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- Capitol Weekly Podcast (John Howard and Tim Foster): Vaccines are coming with Dr. Dean Blumberg, Associate Professor of Pediatrics, UC Davis School of Medicine and Acting Chief, Pediatric Infectious Disease Section, UC Davis Medical Center. (2020-12-07)
- Look West Podcast (Assembly Democratic Caucus): Introduction to new Assembly Democrats (2020-12-07)
- KQED's Political Breakdown (Scott Shafer and Marisa Lagos): Dr. Anthony Fauci on California's New COVID Restrictions and Lessons from the HIV/AIDS Epidemic (2020-12-04)
- Cap•Impact (Chris Micheli @ McGeorge School of Law): Convening the New Legislative Session (2020-12-04)
- Inside Golden State Politics (Bill Boyarsky and Sherry Jeffe): The Myth of the Latino Monolith with journalist Pilar Marrero (2020-12-03)
- Then There's California (Senate Democratic Caucus): Senator Jerry Hill (D-San Mateo) (2020-11-24)
- Capitol Weekly Podcast (John Howard and Tim Foster): Doug Moore, Executive Director of UDW/AFSCME Local 3930 (2020-11-30)
The Nooner for Tuesday, December 8, 2020, presented by SYASL Partners
- December fires (and not the yule log type)
- No juice for you
- Bills, bills, bills
- Refer madness
- Hunger games
-Tiers for Fears
-Stay at Home
--the tragedy of triage
- Cakeday and classifieds
Well, happy Tuesday. We now have a 2021-22 California Legislature. The State Senate's organizational session was somewhat normal, aside from the masks, plexiglass, and eight members participating remotely. They were Patricia Bates, Josh Newman, Steve Glazer, Monique Limón, Melissa Melendez, Jim Nielsen, Richard Roth, and Henry Stern.
The Assembly was a bit different, strewn across what ordinarily would be a basketball arena this time of year. Absent were Richard Bloom, Autumn Burke, Jim Frazier, Dr. Shirley Weber, and Buffy Wicks. Aside from the absence of family members at their desks and an empty "gallery" (arena seats), it was pretty standard fare.
Assembly member Kevin Kiley (R-Roseville) used his nomination speech for Assembly Republican Leader Marie Waldron (R-Escondido) to be Speaker for an attack on Governor Gavin Newsom's response to COVID-19 and the associated restrictions of public health orders. In other words, the 2021-22 Legislative Session begins where we left off in August.
I still don't know why the Assembly didn't sell cardboard cutouts to adorn the seats.
While distanced during the session, The Bee's Hannah Wiley reports that five Assembly members dined together outside at a midtown restaurant:
Assembly members Adrin Nazarian, D-West Toluca Lake, Chad Mayes, I-Rancho Mirage, Tasha Boerner Horvath, D-Encinitas, Marc Levine, D-Marin County, and Chris Ward, D-San Diego, along with Mayes’ fiancée, attended a dinner Monday evening at Maydoon, a newer restaurant in Sacramento’s Midtown neighborhood.
When asked by a Sacramento Bee reporter about their decision to enjoy a multi-household outing, Nazarian responded by asking “Can we not have dinner?”
Levine said they were “supporting a local business,” and pulled his mask from his pocket when asked whether the members had face coverings.
Boerner Horvath quickly pulled her scarf up from around her neck to cover her nose and left the table. During a phone call, her chief of staff Rob Charles said the members were following Sacramento County’s COVID-19 requirements.
“They were dining outside, they were following the protocols, everyone tested negative for COVID-19,” he said, adding that Boerner Horvath flew into Sacramento on Sunday and was staying at a hotel with limited dining options.
California’s rules for restaurants don’t specify the number of households allowed at an outdoor table. Yet state health officials this fall have repeatedly recommended that people from no more than three households meet for a meal, even on a holiday.
...and we know what Kevin Kiley's first speech during session of the new year will be, particularly since Republican-turned-independent Mayes was at the table.
Meanwhile, we crossed a milestone in the pandemic yesterday as California blew past 20,000 deaths, landing at 20,054 according to the LA Times survey of health departments. (The state data is usually a one-day lag.)
Governor Newsom yesterday appointed Dr. Tomás Aragón as the new director of the California Department of Public Health, replacing Dr. Sonia Angel who resigned in August. Aragón has been Health Officer for the City and County of San Francisco and Director of the Population Health Division for the San Francisco Department of Public Health since 2011.
If you missed it on Sunday night, 60 Minutes had a segment on Blue Flame Medical, the company formed by former GOP consultants to import and distribute personal protective equipment during the pandemic. If you recall, this is the company with which California entered a $500 million contract to procure N95 masks early on.
While the payment was being processed, a bank used by the state for the transfer questioned the destination's veracity, given that it was a brand new company. The payment was stopped and masks were ordered directly from a China-based company instead of a middleman. Not all purchasers through Blue Flame were so lucky and waited and waited for promised supplies.
- Bond Fire (Orange County): As of 7:47am, the fire had burned 6,686 acres and was 75% contained. At that time, 31 structures were deemed destroyed and 21 were deemed damaged.
- Airport Fire (Riverside County): As of 12/07, the fire had burned 1,087 acres and was 50% contained. No damage report is available.
NO JUICE FOR YOU: This week in PSPS (public safety power shutoff):
- Pacific Gas and Electric: This week's forecasted public safety power shutoff has been downgraded to only portions of five counties further south, including Fresno, Madera, Mariposa, Tulare, and Tuolumne for 8,448 customers. Restoration is expected midday today.
- Southern California Edison: Shortly after the power was restored following a 2-3 day outage across SCE territory, the utility is has implemented another PSPS outage affecting 161,355 customers. As of 5:30am, power was out for 59,658 customers with restoration expected tomorrow afternoon. For many (including my sister in Simi Valley), this is the second PSPS in a week. An additional 146,682 in seven counies are still under warning that a PSPS may occur.
BILLS, BILLS, BILLS: Following the swearing-in and organizational sessions of both houses, legislators began introducing bills for the 2021-22 Legislative Session. There were 68 bills introduced in the State Senate and 96 in the State Assembly. In the Senate, there were three legislative constitutional amendments introduced, while in the Assembly there were two.
The themes were predictable with members introducing priority bills highlighted on the virtual campaign trail:
- Employment Development Department/unemployment insurance
- COVID-19 restrictions and relief
- Housing, evictions/rent, and homelessness (Alexei Koseff story and Matt Levin story)
Assembly members can continue to introduce bills through December 18, but I didn't hear how long the State Senate "desk" will remain open for such. The two houses reconvene on January 4.
REFER MADNESS: Yesterday, the Secretary of State reported that the proponents of the referendum on SB 793 (Hill), the flavored tobacco ban, have submitted 758,648 raw signatures and ordered county elections offices to conduct a random sample for validity. To avoid failing, proponents need 78.1% validity to reach the 623,212 signatures required for qualification. To qualify without a full count, they would need 90.4%, which won't happen.
It's going to be close as to whether it qualifies or not. From my observations, 78% validity is a well-run petition campaign with verification of signature validity and duplicates before submission. If the measure qualifies, it places SB 793 on hold until the November 8, 2022 election. Otherwise, the law takes effect January 1, 2021.
As you may remember, a few measures have had deadlines extended by courts because of the challenges this year of signature gathering during changing public health orders. This includes two initiatives (plastics reduction and gaming) as well as the proposed recall of Governor Gavin Newsom. However, while the courts ordered extensions of statutory deadlines, the 90-day collection period for referenda is established by Art. II, Sec. 9(b) of the state's Constitution and thus can't be extended by the courts.
HUNGER GAMES: We have the Senate seat. If Newsom taps Secretary of State Alex Padilla, now the odds-on favorite following yesterday's pick of Becerra as HHS Secretary, that opens up an appointment to SOS. Then, presuming Becerra is confirmed by the US Senate to HHS, then Newsom will have AG to fill.
On the Senate speculation list (assuming not a caretaker):
- Rep. Karen Bass (D-Los Angeles)
- Rep. Barbara Lee (D-Oakland)
- Secretary of State Alex Padilla
While I have removed House members from the AG list, I'm leaving a couple on the possibles for the U.S. Senate seat. I could see Pelosi green-lighting the appointment of a Democrat from a safe seat to the upper house despite the slim margin in the House.
On the Attorney General speculation list, some additions and some deletions from that included yesterday. List again is alphabetical.
- Contra Costa DA (and former superior court judge) Diana Becton
- Assembly member Rob Bonta (D-Alameda)
- State Senator Anna Caballero (D-Salinas)
- Former state treasurer John Chiang
- Assembly member David Chiu (D-San Francisco)
- SF City Attorney Dennis Herrera
- State Senator Bob Hertzberg (D-Van Nuys)
- Former insurance commissioner Dave Jones
- Former supervising deputy AG Maggy Krell (currently, chief counsel of Planned Parenthood Affiliates of CA)
- Sacramento mayor Darrell Steinberg
- State Senator Tom Umberg (D-Villa Park)
- Rick Zbur, executive director, Equality California
On the Secretary of State speculation list (alphabetical):
- State Senate President Pro Tem Toni Atkins (D-San Diego)
- Assembly Member Marc Berman (D-Palo Alto) - chair, Asm Elections and Redistricting
- Assembly member Lorena Gonzalez (D-San Diego) - declared 2022 candidate
- Assembly member Evan Low (D-Campbell) - declared 2022 candidate
- Assembly Speaker Pro Tem Kevin Mullin (D-South San Francisco)
- State Senator Tom Umberg - chair, Senate Elections and Redistricting
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COVID-19: Yesterday, 117 deaths were reported in the state, bringing the total to 20,054.
-Tiers for fears: No changes to county tier assignments. Purple/Widespread=52 counties; Red=5/Substantial; Orange/Moderate=1
-Stay at home: I am not including all of the main points and restrictions of the new stay at home order. You can find them in The Nooner for December 5, or read the state order or state guidance.
Update on 12/03 with Governor Newsom and HHS Secretary Dr. Mark Ghaly:
Update on 12/07:
Regions: Here is the latest ICU capacity by region, which is from this state page.
- Northern California: Del Norte, Glenn, Humboldt, Lake, Lassen, Mendocino, Modoc, Shasta, Siskiyou, Tehama, Trinity
ICU capacity as of 12/06: 28.2%
- Bay Area: Alameda*, Contra Costa*, Marin*, Monterey, Napa, San Francisco*, San Mateo, Santa Clara*, Santa Cruz, Solano, Sonoma
ICU capacity as of 12/06: 25.7%
- Greater Sacramento: Alpine, Amador, Butte, Colusa, El Dorado, Nevada, Placer, Plumas, Sacramento, Sierra, Sutter, Yolo, Yuba
ICU capacity as of 12/06: 30.3%
- San Joaquin Valley: Calaveras, Fresno, Kern, Kings, Madera, Mariposa, Merced, San Benito, San Joaquin, Stanislaus, Tulare, Tuolumne
ICU capacity as of 12/06: 6.3%
- Southern California: Imperial, Inyo, Los Angeles, Mono, Orange, Riverside, San Bernardino, San Diego, San Luis Obispo, Santa Barbara, Ventura
ICU capacity as of 12/06: 10.9%
*County has voluntarily adopted the state's Stay At Home Order
Cite: COVID19.CA.GOV: About COVID-19 restrictions (Under "Regional Stay Home Order")
Central Coast: San Luis Obispo, Santa Barbara, and Ventura counties are seeking to be removed from the Southern California region because they feel they are being dragged down to Stay At Home based on Los Angeles and other counties' numbers. However, they don't point out that California's existing EMS mutual aid regions breakdown has the counties with LA and Orange counties, something that hasn't been complained about before when they had the theoretical resources in the event of, say, a Central Coast earthquake.
The regions were modified from six to five because this emergency is a virus rather than a localized incident like a natural disaster or chemical spill. Travel patterns matter in addition to hospital resources. If the Central Coast counties were to break off from the Southern California region, those from Brentwood, Beverly Hills and the like with resources would spend their time in hotels and hanging out on bar patios on the Central Coast commuting back and forth to Los Angeles and defeating the purpose of the Stay At Home order.
That's what I'm hearing, anyway...
It would also be a lot easier to have a statewide order. 84.5% of Californians are already under one at this point and most Sacramentans I talk to figure it's basically here (Bizjak article). But, I understand why the regions and ICU capacity are being used given all of the criticism that orders weren't data-driven this year.
Restaurants: In the LAT, Anh Do and Luke Money look at restaurants unwilling to abide by the Stay at Home order in Southern California.
[T]he economic toll poses its own existential threat. While many businesses in areas covered by the state’s new regional stay-at-home order appear to be complying, some are trying to figure out ways to keep their businesses going.
With a court case being heard on Tuesday challenging L.A. County’s ban on outdoor dining, [LA County director of public health Barbara] Ferrer declined to comment on the lawsuit but did say there was ample evidence that outdoor restaurant dining was too risky to allow now, with the virus so much more widespread than before.
“We could tolerate that risk before,” Ferrer said, when only 1 in 800 people in L.A. County were out and about and contagious with the virus. Now that 1 in 145 are contagious and the hospital system is about to be overwhelmed, “you have to look at all of the activities and say: ‘We need to reduce risk as much as possible everywhere.’”
The superior court judge found in favor of the restaurant plaintiffs in a tentative ruling, writing that the County "acted arbitrarily" and "failed to perform the required risk-benefit analysis."
The trend: Here are the first five days of data.
|ICU Bed Capacity by Region*
|San Joaquin Valley
|*Beginning December 4, PICU and NICU beds were removed and adult ICU beds were standardized.
|Source: California Dept of Public Health, https://covid19.ca.gov/stay-home-except-for-essential-needs/
Here are the numbers of available ICU beds for the Greater Sacramento region and I've updated the spreadsheet for all five regions with this morning's availability data. Generally, these reflect the percentages above calculated the previous day. So, for Greater Sac, the 113 beds for 12/07 would tie to the dip to 18.2% on 12/06 and the 138 beds this morning would tie to the 20.3% availability calculated yesterday. I'm doing this mostly because of social media suspicions about how the percentages are calculated and I was trying to figure it out myself.
If this assumption is correct, Southern California should rebound back to around 12.5% today.
We see good news on availability for Stay At Home considerations, although it's always important to remember that an increase in the number of available ICU beds may signify more sad loved ones.
|Greater Sacramento Region
|Available ICU Beds
THE TRAGEDY OF TRIAGE: In the LAT, a team reports on the tough decisions facing health care professionals amidst strained resources in hospitals.
With intensive care units across California rapidly filling with COVID-19 patients, hospitals have a limited number of tools available to free up more capacity in the coming weeks as cases are expected to surge.
Back in the spring, the government opened a so-called “surge” hospital in Los Angeles and even docked a Navy medical ship in San Pedro harbor to take overflow patients if medical centers filled up. But officials found that those supplemental facilities did not treat many patients and did not provide the same level of care as traditional hospitals.
“Hospital ships are wonderful if you’re a 23-year-old wounded sailor. But it’s no place to take care of ICU patients” sick with COVID-19, said Dr. George Rutherford, an epidemiologist and infectious-diseases expert at UC San Francisco. “If they need to be in the ICU, they need to be in the ICU.”
So in the coming weeks in L.A. County, hospitals will try to choreograph their staffing to best meet the needs of critically ill patients, some of whom still might have to be sent to other areas of the hospital that don’t typically treat ICU cases.
But that comes with risks. Should a staff shortage become particularly dire, critically ill patients could end up getting care from nurses and doctors without up-to-date specialized intensive care training.
I was already going to write about this today so that's a good stage-setter. We don't like to talk about what happens when a hospital's critical resources become overloaded as they did in Italy causing a disaster early in the pandemic. We don't like to talk about the choices that have to be made as to who lives and who dies. In California, there's a chart for that put out by the California Department of Public Health. As I understand it, this is the same triage tree for any public health emergency that overruns critical care resources, such as after a natural disaster. You can find this chart and the associated narrative on page 15 of the June 2020 memo sent to health leaders and county health departments.
When ICU capacity is overrun, these are the questions that physicians must ask and answer. I hear a lot of complaints about industry restrictions but rarely talk about this, because it's "yucky." We don't like to talk about death. Our health care professionals are dealing with it daily and the more we blow off restrictions (I hate them too and feel similar economic pain and fear), the more likely professionals have to turn to this triage tree and decides who lives and who dies.
Meanwhile, I just saw photos of some NorCal folks poolside in Palm Springs "sheltering," in clear violation of the Southern California health order (by both the patrons and the AirBNB owner). I've seen several other examples; this one just popped up while writing this item.
The app: The LAT's Suhauna Hussain takes a look at the new app for contact notification announced during Governor Newsom's briefing yesterday.
When users of the app test positive for COVID-19, they will receive a text notification from the California Department of Public Health with a code to input.
Those whose phones have been in proximity to the phone of the infected person within the previous two weeks will receive exposure alerts.
The idea is to identify exposed individuals early, allowing them to quickly quarantine. In a pilot program involving an estimated 250,000 students, staff and faculty at seven UC campuses earlier this fall, the system proved effective, Dr. Christopher Longhurst, chief information officer at UC San Diego Health, said in a statement.
Californians voluntarily activate the app. There is no requirement that you use it.
Newsom underscored this point in Monday’s news conference, aiming to get out ahead of privacy concerns that could deter use of the platform.
“It’s 100% private, 100% secure, 100% voluntary. You opt in, or you choose not to,” he said.
...cakeday and classifieds after the jump
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CCST Expert Briefing: Carbon Neutral California: Blue Carbon Sequestration along California’s Coast
Join the California Council on Science and Technology (CCST) in partnership with the Office of Assemblymember Mark Stone and the California Ocean Science Trust on Wednesday, December 9th from 1:30-2:30pm for our latest Virtual CCST Expert Briefing: Blue Carbon Sequestration along California’s Coast. A panel of experts from San Diego State University, USGS, Silvestrum Climate Associates, and LandSea Science will discuss strategic ways to increase blue carbon sequestration in California’s coastal ecosystems. RSVP
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