latimes--2020-05-10--A nurse without an N95 mask raced in to treat a 'code blue' patient. She died 14 days later

The decision that Celia Marcos made , the one that would ultimately steal years from her life , had been hard-wired after decades working as a nurse .
On the ward that she oversaw at Hollywood Presbyterian Medical Center , a man with COVID-19 had stopped breathing .
Marcos ’ face was covered only with a thin surgical mask , and obtaining a more protective N95 mask before entering his room would have wasted valuable time , her colleagues say .
The 61-year-old charge nurse knew the chest compressions and other breathing treatments the patient needed would likely spew dangerous @ @ @ @ @ @ @ land on her face and clothing .
She would be at high risk of catching the coronavirus .
Marcos raced into the room .
Fourteen days later , she was dead .
Marcos died in the same hospital where she had worked for more than 16 years , one of at least 36 healthcare workers in California who have succumbed to COVID-19 .
In one version of her story , she is a selfless caregiver who chose her patient ’ s life over her own by rushing into his room without an N95 @ @ @ @ @ @ @ the reality is much bleaker .
As charge nurse , Marcos was required to respond to patients who stopped breathing , but she wasn ’ t provided an N95 mask at the beginning of her shift , her coworkers say .
The masks are scarce , and staff who do get them are often asked to reuse them over multiple days , they said .
“ The hospital wasn ’ t giving us appropriate PPE — the N95s were locked , ” said one nurse , who , like others , spoke on @ @ @ @ @ @ @ of retaliation from hospital administrators .
“ It ’ s just too painful for everybody , what happened to her.
” Though all front-line workers are vulnerable to the coronavirus , Marcos ’ death illustrates the way that risk has been amplified by a national shortage of personal protective equipment .
Such exposures have been cataloged at hospitals across California .
“ I was the one right in front of his face , ” Marcos wrote in a text to her niece reviewed by The Times .
Concerned she had been infected , @ @ @ @ @ @ @ after leaving the patient ’ s room , and showered as soon as she got home , she said in the message .
Hollywood Presbyterian officials denied that Marcos treated COVID patients without proper protective gear and said the hospital adheres to all local and federal recommendations .
“ Despite these efforts , and our commitment to following all guidelines , we still lost one of our own to this terrible virus , and we feel this loss very deeply , ” administrators said in a statement to The Times .
The nurses @ @ @ @ @ @ @ the state Occupational Safety and Health Administration that called Marcos ’ death “ the result of inadequate PPE provided to staff.
” The union also alleged in a separate complaint to the state health department that Marcos received substandard treatment once she became a patient at the hospital .
Lying in her hospital bed , surrounded by colleagues who had become her caretakers , one of the last things Marcos said was : “ I don ’ t want to die.
” Marcos began working at Hollywood Presbyterian in 2004 , three years @ @ @ @ @ @ @ family .
Back home in the Philippines , she had trained to be a nurse , her longtime dream , according to her sons .
At the Los Angeles hospital , she was known for her sweet nature and ability to heal rifts and remain cool-headed , no matter the situation .
Filipino colleagues called her “ ate ” — big sister in Tagalog .
“ She ’ s the type of person who in an emergency you can really count on , ” said another colleague , who also asked for anonymity @ @ @ @ @ @ @ ’ s the calm that we can look to in order to get through.
” On the night of April 3 , Marcos was asked to put those skills to use .
A man admitted on her floor with COVID-19 had been complaining that he wanted to go home because he didn ’ t feel sick .
Two hours later , he stopped breathing , Marcos wrote in a text to her niece Andrea Gian Lardizabal , who works as a nurse in the Philippines .
Marcos worked on a ward that took @ @ @ @ @ @ @ full .
Because her floor wasn ’ t primarily for COVID patients , N95s weren ’ t regularly given to staff , and instead preserved for those treating COVID patients , staff say .
Sydnie Boylan , another charge nurse , initially worked on Marcos ’ floor but worried about the lack of protective gear .
She switched to the COVID unit “ because that ’ s where the PPE is , ” she said .
“ Even if we don ’ t have enough , we have more than everybody else.
” @ @ @ @ @ @ @ stayed in the patient ’ s room for at least 30 minutes while he was resuscitated and eventually placed on a ventilator to help him breathe , before being moved to the ICU , her colleagues say .
Marcos strapped an oxygen mask on the patient , who had “ almost died , ” she told her niece in a text message .
“ Celia was called to a COVID-19 isolation room while wearing only a surgical mask — not the required N95 respirator , gown , face shield , and booties that @ @ @ @ @ @ @ her protection , ” said SEIU 121 President Nina Wells said in a statement to the Times .
“ Now we know she gave her life to try to save a life.
” Hospital officials dispute that Marcos , or any staff members , were under-equipped .
They did not say if Marcos wore an N95 mask that day , but said that nurses responding to “ code blues ” are provided with them .
A hospital investigation determined Marcos did not have “ unprotected exposure to COVID-19 at the hospital , ” @ @ @ @ @ @ @ due to a recent change in CDC guidelines around the coronavirus .
Early in the pandemic , the agency recommended that N95 masks were needed for treating all suspected COVID-19 patients , but amid a severe shortage of gear , switched to recommending the masks only for high-risk procedures .
The rules have created a gray area that allows hospitals to instruct staff that in most cases , surgical masks are all that is needed to protect them from the coronavirus , nurses say .
“ Imagine you get inside the room just @ @ @ @ @ @ @ ?
” said one COVID-19 nurse at Hollywood Presbyterian , who added that she had been repeatedly told she didn ’ t need an N95 for most patient visits .
“ I don ’ t trust the CDC anymore.
” Hospital staff said they did not blame Hollywood Presbyterian , but viewed the facility as a victim of national shortages .
At St. John ’ s Health Center in Santa Monica , supervisors did not provide N95s to some nurses treating COVID-19 patients last month and the nurses refused to enter the rooms @ @ @ @ @ @ @ my hospital is worse than anyone else ’ s hospital , ” Boylan said .
“ I don ’ t know who threw out the rule book when it comes to infection control.
” Marcos ’ experience on April 3 seemed to rattle her .
In a text message to Lardizabal , Marcos described the patient ’ s rapid deterioration and warned the younger woman to stay home and wash her hands .
“ No wonder a lot of covid patients get intubated and some die in just a few days , ” @ @ @ @ @ @ @ Pls be extra careful.
” Marcos began feeling sick three days after she treated the man with COVID .
She told her niece that she was doing steam inhalation twice a day as a preventive measure .
But on April 11 , she told her oldest son , Donald Jay Marcos , that she had a headache and difficulty breathing .
He urged her to see a doctor .
Before the pandemic , Marcos and her two sons had planned a trip to the Philippines for last month .
Marcos loved to travel @ @ @ @ @ @ @ of her savings visiting her family .
Donald , 41 , didn ’ t hear from his mother again until April 15 , when she answered his video call from her hospital bed .
She told him she had developed pneumonia in both lungs .
Her labored breathing made it difficult for her to talk , Donald recalled .
Through their screens , the two watched each other cry .
Marcos had no health conditions other than high blood pressure , which she controlled with medication .
She was healthy , vibrant and @ @ @ @ @ @ @ also a nurse , her son said .
On April 17 , Marcos ’ heart stopped repeatedly , requiring staff to resuscitate her multiple times .
News of her rapid deterioration spread through the hospital .
A colleague received a call that Marcos was crashing .
“ I said , ‘ Don ’ t ever say that to me , ’ ” and I was crying , ” said the nurse .
“ I was like , ‘ Don ’ t ever say that to me.
’ ” Some have suggested there were @ @ @ @ @ @ @ some staff were scared to treat her for fear of catching the virus themselves .
In a complaint filed last week with the state health department , representatives from SEIU 121 said that nurses who took care of Marcos said a doctor refused to provide necessary care , including intubation to help her breathe , “ prior to her ultimate demise from COVID19 , ” according to documents reviewed by The Times .
Hospital administrators said they could not comment due to patient privacy laws , but added that their “ goal is @ @ @ @ @ @ @ our patients.
” The doctor could not be reached for comment .
In the waning daylight Wednesday , staff filtered out of Hollywood Presbyterian in scrubs and masks to pay tribute to Marcos at a vigil outside the facility ’ s entrance .
Despite social distancing recommendations , nurses packed in to watch the ceremony , saying that inside the hospital , they are always close together .
At the beginning of the first shift without Marcos , on April 20 , the administration gathered the nurses on her floor to say a @ @ @ @ @ @ @ a painful reminder of her absence , said one nurse .
“ It ’ s difficult to even fathom that Celia is gone , ” the nurse said .
“ I still think of her as being on vacation .
It is easier than having to lose someone.
” The death has made waves at the hospital .
Another nurse who treats COVID-19 patients said staff members began demanding better protections after Marcos ’ death .
Some have have refused to work without proper gear , she said .
Supervisors are providing more @ @ @ @ @ @ @ for bringing their from home , the nurse said .
She added that they will continue to fight for more safeguards .
“ I love my job , but I ’ m not trying to die a hero , ” she said .

The decision that Celia Marcos made, the one that would ultimately steal years from her life, had been hard-wired after decades working as a nurse.
On the ward that she oversaw at Hollywood Presbyterian Medical Center, a man with COVID-19 had stopped breathing. Marcos’ face was covered only with a thin surgical mask, and obtaining a more protective N95 mask before entering his room would have wasted valuable time, her colleagues say.
The 61-year-old charge nurse knew the chest compressions and other breathing treatments the patient needed would likely spew dangerous virus particles into the air that could land on her face and clothing. She would be at high risk of catching the coronavirus.
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Marcos raced into the room. Fourteen days later, she was dead.
Marcos died in the same hospital where she had worked for more than 16 years, one of at least 36 healthcare workers in California who have succumbed to COVID-19.
In one version of her story, she is a selfless caregiver who chose her patient’s life over her own by rushing into his room without an N95. But staff at Hollywood Presbyterian say the reality is much bleaker.
As charge nurse, Marcos was required to respond to patients who stopped breathing, but she wasn’t provided an N95 mask at the beginning of her shift, her coworkers say. The masks are scarce, and staff who do get them are often asked to reuse them over multiple days, they said.
“The hospital wasn’t giving us appropriate PPE — the N95s were locked,” said one nurse, who, like others, spoke on the condition of anonymity after expressing fear of retaliation from hospital administrators. “It’s just too painful for everybody, what happened to her.”
Though all front-line workers are vulnerable to the coronavirus, Marcos’ death illustrates the way that risk has been amplified by a national shortage of personal protective equipment. Such exposures have been cataloged at hospitals across California.
Advertisement
“I was the one right in front of his face,” Marcos wrote in a text to her niece reviewed by The Times. Concerned she had been infected, Marcos put hand sanitizer in her hair after leaving the patient’s room, and showered as soon as she got home, she said in the message.
Nurses attend a vigil for Celia Marcos outside Hollywood Presbyterian Medical Center on Wednesday. (Wally Skalij/Los Angeles Times)
Hollywood Presbyterian officials denied that Marcos treated COVID patients without proper protective gear and said the hospital adheres to all local and federal recommendations. “Despite these efforts, and our commitment to following all guidelines, we still lost one of our own to this terrible virus, and we feel this loss very deeply,” administrators said in a statement to The Times.
The nurses union SEIU 121RN filed a complaint with the state Occupational Safety and Health Administration that called Marcos’ death “the result of inadequate PPE provided to staff.” The union also alleged in a separate complaint to the state health department that Marcos received substandard treatment once she became a patient at the hospital.
Lying in her hospital bed, surrounded by colleagues who had become her caretakers, one of the last things Marcos said was: “I don’t want to die.”
*
Marcos began working at Hollywood Presbyterian in 2004, three years after immigrating to the U.S. with her family. Back home in the Philippines, she had trained to be a nurse, her longtime dream, according to her sons.
At the Los Angeles hospital, she was known for her sweet nature and ability to heal rifts and remain cool-headed, no matter the situation. Filipino colleagues called her “ate” — big sister in Tagalog.
“She’s the type of person who in an emergency you can really count on,” said another colleague, who also asked for anonymity for fear of retaliation. “She’s the calm that we can look to in order to get through.”
On the night of April 3, Marcos was asked to put those skills to use.
A man admitted on her floor with COVID-19 had been complaining that he wanted to go home because he didn’t feel sick. Two hours later, he stopped breathing, Marcos wrote in a text to her niece Andrea Gian Lardizabal, who works as a nurse in the Philippines.
Marcos worked on a ward that took coronavirus patients when the COVID units were full. Because her floor wasn’t primarily for COVID patients, N95s weren’t regularly given to staff, and instead preserved for those treating COVID patients, staff say.
Sydnie Boylan, another charge nurse, initially worked on Marcos’ floor but worried about the lack of protective gear. She switched to the COVID unit “because that’s where the PPE is,” she said. “Even if we don’t have enough, we have more than everybody else.”
With only a surgical mask, Marcos stayed in the patient’s room for at least 30 minutes while he was resuscitated and eventually placed on a ventilator to help him breathe, before being moved to the ICU, her colleagues say. Marcos strapped an oxygen mask on the patient, who had “almost died,” she told her niece in a text message.
“Celia was called to a COVID-19 isolation room while wearing only a surgical mask — not the required N95 respirator, gown, face shield, and booties that her hospital should have given her for her protection,” said SEIU 121RN President Nina Wells said in a statement to the Times. “Now we know she gave her life to try to save a life.”
Hospital officials dispute that Marcos, or any staff members, were under-equipped. They did not say if Marcos wore an N95 mask that day, but said that nurses responding to “code blues” are provided with them. A hospital investigation determined Marcos did not have “unprotected exposure to COVID-19 at the hospital,” they said.
The discrepancy may be due to a recent change in CDC guidelines around the coronavirus. Early in the pandemic, the agency recommended that N95 masks were needed for treating all suspected COVID-19 patients, but amid a severe shortage of gear, switched to recommending the masks only for high-risk procedures.
The rules have created a gray area that allows hospitals to instruct staff that in most cases, surgical masks are all that is needed to protect them from the coronavirus, nurses say.
“Imagine you get inside the room just wearing those. Do you feel protected?” said one COVID-19 nurse at Hollywood Presbyterian, who added that she had been repeatedly told she didn’t need an N95 for most patient visits. “I don’t trust the CDC anymore.”
Hospital staff said they did not blame Hollywood Presbyterian, but viewed the facility as a victim of national shortages. At St. John’s Health Center in Santa Monica, supervisors did not provide N95s to some nurses treating COVID-19 patients last month and the nurses refused to enter the rooms.
“I don’t think my hospital is worse than anyone else’s hospital,” Boylan said. “I don’t know who threw out the rule book when it comes to infection control.”
Marcos’ experience on April 3 seemed to rattle her. In a text message to Lardizabal, Marcos described the patient’s rapid deterioration and warned the younger woman to stay home and wash her hands.
“No wonder a lot of covid patients get intubated and some die in just a few days,” she wrote in a text. “Pls be extra careful.”
*
Marcos began feeling sick three days after she treated the man with COVID. She told her niece that she was doing steam inhalation twice a day as a preventive measure.
But on April 11, she told her oldest son, Donald Jay Marcos, that she had a headache and difficulty breathing. He urged her to see a doctor.
Before the pandemic, Marcos and her two sons had planned a trip to the Philippines for last month. Marcos loved to travel to new places, but spent most of her savings visiting her family.
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Donald, 41, didn’t hear from his mother again until April 15, when she answered his video call from her hospital bed. She told him she had developed pneumonia in both lungs.
Her labored breathing made it difficult for her to talk, Donald recalled. Through their screens, the two watched each other cry.
Marcos had no health conditions other than high blood pressure, which she controlled with medication. She was healthy, vibrant and lived with her partner, who is also a nurse, her son said.
Celia Marcos with her grandson, Drujay. (Donald Jay Marcos)
On April 17, Marcos’ heart stopped repeatedly, requiring staff to resuscitate her multiple times. News of her rapid deterioration spread through the hospital. A colleague received a call that Marcos was crashing.
“I said, ‘Don’t ever say that to me,’” and I was crying,” said the nurse. “I was like, ‘Don’t ever say that to me.’”
Some have suggested there were problems with Marcos’ care and that some staff were scared to treat her for fear of catching the virus themselves.
In a complaint filed last week with the state health department, representatives from SEIU 121RN said that nurses who took care of Marcos said a doctor refused to provide necessary care, including intubation to help her breathe, “prior to her ultimate demise from COVID19,” according to documents reviewed by The Times.
Hospital administrators said they could not comment due to patient privacy laws, but added that their “goal is to provide excellent care to all of our patients.” The doctor could not be reached for comment.
In the waning daylight Wednesday, staff filtered out of Hollywood Presbyterian in scrubs and masks to pay tribute to Marcos at a vigil outside the facility’s entrance. Despite social distancing recommendations, nurses packed in to watch the ceremony, saying that inside the hospital, they are always close together.
At the beginning of the first shift without Marcos, on April 20, the administration gathered the nurses on her floor to say a prayer for her. The gesture was a painful reminder of her absence, said one nurse.
“It’s difficult to even fathom that Celia is gone,” the nurse said. “I still think of her as being on vacation. It is easier than having to lose someone.”
The death has made waves at the hospital. Another nurse who treats COVID-19 patients said staff members began demanding better protections after Marcos’ death. Some have have refused to work without proper gear, she said.
Supervisors are providing more PPE and staffers are no longer reprimanded for bringing their from home, the nurse said. She added that they will continue to fight for more safeguards.
“I love my job, but I’m not trying to die a hero,” she said.


latimes--2020-05-10--Meet the 73-year-old surgeon working to keep California veterans safe from COVID-19

Dr. Vito Imbasciani has been at war with viruses since he was 5 .
Growing up near the U.S. Military Academy at West Point in New York , he contracted polio in 1952 and couldn ’ t walk for two months .
In medical school in Vermont 30 years later , he saw AIDS steal the lives of otherwise healthy gay men .
Now , Imbasciani , secretary of California ’ s Department of Veterans Affairs , and his staff are responsible for keeping the novel coronavirus away from the state ’ s eight veterans homes .
California ’ s @ @ @ @ @ @ @ many say , lies in CalVet ’ s intense preparation , quick response , attention to hygiene and leadership , starting with Imbasciani , a physician and retired colonel who not too many years ago could have been discharged from the military because he is gay .
“ We created our own fortune , ” Imbasciani said , looking to knock on wood .
Deaths are part of life in the state-run veterans homes .
The homes are populated largely by frail men and women , some of them veterans of World War @ @ @ @ @ @ @ the Vietnam War era .
A quarter of the vets admitted to California ’ s homes in recent years had been living homeless .
COVID-19 has hastened the end for scores of retired soldiers in veterans homes in other states : More than 70 veterans have died of the disease at a “ soldiers ’ home ” in Massachusetts ; more than 125 have died in New Jersey ’ s three homes ; more than 60 residents of an Alabama veterans home tested positive , and eight have died .
The California Department @ @ @ @ @ @ @ is holding the beastly infection at bay .
In its eight homes , where 2,100 veterans reside , three residents have contracted the disease , and two have died of it , one in his 90s and one in his late 80s .
“ It ’ s all hands on deck , ” state Sen. Bob Archuleta , a Los Angeles-area Democrat who chairs the Senate Veterans Affairs Committee , said of CalVet ’ s response .
“ It goes back to the staff .
We have people who care about their veterans @ @ @ @ @ @ @ mile.
” Like Archuleta , Imbasciani credits the work of the front-line staff of nurses , nursing assistants and doctors who provide direct care .
But leadership matters , and Archuleta and others also point to Imbasciani .
CalVet ’ s leader is a 73-year-old urologic surgeon who speaks six languages and has a master ’ s degree in musicology and a doctorate in philosophy .
The son of a World War II tail gunner and grandson of a World War I vet , Imbasciani served 27 years in the Army Medical Corps @ @ @ @ @ @ @ times before retiring as a colonel in 2014 .
For most of those years , Imbasciani had to hide his personal life because of President Clinton ’ s “ don ’ t ask , don ’ t tell ” policy that sought to keep LGBTQ service people serving in the closet .
That changed when President Obama signed legislation repealing the policy in 2010 .
Two years later , Imbasciani introduced Obama at a fundraiser hosted by LGBTQ community leaders in Beverly Hills .
“ The price of my service was to live @ @ @ @ @ @ @ crowd of 600 when introducing the president , as quoted by the Washington Post .
“ But not anymore.
” Imbasciani was director of government relations at the Southern California Permanente Medical Group in September 2015 when Gov .
Jerry Brown appointed him secretary of the California Department of Veterans Affairs .
Gov .
Gavin Newsom reappointed him in January , even as the novel coronavirus was starting its global spread .
Over the years , Imbasciani has tracked severe acute respiratory syndrome , or SARS , Ebola and Zika , among other @ @ @ @ @ @ @ scientists in China sequenced the DNA of a mysterious new coronavirus that had emerged in Wuhan , Imbasciani thought , “ Here we go again.
” He assumed the virus would storm the West Coast , as did CalVet ’ s director of long-term care , Thomas Bucci .
Based on the devastating events unfolding in Wuhan , they quickly recognized COVID-19 as a disease far worse than the flu .
Bucci , an Air Force veteran , spent 38 years as a healthcare administrator before going to work for the state in @ @ @ @ @ @ @ people are particularly vulnerable , Bucci said : “ We had a big bull ’ s-eye on ourselves.
” By mid-February , a month before the World Health Organization declared COVID-19 to be a pandemic , Bucci was regularly communicating with directors of the eight veterans homes about the threat , and , along with Imbasciani , implementing a 38-step plan .
The protocol began with the basics .
Directors of each home updated their emergency operations plans .
They ensured they had enough surgical and N95 masks , gloves and gowns for @ @ @ @ @ @ @ , to minimize the chance of spread .
As of Feb. 26 , all visitors were directed to sanitize their hands before entry , and staff began disinfecting common surfaces every 30 minutes .
On March 4 , as the infection killed the first of dozens of residents at the Life Care Center in Kirkland , Wash. , Imbasciani discussed the coming onslaught at an executive team meeting .
And by March 15 — four days before Newsom issued the statewide stay-at-home order — all visitors were barred , with the exception of @ @ @ @ @ @ @ hospice .
Now , all staffers have their temperatures taken when they arrive for work and are sent home if they show symptoms .
At four of the homes , all workers are encouraged to take tests for the virus , and all residents are tested .
At the other four , employees who have been exposed to a known or suspected COVID-19 case are being tested , as are any residents who show symptoms .
All staffers wear masks , as do residents when not in their rooms .
Residents are required @ @ @ @ @ @ @ for conversation or card games .
Meals are delivered to residents ’ rooms .
The Veterans Home of California-Yountville opened in Napa Valley in 1884 .
How it withstood the 1918-19 influenza pandemic is for the most part lost to history .
A century later , however , not a single COVID-19 case has been recorded among its nearly 1,000 residents .
Muriel Zimmer , 85 , a Korean War-era Air Force veteran , has been living at the Yountville home for nine years with her husband , Dick .
He needs more @ @ @ @ @ @ @ of the facility , limiting her ability to see him .
They ’ re allowed only brief conversations , and from a safe distance .
She also misses seeing friends in the dining hall .
But she remembers rationing during World War II , and knows others have it much harder .
She is able to walk across the Yountville grounds , with its sweeping views of the Napa vineyards below , and notices small things , like the monarch butterfly that flitted by the other day .
“ I almost get teary-eyed @ @ @ @ @ @ @ ” she said .
“ We are blessed.
” At the Redding Veterans Home in Shasta County , Michael Vancleemput , a Vietnam-era Army veteran , spoke by phone through a mask , as a worker walked past disinfecting surfaces .
“ They ’ re personally motivated to serve us .
It ’ s not like they ’ re doing a job , ” said Vancleemput , 79 .
He has to socially distance from his friends , not that it ’ s a problem .
He lived alone for years in the @ @ @ @ @ @ @ of Mt .
Shasta before moving to the veterans home five years ago .
A ham radio operator , he said he keeps in touch with other members of the home ’ s amateur radio operators club .
“ I would invite you to visit our institution , ” Vancleemput said , then paused .
“ Not now.
” No visitors allowed .
The bulwark that CalVet has erected against COVID-19 builds on a series of improvements .
When Imbasciani and Bucci arrived , the state-run homes used paper records .
Now , @ @ @ @ @ @ @ home once operated independently .
Now , they are part of a system with standardized procedures .
CalVet ’ s nurses , nursing assistants and physicians are state civil servants with union representation and paid sick leave .
One nursing assistant might be responsible for six or eight residents .
At a private nursing home , an aide more typically handles 10 or 12 .
CalVet also has staff physicians on-site every day .
For many years , the federal government , which rates nursing homes , gave CalVet ’ s homes dismal @ @ @ @ @ @ @ that have been rated , four have the highest designation of five stars , and one has four stars .
“ It does show that when there is strong and visionary leadership , it can make a big difference , ” said Charlene Harrington , an expert on nursing home care and professor emerita at UC San Francisco .
In the military , superiors give what are known as challenge coins to soldiers as an attaboy .
The coins have a hierarchy .
One bestowed by a two-star general carries greater bragging rights @ @ @ @ @ @ @ a one-star general .
Imbasciani ’ s challenge coin is one of his most prized possessions .
It ’ s a little larger than a silver dollar and is stamped with the presidential seal and the name of the 44th president .
Obama gave it to him , and no one outranks the commander in chief , Imbasciani noted .
At California ’ s eight veterans homes , the walls are holding , so far .
But Imbasciani knows an asymptomatic carrier could cause a breach any day .
He is , after @ @ @ @ @ @ @ viruses since he was a boy .
He can even imagine the epitaph on his tombstone : This story was produced by Kaiser Health News , which publishes California Healthline , an editorially independent service of the California Health Care Foundation .
KHN is not affiliated with Kaiser Permanente .

Dr. Vito Imbasciani, secretary of the California Department of Veterans Affairs, tracked the Zika and Ebola viruses before dealing with the novel coronavirus.
Dr. Vito Imbasciani has been at war with viruses since he was 5.
Growing up near the U.S. Military Academy at West Point in New York, he contracted polio in 1952 and couldn’t walk for two months. In medical school in Vermont 30 years later, he saw AIDS steal the lives of otherwise healthy gay men.
Now, Imbasciani, secretary of California’s Department of Veterans Affairs, and his staff are responsible for keeping the novel coronavirus away from the state’s eight veterans homes. California’s defenses are holding.
The explanation, many say, lies in CalVet’s intense preparation, quick response, attention to hygiene and leadership, starting with Imbasciani, a physician and retired colonel who not too many years ago could have been discharged from the military because he is gay.
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“We created our own fortune,” Imbasciani said, looking to knock on wood.
Deaths are part of life in the state-run veterans homes. The homes are populated largely by frail men and women, some of them veterans of World War II and Korea, and many from the Vietnam War era. A quarter of the vets admitted to California’s homes in recent years had been living homeless.
COVID-19 has hastened the end for scores of retired soldiers in veterans homes in other states: More than 70 veterans have died of the disease at a “soldiers’ home” in Massachusetts; more than 125 have died in New Jersey’s three homes; more than 60 residents of an Alabama veterans home tested positive, and eight have died.
The Veterans Home of California in Los Angeles. (Gary Coronado / Los Angeles Times)
The California Department of Veteran Affairs, by contrast, is holding the beastly infection at bay. In its eight homes, where 2,100 veterans reside, three residents have contracted the disease, and two have died of it, one in his 90s and one in his late 80s.
“It’s all hands on deck,” state Sen. Bob Archuleta, a Los Angeles-area Democrat who chairs the Senate Veterans Affairs Committee, said of CalVet’s response. “It goes back to the staff. We have people who care about their veterans, and they will go the extra mile.”
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Like Archuleta, Imbasciani credits the work of the front-line staff of nurses, nursing assistants and doctors who provide direct care. But leadership matters, and Archuleta and others also point to Imbasciani.
CalVet’s leader is a 73-year-old urologic surgeon who speaks six languages and has a master’s degree in musicology and a doctorate in philosophy. The son of a World War II tail gunner and grandson of a World War I vet, Imbasciani served 27 years in the Army Medical Corps. He deployed to war zones four times before retiring as a colonel in 2014.
For most of those years, Imbasciani had to hide his personal life because of President Clinton’s “don’t ask, don’t tell” policy that sought to keep LGBTQ service people serving in the closet.
That changed when President Obama signed legislation repealing the policy in 2010. Two years later, Imbasciani introduced Obama at a fundraiser hosted by LGBTQ community leaders in Beverly Hills.
“The price of my service was to live a lie,” Imbasciani told the crowd of 600 when introducing the president, as quoted by the Washington Post. “But not anymore.”
Dr. Vito Imbasciani. (Gary Coronado / Los Angeles Times)
Imbasciani was director of government relations at the Southern California Permanente Medical Group in September 2015 when Gov. Jerry Brown appointed him secretary of the California Department of Veterans Affairs. Gov. Gavin Newsom reappointed him in January, even as the novel coronavirus was starting its global spread.
Over the years, Imbasciani has tracked severe acute respiratory syndrome, or SARS, Ebola and Zika, among other viral threats. In January, when scientists in China sequenced the DNA of a mysterious new coronavirus that had emerged in Wuhan, Imbasciani thought, “Here we go again.”
He assumed the virus would storm the West Coast, as did CalVet’s director of long-term care, Thomas Bucci. Based on the devastating events unfolding in Wuhan, they quickly recognized COVID-19 as a disease far worse than the flu.
Bucci, an Air Force veteran, spent 38 years as a healthcare administrator before going to work for the state in 2015. Knowing that older and immunosuppressed people are particularly vulnerable, Bucci said: “We had a big bull’s-eye on ourselves.”
By mid-February, a month before the World Health Organization declared COVID-19 to be a pandemic, Bucci was regularly communicating with directors of the eight veterans homes about the threat, and, along with Imbasciani, implementing a 38-step plan.
The protocol began with the basics. Directors of each home updated their emergency operations plans. They ensured they had enough surgical and N95 masks, gloves and gowns for the staff, and even disposable dinnerware, to minimize the chance of spread.
As of Feb. 26, all visitors were directed to sanitize their hands before entry, and staff began disinfecting common surfaces every 30 minutes. On March 4, as the infection killed the first of dozens of residents at the Life Care Center in Kirkland, Wash., Imbasciani discussed the coming onslaught at an executive team meeting. And by March 15 — four days before Newsom issued the statewide stay-at-home order — all visitors were barred, with the exception of family members paying respects to veterans in hospice.
Now, all staffers have their temperatures taken when they arrive for work and are sent home if they show symptoms. At four of the homes, all workers are encouraged to take tests for the virus, and all residents are tested. At the other four, employees who have been exposed to a known or suspected COVID-19 case are being tested, as are any residents who show symptoms.
All staffers wear masks, as do residents when not in their rooms. Residents are required to social-distance, meaning no congregating closely for conversation or card games. Meals are delivered to residents’ rooms.
The Veterans Home of California-Yountville opened in Napa Valley in 1884. How it withstood the 1918-19 influenza pandemic is for the most part lost to history. A century later, however, not a single COVID-19 case has been recorded among its nearly 1,000 residents.
Muriel Zimmer, 85, a Korean War-era Air Force veteran, has been living at the Yountville home for nine years with her husband, Dick. He needs more care and lives in the skilled-nursing section of the facility, limiting her ability to see him. They’re allowed only brief conversations, and from a safe distance.
“I miss him,” she said.
She also misses seeing friends in the dining hall. But she remembers rationing during World War II, and knows others have it much harder. She is able to walk across the Yountville grounds, with its sweeping views of the Napa vineyards below, and notices small things, like the monarch butterfly that flitted by the other day.
“I almost get teary-eyed when I think about the staff,” she said. “We are blessed.”
At the Redding Veterans Home in Shasta County, Michael Vancleemput, a Vietnam-era Army veteran, spoke by phone through a mask, as a worker walked past disinfecting surfaces. “They’re personally motivated to serve us. It’s not like they’re doing a job,” said Vancleemput, 79.
He has to socially distance from his friends, not that it’s a problem. He lived alone for years in the small town of McCloud at the base of Mt. Shasta before moving to the veterans home five years ago. A ham radio operator, he said he keeps in touch with other members of the home’s amateur radio operators club.
“I would invite you to visit our institution,” Vancleemput said, then paused. “Not now.” No visitors allowed.
The bulwark that CalVet has erected against COVID-19 builds on a series of improvements. When Imbasciani and Bucci arrived, the state-run homes used paper records. Now, medical records are tracked electronically. Each home once operated independently. Now, they are part of a system with standardized procedures.
CalVet’s nurses, nursing assistants and physicians are state civil servants with union representation and paid sick leave. One nursing assistant might be responsible for six or eight residents. At a private nursing home, an aide more typically handles 10 or 12. CalVet also has staff physicians on-site every day.
For many years, the federal government, which rates nursing homes, gave CalVet’s homes dismal marks. Now, among the homes that have been rated, four have the highest designation of five stars, and one has four stars.
“It does show that when there is strong and visionary leadership, it can make a big difference,” said Charlene Harrington, an expert on nursing home care and professor emerita at UC San Francisco.
In the military, superiors give what are known as challenge coins to soldiers as an attaboy. The coins have a hierarchy. One bestowed by a two-star general carries greater bragging rights than, say, one given by a one-star general.
Imbasciani’s challenge coin is one of his most prized possessions. It’s a little larger than a silver dollar and is stamped with the presidential seal and the name of the 44th president. Obama gave it to him, and no one outranks the commander in chief, Imbasciani noted.
At California’s eight veterans homes, the walls are holding, so far. But Imbasciani knows an asymptomatic carrier could cause a breach any day. He is, after all, someone who has been battling viruses since he was a boy. He can even imagine the epitaph on his tombstone:
“Here lies Vito. He hated viruses.”
This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. KHN is not affiliated with Kaiser Permanente.


latimes--2020-05-10--Freight industry takes hits during the pandemic, but the trains keep chugging along

The sounds of traffic and airplanes have quieted across much of Los Angeles County and California as health orders keep people indoors .
But if you listen closely , you ’ ll still hear the whistle of trains as they cart and transport food , consumer products , chemicals and livestock to and from manufacturers , stores and ports across the country .
At the Burlington Northern Santa Fe Railway , or BNSF , transit hub in La Mirada , Russ Abbott , a locomotive engineer , said that when the pandemic first hit , his only clue that life @ @ @ @ @ @ @ quicker commute between home and work .
“ It was really fast , ” he said , describing the lack of traffic on the roads .
“ That was different .
“ But here , nobody was sick , we kept moving cars and it all felt pretty normal , ” he said to a curious visitor sitting in the cab of the 3800-horsepower BNSF locomotive he was driving on the railroad tracks that parallel Stage Road in this eastern suburb of Los Angeles County .
Over the last two months , the @ @ @ @ @ @ @ supply chains nationwide and have hammered all sectors of the transportation industry .
Freight-carrying railroads have also been hit , but not to the degree of airlines and auto manufacturers .
That ’ s because railroads carry essential items during this pandemic , including frozen meat and vegetable oil , and chemicals such as chlorine bleach and sand for fracking .
Abbott bears witness to this supply chain on his workdays , soaking in the clickety-clack of train wheels , carrying thousands of tons of supplies , as they roll over the joints @ @ @ @ @ @ @ In La Mirada , those tracks run on a northwest-to-southeast trajectory , behind a Home Depot , International Paper warehouse , and a U.S. Foods outlet .
A small spur takes the railway west to an Amazon fulfillment center , a Frito-Lay warehouse and a Staples fulfillment center .
The railroad provides these companies with a direct connection to the coastal ports of Los Angeles and Long Beach , as well as the vast interior of the country .
And while Abbott enjoys moving the trains back and forth among the suppliers and @ @ @ @ @ @ @ s the Cajon Pass he relishes .
“ I still get chills every time I go through it , ” he said , describing the picturesque ride through the San Bernardino and San Gabriel mountains , which are now covered with bright poppies and wildflowers .
“ It never gets old.
” And although Abbott ’ s day-to-day hasn ’ t changed drastically since the beginning of the year , there are differences , said Lena Kent , a spokeswoman for BNSF .
Employees now mostly enter information and data via iPads outside @ @ @ @ @ @ @ to congregate in the office ; trains are wiped down between shifts ; and operators and other employees wear masks to prevent the spread of the coronavirus .
“ But safety has always been a mainstay , ” said Kent , who noted that train crews , who work with powerful moving machinery , are always generally small in number and spread out .
In addition , the volume being moved has shrunk , or in the words of Kent , “ softened.
” In La Mirada , the shrinkage is related to @ @ @ @ @ @ @ ports of Los Angeles and Long Beach , which have been hit by a combination of trade war disputes and the economic slowdown tied to the coronavirus .
On Thursday , Gene Seroka , the executive director of the Port of Los Angeles , announced at a news conference that movement is 80 % of what it was this time last year .
Port statistics show container volume is down 15.5 % , and officials predict business will remain “ soft ” for the next few months .
He noted steep declines in @ @ @ @ @ @ @ metal and steel , with an uptick in produce coming from Latin America .
On the railroads , the movement of auto parts has dropped more than 90 % compared with the same week last year .
“ We ’ ve gone from uncertainty ” as a result of the trade war “ to radical uncertainty , ” said Mario Cordero , executive director of the Port of Long Beach .
“ I don ’ t think anyone can forecast where we ’ re going as a nation with our economy .
... @ @ @ @ @ @ @ for 2020 , or for that matter for 2021 .
At least in terms of business normalcy.
” Cordero also pointed to the blank sailing statistics , which are the cancellations of scheduled ships .
He said in the first quarter of this year , there were 61 blank sailings to the ports of Long Beach and Los Angeles .
Forty-eight are expected for this quarter .
“ That ’ s unprecedented , ” he said , and it translates to real money and jobs .
Without a doubt , that reduction in @ @ @ @ @ @ @ supply chain , including trains , he said .
Then there ’ s the drop in demand for coal , which is crippling the economy in the Midwest and mountain states .
Last week , more than 340 BNSF employees were laid off in Montana and Wyoming , where the demand for coal has plummeted .
Several BNSF railroad facilities in Montana , Wyoming , Kansas , North Dakota , Wisconsin and Nebraska are now either permanently shuttered or temporarily reduced in size .
And other railroad companies , such as Union Pacific @ @ @ @ @ @ @ and coal demand , according to published reports .
While freight traffic has dropped around the nation , the workload has stayed “ relatively steady ” at the little hub in La Mirada , Kent said .
Warren Buffett , whose Berkshire Hathaway owns BNSF , remains bullish about both the U.S. economy and the rail industry , which has a climate footprint just a fraction of that of trucking .
“ Nothing can basically stop America , ” Buffett said at Berkshire Hathaway ’ s virtual shareholder meeting early this month .
@ @ @ @ @ @ @ magic has always prevailed and it will do so again.
” Times staff writer Susanne Rust and photographer Carolyn Cole are embarking on a road journey throughout California .
They aim to give voice to those in remote parts of the state as they grapple with the worst health and economic calamity of our lifetimes .

The sounds of traffic and airplanes have quieted across much of Los Angeles County and California as health orders keep people indoors.
But if you listen closely, you’ll still hear the whistle of trains as they cart and transport food, consumer products, chemicals and livestock to and from manufacturers, stores and ports across the country.
At the Burlington Northern Santa Fe Railway, or BNSF, transit hub in La Mirada, Russ Abbott, a locomotive engineer, said that when the pandemic first hit, his only clue that life outside the railroad had changed was his quicker commute between home and work.
“It was really fast,” he said, describing the lack of traffic on the roads. “That was different.
“But here, nobody was sick, we kept moving cars and it all felt pretty normal,” he said to a curious visitor sitting in the cab of the 3,800-horsepower BNSF locomotive he was driving on the railroad tracks that parallel Stage Road in this eastern suburb of Los Angeles County.
Advertisement
Russ Abbott, a locomotive engineer, drives the 3800 horsepower BNSF locomotive at the transit hub for the Burlington Northern Santa Fe Railway in La Mirada, Calif. (Carolyn Cole / Los Angeles Times)
Over the last two months, the COVID-19 pandemic and resulting lockdowns have disrupted supply chains nationwide and have hammered all sectors of the transportation industry. Freight-carrying railroads have also been hit, but not to the degree of airlines and auto manufacturers.
That’s because railroads carry essential items during this pandemic, including frozen meat and vegetable oil, and chemicals such as chlorine bleach and sand for fracking. Abbott bears witness to this supply chain on his workdays, soaking in the clickety-clack of train wheels, carrying thousands of tons of supplies, as they roll over the joints and squats of the rail line.
Business Truckers, dockworkers suffer as coronavirus chokes L.A., Long Beach ports cargo The nation’s largest port is hurting. That may be a leading indicator of the pain that’s in store for Southern California and the U.S. economy as businesses hunker down to deal with the rapidly expanding new coronavirus.
In La Mirada, those tracks run on a northwest-to-southeast trajectory, behind a Home Depot, International Paper warehouse, and a U.S. Foods outlet. A small spur takes the railway west to an Amazon fulfillment center, a Frito-Lay warehouse and a Staples fulfillment center.
The railroad provides these companies with a direct connection to the coastal ports of Los Angeles and Long Beach, as well as the vast interior of the country.
And while Abbott enjoys moving the trains back and forth among the suppliers and distributors in the county, it’s the Cajon Pass he relishes.
“I still get chills every time I go through it,” he said, describing the picturesque ride through the San Bernardino and San Gabriel mountains, which are now covered with bright poppies and wildflowers. “It never gets old.”
The Tehachapi loop is a three-quarter-mile spiral that connects the San Joaquin Valley to the Mojave Desert, gaining 77 feet in elevation. (Carolyn Cole / Los Angeles Times)
And although Abbott’s day-to-day hasn’t changed drastically since the beginning of the year, there are differences, said Lena Kent, a spokeswoman for BNSF.
Advertisement
Employees now mostly enter information and data via iPads outside, so they don’t have to congregate in the office; trains are wiped down between shifts; and operators and other employees wear masks to prevent the spread of the coronavirus.
“But safety has always been a mainstay,” said Kent, who noted that train crews, who work with powerful moving machinery, are always generally small in number and spread out.
Russ Abbott climbs aboard his BNSF locomotive. (Carolyn Cole / Los Angeles Times)
In addition, the volume being moved has shrunk, or in the words of Kent, “softened.”
In La Mirada, the shrinkage is related to a drop in goods coming into the ports of Los Angeles and Long Beach, which have been hit by a combination of trade war disputes and the economic slowdown tied to the coronavirus.
On Thursday, Gene Seroka, the executive director of the Port of Los Angeles, announced at a news conference that movement is 80% of what it was this time last year.
Port statistics show container volume is down 15.5%, and officials predict business will remain “soft” for the next few months.
He noted steep declines in the fast-fashion business, automobiles, scrap metal and steel, with an uptick in produce coming from Latin America.
Coronavirus Journal Two Times journalists are embarking on a journey throughout California to cover the nation’s most populous and diverse state during the coronavirus crisis. More Stories
On the railroads, the movement of auto parts has dropped more than 90% compared with the same week last year.
“We’ve gone from uncertainty” as a result of the trade war “to radical uncertainty,” said Mario Cordero, executive director of the Port of Long Beach. “I don’t think anyone can forecast where we’re going as a nation with our economy. ... I don’t see any normalcy for 2020, or for that matter for 2021. At least in terms of business normalcy.”
Cordero also pointed to the blank sailing statistics, which are the cancellations of scheduled ships. He said in the first quarter of this year, there were 61 blank sailings to the ports of Long Beach and Los Angeles. Forty-eight are expected for this quarter.
Lena Kent, spokeswoman for Burlington Northern Santa Fe Railway at the BNSF transit hub. (Carolyn Cole / Los Angeles Times)
“That’s unprecedented,” he said, and it translates to real money and jobs. Without a doubt, that reduction in traffic will affect all sectors of the supply chain, including trains, he said.
Then there’s the drop in demand for coal, which is crippling the economy in the Midwest and mountain states.
Last week, more than 340 BNSF employees were laid off in Montana and Wyoming, where the demand for coal has plummeted. Several BNSF railroad facilities in Montana, Wyoming, Kansas, North Dakota, Wisconsin and Nebraska are now either permanently shuttered or temporarily reduced in size.
And other railroad companies, such as Union Pacific, are getting squeezed by decreased oil and coal demand, according to published reports.
While freight traffic has dropped around the nation, the workload has stayed “relatively steady” at the little hub in La Mirada, Kent said.
More than 340 BNSF employees were laid off this month in Montana and Wyoming, where the demand for coal has plummeted. While freight traffic has dropped around the country, the workload has stayed relatively steady at the hub in La Mirada. (Carolyn Cole / Los Angeles Times)
Advertisement
Warren Buffett, whose Berkshire Hathaway owns BNSF, remains bullish about both the U.S. economy and the rail industry, which has a climate footprint just a fraction of that of trucking.
“Nothing can basically stop America,” Buffett said at Berkshire Hathaway’s virtual shareholder meeting early this month. “The American miracle, the American magic has always prevailed and it will do so again.”
Times staff writer Susanne Rust and photographer Carolyn Cole are embarking on a road journey throughout California. They aim to give voice to those in remote parts of the state as they grapple with the worst health and economic calamity of our lifetimes.


latimes--2020-05-10--California faces a perilous fire season as coronavirus threatens firefighters

As forecasters predict higher-than-normal chances of large fires in Northern California this year — as well as the usual risk of “ large significant ” burning in Southern California — fire authorities are growing increasingly concerned over their ability to muster a large , healthy force of firefighters in the face of COVID-19 .
Realizing that wildfire smoke will steadily impair a firefighter ’ s immune system , and that traditional base camps can magnify the risk of infection , federal , state and county officials are urging a blitzkrieg approach to wildfires that will rely heavily on the use @ @ @ @ @ @ @ circulating , they say they can not allow even the smallest secluded fire to smolder for the sake of forest ecology .
All fires , they say , must be extinguished as quickly as possible .
“ Unfortunately , this is not a year in which we can afford to assign firefighters to monitor and manage such wildland fires , ” Sen. Lisa Murkowski ( R-Alaska ) wrote to the departments of Interior and Agriculture recently as she urged aggressive firefighting in Northern California and other parts of the West .
“ Given @ @ @ @ @ @ @ , it is essential to utilize federal resources for immediate wildfire suppression to the greatest extent practicable.
” The call for highly aggressive firefighting marks a return to an older ethos , particularly on federal lands , where most California forests are .
For most of the last century , the federal government ’ s policy was to knock down every fire wherever it sprang up .
In recent decades however , a different approach has evolved : Fires that don ’ t pose a threat to the public are allowed to expand @ @ @ @ @ @ @ That is unlikely to be the case this fire season however , as protections against the spread of the coronavirus place new strains on fire agencies and their crews .
In many ways , the coronavirus is sending wildland firefighters back to the old school this fire season .
“ Aggressive initial attack is the single most important method to ensure the safety of firefighters and the public ; it also limits suppression costs , ” said Jessica Gardetto , a spokesperson for the Bureau of Land Management at the National Interagency Fire @ @ @ @ @ @ @ of aircraft however , fire authorities still face a hard reality .
Planes and helicopters are effective in slowing most fires , and allow crews on the ground to get on the scene and contain it , but history shows they do little to halt the wind-driven monsters that cause the most death and destruction .
The continued spread of the coronavirus , as well as the economic paralysis that has accompanied health restrictions , has impacted every aspect of wildland firefighting , including mutual aid arrangements and the widespread use of inmate @ @ @ @ @ @ @ , this is a game changer with COVID-19 , ” said Mike Mohler , spokesman for the California Department of Forestry and Fire Protection .
“ It ’ s going to have to be an ‘ everybody ’ s hands on deck ’ approach to this.
” Mohler said his biggest concern is firefighters contracting COVID-19 and silently spreading it among fellow firefighters and knocking them out of service , or even spreading it among the public .
Already , the coronavirus has reduced the number of overall firefighters available in California .
@ @ @ @ @ @ @ , authorities granted early release to thousands of minimum-security inmates in an effort to reduce crowding and slow the spread of disease .
Of those releases , 242 were inmate firefighters , according to the California Department of Corrections and Rehabilitation .
Inmate firefighters make up 43 % of the state firefighting force .
In Los Angeles County , where voters recently rejected a measure to hire more firefighters and paramedics , Fire Chief Daryl Osby said potential staffing shortages and increased brush growth due to late-spring rains are cause for worry .
@ @ @ @ @ @ @ toward wildfires , crews are preparing five of the county ’ s water-dropping helicopters to deploy during the day and night throughout the summer .
The county is also planning to contract with two air tankers from Canada in August — a month earlier than usual , Osby said .
And , later this month , crews will begin inspecting wildfire-vulnerable homes to ensure that they have fire defensible space .
“ It ’ s going to be really important for our citizens to do the proper brush clearance , ” Osby said @ @ @ @ @ @ @ the fall months and start having our wind-driven incidents , we can not guarantee to place an engine at every home.
” Traditionally , California has been able to rely on its mutual-aid system for backup .
The system , which sends local fire departments to battle wildfires in other jurisdictions , is experiencing heavy strain that could intensify as COVID-19-related budget shortfalls hit municipalities hard .
Among them is the Seaside Fire Department in Monterey County , where the firefighters ’ union recently agreed to a 10 % pay cut amid a @ @ @ @ @ @ @ retirements that were being considered have been avoided for now , said Jason Black , the president of the firefighters union .
But for how long is unclear .
“ I don ’ t have a crystal ball , ” Black said , “ it ’ s like everybody else , it depends on the rebound of the economy as the shelter in place gets lifted.
” In an effort to limit the transmission of illness among wildland firefighters , officials are adjusting the layout at fire base camps , where fire crews @ @ @ @ @ @ @ close quarters , along with many caterers and contractors .
Even before the COVID-19 pandemic , outbreaks of “ camp crud ” were notorious in such environments , and a union representative for the U.S. Forest Service has likened them to “ cruise ships on land.
” Cal Fire said its camps may end up taking up a larger footprint , such as two fairgrounds instead of one , or a large parking lot , to provide adequate spacing among crews .
Either way , firefighters battling flames on the front lines and @ @ @ @ @ @ @ infection because of their smoke exposure , said Dr. John Balmes , a volunteer physician with the American Lung Assn .
and a member of the California Air Resources Board .
“ Wildfire smoke is kind of like cigarette smoke — a mixture of carbon-based particles and irritant gases , ” Balmes said .
With the body ’ s immune system preoccupied battling these foreign invaders in the lungs , that gives it less ammunition to fight the coronavirus , Balmes explained .
In California , a soggy spring has so far kept @ @ @ @ @ @ @ In states where fires have already begun however , fire crews are learning that protections against the coronavirus — cleaning , distancing and wearing masks — can become burdens when trying to respond to wildfires .
Shawn Faiella , superintendent of the Lolo National Forest ’ s interagency hotshot crew in Montana , summed it up this way in a report to the federally funded Wildland Fire Lessons Learned Center : “ It is damn tough to take these practices to the fireline.
” On the long drive to an incident , firefighters @ @ @ @ @ @ @ about touching their face masks , and increased their risk of dehydration .
They also traveled in more vehicles than usual , to ensure proper distancing , and thereby increased their chances of a crash — one of the leading causes of death for firefighters .
“ If this had been an emerging incident with evacuations , tight road parking , smoke , and significant fire growth , not only would this be an impossible feat to park all the vehicles — we would be putting my crew in significant danger .
And @ @ @ @ @ @ @ Faiella wrote .
Finding places to eat in states with shelter-at-home orders proved difficult as well , as did maintaining social distance with colleagues on the fire line and the public who approached with questions .
Routine things to speed up a firefight like sharing equipment between agencies now violate COVID-19 guidelines .
“ If the intent is to fight fire , there needs to be an understanding that COVID-19 social distancing recommendations can not be fully adhered to when engaged in firefighting , ” read a report from the April 17 Verde @ @ @ @ @ @ @ needs to be answered : does a lack of completely adhering to COVID measures mean less engagement or not ?
” Frank Carroll , a retired 31-year veteran of the U.S. Forest Service , has a son who is a federal hotshot firefighter .
He and his fellow crew members were looking to older practices in firefighting in order to deal with coronavirus concerns .
For example , his son ’ s crew started loading extra vehicles with 14 days ’ worth of rations for each firefighter , in case they get infected @ @ @ @ @ @ @ into the forest and eat and sleep where they work , instead of returning to a large base camp with hundreds of others .
“ It ’ s really old school but you know what ?
Old school worked really well , ” Carroll said .

An El Dorado County firefighter moves away from flames during the Rim fire near Yosemite National Park in 2013. Because of the COVID-19 pandemic, firefighters say they will be more aggressive in keeping wildland fires small this year, but may have to do it with fewer resources.
As forecasters predict higher-than-normal chances of large fires in Northern California this year — as well as the usual risk of “large significant” burning in Southern California — fire authorities are growing increasingly concerned over their ability to muster a large, healthy force of firefighters in the face of COVID-19.
Realizing that wildfire smoke will steadily impair a firefighter’s immune system, and that traditional base camps can magnify the risk of infection, federal, state and county officials are urging a blitzkrieg approach to wildfires that will rely heavily on the use of aircraft.
With the coronavirus still circulating, they say they cannot allow even the smallest secluded fire to smolder for the sake of forest ecology. All fires, they say, must be extinguished as quickly as possible.
Advertisement
“Unfortunately, this is not a year in which we can afford to assign firefighters to monitor and manage such wildland fires,” Sen. Lisa Murkowski (R-Alaska) wrote to the departments of Interior and Agriculture recently as she urged aggressive firefighting in Northern California and other parts of the West. “Given the unprecedented conditions in this fire season, it is essential to utilize federal resources for immediate wildfire suppression to the greatest extent practicable.”
The call for highly aggressive firefighting marks a return to an older ethos, particularly on federal lands, where most California forests are.
For most of the last century, the federal government’s policy was to knock down every fire wherever it sprang up. In recent decades however, a different approach has evolved: Fires that don’t pose a threat to the public are allowed to expand naturally, and burn away overgrowth. That is unlikely to be the case this fire season however, as protections against the spread of the coronavirus place new strains on fire agencies and their crews.
In many ways, the coronavirus is sending wildland firefighters back to the old school this fire season.
“Aggressive initial attack is the single most important method to ensure the safety of firefighters and the public; it also limits suppression costs,” said Jessica Gardetto, a spokesperson for the Bureau of Land Management at the National Interagency Fire Center.
Even with the increased use of aircraft however, fire authorities still face a hard reality. Planes and helicopters are effective in slowing most fires, and allow crews on the ground to get on the scene and contain it, but history shows they do little to halt the wind-driven monsters that cause the most death and destruction.
Advertisement
The continued spread of the coronavirus, as well as the economic paralysis that has accompanied health restrictions, has impacted every aspect of wildland firefighting, including mutual aid arrangements and the widespread use of inmate firefighters.
“Speaking across the board, this is a game changer with COVID-19,” said Mike Mohler, spokesman for the California Department of Forestry and Fire Protection. “It’s going to have to be an ‘everybody’s hands on deck’ approach to this.”
Mohler said his biggest concern is firefighters contracting COVID-19 and silently spreading it among fellow firefighters and knocking them out of service, or even spreading it among the public.
Already, the coronavirus has reduced the number of overall firefighters available in California.
When coronavirus infections spiked in state prisons, authorities granted early release to thousands of minimum-security inmates in an effort to reduce crowding and slow the spread of disease. Of those releases, 242 were inmate firefighters, according to the California Department of Corrections and Rehabilitation. Inmate firefighters make up 43% of the state firefighting force.
In Los Angeles County, where voters recently rejected a measure to hire more firefighters and paramedics, Fire Chief Daryl Osby said potential staffing shortages and increased brush growth due to late-spring rains are cause for worry.
Aiming to take a more aggressive posture toward wildfires, crews are preparing five of the county’s water-dropping helicopters to deploy during the day and night throughout the summer. The county is also planning to contract with two air tankers from Canada in August — a month earlier than usual, Osby said.
And, later this month, crews will begin inspecting wildfire-vulnerable homes to ensure that they have fire defensible space.
“It’s going to be really important for our citizens to do the proper brush clearance,” Osby said, “because when we get toward the fall months and start having our wind-driven incidents, we cannot guarantee to place an engine at every home.”
Traditionally, California has been able to rely on its mutual-aid system for backup. The system, which sends local fire departments to battle wildfires in other jurisdictions, is experiencing heavy strain that could intensify as COVID-19-related budget shortfalls hit municipalities hard.
Among them is the Seaside Fire Department in Monterey County, where the firefighters’ union recently agreed to a 10% pay cut amid a citywide hiring freeze. Layoffs and early retirements that were being considered have been avoided for now, said Jason Black, the president of the firefighters union.
But for how long is unclear.
“I don’t have a crystal ball,” Black said, “it’s like everybody else, it depends on the rebound of the economy as the shelter in place gets lifted.”
In an effort to limit the transmission of illness among wildland firefighters, officials are adjusting the layout at fire base camps, where fire crews traditionally eat, sleep and bathe in close quarters, along with many caterers and contractors. Even before the COVID-19 pandemic, outbreaks of “camp crud” were notorious in such environments, and a union representative for the U.S. Forest Service has likened them to “cruise ships on land.”
Cal Fire said its camps may end up taking up a larger footprint, such as two fairgrounds instead of one, or a large parking lot, to provide adequate spacing among crews.
Either way, firefighters battling flames on the front lines and communities downwind will be more vulnerable to infection because of their smoke exposure, said Dr. John Balmes, a volunteer physician with the American Lung Assn. and a member of the California Air Resources Board.
“Wildfire smoke is kind of like cigarette smoke — a mixture of carbon-based particles and irritant gases,” Balmes said. With the body’s immune system preoccupied battling these foreign invaders in the lungs, that gives it less ammunition to fight the coronavirus, Balmes explained.
In California, a soggy spring has so far kept the 2020 fire season at bay. In states where fires have already begun however, fire crews are learning that protections against the coronavirus — cleaning, distancing and wearing masks — can become burdens when trying to respond to wildfires.
Shawn Faiella, superintendent of the Lolo National Forest’s interagency hotshot crew in Montana, summed it up this way in a report to the federally funded Wildland Fire Lessons Learned Center: “It is damn tough to take these practices to the fireline.”
On the long drive to an incident, firefighters avoided drinking water, out of concern about touching their face masks, and increased their risk of dehydration. They also traveled in more vehicles than usual, to ensure proper distancing, and thereby increased their chances of a crash — one of the leading causes of death for firefighters.
“If this had been an emerging incident with evacuations, tight road parking, smoke, and significant fire growth, not only would this be an impossible feat to park all the vehicles — we would be putting my crew in significant danger. And we just arrived on incident,” Faiella wrote.
Finding places to eat in states with shelter-at-home orders proved difficult as well, as did maintaining social distance with colleagues on the fire line and the public who approached with questions. Routine things to speed up a firefight like sharing equipment between agencies now violate COVID-19 guidelines.
“If the intent is to fight fire, there needs to be an understanding that COVID-19 social distancing recommendations cannot be fully adhered to when engaged in firefighting,” read a report from the April 17 Verde fire in Colorado. “The question needs to be answered: does a lack of completely adhering to COVID measures mean less engagement or not?”
Frank Carroll, a retired 31-year veteran of the U.S. Forest Service, has a son who is a federal hotshot firefighter. He and his fellow crew members were looking to older practices in firefighting in order to deal with coronavirus concerns.
For example, his son’s crew started loading extra vehicles with 14 days’ worth of rations for each firefighter, in case they get infected and have to quarantine, then march into the forest and eat and sleep where they work, instead of returning to a large base camp with hundreds of others.
“It’s really old school but you know what? Old school worked really well,” Carroll said.


latimes--2020-05-10--During the pandemic, Republicans see a rare political opportunity in California

There was no such thing as YouTube or Twitter .
President Clinton was on the brink of impeachment .
Donald Trump was a New York real estate developer , building his first golf course .
The year was 1998 , and it was the last time California Republicans managed to flip a congressional seat from blue to red .
After more than two decades of losing , that futility may soon come to an end .
A special election to fill a vacant House seat to the north of Los Angeles is highly competitive , both sides agree , pitting @ @ @ @ @ @ @ candidate Mike Garcia .
The closeness is due in good part to the COVID-19 pandemic .
The contest is one of two special congressional elections being held Tuesday amid the strictures arising from the novel coronavirus , which has reduced competition to a bunkered campaign of texting , remote voter outreach , virtual appearances and — in California — millions of dollars in online and television advertising .
The other open seat , in rural Wisconsin , is expected to easily remain in GOP hands .
The pandemic is , not surprisingly , @ @ @ @ @ @ @ scenes of doctors and nurses , closed businesses and grim headlines recounting the rising toll .
( One spot showing Smith addressing a roomful of supporters dutifully notes : “ All footage filmed prior to stay at home order.
” ) Elections like the one Tuesday are typically low-turnout affairs , and that often benefits Republicans , as older , more conservative voters can be counted on to cast their ballots more reliably than younger , more moderate ones .
The fact that most of the election will be conducted by mail , @ @ @ @ @ @ @ , may also help Garcia .
A ballot was mailed to each of the 25th District ’ s roughly 425,000 voters , with return postage paid .
As of Saturday , 39 % of GOP voters had mailed in their ballots compared with 25 % of Democrats , according to Political Data Inc. , an election analysis firm .
The contest is being held to fill the seat vacated last fall by Democratic freshman Katie Hill , who resigned after nude photos of her were leaked and she faced a House Ethics Committee @ @ @ @ @ @ @ with a congressional aide .
Hill recently surfaced — to the chagrin of some Democrats — in a video ad criticizing Trump ’ s handling of the pandemic and urging voters to take part in the special election .
Privately , party strategists said they would have preferred the ex-congresswoman remain out of sight .
Garcia , 44 , a defense industry executive and former Navy fighter pilot , has made Hill ’ s conduct a part of his campaign .
“ The last year and a half has been an embarrassment for @ @ @ @ @ @ @ a recent opinion piece in the Santa Clarita Valley Signal , “ and it ’ s time we restore integrity to our representation in our nation ’ s capitol.
” Garcia has also vigorously campaigned against Democrats in Sacramento — even more than he has taken on Washington — saying the party ’ s dominance has turned California into a hellscape of homelessness , over-regulation and high taxes .
“ I don ’ t want my nation to become what this state has become , ” Garcia said in a Zoom debate sponsored @ @ @ @ @ @ @ Commerce .
He declined to be interviewed for this story .
The 25th Congressional District sprawls through suburbs and high desert from Simi Valley , Porter Ranch , Santa Clarita and Palmdale to a portion of Lancaster .
It remained safely in Republican hands for decades until Hill won the seat in 2018 as part of a blue wave that netted 40 seats nationwide and put Democrats in control of the House .
Smith , 50 , a former U.S. Department of Education analyst and veteran of the Newhall school board , was @ @ @ @ @ @ @ a district that overlaps about 60 % of the congressional turf .
Her campaign has focused heavily on tying Garcia to Trump , whom he ardently supports .
One Democratic ad interspersed the president ’ s statements downplaying the coronavirus with news accounts of its spread and footage of Garcia extolling Trump ’ s performance as president .
Another said Garcia would fail to protect people with preexisting conditions — a reference to a statement he made last summer favoring repeal of the Affordable Care Act — “ and hike up costs for @ @ @ @ @ @ @ strategy Democrats used to great effect in 2018 , when the midterm election served as a referendum on Trump and GOP efforts to kill the program they deride as Obamacare .
The Zoom debate — each candidate appearing from home , onscreen in their own little box — was the one ( sort of ) face-to-face encounter of the campaign .
Though the pandemic was an inevitable part of the hourlong discussion , it wasn ’ t the sole topic , as the candidates discussed traffic issues , housing costs and ways to @ @ @ @ @ @ @ name was never mentioned , though Garcia echoed a favorite presidential talking point when he praised the 2017 tax cut as “ the catalyst and the fuel that started this booming economy that is now the best economy , before the coronavirus , that this world has ever seen.
” Both candidates pledged to head to Washington as bipartisan problem-solvers ; Smith noted she used to be a Republican at a time , she gibed , when the party ’ s lawmakers believed in balancing budgets .
( “ I ’ m one @ @ @ @ @ @ @ the party was leaving them and I just didn ’ t have a place there anymore , ” Smith said in an interview , citing the GOP ’ s rightward shift on abortion , pay equity and environmental issues . )
The debate spawned one bit of controversy .
Soon after , Smith apologized for seeming to make light of Garcia ’ s military service during a video chat with supporters .
“ OK , he ’ s got pictures of planes behind him , ” she said of their respective Zoom backdrops @ @ @ @ @ @ @ law books.
” Trump pounced .
“ Now she ’ s mocking our Great Vets !
” he tweeted .
“ We need Navy Fighter Pilot Mike Garcia in # CA25 !
” Smith quickly fired back .
“ Mr .
President on behalf of Americans let me suggest some better uses of your time , ” she wrote .
“ Plan & support a national testing program .
Withdraw your court case to destroy [ the Affordable Care Act ] .
Support [ the World Health Organization ] so that when world @ @ @ @ @ @ @ t sidelined .
Be a leader .
# TrumpDepression.
” It may take several days for the results in the 25th District to be known , especially if the race is close .
Ballots postmarked no later than Tuesday will be counted so long as they arrive at the election offices in Los Angeles and Ventura counties by the end of business Friday .
A Garcia victory would give beleaguered California Republicans a rare cause for cheer and deliver something Trump could crow about , though the GOP still faces steep odds taking @ @ @ @ @ @ @ .
Whatever the outcome , the two candidates will face each other again Nov. 3 , when they will bid for a full two-year term beginning in January .
Democrats believe Smith will have the advantage in that contest , with a much larger turnout expected as voters cast their ballots in the presidential race .
In 2016 , Hillary Clinton carried the district by nearly 7 percentage points .
Two years later , Hill did even better , winning by more than 8 points .

Republican Mike Garcia and Democrat Christy Smith are locked in a congressional race that both sides rate a toss-up.
There was no such thing as YouTube or Twitter. President Clinton was on the brink of impeachment. Donald Trump was a New York real estate developer, building his first golf course.
The year was 1998, and it was the last time California Republicans managed to flip a congressional seat from blue to red.
After more than two decades of losing, that futility may soon come to an end.
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A special election to fill a vacant House seat to the north of Los Angeles is highly competitive, both sides agree, pitting Democratic Assemblywoman Christy Smith against first-time Republican candidate Mike Garcia.
The closeness is due in good part to the COVID-19 pandemic.
The contest is one of two special congressional elections being held Tuesday amid the strictures arising from the novel coronavirus, which has reduced competition to a bunkered campaign of texting, remote voter outreach, virtual appearances and — in California — millions of dollars in online and television advertising. The other open seat, in rural Wisconsin, is expected to easily remain in GOP hands.
The pandemic is, not surprisingly, inescapable. Campaign ads are replete with scenes of doctors and nurses, closed businesses and grim headlines recounting the rising toll. (One spot showing Smith addressing a roomful of supporters dutifully notes: “All footage filmed prior to stay at home order.”)
Elections like the one Tuesday are typically low-turnout affairs, and that often benefits Republicans, as older, more conservative voters can be counted on to cast their ballots more reliably than younger, more moderate ones.
The fact that most of the election will be conducted by mail, with get-out-the-vote efforts limited by social distancing, may also help Garcia. A ballot was mailed to each of the 25th District’s roughly 425,000 voters, with return postage paid. As of Saturday, 39% of GOP voters had mailed in their ballots compared with 25% of Democrats, according to Political Data Inc., an election analysis firm.
(On Saturday, President Trump accused Democrats of trying to steal the congressional seat after Los Angeles County’s elections supervisor added an in-person voting center in Lancaster, which has substantial black and Latino populations. The move followed requests from, among others, the city’s Republican mayor.)
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The contest is being held to fill the seat vacated last fall by Democratic freshman Katie Hill, who resigned after nude photos of her were leaked and she faced a House Ethics Committee probe into allegations of an improper affair with a congressional aide.
Hill recently surfaced — to the chagrin of some Democrats — in a video ad criticizing Trump’s handling of the pandemic and urging voters to take part in the special election. Privately, party strategists said they would have preferred the ex-congresswoman remain out of sight.
Garcia, 44, a defense industry executive and former Navy fighter pilot, has made Hill’s conduct a part of his campaign.
“The last year and a half has been an embarrassment for our district,” he wrote in a recent opinion piece in the Santa Clarita Valley Signal, “and it’s time we restore integrity to our representation in our nation’s capitol.”
Garcia has also vigorously campaigned against Democrats in Sacramento — even more than he has taken on Washington — saying the party’s dominance has turned California into a hellscape of homelessness, over-regulation and high taxes.
“I don’t want my nation to become what this state has become,” Garcia said in a Zoom debate sponsored by the Santa Clarita Valley Chamber of Commerce.
He declined to be interviewed for this story.
The 25th Congressional District sprawls through suburbs and high desert from Simi Valley, Porter Ranch, Santa Clarita and Palmdale to a portion of Lancaster. It remained safely in Republican hands for decades until Hill won the seat in 2018 as part of a blue wave that netted 40 seats nationwide and put Democrats in control of the House.
Smith, 50, a former U.S. Department of Education analyst and veteran of the Newhall school board, was elected to the Assembly in 2018 in a district that overlaps about 60% of the congressional turf. Her campaign has focused heavily on tying Garcia to Trump, whom he ardently supports.
One Democratic ad interspersed the president’s statements downplaying the coronavirus with news accounts of its spread and footage of Garcia extolling Trump’s performance as president. Another said Garcia would fail to protect people with preexisting conditions — a reference to a statement he made last summer favoring repeal of the Affordable Care Act — “and hike up costs for lifesaving drugs.”
The attack echoed the strategy Democrats used to great effect in 2018, when the midterm election served as a referendum on Trump and GOP efforts to kill the program they deride as Obamacare.
The Zoom debate — each candidate appearing from home, onscreen in their own little box — was the one (sort of) face-to-face encounter of the campaign.
Though the pandemic was an inevitable part of the hourlong discussion, it wasn’t the sole topic, as the candidates discussed traffic issues, housing costs and ways to help local business. Trump’s name was never mentioned, though Garcia echoed a favorite presidential talking point when he praised the 2017 tax cut as “the catalyst and the fuel that started this booming economy that is now the best economy, before the coronavirus, that this world has ever seen.”
Both candidates pledged to head to Washington as bipartisan problem-solvers; Smith noted she used to be a Republican at a time, she gibed, when the party’s lawmakers believed in balancing budgets. (“I’m one of those people who felt decades ago the party was leaving them and I just didn’t have a place there anymore,” Smith said in an interview, citing the GOP’s rightward shift on abortion, pay equity and environmental issues.)
The debate spawned one bit of controversy. Soon after, Smith apologized for seeming to make light of Garcia’s military service during a video chat with supporters. “OK, he’s got pictures of planes behind him,” she said of their respective Zoom backdrops. “I’ve got constitutional law books.”
Trump pounced. “Now she’s mocking our Great Vets!” he tweeted. “We need Navy Fighter Pilot Mike Garcia in #CA25!”
Smith quickly fired back. “Mr. President on behalf of Americans let me suggest some better uses of your time,” she wrote. “Plan & support a national testing program. Withdraw your court case to destroy [the Affordable Care Act]. Support [the World Health Organization] so that when world scientists find a cure we aren’t sidelined. Be a leader. #TrumpDepression.”
It may take several days for the results in the 25th District to be known, especially if the race is close. Ballots postmarked no later than Tuesday will be counted so long as they arrive at the election offices in Los Angeles and Ventura counties by the end of business Friday.
A Garcia victory would give beleaguered California Republicans a rare cause for cheer and deliver something Trump could crow about, though the GOP still faces steep odds taking back control of the House this fall.
Whatever the outcome, the two candidates will face each other again Nov. 3, when they will bid for a full two-year term beginning in January.
Democrats believe Smith will have the advantage in that contest, with a much larger turnout expected as voters cast their ballots in the presidential race. In 2016, Hillary Clinton carried the district by nearly 7 percentage points. Two years later, Hill did even better, winning by more than 8 points.