California, Coronavirus, Covid 19, Public Health, Testing

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.

Coronavirus, Covid 19, Solano County CA

Two excellent covid-19 data maps – Solano County among lowest rates in Bay Area

Vital information for city, state and national planners

By Roger Straw, April 11, 2020

In a previous posting, I shared links to the excellent Johns Hopkins coronavirus map.

Today, another great source was brought to my attention: the Topos.com COVID-19 Compiler.

The Topos map begins with a map of the U.S. (right), and allows you to drill down to state and county level statistics.

I found the chart showing “Cases Per Capita (per 100K PPL)” especially interesting.  Solano County is currently reporting a rate of 27.36 cases per 100K, which compares favorably to other Bay Area Counties.

The Topos map allows for comparison using an amazing number of other factors and data points.  For instance, you can compare Solano County’s overall Cases Per Capita, 27.36 to its Flu and Pneumonia Cases Per Capita, 24.9.

Much more is available on the map.  Interesting and vital information for city, state and national planners.

FROM THE ABOUT PAGE:

“COVID-19 Compiler aims to display relevant data about the novel coronavirus outbreak in the United States.

“Our goal is to provide a multidimensional view of covid-19’s impact in counties across the US encompassing the mapping of vulnerable populations, state and local policies to reduce transmission, and data on medical / health care resources. The site is updated daily with the latest data available on the outbreak.”

Coronavirus, Covid 19

COVID-19: Some auto insurers offer coronavirus rebates

Allstate, Geico, American Family offer rebates as cars stay parked

Vallejo Times-Herald, by Michael Nowels, April 11, 2020
SAN FRANCISCO, CA – APRIL 07: A lone car is seen from San Francisco International Airport in San Francisco, Calif., on Tuesday, April 7, 2020. Air traffic was practically at a standstill due to the coronavirus pandemic. (Jane Tyska/Bay Area News Group)

How long has it been since you drove your car?

For many Californians during this pandemic, the automobile has been more of an idea than a tool as stay-at-home directives keep them from driving to work or much of anywhere other than possibly the grocery store.

Some auto insurance companies have begun offering rebates due to decreased use. It began with Allstate on Monday announcing it would return $600 million in premiums to customers. Now American Family, Geico and Liberty Mutual are among the insurance companies returning money to their policy holders.

Most are offering about 15 percent in a rebate, while American Family is offering $50 back per vehicle.
Meanwhile, the California Department of Insurance is calling upon all auto insurers to do the same: “Consumers and businesses need rate relief now and we need insurers to move with all possible speed to reassess their risk profiles in light of California’s proactive shelter in place efforts,” commissioner Ricardo Lara said in a statement via email.

“I and my Department will be reviewing all insurance company actions to make sure money is returned to consumers, drivers and businesses in a manner that is not unfairly discriminatory, is transparent, and which follows the spirit of California’s strong consumer protections, including under Proposition 103,” which gives CDI the right to review all property and casualty insurance rates in the state.”

AAA California has not responded to a request for comment on the issue, while State Farm and Progressive told Reuters earlier this week they were considering options for rebates, but they haven’t yet announced any specific plans to return value to drivers. Lara also highlighted commercial auto insurance and worker’s compensation insurance as areas with lower risk during the pandemic, therefore making them candidates for consumer rebates as many face financial struggles.
He threatened to force insurers to offer rebates, saying the department would have a broader announcement in the near future.

“f the companies will not do it voluntarily, my Department will exercise its authority under California law so that drivers are not overpaying for insurance during this emergency,” Lara said. “Every dollar counts for drivers and businesses, and the Department is actively exploring how we get money back to policyholders — including the ability for policyholders and businesses to be re-rated given the significant impact that “shelter in place” directives have had on miles driven and business receipts.”

Coronavirus, Covid 19, Federal deregulation, Public Health

When you drown the government in the bathtub, people die

Washington Post, by Dana Milbank, April 10, 2020

A doctor wears a protective mask as he walks outside Mount Sinai Hospital in Manhattan on April 1. (Brendan Mcdermid/Reuters)

I had been expecting this for 21 years.

“It’s not a matter of ‘if,’ but ‘when,’” the legendary epidemiologist D.A. Henderson told me in 1999 when we discussed the likelihood of a biological event causing mass destruction.

In 2001, I wrote about experts urging a “medical Manhattan Project” for new vaccines, antibiotics and antivirals.

Reporting on a congressional briefing in 2005, I quoted public health experts predicting a pandemic that would overwhelm hospitals and exhaust respirator supplies. “I want to emphasize the certainty that a pandemic will occur,” the Mayo Clinic’s Gregory Poland said.

In 2009, during the swine flu scare, I relayed warnings about “the nation’s patchwork of a public health system” and the need for better “vaccine and public-health infrastructure before a more severe pandemic comes along.”

I repeat these things not to pretend I was prescient but to show that the nation’s top scientists and public health experts were shouting these warnings from the rooftops — deafeningly, unanimously and consistently. In the years after the 2001 terrorist attacks, the Bush and Obama administrations seemed to be listening.

But then came the tea party, the anti-government conservatism that infected the Republican Party in 2010 and triumphed with President Trump’s election. Perhaps the best articulation of its ideology came from the anti-tax activist Grover Norquist, who once said: “I don’t want to abolish government. I simply want to reduce it to the size where I can drag it into the bathroom and drown it in the bathtub.”

They got their wish. What you see today is your government, drowning — a government that couldn’t produce a rudimentary test for coronavirus, that couldn’t contain the pandemic as other countries have done, that couldn’t produce enough ventilators for the sick or even enough face masks and gowns for health-care workers.

Now it is time to drown this disastrous philosophy in the bathtub — and with it the poisonous attitude that the government is a harmful “beast” that must be “starved.” It is not an exaggeration to say that this ideology caused the current debacle with a deliberate strategy to sabotage government.

Overall, entitlement programs continued to grow, and the Pentagon’s many friends protected its budget. And Trump has abandoned responsible budgeting. But in one area, the tea party types, with their sequesters, debt-limit standoffs and other austerity schemes, did all too well. Between 2011 and 2018, nondefense discretionary spending fell by 12 percent — and, with it, the government’s already iffy ability to prevent and ameliorate public health emergencies unraveled.

John Auerbach, president of Trust for America’s Health, described for me the fallout: Over a dozen years, the Public Health Emergency Preparedness grants to state and local public health departments were cut by a third and the Hospital Preparedness Program cut in half, 60,000 jobs were lost at state and local public health departments, and similarly severe cuts were made to laboratories. A $15 billion grant program under the 2010 Affordable Care Act, the Prevention and Public Health Fund, was plundered for other purposes.

Now Americans are paying for this with their lives — and their livelihoods.

If the United States had more public health capacity, it “absolutely” would have been on par with Singapore, South Korea and Taiwan, which have far fewer cases, Auerbach said. South Korea has had 4 deaths per 1 million people, Singapore 1 death per million, and Taiwan 0.2 deaths per million. The United States: 39 per million — and rising fast.

To have mitigated the virus the way Singapore, South Korea and Taiwan did would have required spending about $4.5 billion a year on public health, Auerbach estimates. Instead, we’re spending trillions to rescue the economy.

Democrats aren’t blameless in pandemic preparedness. And some Republicans tried to be responsible — but the starve-the-beast crowd wouldn’t hear of it.

After Sen. Arlen Specter (R-Pa.) voted for the 2009 stimulus bill because he secured $10 billion for the National Institutes of Health, he was essentially forced out of the GOP. Rising in the party were people such as Rep. Jim Jordan (Ohio), whose far-right Republican Study Committee in 2011 proposed a plan, applauded by GOP leadership, to cut NIH funding by 40 percent.

In 2014, NIH chief Francis Collins said there likely would have been a vaccine for the Ebola outbreak if not for a 10 percent cut in NIH funding between 2010 and 2014 that included halving Ebola vaccine research. Republicans jeered.

In 2016, when President Barack Obama requested $1.9 billion to fight the Zika virus, Republicans in Congress sat on the request for seven months and then cut it nearly in half.

Since then, Trump has proposed cuts to the NIH and the Centers for Disease Control and Prevention so severe even congressional Republicans rejected them. And last month they fed the “beast” a $2.2 trillion feast to fight the pandemic.

Now they know: When you drown the government in the bathtub, people die.