latimes--2020-07-28--Church services move to California beaches, sparking fears of coronavirus outbreaks

With the coronavirus continuing to surge in California , officials imposed limits on indoor church services in many areas .
But now , there are concerns about several large church services being held on beaches .
It started with a series of large gatherings in Huntington Beach .
Then this weekend , there was another one at Cardiff State Beach in San Diego County .
For the most part , religious institutions have followed the COVID-19 restrictions .
But a few have filed lawsuits , arguing the restrictions violate their constitutional rights .
The latest lawsuit was filed earlier this @ @ @ @ @ @ @ California claiming that a ban on singing in places of worship violates their 1st Amendment rights .
Here is what we know about the beach services : A large beach gathering Sunday with most in attendance worshiping shoulder-to-shoulder without masks drew concern from a top public health official Monday .
Asked for her reaction to the gathering , estimated to have drawn more than 1,000 participants to Cardiff State Beach in the late afternoon and early evening , Dr. Wilma Wooten , San Diego County ’ s public health officer , said she @ @ @ @ @ @ @ .
“ In the photos that I saw , it really was a massive group of people gathering together without social distancing and without wearing facial coverings , so we will continue to address these egregious violations as we have others that have come to our attention , ” Wooten said .
She did not , however , say more about what actions the county might take .
The event was organized by worship leader Sean Feucht , who recently received coverage in faith-focused media for an ongoing tour of “ outdoor gospel @ @ @ @ @ @ @ Redding , Pasadena , Bakersfield and Fresno .
Feucht did not respond to a request for an interview made through his website Monday evening .
Sgt .
Jake Pflepsen , a state park peace officer supervisor and lifeguard assigned to Cardiff , said Monday evening that while no permit was issued for the gathering , no tickets were issued .
Saying only that state parks ’ main enforcement goal is “ public safety , ” he deferred further questions about the state ’ s citation policies to headquarters in Sacramento , which was @ @ @ @ @ @ @ Beach officials have expressed concern about Saturate OC , a religious workshop being held on the sand .
Its organizers estimate that as many as 1,800 people attended for nearly two hours of musical performances , baptisms and prayers .
The city of Huntington Beach said in a statement that it “ firmly supports the right of any religious group to worship , ” but that they must follow permitting and safety protocols .
“ Unfortunately , the Saturate OC event promoters have not instituted safety protocols prescribed by the state and county @ @ @ @ @ @ @ a permit for their event , ” the city said .
The event ’ s directors told The Times on Saturday they thought they were being singled out because of their religion .
“ I think it ’ s more of a political statement than anything at this point , for people to actually shut down a worship service when there ’ s mass protests with hundreds of thousands of people in L.A. and then we ’ re getting highlighted in the news for spreading the virus , ” said Parker Green , @ @ @ @ @ @ @ with his wife Jessi , 35 .
On Friday , the Greens provided participants with hand sanitizer and gave out hundreds of masks , they said , but they estimated at least 60 % of people chose not to wear them .
“ Suicide rates have shot up since COVID , and we have people crying on the beach because they ’ re getting set free from suicidal thoughts , and they ’ re saying this is the thing that they ’ ve needed , ” Jessi Green said .
“ And I @ @ @ @ @ @ @ s so many people coming to the beach .
”

With the coronavirus continuing to surge in California, officials imposed limits on indoor church services in many areas.
But now, there are concerns about several large church services being held on beaches. It started with a series of large gatherings in Huntington Beach. Then this weekend, there was another one at Cardiff State Beach in San Diego County.
For the most part, religious institutions have followed the COVID-19 restrictions. But a few have filed lawsuits, arguing the restrictions violate their constitutional rights. The latest lawsuit was filed earlier this month, with three churches in Northern California claiming that a ban on singing in places of worship violates their 1st Amendment rights.
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Here is what we know about the beach services:
Cardiff
A large beach gathering Sunday with most in attendance worshiping shoulder-to-shoulder without masks drew concern from a top public health official Monday.
Asked for her reaction to the gathering, estimated to have drawn more than 1,000 participants to Cardiff State Beach in the late afternoon and early evening, Dr. Wilma Wooten, San Diego County’s public health officer, said she had seen images of the peaceful event.
“In the photos that I saw, it really was a massive group of people gathering together without social distancing and without wearing facial coverings, so we will continue to address these egregious violations as we have others that have come to our attention,” Wooten said.
She did not, however, say more about what actions the county might take.
The event was organized by worship leader Sean Feucht, who recently received coverage in faith-focused media for an ongoing tour of “outdoor gospel” events in California cities, including Redding, Pasadena, Bakersfield and Fresno. Feucht did not respond to a request for an interview made through his website Monday evening.
Sgt. Jake Pflepsen, a state park peace officer supervisor and lifeguard assigned to Cardiff, said Monday evening that while no permit was issued for the gathering, no tickets were issued. Saying only that state parks’ main enforcement goal is “public safety,” he deferred further questions about the state’s citation policies to headquarters in Sacramento, which was unavailable to comment Monday evening.
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Huntington Beach
Huntington Beach officials have expressed concern about Saturate OC, a religious workshop being held on the sand. Its organizers estimate that as many as 1,800 people attended for nearly two hours of musical performances, baptisms and prayers.
The city of Huntington Beach said in a statement that it “firmly supports the right of any religious group to worship,” but that they must follow permitting and safety protocols. “Unfortunately, the Saturate OC event promoters have not instituted safety protocols prescribed by the state and county, and they have refused to obtain a permit for their event,” the city said.
The event’s directors told The Times on Saturday they thought they were being singled out because of their religion.
“I think it’s more of a political statement than anything at this point, for people to actually shut down a worship service when there’s mass protests with hundreds of thousands of people in L.A. and then we’re getting highlighted in the news for spreading the virus,” said Parker Green, 34, who organized the recurring event with his wife Jessi, 35.
On Friday, the Greens provided participants with hand sanitizer and gave out hundreds of masks, they said, but they estimated at least 60% of people chose not to wear them.
“Suicide rates have shot up since COVID, and we have people crying on the beach because they’re getting set free from suicidal thoughts, and they’re saying this is the thing that they’ve needed,” Jessi Green said. “And I think that’s why there’s so many people coming to the beach.”
Sisson writes for the San Diego Union-Tribune.


latimes--2020-07-28--In L.A. race, is this incumbent a 'progressive fighter' or a knockoff?

When L.A. City Council candidate Nithya Raman pledged not to accept any political donations from police unions , she tweeted a photo of herself , head bowed , signing the document .
Hours later , Councilman David Ryu tweeted that he too was signing the “ No Cop Money ” pledge and shared a similar photo , triggering accusations that he was copying his progressive challenger .
The Ryu campaign called those claims a “ misrepresentation , ” pointing out that the pledge gave clear instructions on how to take a photo and tweet it .
The councilman and his @ @ @ @ @ @ @ progressive .
“ The political climate has shifted — I haven ’ t , ” Ryu said , calling himself a “ progressive fighter.
” But as Ryu fights to keep his seat against Raman , he is clearly running a different campaign than five years ago or even five months ago , when L.A. 's police union shelled out nearly $ 45,000 in independent spending to support him .
The race reflects the changing dynamics of L.A. elections : Local contests now come at the same time as national races that tend @ @ @ @ @ @ @ the polls .
On top of that , the eruption of protests against police brutality has spurred a national reckoning over racism and police power .
The result is that a council district that stretches from Sherman Oaks to the Miracle Mile and includes wealthy , majority-white neighborhoods like Hancock Park and the Hollywood Hills is now seeing a progressive showdown over issues such as protecting tenants and reimagining policing .
Activist groups such as Ground Game LA hope to harness those currents to elect Raman , an urban planner who headed the @ @ @ @ @ @ @ sexual misconduct and led a Silver Lake homeless outreach group .
Raman has advocated for a network of community access centers to assist unhoused people and opposed laws that “ criminalize ” homelessness , including broad restrictions on where people can sleep in their cars .
“ We live in a city where almost every politician calls themselves a progressive , ” yet “ you often see a disconnect ” with the policies emerging from City Hall , Raman said .
In March , she forced Ryu into a November runoff by winning @ @ @ @ @ @ @ nearly 45 % — a feat that was even more remarkable because Ryu outspent her by more than 3 to 1 .
When Ryu first won the council seat , the race was dominated by concerns about out-of-scale development .
His victory stunned many because Ryu was a City Hall outsider — a former aide to a county supervisor who worked for a South L.A. psychiatric hospital and community health center — pitted against a former council staffer backed by city leaders .
His public push against campaign donations from real estate developers @ @ @ @ @ @ @ .
No one bit on his initial bid to bar donations from corporations and other groups , and the idea of limiting developer money gained little traction until after the FBI descended on City Hall .
As homelessness surged to the forefront , Ryu touted new housing and shelters he had approved for homeless residents , but Raman argued the city could be doing much more .
Critics also pointed out that Ryu voted to reinstate restrictions on sleeping in cars and had initially forwarded a plan to limit sidewalk sleeping , which @ @ @ @ @ @ @ city commissioner William Funderburk , who supports Ryu , argued that the councilman is uniquely qualified to tackle issues of homelessness and disadvantage because of his earlier work in social services and mental health , saying that he “ has always been the person who takes on the powerful and the privileged.
” “ The close race has given him an opportunity to define who he really is — the person who fights for the underdog , ” Funderburk said .
Since the March election , Ryu has gotten a new campaign manager @ @ @ @ @ @ @ campaign website , which is now full of photos of Ryu at protests and frames him as an activist fighting for systemic change .
This spring , amid the COVID-19 pandemic , Ryu backed a blanket ban on evictions that failed to win council approval .
He succeeded in pushing through new restrictions on ejecting belongings from storage units and a rent freeze in units covered by the Rent Stabilization Ordinance , which limits annual hikes .
Not everyone is impressed .
“ He ’ s chasing whatever he thinks is politically expedient @ @ @ @ @ @ @ political consultant who previously worked with Sarah Kate Levy , another candidate who challenged Ryu in the primary .
Cendejas questioned whether it would win him support .
Ryu has lost at least one group since the primary : A political action committee tied to the Los Angeles Area Chamber of Commerce yanked its earlier endorsement of Ryu , saying his actions at City Hall had “ led to an unfair burden on Los Angeles businesses.
” Some Raman supporters accuse Ryu of running a knockoff campaign .
Ryu came out in support @ @ @ @ @ @ @ Angelenos ; Raman had included that idea in her platform , arguing it would reduce the concentration of power .
Raman championed a rent freeze ahead of the March election ; Ryu introduced it during the pandemic .
During a videoconference meeting for campaign volunteers , Raman argued that “ it shouldn ’ t take a global pandemic to put real eviction protections in place , to put a rent freeze into place in a city that has had tens of thousands of evictions annually.
” She wants the city to go further @ @ @ @ @ @ @ policy with tax credits for big landlords amid the crisis .
Ryu is “ trying to get on board with a lot of this and I respect that , ” said Suju Vijayan , a Sherman Oaks resident volunteering on the Raman campaign .
But Raman “ is not following but leading in those areas.
” Others reject the idea that Ryu has changed his focus to compete with Raman .
Tenant advocate and city commissioner Larry Gross said “ the guy has been there for tenants before and throughout , ” pointing @ @ @ @ @ @ @ Hollywood apartment building into a hotel and recent letters telling landlords to “ back off ” on improper demands .
Los Feliz resident J.P. Lavin said Ryu helped him and other tenants when a landlord was trying to eject them from their building .
“ He could have easily taken the side of business ... .
To me , that ’ s as progressive as you can get , ” Lavin said .
Gross said Ryu may not have proposed a rent freeze before the pandemic , but “ I don ’ t @ @ @ @ @ @ @ there for that ” at the time .
Ryu also said he had long been interested in expanding the council and “ tried to talk about this issue five years ago , but no one would even hear it.
” When Ryu pledged not to take political donations from police unions , critics pointed out he had already benefited from nearly $ 45,000 in independent spending by the Los Angeles Police Protective League during the primary .
Raman supporter Mitra Jouhari said “ it ’ s not impressive to me if you ’ @ @ @ @ @ @ @ you ’ ve already done.
” Such independent spending can not legally be controlled by candidates .
The councilman argued that the money spent by the police union had not influenced him , pointing out that he voted to reduce the LAPD budget and sought a review of police tactics against protesters .
His campaign said he had stated his opposition to boosting the LAPD budget in April .
But while Ryu had expressed concerns about cuts to city services , his representatives were unable to provide specific examples of Ryu saying in @ @ @ @ @ @ @ budget .
Critics pointed out that in February , Ryu tweeted that he was “ fighting for more officers for our local LAPD divisions.
” “ This is a guy who really until last month had never spoken a word about police violence or racial injustice in the city of L.A. ... suddenly posting pictures of himself marching with Black activists , ” said Hayes Davenport , who worked with Raman at her homeless outreach group and volunteers on her campaign .
Ryu countered that he has worked on issues of racial justice @ @ @ @ @ @ @ into a career in nonprofits and public service .
Former county Supervisor Yvonne Brathwaite Burke said that as her aide , he was deeply involved in matters that disproportionately affected the Black community .
The councilman , in turn , questioned whether Raman had spoken much about police brutality ahead of the primary .
Raman countered that she had repeatedly talked about police shootings — including the shooting of a homeless man , which she said underscored the need to fund other services besides police .
Times staff writers Ben Welsh and Sandhya @ @ @ @ @ @

Los Angeles City Council candidates David Ryu and Nithya Raman are running to represent a district that stretches from Sherman Oaks to the Miracle Mile.
When L.A. City Council candidate Nithya Raman pledged not to accept any political donations from police unions, she tweeted a photo of herself, head bowed, signing the document.
Hours later, Councilman David Ryu tweeted that he too was signing the “No Cop Money” pledge and shared a similar photo, triggering accusations that he was copying his progressive challenger.
The Ryu campaign called those claims a “misrepresentation,” pointing out that the pledge gave clear instructions on how to take a photo and tweet it. The councilman and his supporters argue Ryu has always been a progressive.
“The political climate has shifted — I haven’t,” Ryu said, calling himself a “progressive fighter.”
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But as Ryu fights to keep his seat against Raman, he is clearly running a different campaign than five years ago or even five months ago, when L.A.’s police union shelled out nearly $45,000 in independent spending to support him.
The race reflects the changing dynamics of L.A. elections: Local contests now come at the same time as national races that tend to draw a more left-leaning crowd to the polls. On top of that, the eruption of protests against police brutality has spurred a national reckoning over racism and police power.
The result is that a council district that stretches from Sherman Oaks to the Miracle Mile and includes wealthy, majority-white neighborhoods like Hancock Park and the Hollywood Hills is now seeing a progressive showdown over issues such as protecting tenants and reimagining policing.
Activist groups such as Ground Game LA hope to harness those currents to elect Raman, an urban planner who headed the Time’s Up Entertainment campaign against sexual misconduct and led a Silver Lake homeless outreach group. Raman has advocated for a network of community access centers to assist unhoused people and opposed laws that “criminalize” homelessness, including broad restrictions on where people can sleep in their cars.
“We live in a city where almost every politician calls themselves a progressive,” yet “you often see a disconnect” with the policies emerging from City Hall, Raman said. In March, she forced Ryu into a November runoff by winning 41% of the vote to his nearly 45% — a feat that was even more remarkable because Ryu outspent her by more than 3 to 1.
When Ryu first won the council seat, the race was dominated by concerns about out-of-scale development.
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His victory stunned many because Ryu was a City Hall outsider — a former aide to a county supervisor who worked for a South L.A. psychiatric hospital and community health center — pitted against a former council staffer backed by city leaders.
His public push against campaign donations from real estate developers also set him apart on the council. No one bit on his initial bid to bar donations from corporations and other groups, and the idea of limiting developer money gained little traction until after the FBI descended on City Hall.
As homelessness surged to the forefront, Ryu touted new housing and shelters he had approved for homeless residents, but Raman argued the city could be doing much more. Critics also pointed out that Ryu voted to reinstate restrictions on sleeping in cars and had initially forwarded a plan to limit sidewalk sleeping, which he later opposed.
Attorney and former city commissioner William Funderburk, who supports Ryu, argued that the councilman is uniquely qualified to tackle issues of homelessness and disadvantage because of his earlier work in social services and mental health, saying that he “has always been the person who takes on the powerful and the privileged.”
“The close race has given him an opportunity to define who he really is — the person who fights for the underdog,” Funderburk said.
Since the March election, Ryu has gotten a new campaign manager, replaced his consultant and overhauled his campaign website, which is now full of photos of Ryu at protests and frames him as an activist fighting for systemic change.
This spring, amid the COVID-19 pandemic, Ryu backed a blanket ban on evictions that failed to win council approval. He succeeded in pushing through new restrictions on ejecting belongings from storage units and a rent freeze in units covered by the Rent Stabilization Ordinance, which limits annual hikes.
Not everyone is impressed.
“He’s chasing whatever he thinks is politically expedient,” said Danielle Cendejas, a political consultant who previously worked with Sarah Kate Levy, another candidate who challenged Ryu in the primary.
Cendejas questioned whether it would win him support. Ryu has lost at least one group since the primary: A political action committee tied to the Los Angeles Area Chamber of Commerce yanked its earlier endorsement of Ryu, saying his actions at City Hall had “led to an unfair burden on Los Angeles businesses.”
Some Raman supporters accuse Ryu of running a knockoff campaign. Ryu came out in support of expanding the council to better represent Angelenos; Raman had included that idea in her platform, arguing it would reduce the concentration of power. Raman championed a rent freeze ahead of the March election; Ryu introduced it during the pandemic.
During a videoconference meeting for campaign volunteers, Raman argued that “it shouldn’t take a global pandemic to put real eviction protections in place, to put a rent freeze into place in a city that has had tens of thousands of evictions annually.”
She wants the city to go further and pursue a “rent forgiveness” policy with tax credits for big landlords amid the crisis.
Ryu is “trying to get on board with a lot of this and I respect that,” said Suju Vijayan, a Sherman Oaks resident volunteering on the Raman campaign. But Raman “is not following but leading in those areas.”
Others reject the idea that Ryu has changed his focus to compete with Raman. Tenant advocate and city commissioner Larry Gross said “the guy has been there for tenants before and throughout,” pointing to his steady opposition to turning a Hollywood apartment building into a hotel and recent letters telling landlords to “back off” on improper demands.
Los Feliz resident J.P. Lavin said Ryu helped him and other tenants when a landlord was trying to eject them from their building. “He could have easily taken the side of business.... To me, that’s as progressive as you can get,” Lavin said.
Gross said Ryu may not have proposed a rent freeze before the pandemic, but “I don’t think there would have been the votes there for that” at the time. Ryu also said he had long been interested in expanding the council and “tried to talk about this issue five years ago, but no one would even hear it.”
When Ryu pledged not to take political donations from police unions, critics pointed out he had already benefited from nearly $45,000 in independent spending by the Los Angeles Police Protective League during the primary. Raman supporter Mitra Jouhari said “it’s not impressive to me if you’re promising to not do something that you’ve already done.”
Such independent spending cannot legally be controlled by candidates. The councilman argued that the money spent by the police union had not influenced him, pointing out that he voted to reduce the LAPD budget and sought a review of police tactics against protesters. His campaign said he had stated his opposition to boosting the LAPD budget in April.
But while Ryu had expressed concerns about cuts to city services, his representatives were unable to provide specific examples of Ryu saying in April that he opposed increasing the police budget.
Critics pointed out that in February, Ryu tweeted that he was “fighting for more officers for our local LAPD divisions.”
“This is a guy who really until last month had never spoken a word about police violence or racial injustice in the city of L.A. ... suddenly posting pictures of himself marching with Black activists,” said Hayes Davenport, who worked with Raman at her homeless outreach group and volunteers on her campaign.
Ryu countered that he has worked on issues of racial justice since the unrest of 1992 propelled him into a career in nonprofits and public service. Former county Supervisor Yvonne Brathwaite Burke said that as her aide, he was deeply involved in matters that disproportionately affected the Black community.
The councilman, in turn, questioned whether Raman had spoken much about police brutality ahead of the primary. Raman countered that she had repeatedly talked about police shootings — including the shooting of a homeless man, which she said underscored the need to fund other services besides police.
Times staff writers Ben Welsh and Sandhya Kambhampati contributed to this report.


latimes--2020-07-28--'Underserved and underfunded': Inside California's county hit hardest by COVID-19

In all of their 47 years of marriage , Pedro and Patricia Luera had never been apart .
Even now , in sickness , they were together .
The couple had tested positive for COVID-19 .
They were feverish , weak and struggling to breathe .
On July 2 , a day after his wife had been admitted , 68-year-old Pedro Luera walked into the emergency room of El Centro Regional Medical Center , one of two hospitals serving Imperial County , a rural and impoverished region of about 180,000 people .
A surge in COVID-19 cases had put a @ @ @ @ @ @ @ running out of ventilators and intensive care unit beds almost every day , forcing it to send patients to other hospitals .
Soon , the Lueras would be at Paradise Valley Hospital in San Diego County , hooked up to breathing machines .
Before his father was sedated and intubated , Luera ’ s son , Pedro Jr. , exhorted his father to hang tough .
“ You ’ re strong .
There ’ s still a lot of things you need to do , ” he told him .
“ You ’ @ @ @ @ @ @ @ .
Be strong.
” His father croaked out : “ I ’ m going to fight.
” The pandemic has brought an unprecedented level of hardship for residents in a county where the coronavirus hardly feels like an abstraction .
The high infection rates can make it feel like nearly everyone knows or knows of somebody who has contracted COVID-19 or died from it .
As most of California begins a second shutdown over the pandemic , no place has been hit as hard as Imperial County .
In the last two weeks @ @ @ @ @ @ @ per 100,000 people , compared with Los Angeles County ’ s 400.3 .
Its mortality rate is the highest in the state , averaging 25.5 deaths per 100,000 people — four times greater than L.A. County ’ s .
Imperial County was already at a disadvantage when the pandemic hit .
For years , the county led the state with the , high-risk factors that make people susceptible to catching COVID-19 and become severely ill or die .
“ When you have a population with those preexisting conditions and you throw COVID-19 on @ @ @ @ @ @ @ problem , ” said Thomas Henderson , executive director of the Imperial County Medical Society .
Health experts say other factors contributed to the spread of the disease .
The county lacked contact tracers .
COVID-19 stigma led some residents not to alert others of their infection .
Gatherings were also problematic as were residents traveling to and from neighboring counties , including those in Arizona .
The county ’ s two hospitals — El Centro Regional Medical Center and Pioneers Memorial Healthcare District — became so overwhelmed by the surge of cases @ @ @ @ @ @ @ than 500 patients to other California hospitals .
Two weeks ago , when El Centro Regional Medical Center ran out of ICU beds , Chief Executive Adolphe Edward said : “ It ’ s horrible .
I feel helpless.
” The pandemic also hit a region that was still struggling to recover from the .
Even with a pandemic affecting many counties , its unemployment rate remains the highest in the state , according to the Employment Development Department .
Early in July , on a hot morning in Calexico , Manuel Espinoso @ @ @ @ @ @ @ a doughnut shop .
The irrigation installer , who lives in Mexicali , Mexico , had gone a week without work .
Agricultural jobs were drying up in the area because of the pandemic , he said .
In a good week , he could earn about $ 300 to help take care of his family .
But lately , he hasn ’ t found any work , even as some job seekers in Mexico refuse to cross the border because they are afraid of becoming infected .
Espinoso has every reason to @ @ @ @ @ @ @ 42-year-old daughter , the oldest of three , and her husband fell ill with COVID-19 .
She died .
“ There wasn ’ t much I could do , ” Espinoso said .
“ I worry more now about my other two daughters , and my wife .
...
I don ’ t want to infect her.
” Even if he finds a much-needed job , he said the risks are high .
Workers are often crammed together into vehicles as they go from one field to another .
The situation isn ’ @ @ @ @ @ @ @ said .
“ There ’ s a lot of infections over there , ” Espinoso said .
But he said he has no choice : He has to work .
“ You got to work until you can ’ t .
You have to keep working , ” Espinoso said .
“ What can you do when you ’ re doing it out of necessity ?
” Nearby , Rudy Kim , 60 , had just opened his discount store , Mi Manera .
He used a leaf blower to clean the sidewalk @ @ @ @ @ @ @ play Spanish music for his mostly Latino clientele .
A sign near the front read “ No Mask , No Service.
” Kim said he has lost a lot of business because of the pandemic .
With a new shutdown bearing down , he feared he might need to shut his store for good .
“ It ’ s a ghost town , ” he said .
“ Some days I ’ m only open for four hours.
” Kim had to lay off about 12 employees .
He lost about $ 5,000 @ @ @ @ @ @ @ open and sell Easter merchandise , which now sits in storage .
But bad business or not , he still has to pay about $ 8,000 a month in rent .
“ I ’ m very frustrated , ” he said .
“ I can not afford this anymore.
” Nearby , more than 100 people were standing in line , waiting to pull out money from the ATM because there were few banks around .
Many had filed for unemployment and were withdrawing money for rent .
A block away at Selecto @ @ @ @ @ @ @ host of services , including unemployment and tax preparation .
Fernando Fausto , 59 , a Mexicali resident with a green card who worked in the U.S. , said he was there to file for unemployment but needed to prove he had paid taxes .
He said the company he worked for shut down in March .
The field worker had been unable to find work .
“ I need to pay bills and rent , ” he said .
Bordered by Arizona to the east , Riverside County to the north , @ @ @ @ @ @ @ to the south , Imperial County is besieged by agricultural burning , toxic dust from the Salton Sea and fumes from the dozens of factories operating in Mexico .
There ’ s also the pollution from thousands of cars and commercial trucks idling at the border .
The Calexico West Port of Entry — one of two in the county — is the third-busiest land port in the state , processing about 20,000 northbound vehicles and 12,500 pedestrian crossings per day , according to The region has high levels of air pollution that @ @ @ @ @ @ @ as asthma , bronchitis and chronic obstructive pulmonary disease .
All of those are risk factors for a disease that can leave people feeling like they ’ re drowning in the worst cases .
“ We got people that are poor , unemployed , people who aren ’ t able to get fresh fruits and veggies , and so they ’ re eating a lot of stuff that ’ s making them obese and diabetic , ” said Edward , the hospital executive .
“ When you add all that together , the @ @ @ @ @ @ @ infection decreases.
” Addressing lawmakers during a hearing in June , Janette Angulo , director of the Imperial County Public Health Department , said that if there was a painful silver lining , it was that the pandemic was drawing attention to the region ’ s problems .
“ Imperial County is a chronically disadvantaged , underserved and underfunded community , ” she said .
“ It ’ s no secret that prior to this pandemic , the county was in dire need for resources .
COVID-19 just came along to aggravate its @ @ @ @ @ @ @ May when COVID-19 cases began to climb .
Health experts say social gatherings had led to a surge .
Late that month , Mexicali hospitals began to turn COVID-19 patients away , forcing U.S. citizens and green card holders to cross the border into Imperial County .
The influx began to overwhelm hospitals , forcing them to stabilize and transport COVID-19 patients out of the region .
More than 40 of them were sent to Paradise Valley Hospital in National City .
In a span of three days in mid-May , the hospital @ @ @ @ @ @ @ .
Many of them were critically ill and would require up to two months of care .
“ It was like watching a storm coming in , ” said Patricia Dobbs , a charge nurse at Paradise Valley .
“ The floodgate had opened , ” added Jennifer Saunders , director of emergency services at the hospital .
“ Everyone was very scared.
” The hospital was so busy with patient transfers that at times one ambulance helicopter would be circling above , in a holding pattern , while another was dropping off @ @ @ @ @ @ @ state officials were calling for transfers and making sure medical charts had been received .
Even residents were calling , asking why there were so many helicopter landings .
Saunders said because hospital visitations were not allowed , they used tablets to let families FaceTime each other .
“ It ’ s heart-wrenching to know that a family member can go to the hospital and say goodbye to their family and not see them again for a month , ” she said .
On the Fourth of July , Saunders got another call @ @ @ @ @ @ @ Center .
The Imperial County hospital needed to transfer patients .
That included a married couple — the Lueras .
Saunders had already seen COVID-19 ’ s ability to separate families ; one man had family scattered in hospitals across California .
Even hospital staff had been away from their own families .
“ It used to be that your spouse went into the hospital and you could go visit , ” she said .
“ Now , all of that is gone.
” If the hospital could keep the Lueras together , @ @ @ @ @ @ @ On July 5 , the Lueras arrived by helicopters .
They were placed in the ICU , just a room apart from one another , sedated and hooked up to ventilators .
Pedro Jr. counted himself lucky .
In early June , the 37-year-old restaurant owner in El Centro said he had been infected with COVID-19 .
He quarantined himself in a guest room at home for almost a month .
He also told his parents not to visit .
He said he got tested six times until one showed he had the @ @ @ @ @ @ @ , 37 , got tested on June 22 .
It took about 16 days for her to get her results : positive .
Their 8- and 7-year-old sons and 4-month-old daughter have not shown symptoms of being infected .
Pedro Jr. said he ’ d rather have his mother and father healthy and at home .
But knowing that his parents were together at least brought some peace of mind .
On July 17 , his mother was moved out of the ICU .
His father remains on a ventilator .
It was @ @ @ @ @ @ @ Although his mother was doing better , there were other health complications she now had to take care of .
And his father was still sick .
Still , he said , he remained hopeful that they would both make a full recovery : “ I ’ m praying for that .
”

In all of their 47 years of marriage, Pedro and Patricia Luera had never been apart. Even now, in sickness, they were together.
The couple had tested positive for COVID-19. They were feverish, weak and struggling to breathe.
On July 2, a day after his wife had been admitted, 68-year-old Pedro Luera walked into the emergency room of El Centro Regional Medical Center, one of two hospitals serving Imperial County, a rural and impoverished region of about 180,000 people.
A surge in COVID-19 cases had put a strain on the hospital. It was running out of ventilators and intensive care unit beds almost every day, forcing it to send patients to other hospitals.
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Soon, the Lueras would be at Paradise Valley Hospital in San Diego County, hooked up to breathing machines.
Before his father was sedated and intubated, Luera’s son, Pedro Jr., exhorted his father to hang tough.
“You’re strong. There’s still a lot of things you need to do,” he told him. “You’re going to come out of this. Be strong.”
His father croaked out: “I’m going to fight.”
Pedro Luera Jr., right, is shown with his family at his El Centro residence. Both of his parents were hospitalized after contracting COVID-19. (Irfan Khan / Los Angeles Times)
The pandemic has brought an unprecedented level of hardship for residents in a county where the coronavirus hardly feels like an abstraction. The high infection rates can make it feel like nearly everyone knows or knows of somebody who has contracted COVID-19 or died from it.
As most of California begins a second shutdown over the pandemic, no place has been hit as hard as Imperial County.
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In the last two weeks, the county has averaged 688.1 infections per 100,000 people, compared with Los Angeles County’s 400.3. Its mortality rate is the highest in the state, averaging 25.5 deaths per 100,000 people — four times greater than L.A. County’s.
Imperial County was already at a disadvantage when the pandemic hit.
For years, the county led the state with the highest rates of diabetes, heart disease, asthma hospitalizations and obesity , high-risk factors that make people susceptible to catching COVID-19 and become severely ill or die.
“When you have a population with those preexisting conditions and you throw COVID-19 on top of it, you have a problem,” said Thomas Henderson, executive director of the Imperial County Medical Society.
Health experts say other factors contributed to the spread of the disease. The county lacked contact tracers. COVID-19 stigma led some residents not to alert others of their infection. Gatherings were also problematic as were residents traveling to and from neighboring counties, including those in Arizona.
The county’s two hospitals — El Centro Regional Medical Center and Pioneers Memorial Healthcare District — became so overwhelmed by the surge of cases that they were forced to move more than 500 patients to other California hospitals.
Two weeks ago, when El Centro Regional Medical Center ran out of ICU beds, Chief Executive Adolphe Edward said: “It’s horrible. I feel helpless.”
The pandemic also hit a region that was still struggling to recover from the last economic downturn . Even with a pandemic affecting many counties, its unemployment rate remains the highest in the state, according to the Employment Development Department.
“It’s no secret that prior to this pandemic the county was in dire need for resources. COVID-19 just came along to aggravate its situation.” — Janette Angulo, director of the Imperial County Public Health Department
Manuel Espinoso, 65, waits for a job while sitting outside a doughnut shop on Pauline Avenue in Calexico. (Irfan Khan / Los Angeles Times)
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Early in July, on a hot morning in Calexico, Manuel Espinoso, 65, waited for work near a doughnut shop. The irrigation installer, who lives in Mexicali, Mexico, had gone a week without work. Agricultural jobs were drying up in the area because of the pandemic, he said.
In a good week, he could earn about $300 to help take care of his family. But lately, he hasn’t found any work, even as some job seekers in Mexico refuse to cross the border because they are afraid of becoming infected.
Espinoso has every reason to worry himself. In June, his 42-year-old daughter, the oldest of three, and her husband fell ill with COVID-19. She died.
“There wasn’t much I could do,” Espinoso said. “I worry more now about my other two daughters, and my wife. ... I don’t want to infect her.”
Even if he finds a much-needed job, he said the risks are high. Workers are often crammed together into vehicles as they go from one field to another. The situation isn’t any better in Mexico, he said.
“There’s a lot of infections over there,” Espinoso said.
But he said he has no choice: He has to work.
“You got to work until you can’t. You have to keep working,” Espinoso said. “What can you do when you’re doing it out of necessity?”
Nearby, Rudy Kim, 60, had just opened his discount store, Mi Manera.
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He used a leaf blower to clean the sidewalk and turned on the radio to loudly play Spanish music for his mostly Latino clientele. A sign near the front read “No Mask, No Service.”
Kim said he has lost a lot of business because of the pandemic. With a new shutdown bearing down, he feared he might need to shut his store for good.
“It’s a ghost town,” he said. “Some days I’m only open for four hours.”
A street scene in Calexico. (Irfan Khan / Los Angeles Times)
Kim had to lay off about 12 employees. He lost about $5,000 in April when he couldn’t open and sell Easter merchandise, which now sits in storage. But bad business or not, he still has to pay about $8,000 a month in rent.
“I’m very frustrated,” he said. “I cannot afford this anymore.”
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Amelia Gurrero stands in line for more than an hour to use a Bank of America ATM in Calexico. (Irfan Khan / Los Angeles Times)
Nearby, more than 100 people were standing in line, waiting to pull out money from the ATM because there were few banks around. Many had filed for unemployment and were withdrawing money for rent.
A block away at Selecto Services, a line formed for a host of services, including unemployment and tax preparation.
Fernando Fausto, 59, a Mexicali resident with a green card who worked in the U.S., said he was there to file for unemployment but needed to prove he had paid taxes.
He said the company he worked for shut down in March. The field worker had been unable to find work.
“I need to pay bills and rent,” he said.
Fernando Fausto, 59, a resident of Mexicali, waits at a private service agency to file for unemployment in Calexico. (Irfan Khan / Los Angeles Times)
Bordered by Arizona to the east, Riverside County to the north, San Diego to the west and Mexico to the south, Imperial County is besieged by agricultural burning, toxic dust from the Salton Sea and fumes from the dozens of factories operating in Mexico.
There’s also the pollution from thousands of cars and commercial trucks idling at the border.
Emmanuel Vazquez, right, makes sure everyone entering a private service agency in Calexico is wearing a mask and that their hands are sanitized. (Irfan Khan / Los Angeles Times)
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The Calexico West Port of Entry — one of two in the county — is the third-busiest land port in the state, processing about 20,000 northbound vehicles and 12,500 pedestrian crossings per day, according to the California Air Resources Board.
The region has high levels of air pollution that lead to or exacerbate respiratory conditions such as asthma, bronchitis and chronic obstructive pulmonary disease. All of those are risk factors for a disease that can leave people feeling like they’re drowning in the worst cases.
“We got people that are poor, unemployed, people who aren’t able to get fresh fruits and veggies, and so they’re eating a lot of stuff that’s making them obese and diabetic,” said Edward, the hospital executive. “When you add all that together, the body’s ability to fight an infection decreases.”
Addressing lawmakers during a hearing in June, Janette Angulo, director of the Imperial County Public Health Department, said that if there was a painful silver lining, it was that the pandemic was drawing attention to the region’s problems.
“Imperial County is a chronically disadvantaged, underserved and underfunded community,” she said. “It’s no secret that prior to this pandemic, the county was in dire need for resources. COVID-19 just came along to aggravate its situation.”
Two women wearing masks enter the United States from Mexicali at the border crossing in Calexico. (Irfan Khan / Los Angeles Times)
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That much was visible in May when COVID-19 cases began to climb. Health experts say social gatherings had led to a surge. Late that month, Mexicali hospitals began to turn COVID-19 patients away, forcing U.S. citizens and green card holders to cross the border into Imperial County.
The influx began to overwhelm hospitals, forcing them to stabilize and transport COVID-19 patients out of the region. More than 40 of them were sent to Paradise Valley Hospital in National City.
“It used to be that your spouse went into the hospital and you could go visit. Now, all of that is gone.” — Jennifer Saunders, director of emergency services at Paradise Valley Hospital
Tents have been erected at El Centro Regional Medical Center to serve coronavirus patients. (Irfan Khan / Los Angeles Times)
In a span of three days in mid-May, the hospital received about 20 patients from Imperial County. Many of them were critically ill and would require up to two months of care.
“It was like watching a storm coming in,” said Patricia Dobbs, a charge nurse at Paradise Valley.
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“The floodgate had opened,” added Jennifer Saunders, director of emergency services at the hospital. “Everyone was very scared.”
The hospital was so busy with patient transfers that at times one ambulance helicopter would be circling above, in a holding pattern, while another was dropping off a patient.
Every two hours, state officials were calling for transfers and making sure medical charts had been received. Even residents were calling, asking why there were so many helicopter landings.
An ambulance helicopter lands at El Centro Regional Medical Center to pick up a patient. (Irfan Khan / Los Angeles Times)
Saunders said because hospital visitations were not allowed, they used tablets to let families FaceTime each other.
“It’s heart-wrenching to know that a family member can go to the hospital and say goodbye to their family and not see them again for a month,” she said.
On the Fourth of July, Saunders got another call for help from El Centro Regional Medical Center. The Imperial County hospital needed to transfer patients. That included a married couple — the Lueras.
Saunders had already seen COVID-19’s ability to separate families; one man had family scattered in hospitals across California. Even hospital staff had been away from their own families.
“It used to be that your spouse went into the hospital and you could go visit,” she said. “Now, all of that is gone.”
If the hospital could keep the Lueras together, they would jump at the chance.
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Nurse Kyah Paschall checks on coronavirus patient Patricia Luera, 64, who was connected to a ventilator at Paradise Valley Hospital in National City. (Irfan Khan / Los Angeles Times)
On July 5, the Lueras arrived by helicopters. They were placed in the ICU, just a room apart from one another, sedated and hooked up to ventilators.
Pedro Jr. counted himself lucky. In early June, the 37-year-old restaurant owner in El Centro said he had been infected with COVID-19.
He quarantined himself in a guest room at home for almost a month. He also told his parents not to visit. He said he got tested six times until one showed he had the infectious disease.
His wife, Aracely, 37, got tested on June 22. It took about 16 days for her to get her results: positive. Their 8- and 7-year-old sons and 4-month-old daughter have not shown symptoms of being infected.
Pedro Jr. said he’d rather have his mother and father healthy and at home. But knowing that his parents were together at least brought some peace of mind.
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On July 17, his mother was moved out of the ICU. His father remains on a ventilator.
It was a bittersweet moment for Pedro Jr. Although his mother was doing better, there were other health complications she now had to take care of. And his father was still sick.
Still, he said, he remained hopeful that they would both make a full recovery: “I’m praying for that.”


latimes--2020-07-29--California won't conquer the coronavirus, and fully reopen, until it can protect essential workers

Five months into the pandemic , it ’ s becoming increasingly clear that California is not going to conquer the coronavirus until it dramatically improves safety measures for essential workers at the epicenter of the health crisis .
From farming communities to urban centers and suburbs , workers in retail , manufacturing , agriculture and logistics are bearing the brunt of COVID-19 outbreaks , and state and local officials are struggling to control the infections even as the outlook in more prosperous communities has improved .
A growing number of officials and health experts say it ’ s critical now @ @ @ @ @ @ @ including pushing for masks and social distancing measures inside workplaces as well as cracking down much harder on employers who don ’ t follow the rules .
But that is only part of the problem .
Some low-wage workers are reluctant to call in sick because they need the money and are afraid to report safety violations for fear of being fired .
To deal with that , the state might need to provide additional disability pay to those who become ill and a process to aid workers who face retaliation for speaking @ @ @ @ @ @ @ challenge because many of these industries were ripe for worker exploitation before the pandemic .
Some workers lack legal residency and are fearful of working with authorities and crossing their bosses .
But experts say California has no hope of fully reopening the economy unless it can get worker infections under control .
“ What we ’ re talking about are low-wage workers — workers that don ’ t themselves have enough protection , ” said Dr. Kirsten Bibbins-Domingo , chair of UC San Francisco ’ s Department of Epidemiology and Biostatistics .
@ @ @ @ @ @ @ order to be off of work … and they need protections to be able to come back to work.
” She and others acknowledge it ’ s going to be difficult .
Some of these workers are hired by middle men instead of big corporations , and building trust in government action is going to be essential .
“ If we as a state — and then the counties most heavily affected — are going to get these sectors under control , we ’ re going to have to deal with the messiness @ @ @ @ @ @ @ “ We call these essential workers because the sectors they ’ re working in are essential to the California economy .
And it ’ s essential , therefore , that we figure out ” how to protect them .
Latinos in California are being infected and dying from the coronavirus at rates significantly higher than white residents , driven by job and housing conditions that continually bring them into contact with others , facilitating the spread of COVID-19 .
While Latinos — the state ’ s largest ethnic group — make up 39 @ @ @ @ @ @ @ they make up 56 % of all coronavirus cases and 46 % of deaths .
Some of the state ’ s largest outbreaks have occurred at factories , food processing plants , and housing complexes for agricultural workers , both in cities and in agricultural communities .
There is a potential model for this fight in nursing homes , where many Californians who died from the virus were infected .
If officials have been able to figure out how to reduce the spread there through widespread adoption of masks and improved infection control @ @ @ @ @ @ @ essential workers , experts said .
“ If you can cut this in a hospital or a nursing home , almost certainly you can handle it somewhere else .
That ’ s a no brainer , ” said Dr. Shruti Gohil , associate medical director of epidemiology and infection prevention at UC Irvine .
With coronavirus raging in Latino communities in the Central Valley , Gov .
Gavin Newsom on Monday announced $ 52 million in additional aid aimed at education , testing and tracing .
But many say much more must be @ @ @ @ @ @ @ were unprepared ... and too many farmworkers and essential workers are at risk , ” said state Assemblyman Robert Rivas ( D-Hollister ) , whose grandfather was a farmworker .
“ That needs to change.
” Rivas has pushed a relief package of five bills for farmworkers since March .
While many of those provisions were put in place by Newsom on Monday , he and others said there are more big-picture fixes that need to happen to protect workers , and ultimately the California economy , which relies on their labor .
@ @ @ @ @ @ @ more safe isolation spaces and housing , more enforcement by state worker safety agencies and better sick leave and unemployment , especially for undocumented workers with no safety net .
The situation on the ground in rural areas is dire .
The calls come in to the Rev .
Nelson Rabell ’ s cellphone every day now : Latino workers desperate for help , for rent , for medical care .
From his Lutheran parish in Lodi in the Central Valley , he has worked with his wife , an epidemiologist and dentist @ @ @ @ @ @ @ food , tests — since the coronavirus began .
Many of his parishioners are poor , working jobs in fields , grocery stories , day care centers and medical facilities .
But what he can do is not enough .
“ They are suffering a lot , ” Rabell said .
“ It ’ s just the perfect storm of irresponsible government action at all levels.
” He believes government needs to provide direct financial aid to workers , especially those who are infected , so that they can stay home from work @ @ @ @ @ @ @ food or shelter .
Though Newsom ’ s aid package increases quarantine housing for workers who can ’ t isolate at home and provides sick leave for more workers , Rabell points out that many of those in essential jobs live paycheck to paycheck and need immediate money if they fall ill. Rabell said there must be “ robust accountability and supervision ” of workplaces such as farms and packing plants , including greater penalties for employers who don ’ t comply with social distancing or provide protective gear .
Jose Rodriguez , @ @ @ @ @ @ @ housing and programs for farmworkers in San Joaquin County , said he believes government needs to also be stricter with isolation and quarantine rules , and better at contact tracing , so that those exposed to the virus are clear about quarantine protocols .
In his county , as in many places in the Central Valley , health departments have been overwhelmed by the spiraling number of cases and unable to contact trace each positive , leaving many not even knowing they may be carrying the virus .
He said one of his @ @ @ @ @ @ @ .
A day after receiving the results , county health workers came to her house and instructed all the residents that they had to quarantine for 14 days , and have made repeated checks since to make “ sure the family is doing what they are told.
” “ Unless someone is doing that here , they are not taking it seriously , ” he said .
Lin reported from San Francisco , Chabria from Sacramento .
Times staff writer Iris Lee contributed to this report .

Five months into the pandemic, it’s becoming increasingly clear that California is not going to conquer the coronavirus until it dramatically improves safety measures for essential workers at the epicenter of the health crisis.
From farming communities to urban centers and suburbs, workers in retail, manufacturing, agriculture and logistics are bearing the brunt of COVID-19 outbreaks, and state and local officials are struggling to control the infections even as the outlook in more prosperous communities has improved.
A growing number of officials and health experts say it’s critical now for California to act more aggressively, including pushing for masks and social distancing measures inside workplaces as well as cracking down much harder on employers who don’t follow the rules.
But that is only part of the problem. Some low-wage workers are reluctant to call in sick because they need the money and are afraid to report safety violations for fear of being fired. To deal with that, the state might need to provide additional disability pay to those who become ill and a process to aid workers who face retaliation for speaking out.
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It’s a particular challenge because many of these industries were ripe for worker exploitation before the pandemic. Some workers lack legal residency and are fearful of working with authorities and crossing their bosses. But experts say California has no hope of fully reopening the economy unless it can get worker infections under control.
“What we’re talking about are low-wage workers — workers that don’t themselves have enough protection,” said Dr. Kirsten Bibbins-Domingo, chair of UC San Francisco’s Department of Epidemiology and Biostatistics. “They need protection of wages in order to be off of work … and they need protections to be able to come back to work.”
She and others acknowledge it’s going to be difficult. Some of these workers are hired by middle men instead of big corporations, and building trust in government action is going to be essential.
“If we as a state — and then the counties most heavily affected — are going to get these sectors under control, we’re going to have to deal with the messiness of this,” Bibbins-Domingo said. “We call these essential workers because the sectors they’re working in are essential to the California economy. And it’s essential, therefore, that we figure out” how to protect them.
Latinos in California are being infected and dying from the coronavirus at rates significantly higher than white residents, driven by job and housing conditions that continually bring them into contact with others, facilitating the spread of COVID-19. While Latinos — the state’s largest ethnic group — make up 39% of California’s population, they make up 56% of all coronavirus cases and 46% of deaths.
Some of the state’s largest outbreaks have occurred at factories, food processing plants, and housing complexes for agricultural workers, both in cities and in agricultural communities.
Advertisement
There is a potential model for this fight in nursing homes, where many Californians who died from the virus were infected. If officials have been able to figure out how to reduce the spread there through widespread adoption of masks and improved infection control procedures, they can probably protect low-income essential workers, experts said.
“If you can cut this in a hospital or a nursing home, almost certainly you can handle it somewhere else. That’s a no brainer,” said Dr. Shruti Gohil, associate medical director of epidemiology and infection prevention at UC Irvine.
With coronavirus raging in Latino communities in the Central Valley, Gov. Gavin Newsom on Monday announced $52 million in additional aid aimed at education, testing and tracing. But many say much more must be done.
“Under this pandemic we were unprepared ... and too many farmworkers and essential workers are at risk,” said state Assemblyman Robert Rivas (D-Hollister), whose grandfather was a farmworker. “That needs to change.”
Rivas has pushed a relief package of five bills for farmworkers since March. While many of those provisions were put in place by Newsom on Monday, he and others said there are more big-picture fixes that need to happen to protect workers, and ultimately the California economy, which relies on their labor. Fixes he would like to see include more safe isolation spaces and housing, more enforcement by state worker safety agencies and better sick leave and unemployment, especially for undocumented workers with no safety net.
The situation on the ground in rural areas is dire.
The calls come in to the Rev. Nelson Rabell’s cellphone every day now: Latino workers desperate for help, for rent, for medical care.
From his Lutheran parish in Lodi in the Central Valley, he has worked with his wife, an epidemiologist and dentist, to provide aid — money, food, tests — since the coronavirus began. Many of his parishioners are poor, working jobs in fields, grocery stories, day care centers and medical facilities.
But what he can do is not enough.
“They are suffering a lot,” Rabell said. “It’s just the perfect storm of irresponsible government action at all levels.”
He believes government needs to provide direct financial aid to workers, especially those who are infected, so that they can stay home from work without fear of their families being without food or shelter. Though Newsom’s aid package increases quarantine housing for workers who can’t isolate at home and provides sick leave for more workers, Rabell points out that many of those in essential jobs live paycheck to paycheck and need immediate money if they fall ill.
Rabell said there must be “robust accountability and supervision” of workplaces such as farms and packing plants, including greater penalties for employers who don’t comply with social distancing or provide protective gear.
Jose Rodriguez, director of El Concilio, which runs housing and programs for farmworkers in San Joaquin County, said he believes government needs to also be stricter with isolation and quarantine rules, and better at contact tracing, so that those exposed to the virus are clear about quarantine protocols. In his county, as in many places in the Central Valley, health departments have been overwhelmed by the spiraling number of cases and unable to contact trace each positive, leaving many not even knowing they may be carrying the virus.
He said one of his cousins in Sutter County recently tested positive. A day after receiving the results, county health workers came to her house and instructed all the residents that they had to quarantine for 14 days, and have made repeated checks since to make “sure the family is doing what they are told.”
“Unless someone is doing that here, they are not taking it seriously,” he said.
Lin reported from San Francisco, Chabria from Sacramento. Times staff writer Iris Lee contributed to this report.


latimes--2020-07-29--Meet Perseverance, JPL's newest Mars rover

NASA ’ s newest Mars rover is called Perseverance , and it has already lived up to the name .
Weighing in at just over a ton and loaded with the most sophisticated instruments ever sent to the red planet , the six-wheeled vehicle has already survived a hurdle no previous rover has had to face : a global pandemic .
After overcoming months of uncertainty , Perseverance is at the Kennedy Space Center in Florida , awaiting the start of the 309-million-mile journey that will take it to an ancient lake bed that may contain evidence of extraterrestrial life @ @ @ @ @ @ @ $ 2.4-billion space robot is expected to blast off from Cape Canaveral Air Force Station as early as Thursday — right on schedule .
The rover traveled across the country from its birthplace at the Jet Propulsion Laboratory in La Cañada Flintridge in February .
After its arrival , as many as 90 NASA employees gathered in a cleanroom every day to reassemble , test and otherwise prepare the SUV-sized machine for the rigors of spaceflight .
Even in the midst of a devastating health crisis , that work can not be done @ @ @ @ @ @ @ team did their part and kept themselves healthy , ” said Luis Dominguez , deputy electrical lead for the mission at JPL , who has been based in Florida since February .
“ We were incredibly lucky.
” Delaying the launch for even a few months was never an option .
The orbits of Earth and Mars align only once every 26 months .
In order to get to Mars in a reasonable period of time with a manageable amount of fuel , the rover has to launch within a period of 20 @ @ @ @ @ @ @ approach .
“ If you miss a planetary window to Mars , you essentially have to wait two years for the next opportunity , ” said Matt Wallace , Perseverance deputy project manager at JPL .
“ That ’ s why the other countries that are launching missions are launching them right now.
” If everything goes according to plan , Perseverance will spend seven months flying through space before touching down in Jezero Crater in mid-February .
Once there , it will quickly begin searching for conclusive evidence that life once flourished @ @ @ @ @ @ @ has seen in one way or another that Mars was once habitable ” said , a geologist at JPL and deputy project scientist of the overall mission known as Mars 2020 .
“ But with Perseverance we are taking the next step — looking for signs of life in the ancient rock record.
” To do this , scientists on Earth will peer through Perseverance ’ s camera “ eyes , ” scouring Jezero for rocks that contain patterns , textures and the distribution of chemicals that can only be explained by biological @ @ @ @ @ @ @ for stromatolites , rock structures that look similar to those created by microbial mats on Earth billions of years ago .
But it will seek out other indicators of past life as well , including ones that could be unique to Mars .
“ Our search is firmly based on what we see in the early Earth rock record , but we will also open our minds to what signs of life might look like on another planet , ” Stack Morgan said .
While Perseverance is tasked with finding evidence of past @ @ @ @ @ @ @ have the capability to prove that life actually existed .
Instead , the rover will use a powerful drill at the end of its hinged arm to bore into promising rocks and collect core samples , each about the size of a marker pen .
Those samples will be sealed inside 43 metal tubes in the rover ’ s belly .
Filled tubes will likely be deposited in batches on the martian surface and collected by another rover sometime in the future so they can be sent to Earth for further study .
@ @ @ @ @ @ @ process that could take more than a decade to complete , NASA engineers said .
But when it comes to declaring the past presence of extraterrestrial life , the bar is high .
“ To make the claim that you have found signs of life on another planet requires the full capability of the terrestrial science community , ” Wallace said .
“ We can take maybe 100 pounds of instruments with us on the rover .
In a single laboratory on Earth you can have a ton of equipment.
” Perseverance will @ @ @ @ @ @ @ used to support eventual crewed missions to Mars .
These include an instrument the size of a small microwave oven that ’ s designed to make oxygen from the abundant carbon dioxide in the martian atmosphere .
The , or Moxie , relies on a process called electrolysis that uses an electrical charge to drive a chemical reaction .
Generating oxygen on Mars is a necessity because it would be impractical for a crew to bring it with them from Earth , said Asad Aboobaker , a systems engineer and member of the @ @ @ @ @ @ @ If Moxie works as expected , it will generate 6 to 10 grams of oxygen an hour .
That ’ s a small fraction of the 30 to 40 grams of oxygen per hour that NASA budgets for each astronaut aboard the International Space Station , but Aboobaker said the technology is fairly easy to scale up .
Even more importantly , an instrument like Moxie will likely be used to create the 30,000 kilograms of oxygen necessary to make the liquid propellant that would rocket future human explorers off Mars when they @ @ @ @ @ @ @ “ We know how to land hundreds of kilograms of stuff on Mars , we don ’ t know how to land 30,000 kilograms of stuff on Mars , ” Aboobaker said .
The Mars 2020 mission also includes a 4-pound helicopter nicknamed Ingenuity that could be the very first vehicle to fly on Mars .
If it works , future iterations could be used to create higher-resolution maps of the martian surface and explore areas not suitable for wheeled rovers .
Because the martian atmosphere is so thin — about 1 % @ @ @ @ @ @ @ at its surface — scientists were not sure that flying on Mars was possible .
“ From the beginning there was a natural skepticism , ” said Mimi Aung , an engineer and project manager for Ingenuity at JPL .
“ The question at first wasn ’ t how , but if.
” Aung and her team determined that it is possible to fly in the thin Martian air if you have strong blades that can spin incredibly fast .
So on Mars , Ingenuity ’ s blades will make 2400 revolutions per @ @ @ @ @ @ @ a vehicle that had all the necessary sensors , computers and heaters to function on Mars , yet was still light enough to become airborne .
“ Just to get where we are now is already a significant milestone , ” Aung said .
After landing on Mars , Perseverance will place Ingenuity on the surface , then drive a safe distance away .
The helicopter will have 30 martian days , or sols , to perform its experiments , including five planned test flights .
The first flight will be very modest @ @ @ @ @ @ @ feet , flying about three feet horizontally , then landing where it started .
If everything goes well , subsequent flights will last longer , with the fifth one continuing for up to 90 seconds .
“ We see this as a pathfinder that will pave the way for future missions , ” Aung said .
“ It will be the basis for building much larger vehicles capable of much longer flights.
” The mission ’ s descent vehicle is equipped with terrain-relative navigation , a new system that will allow it to @ @ @ @ @ @ @ s time to land .
During the descent , Perseverance will take pictures of the martian surface and compare them to images stored in its onboard computer .
If it recognizes a dangerous spot , it can steer away .
This technology will allow the rover to land at NASA ’ s most high-risk site yet , an area about the size of Lake Tahoe that ’ s littered with potential threats like rocks , dunes and cliffs .
Lake environments are a promising place to look for signs of past life , @ @ @ @ @ @ @ standing water for thousands , if not hundreds of thousands , of years — long enough to give life plenty of opportunity to establish itself .
And because they are relatively calm and peaceful environments , they allow sediments to settle gently on the bottom , creating well-preserved sequences of rock and , potentially , organic matter .
“ Every lake we have on Earth is inhabited , just dripping with life , ” she said .
“ We are going there with the expectation that if life was on Mars , it @ @ @ @ @ @ @ will last one Martian year — just under two years on Earth — with a budget of $ 300 million .
If the past is any guide , however , the rover will keep working long after that .
( Curiosity has been roving for more than six years beyond its initial 23-month mission . )
If Perseverance succeeds , it will be due in part to the accomplishments of JPL ’ s four previous rovers that have roamed the red planet since 1997 .
These include Sojourner , which proved that driving @ @ @ @ @ @ @ possible ; the twins Spirit and Opportunity , which discovered evidence that Mars was once flooded with water ; and Curiosity , which found that the red planet once harbored the building blocks of life .
With Perseverance , scientists hope to finally show that life on Mars did in fact exist .

An illustration of NASA’s Perseverance rover on the surface of Mars. The vehicle, built at the Jet Propulsion Laboratory, will blast off for Mars as soon as Thursday.
NASA’s newest Mars rover is called Perseverance, and it has already lived up to the name.
Weighing in at just over a ton and loaded with the most sophisticated instruments ever sent to the red planet, the six-wheeled vehicle has already survived a hurdle no previous rover has had to face: a global pandemic.
After overcoming months of uncertainty, Perseverance is at the Kennedy Space Center in Florida, awaiting the start of the 309-million-mile journey that will take it to an ancient lake bed that may contain evidence of extraterrestrial life.
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Despite the unprecedented challenges, the $2.4-billion space robot is expected to blast off from Cape Canaveral Air Force Station as early as Thursday — right on schedule.
The rover traveled across the country from its birthplace at the Jet Propulsion Laboratory in La Cañada Flintridge in February. After its arrival, as many as 90 NASA employees gathered in a cleanroom every day to reassemble, test and otherwise prepare the SUV-sized machine for the rigors of spaceflight.
Even in the midst of a devastating health crisis, that work cannot be done from home.
“Everyone on the team did their part and kept themselves healthy,” said Luis Dominguez, deputy electrical lead for the mission at JPL, who has been based in Florida since February. “We were incredibly lucky.”
VIDEO | 01:24 Building NASA’s Mars 2020 rover Watch the assembly of Perseverance rover at Jet Propulsion Laboratory
Delaying the launch for even a few months was never an option. The orbits of Earth and Mars align only once every 26 months. In order to get to Mars in a reasonable period of time with a manageable amount of fuel, the rover has to launch within a period of 20 days or so relative to that closest approach.
“If you miss a planetary window to Mars, you essentially have to wait two years for the next opportunity,” said Matt Wallace, Perseverance deputy project manager at JPL. “That’s why the other countries that are launching missions are launching them right now.”
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If everything goes according to plan, Perseverance will spend seven months flying through space before touching down in Jezero Crater in mid-February. Once there, it will quickly begin searching for conclusive evidence that life once flourished on Mars.
NASA’s Perseverance rover is set to touch down within the oval marked on this image of Jezero Crater on Mars. Lighter colors represent higher elevations. (NASA)
“Every previous mission has seen in one way or another that Mars was once habitable” said Katie Stack Morgan , a geologist at JPL and deputy project scientist of the overall mission known as Mars 2020. “But with Perseverance we are taking the next step — looking for signs of life in the ancient rock record.”
To do this, scientists on Earth will peer through Perseverance’s camera “eyes,” scouring Jezero for rocks that contain patterns, textures and the distribution of chemicals that can only be explained by biological activity.
The rover will mostly hunt for stromatolites, rock structures that look similar to those created by microbial mats on Earth billions of years ago. But it will seek out other indicators of past life as well, including ones that could be unique to Mars.
“Our search is firmly based on what we see in the early Earth rock record, but we will also open our minds to what signs of life might look like on another planet,” Stack Morgan said.
While Perseverance is tasked with finding evidence of past life on Mars, it does not have the capability to prove that life actually existed.
Instead, the rover will use a powerful drill at the end of its hinged arm to bore into promising rocks and collect core samples, each about the size of a marker pen. Those samples will be sealed inside 43 metal tubes in the rover’s belly. Filled tubes will likely be deposited in batches on the martian surface and collected by another rover sometime in the future so they can be sent to Earth for further study.
Science & Medicine How NASA will bring a little bit of Mars back to Earth NASA and the European Space Agency have a complex plan to collect samples of Martian rock and soil and send them to Earth. Here’s how it will work.
It’s a long and complicated process that could take more than a decade to complete, NASA engineers said. But when it comes to declaring the past presence of extraterrestrial life, the bar is high.
“To make the claim that you have found signs of life on another planet requires the full capability of the terrestrial science community,” Wallace said. “We can take maybe 100 pounds of instruments with us on the rover. In a single laboratory on Earth you can have a ton of equipment.”
Perseverance will also test new technologies that could be used to support eventual crewed missions to Mars.
These include an instrument the size of a small microwave oven that’s designed to make oxygen from the abundant carbon dioxide in the martian atmosphere. The Mars Oxygen In-Situ Resource Utilization Experiment , or Moxie, relies on a process called electrolysis that uses an electrical charge to drive a chemical reaction.
Generating oxygen on Mars is a necessity because it would be impractical for a crew to bring it with them from Earth, said Asad Aboobaker, a systems engineer and member of the science team for Moxie at JPL.
If Moxie works as expected, it will generate 6 to 10 grams of oxygen an hour. That’s a small fraction of the 30 to 40 grams of oxygen per hour that NASA budgets for each astronaut aboard the International Space Station, but Aboobaker said the technology is fairly easy to scale up.
Even more importantly, an instrument like Moxie will likely be used to create the 30,000 kilograms of oxygen necessary to make the liquid propellant that would rocket future human explorers off Mars when they are ready to return to Earth.
“We know how to land hundreds of kilograms of stuff on Mars, we don’t know how to land 30,000 kilograms of stuff on Mars,” Aboobaker said.
The Mars 2020 mission also includes a 4-pound helicopter nicknamed Ingenuity that could be the very first vehicle to fly on Mars. If it works, future iterations could be used to create higher-resolution maps of the martian surface and explore areas not suitable for wheeled rovers.
Because the martian atmosphere is so thin — about 1% the density of Earth’s atmosphere at its surface — scientists were not sure that flying on Mars was possible.
“From the beginning there was a natural skepticism,” said Mimi Aung, an engineer and project manager for Ingenuity at JPL. “The question at first wasn’t how, but if.”
Aung and her team determined that it is possible to fly in the thin Martian air if you have strong blades that can spin incredibly fast. So on Mars, Ingenuity’s blades will make 2400 revolutions per minute.
The next challenge was designing a vehicle that had all the necessary sensors, computers and heaters to function on Mars, yet was still light enough to become airborne.
“Just to get where we are now is already a significant milestone,” Aung said.
After landing on Mars, Perseverance will place Ingenuity on the surface, then drive a safe distance away. The helicopter will have 30 martian days, or sols, to perform its experiments, including five planned test flights.
The first flight will be very modest, with the helicopter rising just 10 feet, flying about three feet horizontally, then landing where it started. If everything goes well, subsequent flights will last longer, with the fifth one continuing for up to 90 seconds.
“We see this as a pathfinder that will pave the way for future missions,” Aung said. “It will be the basis for building much larger vehicles capable of much longer flights.”
× Perseverance’s journey from JPL to the launch pad
The mission’s descent vehicle is equipped with terrain-relative navigation, a new system that will allow it to spot and avoid hazards when it’s time to land.
During the descent, Perseverance will take pictures of the martian surface and compare them to images stored in its onboard computer. If it recognizes a dangerous spot, it can steer away.
This technology will allow the rover to land at NASA’s most high-risk site yet, an area about the size of Lake Tahoe that’s littered with potential threats like rocks, dunes and cliffs.
Lake environments are a promising place to look for signs of past life, Stack Morgan said. They likely held standing water for thousands, if not hundreds of thousands, of years — long enough to give life plenty of opportunity to establish itself.
And because they are relatively calm and peaceful environments, they allow sediments to settle gently on the bottom, creating well-preserved sequences of rock and, potentially, organic matter.
“Every lake we have on Earth is inhabited, just dripping with life,” she said. “We are going there with the expectation that if life was on Mars, it should be there.”
The primary mission will last one Martian year — just under two years on Earth — with a budget of $300 million. If the past is any guide, however, the rover will keep working long after that. (Curiosity has been roving for more than six years beyond its initial 23-month mission.)
If Perseverance succeeds, it will be due in part to the accomplishments of JPL’s four previous rovers that have roamed the red planet since 1997.
These include Sojourner, which proved that driving a robot on another planet is indeed possible; the twins Spirit and Opportunity, which discovered evidence that Mars was once flooded with water; and Curiosity, which found that the red planet once harbored the building blocks of life.
With Perseverance, scientists hope to finally show that life on Mars did in fact exist.


latimes--2020-07-29--Health crisis looming inside a health crisis: People are avoiding going to the doctor

These days , Los Angeles acting teacher Deryn Warren balances her pain with her fear .
She ’ s a bladder cancer patient who broke her wrist in November .
She still needs physical therapy for her wrist , and she ’ s months late for a cancer follow-up .
But Warren won ’ t go near a hospital , even though she says her wrist hurts every day .
“ If I go back to the hospital , I ’ ll get COVID .
Hospitals are full of COVID people , ” says Warren , a former film director @ @ @ @ @ @ @ to Make Your Audience Fall in Love With You.
” “ Doctors say , ‘ Come back for therapy , ’ and my answer is , ‘ No thank you.
’ ” Many , many patients like Warren are shunning hospitals and clinics .
The coronavirus has so diminished trust in the U.S. medical system that even people with obstructed bowels , chest pain and stroke symptoms are ignoring danger signs and staying out of the emergency room , with potentially mortal consequences .
A study by the Centers for Disease Control and @ @ @ @ @ @ @ fell 42 % in April , from a mean of 2.1 million a week to 1.2 million , compared with the same time period in 2019 .
A Harris poll on behalf of the American Heart Assn .
found roughly 1 in 4 adults experiencing a heart attack or stroke would rather stay at home than risk getting infected with the coronavirus at the hospital .
These concerns are higher in Black ( 33 % ) and Latino ( 41 % ) populations , said Dr. Mitchell Elkind , president of the American @ @ @ @ @ @ @ neurology and epidemiology at Columbia University .
Perhaps even more worrisome is the drastic falloff of routine screening , especially in regions hit hard by the virus .
Models created by the medical research company IQVIA predict delayed diagnoses of an estimated 36,000 breast cancers and 19,000 colorectal cancers due to COVID-19 ’ s scrambling of medical care .
At Hoag Memorial Hospital Presbyterian in Newport Beach , mammograms have dropped as much as 90 % during the pandemic .
“ When you see only 10 % of possible patients , you ’ @ @ @ @ @ @ @ with early-stage breast cancer who needs a follow-up biopsy , ” said Dr. Burton Eisenberg , executive medical director of the Hoag Family Cancer Institute .
Before the pandemic , Eisenberg saw five melanoma patients a week .
He hasn ’ t seen any in the last month .
“ There ’ s going to be a lag time before we see the results of all this missed care , ” he said .
“ In two or three years , we ’ re going to see a spike in breast cancer in @ @ @ @ @ @ @ know why , ” he said .
Dr. Farzad Mostashari , former national coordinator for health information technology at the U.S. Department of Health and Human Services , agreed .
“ There will be consequences for deferring chronic disease management , ” he said .
“ Patients with untreated high blood pressure , heart and lung and kidney diseases are all likely to experience a slow deterioration .
Missed mammograms , people keeping up with blood pressure control — there ’ s no question this will all cause problems.
” In addition to @ @ @ @ @ @ @ have prevented some from getting needed care .
Many medical offices have remained closed during the pandemic , delaying timely patient testing and treatment .
Other sick patients lost their company-sponsored health insurance during virus-related job layoffs and are reluctant to seek care , according to a study by the Urban Institute .
A study by the American Cancer Society ’ s Cancer Action Network found that 79 % of cancer patients in treatment had experienced delays in care , including 17 % who saw delays in chemotherapy or radiation therapy .
“ @ @ @ @ @ @ @ people were afraid to go to the ones that were open for fear of contracting COVID , ” said Dr. William Cance , chief medical and scientific officer for the American Cancer Society .
And then there are patients who have fallen through the cracks because of the medical system ’ s fixation on COVID-19 .
Dimitri Timm , a 43-year-old loan officer from Watsonville , Calif. , began feeling stomach pain in mid-June .
He called his doctor , who suspected the coronavirus and directed Timm to an urgent care facility that @ @ @ @ @ @ @ office was closed for the day .
When he was finally examined the following afternoon , Timm learned his appendix had burst .
“ If my burst appendix had become septic , I could have died , ” he said .
The degree to which non-COVID patients are falling through the cracks may vary by region .
Doctors in Northern California , where hospitals haven ’ t yet seen an overwhelming surge of COVID-19 cases , have continued to see other patients , said Dr. Robert Harrington , chairman of the Stanford University @ @ @ @ @ @ @ the American Heart Assn .
Non-COVID issues were more likely to have been missed in , say , New York during the April wave , he said .
The American College of Cardiology and American Heart Assn .
have launched campaigns to get patients to seek urgent care and continue routine appointments .
The impact of delayed care might be felt this winter if a renewed crush of COVID-19 cases collides with flu season , overwhelming the system in what CDC Director Robert Redfield has predicted will be “ one of the most @ @ @ @ @ @ @ in American public health.
” The healthcare system ’ s ability to handle it all is “ going to be tested , ” said Anthony Wright , executive director of Health Access California , an advocacy group .
But some patients who stay at home may actually be avoiding doctors because they don ’ t need care .
Yale University cardiologist and researcher Dr. Harlan Krumholz believes the pandemic could be reducing stress for some heart patients , thus reducing heart attacks and strokes .
“ After the nation shut down , the @ @ @ @ @ @ @ less trafficked .
And so , paradoxically , people say they were experiencing less stress in the pandemic , not more , ” said Krumholz , who wrote an April op-ed in the New York Times headlined “ Where Have All the Heart Attacks Gone ?
” “ While sheltering in place , they were eating healthier , changing lifestyles and bad behaviors , ” he said .
At least some medical experts agree .
“ The shutdown may have provided a sabbatical for our bad habits , ” said Dr. Jeremy Faust @ @ @ @ @ @ @ health policy and public health at Boston ’ s Brigham and Women ’ s Hospital .
“ We ’ re making so many changes to our lives , and that includes heart patients .
If you go to a restaurant three times a week or more , do you realize how much butter you ’ re eating ?
” While some patients may be benefiting from a COVID-19 regime change , many people have urgent and undeniable medical needs .
And some are pressing through their fear of the virus to seek care @ @ @ @ @ @ @ .
In March , when the virus took hold , Kate Stuhr-Mack was undergoing a clinical trial at Hoag for her Stage 4 ovarian cancer , which had recurred after a nine-month relapse .
Members of her online support group considered staying away from the facility , afraid of contracting the virus .
But Stuhr-Mack , 69 , a child psychologist , had no choice : To stay in the trial , she had to keep her regular outpatient chemotherapy appointments .
“ We all make choices , so you have to be @ @ @ @ @ @ @ And I thought it was far more risky not to get my cancer treatment than face the off-chance I ’ d contract COVID on some elevator.
” Glionna is a former national reporter for the Los Angeles Times .
This story was produced by KHN ( Kaiser Health News ) , which publishes California Healthline , an editorially independent service of the California Health Care Foundation .
KHN is not affiliated with Kaiser Permanente .

Health experts fear a surge in preventable medical problems, such as high blood pressure, because people are avoiding going to the doctor during the COVID-19 pandemic.
These days, Los Angeles acting teacher Deryn Warren balances her pain with her fear. She’s a bladder cancer patient who broke her wrist in November. She still needs physical therapy for her wrist, and she’s months late for a cancer follow-up.
But Warren won’t go near a hospital, even though she says her wrist hurts every day.
“If I go back to the hospital, I’ll get COVID. Hospitals are full of COVID people,” says Warren, a former film director and author of the book “How to Make Your Audience Fall in Love With You.”
Advertisement
“Doctors say, ‘Come back for therapy,’ and my answer is, ‘No thank you.’”
Many, many patients like Warren are shunning hospitals and clinics. The coronavirus has so diminished trust in the U.S. medical system that even people with obstructed bowels, chest pain and stroke symptoms are ignoring danger signs and staying out of the emergency room, with potentially mortal consequences.
A study by the Centers for Disease Control and Prevention found that emergency room visits nationwide fell 42% in April, from a mean of 2.1 million a week to 1.2 million, compared with the same time period in 2019.
A Harris poll on behalf of the American Heart Assn. found roughly 1 in 4 adults experiencing a heart attack or stroke would rather stay at home than risk getting infected with the coronavirus at the hospital. These concerns are higher in Black (33%) and Latino (41%) populations, said Dr. Mitchell Elkind, president of the American Heart Assn. and a professor of neurology and epidemiology at Columbia University.
Perhaps even more worrisome is the drastic falloff of routine screening, especially in regions hit hard by the virus. Models created by the medical research company IQVIA predict delayed diagnoses of an estimated 36,000 breast cancers and 19,000 colorectal cancers due to COVID-19’s scrambling of medical care.
At Hoag Memorial Hospital Presbyterian in Newport Beach, mammograms have dropped as much as 90% during the pandemic. “When you see only 10% of possible patients, you’re not going to spot that woman with early-stage breast cancer who needs a follow-up biopsy,” said Dr. Burton Eisenberg, executive medical director of the Hoag Family Cancer Institute.
Advertisement
Before the pandemic, Eisenberg saw five melanoma patients a week. He hasn’t seen any in the last month. “There’s going to be a lag time before we see the results of all this missed care,” he said. “In two or three years, we’re going to see a spike in breast cancer in Orange County, and we’ll know why,” he said.
Dr. Farzad Mostashari, former national coordinator for health information technology at the U.S. Department of Health and Human Services, agreed. “There will be consequences for deferring chronic disease management,” he said.
“Patients with untreated high blood pressure, heart and lung and kidney diseases are all likely to experience a slow deterioration. Missed mammograms, people keeping up with blood pressure control — there’s no question this will all cause problems.”
In addition to fear? Changes in the healthcare system have prevented some from getting needed care.
Many medical offices have remained closed during the pandemic, delaying timely patient testing and treatment. Other sick patients lost their company-sponsored health insurance during virus-related job layoffs and are reluctant to seek care, according to a study by the Urban Institute.
A study by the American Cancer Society’s Cancer Action Network found that 79% of cancer patients in treatment had experienced delays in care, including 17% who saw delays in chemotherapy or radiation therapy.
“Many screening facilities were shuttered, while people were afraid to go to the ones that were open for fear of contracting COVID,” said Dr. William Cance, chief medical and scientific officer for the American Cancer Society.
And then there are patients who have fallen through the cracks because of the medical system’s fixation on COVID-19.
Dimitri Timm, a 43-year-old loan officer from Watsonville, Calif., began feeling stomach pain in mid-June. He called his doctor, who suspected the coronavirus and directed Timm to an urgent care facility that handled suspected COVID-19 patients.
But that office was closed for the day. When he was finally examined the following afternoon, Timm learned his appendix had burst. “If my burst appendix had become septic, I could have died,” he said.
The degree to which non-COVID patients are falling through the cracks may vary by region. Doctors in Northern California, where hospitals haven’t yet seen an overwhelming surge of COVID-19 cases, have continued to see other patients, said Dr. Robert Harrington, chairman of the Stanford University Department of Medicine and outgoing president of the American Heart Assn. Non-COVID issues were more likely to have been missed in, say, New York during the April wave, he said.
The American College of Cardiology and American Heart Assn. have launched campaigns to get patients to seek urgent care and continue routine appointments.
The impact of delayed care might be felt this winter if a renewed crush of COVID-19 cases collides with flu season, overwhelming the system in what CDC Director Robert Redfield has predicted will be “one of the most difficult times that we’ve experienced in American public health.”
The healthcare system’s ability to handle it all is “going to be tested,” said Anthony Wright, executive director of Health Access California, an advocacy group.
But some patients who stay at home may actually be avoiding doctors because they don’t need care. Yale University cardiologist and researcher Dr. Harlan Krumholz believes the pandemic could be reducing stress for some heart patients, thus reducing heart attacks and strokes.
“After the nation shut down, the air was cleaner, the roads were less trafficked. And so, paradoxically, people say they were experiencing less stress in the pandemic, not more,” said Krumholz, who wrote an April op-ed in the New York Times headlined “Where Have All the Heart Attacks Gone?” “While sheltering in place, they were eating healthier, changing lifestyles and bad behaviors,” he said.
At least some medical experts agree.
“The shutdown may have provided a sabbatical for our bad habits,” said Dr. Jeremy Faust, a physician in the division of health policy and public health at Boston’s Brigham and Women’s Hospital. “We’re making so many changes to our lives, and that includes heart patients. If you go to a restaurant three times a week or more, do you realize how much butter you’re eating?”
While some patients may be benefiting from a COVID-19 regime change, many people have urgent and undeniable medical needs. And some are pressing through their fear of the virus to seek care, after balancing the risks and benefits.
In March, when the virus took hold, Kate Stuhr-Mack was undergoing a clinical trial at Hoag for her Stage 4 ovarian cancer, which had recurred after a nine-month relapse.
Members of her online support group considered staying away from the facility, afraid of contracting the virus. But Stuhr-Mack, 69, a child psychologist, had no choice: To stay in the trial, she had to keep her regular outpatient chemotherapy appointments.
“We all make choices, so you have to be philosophical,” she said. “And I thought it was far more risky not to get my cancer treatment than face the off-chance I’d contract COVID on some elevator.”
Glionna is a former national reporter for the Los Angeles Times. This story was produced by KHN (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--2020-07-29--Coronavirus surge turns the Southland inside out

Dozens of worshipers , some in lawn chairs , most in their cars , attend a Robert Schuller Ministries church @ @ @ @ @ at the Newport Dunes in Newport Beach .
Schuller has been conducting services for several @ @ @ @ @ Schuller is the only son of Crystal Cathedral founders Robert H. Schuller and Arvella Schuller @ @ @ @ @ minister on the “ Hour of Power ” weekly television program broadcast from the Crystal @ @ @ @ @

Randalee, left, braids the hair of a fellow camper at the Black Unity LA encampment in Grand Park. The encampment, in support of Black Lives Matter has been in place since late May. There are about two of dozen people living in the park, made up of activists and protesters. The camp has a community garden, antibacterial supplies and other items to fight the coronavirus.
(Genaro Molina/Los Angeles Times)