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: Written by: Adia White; Published: 19 March 2020

By Ricardo Cano and Laurel Rosenhall, CalMatters

In a stunning announcement that revealed disruption from the coronavirus is far from over, Gov. Gavin Newsom said Tuesday that California schools will remain closed not just until sometime next month, as most announced over the weekend, but probably for the rest of the school year.

“Don’t anticipate schools are going to open up in a week. Please don’t anticipate in a few weeks,” Newsom said. “I would plan and assume that it’s unlikely that many of these schools –few, if any –will open before the summer break.”

The governor dropped the bombshell in the middle of a wide-ranging press conference about the state’s response to the pandemic, in which Newsom also predicted severe restrictions now in place in the San Francisco Bay Area will soon spread to other regions and revealed that he had put the National Guard on alert.

(Image: Oakland Technical High School students leave campus after an announcement that all Oakland schools would close for the pandemic, March 13, 2020. Photo by Anne Wernikoff for CalMatters)

Newsom also signed bills the Legislature passed Monday to spend up to $1 billion ramping up hospital capacity to handle an expected onslaught of virus-stricken patients. California, he said, had spent years preparing its health care system for an emergency such as this pandemic.

But he added that if the proportion of coronavirus patients reaches the higher end of the state’s projections, the state could need as many as 20,000 additional hospital beds —about twice the current surge capacity of 10,000. Asked about other potential shortfalls in ventilators, hospital supplies and rooms for convalescents, the governor said he’d rather not alarm Californians with more estimates.

That’s why the state is focusing on social distancing, he added. “The more we do individually will reduce those rates,” Newsom said. “We are not victims of fate. We are victims only of bad decisions.”

But schools were the big news. With millions of families already housebound and scrambling to improvise work, study and child care arrangements, Newsom said parents should not only prepare for the possibility that public schools would be closed through the end of the academic year —which runs through early to mid-June for most schools —but also to homeschool their children as part of the state’s transition to the new reality of virtual instruction.

On Monday night, he added, he had made the same sobering prediction to his daughter, who was upset at having to be separated from her friends and “expressing deep anxiety that she wasn’t in school.” She’d thrown pillows and a little bunny rabbit on the floor of her room, he said, and in an hour-long conversation, the governor told his daughter, “‘Honey, I don’t think the schools are gonna open again.’”

“If I can tell my daughter that and not tell your daughter that, or the people, then I’m not being honest and true to the people of the state of California,” Newsom said, adding: “Boy, I hope I’m wrong, but I believe that to be the case based upon the work we all have to do.”

Newsom has not made any formal orders to close schools, even though the vast majority in California have already shut down voluntarily as they figure out plans for online learning. The governor had expressed hesitance in a statewide order, saying that several schools across the state had been unprepared to deal with the logistics of transitioning to distance learning and feeding students who rely on schools for meals. In California, about 6 in 10 kids who attend public schools participate in free or reduced priced lunch programs, though in some areas, Newsom has said, the proportion is more like 80%.

Local school systems across the state have begun to create “grab-n-go” meal programs in which parents and students can go to designated school sites to pick up meals. Los Angeles, for example, has set up 60 grab-and-go centers for student meals. And Fresno Unified, the state’s fourth-largest district, is letting students pick up as many meals for their families at meal distribution centers across the city, according to The Fresno Bee.

Newsom said that the state will formally submit a waiver to the U.S. Department of Education to forgo testing, saying educators and students “shouldn’t worry about coming back and the SAT, ACT and AP, all these other exams when we already have enough anxiety related to this moment.”

Virtually all of California’s 6.2 million students have been affected by school closures. Large, urban school districts such as Los Angeles, San Diego and San Francisco had announced late last week that their schools would close, and a wave of announcements up and down the state almost immediately followed.

The duration in initial closure plans differed across school districts. Some told parents and community members they planned to be closed through the end of March, while others said to be prepared for closures through mid-April.

The governor said he expected that the handful of small and rural districts still open “will likely start to shut down.”

Homeschooling and SATs

Last week, the U.S. Department of Education issued guidance to states that released them from several federally mandated testing and accountability measures. That federal guidance also stated that schools would not be required to provide special education while schools are shut down due to the pandemic unless they shift to online learning, long-term.

Newsom said a task force led by state education board president Linda Darling-Hammond and state schools superintendent Tony Thurmond is working on guidance to schools on how to continue to provide services for students with special needs “who are truly most vulnerable.”

Meanwhile, the California Department of Education on Tuesday published a list of online learning resources for schools and families. The state plans to update its guidance to schools weekly. The guidance notes that schools ought to plan for the transition to distance learning “immediately” and consider the fact that several students across the state might not have reliable access to internet.

(Image: Brianna Brown, 13, sits on the swings at Kloss park in Elk Grove, where the coronavirus has prompted authorities to cancel school. Photo by Anne Wernikoff for CalMatters)

“In these difficult times, we cannot lose track of the needs of our most disadvantaged students. LEAs (school districts) will need to solve a variety of concerns about access,” the state’s guidance reads.

Many questions remain unanswered as the state’s massive K-12 education system —1,000 school districts serving more than 6 million children in the public schools alone —begins to absorb the news that the school year may be upended. Among them: Will summer school be available to make up lost learning? Will students have to repeat their current grade next year? And, more broadly, how will working parents adapt to the prolonged school closures and still hold onto their jobs?

Parents can use sick time to care for children whose schools have been closed by the government, according to guidanceNewsom issued Tuesday, though many workers only have a few days of sick leave. Parents who can’t work because they are taking care of their children during the school closures can apply for unemployment benefits, the guidance says.

Some campuses will open for meal service or be turned into child care sites to help working parents, Newsom said, though it remains unclear how that will stem the spread of disease. If campuses are open for child care, why not open them for school? Newsom said the decisions were being made locally by districts that vary from tiny rural outposts to enormous urban centers.

Alarming estimates

Newsom also talked about preparedness. “We’re running every conceivable model,” Newsom said.

Newsom and Mark Ghaly, secretary of California Health and Human Services would not say whether they would make these models public. But Newsom did project, with a 5% hospitalization rate, a need for 4,000 additional beds —and that’s on the low end, Newsom said.“You get up to 20%, you’re closer to 19 –20,000 beds.”

Newsom said he’d rather not alarm anyone with more estimates. But a need for 20,000 additional beds is double what Newsom pegged the state’s current surge capacity at roughly 10,000 hospital beds. That’s why the state is focusing on social distancing. “The more we do individually will reduce those rates,” Newsom said. “We are not victims of fate. We are victims only of bad decisions.”

In other developments on Tuesday, Sacramento and Monterey counties adopted the severe restrictions already in place in Bay Area counties —requiring people to stay at home except for essential trips to get food or medicine. Newsom said he expects additional counties to adopt the rules in the coming days, but stopped short of ordering a statewide lockdown or formal order to “shelter in place.”

“If we don’t feel they are doing it quickly enough we will encourage more,” he said.

Newsom said he had put the National Guard on alert to be ready to distribute food and maintain public safety, and raised the possibility that the state could eventually move to military control if people don’t follow the guidance to stay home.

“We have the ability to do martial law, things like that, layer new requirements and authority,” he said. “If we feel the necessity to do that, we will do that.”

CalMatters reporter Rachel Becker contributed to this report.

CalMatters.org is a nonprofit, nonpartisan media venture explaining California policies and politics.

: Written by: Adia White; Published: 18 March 2020

While shelter in place orders do not apply to going to the grocery store, you may still be concerned about leaving your home. The Sonoma County Council on Aging offers a number of resources available to seniors during this time, including their meals on wheels fresh food delivery service. KRCB’s Adia White spoke with Marianne McBride, the President and CEO of the Council on Aging, about how you may be able to qualify.

(Image: A Meals on Wheels recipient of a Thanksgiving dinner sponsored by the Great Falls Community Food Bank. Credit: U.S. Air Force photo/Airman 1st Class Katrina Heikkinen)

Here's a story from KPBS in San Diego about what that city is doing to make sure seniors have enough food.

: Written by: Norcal Administrator; Published: 18 March 2020

Note: We've changed the headline of this story to reflect that Gov. Gavin Newsom’s spokesperson said these figures are possible without mitigation efforts. We have also updated the figure to 22 million to correct a math error in the governor's letter.

: Written by: Steve Mencher; Published: 18 March 2020

By Rachel Becker and Ana B. Ibarra, CalMatters

Coronavirus testing has been plagued by confusion, delays and chaos, with the number of available, usable tests far outstripped by the need. The situation, health care providers and experts say, has impaired their ability to know how many people have the virus — but a significantly larger number, they suspect, than that confirmed by state and federal officials.

Gov. Gavin Newsom says, however, that help is on the way, from university medical centers, private labs, the tech sector and more. So where are we on this? Who can get tested and where exactly should you go? If you do get a hold of a test, is it going to cost anything? Here’s what you need to know.

How many tests does California have?

On Sunday, California Gov. Gavin Newsom said California has conducted 8,316 tests, and has the capacity to run just short of 9,000 more. On Monday evening, he said that the state’s 19 public health labs have increased tests “by a few hundred” over the previous 24 hours. Still, he said, “That clearly is not enough.”

By Tuesday, the number of public health labs conducting testing had increased to 21. And the state has also turned to academic medical centers as well as private companies to fill in those gaps. UC San Francisco, UC Los Angeles, UC San Diego, and Stanford are all offering tests for the novel coronavirus — and UC Davis is currently racing to get three different types of tests online.

Nam Tran, associate professor and senior director of clinical pathology at UC Davis, said one of the tests that runs on an SUV-sized instrument created by Roche Diagnostics should come online within weeks and is expected to churn out 1400 results per day. He called it a “game changer.”

As for private companies, Quest Diagnostics has been running 1,200 tests a day out of its lab in San Juan Capistrano, Newsom said Monday — and could ramp up to 10,000 tests per day across the country with the addition of another laboratory by the end of this week.

Should I get tested?

Californians are still facing delays, or no tests at all. And a surge of demand for testing supplies — including swabs, kits for extracting the virus’s genetic material, and personal protective equipment for healthcare workers — threatens the state’s efforts to scale up tests.

At a time of limited resources, testing should be reserved for people with moderate to severe symptoms and for those with underlying health conditions, said Michael Romero, a program manager with Placer County’s public health emergency preparedness team.

Symptoms can show up between two days and two weeks after exposure to the virus, and include fever, cough, and trouble breathing, according to the CDC.

“Our guidance is if you have mild symptoms, just stay home, testing would help you know whether you have it or not, but it wouldn’t change anything,” because there is currently no treatment, he said.

Can I get tested?

One challenge is the patchwork of guidance about whom to test first across California’s counties, private testing companies, and health systems, according to Kat DeBurgh, executive director of the Health Officers Association of California.

Guidelines may vary from county to county because of the uneven spread of the novel coronavirus, and local public health departments are required to approve the tests run through their labs, DeBurgh said. She’s calling for more guidance from the state about whom to prioritize, she said, to help with the crush of calls that local public health officers are triaging.

In Los Angeles County, for instance, the public health laboratory “will test specimens from high risk patients requiring a rapid public health response if they test positive,” according to guidance from the county. Any other patients with fever and symptoms of a respiratory illness who may have been exposed should be tested by a commercial laboratory, instead.

At Kaiser Permanente, whom to test is up to clinicians, spokesperson Marc Brown told CalMatters in an email. Tests are only available to Kaiser members with a doctor’s order.

Priority goes to hospitalized patients as well as people experiencing symptoms who also have additional risk factors such as being over 60 years old, heart or lung disease, or who are immunocompromised. Anyone exposed to someone with a confirmed or suspected case of the novel coronavirus, or who recently traveled somewhere affected by it, will also be prioritized.

Where can I get tested?

People should first check with their doctor’s office to ask whether they’re collecting specimens, said Romero with Placer County. If their doctor is not doing testing, they can try calling their local urgent care. Romero said people should not go to the emergency department just for testing. That is what would cause unnecessary overflooding in the ER, he said.

Some counties, like Los Angeles and San Diego, ask that people who do not have a primary care provider call the county’s 2-1-1 line for information on where they can find providers with tests.

Sutter Health, for example, is asking that its patients schedule a video visit with a doctor to check whether they meet testing criteria. If a person does meet the criteria, then doctors make arrangements with patients about specific locations where they can go for testing.

Some health systems have also opened drive-thru testing for its members.

Is testing free? What if you’re uninsured?

Earlier this month, Newsom announced that all screening and testing fees would be waived for about 24 million Californians. That includes co-pays and deductibles for a hospital and doctor office visit associated with the test. But if a person is sick and needs further treatment and care, that cost is not required to be waived.

Newsom’s order does not apply to people who work for large employers and whose private health plans are regulated by the federal government. That said, an emergency coronavirus response bill pending in Congress would require that testing and all related fees be covered by all forms of insurance without out-of-pocket costs for the patient.

The California Department of Public Health has said that people who are uninsured and have symptoms should contact their local health department for information on how to get tested.

Some health clinics, like the AltaMed group in Southern California, are waiving test fees even for patients who are uninsured, but again, tests are only given to people who are showing symptoms. Also, clinics can help enroll patients in any available county program that may cover fees, and clinics themselves often charge on a sliding scale, which means costs are based on a person’s ability to pay.

Testing through the Verily screening pilot program screening in Santa Clara and San Mateo counties is a philanthropic effort and also free to the public.

What’s the deal with Verily’s triage site?

Confusion has dogged the rollout of a triage site aimed at directing concerned Californians to testing. At first, President Donald Trump said Friday that “Google has 1,700 engineers working” on a screening website that would be “very quickly done.”

In fact, it was Verily, the life sciences subsidiary of Google’s parent company Alphabet, behind the effort, and the site was not a nationwide screening tool but one specifically for Californians in the Bay Area. Newsom announced the triage website on Sunday, where people can fill out a questionnaire and schedule an appointment at one of two test sites in Santa Clara and San Mateo.

So far, however, demand far outstrips availability: 174,000 people visited the website in the first day since it opened, Newsom said Monday. 174 people filled out the questionnaire. 50 people signed up for specific appointments — and 30 people actually showed up. Newsom said he expects testing to grow by 200 to 400 tests per site, and in a press briefing on Tuesday, he projected the Verily mobile test sites had conducted 320 tests that day.

Newsom said Monday the whole idea is to expand these mobile test sites beyond the Bay Area. “The good news is operationally, things went fairly well, not perfectly, but fairly well.”

What will this test actually tell me?

The current test for the novel coronavirus looks for the virus itself by sniffing out the virus’s genetic code. These tests can tell you if you have an active infection. What they can not tell you is whether you’ve been infected and recovered.

“Something that is missing from our knowledge of this virus is how many people are exposed to it,” said Philip Felgner, director of the vaccine research and development center at the UC Irvine School of Medicine. That data is key for understanding the breadth of the outbreak, and just how lethal it really is.

So how will we be able to track the virus?

Researchers across the world are working on developing another kind of test — one that looks for signs of the immune response to the virus, called antibodies. This kind of test — a serological test — would allow scientists to search out people who have recovered from less severe or asymptomatic cases of the virus who never ended up in a hospital.

That could help scientists identify chains of viral transmission, home in on hotspots of the outbreak, and would be a first step towards a fuller understanding of why some people recover more readily than others. STAT has reported that the CDC is working on developing two of these tests, and Science has reported that scientists in Singapore used a serological test to track the outbreak.

Here in California, Felgner at UC Irvine has teamed up with a company called SinoBiological to create tests that can hunt for antibodies to nine different infectious agents including other coronaviruses like ones that cause SARS and MERS, as well as viruses that lead to similar symptoms, like influenza.

Felgner and a research institute in San Francisco called Vitalant intend to validate these tests and other, similar ones, by running them with leftover samples of donated blood from Seattle. Another test will look for the kinds of antibodies that can neutralize infections, giving a sense for how effective the immune response actually is.

Michael Busch, director of the Vitalant Research Institute, clarifies that these tests aren’t to screen the blood. “We don’t screen blood purposefully for this virus, it’s not a transfusion transmissible agent,” Busch said.

The goal, instead, is to survey communities to find out just how far the virus spreads, and for how long. “What it does show you is how many people were infected,” Busch said. That changes the calculus for what we understand about how often the virus causes severe symptoms, or kills people — and where exactly to be looking for it.

CalMatters.org is a nonprofit, nonpartisan media venture explaining California policies and politics.