Category Archives: California

California Identifies 261 Nursing Homes with Residents and Staff Who Have COVID-19

What Data’s Missing; What Action is Needed Now?

California Advocates for Nursing Home Reform (CANHR), April 18, 2020

Californians finally got a partial glimpse of COVID-19’s epidemic impact within the state’s nursing homes on April 17th when state officials released an incomplete list of nursing homes that have residents or staff who are infected with the virus. Released on a Friday evening, the list identifies 261 nursing homes that have reported COVID-19 infections involving either a resident or a staff member. In total, those facilities reported that 1,740 residents and 1,290 workers have tested positive for COVID-19.

Most likely, many nursing homes with COVID-19 outbreaks are not included on the state’s list. Some facilities are in the dark about the presence of the virus due to lack of testing. Other nursing homes are not on the list because they have failed to report outbreaks. California has no system to ensure that nursing homes are reporting outbreaks as required. Even Magnolia Rehabilitation and Nursing Center, the Riverside nursing home that had all 83 of its residents evacuated last week due to a major outbreak, is not on the list.

The state’s reporting system has other gaping holes. The newly published list gives no information on the rapidly escalating death toll in California nursing homes, no information on outbreaks in assisted living facilities and no information on any facilities in Kern, Fresno and other counties.

What Does the List Tell Us about the Safety of California Nursing Home Residents?

California nursing home residents are in grave danger right now. Despite its limitations, the state’s list identifies nearly 50 California nursing homes that have between 11 and 91 residents who are infected with the virus. Many nursing homes are woefully unprepared to keep residents safe due to their lack of leadership, staff, testing, attention to infection control protocols, personal protective equipment and other resources.

Actions Needed Now to Save Residents’ Lives in California

Public health officials throughout the world have expressed alarm that COVID-19 spreads like wildfire in long term care facilities. It is critical that California start treating outbreaks in long term care facilities with the same urgency it does for wildfires. The state should deploy multi-agency strike teams that have command of all available public and private resources to every facility with an outbreak and appoint commanders to lead efforts to save residents lives and to keep the public well informed about their actions and outcomes on a daily basis.

Beyond containing tragedies, California officials must do much more to prevent them. First and foremost, the state should order long term care facilities without COVID-19 patients not to admit outside patients with infectious COVID-19. Equally important, the state should assign a CDPH surveyor to conduct daily onsite monitoring visits at each facility with residents or staff who have COVID-19 and at each facility with a history of poor care to ensure infection control practices and staffing levels are safe and to sound the alarm on the need for immediate intervention if they are not. CANHR’s Emergency Action Plan to Save Lives of Residents of California Long Term Care Facilities gives other critically important recommendations.

Governor Newsom’s plan to re-open California

Repost of Governor’s press release, gov.ca.gov April 14, 2020


Governor Newsom Outlines Six Critical Indicators the State will Consider Before Modifying the Stay-at-Home Order and Other COVID-19 Interventions

Published: 
Governor’s six key indicators (VIEW HERE).

SACRAMENTO – Governor Gavin Newsom today unveiled six key indicators that will guide California’s thinking for when and how to modify the stay-at-home and other orders during the COVID-19 pandemic.

The Governor noted that the progress in flattening the curve, increased preparedness of our health care delivery system and the effects of other COVID-19 interventions have yielded positive results. However, these actions have also impacted the economy, poverty and overall health care in California. Any consideration of modifying the stay-at-home order must be done using a gradual, science-based and data-driven framework.

“While Californians have stepped up in a big way to flatten the curve and buy us time to prepare to fight the virus, at some point in the future we will need to modify our stay-at-home order,” said Governor Newsom. “As we contemplate reopening parts of our state, we must be guided by science and data, and we must understand that things will look different than before.”

Until we build immunity, our actions will be aligned to achieve the following:

  • Ensure our ability to care for the sick within our hospitals;
  • Prevent infection in people who are at high risk for severe disease;
  • Build the capacity to protect the health and well-being of the public; and
  • Reduce social, emotional and economic disruptions

California’s six indicators for modifying the stay-at-home order are:

  • The ability to monitor and protect our communities through testing, contact tracing, isolating, and supporting those who are positive or exposed;
  • The ability to prevent infection in people who are at risk for more severe COVID-19;
  • The ability of the hospital and health systems to handle surges;
  • The ability to develop therapeutics to meet the demand;
  • The ability for businesses, schools, and child care facilities to support physical distancing; and
  • The ability to determine when to reinstitute certain measures, such as the stay-at-home orders, if necessary.

The Governor said there is not a precise timeline for modifying the stay-at-home order, but that these six indicators will serve as the framework for making that decision.

He also noted that things will look different as California makes modifications. For example, restaurants will have fewer tables and classrooms will be reconfigured.

For more information on California’s response, visit covid19.ca.gov.

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False reports that Gov. Newsom extended stay-at-home order through May 15

By Roger Straw, April 12, 2020

A number of news outlets are reporting that California Governor Gavin Newsom extended the coronavirus stay-at-home order through May 15.

But as of today, nothing on the Governor’s coronavirus page confirms the extension.  Nor do any reliable news sources confirm the extension.

The story seems to have arisen in connection with actions taken by several southern California jurisdictions which extended the order through May 15, including Los Angeles County and the City of Santa Clarita.

California’s statewide stay-at-home order, issued on March 19, remains in effect “until further notice.”

Here in Benicia, we are also under Solano County orders to stay at home.  Solano County’s current extension order was issued on March 30, and continues through April 30.  The City of Benicia declared an emergency on March 15, and has repeatedly issued guidelines supporting the County’s order.

Testing chaos undermines California coronavirus response

San Francisco Chronicle Editorial Board, April 7, 2020
A health care worker speaks with a driver at a drive-thru coronavirus testing site in a parking lot of the old California Pacific Medical Center on California Street in San Francisco, Calif. on Thursday, April 2, 2020. The appointment only tests were provided for employees and staff of CPMC and Brown and Toland physicians.
A health care worker speaks with a driver at a drive-thru coronavirus testing site in a parking lot of the old California Pacific Medical Center on California Street in San Francisco, Calif. on Thursday, April 2, 2020. The appointment only tests were provided for employees and staff of CPMC and Brown and Toland physicians. Photo: Paul Chinn / The Chronicle

California has so far escaped an exponential coronavirus outbreak on the order of New York’s thanks to nation-leading social-distancing measures, particularly in the Bay Area. But the state has lagged in testing for the virus, undermining a relatively encouraging trajectory and threatening its ability to combat the contagion over the long term.

While federal failures have plagued coronavirus testing across the country, California’s capacity to identify the disease it’s fighting has been particularly poor. About 126,000 Californians had been tested for the novel coronavirus as of Saturday, Gov. Gavin Newsom said, or 0.3% of the population. That’s only about half the per capita rate nationwide in a country that has been a global underachiever in tracking the pandemic, ranking 42nd among the states according to one analysis. New York, with about half the population, has tested more than 300,000.

Extraordinary delays in processing those tests that have been conducted exacerbated California’s shortfall. At one point last week, results were still pending for more than 60% of tests. Some patients reported waiting well over a week to find out whether they tested positive, defeating any attempt to quickly identify and contain infections.

To Newsom’s credit, he took responsibility for the problem Saturday and vowed to increase testing “exponentially” by forming a testing task force and several diagnostic “hubs,” coordinating the distribution of supplies, and working with UC Davis and UC San Diego. The governor also reported significant progress on the testing backlog, which had fallen from nearly 60,000 awaiting results to around 13,000 as of last weekend.

Federal miscues early on put the entire country at a disadvantage in detecting the pandemic. Although the World Health Organization had distributed hundreds of thousands of working coronavirus tests by early February, the U.S. Centers for Disease Control and Prevention insisted on developing its own test only to discover flaws that made it largely unusable. The government nevertheless took weeks to relax regulations that prevented labs around the country from employing alternatives, finally doing so in late February.

Those difficulties were compounded in California thanks to shortages of testing supplies, a lack of coordination among dozens of public and private labs, and a huge backlog at one of them. Testing capacity has also been reduced by closures of about a quarter of the state’s public health labs over the past two decades.

If California’s relative success in slowing the spread of of the contagion continues, one likely consequence is that more of the population will remain unexposed and therefore vulnerable until a vaccine is developed, a process expected to take more than a year. A coherent testing regime will be that much more crucial to detecting and controlling any resurgence of the pandemic and beginning to restore a semblance of normalcy.