Below is the powerpoint Governor Newsom used at his noon press conference today to outline the process for California’s road to modifying stay-at-home orders and re-opening the businesses and workplaces. A good summary can be found at CBS8 San Diego. (A print version is likely to appear soon on the Governor’s coronavirus page.)
Governor Newsom Announces Plan to Resume Delayed Health Care that was Deferred as Hospitals Prepared for COVID-19 SurgeDecision based on progress toward preparing California’s hospitals and health care delivery system for a COVID-19 surge in patients – one of California’s six indicators to gradually modify state’s stay-at-home order
State also announces plans to add at least an additional 80 testing sites, mainly in underserved communities; train up to 10,000 contact tracers
SACRAMENTO — Today, California Governor Gavin Newsom announced plans to allow hospitals and health systems to resume delayed medical care for Californians – such as heart valve replacements, angioplasty and tumor removals, and key preventive care services, such as colonoscopies – which were deferred as the state’s health care delivery systems prepared for a surge of COVID-19 patients. The decision was based on progress toward preparing California hospitals and health systems for a surge in COVID-19 patients – one of the six critical indicators the governor unveiled last week as part of the state’s framework for gradually modifying California’s stay-at-home order.
As part of the Western State’s Pact, California will work with Washington and Oregon to share best practices on how our states can allow hospitals and medical providers to resume delayed medical care in areas that have sufficient hospital capacity, while ensuring the safety and health of our health care workers and patients. The Western states had previously announced a shared, science-based vision for gradually reopening their economies and controlling COVID-19 into the future.
“From the beginning, I have said California’s decisions will be guided by science, not politics, and that Californians’ health comes first,” said Governor Newsom. “Thanks to the work our health care delivery system has done expanding hospital capacity and reducing the rate of spread of COVID-19, hospitals and health systems can consider resuming medical care that residents have delayed during this crisis, such as heart valve replacements, angioplasty and tumor removals, when such care can be delivered safety and with appropriate protections for health care workers. It’s in the best interest of the overall health of our state to allow these procedures to resume when they can be done safely.”
Last week, Governor Newsom announced six indicators that would drive California’s decision to gradually modify portions of the state’s stay-at-home order. They include:
Also today, Governor Newsom announced that President Trump has personally committed to sending the state 100,000 testing swabs next week and 250,000 swabs the following week.
Health officials also outlined progress toward the first indicator: expanding testing and contact tracing to be able to identify and isolate those with the virus.
To that end, the state announced the expansion of community testing in underserved areas. The state is contracting with Verily, an Alphabet company, in partnership with Community Organized Relief Effort (CORE) and with support from Rockefeller Foundation and an anonymous donor, to establish six new community testing sites focused on underserved communities such as farmworkers and communities of color. Additionally, the state is contracting with OptumServe, to establish an additional 80 community testing sites, which too will be focused on underserved communities.
“We know that communities of color are disproportionately affected by COVID-19,” said Governor Newsom. “We must ensure that we are deploying testing equitably in an effort to reduce the higher death rates we are seeing in African American and Latino communities.”
In addition, the state is:
Now that testing has become more widely available across the state, California updated its testing guidance earlier this week to become the first state to recommend testing of some asymptomatic individuals such as health care workers, first responders and correctional workers. This action will better protect Californians and prevent COVID-19 spread in high-risk settings such as congregate living facilities and correctional facilities.
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Vallejo Times-Herald, by Evan Webeck, April 22, 2020
Cases spiked Tuesday for a second straight day and California reported the third-most deaths in a single 24-hour period since the onset of the COVID-19 outbreak.
The deadly respiratory illness, caused by the new coronavirus, claimed another 93 lives in the state Tuesday as California’s death toll climbed to 1,316, according to data compiled by the Bay Area News Group.
The state has seen its largest increase in cases the past two days, adding nearly 2,000 on Tuesday alone to bring its total to 35,802. Patients in acute hospital beds, as well as intensive care units, rose by about 3% to 3,365 and 1,241, respectively. Statewide, the case count has grown by nearly 15% since the week began.
Those numbers would seem to indicate California has not yet turned the corner in its fight against the virus.
One widely cited model predicted the state passed its peak late last week. But there have been five days on which the state has reported more fatalities than the model projected on its deadliest day, and two since the projected peak. Researchers revised their projections Tuesday to show the state’s final death occurring May 12, with a final death toll of 1,743 (with a confidence interval from 1,340 to 2,701) — about 400 more than its total as of Tuesday.
But a lack of widespread testing has made it difficult to gauge what stage the outbreak is in. Labs in the state conducted their 300,000th test Monday, the most recent day for which data was available, but that still amounts to less than 1% of the state’s total population. Gov. Gavin Newsom set a goal of performing 25,000 tests per day, but on Tuesday, he admitted that wouldn’t be enough.
Another variable was thrown into the equation Tuesday. Officials in Santa Clara County discovered new deaths from from COVID-19 as far back as Feb. 6, a whole month before what was believed to be the first coronavirus fatality in the county and weeks before what had been thought to be the first death in the nation on Feb. 29 in the state of Washington.
“To have at least three people right around the beginning of February and late January already have the infection and two of them pass away means the virus has been around for a while,” County Executive Jeff Smith said. “It’s a much more dangerous virus than we initially recognized because we had limited testing.”
Residents in several California counties will now be required to cover their faces in most public settings, or risk possible fines or misdemeanor charges.
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.
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