[NOTE: Latest COVID-19 analysis by Solano County Public Health shows Whites at 39% of the county’s population, but only 25% of cases, 23% of hospitalizations and 23% of deaths. Vallejo and Fairfield account for 54% of the population, but 73% of COVID cases, surely reflecting the two cities’ relatively poorer and browner neighborhoods. – R.S.]
The coronavirus crisis is revealing the inequities inherent in public health due to societal factors, Nancy Krieger, a professor of social epidemiology, says. Photograph by Johannes Eisele / AFP / Getty
According to preliminary data about the coronavirus pandemic, African-Americans are bearing a strikingly disproportionate share of the suffering in the United States. In Illinois, where fourteen per cent of the population is African-American, black Americans represent more than forty per cent of the state’s confirmed coronavirus deaths. Coronavirus fatalities have a similar breakdown in Michigan, and several Southern states show even greater disparities.
The possible reasons for these inequities are myriad: African-Americans are less likely than white Americans to have the option of working from home and to receive high-quality medical care, and more likely to have preëxisting medical conditions that lead to worse outcomes from the novel coronavirus. New research links coronavirus deaths to air quality, which is often worse in poor communities and communities of color.
Nancy Krieger is a professor of social epidemiology at the Harvard T. H. Chan School of Public Health. Her work focuses on health disparities between demographic groups and the social structures that help determine those disparities. We recently spoke by phone about how American health inequities are playing out during the pandemic. During our conversation, which has been edited for length and clarity, we discussed why the field of social epidemiology is crucial to understanding inequality, the causes of racial disparity in health outcomes, and what can be done to ameliorate the suffering of the most vulnerable Americans during this crisis.
Is the spread of the coronavirus, and especially its disproportionate impact on the African-American community, teaching us new things about racial disparities in health care and health outcomes or confirming things we have long known?
More the latter. What the virus is doing is pulling a thread that is showing how many things are actually connected, and how deeply people are actually connected. But it’s also revealing the very different conditions in which we live because of social structures that are inequitable, both within the United States and between countries. By pulling the thread, it’s revealing patterns that have been long known in public health.
So, when you think about something like this coronavirus, you have to think about who’s exposed in the first place and where they are exposed—at work, at home, and what are the conditions? You have to think about, if they’re exposed, do they get infected? You have to think about, if they get infected, do they get ill? And you have to think about, if they’re ill, do they actually die?
And you take each of those steps, which are all different steps in this process, and turn to what are the preliminary—and, I emphasize, preliminary—data on the excessive death rates. My state, Massachusetts… […continued…]
East Bay Times, By Annie Sciacca, UPDATED June 24, 2020
At least 15 people have died from COVID-19 infections at the San Miguel Villa nursing facility in Concord, according to data from the California Department of Public Health as of Tuesday, June 23, 2020. (Photo courtesy of Google Street View)
CONCORD — At least 14 people are dead after COVID-19 infected 75 people at an East Bay skilled nursing facility, according to data published by the state.
The state Department of Public Health’s latest report shows that 14 patients at San Miguel Villa, a post-acute nursing facility in Concord, have died after contracting the virus, which infected 62 residents and 13 workers at the facility.
A call to the facility was not immediately returned, so it’s unclear when the deaths occurred. Data reported to the state by the nursing home within the past 24 hours reveal that there are still 45 patients there infected with COVID-19
The state list on Tuesday showed that at least one healthcare worker at the facility had also died of COVID-19, but a spokesman for the facility, Dan Kramer, said Wednesday that it had been incorrectly reported, and that no workers had died.
The latest outbreak is yet another example of how the disease has ravaged the Bay Area’s most vulnerable population of elders living in congregate settings such as skilled nursing facilities or assisted living centers.
Of the 94% of the state’s 1,223 skilled nursing facilties that reported COVID-19 cases this week, there are currently 2,300 patients and 49 health care workers with confirmed COVID-19 infections, according to the state data. Cumulatively, there have been at least 12,282 confirmed cases across California and 7,655 cases among workers at skilled nursing facilities. And 2,299 patients and 89 health care workers have died from causes related to the deadly virus.
In non-medical residential care facilities — known commonly as assisted living facilities — there have been at least 2,969 confirmed COVID-19 cases among patients and staff, who often provide assistance in feeding, bathing, taking medication and other activities. At least 398 people in those facilities have died from COVID-19.
In Contra Costa County, health services director Anna Roth told the Board of Supervisors during its Tuesday meeting that of the 18 COVID-19 deaths that occurred the past week, 16 were from long-term care facilities, such as nursing homes. She did not identify the facilities.
Dr. Sara Levin, a deputy health officer for the county, told the supervisors a county task force had been set up to visit care facilities and help them proactively beef up infection control protocols and provide support in acquiring masks, gloves and other protective equipment, as well as ensuring they had enough staff if workers had fallen ill. The county at the end of May issued a health order to conduct mass testing as a baseline for all long-term care facilities, and then to continue testing staff monthly.
“Where we’ve seen a lot of the spread is when staff in these low-wage jobs are having to work in multiple facilities to ensure their financial stability, without benefits that don’t necessarily allow them to have sick leave,” Levin said. When federal, state and county mandates prevented most visitors, she said, “many residents were staying in facilities, so it was staff members going out to the community … and bringing it in.”
Concord’s San Miguel Villa is a 190-bed nursing facility on San Miguel Road owned and operated by Mark Callaway, Gary Jarvis and Velda Pierce. Pierce and Callaway also own other Contra Costa nursing facilities: Alhambra Convalescent Hospital, Lone Tree Convalescent and Antioch Convalescent Hospital, according to state records.
Since 2017, the facility has had a total of 106 complaints or reported incidents, and state inspectors found a total of 36 “deficiencies.” Some of those deficiencies included problems with infection control.
In an inspection in April 2019, for instance, state inspectors found multiple licensed vocational nurse staff members had not followed proper handwashing protocols.
Last year, the family of an elderly man who died at San Miguel Villa sued the facility, saying its lack of staffing and training led to the man’s suffering. The facility used drugs to sedate him, the lawsuit alleged.
Staffing shortages and lack of adherence to infection control practices have contributed to the outbreaks in nursing homes, experts have said.
“We are really concerned about the lack of oversight in skilled nursing facilities like San Miguel Villa,” said Nicole Howell, executive director of Ombudsman Services of Contra Costa, Solano and Alameda counties. “This underscores the need to improve regulation and oversight — particularly one that specializes in dementia and memory loss.”
The outbreak and death toll at San Miguel Villa is among the largest in East Bay skilled nursing facilities.
East Bay Post-Acute in Castro Valley has had a total of 16 COVID-19-related patient deaths, and 18 patients at Gateway Care and Rehabilitation Center in Hayward have died of the virus.
In San Mateo County, Millbrae Skilled Care has had 14 COVID-related deaths, and more than 100 cumulative infections among patients and 31 cases among health care workers there. But the state data shows there are no infections reported in the last 24 hours at that facility.
In Santa Clara County, 12 patients of Canyon Springs Post-Acute nursing facility in San Jose have died of COVID-19, and at one point 106 patients and staff were infected with the virus. There were no current cases within the last 24 hours, according to the state data.
Update: An earlier version of this story reported at least 15 people had died of COVID-19 at San Miguel Villa. A spokesperson confirmed the state data incorrectly reported that a healthcareworker had died.
Friday, June 26: 24 new cases today, no new deaths. Since the outbreak started: 1,118 cases, 101 hospitalized, 23 deaths.
Compare yesterday’s report, Thursday June 25:Summary
Solano County reported 24 new cases today, total of 1,118 cases since the outbreak started. This past week Saturday-Friday, Solano reported 258 new cases, an average of 37 per day.
No new deaths today, total of 23, no new hospitalizations, total of 101.
Solano reported 22 fewer ACTIVE cases today, total 250.
Testing – Solano county reported 431 residents were tested since yesterday’s report.
Solano’s new Public Health Dashboard design has 2 tabs
The County’s new Public Health Dashboard design includes a second tab (panel), the “Details / Demographics” tab (shown here). Note that both tabs are user interactive – hover over a chart (or tap) to get details. On the Details/Demographics tab, most of the charts have a small additional tab showing the rate per 100,000. Go there and explore the two tabs. (Expand a chart by clicking the small button in its upper right corner.)
SEVEN DAY MOVING AVERAGE
The County has added an important new feature: a Seven day moving average chart. The chart is “The average of the number of laboratory-confirmed cases of COVID-19 in Solano County residents over the past 7 calendar days, by the date that their specimens were collected.” Here is today’s chart, with a 7-day moving average of28 new cases per day, up from 26 yesterday. This chart shows a significant rise in the average number of cases during mid-June, tapering off only a little here at the end of June.
BY AGE GROUP
Youth 17 and under – 1 new case today, total of 88 cases, only one ever hospitalized. 11 days ago, there were only 40 cases among this age group – we’ve seen 48 new cases in 11 days!I continue to be alarmed for Solano’s youth. Cases among Solano youth have increased in recent weeks to nearly 8% of the 1,118 total confirmed cases. The Centers for Disease Control and Prevention puts the figure of coronavirus-infected kids younger than 18 at around 4% of those with the disease. Our youth are testing positive at almost double the national rate!
Persons 18-49 years of age – 16 new cases today, total of 634 cases. This age group represents 57% of the 1,118 total cases, by far the highest percentage of all age groups. The County reported no new hospitalizations among this age group today, and no new deaths. Total of 27 hospitalized at one time and 2 deaths.
Persons 50-64 years of age – 3 new cases today, total of 231 cases. This age group represents 21% of the 1,118 total cases. No new hospitalizations today, total of 34 hospitalized at one time. No new deaths, total of 3 deaths.
Persons 65 years or older – 4 new cases today, total of 164 cases. This age group represents 15% of the 1,118 total cases. No new hospitalizations and no new deaths today. Total of 39 hospitalized at one time and 18 deaths. In this older age group, 24% were hospitalized at one time, a substantially higher percentage than in the lower age groups. And this group counts for 18 of the 23 deaths, or 78%.
CITY DATA
Vallejoadded 4 new cases today, total of 460.
Fairfield added 11 new cases today, total of 360.
Vacaville added 5 new cases today, total of 150 cases.
Suisun City added 2 new cases today, total of 70 cases.
Benicia remained at 25 cases.
Dixonadded 1 new case today, total of 38 cases.
Rio Vista and “Unincorporated” are still not assigned numerical data: today both remain at <10 (less than 10). 1 new case was evidently in this group today, unaccounted for among the other city counts. The total numbers for other cities add up to 1,103, leaving 15 cases somewhere among the 2 locations in this “<10” category (one more than last reported). Residents and city officials have pressured County officials for city case counts. Today’s data is welcome, but remains incomplete for folks in Rio Vista and unincorporated areas of the County.
The “Rate” column shows the rate of positive COVID-19 cases (per 100,000 population) for each city. Benicia is leading the way here, with a rate of only 90.7 cases per 100,000. Compare with other Solano cities in the chart, and note that the CDC reports today’s rate in California at 494 per 100,000 (up from 481 yesterday). Johns Hopkins lists the overall Solano County rate at 245 (up from 238 yesterday).
RACE / ETHNICITY
Cases, hospitalizations and deaths by race/ethnicity – Solano County, June 26Incidence rate, hospitalization rate, and death rate (per 100,000) by race/ethnicity – Solano County, June 26
The County report on race / ethnicity data includes case numbers, hospitalizations, deaths and Solano population statistics. There are tabs showing a calculated rate per 100,000 by race/ethnicity for each of these boxes (second image above). This information is discouragingly similar to national reports that indicate worse outcomes among black and brown Americans. As of today:
White Americans are 39% of the population in Solano County, but only account for 25% of cases, 23% of hospitalizations and 23% of deaths.
Black Americans are 14% of Solano’s population, and account for 13% of cases, but 29% of hospitalizations and 36% of deaths.
Latinx Americans are 26% of Solano’s population, but account for 36% of cases. They account for 24% of hospitalizations and only 14% of deaths.
Asian Americans are 14% of Solano’s population, and account for 12% of cases and 15% of hospitalizations (down 1% from yesterday), but 23% of deaths.
Newsom threatens California counties that defy coronavirus rules as cases spike
San Francisco Chronicle, by Alexei Koseff June 24, 2020
Gov. Gavin Newsom at a news conference in Sacramento on June 5. Photo: Rich Pedroncelli / Associated Press
SACRAMENTO — Gov. Gavin Newsom could withhold financial relief from local governments in the upcoming state budget if they do not follow guidelines that he says are necessary to tamp down the spike in coronavirus cases in California.
The budget deal with legislative leaders announced this week ties $750 million in funding to replace lost tax revenue for county services, as well as $1.3 billion for counties and $500 million for cities from the federal bailout package, to local governments’ compliance with the stay-at-home order and other state requirements on the coronavirus response.
Newsom, through his Department of Finance, could order state officials not to send local governments their portion of the money if they do not certify they are following the rules, which include a new mandate for Californians to wear masks nearly everywhere outside the home.
At a news conference Wednesday, the governor said that authority would give him leverage over those who “simply thumb their nose” at state guidelines. He did not specify how cities and counties would be expected to prove their compliance, though he added that he was trying to encourage good behavior rather than punish bad behavior.
“We give an enormous amount of power, control and authority to local government, but what we’re now looking for is accountability,” Newsom said.
Since the state rolled out its requirement for face coverings last week, county sheriffs and local police chiefs from Orange County to Sacramento have announced that they do not plan to enforce the order. The mayor of Nevada City, in Nevada County, encouraged residents to defy the mandate to “prevent all of us from slipping down the nasty slope of tyranny.”
Newsom, who has previously used state regulatory agencies to pressure businesses and local governments that defied his lockdown measures, said Wednesday that the “power of the purse” would give him another tool.
“If counties that have submitted that they need more state money to address this pandemic but are unwilling to enforce the rules and laws related to mitigate that pandemic, it seems not only counterintuitive that you would continue to provide those resources, but actually harmful to the broader effort,” he said.
California reported a record 7,149 new cases of the coronavirus Tuesday, Newsom said, which he attributed not only to an increase in testing but also a rising rate of positive tests. The state has recorded more than 12,000 cases in the past two days.
Hospitalizations of coronavirus patients have grown by 29% over the past two weeks, to 4,095, though the governor noted that is only a fraction of the state’s capacity.
Newsom blamed the spread on more Californians venturing out of their homes to visit family and friends, which he suggested was threatening the ability of the state to continue reopening its economy.
“Many of us, understandably, developed a little cabin fever. Some, I would argue, have developed a little amnesia. Others have just, frankly, taken down their guard,” he said. “It is our behaviors that are leading to these numbers, and we are putting people’s lives at risk.”
Earlier this week, Newsom acknowledged that he might have to shut down businesses again if the state loses control of its coronavirus outbreak. He released a video with former governors Jerry Brown, Arnold Schwarzenegger, Gray Davis and Pete Wilson encouraging the public to wear masks.
On Wednesday, Newsom pleaded with the public to continue washing their hands, wearing face coverings and avoiding large crowds and intimate gatherings.
“Consider others in your life and strangers. Love thy neighbors like yourself,” he said. “If you cannot practice physical distancing, then are you practicing love?”
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