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Daily Edition: Sept. 30, 2021

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California Healthline
Daily Edition
A service of the California Health Care Foundation
Thursday, September 30, 2021
Check California Healthline online for the latest news
  News Of The Day

It's Vaccine D-Day For Health Workers: California's vaccination mandate for health care workers arrives as planned today despite a last-minute indication from the California Hospital Association that a 45-day extension would be available for facilities experiencing a "critical staffing shortage." Asked about the statement, the California Department of Public Health said Wednesday that "no changes to the vaccine requirements for health care workers have been made or are imminent." Read more from the San Diego Union-Tribune. Scroll down for more coverage of California's vaccine mandates.

Newsom Signs 'Historic' Bills For Mental Health Services, Housing: On the eve of the end of the state's pandemic-spurred ban on evictions, Gov. Gavin Newsom on Wednesday signed a multibillion-dollar package of bills aimed at what officials called a "historic" rebuilding of mental health services and housing in a larger push to ease the homeless crisis. Read more from Media News and AP.

Below, check out the roundup of California Healthline's coverage. For today's national health news, read KHN's Morning Briefing.

More News From Across The State

Vaccine and Mask Mandates

CalMatters: Vaccine Mandate: Most California Health Care Workers Are Complying
Kaiser Permanente, Dignity Health, Keck Medicine and other major hospital systems in California say they are well on their way to meeting Thursday's deadline for the state's COVID-19 vaccination mandate, with several citing vaccination rates of 90% or higher. California was the first state in the nation to announce that all health care workers must be fully vaccinated. The order, which includes physicians, nurses, technicians, janitors and other workers in hospitals, dialysis centers, doctor's offices, nursing homes, substance abuse centers and other facilities remains one of the most stringent in the country. Only limited medical and religious exemptions are allowed. (Hwang, 9/29)

San Francisco Chronicle: Will Bay Area Hospitals See Problems From The Health Worker Vaccine Mandate? Here's What We Know
Hospitals around the Bay Area will likely avoid the staff shortages and suspensions seen in other parts of the country as the state's deadline arrives for health care workers to get vaccinated against COVID-19. Under an order issued by Gov. Gavin Newsom, all California health care workers must be fully vaccinated by Thursday. Unlike teachers, they do not have the option to "test out" of the vaccine requirement unless they get a medical or religious exemption. (Vaziri, 9/29)

San Diego Union-Tribune: Only 5 Nursing Homes In San Diego County Have Fully Vaccinated Staffs
Only five of San Diego County's nursing homes had a fully vaccinated staff as of Sept. 5, according to the Centers for Medicare and Medicaid Services. More than one-third of San Diego County's 86 skilled nursing facilities fell below the state's average of 84.7 percent of staff fully vaccinated, according to CMS data, though all the facilities exceeded the national average of 63.7 percent of staff fully vaccinated. (Mapp, 9/29)

Sacramento Bee: Sacramento County Mask Mandate Could End Soon, Official Says
Sacramento's top health official expects to remove the county's indoor mask mandate once the local coronavirus transmission rate returns to a level about as low as it was just before the start of the delta surge. Reaching a seven-day average of less than five daily COVID-19 cases per 100,000 "would be a good point to end the indoor masking mandate that we have in Sacramento County," health officer Dr. Olivia Kasirye said during a Board of Supervisors meeting Tuesday. (McGough, 9/29)

Los Angeles Daily News: LA City Council Supports Indoor-Business Vaccine Rules, But Councilman Delays Vote Until Next Week
The Los Angeles City Council on Wednesday, Sept. 28, effectively advanced a city measure that would require businesses to obtain proof of vaccination from patrons before they could enter indoor spaces at bars, restaurants, gyms, nail salons and other sites — but there was no vote taken, because Councilman Joe Buscaino invoked an obscure rule allowing him to avoid having to post a dissenting vote. The proposed ordinance, which would go into effect Nov. 4, would go beyond a similar order at the county level that is requiring proof of vaccinations for indoor spaces, but at fewer types of locations. (Chou, 9/29)

Los Angeles Times: L.A. Puts Off Vote On COVID-19 Vaccine Proof Indoor Mandate
Many members of the Los Angeles City Council voiced support Wednesday for a sweeping proposal that would require people to show proof of vaccination against COVID-19 to go inside restaurants, shopping centers, movie theaters, hair and nail salons, and a range of other indoor venues in Los Angeles. But after more than an hour of discussion, the council did not vote on the proposed ordinance after Councilman Joe Buscaino, a candidate for mayor, raised concerns about the measure and said he would withhold his vote. (Alpert Reyes and Money, 9/29)

San Francisco Chronicle: Nearly 300 S.F. Police Officers Remain Unvaccinated. Department Plans Reassignments To Maintain Policing Services
So many San Francisco police officers have yet to get COVID-19 vaccinations that officials are preparing to shuffle assignments to ensure that the city can provide core policing services regardless of the number of unvaccinated officers — and whether they remain employed — according to a departmental email obtained by The Chronicle. Police Chief Bill Scott sent the email to the department staff Wednesday saying that 313 department employees — 267 officers and 46 unsworn staffers — remain unvaccinated. The department has 2,835 employees, including 2,122 officers. (Cabanatuan, 9/29)

San Francisco Chronicle: More Companies Are Requiring Applicants To Be Vaccinated, And Not Just In California
In the wake of the delta variant's spread, more companies are requiring job candidates to be vaccinated, but not as many as you might expect — and California isn't leading the pack when it comes to the requirements, despite the state boasting the lowest coronavirus case rate in the nation. A Sept. 24 snapshot of postings on the job site Indeed showed California came in 10th out of all 50 U.S. states that mentioned vaccine requirements. That amounted to 1.6% of statewide jobs as a seven day moving average. (DeFeliciantonio, 9/29)

K-12 Schools

San Diego Union-Tribune: What You Need To Know About San Diego Unified's Vaccine Mandate
Several thousand San Diego Unified students, age 16 and older, will soon have to get a COVID vaccine or else be barred from in-person learning. The San Diego Unified School Board approved a vaccine mandate for all staff and eligible students at its Tuesday board meeting. District leaders said it's needed for several reasons: it will help reduce the spread of COVID in and out of schools, it will help keep students in school by minimizing how often students have to quarantine at home, and it will help increase herd immunity in San Diego. (Taketa, 9/29)

Bay Area News Group: COVID: West Contra Costa Unified Vaccine Mandate Meeting Set
West Contra Costa Unified is considering joining a few other East Bay school districts in requiring students 12 years and older to be fully vaccinated against COVID-19. At a 6:30 p.m. special meeting Thursday, the board is scheduled to vote on a proposal to mandate that all eligible students as well as district staff, volunteers, contractors and even the trustees themselves be inoculated. The mandate is likely to be approved because trustees Demetrio Gonzalez Hoy and Otheree Christian worked on a resolution calling for it earlier this month and trustee Leslie Reckler has publicly supported such a requirement at past meetings. (Mukherjee, 9/29)

CapRadio: Can California School Districts Independently Mandate COVID-19 Vaccines For Students?
The Los Angeles Unified School District saw protesters when its board voted to mandate COVID-19 shots for students over 12 years of age on Sept. 9. The vote led to claims online that the district did not have the legal authority to require vaccinations. Last week, a crowd of parents holding signs with slogans like "My child, my choice" gathered outside a high school in Glendale, even though the school currently has no COVID-19 vaccination mandate in place for pupils. Experts say previous legal rulings indicate that schools can generally mandate vaccinations for students and employees. But in California, where the state Legislature has already passed laws on student vaccination mandates, it's unclear how much latitude districts might have to require schoolchildren to get the shot. (Hupka, 9/29)

Modesto Bee: Stanislaus K-12 School Districts Seeing Fewer COVID-19 Cases
COVID-19 cases in Stanislaus County schools dropped for the third consecutive week, according to data posted Wednesday. School districts confirmed a little over 200 cases the week beginning Sept. 19, according to the county's COVID-19 schools dashboard. Most of the cases were reported among high school students, consistent with the previous couple of weeks. (Isaacman, 9/29)

Covid Shots and Boosters

Axios: CDC Issues Urgent Advisory Calling On Pregnant People To Get COVID Vaccine
The CDC issued "an urgent health advisory" on Wednesday urging people who are pregnant or planning to become pregnant to get the COVID-19 vaccine. The CDC said it "strongly recommends" vaccination because its benefits for a pregnant person and the fetus outweigh the risks. It added that pregnant people with COVID-19 are at "increased risk" of outcomes such as preterm birth, stillbirth and admission of a newborn into the ICU. (Gonzalez, 9/29)

Bloomberg: Moderna Booster Shot: FDA Leans Toward Authorizing Half Dose Of Covid Vaccine
The U.S. Food and Drug Administration is leaning toward authorizing half-dose booster shots of the Moderna Inc. coronavirus vaccine, satisfied that it's effective in shoring up protection, people familiar with the matter said. The authorization would set the stage to further widen the U.S. booster campaign after earlier authorization of the Pfizer Inc.-BioNTech SE shot. About 170 million fully vaccinated people in the U.S. received the Moderna or Pfizer shots, or 92% of the total inoculated so far. The people spoke on the condition of anonymity, before a potential announcement. It's not clear when an announcement will come. (Wingrove and Jacobs, 9/29)

Modesto Bee: White House Says CDC Booster Shot Guidance Was Equitable
Minority groups hit hardest by COVID-19 were not included in the recent guidance for booster shots, but the White House says the eligibility list is broad enough that anyone in those communities at heightened risk for infection can easily get another vaccine dose. The guidance on booster shots that the Centers for Disease Control and Prevention released last week was written in a way that any adult seeking a third dose of the Pfizer-BioNTech COVID-19 vaccine can get it. (Chambers, 9/29)

Modesto Bee: Stanislaus Cities Have Low COVID Vaccine Rate, Except For One
In one of the cities in Stanislaus County, about two-thirds of the eligible residents are fully vaccinated against COVID-19. Patterson stands head and shoulders above the other eight cities with its full vaccination rate of 65 percent among residents eligible for the COVID vaccine (those age 12 and older), according to data released by county public health Tuesday. No other cities in the county have cracked the 60 percent level, and three cities — Oakdale, Hughson and Waterford — are below 50 percent, making it easier for the potentially deadly respiratory disease to spread. (Carlson, 9/29)

Los Angeles Times: Minority Of Sanitation Workers Are Vaccinated, Worrying Homeless Advocates
In March 2020, Los Angeles sanitation crews mostly stopped doing their most extensive cleanups at homeless encampments, hoping to reduce the chances of spreading COVID-19 on the streets. More than a year later, the number of residents becoming sick from the virus has dropped and the cleanups have resumed. But advocates for homeless people warn that the risks from COVID-19 are still present, and they fear the renewed cleanups will spread the virus among the unhoused. Adding to the fear is the fact that many sanitation workers — possibly even most — are still not vaccinated. (Oreskes and Zahniser, 9/30)

Sacramento Bee: Poll Finds 20% Of Americans Opposed To Getting COVID Vaccine
The number of Americans opposed to getting a COVID-19 vaccine reached a new low this month, a poll found. The Gallup poll, conducted Sept. 13-19, found fewer respondents than ever said they don't plan to get a coronavirus vaccine while more than ever said they are already vaccinated or plan to be. The findings, released Wednesday, come as concerns about contracting the virus have risen as the highly contagious delta variant sparks outbreaks and weeks after the U.S. Food and Drug Administration gave the Pfizer vaccine its full approval. (Aldridge, 9/29)

Silicon Valley

KQED: Fighting Wave Of Misinformation, YouTube Bans Content Containing False Vaccine Claims
YouTube announced a sweeping effort Wednesday to remove video content containing misleading and inaccurate information about vaccines. The platform announced the change in a blog post, explaining that its current community guidelines, which already prohibit the sharing of medical misinformation, have been extended to cover "currently administered" vaccines that have been proven safe by the World Health Organization and other health agencies. (Pruitt-Young, 9/29)

The Wall Street Journal: YouTube To Remove Videos Containing Vaccine Misinformation
YouTube said it would remove content that falsely alleges approved vaccines are dangerous and cause severe health effects, expanding the video platform's efforts to curb Covid-19 misinformation to other vaccines. Examples of content that would be taken down include false claims that approved vaccines cause autism, cancer or infertility or that they don't reduce transmission or contraction of diseases, the Alphabet Inc. division said Wednesday. (Sebastian, 9/29)

Slate: Why Is YouTube So Much Worse Than Facebook and Twitter at Stopping Misinformation?
On Wednesday, YouTube announced a major escalation in how it deals with content that poses a public health risk: The platform is banning misinformation related to any vaccine approved by local health authorities and the World Health Organization. YouTube's medical misinformation policies previously prohibited the promotion of harmful untested treatments and false claims about COVID-19, but the Google subsidiary says that the pandemic has spurred it to scrutinize anti-vaccine content in general. "We've steadily seen false claims about the coronavirus vaccines spill over into misinformation about vaccines in general, and we're now at a point where it's more important than ever to expand the work we started with COVID-19 to other vaccines," a company blog post explaining the decision reads. (Mak, 9/29)

Bloomberg: Google Adds Context To Search Results To Combat Misinformation
Google will start adding details and context about topics and sources to search-engine results, a move to help U.S. users become more literate about the origins of online material and to combat misinformation. The Alphabet Inc. company will add descriptions about listed websites in its own words, reviews of sites from other parties, and information about topics from third-party sources, Google said during its Search On event Wednesday. These details will be findable in the existing "About This Result" panel, accessed by clicking the three dots beside search results. (Grant, 9/29)

Coronavirus

San Francisco Chronicle: Charts Show How 'Red COVID' Political Death Divide In California Has Intensified
Even with California recording the lowest coronavirus transmission rate in the country, data shows that the partisan gap between who is suffering the most in the post-vaccine era is intensifying. A recent Chronicle analysis found that during this year's surge fueled by the delta variant, California counties that voted heavily for then-President Donald Trump in the November election saw higher death rates than their more Democratic counterparts — a trend mirrored on the national level, dubbed "red COVID" by the New York Times. (Echeverria and Nielson, 9/30)

San Francisco Chronicle: Maps Show Bay Area Counties Among Few In U.S. At 'Moderate' COVID Level
California continues to record the lowest coronavirus transmission rate among U.S. states, in federal health officials' orange "substantial" category — but in the Bay Area, several counties this week moved to a level even lower. As of Wednesday, Alameda, Marin, San Mateo, Santa Clara and Sonoma counties were all in the yellow "moderate" tier on the Centers for Disease Control and Prevention's tracker, based on case rates and positive test rates. Joining them were nearby San Benito and Santa Cruz counties. (Hwang, 9/29)

Los Angeles Times: What Is The R.1 Coronavirus Variant? How Does Delta Differ?
The worst of California's months-old coronavirus surge now appears to be in the rearview mirror, but worrisome headlines are cropping up about the presence of a potentially dangerous new strain. Still, officials and experts say the latest variant to enter the public consciousness, dubbed R.1, likely doesn't present nearly the same threat as previous strains — in part because, despite all the recent attention, it appears to have already petered out. (Money and Lin II, 9/29)

CNN: Long Covid Is A Bigger Problem Than We Thought
The long Covid problem might be bigger than we thought. A large study has revealed that one in three Covid-19 survivors have suffered symptoms three to six months after getting infected, with breathing problems, abdominal symptoms such as abdominal pain, change of bowel habit and diarrhea, fatigue, pain, anxiety and depression among the most common issues reported. (Kottasova and Friend, 9/29)

The Mercury News: COVID Delta Variant Spooks Consumers, Slows California Recovery: Study
The spread of COVID's delta variant is slowing California's economic recovery as it seeks to rebound from the epic job losses that devastated the state and Bay Area at the start of the pandemic, according to the state's leading economic forecast, released Wednesday. The growth of California's job market is expected to trail the United States in 2021, according to the UCLA Anderson Forecast, which just six months ago projected that the Golden State would bounce back much faster than the nation. Now, forecasters said, it will be 2022 before the state is poised to charge past the nation. The latest quarterly forecast found that California didn't really roar back to recovery after the statewide economy was formally reopened in June of this year. In fact, measured by nonfarm payroll employment, California's job market is predicted to grow by just 1.8% over the course of this year — less than half of the 3.7% increase projected for the nationwide economy. (Avalos, 9/29)

Sacramento Bee: California Renters Struggling Despite Assistance, Eviction Ban
Thousands of California tenants are still struggling to pay rent and fear impending evictions, a new California Housing Partnership report found, despite unprecedented levels of emergency financial assistance and renter protections during the coronavirus pandemic. As of last month, about one in four California tenants said they had no or slight confidence they could pay next months rent. California renters of color have disproportionately struggled to pay rent during the pandemic, according to the report: An average of 19% of Black renters, 17% of Latinx renters and 17% of Asian renters said they fell behind on rent in the last year, compared to 8% of white renters. (Yoon-Hendricks, 9/30)

Capitol Hill

The Washington Post: Biden Sticks To His Dealmaking Strategy, As Some Democrats Want Him To Do More To Bring Holdouts On Board
President Biden is navigating the most perilous week for his legislative agenda yet with an approach he's honed over his decades in Washington: Hear out the warring factions, determine the realm of the possible and find the point of compromise that satisfies all sides. That strategy has been clear in meetings with pivotal Democrats in the past week, with Biden speaking and hosting a stream of lawmakers — in particular a pair of moderate Senate Democrats who have wielded outsize influence in shaping the president's agenda. (Kim, 9/29)

The Wall Street Journal: Infrastructure Bill's Fate Uncertain Heading Into Planned House Vote
A crucial piece of President Biden's domestic agenda hung in the balance Thursday, as Democratic leaders moved toward a planned House vote on a $1 trillion infrastructure bill that many progressive Democrats have threatened to oppose. ... But the infrastructure measure's fate was far less clear, as Democratic leaders tried to unify the party's increasingly combative progressive and moderate wings around changes to a separate $3.5 trillion healthcare, education and climate package. (Duehren and Peterson, 9/30)

Politico: Manchin Offers Alternative Plans To Democrats' 'Fiscal Insanity'
Joe Manchin released a statement on Wednesday afternoon panning his colleagues' spending plans as "fiscal insanity." Then he started to lay out how he wants to work on President Joe Biden's family plan. As all of Washington hangs on his every word, Manchin said he did want to clinch a reconciliation bill even as some progressives fear he's trying to kill the whole thing. But rather than approach the effort as the multi-trillion-dollar social spending and climate change bill envisioned by his colleagues, Manchin said Democrats needed to start with gutting the 2017 Trump tax cuts and go from there. (Everett, 9/29)

Facebook

The New York Times: Facebook To Face Senate Grilling Over Instagram's Effects On Teens
Antigone Davis, Facebook's global head of safety, is expected to face harsh questioning from senators on Thursday morning about Instagram's effect on teenagers, addressing accusations that Facebook has known for years that its photo-sharing app has caused mental and emotional harm. The hearing, which starts at 10, is the first of two that the Senate's consumer protection subcommittee will hold on the effect that Facebook has on young people. The second, on Tuesday, will be with a whistle-blower who has shared information about Facebook's research on teenagers. (Kang, 9/30)

The Washington Post: Facebook Attempts To Minimize Its Own Research Ahead Of Children's Safety Hearings
Facebook late Wednesday released heavily annotated documents discounting its own research into user harm — an attempt to deflect criticism as lawmakers gear up to deliver the company a harsh rebuke on Capitol Hill. The research decks, one called "Hard Life Moments — Mental Health Deep Dive" and another called "Teen Mental Health Deep Dive," feature internal research into Instagram's effects on adults' and teens' mental health. (Zakrzewski and Lerman, 9/30)

AP: Foes United Vs Facebook Over Instagram's Effect On Teens
Political adversaries in Congress are united in outrage against Facebook for privately compiling information that its Instagram photo-sharing service appears to grievously harm some teens, especially girls, while publicly downplaying the popular platform's negative impact. Mounting public pressure over the revelations have prompted Facebook to put on hold its work on a kids' version of Instagram, which the company says is meant mainly for tweens aged 10 to 12. But it's just a pause. (Gordon, 9/30)

The Wall Street Journal: Facebook's Documents About Instagram And Teens, Published
Facebook Inc. is scheduled to testify at a Senate hearing on Thursday about its products' effects on young people's mental health. The hearing in front of the Commerce Committee's consumer-protection subcommittee was prompted by a mid-September article in The Wall Street Journal. Based on internal company documents, it detailed Facebook's internal research on the negative impact of its Instagram app on teen girls and others. (9/29)

Theranos Trial

Bay Area News Group: Elizabeth Holmes Trial: New Windows Into Holmes' Life, Vegan Diet
Theranos founder Elizabeth Holmes tried to keep secret both her food preferences and her intimate relationship with company president Sunny Balwani, according to an interview with her personal assistant detailed in an FBI report filed in court in connection with Holmes' criminal fraud trial. "Holmes was very private," the assistant, Paige Williams, who worked for Holmes from June 2015 to July 2018, told the FBI. "Sensitive items included Holmes' food preferences." Shopping lists for Holmes' food at home and work were "kept private" because "she was vegan for a period and did not want it to be made a big deal," according to the FBI report. (Baron, 9/29)

U.S. Military

USA Today: Military Suicides: Deaths By Suicide Spike 15% In 2020 From 2019
Suicide among U.S. troops increased 15% in 2020 from the previous year, a troubling trend that has defied Pentagon initiatives to prevent service members from taking their own lives. In 2020, 580 troops died by suicide compared with 504 in 2019, according to figures confirmed Wednesday night for USA TODAY by congressional and Defense Department sources. The sources were not authorized to speak publicly about the figures, which the Pentagon plans to release on Thursday. In 2018, there were 543 suicide deaths among troops. It's not clear why there was a decrease in 2019 followed by a jump in 2020, according to the Defense Department official. (Vanden Brook, 9/29)

Public Health

NPR: California May Be First State To Try Treatment That Pays Meth Users Not To Use
When Billy Lemon was trying to kick his methamphetamine addiction, he went to a drug treatment program at the San Francisco AIDS Foundation three times a week and peed in a cup. If it tested negative for meth, he got paid about $7. "For somebody who had not had any legitimate money – without committing felonies – that seemed like a cool thing," says Lemon, who was arrested three times for selling meth before starting recovery. The payments were part of a formal addiction treatment called contingency management, which incentivizes drug users with money or gift cards to stay off drugs. At the end of 12 weeks, after all his drug tests came back negative for meth, Lemon received $330. But for him, it was about more than just the money. It was being told, good job. (Dembosky, 9/30)

Los Angeles Times: How Modern Medicine Still Neglects Disabled Mothers
The National Council on Disabilities estimates there are at least 4.1 million disabled parents raising kids under 18, making them about 25% more common than disabled children, according to the U.S. Census. In California, the cradle of the disability rights movement, thousands give birth every year. Yet while disabled doctors, artists, athletes and politicians are increasingly seen as normal, disabled mothers are still scarcely imagined to exist. (Sharp, 9/30)

Health Care Research

San Diego Union-Tribune: SDSU Gets $15 Million To Research Latino Health Disparities
San Diego State University is planning to use a $15 million grant to boost research into Latino health disparities while building a pipeline of scientists who will focus on that community. School officials said they will begin by hiring 11 faculty members — three who will work from the university's Imperial Valley campus. Imperial Valley residents, who are predominantly Latino, face environmental challenges, exposure to climate change and hurdles to accessing health care, which are some of the subjects the new faculty members will explore, researchers said. (Lopez-Villafana, 9/29)

California Healthline is an editorially independent service of the California Health Care Foundation. It is produced by KHN, an editorially independent program of the KFF. (c) 2021 Kaiser Family Foundation. All rights reserved.

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