Hello My Fellow Californians:
Do you want to spend your last days in a California nursing home? I didn’t think so. If you weren’t sure before the coming of Covid, I bet you are now. I have been so baffled by the state’s lackadaisical attitude towards nursing homes during the pandemic that I did a quick search to see who would win the advocacy group battle: Nursing homes, homeless people, or prisoners? You guessed it, not old people.
Homelessness: Dozens of advocacy groups. It’s a national, complex problem, agreed, lots of people are homeless for different reasons. There is a national coalition to end homelessness. There are 10 pages of local California chapters on nationalhomeless.org/… I didn’t keep looking. Point is, there’s a lot. Good.
Prison reform: Also, many groups. Also, a complex, national problem which has spawned many national organizations with prominent California participation. Justice reform, Reimagining punishment, sentencing reform , Prison reform coalitions, Youth Incarceration and juvenile justice reform. Just to name a few.
Nursing homes: Um, wow. Basically, the AARP and California Advocates for Nursing Home Reform, an awesome group. A few small organizations.
Is it any wonder that the first place the state should have dealt with, given what we learned from Washington State, is one of the last places they are finally dealing with? I personally had no idea it was this bad.
When I was a baby lawyer looking for a progressive place to hang a shingle, I looked into health care advocacy. My eyes glazed over. It was and is a blizzard of government regulations, acronym hell, and soul-less bureaucratic BS. Within 3 minutes everyone forgets that there are human beings involved. Health care stuff is way expensive, every player has their hand out for $$$, and frankly, no governmental organization wants to spend any money there.
Predictable result: Even before the pandemic, infections ran wild in nursing homes. Last week, the GAO reported that 82% of nursing homes had infection control problems prior to Covid, and half of them had persistent problems. It was a catastrophe lying in wait. Of course these places have been decimated by a virus far more deadly than the stuff they are used to ignoring on a daily basis, like GI bugs and MRSA.
Nursing home residents have no voice, few active coalitions, plenty of money against them wanting to keep things the way they are, and politicians playing ball with rich people. Unless we the people find out and stop them.
I am telling you this for two reasons.
- First, the contagion in California will not stop until the state gets serious about senior congregate living facilities. Stop flapping their mouths and expressing Susan Collins-esqe “concern.” Require testing of every resident and employee of every nursing home and every assisted living facility. Fund it and train the testers and do whatever you need to to make this happen. Stop making excuses. The entire economy of California has been shut down to stop the virus and yet this major spot of contagion absolutely, bafflingly, is consistently ignored. Almost half of the state’s deaths come from this one center.
Finally, finally: the state finally a few hours ago sent out a directive mandating that all nursing home staff and residents be tested. Nursing homes are under the jurisdiction of the California Department of Public Health, which until today had a catastrophic “FAIL” in this category. My question is, why the hell did it take them this long?
- Here’s the second reason I am telling you this. Does California still have the money to maintain the programs that keep people in their homes and out of these dangerous places? Turns out they do. Good! Too bad that, according to theCalifornia Advocates for Nursing Home Reform, California is going to terminate, gut and slash these programs and give the money to nursing home operators instead. This back-room deal has been in the works for months, according to the group.
Once you wade through the mumbo-jumbo, there’s a bottom line. Nursing home operators are coddled, residents are screwed, seniors who want to stay in their own homes get the finger, and politicians, including the Governor, hope we don’t notice because it’s too complicated, too expensive, and damn those people are old anyway.
You want to do something? Go HERE and write a letter to your state representatives. Tell them you see what’s going on, it’s not ok with you, and it’s not going to happen on your watch. It’s the least we can do. All of us will be geezer persons some day. As a geezer person myself, I can say I ain’t going into one of those places, ever, full stop. But I will fight like hell to make sure that if you have to go there, it’s a place where you can live with dignity, comfort, and safety.
BY THE NUMBERS
Whew.
Meanwhile….
Before the Deep Dyve into SoCal, here are some state stats:
HOT SPOTS: These great interactive maps courtesy of the Los Angeles Times. Support local journalism!
NEW CASES — LAST 14 DAYS
New Deaths --Last 14 days
You look at those bright-red maps of California on the evening news for its huge number of cases...horrifying, right? However, California is the most populous state. Look at another map: cases per 100,000 population. The situation looks hella different.
Total California cases -looks bad!
Cases per 100k of population — very different
Southern California is the epicenter of the outbreak.
SOUTHERN CALIFORNIA CASES AND MORTALITY
Los Angeles County remains the epicenter of the epidemic, with almost half the state’s cases and well over half the state’s deaths. Why?
The Los Angeles Times has been looking at this for a few weeks. Here is as much sense as we can make of it right now. Major culprits: Density and poverty.
- Los Angeles was relatively slow to close. On March 16, when the Bay Area abruptly closed down, it didn’t make sense to Los Angeles because they had far fewer cases.
- Although the county shut down 3 days later, functionally it was 6 days later, since so many people crowded the beaches the weekend after the announcement.
- In San Francisco, far fewer people were going to public spaces as early as late February, long before such a change happened in Los Angeles. Many Bay Area tech companies asked employees to work from home.
- Oddly enough, LA’s population skews younger than the state as a whole.
- Density may play a part: the county is 10 times more dense than the state as a whole. Hence, explosive Covid growth is in manufacturing and meat-packing plants, assisted living facilities, jails, and nursing homes.
- Los Angeles has higher rates of poverty than almost every other urban county in the state. Poorer people are likely to be homeless and unable to stay home when sick, have less access to healthy foods or medical care, and live in polluted areas.
- South LA county has a baseline of chronic diseases that are poorly treated: there are over 100k visits to Martin Luther King Community hospital every year for diabetes, hypertension, pulmonary disease and mental health. The rate of diabetes is three time the national average, and amputations are among most frequent procedures. The average life expectancy is 10 years shorter than the California average. 12% of the population has no insurance.
These factors have set the stage for other contagious disease outbreaks in Los Angeles, such as measles, typhus, and hepatitis A.
On a positive note: the quarantine has lowered transmission rates from +3 to below 1. With each infected person transmitting to less than 1 person, the number of infections will start to fall.
In Orange County, which recorded 5 more deaths and its highest number of hospitalized Covid patients on Wednesday, the Supervisors declared religious services essential, starting this weekend. How can these two things coexist in a rational brain? 1. They can’t. or, 2) Because, frankly, death only happens to “those” people.
Which “other”?
- 54 of the 136 people who have died (40%) were residents of skilled nursing facilities.
- 11% of cases are skilled-nursing facility residents
- 6.5% are county jail inmates
- 17% live in Anaheim
- 19% live in Santa Ana, both with majority-minority populations.
And, as in other places in the state, the young are getting sick and the old are dying. All but 35 of the deaths are in people 65 and older. The vast majority of the cases are in people younger than 65.
If you are younger than 65 and live in the OC, do the math. Wear a mask. Not to protect you, but to protect your parents and those stupid nitwit persons marching around with American flags, no masks and give-me-liberty-and-death signs in Newport Beach.
San Diego is in discussions to reopen Sea World and the San Diego Zoo as county cases rise to almost 7000. Still, the number of deaths remained unchanged at 249 on Tuesday for the 3rd day in a row. Good!
San Diego is proposing some sensible rules about spacing and masks, etc. – much better than what happened in Lake of the Ozarks over the weekend. Since outdoor transmission is not very common, with sensible rules, reopening these places might be ok. Not that I would go there.
Imperial County, one of the southernmost counties in the state and contiguous with Mexico and Arizona, has maxed out its hospital capacity and is sending patients to Riverside hospitals. Imperial has a small population, (181,000+) but has many border towns, and it has the highest per capita rate of Covid hospitalizations in California and ICU rates double that of Los Angeles. It also has some of the most polluted air in California, and had high rates of respiratory illness even before Covid. (TB is 8 times the national average there, speaking of contagious respiratory diseases). Imperial is an invisible county with a very serious problem. All but 2 of Imperial’s 14 deaths were over the age of 70.
TESTING
- CVA drive-through pharmacies will begin doing Covid tests on Friday. Schedule online.
IN THE NEWS
- LA County is allowing churches and stores to reopen, churches at 25% and malls at 50%. You still have to wear a mask. If you want to know what’s open and what’s not in LA County, the LA Times has a great resource HERE.
- Well, at least California unemployment claims fell to a two-month low.
Three things are interesting about this story. 1) California prison officials (or some official) sent this fellow to Alaska on a commercial flight the day after he tested positive. 2) It took 4 days for California prison officials to contact his Alaska parole officer with news of the positive result; 3) Alaska requires anyone entering the state to quarantine for 14 days. Who knew?
The guy had no symptoms but nevertheless was apparently a walking contagion. So far, his mom and daughter have tested negative.
Reopening is Hard to Do:
- Lassen County in the far north, which had no cases for three months, now has 5 after a resident traveled outside the county and became infected. Now the county has a problem, with 5 cases and 22 tests pending. They have reversed their reopening, closed churches and dine-in restaurants.
- El Dorado County still doesn’t want you: South Lake Tahoe is really unhappy about people from outside the county coming to visit. The county lifted its nonessential travel ban but is happy that a state order still prohibits tourism to Lake Tahoe.
- State Health officials are extremely worried that reopening too quickly or too carelessly can backfire. LA County PH Director Barbara Ferrer is concerned that we could have a renewal of explosive growth if people don’t maintain social distancing and wear masks.
- Barbara Cody, the Santa Clara PH Director, fears that California is reopening too quickly, particularly concerning religious, political and cultural gatherings of up to 100 people. This seems like a terrible thing to allow, just asking for trouble. Reopening is clearly much harder than shutting down.
- Covid cases spiked an astonishing 40% in the Bay Area, especially in Alameda County, which just had its worst week in new cases and has surpassed Santa Clara as hardest hit in the region. Anecdotally, Alameda has seen a spike in cases among construction workers, who were allowed to resume working about 4 weeks ago, and people in “essential” jobs.
AND FINALLY ….
It was inevitable. Everything Donald Trump touches is such a scam that people are mistaking their stimulus checks for junk mail or a scam and throwing them away. This should cheer the IRS right up, since they sent out so many stimulus checks to dead people. As they forgot to put in a provision requiring people to return a check for the dearly departed, people are cashing them. One fellow noted that a stimulus check to his departed wife had a notation on it that said, “deceased”. Naturally the bank cashed it.