Latest From California Healthline:
A seedy section of downtown Los Angeles has become the go-to place for those who trade in wholesale — and sometimes counterfeit — vaping products. As more people fall ill with a mysterious lung disease linked to e-cigarette use, the manufacture and distribution of vaping products face increased scrutiny. (Heidi de Marco, 10/18)
Good morning! More than half a million Californians could lose power this week as everyone braces for the heightened potential of fast-moving wildfires. The power shut-offs highlight in particular how vulnerable some populations are despite the time to prepare. Read more on that below, but first here are your top California health stories for the day.
Union Representing 4,000 Behavioral Health Specialists Announces Five-Day Strike Against Kaiser Set For November: The National Union of Healthcare Workers said a walkout would occur Nov. 11-15 at more than 100 Kaiser Permanente facilities. “We’re fighting to end a double standard,” said Kaiser social worker Elizabeth White, in a news release from the union. “We know the medical care we receive as Kaiser patients is much better than the care we can provide as mental health therapists, and we won’t accept second-class status for our patients or ourselves.” Kaiser has said that it has made an offer to the union that would provide immediate relief from staffing shortages and constraints in appointments. The union rejected that offer in July, saying it would not alleviate wait times for return visits. On Wednesday morning, workers gathered for a pre-dawn vigil outside the health care giant’s Oakland headquarters to remember patients who have died by suicide — in some cases, because they had to wait too long for care, workers say. Read more from Cathie Anderson of the Sacramento Bee, Fiona Kelliher of the Bay Area News Group, and Alex Kacik of Modern Healthcare.
Expanding Homeless Crisis Tests California’s Reputation For Its Commitment To Tolerance: Homelessness is an expanding crisis that comes amid skyrocketing housing prices, a widening gap between the rich and poor and the persistent presence on city streets of the mentally ill and drug-dependent despite billions of dollars spent to help them. Residents say they have found themselves weighing concerns for the less fortunate against disruptions to their own quality of life. “I do think this is, in a lot of ways, a test of who are we as a community,” said John Maceri, the chief executive of the People Concern, a social services agency in Los Angeles. “Some people who I’d put in the fed-up category, they’re not bad people … but at some point they reach the breaking point.” For many, that breaking point was the worsening squalor in the streets of cities like Los Angeles and San Francisco, where open-air drug dealing is rampant in some spots and where human feces and scattered needles and syringes have been found lying about. Read more from Thomas Fuller, Tim Arango and Louis Keene of the Los Angeles Times.
Hundreds At Disneyland Possibly Exposed To Measles: A person who was infectious with measles visited Disneyland last week, leading public health officials to warn that hundreds of other people at the theme park were possibly exposed to the highly contagious disease. Measles, which was declared eliminated from the United States in 2000, has returned with a vengeance this year, with 1,250 individual cases confirmed in 31 states so far in 2019. Though no other measles cases have yet been linked to last week’s visit, places that have a high volume of visitors, like Disneyland, strike a special fear among public health officials. Read more from Adeel Hassan of The New York Times and Miranda Cosgrove of the San Diego Union-Tribune.
Below, check out the full round-up of California Healthline original stories, state coverage and the best of the rest of the national news for the day.
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More News From Across The State
Los Angeles Times:
California Braces For More Power Outages As Dangerous Winds Pick Up
More than half a million utility customers could lose power this week as California braces for hot weather, strong winds and the heightened potential for fast-moving wildfires. Southern California Edison said more than 308,000 customers in seven counties — Ventura, Los Angeles, San Bernardino, Riverside, Orange, Kern and Santa Barbara — could face blackouts starting Wednesday night and rolling into midday Thursday. (Fry and Cosgrove, 10/23)
Power Outages Show Rural CA Health Safety Net Is Vulnerable
The widespread PG&E power shutdowns are depriving California’s rural and indigent residents of critical care from community health clinics that they have come to count on not only for primary care but also for many types of emergency care, leaders in the industry told The Bee. “The health center in Winters ... had some available power, but they had to make the choice between keeping the lights on, keeping the electronic medical records running or keeping the vaccine refrigerator running,” said Thomas Tighe, chief executive officer of Direct Relief, a nonprofit that supports clinics in medically under-served regions of the United States and world. “They decided to keep the electronic medical records operational and hand off the vaccines to a hospital that did have backup power.“ (Anderson, 10/24)
The Wall Street Journal:
Second Round Of Blackouts Begins In California, With More On Horizon
PG&E Corp. on Wednesday began shutting off power to 179,000 customers in 17 California counties, its second major intentional blackout this month meant to head off potential wildfires. The shut-offs began at 2 p.m. local time in the Sierra Nevada foothills and 3 p.m. in some counties north of San Francisco. More were planned for 1 a.m. Thursday in parts of San Mateo County, between San Francisco and San Jose, and Kern County, in the southern part of the state’s Central Valley. (Carlton, 10/24)
California Pursues A Holy Grail: High-Tech Data To Predict How Wildfire Will Spread
On a recent day at an expansive National Guard airfield in Los Alamitos, local fire officials put on display what $4.5 million can buy: planes crammed with high-definition cameras, radar and infrared equipment that peers through smoke. This eye in the sky can provide commanders on the ground with a broad picture of a wildfire in its infancy, the most critical time for decision-making. The plane — operating at 10,000 feet, out of signal range — beams the information to a smaller aircraft below, which relays it to a UC San Diego research team running a lab known as WIFIRE. The lab’s supercomputer spits out mapping and heat-detection data within minutes, and it generates a model of how the fire might spread based on a number of factors — the holy grail for fire bosses. Eventually, such information will go to a wildfire warning center created under a new state law. (Cart, 10/23)
Los Angeles Times:
Large, Fast-Moving Wildfire Explodes In Sonoma County, Prompting Evacuations
A rapidly spreading wildfire driven by strong winds exploded in Sonoma County late Wednesday, prompting evacuation orders for residents east of Geyserville. The Kincade fire is an estimated 7,000 acres and has no containment, according to the California Department of Forestry and Fire Protection and local officials. It is being driven by strong north winds and is moving south, a Cal Fire spokeswoman said Wednesday night. It started in a mountainous area near Kincade Road and Burned Mountain Road, according to preliminary information. (Cosgrove and Lin, 10/24)
Los Angeles Times:
Extreme Or Critical Fire Danger Forecast For Thursday In California
Strong offshore winds and extremely dry conditions will result in widespread critical fire weather conditions throughout California on Thursday, according to the National Weather Service. Strong surface high pressure in the Great Basin will promote strong northeasterly Santa Ana winds. (Duginski, 10/23)
The Associated Press:
NYC, California Sue Postal Service Over Smuggled Cigarettes
California and New York City sued the U.S. Postal Service on Tuesday to stop tens of thousands of cigarette packages from being mailed from foreign countries to U.S. residents, saying the smugglers are engaging in tax evasion while postal workers look the other way. The lawsuit in Brooklyn federal court blames the Postal Service for deliveries from Vietnam, China, Israel and other countries, saying the failure to enforce a federal law aimed at banning cigarette mail deliveries costs California an average of $19 million annually in tax revenues and New York City and state over $21 million each year. (10/22)
Newly Uncovered Cases Of Patient Abuse At Laguna Honda Bring Victim Count To 130
The number of patients subject to various forms of abuse at San Francisco's Laguna Honda Hospital is now 130 — not 23, as previously reported by city officials. The latest incidents were uncovered from a forensic analysis of the cellphones of six former employees, who allegedly carried out the abuse over a three-year period from 2016 to January 2019. (Siler, 10/24)
San Jose Mercury News:
Stanford New Hospital Prepares To Open In November 2019
After more than a decade in the making, Stanford University’s new $2 billion, state-of-the-art hospital — propped above a moat and coasters that will allow it to ride out a big earthquake — is just weeks away from welcoming its first patients. At a dedication ceremony on Wednesday morning, more than 300 university leaders, medical staff, donors, elected officials and community members gathered to celebrate the hospital’s near completion. (Angst, 10/23)
Los Angeles Times:
The Recent Vaping Deaths Are Bad. The Long Term Toll Will Be Even Worse
The Centers for Disease Control and Prevention has linked vaping to 1,479 cases of a mysterious lung disease over the last six months. At least 33 people have died since the outbreak began. The illness is marked by chest pain, shortness of breath and vomiting, and it has largely affected young people. The vast majority of cases, almost 80%, involve e-cigarette users younger than 35, and another 15% are younger than 18. (Baumgaertner, Greene and Mukherjee, 10/23)
The New York Times:
Marijuana And Vaping: Shadowy Past, Dangerous Present
For years, a divisive debate has raged in the United States over the health consequences of nicotine e-cigarettes. During the same time, vaping of a more contentious substance has been swiftly growing, with scant notice from public health officials. Millions of people now inhale marijuana not from joints or pipes filled with burning leaves but through sleek devices and cartridges filled with flavored cannabis oils. People in the legalized marijuana industry say vaping products now account for 30 percent or more of their business. (Richtel, 10/21)
Nasty Letters. Funding Threats. Here’s Why California's Clean Air Fight With The Feds Matters
Commuters in California may not have to worry about federal threats to yank highway funding just yet — but the recent tiff with the feds over California’s clean air plans is bigger than a simple paper shuffling standoff. The fight started with a two-page missive from U.S. Environmental Protection Agency Administrator Andrew Wheeler. Sent in September, the letter accused California of what the EPA called a “backlog” of federally required paperwork detailing the state’s plans and policies to cut air pollution. The EPA threatened to level sanctions at the state, including withholding federal highway funds, if California did not withdraw plans that the federal government considered “unapprovable.” (Becker, 10/21)
New Meth 'Sobering Centers' Top San Francisco's Plans To Address Drug Crisis
San Francisco Mayor London Breed convened a task force in February to address the fast-growing numbers of meth overdoses and hospitalizations, and on Tuesday the force issued its report, detailing 17 recommendations on how to improve crisis response and treatment options for people with problematic meth use. The number one recommendation, and one the mayor is acting on immediately, is to open a meth sobering center, a safe place where people who are too high or experiencing meth-induced psychosis can safely come down. (Dembosky, 10/23)
Ventura County Star:
Casa Pacifica Youth Services To Unveil New Building, Cottages
Nonprofit Casa Pacifica Centers for Children and Families, a crisis-care facility for foster and at-risk youth, will formally unveil a new multi-purpose building and two new residential cottages at its Camarillo campus Thursday. The ribbon-cutting, which will also include the official unveiling of an existing, repurposed building, will be from 4:30 p.m. to 6 p.m. at 1722 S. Lewis Road. The new building and cottages, which cost about $16.6 million to construct, actually opened their doors earlier this year, Casa Pacifica officials said. But their formal unveiling wasn't scheduled until now, the officials said. (Harris, 10/23)
Los Angeles Times:
Displaced L.A. Tenants Face Hurdles Over 'Right To Return'
L.A. leaders approved the $1-billion development over the vehement objections of the AIDS Healthcare Foundation, which sued the city over the project. In the meantime, scores of tenants still living at the apartment buildings started negotiating over their “right to return.” Now, with a deadline looming, many tenants say that Harridge Development Group is offering them a deal they do not want to accept. Among the conditions that worry them: They must agree not to make any “derogatory, critical, diminuitive, deprecating, or discrediting comments” about the building owner — or even about the deal itself. (Reyes, 10/23)
Housing The Homeless Cuts State's Health Care Burden
The state Department of Health Care Services wants to interrupt the cycle between the street, the hospital, and back again by trying to house the most vulnerable and reduce their health care costs. The project began in 2016, and is known as “Whole Person Care.” The pilot project is intended to model how Medi-Cal could take a more active role in addressing the state’s homeless crisis. (Tinoco, 10/23)
The New York Times:
Obamacare Premiums To Fall And Number Of Insurers To Rise Next Year
Nearly three years into President Trump’s aggressive efforts to undermine the Affordable Care Act, prices for the most popular type of health insurance plan offered through the health law’s federal marketplace will actually drop next year, and the number of insurers offering plans will go up. Administration officials credited Mr. Trump with the resiliency of the law even as they echoed his contempt for it. (Goodnough, 10/22)
Verma To Democrats: Some Insurance ‘Better Than No Insurance At All'
CMS Administrator Seema Verma on Wednesday defended the Trump administration's actions on healthcare, telling the U.S. House of Representatives' Energy and Commerce Committee that her agency is trying to provide greater access to care in the face of rising healthcare costs. Verma touted the CMS' efforts on a range of healthcare issues from health IT interoperability to opioid abuse throughout her testimony, but the committee's Democratic members met her with fierce criticism. They said that under the Trump administration, the healthcare system is heading in the wrong direction and that the Affordable Care Act is succeeding "despite" the administration's best efforts to undermine it. (Brady, 10/23)
How Warren Could Pay For 'Medicare For All'
Sen. Elizabeth Warren’s pledge to reveal how she'd pay for her "Medicare for All" plan carries big risks, no matter which path she takes. Taxing the wealthy won’t cover the trillions in cost. Raising taxes on the middle class is a political third rail. Other options, like reducing health care benefits or raising payroll taxes are also politically dicey. Small wonder then that the top-tier Democrat — whose motto is that she has a plan for everything — doesn’t have one yet for how to pay for universal health care. (Ollstein, 10/21)
The New York Times:
Medicaid Covers A Million Fewer Children. Baby Elijah Was One Of Them
The baby’s lips were turning blue from lack of oxygen in the blood when his mother, Kristin Johnson, rushed him to an emergency room here last month. Only after he was admitted to intensive care with a respiratory virus did Ms. Johnson learn that he had been dropped from Medicaid coverage. The 9-month-old, Elijah, had joined a growing number of children around the country with no health insurance, a trend that new Census Bureau data suggests is most pronounced in Texas and a handful of other states. Two of Elijah’s older siblings lost Medicaid coverage two years ago for reasons Ms. Johnson never understood, and she got so stymied trying to prove their eligibility that she gave up. (Goodnough and Sanger-Katz, 10/22)
How Donald Trump Turned To A Comics Titan To Shape The VA
President Donald Trump personally directed administration officials to report to one of his largest donors, Marvel Entertainment chairman Ike Perlmutter, according to a new book by former Secretary of Veterans Affairs David Shulkin. Starting with Shulkin’s interview for the cabinet post, Trump routinely dialed Perlmutter into meetings and asked if the secretary was keeping Perlmutter informed and happy, Shulkin wrote. Perlmutter would call Shulkin as often as multiple times a day, and White House officials such as Stephen Miller would scold Shulkin for not being in close enough contact with Perlmutter and two of his associates at Mar-a-Lago, Trump’s private club in Florida. (Arnsdorg, 10/22)
In Opioid Settlements, Suboxone Plays A Leading Role
In this week’s $260 million settlement between drug companies and two Ohio counties hit hard by the opioid crisis, $25 million worth of the addiction medication known as Suboxone is a big part of the deal. Suboxone would make up a much larger share of a proposed national settlement announced shortly afterward by a bipartisan group of state attorneys general: an estimated $26 billion over 10 years out of a $48 billion overall settlement. (Vestal, 10/23)
Before Signing Up For Drug Trial, She Wants To Know: Can I Afford It?
It was an alluring pitch. Patidegib was chemically similar to Erivedge but supposedly safer: By rubbing the stuff on to skin, the thinking went, you could avoid the taste loss, hair loss, and muscle cramps that came when you swallowed it — reactions that kept some from taking the pills. ...To scientists, it’s still an exuberant story of discovery against the odds. To patients like [Kaylene] Sheran, it’s a story tempered with worry: Every side effect, it seems, has been prepared for except financial toxicity. (Boodman, 10/23)
The New York Times:
That New Alzheimer’s Drug? Don’t Get Your Hopes Up Yet
Biogen, the drug company, said on Tuesday that it would ask the Food and Drug Administration to approve an experimental drug, aducanumab, to treat people with mild cognitive impairment and the earliest signs of Alzheimer’s disease. About 10 million Americans might qualify for treatment if the drug were approved, according to Michel Vounatsos, the company’s chief executive. Even so, it is not quite time for these patients to celebrate. (Kolata, 10/22)
The New York Times:
Women Should Be Warned Of Breast Implant Hazards, F.D.A. Says
Women considering surgery to receive breast implants should be warned in advance of the risk of serious complications, including fatigue, joint pain and the possibility of a rare type of cancer, the Food and Drug Administration said on Wednesday. Agency officials are urging manufacturers to print a boxed warning on the packaging of the implants, and to provide a checklist spelling out the risks for prospective patients to review before making a decision and putting down a deposit on the surgery. It will be left to doctors to review those risks with women seeking breast implants. (Rabin, 10/23)