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| Goofy Ass Picture of Me and My Sister at Sea World Christmas in the Before Times 12.13.2019 |
I fell out of the habit of sharing what I'm reading and watching because I'm still reading Becoming by Michelle Obama, my checkout of Barack Obama's A Promised Land is going to run out before I can listen to the whole thing, and everything I've been watching on streaming has been news, media briefings, Bravo or just crappy brain junkfood. I thought I'd be 50 cheesy Christmas movies in by now, but we don't have Lifetime or Hallmark, and the ones on other services have been meh, though I loved Jingle Jangle, Happiest Season was pretty good on Hulu, and You Are My Home was not typical sappy fare, pretty tragic actually, but good. I started watching a movie from the early oughts the other day and had to turn it off because Chris Brown was in it. I don't have to make a big to-do about it, but I realized just how many actors and musicians I won't watch or listen to because they're such pieces of shit in real life. The list is long, my friends.
Anyhow, Christmas is only two days away and it is so hard not to run out to Costco and Vons and Target and Big Lots and Ross and buy all the things, but we're trying not to be part of the problem over here. It's like when you're in traffic complaining about traffic without acknowledging that you are the traffic. I'm also a little sad because we love spending the holidays at the Zoo or Safari Park, but that is obviously not an option right now either, and probably won't be well into February or March the way things are going. As it is, I'm in a major quandary if we should even go to my parents' house on Friday, but I'm saving that for a separate post because the decision making is really taxing.
Today Governor Newsom did a short briefing before having a little conversation with Dr. Shirley Weber and Alex Padilla, so notes on that are below. After watching all of that, my neighbor dropped by with her dog so we chatted for a bit (masked/10 feet apart/outside) and then I watched the County's Media Briefing. They had an administrator from Scripps health as a guest and he was much more straight about the crisis around us and it is dark. Meanwhile, I said to keep an eye out for the Pacer's vs San Diego County/Gavin Newsom/State of California Case (Superior Court Case #37-2020-00038194-CU-CR-CTL) and I'm not gonna spend money to get court documents nor do I really understand legal speak, but if I'm reading it correctly, today's hearing was canceled ("ex parte was vacated") and the next "motion hearing" isn't until January 22, 2021, so strip clubs and restaurants, for the time being, must follow the current stay-at-home orders. I think. I'm also gonna guess that somewhere in the ROA (Register of Actions) is where KPBS got ahold of the outbreak information (if it wasn't just from the county with a wink, wink and a 'you didn't get this from me.') I can't be sure, both are just suspicions. Anyway, lots of stuff today.
- Global COVID-19 Stats (JHU 6:22, 12/23):
- 78,623,752 Known Cases
- 1,729,166 Known Deaths
- US COVID-19 Stats (COVID Tracking Project):
- 220,834 New Cases/18,238,850 Known Cases (8.7%+ Change over 7 Days)
- 3,379 New Deaths/317,513 Known Deaths
- 119,463 Current COVID-19 Hospitalizations
- 22,489 Currently COVID-19 patients in ICU
- 7,819 COVID-19 patients currently on ventilator
- California State Discussion with Governor Newsom, Dr. Shirley Weber, Alex Padilla
- This press conference started with the state's data, and then a long back and forth on Zoom with Newsom, Weber and Padilla. Then they took media questions. The answers to those questions or discussions follow:
- Regional stay-at-home appears to be working and case rates seem to be dropping but we'll have to keep an eye out, too early to tell. Still seeing surge on surge from Thanksgiving
- This virus thrives in social gatherings, it thrives indoors, thrives when we're proximate to each other, thrives when we're together for extended amounts of time.
- Crisis-of-care standards are distinct between facilities, cities, counties, and regions. Hospitals and systems are already moving and rearranging elective and scheduled surgeries. Waivers on staffing ratios (1:2 is now 1:3) allowing more flexibility, surge plans have been in place for ICUs and hospital-wide to expand the physical extension of footprints including alternative use of existing space and/or building out tents, trailers in parking lots.
- Federal medical stations are not ICU beds, but allow hospitals to decompress. Repurposing non-ICU beds to ICU, thus allowing hospital beds to be external. Each facility is unique but biggest issue is still staffing. Calguard, Health Corps staffing. Hopefully more staffing will become available after holidays, by first week of January.
- When asked about what his relationship has informed Newsom about the characters of Padilla and Weber, he got teary eyed, saying that he appreciates people who want to do something, not be something. That they're in politics for the right reasons, that they have amazing character. 'Blessed that we have two remarkable Californians who can positively impact the lives of millions of Americans in their elevated positions of influence.'
- When asked if she'll run for full term in '22, Dr. Weber says she is no placeholder and will definitely be running for Secretary of State in 2022. Padilla concurs and will also run for full term in 2022.
- Governor will get his vaccine when it's appropriate and will wait in line for his turn based on the vaccine distribution workgroup guidelines.
- Padilla: Non-partisan voter education campaign was mandated and written into the 2020-2021 budget and was law. Only disagreements are about where the money should have come from, i.e. Secretary of State office or counties. Will be resolved soon.
- UI and direct payments/supplement will go out as soon as possible if the president actually signs. The systems are already set up, kinks have mostly been worked out.
- State is looking at a universal travel policy: PSAs, information campaign, in-flight information, requiring confirmation/verification that travel is essential. By Thursday, east and west coasts will be requiring negative tests from UK for all inbound flight passengers.
- Dr. Weber: Has already served on elections and redistricting committee, so many of the initiatives addressing communities of color, LGBTQ+, and other marginalized groups came through her committee. Has already focused on voter turnout and education and is excited to continue the efforts made by Padilla. Restoring the passion of people who realize how important this democracy is and how important it is to vote. Shooting for 100%. "Shoot for the moon, you get off the ground."
- Padilla: Legislature has created a mandate to increase voter participation rates, especially underrepresented communities. Automatic 'motor-voter' legacy has changed voting in the state. Dr. Weber will steward and continue that to the future.
- California COVID-19 Stats:
- ICU Bed Capacity Statewide: 1.1%
- 39,069 New Cases/1,964,076 Total Cases (2% increase)
- 361* (highest daily total) New Deaths/23,284 Total Deaths (1.6% increase)
- 12.3% 14-day test positivity rate/12.6% 7-day test positivity rate
- 18,828 COVID-19 Hospitalizations (12/1 was 8,517)
- 3,827 COVID-19 ICU hospitalized in CA (12/1 was 2,006)
- 33.5% of all hospital admissions are COVID-19
- 55.4% of all ICU patients are COVID-19
- State is opening Palomar Medical Center as an FMS site for San Diego
- 951 State Staff at 91 facilities in 25 counties; anticipating more support
- 1,373 ICU beds available
- San Diego County Media Briefing (Cox, Fletcher, Dr. Wooten):
- Holiday Celebrations Could Crush ICU Capacity. If you’re planning a gathering during the upcoming holidays, County health officials say you should cancel it. - County News Center (12.22.2020)
- "Avoid large gatherings with people outside your family." Even if you tested recently and you're okay, or you have a safe plan...getting together for the holidays is simply too risky. - Supervisor Cox
- Testing Sites Holiday Open:
- 12/24 & 12/31 all sites close at 4pm
- 12/25 USD, San Marcos, Southeaster SD 10:30am-2:30pm
- "This is the darkest hour and darkest time we've faced." - Nathan Fletcher
- Stop the spread. Please don't gather. Stay home because you love your family, you care about senior citizens, you care about healthcare workers, you care about your fellow San Diegans
- Doing everything we can to avoid crisis of care situations within hospitals, ambulance aversions, Palomar Medical to be activated, pulling vents from County and State inventory, but we have to reduce the spread of the disease.
- Dr. Wooten says Regional Stay At Home Order will remain until ICU bed capacity is above 15% (not exactly true...state is looking at forecasting 3-4 weeks out with expected cases/hospitalizations and ICUs)
- Scripps Health Care:
- Doctors and nurses are disheartened by San Diegans not staying-at-home, restaurants packed, stores packed. San Diego is "on the precipice of mass death."
- Still surging from Thanksgiving: 22% positive test rate
- "Darkest days of COVID are still ahead of us."
- 7/10 - 411 COVID cases in hospitals (including Imperial Valley)
- 12/23 - 1,492 COVID cases in hospitals
- Only 24 Staffed Beds available today/670 total
- Expecting Peak of 1,827 hospitalizations /483 ICU on January 11
- 67% of all ICU beds are COVID-19 patients
- "Med Surg" - Expected Peaks 1/9 of 1,387
- 4,439 Total Hospital Census - 1/10 5,133 (36% COVID)
- Currently have 657 staffed ICU Beds; 582 current patients - projected peak on 1/12 of 726 (67% COVID; 108% of Capacity)
- What are the hospitals doing to manage?
- All regional stopped elective surgeries; only doing time critical surgeries (emergencies, cancers, etc)
- Surge plans to increase capacity
- Scripps Encinitas is at 183% ICU capacity by opening a third ward
- Engineers adding negative pressure rooms
- State waivers/team nursing is implemented
- Load balancing
- Recruiting
- Buying more supplies, PPE, venitilators
- Staff is getting vaccinated
- Working on crisis-care capacity
- Wash your hands. Stay home if you can. If you do mix, wear at least a 3 ply mask. Distance at least 6 feet, even more if you take off masks to eat/drink.
- If you do travel, quarantine after for 7-10 days.
- Vaccines:
- Pfizer 95% efficacy - Deep Freeze - doses are 3 weeks apart = 29,250 doses
- moderna 94.5% efficacy - Refrigerator - doses are 4 weeks apart = 73,300 doses
- Dose numbers do not include pharmacy partners' doses, military, or multi-county health groups like Kaiser
- Centers for vaccines must be approved by CDC and CDPH CalReadie system
- State Data:
- Southern California ICU Bed Availability: 0.0%
- 67.1 cases/100k population (Based on week ending 12/15, Assessed on 12/22. Unadjusted Case Rate)
- 10.9% Test Positivity (Assessed on 12/22)
- 17.2% Health Equity Positivity (Assessed on 12/22)
- County Data:
- San Diego County COVID Update - County News Center
- San Diego County Influenza Watch
- 2,598 New Cases/134,696 Total Cases
- 39 New Reported Deaths/1,350 Total Deaths
- 4.1% of all cases hospitalized
- 1.0% of all cases died
- 8% Daily Test Positivity/12% (7-day avg after 7-day lag)/9.7% Test Positivity (14-day average)
- 36.3 cases/100k population (Assessed on 12/22. Adjusted case rate per 100,000 excluding prisons.)
- 46% Case Investigation (under 70% goal)
- 9% Increasing Day Over Day COVID-19 Hospitalizations (1,347 patients. 190% increase over 30 days)
- 19% Decreasing ICU capacity (under 20% trigger. 143% increase over 30 days)
- 33 ICU Beds Available today across the whole county
- 81% ICU Occupancy (336, 348 patients of 735 Bed Capacity- Patient stats were provided by both Scripps Health and the County. Because situation is fluid, difference in numbers is due to when they pulled their numbers) (under 20% Trigger. % increase over 30 days)
- 12 New/44 Community Outbreaks (7-day)/208 Active Community Outbreaks
- Business 15
- Retail 1
- Grocery 2
- Faith-based Setting 1
- Government 2
- Daycare/preschool 4
- Healthcare 3
- Construction 2
- Emergency Services 3
- Food/Bev Processing 1
- tk-12 school 5
- Warehouse/Distribution 4
- Hotel/Resort/Spa 1
- Private Residences 1
- Thanksgiving Impact:
- From November 27-December 15, 44.1% of 134,696 cases
- 1/162 San Diego residents has reported positive in past 7 days
- Media Questions:
- Palomar will have 202 beds, it's a state site. No additional info at this time.
- NBC: What do you say to business owners are not taking county seriously anymore? Fletcher: Part of the reason there's a lot of back and forth is because the virus is very back and forth. There's also a lot of misinformation. Public/elected officials urging people to defy orders. Ultimately it is up to each San Diegan to do the right thing. (He didn't take the opportunity to slam the judge because today was the hearing which was vacated until Jan 22)
- 24 beds is serious. Scripps system alone saw 62 new COVID patients in last 24 hours, 44 discharged, several died. "We're damn tired of it, too."
- Structures are not the problem; the lack of staffing is. We can find beds, but nobody to staff them.
- Providers register with COVIDReadie. Vaccines won't be available to general public until spring at the earliest.
- UK Strain question...boring...see my past posts. Only a matter of time until UK strain is identified in San Diego.
- San Diego has our own vaccination registry that will track vaccines.
- Paul Sisson keeps asking the same question about what it takes to get to Crisis of Care standards. "To some degree, we're already in that scenario" Some people who would've been ICU are maybe now in a surgical room, patients may be discharged sooner than they should. "Those kinds of decisions are probably already being made because the ICU capacity is so tight. It just gets worse as we go on and staffing gets tighter. We'll have to make those kinds of decisions -- and that is part of where the crisis care comes in, so that we have triage teams that will help support the frontline doctor in making these difficult decisions that'll have to be made if the resources, the beds, the equipment...aren't there." Used example of ECMO machines....Scripps currently has 8 machines, 7 of them are in use. If 3 new patients came in needing them and they can't get patients into other hospitals or get the equipment, those (clinical decisions of who gets treatment) will have to be made.
- If hospital can add a bed and stretch staffing, that bed is added to census as a staffed bed.
- County recognizes the foundational role of faith and religion and the constitutional protections that come with it. Churches are currently allowed to convene in numbers that no other activity can. Court also recognized high danger of indoors, mass services, singing, etc. People are encouraged to be safe. 'There's a difference between passing someone in a grocery store aisle with you mask on and sitting next or near them in a church or restaurant for an extended amount of time.'
- Mike McKinnon, KUSI Trumper douche, wants to know why California cases are so high when we have the strictest restrictions compared to Texas and Florida. Fletcher was quick to say "KUSI news may not be aware of this, but California has twice as many people as Florida has so it is not a fair case of comparison" and the per person cases, hospitalizations, and deathss in Florida are higher than here, and they ought not be the model that we compare ourselves to. Comparing California to Florida doesn't necessarily make a very strong argument
- Universities:
- COVID-19:
- Tennessee Hospitals Are Disturbingly Close To Their Breaking Point - NPR (12.22.2020)
- As the Terror of COVID Struck, Health Workers Struggled to Survive. Thousands Lost the Fight. At least 2,900 health workers have died since the pandemic began. Many were minorities with the highest levels of patient contact. -Kaiser Health News (12.23.2020)
- Politics:
- I don't like to post speculative articles. Like most everyone, I thought the funding/relief bill passing both houses meant a done deal, but never count out someone to derail. And I'm not against higher payments for individuals, but the timing is so ridiculous considering all of our CARES Act stuff expires this weekend. And for the public tantrum to happen on Tuesday, I had to dig back when the $2000 checks was a "Breaking News" item I got last week from The Washington Post. And then last night dude decides to take a stand? As if he didn't already know they were looking at $600. I don't know what's gonna happen, but I guess I'm glad we skipped gifts this year and will be saving every penny we have while we have it.
- White House aides talked Trump out of last-minute demand for stimulus checks as big as $2,000 Chaotic chain of events at White House illustrates why stimulus bill remains in flux - The Washington Post (12.17.2020)
- Trump threatens to torpedo COVID relief with new demands - AP News (12.23.2020)
- There could be 3.2 million deaths in the U.S. this year, at least 400,000 more than in 2019. - NBC News (12.22.2020)
- Comedy Clubs Running During the Pandemic Is an Industry-Wide Failure - Paste (12.22.2020)
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