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Why Researchers Hope to Test High-Risk Groups in California Why Researchers Hope to Test High-Risk Groups in California
(32 minutes later)
By Max Brimelow, Julie Chang, Pedro Cota, Alex Matthews and Kristen HwangBy Max Brimelow, Julie Chang, Pedro Cota, Alex Matthews and Kristen Hwang
Good morning.Good morning.
(If you don’t already get California Today by email, here’s the sign-up.)(If you don’t already get California Today by email, here’s the sign-up.)
Today, we have another dispatch from the University of California, Berkeley Graduate School of Journalism, written by Max Brimelow, Julie Chang, Pedro Cota, Kristen Hwang and Alex Matthews:Today, we have another dispatch from the University of California, Berkeley Graduate School of Journalism, written by Max Brimelow, Julie Chang, Pedro Cota, Kristen Hwang and Alex Matthews:
OAKLAND — In his 20 years in and out of homelessness, Ollie Harris, 69, has seen a lot of things. But what happened on a recent Friday was new.OAKLAND — In his 20 years in and out of homelessness, Ollie Harris, 69, has seen a lot of things. But what happened on a recent Friday was new.
Sitting outside his tent on a patch of ground he and his wife staked out near Lake Merritt, he watched a white van pull up and two women step out wearing surgical masks and latex gloves.Sitting outside his tent on a patch of ground he and his wife staked out near Lake Merritt, he watched a white van pull up and two women step out wearing surgical masks and latex gloves.
“Would you like to be tested today?” one of them asked. “I might as well,” Mr. Harris replied. A nurse quickly swabbed Mr. Harris’s nostrils and throat and then jotted down his information.“Would you like to be tested today?” one of them asked. “I might as well,” Mr. Harris replied. A nurse quickly swabbed Mr. Harris’s nostrils and throat and then jotted down his information.
Mr. Harris was one of the first people tested under a new type of collaboration that has emerged as a distinctive feature in California’s fight against Covid-19.Mr. Harris was one of the first people tested under a new type of collaboration that has emerged as a distinctive feature in California’s fight against Covid-19.
So far at least six new testing initiatives are led by health experts at California’s top public and private universities. They aim to fill gaps in knowledge about the disease’s prevalence, unravel mysteries about survivor immunity and answer other looming questions as California begins to ease its lockdown.So far at least six new testing initiatives are led by health experts at California’s top public and private universities. They aim to fill gaps in knowledge about the disease’s prevalence, unravel mysteries about survivor immunity and answer other looming questions as California begins to ease its lockdown.
Some universities are working independently, others in partnerships with county health departments and community clinics. Most are developing their plans on the fly as they race to get ahead of the fast-moving virus. So far, their work has raised as many questions as it has answered. But there have also been intriguing, if still tentative, findings.Some universities are working independently, others in partnerships with county health departments and community clinics. Most are developing their plans on the fly as they race to get ahead of the fast-moving virus. So far, their work has raised as many questions as it has answered. But there have also been intriguing, if still tentative, findings.
The initiative that tested Mr. Harris, for example, has found just four positive cases out of the 233 homeless people it has tested so far. Another initiative found stark contrasts in infection rates based on whether a person was able to work from home or not. Other university-led studies suggest California remains a long way off from achieving the sort of herd immunity that would slow the virus’s transmission from a gallop to a crawl.The initiative that tested Mr. Harris, for example, has found just four positive cases out of the 233 homeless people it has tested so far. Another initiative found stark contrasts in infection rates based on whether a person was able to work from home or not. Other university-led studies suggest California remains a long way off from achieving the sort of herd immunity that would slow the virus’s transmission from a gallop to a crawl.
[See which California counties have the most coronavirus cases.][See which California counties have the most coronavirus cases.]
The university health experts leading these efforts said they acted to fill a void. Eva Harris, an infectious disease specialist at the University of California, Berkeley, said that watching the virus spread around the world while bickering government leaders hesitated to act was like witnessing the Titanic speeding toward the iceberg. “We finally just said, ‘OK, it hit,’ and still nothing happened, so we need to get involved,” she said.The university health experts leading these efforts said they acted to fill a void. Eva Harris, an infectious disease specialist at the University of California, Berkeley, said that watching the virus spread around the world while bickering government leaders hesitated to act was like witnessing the Titanic speeding toward the iceberg. “We finally just said, ‘OK, it hit,’ and still nothing happened, so we need to get involved,” she said.
While governments at every level and in every region of the United States have struggled to provide enough testing, California has been notably sluggish.While governments at every level and in every region of the United States have struggled to provide enough testing, California has been notably sluggish.
The first known Covid-19 death in the United States happened on Feb. 6 in Santa Clara County. Three months later, government testing in the state remains spotty, in part because of its decentralized and tangled network of test providers spread across a population of 40 million. While California now conducts more than 30,000 tests per day — compared with a few hundred a little more than a month ago — only 26 of every 1,000 Californians have been tested, ranking the state 26th in the nation.The first known Covid-19 death in the United States happened on Feb. 6 in Santa Clara County. Three months later, government testing in the state remains spotty, in part because of its decentralized and tangled network of test providers spread across a population of 40 million. While California now conducts more than 30,000 tests per day — compared with a few hundred a little more than a month ago — only 26 of every 1,000 Californians have been tested, ranking the state 26th in the nation.
Among the vast numbers of the untested are many high-risk groups, but none more so than the 150,000 homeless people living throughout California. Their encampments, often crowded and lacking basic sanitation, could provide a place for the virus to flourish or rekindle.Among the vast numbers of the untested are many high-risk groups, but none more so than the 150,000 homeless people living throughout California. Their encampments, often crowded and lacking basic sanitation, could provide a place for the virus to flourish or rekindle.
One of the most aggressive efforts currently underway to examine the extent of infection in homeless encampments is being led by the Innovative Genomics Institute, a biochemistry lab at the University of California, Berkeley, best known for its work at the forefront of the CRISPR gene-editing process, and Lifelong Medical Care, a community health center also based in Berkeley. The two have begun expanding testing to low-income and homeless populations in Alameda County, including the test given to Mr. Harris at the Lake Merritt camp.One of the most aggressive efforts currently underway to examine the extent of infection in homeless encampments is being led by the Innovative Genomics Institute, a biochemistry lab at the University of California, Berkeley, best known for its work at the forefront of the CRISPR gene-editing process, and Lifelong Medical Care, a community health center also based in Berkeley. The two have begun expanding testing to low-income and homeless populations in Alameda County, including the test given to Mr. Harris at the Lake Merritt camp.
[Read more about California’s testing capacity.][Read more about California’s testing capacity.]
The institute offered Lifelong high-speed automated processing of 5,000 tests, with more to come. Lifelong, which serves about 66,000 patients, had performed fewer than 300 diagnostic tests before the partnership.The institute offered Lifelong high-speed automated processing of 5,000 tests, with more to come. Lifelong, which serves about 66,000 patients, had performed fewer than 300 diagnostic tests before the partnership.
“If we can’t help the vulnerable, what are we doing?” asked Fyodor Urnov, the institute’s scientific director for technology and translation.“If we can’t help the vulnerable, what are we doing?” asked Fyodor Urnov, the institute’s scientific director for technology and translation.
Not far from Dr. Urnov’s office on the Berkeley campus, two professors in the School of Public Health have teamed up for a different kind of study. Dr. Harris, the infectious disease expert, and Lisa Barcellos, a genetic epidemiologist, are investigating the infection’s spread throughout the Bay Area.Not far from Dr. Urnov’s office on the Berkeley campus, two professors in the School of Public Health have teamed up for a different kind of study. Dr. Harris, the infectious disease expert, and Lisa Barcellos, a genetic epidemiologist, are investigating the infection’s spread throughout the Bay Area.
They are testing thousands of residents to look for the presence of active Covid-19 virus as well as antibodies in the blood. This could reveal patients who were exposed but never showed symptoms, and it could also shed light on how widespread the disease truly is in California.They are testing thousands of residents to look for the presence of active Covid-19 virus as well as antibodies in the blood. This could reveal patients who were exposed but never showed symptoms, and it could also shed light on how widespread the disease truly is in California.
The University of Southern California and Stanford University recently released preliminary results of their own antibody studies estimating that between 2 percent to 5 percent of the populations of Los Angeles County and Santa Clara County have been infected, higher than previously believed, but also a potential indicator that California is far away from achieving any possible herd immunity.The University of Southern California and Stanford University recently released preliminary results of their own antibody studies estimating that between 2 percent to 5 percent of the populations of Los Angeles County and Santa Clara County have been infected, higher than previously believed, but also a potential indicator that California is far away from achieving any possible herd immunity.
However, both studies continue to draw attacks over unconventional methodologies, including the use of a test kit that is not approved by the Food and Drug Administration.However, both studies continue to draw attacks over unconventional methodologies, including the use of a test kit that is not approved by the Food and Drug Administration.
As first reported by BuzzFeed News, the Stanford study is now under scrutiny for not disclosing a potential conflict of interest.As first reported by BuzzFeed News, the Stanford study is now under scrutiny for not disclosing a potential conflict of interest.
Updated June 12, 2020Updated June 12, 2020
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
One of the larger testing efforts comes from the University of California, San Francisco’s Division of Infectious Diseases, which, in collaboration with community organizations and local health departments, recently concluded testing of nearly 5,000 people in two different communities — the largely upscale oceanfront town of Bolinas in Marin County, and the Mission District in central San Francisco.One of the larger testing efforts comes from the University of California, San Francisco’s Division of Infectious Diseases, which, in collaboration with community organizations and local health departments, recently concluded testing of nearly 5,000 people in two different communities — the largely upscale oceanfront town of Bolinas in Marin County, and the Mission District in central San Francisco.
The two studies used diagnostic and antibody tests to understand how the virus moves through rural versus urban populations.The two studies used diagnostic and antibody tests to understand how the virus moves through rural versus urban populations.
[What are your chances of catching the virus outdoors? Here’s what to know.][What are your chances of catching the virus outdoors? Here’s what to know.]
U.C.S.F. chose the Mission because the community’s Latinx population was hit hard in the initial outbreak. Bolinas became part of the university’s research focus when two of its residents, Cyrus Harmon, a biotech executive, and Jyri Engeström, a venture capitalist, proposed to get every person in their town tested. When they consulted U.C.S.F. for guidance, they were brought into the university’s Covid-19 testing program for comparison with the Mission study.U.C.S.F. chose the Mission because the community’s Latinx population was hit hard in the initial outbreak. Bolinas became part of the university’s research focus when two of its residents, Cyrus Harmon, a biotech executive, and Jyri Engeström, a venture capitalist, proposed to get every person in their town tested. When they consulted U.C.S.F. for guidance, they were brought into the university’s Covid-19 testing program for comparison with the Mission study.
Initial results released in early May correlate the highest infection rates to low-wage and essential workers who, for economic reasons, have no choice but to work outside the home.Initial results released in early May correlate the highest infection rates to low-wage and essential workers who, for economic reasons, have no choice but to work outside the home.
Of the 2,959 people tested in the Mission, 62 tested positive. Of those who tested positive, 90 percent said they were unable to work from home and nearly as many said they earn less than $50,000 a year. Ninety five percent of those who tested positive were Latinx, although only 44 percent of the overall sample were Latinx.Of the 2,959 people tested in the Mission, 62 tested positive. Of those who tested positive, 90 percent said they were unable to work from home and nearly as many said they earn less than $50,000 a year. Ninety five percent of those who tested positive were Latinx, although only 44 percent of the overall sample were Latinx.
Of the 1,845 people tested in Bolinas, none tested positive.Of the 1,845 people tested in Bolinas, none tested positive.
“The virus exploits pre-existing vulnerabilities in our society,’’ Diane Havlir, a physician involved in the U.C.S.F. study, said.“The virus exploits pre-existing vulnerabilities in our society,’’ Diane Havlir, a physician involved in the U.C.S.F. study, said.
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Jill Cowan grew up in Orange County, went to school at U.C. Berkeley and has reported all over the state, including the Bay Area, Bakersfield and Los Angeles — but she always wants to see more. Follow along here or on Twitter.Jill Cowan grew up in Orange County, went to school at U.C. Berkeley and has reported all over the state, including the Bay Area, Bakersfield and Los Angeles — but she always wants to see more. Follow along here or on Twitter.
California Today is edited by Julie Bloom, who grew up in Los Angeles and graduated from U.C. Berkeley.California Today is edited by Julie Bloom, who grew up in Los Angeles and graduated from U.C. Berkeley.