latimes--2020-12-18--Ventura County district attorney's office releases new details on Borderline mass shooting

A Ventura County district attorney ’ s report released Thursday on the 2018 mass shooting at a packed Thousand Oaks bar reveals new details from the scene and background on the gunman ’ s mental state .
Borderline Bar and Grill was hosting line-dancing classes for college students as young as 18 and two birthday parties for newly 21-year-olds when a former U.S. Marine machine gunner opened fire about 11:20 p.m. Nov. 7 , 2018 .
Ian David Long , 28 , was armed with a folding knife and a .45-caliber Glock with a laser sight attached .
Patrons quickly @ @ @ @ @ @ @ and in bathroom stalls ; some used bar stools to break second-story windows to flee the building by jumping .
More than 200 patrons and employees were inside when Long began firing .
The , including Ventura County Sheriff ’ s Sgt .
Ron Helus , who engaged in a gunfight with the assailant , and 18 injured .
When Long entered the Borderline , he tossed smoke bombs — of which he had 10 — and fired two high-capacity magazines of 30 shots each into the crowd , Ventura County Sheriff Bill @ @ @ @ @ @ @ the next few minutes maneuvering through the thick smoke looking for victims and shooting them as he found them .
Soon after , he made his way to the front office where a monitor displayed live video feeds from the bar ’ s nine security cameras .
While there , Long frequently checked his social media , the report stated .
He even posted twice during the massacre .
He wrote that he hoped people would refer to him as and openly mocked the “ thoughts and prayers ” frequently offered in public @ @ @ @ @ @ @ shootings .
One post was prewritten and another was composed at the scene , according to the report .
Detectives later found a handwritten note from Long that read , “ NO Funeral , ” while searching his home .
Long ’ s former teachers , roommates and neighbors , and even drew the police to his door .
When Long was a toddler , his parents separated and later divorced ; his father died when he was in the fifth grade .
Long lived with his mother , who moved around for @ @ @ @ @ @ @ Park , where he lived when the Borderline shooting occurred .
Long had enlisted in the Marines in 2008 and was honorably discharged in 2013 with the rank of corporal .
His service included a seven-month deployment to Afghanistan in Operation Enduring Freedom .
U.S. Department of Veterans Affairs had no record of Long receiving medical or mental health-related treatment , according to the FBI , but authorities had speculated that he suffered from post-traumatic stress disorder .
Long received physical and mental health treatment from Kaiser Permanente from 2015 to 2016 , @ @ @ @ @ @ @ diagnosed with adjustment disorder with mixed anxiety and depressed mood , PTSD , combat and military operational stress reaction , and chronic pain .
Long had a few contacts with the Ventura County Sheriff ’ s Office before the mass shooting , including a traffic collision in 2006 , a bar fight in 2015 and a welfare check in 2018 .
Long told the deputies that he had injured his left shoulder in a motorcycle accident , which prevented him from finding employment or reenlisting in the military .
A mental health crisis @ @ @ @ @ @ @ did not meet the criteria for involuntary hospitalization .
The report also recounted details on the gunfight between Long , Helus and California Highway Patrol Officer Todd Barrett .
The latter two , along with CHP Officer Lidia Espinoza , were the first to arrive on the scene , just minutes after Long began shooting .
Long was monitoring their whereabouts from the security video in the front office and ambushed Barrett and Helus from the office doorway .
Barrett retreated to the front stairway , but Helus had fallen and crawled to @ @ @ @ @ @ @ back up , Helus was struck by one of Barrett ’ s gunshots , according to the report .
Helus managed to reach an alcove outside the front entrance , rolled on his back and continued firing at Long .
Long was not struck by any shots fired by authorities , but Helus was struck by five bullets from Long .
The who planned to retire in a year or two was pronounced dead at a hospital .
The fatal bullet was from Barrett ’ s .223 rifle , which perforated Helus ’ @ @ @ @ @ @ @ office determined Barrett ’ s deadly use of force was justified .
Authorities found Long ’ s body in the front office with a single gunshot wound .
Autopsies confirmed that Long shot himself through the chin , penetrating his brain .
Traces of marijuana , caffeine and tobacco were found in his system from toxicological testing , according to the report .

Deputies at the scene of the 2018 mass shooting at Thousand Oaks’ Borderline Bar and Grill, which left 12 people dead.
A Ventura County district attorney’s report released Thursday on the 2018 mass shooting at a packed Thousand Oaks bar reveals new details from the scene and background on the gunman’s mental state.
Borderline Bar and Grill was hosting line-dancing classes for college students as young as 18 and two birthday parties for newly 21-year-olds when a former U.S. Marine machine gunner opened fire about 11:20 p.m. Nov. 7, 2018. Ian David Long, 28, was armed with a folding knife and a .45-caliber Glock with a laser sight attached.
Patrons quickly took cover, crouching behind pool tables and in bathroom stalls; some used bar stools to break second-story windows to flee the building by jumping.
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More than 200 patrons and employees were inside when Long began firing. The rampage left 12 dead , including Ventura County Sheriff’s Sgt. Ron Helus, who engaged in a gunfight with the assailant, and 18 injured.
When Long entered the Borderline, he tossed smoke bombs — of which he had 10 — and fired two high-capacity magazines of 30 shots each into the crowd, Ventura County Sheriff Bill Ayub said in a 2018 news conference .
Long spent the next few minutes maneuvering through the thick smoke looking for victims and shooting them as he found them. Soon after, he made his way to the front office where a monitor displayed live video feeds from the bar’s nine security cameras.
While there, Long frequently checked his social media, the report stated. He even posted twice during the massacre.
He wrote that he hoped people would refer to him as “insane” and openly mocked the “thoughts and prayers” frequently offered in public statements and on social media after mass shootings. One post was prewritten and another was composed at the scene, according to the report.
Detectives later found a handwritten note from Long that read, “NO Funeral,” while searching his home.
Long’s behavior long concerned former teachers, roommates and neighbors, and even drew the police to his door. When Long was a toddler, his parents separated and later divorced; his father died when he was in the fifth grade.
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Long lived with his mother, who moved around for work. Eventually they moved to Newbury Park, where he lived when the Borderline shooting occurred.
Long had enlisted in the Marines in 2008 and was honorably discharged in 2013 with the rank of corporal. His service included a seven-month deployment to Afghanistan in Operation Enduring Freedom.
U.S. Department of Veterans Affairs had no record of Long receiving medical or mental health-related treatment, according to the FBI, but authorities had speculated that he suffered from post-traumatic stress disorder.
The report released Thursday confirmed it.
Long received physical and mental health treatment from Kaiser Permanente from 2015 to 2016, according to the report. He was diagnosed with adjustment disorder with mixed anxiety and depressed mood, PTSD, combat and military operational stress reaction, and chronic pain.
Long had a few contacts with the Ventura County Sheriff’s Office before the mass shooting, including a traffic collision in 2006, a bar fight in 2015 and a welfare check in 2018. Long told the deputies that he had injured his left shoulder in a motorcycle accident, which prevented him from finding employment or reenlisting in the military. A mental health crisis team conducted an evaluation but determined Long did not meet the criteria for involuntary hospitalization.
The report also recounted details on the gunfight between Long, Helus and California Highway Patrol Officer Todd Barrett. The latter two, along with CHP Officer Lidia Espinoza, were the first to arrive on the scene, just minutes after Long began shooting. Long was monitoring their whereabouts from the security video in the front office and ambushed Barrett and Helus from the office doorway.
Barrett retreated to the front stairway, but Helus had fallen and crawled to the entrance. As he was standing back up, Helus was struck by one of Barrett’s gunshots, according to the report. Helus managed to reach an alcove outside the front entrance, rolled on his back and continued firing at Long. Long was not struck by any shots fired by authorities, but Helus was struck by five bullets from Long.
The 29-year veteran of the department who planned to retire in a year or two was pronounced dead at a hospital. The fatal bullet was from Barrett’s .223 rifle, which perforated Helus’ heart. The district attorney’s office determined Barrett’s deadly use of force was justified.
Authorities found Long’s body in the front office with a single gunshot wound. Autopsies confirmed that Long shot himself through the chin, penetrating his brain. Traces of marijuana, caffeine and tobacco were found in his system from toxicological testing, according to the report.


latimes--2020-12-17--Photos | ICU availability in Southern California at 0% amid deluge of COVID-19 patients

The availability of intensive care unit beds throughout Southern California hit 0 % Thursday , and officials warned that conditions @ @ @ @ @ erode further if COVID-19 continues to spread unchecked .

The availability of intensive care unit beds throughout Southern California hit 0% last week, and officials warned that conditions in hospitals were expected to erode further if the coronavirus continued to spread unchecked.
An ICU, or intensive care unit, is a specialized hospital department that cares for people in the most critical health situations, such as those with life-threatening injuries or severe illnesses. ICUs are equipped with specialized equipment, such as ventilators.
Most important, ICUs are staffed with highly trained nurses and physicians who provide round-the-clock care to their patients — checking their breathing, blood pressure, fluids and other vital signs. Dr. Shruti Gohil, an infectious disease specialist at UCI Health, said there was a 1-to-1 ratio of nurses to patients in ICUs.
Here are images from area hospitals where healthcare workers are laboring, treating a flood of COVID-19 patients.
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Emergency room staff rush a trauma patient to the exam area in Moreno Valley. (Gina Ferazzi / Los Angeles Times)
Registered nurse Michelle Goldson works with a COVID-19 patient in the ICU at Martin Luther King Jr. Community Hospital on Dec. 17. The writing on the window lists the times the patient was in the prone and supine positions. (Francine Orr/Los Angeles Times)
A nurse gets help putting on her personal protective equipment before heading into a negative pressure room at Sharp Chula Vista Medical Center. (Marcus Yam / Los Angeles Times)
Emergency department medical director Dr. Leroy Pascal, in white mask, and respiratory therapists scramble to attend to a COVID-19 patient at Desert Valley Hospital in Victorville. (Irfan Khan / Los Angeles Times)
Pulmonologist Dr. Laren Tan, center, and his team of nurses and respiratory therapists intubate a COVID-19 patient in the ICU at Loma Linda University Medical Center. (Gina Ferazzi / Los Angeles Times)
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ER nurse Jennifer Caspary helps Dr. Leroy Pascal with his protective gear on Dec. 17 at Desert Valley Hospital in Victorville. (Irfan Khan / Los Angeles Times)
A patient is rushed to ICU to be intubated and placed on a ventilator at Providence Saint John’s Health Center in Santa Monica. (Francine Orr / Los Angeles Times)
Michelle Goldson, RN works inside the ICU at Martin Luther King, Jr. Community Hospital during the latest surge. (Francine Orr/Los Angeles Times)
A nurse checks on COVID-19 patient Jose Mariscal, 66, in the ICU at Arrowhead Regional Medical Center in Colton, Calif. (Gina Ferazzi / Los Angeles Times)
Jennifer Caspary, ER incharge-nurse left, and Dr. Leroy Pascal, emergency department medical director, attend to a COVID-19 patient at Desert Valley Hospital. (Irfan Khan/Los Angeles Times)
A patient is rushed to be placed on a ventilator at Providence Saint John’s Health Center in Santa Monica. (Francine Orr / Los Angeles Times)
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Michelle Goldson, RN, in the ICU at Martin Luther King Jr. Community Hospital in Los Angeles. (Francine Orr / Los Angeles Times)
Nurse Jeanette Pimentel checks on Pedro Luera, 68, who was airlifted from El Centro, Calif., to Paradise Valley Hospital in National City. (Irfan Khan / Los Angeles Times)


latimes--2020-12-17--Garcetti plans to remain in office and says his  daughter, 9, has coronavirus

Los Angeles Mayor Eric Garcetti said Thursday that he plans to remain mayor , an announcement aimed at ending speculation that he might join President-elect Joe Biden ’ s administration .
He also announced at a briefing Thursday that his 9-year-old daughter , Maya , had tested positive for the coronavirus .
Both Garcetti and his wife , Amy Wakeland , tested negative , he said .
Garcetti said he told the Biden team this week that he wanted to remain in Los Angeles .
“ There were things on the table for me , ” Garcetti said .
He @ @ @ @ @ @ @ him .
He also did not definitively rule out leaving office before his term ends in 2022 .
Garcetti made his remarks from the Getty House , the mayor ’ s official residence , and said that he and his wife are quarantining in light of his daughter ’ s diagnosis .
Talking broadly about the pandemic , he said that “ there is nothing more important to me , no task more urgent than being here as your mayor.
” Garcetti was a co-chair of Biden ’ s presidential campaign , helped @ @ @ @ @ @ @ viewed as a contender for a Cabinet position , perhaps leading the Department of Transportation or Housing and Urban Development .
Instead , former South Bend , Ind.
, Mayor Pete Buttigieg was tapped this week for the Transportation spot , while Ohio Rep. Marcia L. Fudge was announced as the nominee last week to lead HUD .
That left a dwindling number of available posts for Garcetti , who was also eyed as a possible contender to head the Environmental Protection Agency , Bloomberg reported .
But on Thursday , Biden picked @ @ @ @ @ @ @ North Carolina , to head the EPA .
A source familiar with those discussions told The Times that Garcetti was informed this week that he didn ’ t get the EPA administrator post .
The source , who wasn ’ t authorized to speak to the media , asked to remain anonymous .
A Garcetti spokesman declined to comment .
A Biden transition representative didn ’ t immediately respond to questions from The Times .
Any nomination to a Cabinet position for Garcetti could have brought unwanted scrutiny to allegations made against him @ @ @ @ @ @ @ , a Los Angeles police officer , alleges that Garcetti ’ s longtime advisor sexually harassed him and that Garcetti failed to intervene .
Garcetti denies witnessing any harassment and the advisor has said he didn ’ t harass anyone .
A judge on Thursday ordered Garcetti to be deposed in the case .
Meanwhile , Black Lives Matter Los Angeles and other activists have gathered regularly outside the mayor ’ s official residence , the Getty House , to protest any Garcetti appointment .
Following Garcetti ’ s briefing Thursday , Black @ @ @ @ @ @ @ the daily demonstrations worked .
“ Political calculations were made and Garcetti carried too much baggage with him , including lots of very loud protesters who vigorously opposed any such appointment , ” Abdullah said .
Devon Manney , spokesman for Koreatown-based homeless outreach group Ktown for All , said Thursday that the group hopes Garcetti “ starts listening to the activists demanding he step up and provide real solutions to help Angelenos , rather than pretend his hands are tied.
” Garcetti ’ s decision to remain in Los Angeles comes as @ @ @ @ @ @ @ the ongoing pandemic , a fiscal emergency at City Hall and rising crime .
The availability of intensive care unit beds throughout Southern California dropped Thursday to 0 % , generating alarm about the region ’ s ability to cope with the surging number of COVID-19 cases .
Garcetti was praised for his handling of the pandemic in the spring , including his support for widespread coronavirus testing and for his calming demeanor when addressing anxious Angelenos .
More recently , he ’ s faced criticism over the city ’ s messaging on @ @ @ @ @ @ @ outdoor restaurant dining .
With Garcetti staying in Los Angeles for now , he ’ ll have two more years to grapple with the immediate challenges facing the city .
In an interview with KNBC-TV Channel 4 last month , Garcetti acknowledged the tough moment facing the city but pointed to the 2028 Olympics and new rail lines that are being built across the region .
“ I would never bet against Los Angeles long-term , ” Garcetti said .
“ This is going to be a powerful economy and a powerful place @ @ @ @

Mayor Eric Garcetti, shown in July, said he will remain in office rather than join the Biden administration.
Los Angeles Mayor Eric Garcetti said Thursday that he plans to remain mayor, an announcement aimed at ending speculation that he might join President-elect Joe Biden’s administration.
He also announced at a briefing Thursday that his 9-year-old daughter, Maya, had tested positive for the coronavirus. Both Garcetti and his wife, Amy Wakeland, tested negative, he said.
Garcetti said he told the Biden team this week that he wanted to remain in Los Angeles. “There were things on the table for me,” Garcetti said.
He declined to name the positions available to him. He also did not definitively rule out leaving office before his term ends in 2022.
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Garcetti made his remarks from the Getty House, the mayor’s official residence, and said that he and his wife are quarantining in light of his daughter’s diagnosis.
Talking broadly about the pandemic, he said that “there is nothing more important to me, no task more urgent than being here as your mayor.”
Garcetti was a co-chair of Biden’s presidential campaign, helped vet vice presidential candidates and was widely viewed as a contender for a Cabinet position, perhaps leading the Department of Transportation or Housing and Urban Development.
Instead, former South Bend, Ind., Mayor Pete Buttigieg was tapped this week for the Transportation spot, while Ohio Rep. Marcia L. Fudge was announced as the nominee last week to lead HUD.
That left a dwindling number of available posts for Garcetti, who was also eyed as a possible contender to head the Environmental Protection Agency, Bloomberg reported.
But on Thursday, Biden picked Michael Regan, a state regulator in North Carolina, to head the EPA.
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A source familiar with those discussions told The Times that Garcetti was informed this week that he didn’t get the EPA administrator post. The source, who wasn’t authorized to speak to the media, asked to remain anonymous.
A Garcetti spokesman declined to comment. A Biden transition representative didn’t immediately respond to questions from The Times.
Any nomination to a Cabinet position for Garcetti could have brought unwanted scrutiny to allegations made against him by his former bodyguard.
The bodyguard, a Los Angeles police officer, alleges that Garcetti’s longtime advisor sexually harassed him and that Garcetti failed to intervene. Garcetti denies witnessing any harassment and the advisor has said he didn’t harass anyone.
A judge on Thursday ordered Garcetti to be deposed in the case.
Meanwhile, Black Lives Matter Los Angeles and other activists have gathered regularly outside the mayor’s official residence, the Getty House, to protest any Garcetti appointment.
Following Garcetti’s briefing Thursday, Black Lives Matter-Los Angeles co-founder Melina Abdullah said the daily demonstrations worked.
“Political calculations were made and Garcetti carried too much baggage with him, including lots of very loud protesters who vigorously opposed any such appointment,” Abdullah said.
Devon Manney, spokesman for Koreatown-based homeless outreach group Ktown for All, said Thursday that the group hopes Garcetti “starts listening to the activists demanding he step up and provide real solutions to help Angelenos, rather than pretend his hands are tied.”
Garcetti’s decision to remain in Los Angeles comes as the city faces several crises, including the ongoing pandemic, a fiscal emergency at City Hall and rising crime.
The availability of intensive care unit beds throughout Southern California dropped Thursday to 0%, generating alarm about the region’s ability to cope with the surging number of COVID-19 cases.
Garcetti was praised for his handling of the pandemic in the spring, including his support for widespread coronavirus testing and for his calming demeanor when addressing anxious Angelenos.
More recently, he’s faced criticism over the city’s messaging on restrictions and for supporting the ban on outdoor restaurant dining.
With Garcetti staying in Los Angeles for now, he’ll have two more years to grapple with the immediate challenges facing the city.
In an interview with KNBC-TV Channel 4 last month, Garcetti acknowledged the tough moment facing the city but pointed to the 2028 Olympics and new rail lines that are being built across the region.
“I would never bet against Los Angeles long-term,” Garcetti said. “This is going to be a powerful economy and a powerful place with prosperity.”
Times staff writer Anna Phillips contributed to this report.


latimes--2020-12-18--L.A. teachers will spend more live time with students amid uncertainty over school reopening

With children mired in distance learning and many struggling academically , Los Angeles teachers will take on more live online interaction with students next semester , under an agreement announced Friday .
Also under the deal , school nurses will conduct campus-based tests for the coronavirus .
The pact between the teachers union and the Los Angeles Unified School District was essential for the nation ’ s second-largest school system ; its predecessor would have expired Dec. 31 .
And , based on current infection rates , a return to campus in January is almost impossible under state health guidelines @ @ @ @ @ @ @ reflects the shared learning of all who work in schools about the need to maximize the interaction between teachers and students and their families , ” Los Angeles Unified Supt .
Austin Beutner said in a statement .
“ We are gratified to reach an agreement to extend the distance learning agreement , which is what our students need right now , ” said Cecily Myart-Cruz , president of United Teachers Los Angeles .
“ In the face of the upheaval we are all dealing with , educators , students and families need @ @ @ @ @ @ @ “ side letter ” to the teachers ’ contract goes at least part way to addressing complaints from critics — including many parents and some community groups who have called for increased daily live interaction between students and teachers .
“ This agreement still leaves Los Angeles Unified with less learning time , less support for teachers , less partnership with families and less focus on racial equity than other large California school districts , ” said Seth Litt , executive director of Parent Revolution , a local advocacy group that has provided @ @ @ @ @ @ @ of families who contend that the district is violating their legal right to an education .
There also are parents who would settle for nothing less than a return to full-time in-person instruction .
Others support remaining in distance learning , while some worry that current practices force students to remain online for too long , especially younger ones .
No strategy has emerged that offers full academic support and an elimination of risk for school employees and the families they serve .
Making strides in that direction has become more complicated as @ @ @ @ @ @ @ resources past their capacity .
The pandemic closed campuses in March , but schools in counties adjacent to L.A. were able to open in the fall , when local infection rates were lower .
Campuses that opened during that period can remain open , but not every school system did so .
And some districts that reopened have closed their campuses once more .
L.A. County schools were not able to reopen to all students because virus transmission rates never dropped low enough .
But campuses can open under waivers to serve students @ @ @ @ @ @ @ schools can bring in students with special needs , at up to 25 % of enrollment capacity .
L.A. Unified , with about 465,000 students in kindergarten through 12th grade , has moved cautiously .
By early December , the school district had provided in-person instructional services to about 3,000 students , and about 1,700 athletes were coming in for outdoor , physically distanced conditioning , according to information released this week .
Citing the latest virus surge , Beutner suspended all in-person services two weeks before winter break , a move the @ @ @ @ @ @ @ will cover the remainder of the 2020-21 school year if necessary .
It also sets Jan. 24 as the deadline for reaching an agreement on what on-campus instruction will look like when it resumes .
A union spokesperson said January is out of the question for a return to campus .
A recent district survey of employees represented by the teachers union indicated that 24 % are prepared to return to schools ; 55 % said they are able to go back but prefer to remain in distance learning ; 18 % said @ @ @ @ @ @ @ potentially unsafe for them to return ; 2 % said they are 65 or older and would explore continuing to work remotely ; and 1 % said they intend to apply for unpaid leave .
The survey was conducted Nov. 30 through Dec. 6 , with 26,305 responses , well over two-thirds of union members .
The union represents teachers , librarians , counselors and nurses .
Under the new pact , nurses have to help carry out the district ’ s testing program .
They will receive an extra $ 3.50 per @ @ @ @ @ @ @ a campus and additional pay when the work extends beyond normal hours .

With children mired in distance learning and many struggling academically, Los Angeles teachers will take on more live online interaction with students next semester, under an agreement announced Friday. Also under the deal, school nurses will conduct campus-based coronavirus tests.
The pact between the teachers union and the Los Angeles Unified School District was essential for the nation’s second-largest school system; the agreement’s predecessor would have expired Dec. 31. And, based on current infection rates, a return to campus in January is almost impossible under state health guidelines.
The revised weekly schedule calls for a minimum of 30 additional minutes of live interaction with students on Monday — making that day a closer match to other weekdays, when the minimum length of daily live instruction ranges from 60 minutes to 170 minutes, depending on the grade level and a school’s scheduling format.
Many teachers already had been providing more time with students than the specified minimums. As before, the new schedule also includes learning time that does not have to be live and interactive.
The new work plan also incorporates 30 additional daily minutes of office hours for students and family on Tuesday through Friday, which can be scheduled flexibly for mutual convenience. Some office hours already had been built into the schedule, but this expansion — which, again, varies by grade and a school’s format — is a significant expansion.
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“This progress in online instruction reflects the shared learning of all who work in schools about the need to maximize the interaction between teachers and students and their families,” Los Angeles schools Supt. Austin Beutner said in a statement.
“We are gratified to reach an agreement to extend the distance learning agreement, which is what our students need right now,” said Cecily Myart-Cruz, president of United Teachers Los Angeles. “In the face of the upheaval we are all dealing with, educators, students and families need stability most of all.”
The new side letter to the teachers’ contract goes at least part way to addressing complaints from critics — including many parents and some community groups who have called for increased daily live interaction between students and teachers.
“This agreement still leaves Los Angeles Unified with less learning time, less support for teachers, less partnership with families and less focus on racial equity than other large California school districts,” said Seth Litt, executive director of Parent Revolution, a local advocacy group that has provided support for a lawsuit filed on behalf of families who contend that the district is violating their legal right to an education.
There also are parents who would settle for nothing less than a return to full-time in-person instruction. Others support remaining in distance learning, while some worry that current practices force students to remain online for too long, especially younger ones. No strategy has emerged that offers full academic support and an elimination of risk for school employees and the families they serve. Making strides in that direction has become more complicated as an alarming COVID-19 surge stretches local healthcare resources past their capacity.
The pandemic closed campuses in March, but schools in counties adjacent to L.A. were able to open in the fall, when local infection rates were lower. Campuses that opened during that period can remain open, but not every school system did so. And some districts that reopened have closed their campuses once more.
L.A. County schools were not able to reopen to all students because virus transmission rates never dropped low enough. But campuses can open under waivers to serve students in kindergarten through second grade. And schools can bring in students with special needs, at up to 25% of enrollment capacity.
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L.A. Unified, with about 465,000 students in kindergarten through 12th grade, has moved cautiously. By early December, the school district had provided in-person instructional services to about 3,000 students, and about 1,700 athletes were coming in for outdoor, physically distanced conditioning, according to information released this week.
Citing the latest virus surge, Beutner suspended all in-person services two weeks before winter break, a move the teachers union supported.
The new agreement will cover the remainder of the 2020-21 school year if necessary. It also sets Jan. 24 as the deadline for reaching an agreement on what on-campus instruction will look like when it resumes. A union representative said January is out of the question for a return to campus.
A recent district survey of employees represented by the teachers union indicated that 24% are prepared to return to schools; 55% said they are able to go back but prefer to remain in distance learning; 18% said an underlying health condition would make it potentially unsafe for them to return; 2% said they are 65 or older and would explore continuing to work remotely; and 1% said they intend to apply for unpaid leave.
The survey was conducted Nov. 30 through Dec. 6, with 26,305 responses, well over two-thirds of union members. The union represents teachers, librarians, counselors and nurses.
Under the new pact, nurses have to help carry out the district’s testing program. They will receive an extra $3.50 an hour for such work completed in person on a campus and additional pay when the work extends beyond normal hours.


latimes--2020-12-18--Doctor accused of using addicts in medical fraud scheme is out of jail with COVID-19

A Beverly Hills surgeon accused of scamming nearly $ 29 million in insurance money after prosecutors said he recruited patients to undergo unnecessary medical procedures has been released from jail after testing positive for the coronavirus .
Dr. Randy Rosen is charged with 88 felony counts in two criminal cases in Orange County .
Court documents show Rosen , 57 , and his 41-year-old girlfriend , Liza Vismanos , used so-called body brokers to find and pay sober living facility patients to complete medical visits that were then billed to insurance companies .
Among the procedures were cortisone injections and @ @ @ @ @ @ @ can reduce cravings for opioids and alcohol .
The pair and four others are connected with the $ 52-million scheme , according to the district attorney ’ s office .
About $ 12 million was kicked back to the body brokers , whom prosecutors called “ junkie hunters , ” and a smaller portion was given to each individual who was treated .
Rosen bragged on texts about pocketing $ 18,400 for a single injection , records show .
“ A massive network of body brokers amassed by the defendant , the sheer @ @ @ @ @ @ @ vulnerable drug-addicted patients ” and the extended span of time in which the criminal activity was conducted led to the charges this summer , court papers said .
Authorities apprehended Rosen — who operates Wellness Wave surgical center in Beverly Hills and Vismanos Lotus Laboratories , a toxicology testing facility , in Los Alamitos — after one of the body brokers was granted immunity in exchange for cooperation and investigators were able to mine his electronic devices for records , including secret recordings he made while working for Rosen in 2017 and 2018 @ @ @ @ @ @ @ hearing , a judge ruled in October there was sufficient evidence to hold Rosen for trial , and he has been in the Orange County Jail in lieu of $ 10 million bail since .
Vismanos was released on $ 100,000 bond .
Rosen tested positive for the coronavirus while in jail .
More than 600 inmates have become infected with the virus in Orange County , data from the Sheriff ’ s Department show .
In pushing for his release , defense lawyers argued that Rosen was at great risk of complications @ @ @ @ @ @ @ of chronic obstructive pulmonary disease , fat around his waist , coronary artery disease , sleep apnea and high blood pressure .
But prosecutors insisted that despite his diagnosis , Rosen was asymptomatic .
Dr. C. Hsien Chang , the medical director for the county ’ s Correctional Health Services , said he was “ familiar with Rosen ’ s medical conditions and [ has ] complete confidence that CHS can appropriately manage and treat his medical conditions while in the Orange County Jail.
” As a white-collar criminal not accused of violence @ @ @ @ @ @ @ judges are increasingly releasing to reduce overcrowding across California as the pandemic continues to spread across the state .
Orange County Sheriff Don Barnes has been ordered to reduce the jail population by half to prevent the spread of the virus and allow more social distancing .
Superior Court Judge Shirley Hanson agreed that Rosen should be released while awaiting trial , which has not been scheduled .
On Thursday , he was granted zero bail and placed on home confinement for 30 days .
On Friday , Rosen was back in his @ @ @ @ @ @ @ mansion , complete with lap pool and wine cellar .
As a condition of his release , he must wear an electronic ankle monitor .
The move came over the objections of Dist .
Atty .
Todd Spitzer , who described the wealthy Rosen as an obvious flight risk and argued that money from Rosen ’ s insurance scheme helped pay for his luxury lifestyle .
“ We are watching the theater of the absurd , ” Spitzer said .
“ The criminal justice system shouldn ’ t have one set of rules @ @ @ @ @ @ @ separate set of rules who aren ’ t .
”

A Beverly Hills surgeon accused of scamming nearly $29 million in insurance money after prosecutors said he recruited patients to undergo unnecessary medical procedures has been released from jail after testing positive for the coronavirus.
Dr. Randy Rosen is charged with 88 felony counts in two criminal cases in Orange County.
Court documents show Rosen, 57, and his 41-year-old girlfriend, Liza Vismanos, used so-called body brokers to find and pay sober living facility patients to complete medical visits that were then billed to insurance companies. Among the procedures were cortisone injections and implants of naltrexone, a drug that can reduce cravings for opioids and alcohol.
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The pair and four others are connected with the $52-million scheme, according to the district attorney’s office. About $12 million was kicked back to the body brokers, whom prosecutors called “junkie hunters,” and a smaller portion was given to each individual who was treated. Rosen bragged on texts about pocketing $18,400 for a single injection, records show.
“A massive network of body brokers amassed by the defendant, the sheer number of medically unnecessary procedures performed on vulnerable drug-addicted patients” and the extended span of time in which the criminal activity was conducted led to the charges this summer, court papers said.
Authorities apprehended Rosen — who operates Wellness Wave surgical center in Beverly Hills and Vismanos Lotus Laboratories, a toxicology testing facility in Los Alamitos — after one of the body brokers was granted immunity in exchange for cooperation and investigators were able to mine his electronic devices for records, including secret recordings he made while working for Rosen in 2017 and 2018.
World & Nation 1 in 5 prisoners has had the coronavirus, and 1,700 have died Data analysis finds that 1 in 5 prisoners in every five state and federal prisoners has tested positive for the coronavirus, a rate more than four times higher than in the general population.
After a lengthy and complex preliminary hearing, a judge ruled in October there was sufficient evidence to hold Rosen for trial, and he has been in the Orange County Jail in lieu of $10 million bail since. Vismanos was released on $100,000 bond.
Rosen tested positive for the coronavirus while in jail. More than 600 inmates have become infected with the virus in Orange County, data from the Sheriff’s Department show.
In pushing for his release, defense lawyers argued that Rosen was at great risk of complications from the illness because of a history of chronic obstructive pulmonary disease, fat around his waist, coronary artery disease, sleep apnea and high blood pressure.
But prosecutors insisted that despite his diagnosis, Rosen was asymptomatic. Dr. C. Hsien Chang, the medical director for the county’s Correctional Health Services, said he was “familiar with Rosen’s medical conditions and [has] complete confidence that CHS can appropriately manage and treat his medical conditions while in the Orange County Jail.”
As a white-collar criminal not accused of violence, Rosen is the kind of inmate judges are increasingly releasing to reduce overcrowding across California as the pandemic continues to spread across the state. Orange County Sheriff Don Barnes has been ordered to reduce the jail population by half to prevent the spread of the virus and allow more social distancing.
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Superior Court Judge Shirley Hanson agreed that Rosen should be released while awaiting trial, which has not been scheduled. On Thursday, he was granted zero bail and placed on home confinement for 30 days.
On Friday, Rosen was back in his $14-million, 9,000-square-foot West Los Angeles mansion, complete with lap pool and wine cellar. As a condition of his release, he must wear an electronic ankle monitor.
The move came over the objections of Dist. Atty. Todd Spitzer, who described the wealthy Rosen as an obvious flight risk and argued that money from Rosen’s insurance scheme helped pay for his luxury lifestyle.
“We are watching the theater of the absurd,” Spitzer said. “The criminal justice system shouldn’t have one set of rules for people who are wealthy and a separate set of rules who aren’t.”


latimes--2020-12-18--California economy is fast losing momentum; 327,600 give up on seeking jobs

Hundreds of thousands of Californians dropped out of the workforce in November as businesses sharply curtailed the pace of hiring — trends that economists suggest are growing ever more dire .
Golden State employers added 57,100 jobs last month , bringing payrolls to a total of 16.19 million , California officials reported Friday .
That was a dramatic slowdown from the previous month : In October , when hopes were high that the COVID-19 pandemic was abating , payrolls grew by 145,600 .
“ This was the lowest job gain since the recovery began , ” said Taner Osman , @ @ @ @ @ @ @ Los Angeles consultancy .
Given this year ’ s devastation , he said , “ adding 57,000 jobs is a drop in the ocean.
” California has regained fewer than half of the more than 2.6 million nonfarming jobs it lost in March and April due to the COVID-19 pandemic .
The state ’ s unemployment rate fell to 8.2 % in November .
That ’ s down from 9 % in October but exceeds the nationwide rate of 6.7 % .
But the jobless rate counts only people who are actively looking @ @ @ @ @ @ @ s drop reflected a massive exodus of Californians from the labor force : 327,600 who had stopped seeking employment .
“ California ’ s economy lost momentum in November as COVID infections started to climb and federal support programs ran dry , ” said Lynn Reaser , an economist at San Diego ’ s Point Loma Nazarene University .
Monthly changes in labor force can be volatile , “ but the pandemic ’ s overall impact has been stark , ” Reaser said .
“ As of November , California ’ s labor @ @ @ @ @ @ @ its February level.
” Women , many of whom have taken leave to care for children and elderly family members , account for two-thirds of the drop in the labor force , according to Pomona College economist Fernando Lozano .
“ And the data suggest that the largest change in the labor force participation is among persons with a college degree or more education , ” he said .
Cumulative cases of the coronavirus in California have soared from about 870,000 in mid-October to more than 1.7 million this week , according to @ @ @ @ @ @ @ Friday , the number is on pace to double every 30.6 days .
The November jobs numbers are based on surveys taken during the second week of the month and do not reflect stricter lockdowns that began in December .
Most of the state ’ s population is now under stay-at-home orders .
Thousands of businesses have shut , and others are limping along under restrictions to limit the number of customers at any one time .
Job postings in California are down 23 % since January , and small-business openings and revenue @ @ @ @ @ @ @ to Opportunity Insights , an economic research group based at Harvard University .
In the first two weeks of December , more than 380,000 Californians filed new unemployment claims .
The state accounted for more than a fifth of U.S. claims , despite having just 11 % of the nation ’ s civilian labor force .
“ California is falling further behind the rest of the nation in employment , ” said Michael Bernick , a former director of the California Employment Development Department who tracks jobs data .
“ No government program @ @ @ @ @ @ @ until the schools reopen , businesses reopen , and immunization is widely achieved.
” Economists say California ’ s recovery will depend to a great extent on two factors : the success of a mass vaccination program and the generosity of federal aid for millions of unemployed workers , teetering businesses and cash-strapped state and local governments .
With federal programs covering 750,000 jobless Californians set to expire late this month , congressional leaders this week were furiously negotiating a $ 900-billion package , but economists say additional relief will be needed by @ @ @ @ @ @ @ recovery .
“ More temporary layoffs are turning into permanent job losses , ” said Sung Won Sohn , an economist at Loyola Marymount University .
The “ virus wave , the lack of fiscal stimulus and soft holiday sales could knock the economy into another dip during the fourth quarter before the vaccine and additional stimulus from Washington come to rescue.
” In November , the state ’ s leisure and hospitality sector grew by 27,800 jobs , the most of any industry group , reflecting in part an expansion of takeout @ @ @ @ @ @ @ now , with bans on outdoor dining and winter weather setting in , many restaurants can not afford to remain open .
The trade , transportation and utilities sector added the second-largest number of positions : 19,700 .
Grocery stores helped boost retail jobs , and as many Californians avoided shopping in person , online orders for goods fueled a gain in trucking and warehouse positions .
But “ with renewed stay-at-home orders and severe business restrictions once again being enforced , the job revival in these sectors in October and November appears @ @ @ @ @ @ @ Anderson , a Bank of the West economist .
“ We expect big job declines to reappear in these industries in December as furloughs and layoffs once again come home to roost.
” Construction shrank by 5,800 jobs last month .
The government sector lost 10,200 jobs , mainly due to the expiration of temporary Census hires .
Los Angeles County gained 29,800 jobs in November , bringing payrolls to a total of about 4.26 million .
The largest gain ( 22,700 ) was in trade , transportation and utilities .
The largest @ @ @ @ @ @ @ by 3,300 .
Los Angeles County ’ s unemployment rate dropped to 11 % from October ’ s 12 % as its labor force fell by 94,000 workers .
Orange County payrolls grew by 16,500 jobs in November , totaling about 1.56 million .
Its largest gains were in the arts , entertainment and recreation sector ( 9,100 ) and in retail trade ( 6,100 ) .
The construction sector was the biggest decliner , shedding 3,100 jobs .
Its unemployment rate was 6.4 % , down from 7.3 % in October , @ @ @ @ @ @ @ .
In Riverside and San Bernardino Counties , November payrolls grew by 17,200 jobs to about 1.46 million .
Trade , transportation and utilities added the most jobs ( 15,600 ) while education and health services lost the most : 2,700 .
Unemployment in the Inland Empire counties fell to 7.9 % from October ’ s 8.7 % as the labor force dropped by 31,100 .

California’s leisure and hospitality sector gained jobs in November, but this month’s ban on outdoor dining will likely reverse those gains, economists say.
Hundreds of thousands of Californians dropped out of the workforce in November as businesses sharply curtailed the pace of hiring — trends that economists suggest are growing ever more dire.
Golden State employers added 57,100 jobs last month, bringing payrolls to a total of 16.19 million, California officials reported Friday. That was a dramatic slowdown from the previous month: In October, when hopes were high that the COVID-19 pandemic was abating, payrolls grew by 145,600.
“This was the lowest job gain since the recovery began,” said Taner Osman, research manager at Beacon Economics, a Los Angeles consultancy. Given this year’s devastation, he said, “adding 57,000 jobs is a drop in the ocean.”
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California has regained fewer than half of the more than 2.6 million nonfarming jobs it lost in March and April because of the COVID-19 pandemic.
The state’s unemployment rate fell to 8.2% in November. That’s down from 9% in October but exceeds the nationwide rate of 6.7%.
But the jobless rate counts only people who are actively looking for work. Economists said November’s drop reflected a massive exodus of Californians from the labor force: 327,600 who had stopped seeking employment.
Business Will California’s small businesses survive another COVID-19 surge without more help? The lucky among California’s small businesses have cobbled together loans and grants to get through the pandemic so far. But that money has dried up, and “you can only take on so much debt.”
“California’s economy lost momentum in November as COVID infections started to climb and federal support programs ran dry,” said Lynn Reaser, an economist at San Diego’s Point Loma Nazarene University.
Monthly changes in labor force can be volatile, “but the pandemic’s overall impact has been stark,” Reaser said. “As of November, California’s labor force was down a striking 627,000 from its February level.”
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Women, many of whom have taken leave to care for children and elderly family members, account for two-thirds of the drop in the labor force, according to Pomona College economist Fernando Lozano. “And the data suggest that the largest change in the labor force participation is among persons with a college degree or more education,” he said.
Cumulative cases of the coronavirus in California have soared from about 870,000 in mid-October to more than 1.7 million this week, according to data from The Times. As of Friday, the number is on pace to double every 30.6 days.
The November jobs numbers are based on surveys taken during the second week of the month and do not reflect stricter lockdowns that began in December. Most of the state’s population is now under stay-at-home orders. Thousands of businesses have shut, and others are limping along under restrictions to limit the number of customers at any one time.
Job postings in California are down 23% since January, and small-business openings and revenue are both down 28%, according to Opportunity Insights, an economic research group based at Harvard University.
In the first two weeks of December, more than 380,000 Californians filed new unemployment claims.
The state accounted for more than a fifth of U.S. claims, despite having just 11% of the nation’s civilian labor force.
“California is falling further behind the rest of the nation in employment,” said Michael Bernick, a former director of the California Employment Development Department who tracks jobs data. “No government program at this point will turn around hiring until the schools reopen, businesses reopen, and immunization is widely achieved.”
Economists say California’s recovery will depend to a great extent on two factors: the success of a mass vaccination program and the generosity of federal aid for millions of unemployed workers, teetering businesses and cash-strapped state and local governments.
With federal programs covering 750,000 jobless Californians set to expire late this month, congressional leaders this week were furiously negotiating a $900-billion package, but economists say additional relief will be needed by early next year to jump-start a full recovery.
“More temporary layoffs are turning into permanent job losses,” said Sung Won Sohn, an economist at Loyola Marymount University. The “virus wave, the lack of fiscal stimulus and soft holiday sales could knock the economy into another dip during the fourth quarter before the vaccine and additional stimulus from Washington come to rescue.”
In November, the state’s leisure and hospitality sector grew by 27,800 jobs, the most of any industry group, reflecting in part an expansion of takeout, delivery and outdoor dining. But now, with bans on outdoor dining and winter weather setting in, many restaurants cannot afford to remain open.
The trade, transportation and utilities sector added the second-largest number of positions: 19,700. Grocery stores helped boost retail jobs, and as many Californians avoided shopping in person, online orders for goods fueled a gain in trucking and warehouse positions.
But “with renewed stay-at-home orders and severe business restrictions once again being enforced, the job revival in these sectors in October and November appears fragile and unsustainable,” said Scott Anderson, a Bank of the West economist. “We expect big job declines to reappear in these industries in December as furloughs and layoffs once again come home to roost.”
Construction shrank by 5,800 jobs last month. The government sector lost 10,200 jobs, mainly due to the expiration of temporary Census hires.
Business The Golden State’s future? Most Californians are pessimistic White and higher-income Californians are most likely to believe today’s children will be worse off than their parents, a new statewide survey finds.
Los Angeles County gained 29,800 jobs in November, bringing payrolls to a total of about 4.26 million. The largest gain (22,700) was in trade, transportation and utilities. The largest loss was in construction, which shrank by 3,300.
Los Angeles County’s unemployment rate dropped to 11% from October’s 12% as its labor force fell by 94,000 workers.
Orange County payrolls grew by 16,500 jobs in November, totaling about 1.56 million. Its largest gains were in the arts, entertainment and recreation sector (9,100) and in retail trade (6,100). The construction sector was the biggest decliner, shedding 3,100 jobs.
Its unemployment rate was 6.4%, down from 7.3% in October, as its labor force dropped by 28,900.
In Riverside and San Bernardino Counties, November payrolls grew by 17,200 jobs to about 1.46 million. Trade, transportation and utilities added the most jobs (15,600) while education and health services lost the most: 2,700.
Unemployment in the Inland Empire counties fell to 7.9% from October’s 8.7% as the labor force dropped by 31,100.


latimes--2020-12-18--Do you know anyone who is bending the rules to get the COVID-19 vaccine first?

The first people who are supposed to get the COVID-19 vaccine are frontline healthcare workers and residents of long-term care @ @ @ @ @ wealthy patients are already trying to find ways to get a dose of the vaccine @ @ @ @ @ tens of thousands of dollars in cash , The Times reported .
The Times needs @ @ @ @ @ about the medical organizations , doctors or other institutions that are helping people with wealth @ @ @ @ @ immunized sooner than federal and state guidelines recommend .
Share your tip below , and @ @ @ @ @ touch .
If you would prefer to share an anonymous tip , you can do @ @ @ @ @ not print your name or use your information without contacting you first .

Wealthy and well-connected patients are looking for ways to get the COVID-19 vaccine faster.
The first people who are supposed to get the COVID-19 vaccine are frontline healthcare workers and residents of long-term care facilities.
But well-connected and wealthy patients are already trying to find ways to get a dose of the vaccine faster, including by offering tens of thousands of dollars in cash, The Times reported.
The Times needs your help to learn more about the medical organizations, doctors or other institutions that are helping people with wealth, status or connections get immunized sooner than federal and state guidelines recommend. Share your tip below, and a reporter will get in touch.
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If you would prefer to share an anonymous tip, you can do so here. We will not print your name or use your information without contacting you first.


latimes--2020-12-18--Stanford 'neglecting its frontline workers' in COVID-19 vaccine rollout, doctors say

Stanford Medical Center doctors who are completing their residencies and fellowships staged a protest Friday , saying they were passed over during the first wave of COVID-19 vaccinations even though they work directly with patients who have the highly contagious disease .
A few dozen of the residents and fellows carried signs at the demonstration outside a door where the Palo Alto hospital was staging a photo opportunity for journalists covering the initial vaccinations .
One protest sign read : “ I saw 16 Covid patients in the last 24 hours ... More than Double the amount of residents getting @ @ @ @ @ @ @ Twitter to protest the vaccine distribution plan .
“ Disparities in distribution of the vaccine can be seen at a micro-level at Stanford today , ” tweeted Dr. Christine Santiago , an internal medicine resident .
“ I worry that the situation we see at Stanford is a harbinger of population-level inequities of vaccine distribution for our underserved communities.
” Another Stanford resident , who asked to remain unidentified because of fear of retaliation , said only seven of about 1,300 residents and fellows were slated to receive the vaccine during an initial @ @ @ @ @ @ @ care and infectious disease doctors also were passed over , the resident said .
On the other hand , some attending physicians who have been working from home and have not seen a COVID-19 patient in person since the pandemic began were slated to receive the inoculations , the resident said .
“ Stanford hospital is neglecting its frontline workers in their vaccination plans , ” the resident said .
“ The 5,000 vaccines went to [ attending physicians ] and many nonfrontline workers including those who have been working from their couches @ @ @ @ @ @ @ [ face mask ] for the past nine months.
” Dr. Niraj Sehgal , Stanford ’ s chief medical officer , apologized to the doctors who were not included .
“ Despite our best intentions to thoughtfully map out a principled vaccine plan to include our residents , fellows , and faculty , it ’ s clear there were several unintended missteps , ” Sehgal said in an email this week .
“ Please know the perceived lack of priority for residents and fellows was not the intent at all.
” Sehgal said @ @ @ @ @ @ @ doses next week .
“ We ’ re increasingly confident in getting everyone vaccinated , including all of you , ” Sehgal said .
The physician resident who spoke to The Times said the problem appears to be an algorithm that missed frontline responders when the vaccination plan was formed .
Residents and fellows , who are working to complete their medical education , tend to be in their 20s or 30s , an age group that is considered relatively safe from COVID-19 ’ s most serious effects .
But the resident said @ @ @ @ @ @ @ 30s at Stanford have died of the disease , and some residents and fellows live with their parents , who are at higher risk .
“ My resident colleagues have been getting COVID , ” the resident said .
“ We ’ ve been given no direction or promise as to when we will be vaccinated .
It feels like a slap in the face after 10 months of long , relentless work.
” Some other physicians , including full-fledged doctors who work in intensive care , also did not make the vaccine @ @ @ @ @ @ @ spokesperson for the hospital said Stanford Health Care took “ complete responsibility for the errors in the execution of our vaccine distribution plan.
” “ Our intent was to develop an ethical and equitable process for distribution of the vaccine , ” said spokesperson Lisa Kim .
“ We apologize to our entire community , including our residents , fellows and other frontline care providers who have performed heroically during our pandemic response.
” She said Stanford would immediately revise the distribution plan .

Stanford Medical Center doctors who are completing their residencies and fellowships staged a protest Friday, saying they were passed over during the first wave of COVID-19 vaccinations even though they work directly with patients who have the highly contagious disease.
A few dozen of the residents and fellows carried signs at the demonstration outside a door where the Palo Alto hospital was staging a photo opportunity for journalists covering the initial vaccinations. One protest sign read: “I saw 16 Covid patients in the last 24 hours ... More than Double the amount of residents getting the vaccine.”
Some doctors took to Twitter to protest the vaccine distribution plan.
“Disparities in distribution of the vaccine can be seen at a micro-level at Stanford today,” tweeted Dr. Christine Santiago, an internal medicine resident. “I worry that the situation we see at Stanford is a harbinger of population-level inequities of vaccine distribution for our underserved communities.”
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Proud of fellow Stanford residents today! Supporting in spirit while quarantining from home. #staysafestanford https://t.co/YHnXnKRWOc — Christine Santiago (@cksantiago_MD) December 18, 2020
Another Stanford resident, who asked to remain unidentified because of fear of retaliation, said only seven of about 1,300 residents and fellows were slated to receive the vaccine during an initial distribution of 5,000 doses. Some critical care and infectious-disease doctors also were passed over, the resident said.
On the other hand, some attending physicians who have been working from home and have not seen a COVID-19 patient in person since the pandemic began were slated to receive the inoculations, the resident said.
“Stanford hospital is neglecting its front-line workers in their vaccination plans,” the resident said. “The 5,000 vaccines went to [attending physicians] and many non-front-line workers, including those who have been working from their couches and haven’t touched an N95 [mask] for the past nine months.”
Dr. Niraj Sehgal, Stanford’s chief medical officer, apologized to the doctors who were not included.
“Despite our best intentions to thoughtfully map out a principled vaccine plan to include our residents, fellows, and faculty, it’s clear there were several unintended missteps,” Sehgal said in an email this week. “Please know the perceived lack of priority for residents and fellows was not the intent at all.”
Sehgal said the hospital was anticipating receiving more vaccine doses next week. “We’re increasingly confident in getting everyone vaccinated, including all of you,” Sehgal said.
The physician resident who spoke to The Times said the problem appears to be an algorithm that missed front-line responders when the vaccination plan was formed.
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Residents and fellows, who are working to complete their medical education, tend to be in their 20s or 30s, an age group that is considered relatively safe from COVID-19’s most serious effects. But the resident said in an interview that patients in their 30s at Stanford have died of the disease, and some residents and fellows live with their parents, who are at higher risk.
“My resident colleagues have been getting COVID,” the resident said. “We’ve been given no direction or promise as to when we will be vaccinated. It feels like a slap in the face after 10 months of long, relentless work.”
Some other physicians, including full-fledged doctors who work in intensive care, also did not make the vaccine list, the resident said.
A representative for the hospital said Stanford Health Care took “complete responsibility for the errors in the execution of our vaccine distribution plan.”
“Our intent was to develop an ethical and equitable process for distribution of the vaccine,” said spokeswoman Lisa Kim. “We apologize to our entire community, including our residents, fellows and other front-line care providers who have performed heroically during our pandemic response.”
She said Stanford would immediately revise the distribution plan.


latimes--2020-12-18--L.A. County on verge of becoming COVID-19 epicenter: 'We are getting crushed'

Los Angeles County is on the verge of becoming the epicenter of the coronavirus pandemic , a health official said Friday — a dire declaration that comes as Californians are dying from COVID-19 in numbers never seen before .
While the worst wave of the coronavirus has walloped the entire state , the effects have been particularly pronounced in the nation ’ s most-populous county , where officials warned the healthcare system is already being pushed to its breaking point .
“ I ’ m not going to sugarcoat this : We are getting crushed , ” said Dr. Brad @ @ @ @ @ @ @ Angeles County-USC Medical Center .
Local hospitals are already “ critically overcrowded , ” he said during a briefing Friday , and “ L.A .
County is now moving towards becoming the epicenter of the pandemic.
” “ We are not at the stage yet at which other parts of the world , including in the United States , have suffered catastrophic consequences .
But we are heading in that direction , ” he said .
“ And if we don ’ t stop the spread , our hospitals will be overwhelmed .
@ @ @ @ @ @ @ if you get into a car accident , if you fall off a ladder or have a stroke , we may not have a bed for you.
” The top concern for many is the county ’ s intensive care units , which are needed for patients who are critically ill or grievously injured .
More than 1,000 people with COVID-19 are now in L.A. County ’ s ICUs , quadruple the number from Nov. 1 .
There are roughly 2,500 licensed ICU beds countywide , and , as of Friday , officials @ @ @ @ @ @ @ and available .
Throughout Southern California , a state-defined swath that includes L.A. and 10 other counties , the availability of ICU beds hit 0 % Thursday and remained there Friday .
While that doesn ’ t mean no beds are available at all — as the state uses a weighted formula to ensure that some ICU beds remain open for non-COVID patients — it still underscores the harrowing conditions facing hospitals throughout the region .
The “ system is in crisis , ” according to Dr. Christina Ghaly , L.A. County ’ @ @ @ @ @ @ @ When ambulance offload times are up to four hours , six hours , eight hours , that ’ s a crisis .
When hospitals ’ emergency departments are full , that ’ s a crisis .
When there ’ s not sufficiently available beds at the appropriately staffed ratio , that ’ s a crisis , ” she said .
“ That ’ s really the point that we ’ re at.
” Hospitals do have some options to continue providing the highest levels of care possible when ICUs fill up , including @ @ @ @ @ @ @ in the intensive care unit to other areas of the hospital , or keeping them in the emergency room for longer than normal .
Even with those strategies in place , though , there eventually may be too many critically ill patients for the limited numbers of ICU doctors and nurses available — leading to greater chances of patients not getting the care they need and , potentially , increases in mortality .
That ’ s a particularly chilling prospect , as officials have said they fully expect the hospitalization numbers to continue @ @ @ @ @ @ @ It can take two to three weeks for spikes in coronavirus cases to trigger a corresponding increase in hospitalizations , experts and officials say .
Two weeks ago , California as a whole was averaging about 17,800 new coronavirus cases per day .
The average daily caseload has more than doubled since then .
The fear is that a meteoric rise in cases could trigger a fresh wave of hospitalizations — further exacerbating the healthcare crisis .
Already , there are record-high numbers of coronavirus-positive patients hospitalized , 16,019 , and in ICUs @ @ @ @ @ @ @ haven ’ t yet seen that hospitalization volume , ” Ghaly said , referring to the more recent case counts .
“ Those patients are still getting to the point where they might need hospital-level care , and that will continue to put strain on the entire healthcare system.
” State officials have previously estimated that 12 % of newly diagnosed coronavirus cases are likely to require hospitalization , with 12 % of those eventually ending up in the ICU .
By early January , there could be 1,600 to 3,600 COVID-19 patients @ @ @ @ @ @ @ County if virus transmission trends remain the same , forecasts say .
Though healthcare professionals have continually honed their ability to care for the sickest COVID-19 patients over the preceding months — learning to avoid , when possible , placing them on mechanical ventilators and to use alternative ways to get more oxygen into the bloodstream ; to place people on their bellies to make it easier for them to breathe ; and to give patients steroid treatments , for instance — officials and experts have long warned that a severe spike in @ @ @ @ @ @ @ infections and hospitalizations snowballing across the state .
More Californians are dying from COVID-19 now than at any other point in the pandemic .
Over 1,500 people lost their lives in just the last week — a staggering number that represents nearly 7 % of the state ’ s more than 22,000 total coronavirus-related fatalities .
The death tolls seen Tuesday , Wednesday and Thursday — 295 , 394 and 288 , respectively — represent the three deadliest days the state has seen throughout the entire pandemic , according to data compiled by @ @ @ @ @ @ @ not the flu .
This is not something to trifle with , ” Gov .
Gavin Newsom said this week .
“ This is a deadly disease , a deadly pandemic.
” Officials are optimistic , though , that California is nearing a possible turning point .
The first doses of COVID-19 vaccine have arrived , and hundreds of thousands more are on the way .
Hundreds of L.A. County healthcare workers have received a vaccine dose so far , and that number is expected to hit 1,500 by the end of Friday @ @ @ @ @ @ @ Our goal is to get to 10,000 workforce vaccinations by the end of the calendar year , ” said Dr. Paul Giboney , associate chief medical officer at L.A. County Health Services .
However , widespread inoculation is likely still months away , and given how ferocious and widespread coronavirus transmission is at the moment , officials say it ’ s vital that residents do all they can in the meantime to keep themselves and their loved ones safe .
Though healthcare workers and hospitals do all they can to treat those infected @ @ @ @ @ @ @ react ; we can not stop the spread , ” Spellberg said .
“ We need the public to listen to these mitigation strategies to slow the spread or we will completely run out of beds , ” he said .
That means wearing masks in public , regular handwashing and staying home when you ’ re sick .
Perhaps most critically , officials say residents should keep physical distance from , and avoid gathering with , those they don ’ t live with .
While that last ask could be a bridge @ @ @ @ @ @ @ ring in the winter holidays with family and friends , officials say some seeds of today ’ s virulent surge were planted around Thanksgiving , when too many traveled or got together in defiance of public health warnings .
Making the same choice this time around , officials warn , will only prolong — and potentially worsen — the surge .
“ We are now learning a very painful lesson that , despite how much we want things to go back to normal , this virus is relentless and will continue to spread @ @ @ @ @ @ @ tragically , lead to people passing away , ” L.A. County public health director Barbara Ferrer said in a statement .
“ We can ’ t afford another holiday season surge that will further overwhelm our already strained hospitals and healthcare staff .
We must all work together to prevent as much death as possible.
” The county reported more than 16,000 new cases and 96 new deaths Friday .
Times staff writers Colleen Shalby and Soumya Karlamangla contributed to this report .

Los Angeles County is on the verge of becoming the epicenter of the coronavirus pandemic, a health official said Friday — a dire declaration that comes as Californians are dying from COVID-19 in numbers never seen before.
While the worst wave of the coronavirus has walloped the entire state, the effects have been particularly pronounced in the nation’s most-populous county, where officials warned the healthcare system is already being pushed to its breaking point.
“I’m not going to sugarcoat this: We are getting crushed,” said Dr. Brad Spellberg, chief medical officer at Los Angeles County-USC Medical Center.
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Local hospitals are already “critically overcrowded,” he said during a briefing Friday, and “L.A. County is now moving towards becoming the epicenter of the pandemic.”
“We are not at the stage yet at which other parts of the world, including in the United States, have suffered catastrophic consequences. But we are heading in that direction,” he said. “And if we don’t stop the spread, our hospitals will be overwhelmed. If you have a heart attack, if you get into a car accident, if you fall off a ladder or have a stroke, we may not have a bed for you.”
The top concern for many is the county’s intensive care units, which are needed for patients who are critically ill or grievously injured.
More than 1,000 people with COVID-19 are now in L.A. County’s ICUs, quadruple the number from Nov. 1.
There are roughly 2,500 licensed ICU beds countywide, and, as of Friday, officials said only 69 of those were open and available.
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Throughout Southern California, a state-defined swath that includes L.A. and 10 other counties, the availability of ICU beds hit 0% Thursday and remained there Friday.
While that doesn’t mean no beds are available at all — as the state uses a weighted formula to ensure that some ICU beds remain open for non-COVID patients — it still underscores the harrowing conditions facing hospitals throughout the region.
The “system is in crisis,” according to Dr. Christina Ghaly, L.A. County’s director of health services.
“When ambulance offload times are up to four hours, six hours, eight hours, that’s a crisis. When hospitals’ emergency departments are full, that’s a crisis. When there’s not sufficiently available beds at the appropriately staffed ratio, that’s a crisis,” she said. “That’s really the point that we’re at.”
Hospitals do have some options to continue providing the highest levels of care possible when ICUs fill up, including moving some patients who would typically be in the intensive care unit to other areas of the hospital, or keeping them in the emergency room for longer than normal.
Even with those strategies in place, though, there eventually may be too many critically ill patients for the limited numbers of ICU doctors and nurses available — leading to greater chances of patients not getting the care they need and, potentially, increases in mortality.
That’s a particularly chilling prospect, as officials have said they fully expect the hospitalization numbers to continue rising in the weeks to come.
It can take two to three weeks for spikes in coronavirus cases to trigger a corresponding increase in hospitalizations, experts and officials say.
Two weeks ago, California as a whole was averaging about 17,800 new coronavirus cases per day. The average daily caseload has more than doubled since then.
The fear is that a meteoric rise in cases could trigger a fresh wave of hospitalizations — further exacerbating the healthcare crisis.
Already, there are record-high numbers of coronavirus-positive patients hospitalized, 16,019, and in ICUs, 3,447, statewide.
“We haven’t yet seen that hospitalization volume,” Ghaly said, referring to the more recent case counts. “Those patients are still getting to the point where they might need hospital-level care, and that will continue to put strain on the entire healthcare system.”
State officials have previously estimated that 12% of newly diagnosed coronavirus cases are likely to require hospitalization, with 12% of those eventually ending up in the ICU.
By early January, there could be 1,600 to 3,600 COVID-19 patients in need of ICU beds in L.A. County if virus transmission trends remain the same, forecasts say.
Though healthcare professionals have continually honed their ability to care for the sickest COVID-19 patients over the preceding months — learning to avoid, when possible, placing them on mechanical ventilators and to use alternative ways to get more oxygen into the bloodstream; to place people on their bellies to make it easier for them to breathe; and to give patients steroid treatments, for instance — officials and experts have long warned that a severe spike in deaths is an unavoidable consequence of coronavirus infections and hospitalizations snowballing across the state.
More Californians are dying from COVID-19 now than at any other point in the pandemic.
Over 1,500 people lost their lives in just the last week — a staggering number that represents nearly 7% of the state’s more than 22,000 total coronavirus-related fatalities.
The death tolls seen Tuesday, Wednesday and Thursday — 295, 394 and 288, respectively — represent the three deadliest days the state has seen throughout the entire pandemic, according to data compiled by The Times.
“It’s not the flu. This is not something to trifle with,” Gov. Gavin Newsom said this week. “This is a deadly disease, a deadly pandemic.”
Officials are optimistic, though, that California is nearing a possible turning point. The first doses of COVID-19 vaccine have arrived, and hundreds of thousands more are on the way.
Hundreds of L.A. County healthcare workers have received a vaccine dose so far, and that number is expected to hit 1,500 by the end of Friday and roughly 6,000 by Christmas.
“Our goal is to get to 10,000 workforce vaccinations by the end of the calendar year,” said Dr. Paul Giboney, associate chief medical officer at L.A. County Health Services.
However, widespread inoculation is likely still months away, and given how ferocious and widespread coronavirus transmission is at the moment, officials say it’s vital that residents do all they can in the meantime to keep themselves and their loved ones safe.
Though healthcare workers and hospitals do all they can to treat those infected with COVID-19, “we can only react; we cannot stop the spread,” Spellberg said.
“We need the public to listen to these mitigation strategies to slow the spread or we will completely run out of beds,” he said.
That means wearing masks in public, regular handwashing and staying home when you’re sick. Perhaps most critically, officials say residents should keep physical distance from, and avoid gathering with, those they don’t live with.
While that last ask could be a bridge too far for pandemic-weary Californians eager to ring in the winter holidays with family and friends, officials say some seeds of today’s virulent surge were planted around Thanksgiving, when too many traveled or got together in defiance of public health warnings.
Making the same choice this time around, officials warn, will only prolong — and potentially worsen — the surge.
“We are now learning a very painful lesson that, despite how much we want things to go back to normal, this virus is relentless and will continue to spread, make people very ill and, tragically, lead to people passing away,” L.A. County public health director Barbara Ferrer said in a statement. “We can’t afford another holiday season surge that will further overwhelm our already strained hospitals and healthcare staff. We must all work together to prevent as much death as possible.”
The county reported more than 16,000 new cases and 96 new deaths Friday.
Times staff writers Colleen Shalby and Soumya Karlamangla contributed to this report.


latimes--2020-12-18--Yosemite's Ahwahnee Hotel under fire for hosting hundreds at Thanksgiving feast

The famed Ahwahnee Hotel in Yosemite National Park has come under fire for hosting a lavish Thanksgiving feast for hundreds amid stay-at-home pleas from public health officials .
“ This Thanksgiving , celebrate among family , friends and the epic beauty of Yosemite National Park , ” the hotel wrote in promotion of the event .
“ Our Executive Chef is once again preparing a legendary feast served in the Ahwahnee stunning dining room.
” Advertised as a “ hearty touchless buffet , ” the meal cost $ 103 per adult and $ 53 per child , and included options @ @ @ @ @ @ @ , and vegan wild mushroom strudel , .
Guests were strongly advised to make reservations as seating capacity was “ limited due to COVID-19 safety guidelines.
” At the time , Mariposa County , where Yosemite is located , was in the orange tier of California ’ s for reopening , indicating moderate risk of COVID-19 transmission .
According to state guidelines , restaurants in orange-tier counties can be open with a capacity of 50 % or 200 people , whichever is less .
Yet employees that the Ahwahnee was fully booked and @ @ @ @ @ @ @ showed up for dinner between 2 and 8 p.m .
Some hotel workers said they feared for their safety and that face coverings were not enforced among guests .
The bar area reportedly got extremely crowded during the event .
David Freireich , spokesman for Aramark Management Services , which operates the hotel and other concessions in the park , declined to respond to requests for comment .
He told SFGate that only 70 guests were in the dining room at any given time .
The company was “ below the mandates for @ @ @ @ @ @ @ at the time , ” he said .
But in the days leading up to Thanksgiving , the Mariposa County Health Department reported a “ staggering increase in cases ” of COVID-19 and to stay home and celebrate the holiday virtually .
The county moved into the red tier , indicating a more substantial risk of infection , the day after Thanksgiving , Nov. 27 .
Among employee reports of stress and fear during the Thanksgiving dinner was uncertainty about face mask requirements .
As a National Park , Yosemite falls within federal @ @ @ @ @ @ @ could require but not enforce masking among guests .
National Park Service spokeswoman Stephanie Roulett said Yosemite and other parks are following guidance from the Centers for Disease Control and Prevention , as well as state and local officials , to adapt to changing conditions .
“ We continue to work closely with the NPS Office of Public Health using CDC guidance to ensure public areas and workspaces are safe and clean for visitors , employees , partners , and volunteers , ” she said .
“ In short , modifications to park @ @ @ @ @ @ @ ’ s geographic regions as they go into effect.
” Yosemite has been open and closed at various points of the pandemic , with visitors flocking to the park whenever possible as an outdoor respite amid a worsening surge .
Lodging at the hotel closed Dec. 7 in response to stay-at-home orders in the San Joaquin Valley region , which were triggered by dwindling ICU capacity .
The region is currently reporting a scant 0.7 % availability of ICU beds , according to state data .
As of Friday , Mariposa County had @ @ @ @ @ @ @ from 126 on Thanksgiving — although County Health Officer Dr. Eric Sergienko said via email that he did not know of any cases in area residents associated with the Ahwahnee dinner .
“ This comes with the proviso that cases of communicable disease … are reported in the county of residence , not the county where it may have occurred , ” Sergienko said .
“ Because of this , there may have been cases from outside the county , we just don ’ t know.
” Mariposa is now one of only @ @ @ @ @ @ @ in the state , with all others in the purple tier indicating the highest widespread risk of infection .
Yosemite remains open for day-use activities from 8 a.m. to 5 p.m .

The famed Ahwahnee Hotel in Yosemite National Park has come under fire for hosting a lavish Thanksgiving feast for hundreds amid stay-at-home pleas from public health officials.
“This Thanksgiving, celebrate among family, friends and the epic beauty of Yosemite National Park,” the hotel wrote in promotion of the event. “Our Executive Chef is once again preparing a legendary feast served in the Ahwahnee stunning dining room.”
Advertised as a “hearty touchless buffet,” the meal cost $103 per adult and $53 per child, and included options like cider-brined turkey, dijon-herbed salmon filet, and vegan wild mushroom strudel, the menu said . Guests were strongly advised to make reservations as seating capacity was “limited due to COVID-19 safety guidelines.”
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At the time, Mariposa County, where Yosemite is located, was in the orange tier of California’s color-coded blueprint for reopening, indicating moderate risk of COVID-19 transmission. According to state guidelines, restaurants in orange-tier counties can be open with a capacity of 50% or 200 people, whichever is less.
Yet employees told SFGate that the Ahwahnee was fully booked and that “300 to 400” guests showed up for dinner between 2 and 8 p.m. Some hotel workers said they feared for their safety and that face coverings were not enforced among guests. The bar area reportedly got extremely crowded during the event.
David Freireich, spokesman for Aramark Management Services, which operates the hotel and other concessions in the park, declined to respond to requests for comment. He told SFGate that only 70 guests were in the dining room at any given time.
The company was “below the mandates for reduced seating/capacity restrictions that were in place at the time,” he said.
But in the days leading up to Thanksgiving, the Mariposa County Health Department reported a “staggering increase in cases” of COVID-19 and implored people to stay home and celebrate the holiday virtually.
The county moved into the red tier, indicating a more substantial risk of infection, the day after Thanksgiving, Nov. 27.
Among employee reports of stress and fear during the Thanksgiving dinner was uncertainty about face mask requirements. As a National Park, Yosemite falls within federal jurisdiction, and Freireich said the hotel could require but not enforce masking among guests.
National Park Service spokeswoman Stephanie Roulett said Yosemite and other parks are following guidance from the Centers for Disease Control and Prevention, as well as state and local officials, to adapt to changing conditions.
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“We continue to work closely with the NPS Office of Public Health using CDC guidance to ensure public areas and workspaces are safe and clean for visitors, employees, partners, and volunteers,” she said. “In short, modifications to park operations will mirror changes in the state’s geographic regions as they go into effect.”
Yosemite has been open and closed at various points of the pandemic, with visitors flocking to the park whenever possible as an outdoor respite amid a worsening surge. Lodging at the hotel closed Dec. 7 in response to stay-at-home orders in the San Joaquin Valley region, which were triggered by dwindling ICU capacity.
The region is currently reporting a scant 0.7% availability of ICU beds, according to state data.
As of Friday, Mariposa County had 185 confirmed cases of COVID-19, up from 126 on Thanksgiving — although County Health Officer Dr. Eric Sergienko said via email that he did not know of any cases in area residents associated with the Ahwahnee dinner.
“This comes with the proviso that cases of communicable disease … are reported in the county of residence, not the county where it may have occurred,” Sergienko said. “Because of this, there may have been cases from outside the county, we just don’t know.”
Mariposa is now one of only two “red tier” counties left in the state, with all others in the purple tier indicating the highest widespread risk of infection.
Yosemite remains open for day-use activities from 8 a.m. to 5 p.m.