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SACRAMENTO, Calif. (AP) — California state officials have agreed to delay the effective date of what state lawmakers intended as a Jan. 1 ban on flavored tobacco products. They'll wait until county clerks can determine if opponents led by tobacco companies filed enough signatures to put the new law to a statewide vote. Inyo County’s top elections official says her office found many signatures do not match county records. The main group opposing the law says it turned in more than enough signatures to qualify for the ballot. If enough signatures are valid, the measure will likely go before voters in November 2022. 628
SACRAMENTO, Calif. (AP) — The California Legislature is scheduled to keep meeting despite the threat of coronavirus.The U.S. Centers for Disease Control and Prevention has urged all gatherings of more than 50 people to cancel. California Gov. Gavin Newsom has asked all bars to close and for anyone 65 and older to stay at home. Legislative leaders have canceled all committee hearings at the Capitol. But the legislative sessions are still scheduled. At least one lawmaker, 71-year-old Assemblywoman Shirley Weber, stayed home Monday. State Sen. Richard Pan said the Legislature is going to continue its work. 618

Royal Caribbean might be looking for volunteers for its simulated cruises and test out its COVID-19 protocols before they can resume and get back on the water full-time."We are currently reviewing the requirements proposed by the CDC, and with the help of the Healthy Sail Panel, we will determine who is eligible for our simulated cruises," Royal Caribbean told E.W. Scripps in an email. "We are very eager to welcome our guests back on board, but we have a lot to do between now and then, and we're committed to taking the time to do things right."The U.S. Centers for Disease Control and Prevention released new guidelines requiring ships to "test cruise ship operators' ability to mitigate COVID-19 risk" with "simulated cruises."One of the main requirements is that operators must inform volunteers in writing that they are "participating in a simulation of unproven and untested health and safety protocols for purposes of simulating a cruise ship voyage and that sailing during a pandemic is an inherently risky activity."The voyages' procedures will include terminal check-in, onboard activities, including dining and entertainment, private island shore excursions if planned, and social distancing. Evacuation producers must also be tested, isolating anyone who tested positive for COVID and quarantining others on board.According to the CDC rules, volunteers 18 and older must have written certification by a healthcare provider, that they don't have any pre-existing medical conditions that could place them at high-risk for COVID-19. 1553
SACRAMENTO, Calif. (AP) — California has recorded a half-million coronavirus cases in the last two weeks, overwhelming hospitals in urban centers and rural areas. Gov. Gavin Newsom says a projection model shows California could have 100,000 hospitalizations in the next month. Mobile field hospitals are being set up outside facilities to supplement available bed space. At least three are being set up in the Los Angeles and Orange County area, which hit 0% ICU bed availability last week. Other "alternative care" facilities, as the governor refers to them, have been set up near Sacramento and along the Mexican border about 50 miles east of San Diego.“The ICU is at 105% capacity,” Orange County Supervisor Doug Chaffee said of St. Jude. “They’re using every available bed. The emergency department has an overflow ... All the Orange County hospitals are in the same situation. It is dire, so they’ll soon be erecting a tent in the parking lot, probably for triage. I think what we’re seeing is not a surge, but a tsunami.”The governor says he’s likely to extend his stay-at-home order for much of the state. He acknowledged the orders for the Southern California and San Joaquin Valley regions will probably be extended. The orders remain in place for three weeks, and are triggered when a region's available ICU bed capacity dips below 15%. Both of those regions, which combined cover 23 of 58 counties and the lower half of the state, have an ICU bed availability level of 0% according to the California Department of Public Health. The San Francisco Bay area has an ICU bed availability of 13.7%, it's at 16.2% in the Sacramento region and 28.7% in Northern California. 1686
Rural hospitals across the country are in a difficult spot right now. COVID-19 is hitting them harder than many metropolitan hospitals as they deal with issues of lower staffing.According to the National Center for Biotechnology Information, about 20% of our nation’s population lives in rural areas, yet less than 9% of our nation’s physicians practice there.Add on the fact that according to CDC data, COVID is killing rural Americans at a rate 3.5 times higher than those living in metropolitan areas, and this issue is affecting staff and patient care.“I’m very worried about rural health care because rural health care is teetering on the brink right now,” said Dr. Kurt Papenfus, an ER doctor at Keefe Memorial Hospital in rural Cheyenne Wells, Colorado. “There’s a darkness in this illness that I can’t say I’ve said about any other illness.In late October, Dr. Papenfus contracted COVID-19 as he was traveling back from the Northeast to visit his daughter.“I was very cognizant and was wearing a mask at all times, social distancing, and washing my hands,” Papenfus said. “But I remember having this thought on the train that this is a super-spreader event.”When he got home, Papenfus got tested and was confirmed positive for COVID-19. The diagnosis put Keefe Memorial in a tailspin as he served as the only ER doctor in the small 25-bed hospital.“We are a trauma level four hospital so keeping that physician on staff 24/7 is what we are required to do,” said Stella Worley, Keefe Memorial’s CEO. “And it is getting to be more of a challenge to have hired physicians out here in rural [America].”Within minutes of learning of Dr. Papenfus’ COVID-positive diagnosis, Worley was on the phone with several different hospitals working to find a replacement. Within a few hours, they had settled on a former ER doctor who moved to another hospital in Texas a few months prior.After she agreed, Keefe Memorial paid the doctor to drive 10 hours from Texas to Colorado and fill in immediately as Papenfus recovered at home for the next two weeks.“Worst-case scenario is you would have to divert patients if there’s no one in the door to care,” said Worley.Populations in rural America tend to be older, poorer, and less insured than the nation at large, according to the National Conference of State Legislatures.Since 2010, hospital closures in rural America have been growing as there have been 118, including 17 last year.The closures only exacerbate a growing lack of health care coverage in rural America, said Dr. Dan Derksen, a rural health care expert and family physician“Once a critical access hospital (25 beds with a 24/7 emergency department and at least 35 miles from another facility) closes, they almost never come back,” he said. 2756
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