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Good Morning.
At Golden State, the average number of new Covid-19 cases per day last week dropped to 6,641 – not the lowest they have ever been, but the trajectory is notable for the speed with which positivity rates plummeted, especially compared to flattening. slower of cases after the summer’s sudden rise in the state.
As The Los Angeles Times reported, the declining number of cases in California can most likely be attributed to a combination of factors, including widespread behavioral precautions, vaccinations and, ironically, the sheer number of people who have had the virus.
[Read more about the factors affecting when the United States could reach herd immunity.]
At the same time, the nation is facing another unfathomable milestone: half a million deaths from coronavirus, a mere month after the United States exceeded 400,000.
Leaders continue to ask for caution as dangerous variants of the coronavirus gain ground.
And as the vaccine’s launch continues, experts say that losing sight of the inequalities that helped drive California’s winter crisis may shape our recovery; already, the first data suggest that white Californians are being vaccinated more quickly than the groups that were most affected by the virus.
These injustices were on display at Martin Luther King Jr. Community Hospital, as my colleague Sheri Fink recently reported in this harrowing look at the heart of Los Angeles’ sudden rise, when hospitals were overwhelmed and hundreds died.
I asked her what Californians should learn from the plight of the hospital. Here is our conversation:
At the beginning of the pandemic, you sent some of the first and most distressing New York hospital dispatches, and you too reported from Houston during the summer. What was different about reporting from LA during this increase? How does that compare?
Unfortunately, it was very familiar. The disparities were similar, with a disproportionate impact of the disease between the Latinx and Negras communities and in less affluent areas. Hospitals, once again, had to care for far more seriously ill patients than they were designed and equipped to manage, struggling to create space and recruit reinforcements.
The distress among medical providers was even more acute. They were running a marathon and were exhausted and often disbelieving the denial they see in the wider community. Although there is more knowledge now on how to deal with patients with severe Covid, the level of deaths in the hospital where I spent more than a week reporting was horrible.
One difference now is that if you are at a higher risk of progressing to severe Covid-19 – if you are 65 or older or have certain chronic medical conditions – there is a type of treatment that has been shown to reduce hospitalizations and deaths.
But the problem is that you need to be infused with monoclonal antibodies early, before you have to be hospitalized. It blocks the virus from entering cells, and several types have received emergency clearance from the FDA. However, in southern Los Angeles, where I was reporting, relatively few patients who could benefit from it seemed to be accessing them.
There were also some positive differences: Healthcare professionals had the protective equipment they needed to help stay safe. And many of them were vaccinated against the virus that causes Covid-19.
In history, you talked to Dr. Elaine Batchlor, MLK’s chief executive, who expressed frustration that her hospital was full, while other larger hospitals had fewer patients. But state officials said repeatedly during the increase, they were working closely with groups and hospital providers to balance the burden.
Can you explain a little more about whether or why the hospital was unable to transfer a significant number of patients to larger institutions with better resources?
Even when the wave subsided, the MLK remained at the top or near the top of the area for the proportion of Covid patients per licensed hospital bed. For this particular hospital, there was little evidence of any leveling of the load, other than government officials providing National Guard personnel and contracted nurses.
Dr. Batchlor told stories of having telephoned other hospitals in person trying to transfer patients. I was present when government officials informed hospital leaders that two local hospitals had been hired to receive some emergency patients, but that was after the curve was already turning. MLK doctors said that when they tried to transfer patients who they thought needed specialized care at other facilities, they were denied.
In their minds, this had to do with their patients’ payer mix, of which only 4% have commercial insurance. They said it was an age-old problem that the pandemic only highlighted.
What are you looking at more closely now, as vaccinations increase? (I am thinking of national treatment trends, hot spots or equity in vaccine launch.)
Having reported abroad, I have observed the launch of the vaccine not only in our communities and our country, but also in other countries that did not have the means to support early manufacturing or purchase large portions of the global supply.
Lower-income countries have had almost no access to authorized vaccines. If net worth was not an important enough value in itself, the virus itself is reminding us of humanity’s shared destiny.
New strains can emerge wherever they continue to circulate, and some experts say that the global economic recovery depends on the virus being controlled worldwide, not just in the richest countries.
[Read the full story here.]
Here’s what else you may have missed over the weekend
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Jill Cowan grew up in Orange County, graduated from UC Berkeley and has done reporting across the state, including the Bay Area, Bakersfield and Los Angeles – but she always wants to see more. Follow here or Twitter.
California Today is edited by Julie Bloom, who grew up in Los Angeles and graduated from UC Berkeley.