Coronavirus Today: Building vaccine trust

Good evening. I’m Amina Khan, and it’s Monday, Nov. 30. Here’s what’s happening with the coronavirus in California and beyond.

With drugmakers now seeking emergency authorization for their COVID-19 vaccine candidates, public health authorities are turning their attention toward the next big challenge: How do they store, transport, distribute and track vaccines — and make sure that the first limited doses go to those people who need it the most?

Columnist Erika D. Smith says that by focusing on this logistical problem, authorities may be missing a much more critical question: Even if you distribute the vaccine to the most vulnerable populations, what do you do when some of the people who need it refuse to take it?

While vaccine hesitancy is a major cause for concern in general, it’s an acute problem in Black communities. A recent survey by the Pew Research Center found that only 32% of Black adults said they would definitely or probably take a COVID-19 vaccine.

Walter Perez, a Black nurse practitioner working at the U.S. Department of Veterans Affairs hospital in Long Beach, says his Black patients cite a lot of reasons for avoiding a potentially lifesaving vaccine. Some worry that Big Pharma has cut corners when it comes to ensuring the vaccines’ safety. Others fear the medical establishment will use Black people as guinea pigs to test those vaccines.

“The only way I can describe it is there’s a paranoia,� Perez said. “A lot of people are just really paranoid about it.�

That sentiment appears to be particularly widespread in California, where less than 30% of Black people said they would definitely or probably get vaccinated — the lowest share of any racial group surveyed by the Public Policy Institute of California.

Here’s the thing: Those fears exist among Black people for good reason, Smith says.

“Many of us grew up hearing stories as children about how Black men were left to suffer during the Tuskegee Syphilis Study and, as adults, have lived out our own stories of fighting through disparities to try to get adequate care,� she writes.

This legitimate skepticism of the healthcare system will make it much harder to persuade millions of Black people to sign up for these shots, and that will be eye-opening to some elected and public health officials, Smith writes.

“In the same way that the killing of George Floyd in Minneapolis made plain how this country has never truly dealt with its history of systemic racism in policing, the COVID-19 pandemic has made plain the unaddressed history of distrust and systemic racism in the nation’s healthcare system,� she writes.

The point is that while equitable access to healthcare is a big problem for Black patients — one that Gov. Gavin Newsom has pledged to take into account as the state makes plans for vaccine distribution — the problem here isn’t access so much as it is trust.

How can public authorities earn the trust of skeptical, historically marginalized communities? Black doctors and nurses can help instill some confidence, but this is not their burden to bear alone — nor should it be, Smith writes.

Authorities will have to find a solution to this dilemma fast if they want to vaccinate enough people to achieve herd immunity, and stop the pandemic in its tracks.

By the numbers

California cases and deaths as of 6:18 p.m. PST Monday:

(Los Angeles Times Graphics)

Track the latest numbers and how they break down in California with our graphics.

Across California

It was a grim Thanksgiving weekend for coronavirus cases in California. The state now has more people hospitalized with COVID-19 than at any time since the pandemic began. And the worst may be yet to come, because gatherings and other activity over the long holiday weekend could leave even more new infections in their wake.

There were 7,415 COVID-19 patients in California hospitals on Saturday, surpassing the previous high of 7,170 set in July. Keep in mind that just a month ago, on Oct. 28, there were about 2,400 COVID-19 patients in hospitals throughout the state — roughly a third of the number now.

The biggest contingent of hospitalized patients — 2,316 of them as of Sunday — is in Los Angeles County, which has now surpassed its July record of 2,232. With an average of 30 people dying every day, the county’s daily death toll has also roughly tripled since the period around election day.

“We were prepared for an increase,� said Barbara Ferrer, the L.A. County public health director. “None of us really thought the increase would be so big across such a short period of time.�

In response to the surge, the county has instituted sweeping new restrictions that went into effect today. Although the rules are less severe than the springtime stay-at-home order, they’re the strictest in California, and the toughest Angelenos have faced in months. Among them:

• Most gatherings among people from different households are officially banned, with the exception of outdoor religious gatherings and outdoor political protests.
• Essential retail stores can operate at 35% of their capacity, down from the previous cap of 50%. Nonessential retail stores, malls, libraries and personal care outfits are limited to 20% of capacity, down from 25% previously.
• Outdoor museums and zoos are now limited to 50% capacity.
• Playgrounds that aren’t part of a school or child-care center must close.
• Outdoor card rooms must shut down.

Beaches, trails, parks, golf courses, tennis courts and other outdoor recreation spaces are allowed to remain open.

The hope is that these more tailored restrictions will help slow the spread of the virus without having to resort to more draconian measures. But if folks don’t follow the safety precautions, or if they fall short for other reasons, the rules could tighten further.

Health officials had already suspended outdoor dining at restaurants throughout the county — except for in Pasadena, one of two cities with its own health department and thus the authority to decide not to implement the ban. Now, as the surge continues, the city is stepping up enforcement of coronavirus rules. That includes shutting down noncompliant restaurants and dispatching teams to parks and the Rose Bowl loop to break up gatherings and write citations.

In the Bay Area, San Francisco and San Mateo counties were moved to the most restrictive tier of the state’s reopening plan this weekend, which now forces them to close indoor operations of restaurants, gyms, movie theaters and houses of worship. In just the last six weeks, weekly coronavirus cases in San Francisco have more than quadrupled, from about 200 a week in mid-October to about 900 a week now.

Meanwhile, Santa Clara County issued its own tightened COVID-19 rules that in some ways are stricter than those issued by L.A. County’s. There, people who have traveled more than 150 miles must quarantine for 14 days upon their return; hotels will be open only for essential travel or isolation and quarantine; and nonessential retail establishments will be capped at 10% of indoor capacity, down from the current cap of 25%.

Altogether, 51 of California’s 58 counties are now in the purple tier, and they are home to 99% of the state’s population. The only counties doing better are Marin, Amador, Inyo, Mariposa, Mono and Alpine (which are in the red tier) and Sierra (which is in the orange tier).

See the current status of California’s reopening, county by county, with our tracker.

Around the nation and the world

Dr. Anthony Fauci, the nation’s top infectious disease expert, said Sunday that the U.S. may see a “surge upon a surge� of coronavirus cases in the weeks following Thanksgiving — and that he doesn’t expect social distancing recommendations to be relaxed before Christmas. The level of infection in the U.S. won’t suddenly turn around, he told ABC’s “This Week.�

He made similar comments to NBC, adding that it’s “not too late� for folks traveling home after Thanksgiving to help stop the virus’ spread by wearing masks, maintaining their distance from other people and avoiding large groups. “We know we can do something about it,� he said.

Fauci also offered hope to parents eager for their kids to return to school. He noted that coronavirus spread “among children and from children is not really very big at all, not like one would have suspected. So let’s try to get the kids back.�

Colorado Gov. Jared Polis has tested positive for the coronavirus, as has his partner, Marlon Reis, and both are asymptomatic, the governor said. He said he had started quarantining Wednesday after he said he was exposed to the virus. He had tweeted late Wednesday that he had tested negative the night after learning of his exposure but would be retested.

Colorado has been dealing with a significant surge in cases. An estimated one in 41 residents is thought to be contagious. “Now is the time to be more cautious than ever before,� Polis said in his statement. “There is more of the virus circulating across the country, including in Colorado, now than there even was in the spring.�

The pandemic created enormous challenges for U.S. colleges that opened the fall semester with in-person learning. Many of them quickly succumbed to outbreaks as students gathered on and off campus. Now, those that aren’t planning on going virtual-only in the new year are evaluating how they might bring students back after the winter holidays even as coronavirus cases keep surging nationwide. They’re hoping that adjusting testing protocols, introducing new screenings and even canceling spring break will help them keep campuses open.

Cal Poly San Luis Obispo plans to add saliva testing in the winter quarter that will be processed on campus. Colby College in Maine wants to add rapid antigen tests this spring to twice-weekly tests for students, faculty and staff. But a growing contingent of schools, such as George Washington University in Washington, D.C., say they’ll be sticking to virtual instruction through the spring.

Pope Francis has been criticized for somewhat lax and inconsistent mask-wearing and social-distancing policies. But on Saturday, he elevated 13 new cardinals in a ceremony that appeared more reflective of pandemic-related restrictions. Two of the honorees, from Brunei and the Philippines, respectively, did not make it to Rome because of travel restrictions. During the socially distanced and ceremony, which lasted a relatively brief 45 minutes, the red-hatted cardinals wore masks in St. Peter’s Basilica, which was largely empty.

Most of the cardinals did remove their masks when they approached a maskless Francis to receive their new hats, but Cardinal Wilton Gregory — the archbishop of Washington, D.C., who hasn’t shied away from standing up to President Trump, and who is now the first Black American cardinal — kept his affixed to his face.

Your questions answered

Today’s question comes from a reader who wants to know: How easy is it to contract the virus through the eyes?

First off, it is true that SARS-CoV-2, the virus that causes COVID-19, can infect someone though their eyes, said Dr. Lisa Maragakis, senior director of infection prevention at the Johns Hopkins Health System.

This can happen in one of two main ways:

• When respiratory droplets from an infected person travel through the air and land in another person’s eye.
• When a person picks up the virus from a contaminated surface or by touching an infected person, and then touches their face or rubs their eyes without first washing their hands.

The eyes offer the virus an easy doorway into the body, Maragakis said. “The receptors that the virus uses to enter cells and cause an infection are present on the surface of the eyes,� she said.

The best way to protect yourself, she said, will probably involve the practices you’ve already put into place: Maintain physical distance of at least 6 feet between yourself and others, avoid people who aren’t wearing masks correctly, and don’t touch your face or rub your eyes unless you have first thoroughly washed your hands.

“Wearing eye protection such as a face shield, glasses or goggles may also help, but you must be cautious to ensure that wearing these does not cause you to inadvertently touch your face and eyes while adjusting them,� she said.

Eye protection is certainly important in clinical settings, where medical staff are routinely closer than 6 feet to the patients they’re treating, she added.

We want to hear from you. Email us your coronavirus questions, and we’ll do our best to answer them.