Coronavirus Today: Seniors’ many vaccine obstacles

Good evening. I’m Amina Khan, and it’s Thursday, Jan. 28. Here’s what’s happening with the coronavirus in California and beyond.

We’ve heard a lot about the frustrations older Californians have faced in trying to secure their shots of COVID-19 vaccine. Today, we’ll talk about what that reality has looked like for seniors in Los Angeles County.

Take 86-year-old Selda Hollander. She hadn’t been able to navigate the vaccine appointment system, either online or over the phone. But she’d heard about an unofficial standby line at the Balboa Sports Complex in Encino and decided to give it a try.

“I can’t figure out if it’s worth it,” she said, shivering slightly as she hugged her knees against the cold. “I’m waiting for the vaccine, but I can get sick because of the weather.”

Hollander is one of countless Californians over 65 who have discovered that being eligible for the vaccine isn’t the same as actually receiving it, my colleague Hayley Smith reports. It doesn’t help that the system — at least in L.A. County — seems to be a young person’s game. It can take social media skills, tech savvy, reliable transportation and even physical stamina to get hold of a shot. The result is that some of the county’s most vulnerable residents are at a serious disadvantage when it comes to getting one.

It may mean that public health officials need to think more deeply about the ways that they can make these lifesaving vaccines easier to access for older Californians — perhaps akin to the ways they’re thinking of improving access for poorer communities and some communities of color.

“Age is an equity factor, and it should be looked at that way,” said Fred Buzo, associate state director at AARP California, who has worked on Gov. Gavin Newsom’s community vaccine advisory committee since its inception. “Especially when it comes to this crisis.”

The problems start the moment they try to sign up for an appointment. Many seniors, along with their well-meaning children and grandchildren, say they’ve spent hours trying to nab a spot through the clunky online portal. Even if they’re lucky enough to nab one, getting to the vaccination site is no cakewalk: Although there are walk-up sites run by the city of L.A., all five county-run mass vaccination sites are drive-through only, which means that seniors who can’t drive either have to rely on someone they know to take them or bear the cost and risk of hailing a ride-share car.

Even after you make it to a site with an appointment in hand, significant hurdles remain. At the city-run Dodger Stadium drive-through site, many people have reported spending as long as four hours in line; one Eagle Rock resident said that after inching along for two hours, the “call of nature forced me to give up” — and it’s been impossible to get another appointment since then. Another person said she considered buying an adult diaper for the wait. “This is a huge issue for women, and particularly women and men over a certain age,” she said.

Walk-up sites, which include community clinics and sites run by the Los Angeles Fire Department, have their own problems. When parking spots are in short supply, some seniors said they had to park several blocks away and walk. “It’s clownish,” said 65-year-old Max Tolkoff, who had several back surgeries in the last year and had to use a rolling walker to get through a line at Lincoln Park.

As for Hollander, trying to keep warm in Encino, the past year has been hard. Her husband died in July — not from COVID-19, but the pandemic kept her from visiting him in the hospital. Their dog died a week later from grief, she said. “You feel, at my age, is it even worth living?” she asked.

Her long wait for the vaccine was brightened somewhat by a young man who offered her his folding chair, and by someone else who offered her a blanket. Nearly five hours after she arrived, she was called into the sports complex to roll up her sleeve and get a shot.

Her saga isn’t quite over, of course: Hollander will have to venture forth again in a few weeks, when she’ll be due for her second dose.

California announced Wednesday that it will outsource its vaccine distribution operation to Blue Shield of California, with the idea that a centralized system will get shots into waiting arms more quickly and smoothly. Whether this will make the process less burdensome for older Californians remains to be seen.

By the numbers

California cases, deaths and vaccinations as of 5:28 p.m. PST Thursday:

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

Across California

We’ll start off our look at the Golden State with a little dose of good news from the Southland: With four weeks of declining hospitalizations under its belt, L.A. County appears to be on its way out of its third — and deadliest — surge of the pandemic.

Lest we forget, hospitals are still under enormous pressure. Scheduled surgeries are still suspended, and there’s an ongoing shortage of medical staff. The county’s hospitals still have nearly three times as many COVID-19 patients as they did at the peak of the summer wave. And conditions could still get worse, given the rise of new coronavirus variants circulating in the state, my colleagues Rong-Gong Lin II and Luke Money write.

Still, county officials are clearly relieved that they�ve managed to avoid a hospital disaster like the ones seen in New York City and northern Italy. No hospitals here were forced to declare formally that they were providing “crisis standards of care,” in which case overwhelmed doctors would potentially have had to decide which patients would receive aggressive, lifesaving treatment and which would get palliative care as they died.

“The case numbers are down. The hospitalizations are down,” said Dr. Christina Ghaly, the L.A. County health services director. It will take time for the number of people in hospitals to decline. “But [the numbers] are absolutely heading in the right direction.”

Speaking of numbers heading in the right direction, the number of Los Angeles firefighters testing positive for the coronavirus has plummeted since the city agency began vaccinating them on Dec. 28, Fire Chief Ralph Terrazas said in a memo. Before then, LAFD was averaging more than 15 new cases a day. In the most recent week, they’ve averaged fewer than five per day. The L.A. County Fire Department has also seen a sharp drop in cases since its vaccination process began.

The city’s roughly 3,350 firefighters serve on the pandemic’s front lines as paramedics and emergency medical technicians, which is why they were among those first given access to the vaccine. More than 860 firefighters, or close to a quarter of the force, have tested positive during the pandemic. Two have died.

Still, only 60% of LAFD firefighters had been inoculated at the end of last week, according to the department — in spite of the chief’s urging and an incentive program that offers prizes for those who step up for a shot. Some officials said firefighters don’t feel comfortable being among the first to take the vaccine, while others don’t feel they need it because they’ve already been infected. (You still need it even if you’ve had COVID-19, as we�ve discussed in this newsletter.)

L.A. Mayor Eric Garcetti said he encouraged firefighters to “follow your union chief, follow your chief, their example and get the vaccine.” He set his own example last week by getting a shot himself. Garcetti isn’t yet 65 — he’s turning 50 next week — and he’s not a health worker, but aides say he’s eligible because he’s on the front lines of the pandemic response.

Spokesman Alex Comisar said the mayor got his first dose after he spent five days at Dodger Stadium helping with the vaccination effort and “directly interacting with hundreds of Angelenos each day.” “The medical personnel strongly recommended that he receive the vaccine as they have recommended and provided for other field staff and volunteers at the site who have close contact with clients,” Comisar said.

In a possibility that may delight some parents and students, L.A. County Public Health Department Director Barbara Ferrer said Wednesday that elementary school campuses could be eligible to reopen in two to three weeks if countywide coronavirus infection rates continue to drop. But Ferrer warned that the current positive trend could easily reverse. This “assumes that everybody continues to do their very best — play by the rules to keep making sure that transmission goes down and not back up,” she said.

School officials and some local advocacy groups also expressed caution. “It’s concerning to hear this kind of public pronouncement after weeks of alarmingly high case rates, hospitalizations, and deaths, particularly for low-income communities and communities of color,” said Los Angeles school board President Kelly Gonez. “I would like to continue to see a trend of significant decline in COVID-19 spread to avoid setting up in-person supports only to have to close them down again as we did in December.”

The vast majority of county students have been learning from home since March, my colleague Howard Blume writes. Many have struggled with inadequate internet access and difficult learning environments. Pandemic learning disparities have especially affected students who come from low-income families, are learning English or have disabilities.

“There must be a solid strategy to ensure that Black and Latino students are not being disproportionately overlooked in this rapid school reopening effort,” said Shaun Harper, an education professor at the University of Southern California.

See the latest on California’s coronavirus closures and reopenings, and the metrics that inform them, with our tracker.

Around the nation and the world

The Biden administration warned Americans in its first health briefing that as many as 90,000 more in the U.S. will die of COVID-19 in the next four weeks. It’s a sobering reminder of what’s at stake as the government works to improve delivery of the vaccines. “I know this is not news we all want to hear, but this is something we must say so we are all aware,” said Dr. Rochelle Walensky, the new director of the Centers for Disease Control and Prevention. “If we are united in action we can turn things around.”

The tone of Wednesday’s briefing marked a sharp contrast to those given by the previous administration, where former President Trump repeatedly undermined his own public health officials by sharing his unproven ideas.

In many ways, Biden faces an uphill battle. He’s urging a weary nation to recommit to social distancing measures and mask-wearing, pointing to research that shows the practices could save 50,000 lives in the next few months. He’s also battling a certain level of hesitancy among Americans who aren’t sure they should roll up their sleeves for a shot of COVID-19 vaccine.

Dr. David Hamer, a professor of global health and medicine at Boston University’s School of Public Health, said briefings from health officials that are “based on serious science” would go a long way toward improving public perceptions of the vaccines. “Educating people about the vaccine, how it works, how safe it is and how it can protect against the disease but also slow transmission is really important,” he said.

The beleaguered U.S. economy shrank by 3.5% in 2020, suffering its largest contraction in 74 years, according to estimates in a new report from the Commerce Department. The pandemic struck a blow that ended a nearly 11-year U.S. economic expansion, the longest on record. The economy did grow at a 4% annual rate in the final three months of the year, but it wasn’t enough to make up for the shock from the pandemic.

As for 2021, the outlook remains hazy, with economists warning that we won’t see a sustained recovery until vaccines are administered nationwide and government-enacted rescue aid spreads through the economy. That will likely take months.

On to Oregon, where health workers stuck in a snowstorm on their way back from a COVID-19 vaccination clinic went from car to car injecting stranded drivers before some of their doses expired. The Josephine County Public Health Department said the “impromptu vaccine clinic” took place after about 20 employees were stopped in traffic on a highway. Six of the doses they carried were getting close to expiring, so the workers decided not to let them go to waste.

While the shots were meant for other people, “the snow meant those doses wouldn’t make it to them before they expired,” the health department said. County Public Health Director Mike Weber said it was one of the “coolest operations he’d been a part of.”

It was a moment of serendipity in a state that has been wrestling with who belonged at the front of the vaccine line. For instance, 75-year-old Susan Crowley said she was shocked when the state started vaccinating teachers this week ahead of senior citizens, even though more than 90% of Oregonians who had died of COVID-19 were over 60.

“I look at these figures and I am literally afraid. It’s not just a question of missing beers with my friends. It’s a question of actually being afraid that if I am not careful, I will die,” she said. “The thing that is so upsetting to me is that seniors don’t matter, the elderly don’t matter. And it’s painful to hear that implication.”

Democratic Gov. Kate Brown has defended her decision. “No matter what you do, people aren’t happy,” she said. “The teachers in Minnesota are furious at the governor because they are doing seniors first. And here, the seniors are furious at me because I am doing teachers first. There are no right answers, and there are no easy decisions.”

Your questions answered

Today’s question comes from a reader who wants to know: If I got a vaccine from Moderna batch 041L20A, what should I do?

Earlier this month, California’s top epidemiologist told healthcare providers to stop using a batch of Moderna’s COVID-19 vaccine after a “higher than usual” number of people at a San Diego vaccination clinic had what appeared to be allergic reactions to the shot. The state had received about 330,000 doses from the batch in question, 041L20A.

This triggered a question from a concerned reader who, together with her husband, had received a dose from that batch in Huntington Beach. They haven’t suffered any problems since getting their shots, but she wanted to know if there was anything they needed to do before they got their second doses.

As it turns out, California State Epidemiologist Dr. Erica Pan announced last week that providers could immediately restart administering doses from lot 041L20A.

“We convened the Western States Scientific Safety Review Workgroup and additional allergy and immunology specialists to examine the evidence collected,” Pan said in a statement. “We had further discussions with the County of San Diego Department of Public Health, the FDA, CDC and manufacturer, and found no scientific basis to continue the pause.”

So for those of you whose vaccine cards say you’ve received a dose from batch 041L20A, fret not. This batch is now being treated just like any other, and you don’t need to do anything out of the ordinary.

(If you’re curious, you can read the workgroup’s findings here.)

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