COVID burden on California hospitals not yet easing – San Francisco Chronicle

by FoxLive.News

Many passengers wear masks while riding BART in August.
The pressures of declining enrollment during the pandemic, along with administrative costs, led to the decision to close the doors of a 154-year-old East Bay university. Federal authorities are looking at whether to update the existing suite of vaccines and boosters to more effectively fight the evolving coronavirus strains. And UCSF’s Dr. Bob Wachter is trying to clear up the “confusion & misinformation” that he sees abounding on masks, testing and vaccines.
Latest updates:
Millions of people who enrolled in Medicaid during the COVID-19 pandemic could start to lose their coverage on April 1 if Congress passes the $1.7 trillion spending package leaders unveiled Tuesday. The legislation will sunset a requirement of the COVID-19 public health emergency that prohibited states from booting people off Medicaid. The Biden administration has been under mounting pressure to declare the public health emergency over, with 25 Republican governors asking the president to end it in a letter on Monday, which cited growing concerns about bloated Medicaid enrollment. Millions are expected to be bumped from the program, which grants health care coverage to nearly 80 million low-income people throughout the country. The federal government will also wind down extra funds given to states for the added enrollees over the next year under the proposal.
Advocates have raised concerns about how states will notify enrollees if they are being kicked off the program and what their options are, the Associated Press reports. The effort will be particularly challenging for some of the country’s poorest people, who may not have stable home address or access to internet or phone services to check their status. If passed, the spending package would allow states to start kicking people off the program as early as April, but require them to notify enrollees first.
Los Angeles County is seeing a serious shortage in staffing by mental health workers at county-run clinics and other facilities, the Los Angeles Times reports. Filling vacant spots has proven to be a major challenge in a time of rising demand. The increase in need has been attributed partly to the COVID-19 pandemic, public health officials say. Some providers have left their jobs citing overwork and stress, a health department report said, and others have moved out of state, amid a shortage of staff willing to work in person or in field-based positions rather than remotely. Some have gone to the private sector or other public agencies, leaving health officials to describe the diffuculty in keeping county facilities staffed as unprecedented.
The fast-spreading COVID-19 outbreak in China could see more than 1 million deaths over the next year, according to recent projections, with reports emerging about Chinese hospitals and funeral homes already overburdened. The Institute of Health Metrics and Evaluation at the University of Washington projected that 322,000 people in China would die by April. A Reuters analysis of the IHME report found that more than 1 million people in China could die of COVID-19 in 2023. World Health Organization officials now are voicing new worries that the too-low vaccination rates among older residents — only 40% of those over 80 have received booster shots — and lack of “herd immunity, will feed rampant transmission now that China has relaxed its restrictions on everyday life that were part of its zero-COVID policy to keep the virus at bay.
California had 4,500 hospital patients infected with the coronavirus as of Monday, state data shows, continuing a level of strain for health systems aas hospitals also fill up with flu and RSV patients. The COVID patient numbers include both those who were admitted because of COVID and those who test postive when admitted for other reasons. Hospitalizations have climbed since the beginning of the month when there were 4,000 patients with COVID at hospitals statewide. Los Angeles County, hard hit by the latest surge, has by far the state’s biggest population of coronavirus-infected patients, numbering 1,251, with available hospital beds in the county at the lowest level of the pandemic.  The Bay Area as of Monday had 804 COVID-positive hospital patients.
The United States is concerned China’s runaway COVID-19 outbreak might spawn new mutations of the virus as Beijing continues to grapple with its lifting of strict  “COVID Zero” constraints that had kept the pandemic at bay, the State Department says. “When it comes to the current outbreak in China, we want to see this addressed,” State Department spokesman Ned Price told a Monday briefing, according to news accounts. “We know that anytime the virus is spreading in the wild that it has the potential to mutate and to pose a threat to people everywhere.” China is seeing a wave of infections amid growing concerns the government may be hiding the true toll of the virus after years of insisting that the Communist Party had  skillfully dealth with the virus, more so than the West. Spokesman Liu Pengyu at China’s U.S. embassy told Bloomberg News on Monday that China has adopted “scientific and precise prevention and control measures” to minimize the impact of the virus on China’s population and economy.
The sprawling $1.7 trillion compromise spending bill that top lawmakers on Tuesday unveiled to keep the government open through next fall   includes plans intended to improve the nation’s response to future pandemics, though lawmakers did not include a proposal to create an independent panel to investigate the handling of the coronavirus pandemic, the New York Times reports.  It would also require Medicare to pay for telemedicine doctor visits for another two years, extending a popular policy allowed since the beginning of the coronavirus pandemic. To garner crucial Republican votes, Democrats abandoned priorities that included emergency aid to counter the toll of the pandemic, news outlets reported. The package would divert some $10 billion President Biden wanted for COVID-19 pandemic needs to beef up Ukraine and disaster relief, according to Roll Call. Congress is racing to finish the fiscal 2023 omnibus spending bill  by the end of this week.
Several local governments in China encouraged people with mild cases of COVID-19 to go to work this week, another sign of the difficulty the country faces as its rollback of measures to contain the coronavirus sets off a wave of infections — and a growing number of deaths. Health authorities reported Tuesday that five people died in the previous 24 hours, all in Beijing, fueling concern that the toll could rise sharply after the lifting of most “zero-COVID” restrictions. The official toll likely understates the actual number.
Authorities in countries around the world  — from Beijing and Jerusalem to Hyderabad, India, and Perth, Australia — have been using mass surveillance technologies designed for COVID-19 contact tracing to halt travel for activists and ordinary people, an Associated Press investigation found. The tracking data has been used to harass marginalized communities and link people’s health information to other surveillance and law enforcement tools. In some cases, data was shared with spy agencies. The issue has taken on fresh urgency almost three years into the pandemic as China’s ultra-strict zero-COVID policies recently ignited the sharpest public rebuke of the country’s authoritarian leadership since the pro-democracy protests in Tiananmen Square in 1989. For more than a year, AP journalists investigated how technologies marketed to “flatten the curve” were put to other uses, giving officials justification to embed tracking tools in society that have lasted long after lockdowns.
As the last week before Christmas counts down, federal health officials are dispensing pandemic safety advice for travelers, urging “actions to help prevent spread of COVID-19 and other respiratory infections.” That includes wearing a high-quality mask in “indoor public transportation settings.” The guidance Monday from the Centers for Disease Control and Prevention also urges travelers to: Be up to date on COVID-19 vaccines, including an updated booster; get a flu vaccine at least weeks 2 weeks before travel; practice good cough and sneeze etiquette by covering your mouth and nose with a tissue or your elbow; and delay travel on public transportation when you’re sick. Air travel levels this holiday season have been approaching what they were in the pre-pandemic year of 2019, security checkpoint statistics from the government show. 
Declining enrollment in pandemic times was cited Monday as a contributing factor, along with soaring administrative costs, in the closure of venerable 154-year-old Holy Names University in Oakland. The school is preparing to shut down at the end of the spring semester, and had issued advance warnings Dec. 1 of possible mass layoffs. “Five years ago we decided to build a business plan and use it to secure long-term financing. We were plugging along and hitting milestones, and then COVID-19 hit,” said the school’s board chairperson Steven Borg. While the university had a strong five-year strategic business plan, Borg said, it was unable to withstand the intensifying challenges of COVID-19 and a turbulent economy, both of which derailed students’ academic career. Read more about Holy Names University’s decision to shut its doors.
Federal regulators are considering whether today’s COVID-19 vaccines are sufficiently protective or may need updating to fight emerging generations of the coronavirus. The U.S. Food and Drug Administration’s  vaccine advisory committee plans to meet Jan. 26, along with CDC and National Institutes of Health officials to consider “whether and how the composition of currently available primary vaccines should be modified,” and whether booster shot composition and schedules should be adjusted to attack 0evolutionary virus strains. “COVID-19 vaccines remain our best available protection against COVID-19, particularly the most devastating consequences of the disease, including hospitalization and death,” an FDA release stated. Scientists have learned that vaccine protection wanes over time, and breakthrough infections occur as the virus mutates into new variants. “Therefore, it’s important to continue discussions about the optimal composition of COVID-19 vaccines for primary and booster vaccination, as well as the optimal interval for booster vaccination,” FDA’s statement said. At the meeting, manufacturers also will present their timeline needs relating  to vaccine composition changes. After evaluation of the science and issues, “the FDA will consider the most efficient and transparent process to use for selection of strains for inclusion in the primary and booster vaccines.”
As the pandemic spread in 2020, the number of American children who were killed rose precipitously, as did the number injured by firearms, the New York Times reports, citing two scientific studies on Monday. A majority of the deaths were among Black children, and almost half were among children in the southern United States. TheTimes reported last week that gun homicides involving children had increased by more than 73% since 2018 and that the disparity in risk between Black children and others was rapidly widening.  The rate of child homicide in the United States rose by about 28 percent in 2020, from 2.2 per 100,000 in 2019 to 2.8 per 100,000 in 2020, researchers at the Centers for Disease Control and Prevention found. Homicide is the leading cause of death among American children, with about half caused by firearms. The authors of the new study published in JAMA Pediatrics, said the trend revealed a public health concern “warranting immediate attention.” Child homicides are “fundamentally preventable,” yet they are becoming “more common, not less,” an accompanying editorial said.
UCSF’s Dr. Bob Wachter, one of the Bay Area’s most prominent voices on COVID-19, says COVID confusion and misinformation abound, and he sees it focused largely around masks, vaccines, and home tests. In a lengthy, he told his many Twitter followersover the past couple of days that these “correct” statements are the starting point: “Wearing the wrong mask, or wearing a mask incorrectly, doesn’t work. Vaccination/boosters don’t work as well as they used to in preventing infection. Home tests yield more false negative results than they used to.”
But he warned against “unambiguously wrong” statements holding that masks, vaccines, booster shots, and home tests do not work. He called it “dangerous” to say that vaccines do not work. For masking he himself wears an N95 mask in crowded indoor spaces, Wachter said, adding that cloth masks work less well, “though better than nothing” — and a mask worn incorrectly, such as not covering the mouth and nose snugly, will not work.
Regarding vaccination, Wachter noted that despite early evidence showing about 95% effectiveness of the primary shot series against infection, that protection has fallen over time “mostly owing to the immune-evasive properties of successive variants” of the coronavirus. “We now know that current boosters cut the risk of infection by only ~50%, and the effect only lasts for 2-3 months. That’s not nothing,” he wrote. But more important are studies showing the latest bivalent booster shot reduces hospitalization risk by about half across all age groups, he said.
As to home tests, he said, confusion often stems from the higher rate of false negatives seen with rapid antigen home tests than for the PCR tests. It owes to the fact that PCR tests can pick up tinier amounts of virus and thus detect COVID in a person longer. But antigen tests in fact are useful, and he often uses them himself, Wachter said.
Rita Beamish is The San Francisco Chronicle topic editor.
Claire Hao is A Hearst Reporting Fellow who joined the San Francisco Chronicle in 2022. She is a recent graduate of the University of Michigan, where she forayed into journalism at the student newspaper. Since then, she has interned on the news desks of Bloomberg Law and The Chicago Tribune as well as on the editorial board of The Washington Post. She was also the 2021 editor-in-chief of her college paper The Michigan Daily.
Having lived in Michigan for most of her life, Claire is really excited to begin her professional career by exploring two different cities. In her free time, Claire enjoys reading, writing, running and playing the guitar.



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