CoViD-19 California Reveals Safe Schools For All Plan | UK COVID-19 Variant B.1.1.7 Found In San Diego | Local Flu Cases Rising |

 A summer photo sess at our favorite Balboa Park fountain (Taken 8.27.2020)

I'm watching the news and it is hilarious/terrifying how people cherry-pick what they heard from today's Governor's media briefings. There are parent groups that have wanted schools open all along directly countering parent groups and teacher unions who want the science to be followed before schools reopen. So just to be clear, what the governor said today was that a "county must have 7-day average case rate of less than 28 cases/100k people per day to implement plan." Our county is currently at 76.3 unadjusted and 38.1 adjusted so they're all getting in a tizzy prematurely. Remember we were teetering around 6.8-7.2 for over a month back in Oct/Nov so to move down below 28 (which is 4x the previous metric, by the way) is going to require less community spread, and as in the plan, the capacity for weekly asymptomatic testing for staff and students. We're pretty confident Nova will not be in school the remainder of this school year unless Biden's administration comes in like bulldogs and gets their shit together for vax distribution, mandated masking, and extensive increases in testing, PPE, and supply-chain needs. As Dr. Carlos del Rio of Emory University  on PBS Newshour said, "This is an incredibly complicated operation to conduct...Even for a credibly competent government, this is not an easy thing to do."

Things are still mostly chill around here, though I'm kinda freaking out because Nova had a slight fever and yacked today and as we know, we did go to my parents' house for Christmas. We think it's from some spoiled food she ate today, but we're keeping an eye on it and feeling like assholes, even though Christmas was her only time out of the house in like two weeks besides our nighttime dog walks. And are we supposed to test and isolate and mask in our own house now? You can read and watch so much but then you get a scare and feel paralyzed. It also made me wonder if anything else has been studied on food-borne transmission of COVID-19. The WHO and CDC still don't consider these risks, and there was some stuff from China about traces found on frozen food, but that was left amounting to nothing or not studied further, I don't really know. There are a ton of notes for today's State and County briefings but I'm going to get offline before my eyeballs pop out of my head. 

Be safe out there. xoxo
 

• COVID-19:
• U.K. Approves AstraZeneca-Oxford Coronavirus Vaccine - NPR (12.30.2020)
• Los Angeles is America’s new coronavirus hot spot. Urban sprawl might’ve played a role. Car culture can lead SoCal residents to feel more isolated, especially after months of strict and confusing guidelines. - VOX (12.29.2020)
• Politics/News:
• GOP senator to delay affirming Biden victory by forcing votes on Electoral College results - CNN (12.30.2020)
• Other Reading:
• 'Toxic Individualism': Pandemic Politics Driving Health Care Workers From Small Towns - NPR (12.28.2020)
• A Girlfriend of Alleged Nashville DOMESTIC TERRORIST Bomber Was Sent for a Psych Evaluation After Telling Police He Was Building Bombs a Year Ago - Jezebel (12.28.2020)
• State of California Governor Newsom Briefing
• Education is non-negotiable
• CDC studies show student-to-student transmission is uncommon
• Lowering Transmission: Safety and Mitigation
• Masks, physical distancing, small & stable groups, washing hands, ventilation, screenings
• Each layer provides additional protection, and when used together can reduce transmission
• Schools that have not required these measure have seen 2.5x more outbreaks than those that do
• In-person instruction helps well-being of students:
• Decreased anxiety & depression
• Lower rates of undetected abuse and neglect
• Higher rates of immunizations
• Other indicators of public health and wellbeing
• Current Guidance:
• State safety guidance (first issued in May) requires schools to develop and implement plans with key precautions
• Schools apply for waivers to resume in-person learning in elementary grades when in purple tier (widespread community transmission)
• Schools create a safety plan, post online, wotk with parent & labor groups, submit to local health officers, and reopen 14 days later
• Red-  tiered counties could open k-12 for in-person without waivers
• State Supports
• Each school on average received $645,000 per school, with more funding based on equity
• Schools received 2 months of PPE to ensure safe in-person instruction
• Phased In-Person Learning. California's phased approach will
• Begin with in-person learning for K-6, special education, and populations disproportionately impacted by COVID-19
• Support all communities to be on track for safe in-person instruction by early spring 2021
• Distance learning will remain and option for those who choose it
• New State Measures in Place:
• Elementary school may reopen if they submit a COVID-19 Safety Plan to both local and state officials
• Local health department can disapprove within 5 days
• Once opened, local and state officials will monitor 
• County must have 7-day average case rate of less than 28 cases/100k people per day to implement plan
• California Safe Schools For All Plan
1. Funding to support safe reopening - $2B additional 
   Newsom offers $2 billion plan to bring back in-person instruction in elementary grades - Edsource (12.30.3030)
2. Safety & mitigation measures for classrooms
• TESTING IN SCHOOLS
• Yellow- symptomatic & response testing
• Orange- symptomatic & response testing
• Red - symptomatic & response testing; Biweekly asymptomatic testing
• Purple - symptomatic & response testing; Biweekly asymptomatic testing
• >14/100k - symptomatic & response testing; Weekly asymptomatic testing
• PPE required. All staff must wear surgical masks, all students must wear masks
• Contact tracers from state will be deployed to coordinate between 
• Vaccines- staff will be prioritized as vaccines become more available
3. Hands-on oversight and assistance for schools
• Dr Naomi Bardach from UCSF will lead team with experts from CDPH, Cal/OSHA, and educational agencies
• Supports include school visits and walk-throughs as warranted, webinars and training materials, and ongoing technical assistance
4. Transparency & accountability for families and school staff
• State dashboard will enable all Californians to see their school's reopening status, level of available funding, and data on in-school transmissions. 
• School Superintendent of the State Tony Thurmond
• Pandemic exacerbated inequity and problems in schools
• Never intended to have schools closed this long
• Vaccine will be a game-changer, but until then, robust testing (of staff and students) and tracing is critical
• $2B for testing/PPE is critical
• State will work with school districts on the 'how-to' open
• Not every school will be open, state will still help distance learning
• Grants for professional development
• Access to computers 
• Statewide high-speed internet
• Address attendance, kids not in school
• Extra help with English-learners, foster kids, unhoused, kids eligible for school lunch programs 
• Linda Darling-Hammond - President of the California State Board of Education. International Expert on Education/Advisor to President-Elect Biden
• Linda Darling-Hammond removes herself from possible consideration as Secretary of Education. Says she is committed to working with Gov. Newsom to achieve education goals. - EdSource (11.8.2020)
• State focused on online-learning from the beginning
• Still work to do on closing digital divide
• Focus on bringing kids back in safely
• Understand school year in new ways...expanding to summer offerings or year-round systems
• Small Business Grants 
• Applications for $500M in grant funding for small biz & nonprofits open
• Grants range from $5,000-$25,000
• First application runs through midnight of Jan 8
• California COVID-19 Stats:
• Aggregate California ICU Bed Availability: 
• 30,921 New Cases/2,218,142 Total Cases (+1.4% increase. 36,295 7-Day Average)
• 432 New Deaths/24,958 Total Deaths (+1.8% increase, 239 7-day average; 3,477 14-day change)
• 12.2% 14-day test positivity rate
• 21,433 COVID-19 Hospitalizations (+193 patients, +0.9% from prior day, +34% 14-day)
• 4,478 COVID-19 ICU hospitalized in CA (+88 patients, +2.0% from prior day, +34% 14-day)
• 1,270 ICU beds available (-158 from prior day)
• State R-effective is 1.0 (good sign)
• Vaccinate all 58
• To date, 300,696 Vaccine Doses Administered
• Moderna 1,135,300 doses for CA
• Pfizer 1,090,500 doses for CA
• New COVID Strain/Mutation
• Found in Colorado, Not Yet Detected in California Now found in San Diego
• SARS-COV-2 Whole Genome Sequencing Initiative, state sequences 5-10k samples per week
• Media Questions:
• School testing will use Valencia lab (PCR Tests), 1/3 of cost of current labs. Using Prop 98 funds as well as Medicaid reimbursements. Still logistics and staffing problems that need to be ramped up for implementation.
• Encouraging underserved communities to vaccinate. Will focus on education, using lessons learned during census to help promote community-led outreach
• Students with physical and intellectual disabilities have already been in cohorts throughout the pandemic so state feels safe about further implementation of in-person learning. Used Marin as example with 40,000 students back in schools with few cases/transmission.
• School Superintendent and State have been in contact and negotiations with unions, which have been demanding robust testing, tracing    
• Vaccines- fewer came than were expected. More and more being administered daily. Governor clearly does not want to criticize president. Would be nice to have millions more doses to administer, but would rather take a humble approach where we are in effort to vaccinate millions of Americans. Mindful of setbacks and opportunities. Commitment and resolve is universal.
• Asked about incarcerated cases and deaths. See Monday's notes. 
• Was this a lost year of education? State will be creative in funding to address learning-loss. Looking outside of education constructs/agrarian calendar, increasing supplemental tutors and supports. Will be part of January budget presented to legislature. 
• Darling-Hammond: State has been concerned/tracking/supporting learning. Continuity of Instruction plans, using diagnostic assessments. Learning loss wasn't for all students, just some, we are aware of inequity and problems. Addressing interventions to catch students up in a short amount of time to reach curriculum goals. 
• Superintendent: Obviously this is not ideal. Literally trying to preserve life. Safety has to be paramount. Education system wasn't built to provide distance learning for entire school system. Budget will hopefully allow for small classwork, after-school supports, accelerate learning and offset learning gaps. We're forced to learn and change how we approach educating our students. "It would be a misnomer to say that this was a wasted year. This is a year where we are preserving life, where we are surviving, and at the same time, working to offset gaps that have been accelerated by the pandemic."
• Schools that haven't yet physically reopened and are within high transmission areas are still not yet allowed to reopen because the initial opening has a lot of moving parts and needs more attention. 
• With respect to counties in deep-purple...situation is changing everyday. We cannot say something is hard and fast and true today will be the same tomorrow. We have to take steps back and monitor, consultation with County health officers, and at minimum require weekly testing and tracing. Have to prepare for changes. School districts will have to determine if 6-feet distancing is possible. "We can't control the pandemic, but we can control what we do."   
• Staffing:
• 1,203 State Staff Currently Deployed Around State in 125 facilities
• 154 Cal MAT, 657 Contract Staff, 154 Cal Guard, 19 Health Corps, 64 HHS, 75 DOD, 80 AMR Staff
• Federal Staff Currently Deployed Around State
• 10 teams of 20 DOD staff (200 personnel). 75 more expected yesterday. 
• San Diego County Media Briefing
• UK Variant has been detected in San Diego patient. 30 year old male with no travel history. Believe that because he has no travel history that more cases will be found locally. One household contact was symptomatic other was not, but both are being tested. Had very few contacts and interactions in 14 days prior to infection. 
• Because of evidence of new mutation, because of strain on healthcare system, encourage and plead with public to follow public health orders
• Dr. Kristian Andersen of Scripps Health discovered strain in county
• b.1.1.7. detected S-dropout
• confirmed at 3am this morning of UK lineage
• Genomic surveillance taking place Scripps, UCSD, Radys and other partners
• Knew it would be found in CA, just a question of when
• We know there's more, no idea how many
• Doesn't change what we need to do, just do what we're doing better
• Don't yet know if it is more transmissible here
• Have to be consistent about distancing, masking, etc. 
• Early data suggests that it is more transmissible not more virality 
• Vaccines are being distributed. Many are being sent directly to health systems, pharmacies, etc., and county is doing best to collaborate and make sure vaccines don't expire, even if it means jumping sequencing
• Small business grants, relief, SBDC and San Diego Foundation. Small biz grants are now open at CAReliefGrant.com
• Other metrics to look at are influenza: last week 171, 14 cases of co-infection of Flu & COVID. 1/10th of normal, but sudden rise is evidence that people aren't distancing, masking, essential travel only, washing hands regularly, stay home isolate if you're sick and get tested quickly. Measures help stop both COVID and Flu. Flu vaccine is readily available across the county, get now while you're waiting for COVID vaccine. 
• ICU capacity isn't getting better, in fact it may get worse because of holidays
• New Year's one week after Christmas can be amplifying
• Don't let guard down now. 
• State Data:
• Southern California ICU Bed Availability: 0%
• 2,534 New Cases/150,062 Total Cases (+1.7% from prior 
• 31 Deaths/1,435 Total Deaths (+2.2% from prior day)
• 76.3 cases/100k population (Based on week ending 12/22, Assessed on 12/29. Unadjusted Case Rate)
• 13.7% Test Positivity (Assessed on 12/29)/12.7% 14-day avg
• 19.2% Health Equity Positivity (Assessed on 12/29)
• 1,532 COVID-19 hospitalized patients (-28 patients, -1.8% from prior day)
• 398 COVID-19 ICU hospitalized patients (-1 patients, -0.3% from prior day)
• 172 ICU beds available (-4 from prior day)
• County Data:
• San Diego Man Tests Positive for UK Variant of COVID-19 - County News Center 
• Cease & Desist and Closure Orders 
• County of San Diego Influenza Watch
• 2,448 New Cases/152,512 Total Cases 
• 37 New Daily Deaths/1,472 Total Deaths
• 10% Daily Test Positivity/12.3% (7-day avg after 7-day lag)/10.8% Test Positivity (14-day average)
• 38.1 cases/100k population (Assessed on 12/29. Adjusted case rate per 100,000 excluding prisons.) 
• 51% Case Investigation (under 70% goal)
• 4.6% Increasing Day Over Day COVID-19 Hospitalizations (115% increase over 30 days. 1501 patients)
• 18% ICU Capacity (under 20% Trigger. 99% increase over 30 days. 383 Patients)
• 11 New/55 Community Outbreaks (7-day) (one outbreak from 12/24 was removed but not identified so is still included somewhere below)
• Business 23
• Restaurant/bar 1
• Restaurant 1
• Faith-based Setting 5
• Government 1
• Daycare/preschool 7
• Healthcare 8
• Emergency Services 1
• Food/Bev Processing 1
• tk-12 school 1
• Warehouse/Distribution 2
• Hotel/Resort/Spa 4
• Comm-Based Org 1
• Media Questions:
• Public Health State of Emergency was declared on February 14
• Healthcare Capacity Task Force is meeting regularly between health groups, hospitals, EMS to make appropriate adjustments to make sure needs are met within hospitals and between hospitals. State has outlined Crisis Care guidelines.
• Best thing we can do to make sure we have hospital capacity is slow the spread.
• Hunter Sowards from KUSI is a fucking idiot. 
• San Diego Vaccine Update:
• Still in Tier 1 Phase 1A
• Vaccinating people who will help with vaccination
• Fragmented system
• Immunization Registry is delayed/lagged
• Will unveil a vaccination dashboard
• A number of tiers before we get to wider public vaccination
• Hopeful that vaccine or antibodies won't be affected by new strain but we don't know until data comes in
• South Africa variant N501Y is of similar lineage as UK. UK has "s-dropout" but SA does not, so will be different sequencing to detect. UK variant is believed to have come from chronic infection that allowed numerous mutations to occur at once.
• County expect coordination and cooperation from hospitals and healthcare systems to make sure they're observing Tiers and Phases.
• Diagnostic assay tests for Off1, N, S. UK has a deletion in genome of virus. It has a signature where Off1 and N are positive, but S is negative. That is suspected lineage, and then they can further test to definitively identify the S-dropout.  
• County is doing everything they can with enforcement, but there are limits to what they can do. Cannot afford to have another holiday of large gatherings. Variant is concerning that it can spread faster. 
• Message for gatherings is DON'T HAVE THEM
• Don't change what we need to do, but we need to do them better. Surges are from R0 is 1.2 or greater. R0 is 1.0 means less transmission. When it gets below 1 to 0.8, then cases will go normally go down, but if it increases by 50% to 1.2, cases continue to rise. Variant is same virus but may be more transmissible. 
• San Diego City Fire and paramedics (2400 in County) are partnering with County to train to administer vaccines when they're more significantly available. Important to vaccinate the vaccinators who are in a high-priority group.  
• Case counts are going up from Tijuana. About 1/4 tested at border are positive. So far, variant not detected in Mexico, but it's likely to be detected elsewhere and is just a matter of time. Dr. Andersen says they have partnerships with Tijuana and haven't found any of the UK lineage in Tijuana but have only sequenced through November. 
• Last COVID briefing for Supervisor Cox. Called Nathan Fletcher "the great communicator." 
• Global COVID-19 Stats (JHU 12/30 5:22pm):
• 82,625,514 Known Cases
• 1,802,560 Known Deaths
• US COVID-19 Stats (COVID Tracking Project):
• 225,671 New Cases/19,493,586 Known Cases (+6.9% Change over 7 Days)
• 3,903 New Deaths/333,524 Known Deaths
• 125,220 Current COVID-19 Hospitalizations
• 23,069 Currently COVID-19 patients in ICU
• 7,930 COVID-19 patients currently on ventilator
• Universities:
• SDSU COVID-19, UCSD COVID-19, USD COVID-19, CSU San Marcos, PLNU