5 Things California: May revise, Contact tracing, COVID in rural California

A new study reviews the four flu pandemics of the last 100 years. (I didn’t know we had four either.) The frustrating takeaway from the three most likely scenarios: “Based on the most recent flu pandemics, this outbreak will likely last 18 to 24 months… It likely won’t be halted until 60% to 70% of the population is immune.”

That is what all public health folks have told me since this started: we need herd immunity or a vaccine to get through this. However, the economic shut down has created its own trauma. Another 3.2 mi initial jobless claims were filed last week in the US. Economic collapse – and the social conflicts that result – is not waiting for a vaccine.

 

 

 

 

With help from Emily Boerger

1. May revise & budget cuts

Gov. Newsom’s May Revise, which is set to be released in the coming days, will be a far cry from the $222 billion spending plan he originally proposed in January. While there are a lot of unknowns, lawmakers have been warned of a near-term deficit of $35 billion, eventually reaching up to $85 billion in later years. This morning, Gov. Newsom’s office said the revise would include a $54.3 billion deficit and 18% unemployment. California also just became the first state to borrow from the feds to pay unemployment claims.

With the tax deadline extended until July, the details of COVID’s financial impact on California likely won’t become apparent until summer. “Last year I did a May revise with a $21.4 billion budget surplus,” said Newsom on Friday. “This year I will be doing a May revise looking at tens of billions of dollars in deficit. We just went tens of billions in surplus in just weeks to deficits.”


2. Senate Committee discusses rural COVID challenges

Yesterday, lawmakers took up the issue of equitable access to COVID testing during the Senate Special Committee on Pandemic Emergency Response. Through the state’s partnership with OptumServe, 45 new specimen collection sites have opened in underserved communities, with an additional 35 set to open by tomorrow, said Dr. Charity Dean in an update from California’s COVID-19 Testing Task Force.

The committee also heard from Madera County Public Health Director Sara Bosse, who provided an update on testing and tracing challenges in rural counties. Issues like staff shortages and a lack of rapid tests, infrastructure, and internet access in parts of the state means that “contact tracing in rural communities must be more of hands on process,” said Bosse. Our coverage of the committee’s first meeting is available here.


3. Unemployment rate approaching 25%?

A recently updated policy brief from the California Policy Lab paints a bleak picture of the state of unemployment in California. “Since the beginning of the COVID-19 crisis in the labor market in mid-March, 21.4% of women and 16.6% of men in the labor force have filed initial claims. If all 18.8% of workers claiming since March 15th are still unemployed this suggests an unemployment rate approaching 25%, compared to a rate of 5.3% in the first half of March.”

On top of that, when Congress passed the first tranche of the Paycheck Protection Program, California drew down an amount equal to 24% of eligible payroll. With roughly 7.1m Californians employed at small businesses, that means roughly another 1.7m individuals currently have their payroll entirely subsidized by that program. When it begins to expire in five weeks, we will likely see another spike in initial jobless claims.

 

4. A call to strengthen Medi-Cal

In anticipation of a surge in Medi-Cal enrollment due to COVID-19 job losses, L.A. Care Health Plan sent a letter to Congress on Thursday calling on lawmakers to strengthen the Medicaid system. The letter outlines four measures to be included in the next COVID relief package – increase the federal share of Medicaid funding for 2 years, suspend the MFAR proposal, extend presumptive eligibility, and cease implementation of the Public Charge Rule.

One estimate says there may be up to 3 million new Medi-Cal enrollees due to the economic downturn stemming from COVID. That figure is based off an unemployment scenario of 25%, which (see #3 above) may be more than the first numbers we see out (closer to Newsom’s 18% I mention above).

 

5. What does contact tracing look like?

California’s ability to put in place a robust contact tracing system is driving decisions about re-opening the economy. Gov. Newsom announced on Monday a partnership with UCSF and UCLA to train “an army” of contact tracers. He says the ultimate goal is to have a tracing workforce of 20,000 individuals. Newsom also says he expects most of the resources for tracing will come from the federal government.

In his latest column, State of Reform columnist Jim Capretta takes up the topic of federal support by breaking down Congress’ $25 billion investment into testing and tracing as part of the latest round of COVID emergency funding. Of that funding, $11 billion will go to states, territories, and tribes to acquire tests and hire contact tracers; $1 billion will go to the CDC to broaden and modernize its surveillance capacities; and $1.8 billion is slated for NIH to speed research on accurate serologic and point-of-care testing kits.