California releases guidelines for private gatherings with friends

Ahead of the Halloween and Thanksgiving holidays, California Health and Human Services Secretary Dr. Mark Ghaly addressed new guidelines the state released this week allowing private outdoor gatherings with friends if specific conditions are met.

Ghaly said attendees must be from no more than three separate households and gatherings should last no more than two hours.

Gatherings “should be and must be done outside,” he added. People are also expected to take safety precautions, including wearing masks, practicing physical distancing and washing hands.

In the past, the state discouraged any gatherings outside of a single household.


Ghaly said the guidelines are meant to recognize that many close friends and relatives have been apart a long time and increasingly want to be together, especially with the holidays ahead.

The intention of the guidelines is not to encourage gatherings, but to inspire people to socialize safely when they do.

“Guidance here does not mean go,” he said. “It does not mean that we’re endorsing or suggesting small gatherings happen. We just want to provide important ways to reduce your risk, so you protect yourselves, your families and your communities.”

“We believe and still really support the messaging that spending time with your household alone is the way we can reduce transmission the best,” he said.

While much of the country and European nations are seeing a resurgence, coronavirus indicators in California are near their record lows. Hospitalizations are at their lowest level since early April and those in intensive care at their second-lowest level since officials began keeping track in late March. The rate of positive tests has been hovering at 2.6% for two weeks.

“We don’t see the surge other parts of the country are experiencing and other parts of the globe,” he said. “We don’t want to see the spike that could rightfully happen.”

The Associated Press contributed to this story.

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California rules now allow for 3 households to socialize

SACRAMENTO, Calif. (AP) — California is easing its coronavirus restrictions to allow up to three households to socialize outdoors, an expansion of rules aimed at people tempted to have even larger gatherings around Halloween, Thanksgiving and end-of-year holidays, Gov. Gavin Newsom said Monday.

Three households can gather so long as they wear masks and follow other safety precautions designed to stem the spread of the virus, under the new guidelines from the California Department of Public Health. State health officials previously discouraged gatherings outside of a single household.

The goal is not to encourage larger gatherings, Newsom said, but to recognize the increasing pressure for get-togethers and provide ways for people to act appropriately. There’s no limit on the number of people within any three households, though state officials say smaller is better.

Dr. Mark Ghaly, the state’s Health and Human Services secretary, said the guidelines are meant to recognize that many close friends and relatives have been apart a long time and want to be together.


All such gatherings should be outdoors, although it’s OK for guests to use indoor restrooms as long as they are frequently sanitized.

While much of the country and European nations are seeing a resurgence, coronavirus indicators in California are near their record lows. Hospitalizations are at their lowest level since early April and those in intensive care at their second-lowest level since officials began keeping track in late March. The rate of positive tests has been hovering at 2.6% for two weeks.

California has recorded about 850,00 positive tests and has seen more than 16,500 deaths. The number of weekly cases has flattened after a precipitous drop from peak levels during the summer. Average daily deaths have been falling and were at 60 for the most recent seven days.

Newsom said officials want to keep the numbers low.

“We are entering into the holidays, but also we’re entering into part of the year where things cool down and people are more likely to congregate back indoors in settings that put their physical proximity and likelihood of transmission and transmitting disease at higher risk,” he said.

Even the less restrictive guidelines advise that it’s best to stick to the same three households over time.

“Participating in multiple gatherings with different households or groups is strongly discouraged,” the department said in the guidance released late Friday.

People can gather under awnings, roofs or shade structures so long as at least three sides are open to outdoor breezes. Gatherings should be two hours or less to reduce the risk of transmission.

Guests who aren’t from the same household must socially distance and food should not be shared. Masks should be worn except when people are eating or drinking. Singing, chanting and shouting “are strongly discouraged” because those activities increase the release of respiratory droplets and fine aerosols. Hand sanitizer or a place to wash hands must be available.

People who are sick or medically vulnerable should not attend. Those who come down with coronavirus-like symptoms within

The Latest: California Governor Tests Negative for Virus | World News

SACRAMENTO, Calif. — California Gov. Gavin Newsom has tested negative for the coronavirus.

The governor’s office said Newsom was tested on Wednesday after someone in the governor’s office tested positive. The staff member who tested positive had not interacted with Newsom or anyone else who often sees the governor.

The governor’s office said Newsom took the test out of “an abundance of caution.”

Newsom said Wednesday that he has been tested many times and has always been negative. California has reported more than 834,000 coronavirus cases and more than 16,300 deaths.

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— Coronavirus infections in Ukraine began surging in late summer, hospitals are ‘catastrophically short of doctors.’

— The NFL’s Tennessee Titans had another positive test, bringing the team’s outbreak of COVID-19 to 23.

— Follow AP’s pandemic coverage at http://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak

HERE’S WHAT ELSE IS HAPPENING:

BEIJING __ China, which has four coronavirus vaccine candidates in the last stage of clinical trials, announced Friday that it is joining the COVID-19 vaccine alliance known as COVAX.

The country signed an agreement with GAVI, the co-leader of the alliance, on Thursday, China’s Foreign Ministry said in a statement. Initially, China did not agree to join the alliance, missing the global deadline to join in September.

Foreign Ministry spokeswoman Hua Chunying said in a statement that “we are taking this concrete step to ensure equitable distribution of vaccines, especially to developing countries and hope more capable countries will also join and support COVAX.”

The alliance is designed so that richer countries agree to buy into potential vaccines and help finance access for poorer ones. The Trump administration in the U.S. had declined to join the alliance.

The exact terms of the agreement and how China will contribute are not yet clear. .

HARTFORD, Conn. — Dr. Deborah Birx of the White House coronavirus task force says she is concerned about the uptick in coronavirus cases in the Northeast.

She said Thursday at the University of Connecticut’s Hartford campus that a “very different” kind of spread is happening now.

She says it’s not happening in the workplace so much because people are taking precautions. She says more people are becoming infected because of indoor family gatherings and social events as the weather cools.

She says that was a lesson learned in the South during the summer when people went indoors for air conditioning.

BOISE, Idaho — The number of Idaho residents collecting unemployment dropped for the 22nd consecutive week as the state’s reopened economy continues recovering, while at the same time coronavirus pandemic deaths hit 500.

The Idaho Department of Labor said Thursday that the number

Coronavirus outbreak kills 9 at California nursing facility

A coronavirus outbreak at a skilled nursing facility on California’s central coast has killed nine people and infected more than 60 residents and staff, health officials said Wednesday.

The outbreak at the Watsonville Post Acute Center in Santa Cruz County comes as the rates of new COVID-19 cases fall in that county and in California as a whole.

The first case was discovered on Sept. 17 when a resident tested positive for COVID-19 after going to a hospital for unrelated medical reasons, said Dr. David Ghilarducci, deputy public health officer for the county.

FEAR OF CORONAVIRUS DETERS STRANGERS FROM PERFORMING CPR

Coronavirus has claimed nine lives and infected over 60 people at a nursing facility in Santa Cruz, officials say. (iStock)

Coronavirus has claimed nine lives and infected over 60 people at a nursing facility in Santa Cruz, officials say. (iStock)

Testing quickly showed another two dozen residents had the virus but weren’t showing any symptoms, he said.

The facility currently has 56 residents. Seventeen currently are COVID-19-positive and have been segregated from other residents, 27 tested negative but were quarantined because of suspected exposure and a dozen residents showed no evidence of exposure, Ghilarducci said.

The 15 staff members who tested positive were isolated at home or in hotel rooms provided by the county, Ghilarducci said.

That caused a staffing problem and members of the National Guard were brought in to help, he said.

OVER 80% OF CORONAVIRUS CASES LACK ‘CORE’ SYMPTOMS WHEN TESTED: STUDY

Half the deaths occurred over the past two weeks, and the rest occurred over the weekend, he said. They represent half of the 18 COVID-19 deaths that have occurred in the county since the pandemic started.

“We don’t know right now what caused this to blow up,” he said of the outbreak. “I’m speaking with their medical director almost daily trying to figure this out’.”

State public health workers also are involved, he said.

NEW HAMPSHIRE INVESTIGATES CORONAVIRUS OUTBREAK POSSIBLY TIED TO MULTIDAY PRAYER EVENT

Other nursing facilities in the county have shown only a few cases over the past months, he said.

Skilled nursing facilities were hotspots of COVID-19 infection during the early months of the pandemic. Residents are usually elderly and have a variety of health problems that put them at greater risk of getting a serious case of the coronavirus.

At least 4,692 residents and staff members have died, representing nearly a third of all California COVID-19 deaths since the start of the pandemic, according to figures from the California Department of Public Health.

Last week, Gov. Gavin Newsom signed a law requiring skilled nursing facilities to report disease-related deaths during a communicable disease emergency to the state Department of Public Health within 24 hours. The measure also requires nursing homes to have a full-time “infection preventionist” on staff and to have a plan in place for preventing infections.

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Man convicted of murdering California dentist over apparent affair with his wife

An Orange County man was convicted of first-degree murder on Thursday, Oct. 1, for stabbing to death his wife’s apparent ex-lover, an Irvine dentist, after trying to run him down with his Mercedes-Benz SUV.

Jurors found Hongli Sun, 43, guilty of slaying of Dr. Xuan Liu as well as felony assault for injuring a woman who tried to intervene during the July 18, 2015 attack outside a medical building off of Barranca Parkway in Irvine.

During the trial, Senior Deputy District Attorney Mark Birney told jurors that Sun planned to kill Liu when he drove to the dentist’s office that day. Sun’s attorney, John Barnett, countered that Sun suddenly snapped under the pressure of marital infidelity.

Sun and his wife, Cynthia Chen, divorced after she had an affair with Liu, her longtime employer, according to court proceedings. Chen left for China for several months, leaving Sun to care for their young child. When she returned, the couple attempted to reconcile and reversed their divorce.

Sun still suspected that his wife was having an affair with Liu, and on the day of the attack drove to Liu’s office to see if she was there. He arrived to find a letter on the office door, apparently written in his wife’s handwriting, telling visitors they had gone to lunch.

Sun was still waiting in his car when his wife, Liu, and two office workers returned.

According to the prosecutor, Sun drove toward Liu, hitting him with enough force to knock him away from the vehicle before it collided with a wall. Liu tried to run away, but Sun chased after him, stabbing Liu 17 times and also injuring an office worker who tried to stop him, Birney said.

The prosecutor told jurors that Sun felt shamed by his wife cheating on him, as well as the knowledge that other people at Liu’s office knew about the affair. Birney described the motive for the fatal attack as “Mr. Sun’s anger, jealousy and ultimately desire for revenge.”

Barnett denied that there was a plan to kill Liu.

The defense attorney told jurors that Sun learned that Liu had “drugged,” “debased” and “seduced” his wife, had photographed her having sex and had given her a sexually transmitted disease that he believed caused her to get cancer.

Sun’s attempts to forgive his wife had only resulted in more betrayal, the defense attorney said, ultimately leading to his having “snapped” and killing Liu. Sun told police that he “lost my mind” at the moment of the fatal attack.

Sun is scheduled to return to court for sentencing on Oct. 30. He faces 26 years to life in prison.

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Northern California evangelical school tied to ‘very large’ spike in virus cases

SAN FRANCISCO (AP) — A Northern California county will face greater restrictions as it grapples with a surge in coronavirus cases, many of them tied to an evangelical college where more than 120 students and staff have tested positive in the last two weeks, health officials said Tuesday.

Shasta County health officials say that an outbreak of cases among students and staff at the Bethel School of Supernatural Ministry contributed to a recent spike in COVID-19 cases that bumped the county on Tuesday into a new level of regulations on restaurants, bars, theaters and businesses.

“We have been fortunate enough to have a relatively low number of cases throughout the course of the pandemic,” said Kerri Schuette, spokeswoman for Shasta County Health and Human Services. “But we’ve had a very large increase in cases over the past two to three weeks, with 123 being associated with the Bethel School of Supernatural Ministry.”

A school spokesman declined to comment Tuesday but forwarded a statement from earlier this month saying that the school was aware its students and staff accounted for “a portion” of Shasta County’s new cases and the school was taking “swift action” to minimize further spread.

In its statement the school said it shifted to online instruction last week and canceled in-person church services for Oct. 4 and Oct. 11 that have been held outdoors on a sports field. It also asked anyone who came in contact with someone who contracted COVID-19 to quarantine at home.

“This has led to a large number of people staying home as a precaution,” the statement said, adding that staff and students have been required to wear face coverings, socially distance on campus and do daily temperature checks at the door since classes started in early September.


On its website, the school describes itself as “a ministry training center” that is not an accredited university “where our students embrace their royal identity, learn the values of the kingdom, and walk in the authority and power of the King.”

The school does not provide housing for students, saying on its website that it welcomes hundreds of international and U.S. students each year and “it is our hope that our students ‘infiltrate’ the neighborhoods of Redding.”

Shasta County recorded more than 500 new coronavirus cases in the past two weeks, pushing its total number of cases since March to 1,158.

Another cluster was traced to an assisted living facility, called the Windsor Care Facility, where 60 residents and 20 staff have tested positive for the virus since the start of the outbreak, with most of those cases occurring in the past three weeks, Schuette said.

State health officials announced Tuesday that Shasta County was getting bumped to the “red tier” of a color-coded framework for business and school reopenings. It means that restaurants, churches and other businesses can open with limits on the numbers of people allowed inside. Other nonessential businesses like bars must close.

Schuette said the county has been working closely with Bethel

California sees no link from school openings to virus spread

SACRAMENTO, Calif. (AP) — California has not seen a link between the reopening of K-12 schools for in-person learning and increased coronavirus transmission, the state’s top public health official said Tuesday.

Dr. Mark Ghaly, the state’s Health and Human Services secretary, told reporters that officials have been closely watching the return to classrooms in counties where it has been allowed. He said it can take time for trends to emerge, but so far, the results are encouraging.

“We have not seen a connection between increased transmission and school reopening or in-person learning,” Ghaly said. “We’re looking at the information to see if there is a connection, and so far we have not found one.”


California requires counties to report coronavirus levels and infection rates below certain thresholds before they can allow K-12 schools to broadly reopen for in-person instruction. On Tuesday, 32 of the state’s 58 counties were deemed eligible to do so — up from 28 a week earlier.

Counties must meet the threshold for at least two weeks before schools are allowed to reopen. Yuba County, about 140 miles northeast of San Francisco, met the threshold for the first time on Tuesday.

The county is preparing to reopen schools by limiting the number of students in each classroom to make sure people can stay at least 6 feet (1.8 meters) away from each other, Yuba County Superintendent of Schools Francisco Reveles said.

Reveles said students would likely come to school in groups, with some groups attending in the morning while others attend in the afternoon.

“We’re in a different environment now,” he said. “Even though we can open up, there’s certain precautions we need to continue taking.”

The state has seen a broad decline in the number of coronavirus cases and hospitalizations in recent weeks. While some areas are seeing an increase in infections, the state’s overall case numbers have fallen since a surge over the summer following the initial reopening of various business sectors.

California reported a seven-day average of 3,005 new virus cases on Tuesday and a seven-day positivity rate of 2.6%, Ghaly said.

The number of infections is thought to be far higher because many people have not been tested, and studies suggest people can be infected with the virus without feeling sick.

Schools have been allowed to reopen in many smaller California counties as well as more populated ones such as Orange and San Diego. In those counties still barred from resuming broad in-person instruction, some schools have obtained special waivers from the state to let elementary students return to classrooms, and many campuses throughout the state have resumed in-person special education classes and day care programs.

Los Angeles County, which has the largest population in the state, still can’t broadly allow for in-person instruction, but this week began taking applications for limited waivers to reopen transitional kindergarten through second grade classrooms.

For most people, the new coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to

California governor’s office tells diners to wear masks “in between bites”

The California governor’s office put out a tweet on Saturday advising that restaurant-goers keep their masks on while dining. “Going out to eat with members of your household this weekend?” the tweet reads. “Don’t forget to keep your mask on in between bites. Do your part to keep those around you healthy.”

In California, masks are required for anyone going outside their home, as well as workers in customer-facing businesses, offices, factories, and health care professionals, among others, according to the state’s COVID-19 guidance.

While children under 2 years old and those with breathing troubles or medical exemptions do not need to wear a mask, everyone else is required to wear them in all indoor public places — and also outdoors if keeping 6 feet of social distance with others isn’t possible.

The official guidance does say that masks can be removed for a number of reasons, including eating or drinking. However, the tweet from Governor Gavin Newsom’s office offered somewhat different advice, which confused some Twitter users.

“I’m very confused by this tweet. The image suggests you should only take your mask off once when you begin a meal but the text suggests you should put it back on between bites,” journalist Matthew Fuhrman wrote, referring to the graphic shared in the tweet. 

“Should we wash our hands after touching our mask each time we remove it between bites? What if I’m eating chips and salsa and I go for a double dip? Is that technically two bites since it’s the same chip?” another person asked.

“This violates the @WHO ‘Dont’s of Mask wearing,'” another person tweeted, including a graphic from the World Health Organization which advises people to avoid touching their mask as much as possible, and to wash their hands before touching their mask and after discarding it. 

CBS News has reached out to the governor’s office for more information on the guidance in the tweet.

In California’s published guidance for dining in restaurants, wearing a mask in between bites is not mentioned. Physical distancing to the maximum extent possible, the use of face coverings by workers and customers, frequent hand-washing and regular disinfecting are among the elements of the COVID-19 prevention plan. Many counties in California currently limit indoor restaurants to 25% of normal capacity, or are allowing outdoor dining only, depending on local infection rates. 

In New York, which also has a statewide mask mandate and has reopened limited indoor and outdoor dining, the rule is to wear face coverings at all times — except while seated at a restaurants. In Georgia, where masks are “strongly encouraged” but not required, there is an exception “when eating, drinking, or exercising outdoors.” 

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California Joins Movement to Give NPs Practice Autonomy

The national movement to grant nurse practitioners (NPs) greater autonomy reached critical mass this week when California Governor Gavin Newsom signed a bill that will allow NPs to practice on their own after a minimum of 3 years working under a physician’s supervision. Under current state law, NPs must always be supervised by a doctor.

The new law, enacted despite strong opposition from the California Medical Association (CMA), is scheduled to take effect January 1, 2023.

California joins 22 other states that allow NPs to practice independently, according to the California Association for Nurse Practitioners (CANP). Depending on how NP autonomy is defined, the number of states might be as high as 30, Joanne Spetz, PhD, a health economics professor at the University of California San Francisco, told Medscape Medical News.

About a dozen of those states passed their laws within the past decade, Spetz noted, and California is not the only large state in this category. Florida did the same earlier this year.

The significance of this trend has elicited a vigorous response from the American Medical Association.

“The American Medical Association has urged California Governor Gavin Newsom to veto Assembly Bill 890 since it offers no proven solution to expand access to care in rural and underserved areas,” AMA President Susan Bailey, MD, said in a statement emailed to Medscape Medical News.

“Instead, the bill would raise healthcare costs and jeopardize the health and safety of patients in California by asking them to settle for care from a healthcare provider with a fraction of the clinical training that physicians attain,” Bailey continued.

In California, Assembly Bill 890 was passed with the help of a CANP-led coalition that argued relaxation of the restrictions on NPs’ scope of practice would help alleviate the state’s severe provider shortage and increase access to care in rural and underserved areas.

In a news release criticizing the new law, however, the California Medical Association contended that access to care has not improved significantly in other states that have eased supervision of nurse practitioners.

“California still has a critical shortage of healthcare providers — including physicians — and AB 890 will do nothing to change the need for California to educate and train more physicians,” the CMA explains.

Anthony York, vice president of strategic communications for the CMA, told Medscape Medical News that NPs aren’t any more likely to practice in underserved areas than physicians are, and he said he’d seen studies showing evidence of that.

In contrast, Spetz said, “The literature is clear that greater autonomy for NPs facilitates their ability to go into rural areas.”

One of the studies she cited was a systematic review of studies of state laws that allow NPs to practice independently.

The review found that, in comparison with states with more restrictive policies, states that have given NPs greater autonomy tend to have more NPs in relation to the population, greater care provision by NPs, and expanded healthcare utilization, especially among rural and vulnerable populations.

Questions

California voters weigh in again on care at dialysis clinics

California voters will again weigh in on the quality of care dialysis clinics provide to about 80,000 people in the state with kidney failure

SAN FRANCISCO — California voters will again weigh in on the quality of care dialysis clinics provide to about 80,000 people in the state with kidney failure.

Opponents, financed by dialysis clinic companies, say that under that mandate, between two and three doctors would be required at every facility because most are open at least 16 hours a day, creating a financial burden that could lead some clinics to close.

“There are a tremendous number of complications that can occur during and around dialysis, and a doctor onsite will be able to respond not only to emergencies such as cardiac arrest, bleeding, dangerous fluctuations in blood pressure — all other common side effects of dialysis — but they also will be able to oversee the overall quality of care,” said Steve Trossman, a spokesman for the Oakland-based Service Employees International Union-United Healthcare Workers West, which spent more than $6 million in a signature drive to get it on the ballot.

Proposition 23 is the second attempt by the union to increase regulations of dialysis clinics in California, where DaVita Inc. and Fresenius Medical Care — two of the country’s largest for-profit dialysis providers — operate about three-quarters of the state’s dialysis market. Early voting begins Monday for the Nov. 3 contest.

In 2018, the union-backed Proposition 8, which sought to cap dialysis clinics’ profits and force them to invest more of their profits in patient care. Voters rejected the measure but not before it became the most expensive initiative on the 2018 ballot, generating more than $130 million in campaign spending — more than $111 million from dialysis companies to kill the initiative and about $19 million from unions that supported it.

Dialysis providers say most California clinics already offer high-quality care and are regulated by federal and state authorities. They also point out all patients already have a nephrologist — a kidney specialist — who oversees their care and that nephrologists also direct each clinic in California. They say the initiatives are part of a tactic to pressure the dialysis companies to let workers unionize.

“The motive is to force the dialysis community to spend a bunch of money to defeat it because ultimately this is more about a union organizing battle. I have no doubt that in 2022 there will be another initiative on the ballot targeting dialysis providers and dialysis patients,” said Kathy Fairbanks, a spokeswoman for No on Prop. 23, a coalition led by DaVita and Fresenius that