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Bay Area Headlines: Monday, 4/27/20, AM

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As California Hospitals Return To Normal, Patients Wonder When They Can Seek Care / California Cities Report Projected Economic Impact / Sacramento Muslims Celebrate Ramadan Together Virtually

As California Hospitals Return To Normal, Patients Wonder When They Can Seek Care

Hospitals and clinics have canceled thousands of procedures to save resources for COVID-19 patients. Now, California Governor Gavin Newsom says hospitals can bring back some of these services, but not all of them.

Fay Gordon is an Oakland resident whose breast cancer recovery is still in flux. Gordon is still healing from a double mastectomy she had last month. She got the operation just days before California’s stay-at-home order took effect. Now most hospitals have canceled non-emergency procedures, so the breast reconstruction surgeries she needs are delayed.

“The loss of breasts for a woman is very traumatic and for me has been a big mental shift. Not knowing when I will complete this process is unnerving and very surreal.”

In a recent announcement, Newsom gave examples of services that could be allowed soon: heart valve replacements, tumor removals, colonoscopies. But a hospital’s decision about what to bring back depends on many factors:

“What their COVID rates are, how full their hospitals are, what their resources are, what their personnel levels are.”

Dr. Clifford Ko is a professor at UCLA and a director at the American College of Surgeons. They wrote the guidelines on canceling elective procedures.

“Can I do this reconstruction? Can I do this hernia repair? And can we treat these patients safely? In some places, we cannot. And in some places, we’ll be able to.”

It’s also a financial decision. Many hospitals rely on elective surgeries as a main source of income. Some cleared their decks for a COVID-19 surge and then got fewer cases than they expected. Now, they’re feeling strapped for cash.

Kathy Hempstead is a health policy expert with the Robert Wood Johnson Foundation.

“Even though you have this sense that the health care system is so incredibly busy and overworked, at the same time it’s sort of a paradox. At the same time, we see layoffs furloughs, executive pay cuts, and a lot of people that are not working and not getting paid.”

And many patients are skipping out on important medical care. Check-ups and vaccinations are largely not happening, neither are mammograms and other preventive screenings. 

Fay Gordon is wondering if there could have been a better approach.

“As we think about this potential for COVID to come back very strong in the fall, will our health care providers and health care system be more prepared? So that if someone was in my situation in the fall there’d be clearer guidance saying your surgery may be delayed, here’s how it’ll work. And who makes those decisions?”

As the gears of the medical world begin to turn again, she’s not sure if her breast reconstruction will be considered essential.

“This is a part of my body and a core sense of who I am. And this is not a cosmetic surgery. This is about restoring myself and getting my sense of self back. I’m hopeful that this will be essential, they will be rescheduled, they will move forward.”

In the meantime, she’s spending the days doing virtual physical therapy, and trying to keep Diego occupied.

California Cities Report Projected Economic Impact

California's 482 cities say they will collectively lose $6.7 billion over the next two years because of the coronavirus pandemic. The expected shortfall is prompting layoffs and furloughs for public workers and potential cuts to basic services such as sanitation, public safety, and housing.

But that estimate, compiled by the League of California Cities, assumes the stay-at-home order lifts by June 1. That’s an unlikely scenario in a state where Governor Gavin Newsom and public health officials have said bans on large gatherings and unnecessary travel will likely extend well into summer.

In Yountville, up in Napa County, 74 percent of the annual budget comes from taxes on sales and hotel rooms. The mayor says he expects a 60 percent loss in revenue in the upcoming budget.

In San Jose, leaders expect revenues to drop 8.6% — that’s far larger than the 2.9% revenue loss during the Great Recession.

Congress has sent nearly $6 billion to California local governments, but most of that money went to counties. Only six California cities qualified because they had populations greater than 500,000 people: San Jose, San Francisco, Sacramento, Fresno, LA, and San Diego.

But the federal government says cities can't use that money to cover revenue shortfalls and can only use it for coronavirus-related expenses.

The League of California Cities asked Newsom and the state legislature last week to help cities cover their shortfalls. Newsom plans to unveil a budget proposal next month after scrapping the $222.2 billion spending plan he proposed back in January.

Sacramento Muslims Celebrate Ramadan Together Virtually

Ramadan, the Islamic celebration of the end of the year, has begun. But with the state still under a stay at home order, many mosques and Muslims are having to find other ways to celebrate.

Mosques have taken their prayer services digital, and there will be no communal nightly iftar — the traditional breaking of the day’s fast. Muslims in the Sacramento area have been finding the month-long holiday that typically is celebrated by gathering and sharing food and gifts, is looking very different this year. Imam Adr Dabour of the Salam Center is live streaming prayer service and setting up food drive-throughs to give members a sense of community.

"Ramadan, usually at night or in the evening, the masjid is like a honey bee hive, some people reading Quran, some people praying, some people chatting, some people eating, it is just full of life."

He says, in contrast, this year’s services have been very quiet, and he’s using the time for reflection.