavirus\" label=\"more coronavirus coverage\"]“Do I question a white man in a suit who’s coming in looking like he’s a professional when he asks for pain meds versus a black man?” Salazar says.\u003c/p>\n\u003cp>Unconscious bias most often surfaces in high stress environments, like emergency rooms — where doctors are under tremendous pressure and have to make quick, high stakes decisions. Add in a deadly new virus, where the science is changing by the day, and things can spiral.\u003c/p>\n\u003cp>“There’s just so much uncertainty,” he says. “When there is this uncertainty, there always is a level of opportunity for bias to make its way in and have an impact.”\u003c/p>\n\u003cp>Salazar used to teach at UCSF where he helped \u003ca href=\"https://www.kqed.org/stateofhealth/56311/ucsf-doctors-students-confront-their-own-unconscious-bias\" target=\"_blank\" rel=\"noopener noreferrer\">develop unconscious bias training\u003c/a> for medical and pharmacy students. While dozens of medical schools are following suit, he says it’s not as common for hospitals. Even after a negative patient encounter like Karla’s is raised to supervisors, the intervention is usually weak.\u003c/p>\n\u003cp>“How do I tell my clinician, ‘Well, the patient thinks you’re racist?’” Salazar says. “It’s a hard conversation: ‘I gotta be careful, I don’t want to say the race word because I’m going to push some buttons here.’ So it just starts to become really complicated.” [ad fullwidth]\u003c/p>\n\u003ch3>\u003cstrong>A Data-based Approach\u003c/strong>\u003c/h3>\n\u003cp>At Kaiser Permanente, Dr. Ronald Copeland, chief of equity, inclusion and diversity, says he remembers doctors also resisting these conversations in the early days. Suggestions of training in cultural sensitivity or unconscious bias were met with a backlash.\u003c/p>\n\u003cp>“It was viewed almost from a punishment standpoint. ‘Doc, your patients of this persuasion don’t like you and you’ve got to do something about it.’ It’s like, you’re a bad doctor, and so your punishment is you have to go get training,” Copeland says.\u003c/p>\n\u003cp>Now, Kaiser’s approach is rooted in data from patient surveys, the questionnaires patients are often asked to fill out after a doctor’s visit. While they don’t ask patients directly if they think their doctor was racist, they do ask if they felt respected, if the communication was good and if they were satisfied with the experience.\u003c/p>\n\u003cp>Kaiser then breaks this data down by demographics, to see if maybe a doctor gets good scores on respect and empathy from white patients, but not Black patients.\u003c/p>\n\u003cp>“If you see a pattern evolving around a certain group and it’s a persistent pattern, then that tells you there’s something that from a cultural, from an ethnicity, from a gender, something that group has in common, that you’re not addressing,” Copeland says. “Then the real work starts.”\u003c/p>\n\u003cp>When doctors are presented with the data from their patients and the science on unconscious bias, they’re less likely to resist it or deny it, Copeland says. At Kaiser, they’ve reframed the goal of training around delivering better quality care and getting better patient outcomes, so doctors want to do it.\u003c/p>\n\u003cp>“Folks don’t flinch about it,” he said. “They’re eager to learn more about it, particularly about how you mitigate it.”\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Karla Monterroso']‘If I don’t say what’s happening, then people with much less resources are going to come into this experience and they’re going to die.’[/pullquote]\u003c/p>\n\u003ch3>\u003cstrong>Still Unwell\u003c/strong>\u003c/h3>\n\u003cp>It’s been more than three months since Karla first got sick, and she’s still not feeling well.\u003c/p>\n\u003cp>Her heart rate continues to spike and she can’t walk across her apartment without getting winded. She decided recently to leave the Bay Area and move to LA so she could be closer to her family for her recovery.\u003c/p>\n\u003cp>She declined Alameda Hospital’s invitation to speak to their staff about her experience, concluding it wasn’t her responsibility to fix the system that abused her. But she wants the broader health care system to take responsibility for the bias perpetuated in hospitals and clinics.\u003c/p>\n\u003cp>She acknowledges that Alameda Hospital is public, and it doesn’t have the kind of resources that Kaiser and UCSF do. A recent audit warned that Alameda Health System was on the brink of insolvency. But still, Monterroso is the CEO of \u003ca href=\"http://www.code2040.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Code2040\u003c/a>, a racial equity nonprofit, and she says even for her it took an army of friends and activists fighting for her just to be heard.\u003c/p>\n\u003cp>“Ninety percent of the people that are going to come through that hospital are not going to have what I have to fight that,” she says. “And if I don’t say what’s happening, then people with much less resources are going to come into this experience and they’re going to die.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>Research shows how \u003ca href=\"https://www.kqed.org/stateofhealth/54909/doctors-struggle-with-unconscious-bias-same-as-police\" target=\"_blank\" rel=\"noopener noreferrer\">doctors’ unconscious bias\u003c/a> affects the care people receive, with Latino and Black patients being less likely to receive \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448154/#r3\" target=\"_blank\" rel=\"noopener noreferrer\">pain medications\u003c/a> or get referred for \u003ca href=\"https://www.nejm.org/doi/full/10.1056/NEJM199902253400806#t=articleResults\" target=\"_blank\" rel=\"noopener noreferrer\">advanced care\u003c/a> than white patients with the same complaints or symptoms, and more likely to die in childbirth from preventable complications.\u003c/p>\n\u003cp>At nearly every turn during her emergency room visit, Monterroso said providers dismissed her symptoms and concerns. Her low blood pressure? That’s a false reading. Her cycling oxygen levels? The machine’s wrong. The shooting pains in her leg? Probably just a cyst.\u003c/p>\n\u003cp>“The doctor came in and said, ‘I don’t think that much is happening here. I think we can send you home,’” Monterroso recalls.\u003c/p>\n\u003cp>She was feeling woozy and having trouble communicating, so she had a friend and her friend’s cousin, a cardiac nurse, on the phone to help. They started asking questions: What about Karla’s accelerated heart rate? Her low oxygen levels? Her lips are blue.\u003c/p>\n\u003cp>The doctor walked out of the room. He refused to care for Monterroso while her friends were on the phone, she said, and when he came back, the only thing he wanted to talk about was Monterroso’s tone and her friends’ tone.\u003c/p>\n\u003cp>“The implication was that we were insubordinate,” Monterroso says.\u003c/p>\n\u003cp>She told the doctor she didn’t want to talk about her tone. She wanted to talk about her health care. She was worried about possible blood clots in her leg and she asked for a CT scan.\u003c/p>\n\u003cp>“Well, you know, the CT scan is radiation right next to your breast tissue. Do you want to get breast cancer?” Monterroso recalls the doctor saying to her. “I only feel comfortable giving you that test if you say that you’re fine getting breast cancer.”\u003c/p>\n\u003cp>Monterroso thought to herself, “Swallow it up, Karla. You need to be well.” And so she said to the doctor: “I’m fine getting breast cancer.”\u003c/p>\n\u003cp>He never ordered the test.\u003c/p>\n\u003cfigure id=\"attachment_11826930\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11826930\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/06/Black-Health-Matters-800x600.jpeg\" alt=\"\" width=\"800\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">A vehicle parked in Oakland during the first weeks of the 2020 Black Lives Matter protests \u003ccite>(Courtesy of April Dembosky)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Monterroso asked for a different doctor, for a hospital advocate. No and no, she was told. She began to worry for her safety, for her life. She wanted to get out of there. Her friends, all calling every medical professional they knew to confirm that this treatment was not right, came to pick her up and drove her to UCSF. The team there gave her an EKG, a chest x-ray and a CT scan.\u003c/p>\n\u003cp>“One of the nurses came in and she was like, ‘I heard about your ordeal. I just want you to know that I believe you. And we are not going let you go until we know that you are safe to go,’” Monterroso said. “And I started bawling. Because that’s all you want, is to be believed. You spend so much of the process not believing yourself, and then to not be believed when you go in? It’s really hard to be questioned in that way.”\u003c/p>\n\u003cp>Alameda Health System did not respond to multiple requests for comment. Monterroso filed a grievance with the hospital and they invited her to come talk to their staff and residents, but she declined.\u003c/p>\n\u003cp>She believes her experience is an example of why people of color are faring so badly in the pandemic.\u003c/p>\n\u003cp>“Because when we go and seek care, if we are advocating for ourselves, we can be treated as insubordinate,” she says. “And if we are not advocating for ourselves, we can be treated as invisible.”\u003c/p>\n\u003ch3>Unconscious Bias in Health Care\u003c/h3>\n\u003cp>Experts say this happens routinely, and regardless of the doctor’s intentions or race. Monterroso’s doctor was not white, for example.\u003c/p>\n\u003cp>Research shows that every doctor, every human being, has biases they’re not aware of, says Dr. Rene Salazar, assistant dean for diversity at the University of Texas at Austin medical school.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“Do I question a white man in a suit who’s coming in looking like he’s a professional when he asks for pain meds versus a black man?” Salazar says.\u003c/p>\n\u003cp>Unconscious bias most often surfaces in high stress environments, like emergency rooms — where doctors are under tremendous pressure and have to make quick, high stakes decisions. Add in a deadly new virus, where the science is changing by the day, and things can spiral.\u003c/p>\n\u003cp>“There’s just so much uncertainty,” he says. “When there is this uncertainty, there always is a level of opportunity for bias to make its way in and have an impact.”\u003c/p>\n\u003cp>Salazar used to teach at UCSF where he helped \u003ca href=\"https://www.kqed.org/stateofhealth/56311/ucsf-doctors-students-confront-their-own-unconscious-bias\" target=\"_blank\" rel=\"noopener noreferrer\">develop unconscious bias training\u003c/a> for medical and pharmacy students. While dozens of medical schools are following suit, he says it’s not as common for hospitals. Even after a negative patient encounter like Karla’s is raised to supervisors, the intervention is usually weak.\u003c/p>\n\u003cp>“How do I tell my clinician, ‘Well, the patient thinks you’re racist?’” Salazar says. “It’s a hard conversation: ‘I gotta be careful, I don’t want to say the race word because I’m going to push some buttons here.’ So it just starts to become really complicated.” \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch3>\u003cstrong>A Data-based Approach\u003c/strong>\u003c/h3>\n\u003cp>At Kaiser Permanente, Dr. Ronald Copeland, chief of equity, inclusion and diversity, says he remembers doctors also resisting these conversations in the early days. Suggestions of training in cultural sensitivity or unconscious bias were met with a backlash.\u003c/p>\n\u003cp>“It was viewed almost from a punishment standpoint. ‘Doc, your patients of this persuasion don’t like you and you’ve got to do something about it.’ It’s like, you’re a bad doctor, and so your punishment is you have to go get training,” Copeland says.\u003c/p>\n\u003cp>Now, Kaiser’s approach is rooted in data from patient surveys, the questionnaires patients are often asked to fill out after a doctor’s visit. While they don’t ask patients directly if they think their doctor was racist, they do ask if they felt respected, if the communication was good and if they were satisfied with the experience.\u003c/p>\n\u003cp>Kaiser then breaks this data down by demographics, to see if maybe a doctor gets good scores on respect and empathy from white patients, but not Black patients.\u003c/p>\n\u003cp>“If you see a pattern evolving around a certain group and it’s a persistent pattern, then that tells you there’s something that from a cultural, from an ethnicity, from a gender, something that group has in common, that you’re not addressing,” Copeland says. “Then the real work starts.”\u003c/p>\n\u003cp>When doctors are presented with the data from their patients and the science on unconscious bias, they’re less likely to resist it or deny it, Copeland says. At Kaiser, they’ve reframed the goal of training around delivering better quality care and getting better patient outcomes, so doctors want to do it.\u003c/p>\n\u003cp>“Folks don’t flinch about it,” he said. “They’re eager to learn more about it, particularly about how you mitigate it.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch3>\u003cstrong>Still Unwell\u003c/strong>\u003c/h3>\n\u003cp>It’s been more than three months since Karla first got sick, and she’s still not feeling well.\u003c/p>\n\u003cp>Her heart rate continues to spike and she can’t walk across her apartment without getting winded. She decided recently to leave the Bay Area and move to LA so she could be closer to her family for her recovery.\u003c/p>\n\u003cp>She declined Alameda Hospital’s invitation to speak to their staff about her experience, concluding it wasn’t her responsibility to fix the system that abused her. But she wants the broader health care system to take responsibility for the bias perpetuated in hospitals and clinics.\u003c/p>\n\u003cp>She acknowledges that Alameda Hospital is public, and it doesn’t have the kind of resources that Kaiser and UCSF do. A recent audit warned that Alameda Health System was on the brink of insolvency. But still, Monterroso is the CEO of \u003ca href=\"http://www.code2040.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Code2040\u003c/a>, a racial equity nonprofit, and she says even for her it took an army of friends and activists fighting for her just to be heard.\u003c/p>\n\u003cp>“Ninety percent of the people that are going to come through that hospital are not going to have what I have to fight that,” she says. “And if I don’t say what’s happening, then people with much less resources are going to come into this experience and they’re going to die.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>University of California San Francisco paid hackers $1.14 million, officials said late Friday, after a breach into the UCSF School of Medicine's data in early June.\u003c/p>\n\u003cp>While those hackers managed to access key UCSF data and lock it away, the payment should restore that access. University officials said the incident did not impact coronavirus work.\u003c/p>\n\u003cp>\"Importantly, this incident did not affect our patient care delivery options, overall campus network, or COVID-19 work,\" UCSF officials said, in a statement.\u003c/p>\n\u003cp>A malware attack encrypted some servers at the UCSF School of Medicine, making them inaccessible. UCSF worked with a cyber-security consultant and outside experts to reinforce its defenses against further attacks, which are known as \"ransomware\" attacks.\u003c/p>\n\u003cp>The data breached by hackers include some important to \"academic work we pursue as a university serving the public good,\" \u003ca href=\"https://www.ucsf.edu/news/2020/06/417911/update-it-security-incident-ucsf\">UCSF officials said\u003c/a>. Patient medical records were not exposed, UCSF believes.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"This incident reflects the growing use of malware by cyber-criminals around the world seeking monetary gain,\" UCSF officials said. \"We continue to cooperate with law enforcement, and we appreciate everyone’s understanding that we are limited in what we can share while we continue with our investigation.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>— Joe Fitzgerald Rodriguez (\u003ca href=\"http://www.twitter.com/fitzthereporter\">@FitztheReporter\u003c/a>)\u003c/em>\u003c/p>\n\n",
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"content": "\u003cp>\u003cb>California’s Long Road to Economic Recovery\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">This week, Gov. Gavin Newsom eased restrictions on additional businesses. Pending approval from county health departments, retailers can now reopen for in-person shopping but with limits on occupancy and face mask requirements for staff and customers. Barbershops and nail salons can also now reopen pending similar approval and protocols in place. Many businesses, however, remain shuttered, especially in regions hard hit by the pandemic, such as in the Bay Area and Los Angeles. California lawmakers must now grapple with a $54 billion state deficit, with millions of residents out of work, tax revenues plummeting and uncertainty mounting about California’s economic future. \u003c/span>\u003c/p>\n\u003cp>\u003cb>Guest:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Tom Steyer, co-chair, Governor’s Task Force on Business and Jobs Recovery\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>UCSF Doctors and Nurses Help Navajo Nation Fight COVID-19\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">Straddling Arizona, New Mexico and Utah, the Navajo Nation now has the highest rate of coronavirus infection per capita in the country. With a population of roughly 175,000 tribal members living in an area the size of West Virginia, it’s the second-largest federally recognized tribe in the U.S. It’s also an area rife with poverty, where 30% of residents lack access to running water and depend on federally provided health care services. In response to the pandemic, authorities have imposed 57-hour weekend lockdowns and ordered residents to wear face coverings in public. Since late April, teams of volunteer doctors and nurses from UCSF have been traveling to the Navajo Nation to treat COVID-19 patients in this vulnerable community. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\"> \u003c/span>\u003cb>Guest:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Dr. Sriram Shamasunder, associate professor of medicine, UCSF\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Future of Cities\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">Working from home has become the new norm for many in the age of coronavirus. Some tech companies, like Twitter and Square, are now allowing their employees to work from home indefinitely.\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Last week, Facebook said up to half of its 48,000 employees could be working remotely in the next five to 10 years. And as the ability to work away from the office becomes more robust, many will have different choices about where to live. But will cities continue to thrive in this new reality, or will they empty out, driven in part by fears of another pandemic outbreak?\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cb>Guest:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Molly Turner, co-host, Technopolis podcast and lecturer, UC Berkeley Haas School of Business\u003c/span>\u003c/li>\n\u003c/ul>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cb>California’s Long Road to Economic Recovery\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">This week, Gov. Gavin Newsom eased restrictions on additional businesses. Pending approval from county health departments, retailers can now reopen for in-person shopping but with limits on occupancy and face mask requirements for staff and customers. Barbershops and nail salons can also now reopen pending similar approval and protocols in place. Many businesses, however, remain shuttered, especially in regions hard hit by the pandemic, such as in the Bay Area and Los Angeles. California lawmakers must now grapple with a $54 billion state deficit, with millions of residents out of work, tax revenues plummeting and uncertainty mounting about California’s economic future. \u003c/span>\u003c/p>\n\u003cp>\u003cb>Guest:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Tom Steyer, co-chair, Governor’s Task Force on Business and Jobs Recovery\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>UCSF Doctors and Nurses Help Navajo Nation Fight COVID-19\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">Straddling Arizona, New Mexico and Utah, the Navajo Nation now has the highest rate of coronavirus infection per capita in the country. With a population of roughly 175,000 tribal members living in an area the size of West Virginia, it’s the second-largest federally recognized tribe in the U.S. It’s also an area rife with poverty, where 30% of residents lack access to running water and depend on federally provided health care services. In response to the pandemic, authorities have imposed 57-hour weekend lockdowns and ordered residents to wear face coverings in public. Since late April, teams of volunteer doctors and nurses from UCSF have been traveling to the Navajo Nation to treat COVID-19 patients in this vulnerable community. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\"> \u003c/span>\u003cb>Guest:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Dr. Sriram Shamasunder, associate professor of medicine, UCSF\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>Future of Cities\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">Working from home has become the new norm for many in the age of coronavirus. Some tech companies, like Twitter and Square, are now allowing their employees to work from home indefinitely.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Last week, Facebook said up to half of its 48,000 employees could be working remotely in the next five to 10 years. And as the ability to work away from the office becomes more robust, many will have different choices about where to live. But will cities continue to thrive in this new reality, or will they empty out, driven in part by fears of another pandemic outbreak?\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cb>Guest:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Molly Turner, co-host, Technopolis podcast and lecturer, UC Berkeley Haas School of Business\u003c/span>\u003c/li>\n\u003c/ul>\n\n\u003c/div>\u003c/p>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"soldout": {
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"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
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"tagline": "True-life supernatural stories",
"info": "",
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