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The Nooner for Saturday, April 25, 2020, presented by SYASL Partners
"Hello, I'm Gavin Newsom."
-- the first-place item on Bill Maher's top pick-up lines for after the stay-at-home is lifted
SEEN ON TEEVEE: Speaker Nancy Pelosi (D-San Francisco) on Real Time with Bill Maher
LEGAL CHALLENGE TO STAY-AT-HOME: On behalf of several businesses, Mark Geregos and Harmeet Dhillon yesterday filed a lawsuit in the United States District Court for the Central District (Los Angeles) against several state and federal officials arguing that the continuing enforcement of the stay-at-home order infringes on constitutional rights under both the state and federal constitutions.
Dhillon is the Republican National Committeewoman from Los Angeles, who I wrote yesterday filed a suit Thursday against Governor Newsom's allocation to state funds to nonprofit community-based organizations to be used to support noncitizen residents ineligible for federal benefits. Geragos is the well-known criminal lawyer from many high-profile cases like Michael Jackson and Scott Peterson.
The suit alleges that continuing the stay-at-home order deprives plaintiffs their civil rights under the Fifth and Fourteenth Amendments (equal protection and due process) of the U.S. Constitution, codified as a liability for damages to the injured under 42 U.S.C. § 1983.
The specific claims are:
The first four issues are a perfect final exam question for Con Law II or even a bar exam question. Speaking of that, to my knowledge, no decision has been made yet whether or not the July Bar Exam will take place or will be delayed until the fall. Beyond the issue of the exam itself, students who plan to begin bar review classes that they have paid for over the last couple of years may not take place. It's a cluster...
As I wrote about previously in relation to the restrictions on churches, these will be analyzed under strict scrutiny, as will the California constitutional issues. I haven't read all 37 pages yet but my assistant tells me my afternoon is pretty clear.
We need another live pod with UC Davis's Carlton F.W. Larson to talk through this. For those that came to the one in December at Capital Books, you know how I love to geek out on ConLaw. Maybe I can book a Zoom...
more after the jump...
WHERE ARE WE AT?
I first wrote about COVID-19 on January 24:
A passenger arrived at LAX late Wednesday with symptoms of the coronavirus originating from Wuhan, China, report Jonathan Lloyd and Toni Guinyard for NBC LA. Tests of the passenger were sent to the CDC in Atlanta.
The article concluded:
The virus that emerged in Wuhan, China in December has killed 17 people.
SEVENTEEN PEOPLE. WORLDWIDE. This morning (at 7:45am) it is 197,924, according to Johns Hopkins. California now has more than 26 deaths per county.
We may never know whether that patient arriving on a flight connecting in Mexico City indeed had COVID-19 or not, but what we pretty much know certainly is that it wasn't the first case in California. We now know that the first death with COVID-19 was February 6 in Santa Clara County. With a median incubation period of 5 days as reported by the Annals of Internal Medicine, that likely pushes exposure of the first death in to January, perhaps around the time the man arrived in LAX but not from that man.
Please note that I used the phrase with COVID-19. That's important. Some language used in the media suggest that otherwise apparently healthy Patricia Dowd's fatal heart attack was because of COVID-19. We likely will never know. If someone who has COVID-19 dies while cooling down in their swimming pool today, that doesn't create a causal link.
However, this article by Ariana Eunjun Cha in today's WaPo might give a clue as to clotting-related deaths (stroke, heart attack) among younger, healthier people whose lungs otherwise could beat the virus may shed some light. Cha writes:
Reports of strokes in the young and middle-aged — not just at Mount Sinai, but also in many other hospitals in communities hit hard by the novel coronavirus — are the latest twist in our evolving understanding of its connected disease, covid-19. Even as the virus has infected nearly 2.8 million people worldwide and killed about 195,000 as of Friday, its biological mechanisms continue to elude top scientific minds. Once thought to be a pathogen that primarily attacks the lungs, it has turned out to be a much more formidable foe — impacting nearly every major organ system in the body.
It is unclear where Dowd, an auditor for a technology company who traveled regularly, was exposed to the virus but it's now widely expected to have been present in many parts of the U.S. in January if not before.
On February 1, I wrote:
A third case of the coronavirus tied to Wuhan, China has been discovered in Santa Clara County. Thus far, there have been cases in Southern California, Illinois, Massachusetts and Washington.
Health officials have not determined how the virus has spread, although the latest case in California traveled from Wuhan to San José recently. The CDC reports that there have been discovered cases among people who did not personally shop at the Wuhan animal and seafood markets. Out of 241 suspected cases, 6 have been identified as positive, 114 as negative, with 121 tests pending. 195 U.S. citizens are currently on a fourteen-day quarantine at March Air Reserve Base after being evacuated from the Chinese region. The Riverside County base was changed from a full base to a reserve station as part of BRAC in 2003. As I wrote yesterday, major airlines have suspended travel to China. 259 people have died from the virus in China.
Meanwhile, the flu has killed over 10,000 Americans this season, with 19 million cases.
Yeah, that comparison with the flu worked about as well as the President's ""[W]hen you have 15 people, and the 15 within a couple of days is going to be down to close to zero, that's a pretty good job we've done."
Anyway. THREE CASES in California. The third case in Santa Clara County was reported on February 28.
We now know that the first death with COVID-19 was on February 6, the second was February 17, and the third was March 6.
It's been 92 days since the many from Wuhan via Mexico City landed at LAX. It has been 79 since the first death associated with the virus.
Oddly, I have been writing this item for about an hour and now Governor Cuomo is on the teevee talking on a very similar longitudinal subject.
Initially, this was thought to be limited in California to the Bay Area, which made sense given the amount of travel between Asia and the tech-sector heavy region.
The first day I reported on daily numbers was March 17:
California confirmed cases: 617 (+45 from last night), with 11 deaths. Confirmed cases in 30/58 counties (+1 from yesterday).
Today, we are at 41,313 confirmed cases and 1,615 deaths.
We know that the number of confirmed cases has grown so rapidly largely because of expanded testing, but the same is also likely true with the number of deaths.
Like with the Santa Clara County three early deaths just reported this week, there are likely many more fatalities with influenza-like illness where a flu test returned negative before any testing outside of sending samples to the CDC was available. The state has asked county medical examiners to investigate the backlog of these, although we'll unlikely never know the exact ramp up that landed us at the number of deaths we see today. It probably was more than eleven on March 17.
What actually got me on this topic today was when I was reading last night's situation report from Los Angeles County. I noticed that last night's number of deaths -- 848 -- was more than half of the statewide cases. LA County is about 26% of the state population.
I remember monitoring college and university suspension of in-person activities back in the early days of COVID-19 in California. They started in the Bay Area but many in Southern California thought that they were unnecessary. The same thing was true when the stay-at-home orders in the initial 6 Bay Area counties were issued on March 16. First, locals thought they were overreacting. Other than other surrounding Bay Area counties that joined the initial 6, elsewhere in California it was seen to be localized. Within a month, all but six states had statewide stay-at-home orders.
As you'll see below from the data that we have, Los Angeles has taken over from the Bay Area as the epicenter in California, both in cases and deaths. The Bay Area 9 (SFChron) are Alameda, Contra Costa, Marin, Napa, San Francisco, San Mateo, Santa Clara, Solano, and Sonoma.
There will be a lot written about what we're experiencing. I can think of several graduate level theses. Of course, I have time to offer for more questions than answers. Nevertheless, this is what I've been thinking about this morning.
We have the first case of unknown etiology in Santa Clara County likely infected in January, although she may have gotten in while traveling. We have the January 23 case of the man landing at LAX, the first with symptoms that triggered a fear of the first infection and leading to paramedics and policy meeting the plane on the ground. But, it was likely already here.
What was thought to be isolated to travelers from Wuhan or those on cruise ships turned in to a Bay Area health emergency turned in to a statewide order that is now overwhelmingly Southern California. In fact 72.5% of the deaths collectively come from (in order) Los Angeles, San Diego, Riverside, San Bernardino, and Orange. While those are the five most populous counties in the state, they account for 53.7% of the population.
Anyway. Saturday morning rambling. ¡Lo siento!
lots more after the jump...
STATE FAIR, SEE YOU THERE (NEXT YEAR?): It's the announcement we've been waiting for. Yesterday, it was made official. The California State Fair this summer has been canceled over COVID-19 concerns. The fair had been scheduled for July 17-August 2 at the sprawling grounds just east of downtown.
Currently, Cal Expo is playing a regional role in the effort to combat the virus, including serving as a drive-through testing site, as well as a temporary emergency isolation trailer facility for homeless individuals who have been exposed or infected.
Cancelling the California State Fair and many of the 200 year-round events hosted at Cal Expo is having a significant economic impact on Cal Expo and the region. We are sensitive to the fact Cal Expo is a regional, economic engine that generates sales tax revenue and employs over 800 seasonal workers. Our staff is working diligently on a strategy to safely reopen when appropriate and we look forward to the time when we can all gather again safely to celebrate the great things Californians have done and will do in the future.
The cancellation will likely amplify critics who cite that the fair has been losing attendance for several years and question continuing the event at its current scale.
Somewhat presciently, Dan Walters wrote for CalMatters exactly one month before the statewide shutdown:
Cal Expo was envisioned as a year-round attraction, somewhat patterned after Disneyland, complete with a monorail. It never happened and today, Cal Expo is just a collection of somewhat shabby, architecturally bleak and deteriorating structures surrounded by immense parking lots.
The state fair itself, meanwhile, has lost most of whatever cachet it once had. Notwithstanding a slight upward bump last year, its attendance, mostly from the Sacramento area, has been steadily declining — down 40% in the last two decades.
While the fair is supposed to be a showcase for California’s agricultural output, artistic talents and crafts, attendees are mostly drawn by the carnival and arrays of trailers serving deep-fried everything. It doesn’t generate enough money to pay for Cal Expo’s upkeep and its managers have been desperately seeking new revenue streams.
Last year’s version of Cal Expo’s annual financial audit contained this gloomy passage: “Cal Expo has suffered recurring losses from operations, has aging infrastructure which requires significant capital improvements and has stated that doubt exists about Cal Expo’s ability to continue operations into the future.”
Gov. Gavin Newsom has said he wants vacant state-owned land to be made available for shelters to house the homeless. Cal Expo’s crisis is an opportunity for him to take that notion a bit further by offering its mostly unused property as a showcase of how streamlined housing regulation could work.
I've been talking to folks about the fair for a few weeks, predicting its cancelation even if the state "reopened" quickly. As Dan writes, attendance has been a struggle and, while Sacramento foodies love to embrace farm-to-food culture, the State Fair is not the destination that comes to mind. Instead, foodies are looking at the numerous farm-oriented events, the popular annual dinner on the Tower Bridge, and of course the farmers markets.
The biggest draw for me in the years I have gone has been the art from students from grade school through university as well as work done by amazing artists. However, the halls displaying these works are usually sparsely attended. I don't know the lead time for submissions to the State Fair to be considered, but with schools out, much of that art (which draws family attendance) likely would not have come in.
Citing the state's housing crisis and that of declining attendance at the State Fair, Walters continues:
Selling off land for housing, even cheaply, would provide Cal Expo with much-needed money to reconfigure the fairgrounds for a smaller but more focused annual exposition of California’s bounty — a source of pride rather than of derision.
These two crises should not be wasted.
I'm not endorsing anything other than a conversation after this third crisis is creating an opportunity to rethink everything.
SCHOOL DAZE: For CalMatters, Ricardo Cano and Adria Watson report that schools in wealthier areas have not necessarily been faster better at moving to technology-assisted education as in-person instruction at schools is closed.
Based on a CalMatters analysis of more than 170 school districts, which California districts were fastest to switch to remote learning? Not necessarily the wealthiest, it turns out. Just those who had best prepared.
While schools serving poorer communities faced higher hurdles for rolling out distance learning programs, school systems such as Pajaro Valley that did so sooner had spent several years training teachers in online instruction and developing the infrastructure now critical for remote education.
In an effort to understand how some of the state’s school systems adapted to their new reality, CalMatters examined letters, updates and communication sent by districts to families during March and April. The sampling shows that at least three dozen school districts near-seamlessly transitioned to online learning within a week of their initial school closures.
In other districts, distance learning for students began weeks after closures.
HEALTH CARE: While the bill signed by President Trump yesterday that replenished the Paycheck Protection Program with an additional $310 billion also included $75 billion, that doesn't mean all is peachy in the health care world. Kristen Hwang reports for CalMatters on the impact on private practice physicians:
At private practices and small clinics across the state, independent physicians are worried their businesses won’t survive the current crisis, forcing them to either close their doors or sell their practices, which could lead to higher patient costs. In either case, experts worry that will leave the health care system vastly diminished at a time when the state is facing skyrocketing costs and a shortage of doctors.
About one in three Californians get care from private practice physicians and specialists, according to the California Medical Association, which represents roughly 50,000 doctors across the state. In a recent survey, nearly 76% of members reported being extremely worried or very worried about finances.
Empty clinics triggered a cash crunch for doctors after Gov. Gavin Newsom issued a shelter-in-place order last month. That’s because the statewide lockdown forced a majority of medical procedures, from hip replacements to annual check ups, to be canceled or delayed unless they are deemed an emergency.
The hospital money appropriated by the feds responded to a budget crisis particularly among rural hospitals. Caring for seriously ill COVID-19 patients is very expensive and hospitals must serve those who end up there. In normal times, patients might be moved to another hospital if they are stable. Well, these aren't normal times, hospitals are impacted, and the patients often aren't stable.
Part of the way that hospitals balance the books is through elective surgeries and other high-margin activities. Those haven't been taking place (some are allowed under new plans announced by Governor Newsom on Wednesday. Under the plans benign tumors might be removed now, but tummy tucks will have to wait.
However, regular check-ups are postponed. Now, for Kaiser, that's just fine. They're still collecting premiums, so it'll just be a workload factor once things reopen. But, for fee-for-service private physicians who have monthly fixed costs like rent and equipment leases, it is a disaster. The federal bill provides no relief to them, as it funds services for care of COVID-19 patients.
Of course, in many cases, insurance companies who normally reimburse these physicians are holding on to the premium money, much in the manner Kaiser is. Although, with a completely different model, physicians in private practice have a real problem on their hands.
cakeday and classifieds after the jump...
CAKEDAY: Happy birthday to Board of Equalization member Ted Gaines!