Tag Archives: #asianamerican

Out Of Sight. Out Of Mind. Why Seniors Are Getting The Invisible Treatment.

America is going back to normal as states reopen and Covid restrictions lift, but in many communities, the elderly, people of color and people with disabilities feel left out. Though vaccines have brought hope to millions of Americans, seniors are getting the invisible treatment in the race for population immunity. They are at the most at risk, the hardest to reach, and have suffered the highest fatalities from Covid 19.

Covid 19 vaccines are now available at no cost to everyone living in the US (over the age of 12+) regardless of insurance or immigration status.  Given that the world is bracing for the next wave of infections spawned by the virulent Delta and Delta Plus variants, why aren’t vaccines reaching vulnerable seniors who need it most?

Advocates at a June 5th EMS briefing explained why seniors are getting left behind.

Why seniors in minority communities aren’t getting vaccinated 

Overall, some 25% of people 65 and older have not been vaccinated though that number is possibly higher, said Kim McCoy Wade, Director, California Dept. of Aging, which co-sponsored the panel. Data showed shocking disparities about why older people in minority communities were not getting their shots.

Describing the vaccination trend in California, Wade said the variation in vaccination rates by race, ethnicity and age, and by community, was striking.

“The number that jumped out at me was that only 40% of Latinos over 60+ were vaccinated, compared to more than 75% of older adults (3 out of 4 seniors 65 + ) statewide – half of what the state is tracking for White and Asian American elders,” said Wade. The vaccination rate for white and Asian elderly in California is at 80%, and only at 60% for Black and Native American elders, she added. But older Latinos (60+) are the only racial group where the vaccination rate is much lower than for Latinos in their 50s and even lower for those in the 70-80 age range.

At issue in the vaccine rollout employed by the medical establishment, noted disability rights advocate Jessica Lehman, is that race hangs like a shadow over black and brown bodies.

It’s why people facing the greatest challenge accessing vaccines are seniors with limited English language ability from immigrant and low-income communities.


What’s stopping seniors from signing up for vaccines?

Typically, many seniors are isolated and hard to reach because they live alone, are homebound, not mobile, do not speak English, or cannot access the Internet. But there is a higher biological risk associated with age and disability, that the pandemic exposed with devastating effect.

Four percent of older Americas live in nursing homes and assisted living facilities, explained Dr. Louise Aronson, Professor of Medicine, UCSF, but accounted for 35% of deaths nationwide. Older people who contracted Covid when the pandemic hit were relocated to nursing facilities alongside the high-risk residents already there. There was limited or no access to testing or PPE for care givers, who in turn took Covid back into their communities.

For Infectious Disease specialist Dr. Rakhshan Chida, Medical Director at an OTP (opioid treatment program) clinic in New York, it was a nightmare that became reality.  Working in inadequately ventilated treatment rooms when the pandemic hit, without access to masks, PPE, or testing, Chida described the inevitable disaster as “working in a den of covid.” Every day 2 or 3 patients tested positive.

In March, at the start of the pandemic, half her staff of 40 contracted the virus, and Chida took the infection home to her 87-year-old mother who lives with her. While her mother made a quick recovery, Chida experienced severe Covid symptoms and was ill for three weeks. But she was back on the frontlines after her quarantine, to attend to her vulnerable population of active and ex-users, including those who are in the 50+ age group.

But Chida was starting to see signs of vaccine reluctance in her patients. One 73-year-old patient who developed nausea, vomiting, and diarrhea after the first shot, refused to get the second because her reaction scared her.

Fear of the vaccine is not an uncommon barrier reiterated Aronson, an expert on aging and author of the book “Elderhood”. While some seniors are primarily concerned about unknown side effects or allergies, there is a prevailing distrust of vaccines that stems from how quickly they were developed, and suspicion of the people responsible for decision making around them.

One of Aronson’s patients confessed she feared the vaccine would insert a tracking device into her body. Others felt their existing illnesses should preclude them from getting the vaccine when in fact the opposite is true.

“There is so much misinformation, particularly for the limited English community,” added Anni Chung, President & CEO, Self Help for the Elderly.

The fault lies in the US public health structure, remarked Aronson. Without a nationwide system, federal, state, and county websites employ digital strategies that don’t reach or address the needs of at-risk seniors, for the same reason that census and voter registration drives did not work effectively.

With little or no Internet access, it becomes harder for the homebound elderly, people in rural areas, and people for whom English is a second language, to get or receive communication from Federal, state and county health systems.

“Digital strategies are adding to the problem and to the risk,” said Aronson.

A study of Black seniors in their seventies, by Cindy Cox Roman, CEO, Help Age USA, identified gaps in their knowledge of vaccine facts arising from difficulty with digital access, and also from conflicting information obtained via a mix of sources – TV news, senior centers, elected officials, and libraries.

“Everybody does not have access to the web and cable is expensive,” said one respondent. “When the library is closed, where do people go for information? We are the lost generation of the information age.”

Chung, a member of the California Commission on Aging, said that elders could not navigate the appointment system. Some had grandchildren who hovered over their computers for 6 to 8 hours to get two appointments for their grandparents. But a senior who has nobody to help them “is at the mercy of waiting for something to happen.”

Even when seniors did manage to sign up for vaccines at mega sites, they encountered long lines and no seating which drove them away said Aronson. Homebound people had no way to get there. Unfortunately, the mega-site vaccine roll-out also kept away older folk who had been advised to stay away from crowds for their protection.

At Chida’s clinic in New York, one patient refused a vaccine, saying “We don’t leave the house so why should I vaccinate when I’m not going out and meeting people?”

The problem when elders don’t come out of the house, is that they remain invisible in the public eye, warned Aronson, but an older person of color who is homebound – is triply invisible and gets left behind.

Seniors with disabilities are another group getting the invisible treatment, added Lehman, Executive Director at Senior and Disability Action in the East Bay. She said nearly 1 in 10 nursing home residents died of Covid, while 1 in 12 died in long-term facilities, a crisis that took a while to recognize. Instead, hospitals with limited beds or ventilators were guilty of care rationing – making judgment calls about who to treat based on who they viewed as having a better quality of life. Often it meant that older people and people with disabilities were low on the priority list because they are seen as ‘expendable”. In Texas, for example,  Michael Hickson, a black, 46-year-old quadriplegic patient died of Covid after a doctor ordered his removal from a ventilator.

“The Covid pandemic is the most horrific manifestation of ableism and ageism we have ever seen in our lifetime,”  remarked Lehman.

 

How are states vaccinating seniors and at-risk adults?

In California, there’s a push to funnel vaccines from mega-sites to community sites, offer free transportation, phone lines in addition to online sign-ups, and drop-in appointments.

Community groups are getting outreach grants from the state, so trusted messengers – community leaders and partners – can address people’s concerns. In California, public health officials have planned town halls to reach minority communities. For example, Surgeon General Dr. Burke Harris will meet with the African American community and similar strategies will be employed for the Latino and AAPI communities. Gov. Gavin Newson has also introduced a lottery and gift cards to persuade the unvaccinated to get their shot.

High-touch community programs are necessary to reach and deliver information at a local level, using trusted messengers such as the local press, faith leaders, and caregivers. Aronson urged people to contact their health department to identify community groups that are creating vaccine access for homebound elders – fire departments, in-home supportive services, Meals on Wheels, the YMCA, and other community partners.

At her clinic in New York, Chida offered mobile patients metro cards and arranged car services to assist with transportation. About 27 homebound patients were targeted with single-shot Johnson & Johnson vaccinations administered at home by nurses, and schedules for older patients were adjusted to sync vaccines with regular visits. Social worker representatives coordinated with the clinic to organize nurses, sharp boxes, PPE, consent forms and arranged dedicated outreach to patients at homeless shelters. And, the clinic coordinated with New York’s Department of Health to organize an in-house vaccination drive for  its own patients, including seniors.

“The community really has to step in big time,” and rally the community agreed Chung, because many seniors, especially in immigrant communities, are unlikely to answer phone calls from “official government agencies.”

In San Francisco, her Self Help team asked the Department of Health to identify alternative ways to get vaccines out to where seniors need them instead of waiting for seniors to come to get their shots.

Local health departments listened.  By March and April, they began to approve the distribution of vaccines through clinics, PCPs, primary care providers, and locations where seniors were more like to have access and are comfortable. At senior centers, people received shots along with their healthy meal packages.

“At one point 7 of our centers were reaching about 1500 people every day,” said Chung.

In April, Self Help and a community partnership team with providers from  NICOS Chinese Health Coalition, YMCA, Chinatown CDC-Self Help Chinese Hospital, and the Chinese doctors association, headed to a Chinatown zip code with the lowest vaccination rates to administer doses at congregate housing facilities. Through an intensive phone call campaign and neighborhood canvassing, they identified and contacted almost 1000 people in the tract.

”We were just very fortunate there were no major outbreaks in Chinatown,” added Chung. What helped was door-to-door advocacy and education early in the pandemic advising people to mask and practice social distancing, and trust in local, community health professionals. In an initiative to reach vulnerable bed-bound and homebound seniors, Self Help mobilized 14 doctors, 10 volunteer drivers, and 10 social workers, to administer vaccines to about 130 seniors. Self Help’s next vaccination rally in partnership with Walgreen will include a small raffle to persuade seniors to get the vaccine.

The panel encouraged reporters to cover stories from their communities to remind the government to add more resources where they were needed.

The pandemic is far from over cautioned Wade, and a true comeback will depend on being ‘laser focused’ on vaccinating older and at-risk adults.

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In California, everyone age 12 can easily book a Covid 19 vaccine up via the MyTurn website, while entering to win Vax for the Win incentive program. My Turn also helps with organizing transportation and provides a list of hundreds of COVID-19 vaccine clinics accepting walk-ins, or call for services at 1-833-422-4255.

Meera Kymal is the Contributing Editor at India Currents.

 

Racial Inequity Impacts Older Asian Americans

The impact of racial inequity on the lives of elderly Asian Americans has been rudely brought to our attention by the attacks on Asian elders. AARP is hosting several initiatives in an effort to stop Asian hate and advocate for the elders that reflect its promise to protect and serve older Americans of all colors.

 In a webinar on May 6, an AARP panel, #StopAsianHate: Advocating for Our Elders, called attention to the ways individuals, organizations and communities of color can advocate for AAPI elders as they face fallout from the pandemic, racism and ageism. The discussion tackled stereotypes and how to provide support.

Key AAPI organizations discussed policy and planning of racial equity and communications, to bring visibility to their work  supporting elders and to provide information on resources.

 “You can’t legislate racism away,”  said John Yang, President and Executive Director, Asian Americans Advancing Justice (AAJC), pointing out that federal advocacy, though critical, cannot replace educating the public. He urged that a war of words, language and beliefs, hate has to be fought in the classrooms of life. 

Videos of black violence on Asians have been given currency in an attempt to deflect the issue, he added. Viral stories of other communities of color attacking Asian Americans are circulating on social media, when in reality less than 5 percent of the attackers are African American, said Yang.

With better understanding comes better appreciation of the community, and that helps build bridges between different groups, Yang explained. “We must stand together in our fight against hate of all kinds.”

One approach would be to pay tribute to and commemorate the many contributions that generations of Asian American and Pacific Islanders have made to American history, society and culture. Yang suggested that schools could highlight the contribution of Asian Americans in the history of  country.  Images from World War II and railroad workers should not feature only white Americans. Pictures of Asian Americans who helped build this nation alongside other Americans should be shared in classrooms. 

The common thread that runs through history is that the American Asians are perpetual foreigners in their own country.

“No matter how long you have been in the US you are seen as a foreigner. Any time you have a threat in the US, and here there is Covid19 threat or real geopolitical tension against the Chinese government, the backlash happens against Asian Americans. What is different this time however is, the elderly and women are disproportionately being attacked as they are being perceived as vulnerable,” said Yang.

Asian American hate, though systemic throughout American history, has taken new meaning in the wake of the Covid 19 virus and the license to hate given by the previous administration.

“AARP strongly condemns all racially motivated violence and harassment,” stated Nancy McPherson, AARP California State Director. “We must come together as a community to empower and uplift one another, especially during these trying times. This May, let us recognize and celebrate Asian and Pacific Islander Americans’ integral contributions to the United States’ past, presence and future.”

Edna Kane-Williams, Executive Vice President and Chief Diversity Officer, Diversity, Equity & Inclusion, AARP, stated that AARP unequivocally stands in support of AAPI.

AARP is making sure that it is a megaphone for this message.”This is not a time for organizations to stand silently along the sidelines hoping that people get the message. We really have to be active allies and not passive allies. This is not a benign event that is happening. It is malicious. It is  malignant and it really must stop. We must signal our support of the AAPI community and our absolute rejection of what is happening in no uncertain terms,” she said.

“We have to signal our support for the AAPI community and absolute rejection of what is happening. Most importantly we hope everyone leaves this webinar with an idea of what each one of us can do individually. Each one of us must step up.”

Panelists urged the public to step up to support the AAPI community with suitable words and deeds. Words are important and carefully crafted words can damage the cause and exacerbate tensions against the community. Small gestures of kindness to an elderly AAPI neighbor for instance a bunch of flowers on Fathers Day will go a long way, said Yang. 

“Let us all commit to stopping AAPI hate by taking three actions: Learn about how detrimental the ‘model minority myth’ is to AAPIs; shatter the ‘perpetual foreigner’ image of AAPIs; and reach out and support your AAPI friends, neighbors, and colleagues,” said Daphne Kwok, Vice President Diversity Equity & Inclusion, Asian American & Pacific Islander Audience Strategy.

Ritu Marwah is an award-winning author whose story Jinnah’s Daughter, featured in the New York Times’s Express Tribune blog, exemplifies her deep interest and understanding of history and the place of people in it.

Photo by Jason Leung on Unsplash

 

Will They? Won’t They? What Parents Think About Giving Kids A Covid Shot

By September this year, children as young as two may be eligible for a Covid vaccine. While many parents welcome the prospect of protection against a deadly virus, some parents aren’t so sure.

What do parents think about vaccinating their children?

“In my circle”, says Anjana Nagarajan, a Los Altos parent with two high school age children, “parents are gung-ho.” Her 16-year-old daughter is fully vaccinated while her 14-year-old son just received his first shot.  Her view is largely shared by parents in her area where, according to CA data, almost 87% of the population have received one or more doses of the vaccine.

But for Priya Nair Flores, a management consultant in San Antonio, TX, the vaccine is still out of reach for her son who just graduated fifth grade. “My son is 11 years old,” says Flores, “so he’s one year from the age at which CDC recommends children start getting the COVID vaccine, which is 12 years old. I and other parents of his friends talk about how much we wish they could get the vaccine. I believe in science.”

The science says that the vaccine is safe. Clinical trials have demonstrated even higher efficacy rate among adolescents than young adults (16-25 years old). The FDA just approved the Pfizer-BioNTech coronavirus vaccine for emergency use in adolescents 12 to 15 years old. Moderna just announced that its TeenCove study was highly effective at preventing COVID-19 in adolescents ages 12 to less than 18 and will request FDA emergency authorization in early June. By this fall, children ages 2-11 could potentially be eligible for a COVID-19 vaccine. It will be the next major milestone in containing the coronavirus pandemic.

Even so, though vaccine availability across the US is going up, some parents are refusing to vaccinate their children, citing concerns about the newness of the vaccine and its potential side effects in the future. Public health experts fear that vaccine hesitancy will prolong the fight against Covid19.

In a White House briefing on May 19, US Surgeon General Vivek Murthy urged parents to protect their children from Covid 19 and help turn the pandemic around.

Why Parents are Hesitant

Scientists and doctors emphasize that vaccinations are safe and offer protection from COVID-19. The CDC reports that some people may experience short-term side effects which subside after a few days but are normal signs that the body is building protection.

However, at an Ethnic Media briefing on May 21, Dr. Jose Perez, Chief Medical Officer at the South-Central Medical Center in LA, identified misinformation spreading on the Internet as a troubling cause of vaccine hesitancy in his patients.

Dr. Perez’ view was supported by surveys which found that fear and uncertainty about the Covid 19 vaccine ranged from its safety and efficacy to myths about infertility, and fetal cells in vaccines that could change DNA. Among 48% of people ages 18-49 , fear of future infertility was a top concern.

There was uneasiness that the vaccine was created too quickly, even though the technology for mRNA vaccines has been in development for decades and processed through the same FDA clinical trials for all other vaccines.

The Institute for Policy Research reported that young mothers aged 18 – 35 were largely driving the resistance among parents who indicated they were ‘extremely unlikely’ to get their children vaccinated. In contrast, said Matthew Simonson, a researcher with the COVID States project, fathers have become less resistant to the idea of vaccinating their kids.

A KFF survey found that while 30% of parents with children aged 12 to 15 will get them vaccinated right away, nearly 23% definitely will not.

 

When it comes to vaccinating their children, households which have an annual income of under $25,000 or people who have only high school diplomas are the most vaccine resistant, added Simonsen, compared to most pro-vaccine people who tend to live in households making $150,000+ a year or hold a graduate degree.

But, for many parents explained Dr. Perez, whose clinic serves primarily Latino and African American working families, vaccination hesitancy is not a choice. Rather, socio-economic barriers keep many from getting the vaccine.

“One of the major reasons for lack of vaccination, is access to time off from work,” he explained. Parents who have just returned to work low-income jobs as day laborers or in restaurants, have to juggle taking an extra half day off to get their children to a clinic. Most of Dr. Perez’ patients use the bus, so it’s difficult to access public vaccine centers without a car.

“It’s a tremendous barrier,” he stated when “our patients are being asked to choose between earning a day’s living and or vaccinating their children.”

The KFF survey also confirms that underlying socio-economic factors cause vaccine hesitancy. People worry they may have to pay out-of-pocket costs for the vaccine. Fears about immigration status and vaccine eligibility have created vaccine hesitancy because of requirements for a social security number or government-issued identification to get vaccinated (34%), a lack of trust in the provider (32%), or travel difficulties reaching vaccination sites (15%).

Allison Winnike of Texas-based Immunization Partnership told KERA news that their data showed increased vaccination rates in communities of color who were initially skeptical, but that there were higher hesitancy rates among some people that self-identify as more conservative or evangelical.

As a parent himself, with children aged 3 and 4, Vivek Murthy empathized with the challenges of parenting kids in a pandemic which has percolated into kids’ lives in an extraordinary way. “Parents have had to have difficult conversations with their kids about why they can’t see friends and family or have to go to virtual classes.” But parents also worry about the risks of taking their children to the playground or back to school, he said, which is why vaccinating them should be the highest priority.

Why Parents Should Worry

A joint report from the American Academy of Pediatrics and the Children’s Hospital Association found that Covid is now one of ten leading causes of death among young people who make up 22% of all new Covid cases, compared to only 3% a year ago.

“It’s a significant disease. Kids are also at risk,” said Dr. Grace Lee, Professor of Pediatrics at Stanford University School of Medicine. She has personally seen children hospitalized and dying from the virus. Lee pointed out that less attention had been paid to the ‘burden of infection’ on children, though AAP data has confirmed that 4 million children have tested positive for Covid 19 since the onset of the pandemic. She warned that the CDC noted that when adjusting for under-reporting or under-testing on children, at least “22 million children and adolescents 5 to 17 years have been infected in the US since the pandemic began.” Forty percent of children who are hospitalized have no high-risk conditions like asthma, diabetes, obesity or developmental delay or immune compromise issues, said Dr. Lee, “So, we cannot predict who will be hit more severely by Covid 19 infection.”

“We have to protect children from Covid disease,” Dr. Yvonne Maldonado, a principal investigator at Stanford Pfizer trials told NBC. She reiterated that vaccines are necessary for herd immunity. Reports of long-term side effects in teens are only rumors spread by anti-vaxers she added. “There is no evidence that vaccines cause fertility issues – it’s an idea that “has been disproven over and over again.”

In Texas, Priya Flores agrees. “We are a family of scientists and I strongly believe that facts should impact your decision making.” As a healthcare professional, she was in the early wave of those vaccinated . “I felt lucky and grateful I could access the best of what science could offer.  When my extended family who wasn’t vaccinated got sick with Covid, I was able to help them because I was better protected by the vaccine. It was challenging because I wanted my husband and kid to get it too.”

How to Move Forward

Getting that shot in the arms of adults and children means that “The role of people of color like me and professionals like me becomes very important,” said Dr. Perez. Providers who are POC need to dispel misinformation and encourage parents to vaccinate themselves and their children, because when “patients trust people that look like them, the more likely they are to listen to our voices.”

“We have paid a heavy price” said Dr. Murthy, referring to the unprecedented toll on human lives by the virus, but the US has a pathway out of the pandemic with its arsenal of vaccines that time and again, have proven effective.

In Texas, the CDC reports that 51.73% of Texans are fully vaccinated. But Priya Flores says her family is only ‘half protected’ from the virus as she waits for her son’s age group to be approved.  “I often tell my husband our job has shifted from constant vigilance in general to vigilance for our son. We have relaxed a bit, but once again, …the virus hasn’t disappeared, and our fellow Americans haven’t decided to help our children gain herd immunity. So here we are again.”

“If someone asked my son to be part of a vaccine trial I would say yes. I believe in this vaccine and that it is safe and effective for almost all, with the understanding that there will always be vulnerable populations that need higher monitoring and consideration before deciding to take it.”

Meera Kymal is the Contributing Editor at India Currents
image source: CDC

 

Can COVID Burst America’s Bubble While The World Battles The Virus?

On May 13, after combating three waves of the coronavirus, the CDC released guidelines stating that  Americans who are fully vaccinated against Covid-19 can resume activities without wearing masks or physically distancing in most settings, indicating that the pandemic may be near an end.

“If you are fully vaccinated you can start doing the things you had stopped doing because of the pandemic,” announced CDC Director Dr. Rochelle Walensky.

But experts at a May 14 Ethnic Media Services briefing questioned whether it was too soon to go back to normal.

“Bubbles are beautiful, but bubbles do not last long in this world,” remarked Dr. Ben Neuman, Chief Virologist at the Global Health Research Complex at Texas A&M University.  “Any vaccine bubble that may exist is going to be fragile, unfortunately.”

As Covid-19 outbreaks occur in Michigan, Florida and Puerto Rico, the AMA reports  there is potential for a fourth pandemic surge.

And yes, the Indian B.1.617 variant is here, says the CDC. It’s monitoring the Indian mutation that the World Health Organization classified as “a variant of concern at a global level” because it may spread easily. According to the CDC, new mutations of the virus are more transmissible and are resistant to treatments or vaccines. These include five notable variants – B.1.1.7: (UK),  B.1.351 (S. Africa), P.1 (Japan/Brazil), B.1.427 and B.1.429 (identified in CA).

Going back to normal could expose adults and children to deadly new strains of the virus and its variants, rippling across the US and elsewhere in the world.

Peter Maybarduk
Dr. Ben Neuman
Dr. Marc Lipsitch
Dr Rosane Guerra

 

Can America survive in its Covid-19 bubble?

Variants can burst our bubble said experts, voicing concerns about our vulnerability to virus mutations and the prospect of ever reaching herd immunity.

Dr. Neuman has been sequencing the virus strains in Texas, and has identified different variants thriving even locally. At the peak of Covid-19 in January, he found that 30% variants of concern were from the B.1.1.7. UK variant. By late April and early May however, he added, “every single virus …has been a variant of concern.”

The virus is changing in unexpected ways, explained Dr. Neuman, driving certain lineages of the virus out of existence.  It’s a Darwinian process that  showcases “an increase in viral fitness.”

But, without any checks or balances on the virus which operates on a short-term risk-reward cycle – a 6-to-8-hour timetable – scientists find it difficult to predict long-term movement.

You can trust a snake, a chicken, or a cat to act in its own best interests to the best of its ability said Dr. Neuman, but “a virus has no such impulse.” Instead, it has an evolutionary incentive that drives it not in the direction we would hope or expect, but in the direction of more severe, sustained disease.

Over time the virus will continue to mutate, and vary unpredictably, warned Dr. Neuman, and solutions will have to be updated continually.

“In this particular place and time, there is approximately a 100% chance that you will run into something that grows faster, and has the potential to spread farther, and perhaps hit harder than one would be expecting otherwise.”

The world has underestimated the virus over and over by relaxing restrictions and causing a virus resurgence, reiterated Dr. Neuman.

 

The question is, “Can we do the wrong things and still expect the right results?”

One outcome that scientists predict could keep the virus at bay or banished altogether is Herd Immunity, a popular concept that is mired in misconception and misunderstanding. Dr. Marc Lipsitch, Professor of Epidemiology and Director of the Center for Communicable Disease Dynamics at the Harvard School of Public Health, described herd immunity as a state in which completely immune completely or partially immune people in a population slow down transmission by making it impossible for the virus to pass through them from one person to another in a sustained way, “till the virus essentially goes away.”

Will vaccinations and infections create herd immunity in the current phase of the pandemic? Dr. Lipsitch believes that’s an unlikely scenario – even with the vaccines we have.

At the start of the pandemic, before lockdowns and social distancing, a person infected up to 21/2 or 3 people each. But compared to early versions of the virus, contagious new variants have increased transmissibility by up 4 to 5 persons each. To reduce transmissibility by a factor of 5, explained Dr. Lipsitch, means immunizing 80% of the population,  a challenge that may be impossible given a number of factors.

At the moment, every variant in the world is present in the US.  Immunizing the nation won’t be easy because vulnerable populations – especially racial/ethnic minority groups and economically and socially disadvantaged communities – lack equitable vaccine access, children under the age of 12 are ineligible, and vaccine hesitancy is prevalent.

In the US vaccine hesitancy is based on a lack of trust in its efficacy. At issue also, is that all vaccines currently available in the US do not offer 100% protection. But added Dr. Neuman, “I trust the virus less!”

While Yale Medicine rated Pfizer-BioNTech at 95% for preventing symptomatic disease, its stability depends on strict storage requirements; Moderna has a similar high efficacy of 90% upon full immunization, while the single shot Johnson & Johnson vaccine has a 72% overall efficacy.

There is also concern about waning immunity and about revaccination. Limited studies that exist clarify that antibodies decrease over time, but there is uncertainty about at which point a person is no longer protected.

Annual boosters may be necessary at a minimum, confirmed Dr. Neuman, but although each of the vaccines is reasonably effective against each of the variants, there is definitely a lower effectiveness against some, like those coming out of Brazil and South Africa.

It’s more the virus changing than waning immunity that will drive the vaccination cycle.

 

Defanging Not Defeating the Virus

In the wake of the CDC’s new mask guidelines, Dr. Neuman noted that people calculating what precautions to take – to mask, social distance, or get vaccinated – are making decisions predicated on the original versions of the virus.

As ‘stay-at-home’ lockdown measures gradually ease, NIH reports also say that much of the population may return to spending increasing amounts of time in inadequately ventilated workplaces, offices, schools and other public buildings, where they may be exposed to a risk of acquiring viral infections by inhalation.

So, in the midst of an ongoing epidemic, as social barriers to transmission are lowered without reaching herd immunity, and high-risk populations in the other parts of the world face vaccine shortages, we are “in some sense “ said Dr. Lipsitch, “not ‘totally defeating, but simply defanging the virus,” – just making it less dangerous to have transmission.

He predicts “a quiet summer” followed by “some virus resurgence in the fall” as people move indoors and continue to lower their guard.

 

Fighting the Virus at Warp Speed

All the experts argued that the only way out of the pandemic is to ensure that more vulnerable populations across the world get vaccinated.

Peter Maybarduk, Director of Public Citizen’s Access to Medicines Group, called for a global response at warp speed for the world – a catalyst for more funding, sharing resources and technical assistance, more manufacturing, and a definite plan to vaccinate everyone, everywhere, with at least 8 billion doses of MRNA vaccine within a year to make up the global shortfall.

Apart from the moral argument, added Dr. Lipsitch, “we like having interactions with the rest of the world, and for all the reasons we value the rest of the world, we should value their health as well.”

Dr. Neuman called for a single global solution to vaccinate everyone within a window of six months to a year.

Maybarduk, an expert on the Covax initiative which partners with the World Health Organization to get vaccines to low-income countries by sharing vaccines equitably, pointed out that wealthy countries have purchased much of the global supply of doses in bulk, so less than 5 % of the world’s population – only 340 million (one quarter of the doses already administered in the US alone) – have been vaccinated worldwide.

In Brazil only 17% of Brazilians have been vaccinated, said Dr. Rosane Guerra from the Department of Pathology, Biological and Health Sciences Center at the Federal University of Maranhao (UFMA). Brazil does not have an adequate supply of medication to prevent or control the virus.

Covax aims to vaccinate 20 percent of the world with a 2 billion dose target for 2021 but has only been able to ship 64 million doses, stated Maybarduk.  Worldwide access to vaccines is hobbled by the lack of manufacturing capacity, inefficient distribution channels, and low production volumes, access to raw materials, export controls, meeting regulatory requirements for safety and efficacy, obtaining qualifications from WHO for manufacturing facilities, and by politicians prioritizing their own citizens for vaccination first.

Sharing vaccines and vaccine knowledge (like the Trips waiver) is imperative to overcome the vaccine shortfall Maybarduk suggested, and getting vaccines to those who desperately need it in other countries..

“We should not cross our fingers and assume all is going to work out.”

Fighting the virus is like mobilizing for a world war which requires collective, integrated human effort towards achieving one goal. “I don’t think halfway solutions are going to get us there,” said Dr. Neuman. Getting to the next stage requires an integrated effort that scientists know is doable but is ultimately a political decision that world leaders must make.

“It’s impossible to have any kind of bubble in a world when people can move between countries in the middle of an epidemic. We have to close every border to control the disease,” Dr.Guerra concluded.

The bubble could burst as restrictions are relaxed before the pandemic is under control, said Dr. Neuman. “I don’t think that is the path that leads to the fastest extinction of the virus.”

“Get the vaccine, wear a mask, and when the numbers go down, then you know it’s safe to relax!”

Meera Kymal is the Contributing Editor at India Currents

Photo by Marc Sendra Martorell on Unsplash

Photo by Fusion Medical Animation on Unsplash

 

Hate Crimes & The Pandemic Create Mental Health Distress Among Asian Americans

Many Asian Americans say – we can wear a mask to protect against Covid but how can you protect yourself against racism? 

The physical assaults are the stories that show up on the news.  But the mental impacts of racism have been deadly for Asian Americans. They have experienced the highest mental health distress from both the pandemic and rise of hate crimes during pandemic while they are the least likely to seek help for the same.

“There are a lot of trauma reactions, similar to PTSD symptoms. However what makes racial trauma very unique is where PTSD is post traumatic stress disorder, a lot of racial trauma is not post.  There is no ending to it right now.  It is past, present and ongoing.  So, it makes it very unique and tricky trauma symptoms to treat sometimes.” says Linda Yoon, a therapist and the founder of Yellow Chair Collective.  

For many older generation South East Asians including Vietnamese, Cambodian, Laotian refugee immigrant population, the recent violent crimes have triggered their PTSD symptoms that remind them of war, genocide, displacement they experienced in their home countries.  

Yoon says that there are a lot of physical symptoms in this trauma, including sleeplessness, nightmares, flashbacks, dissociation, confusion, loneliness, and a lot of anxiety and depression.  And a lot of anger towards the injustice that they are experiencing. 

A lack of understanding of the available mental health services as well as the cultural stigma associated with it, makes it even harder to reach this community.  

The concept of mental health comes from psychology, which comes from the western culture and study, says Yoon and because psychology separates mind from the physical body, it feels alien to the eastern society.  “In traditional eastern medicine and wellness, they talk about yin and yang – balance which also includes balance of your body and mind.  And there is no separation between body and mind.” 

So a lot of times Asian Americans will complain about their mental health symptoms in their physical somatic sense.  “We talk about pain in our body, we talk about anger that lives inside our body, we talk about the shoulder pain that was caused by family stress, we talk about stomach issues that have been impacted by stress and anxiety.” 

To address mental health issues and reduce the stigma, more integrative holistic approaches to mental health will make more sense to Asian populations in a culturally sensitive and linguistically competent manner. 

But the good news is that they do not want to “shoulder the fear burden anymore” reports Anh Do at the LA Times.  At the start, they “bent to cultural tradition” and kept quiet.  They were taught to keep their troubles to themselves.  And they wanted to avoid attention to their families.  But then as assaults increased, they started reporting and creating safety plans for their loved ones. 

 “They gave their children mace.”  “He makes sure his phone battery is always charged ready to be used in case something happens” and he needs to record it. “Never go alone, even for the smallest errand.” “Hyper vigilance, and avoidance of places”. These are some of the strategies ordinary Asian Americans are employing to stay safe, here in America, according to Do.

The potential for bullying, stereotyping and violence is so high that Asian American parents are afraid to send their kids back to school and generally go back in public.  

 

Who are Asian Americans Exactly?

In 1968, UC Berkeley student activists Emma Gee and Yuji Ichioka coined the term “Asian American” to unite the different communities of Asian descent and strategically create more political power in numbers.  

Then, in the 1980s and ’90s this classification was broadened even further via the addition of Pacific Islander and creating the term Asian American and Pacific Islander, or AAPI.  While AAPI was meant to be inclusive, in reality it has often had the opposite effect. 

According to Pew Research, this demographic marker includes about 19 million people, up 81 percent since 2000. 59 percent of all Asian Americans are immigrants, including 1.4 million of whom are undocumented. Asian Americans are the fastest-growing racial group in America, currently 5.6 percent of the county’s population but projected to be as much as 14 percent by 2065.

The income gaps among different Asian American ethnic groups are the widest of any racial group, and they are still growing. While Indian Americans have the highest median income of $100,000, for example, Burmese Americans have the lowest, at $36,000. By bundling over 50 ethnic groups that speak over a 100 languages under one broad AAPI banner, the aggregated data does a disservice to the individual communities.

But what makes us uniquely Asian says Professor Karthick Ramakrishnan, Professor of Public Policy, UC Riverside, to Vox, “is our “history of exclusion” whether this is the Chinese Exclusion Act of 1882, or the 1917 Immigration Act that barred Indians or by 1924, the Japanese as well. 

In all these three cases, the immigrants came to the US as laborers but were framed as the source of economic problems, and in some cases public health ones, too. 

The yellow peril is a racist metaphor for Asian Americans who are seen as outside threats that are invading the west with their diseases as explained by Professor Russell Jeung, Chair & Professor, Asian American Studies Department at San Francisco State University, at a USC Center for Health Journalism webinar titled “What Anti-Asian Hate Means for Mental Health, Safety and Justice.”

The “model minority” trope that suggests that all Asian Americans are well off, hardworking and successful and pit them against other minorities “masks the inequalities that Asian Americans face.  The yellow peril is much more operative” suggests Professor Jeung, one of the founders of STOPAAPIHATE.org. 

“Sometimes when we are on the inside, we are model minorities, we are white adjacent, we are crazy rich Asians. But in times of war, such as Japanese incarceration, or what happened to South Asian muslims and Arab Americans with islamophobia –  in times of economic downturn and in times of pandemic,  Asian Americans are framed as perpetual foreigners, or outsiders who don’t belong” says Professor Jeung.

Time and again, when diseases come from Asia, says Professor Jeung, “Asian Americans are perceived as the source of the diseases, policies seek to exclude them, and Asian Americans are met with interpersonal violence.” 

 

AAPI Hate Crime on the Rise

#stopAAPIhate website tracker was created to collect individual reports, to document the issue, to figure out what’s happening, to track trends, and to provide policy interventions.  The hate and anger directed against Asians was appalling, up to 100 incidents a day and that surge has continued. 

Asian Americans report everything from being barred from ride shares, to being coughed and spat on, their businesses being shunned, their elderly being shoved and kicked, their children being bullied in person and online, racial epithets and slurs and the ever common curse –  “go back to China”. 

Almost unanimously, respondents named racism as their biggest stressor and greatest fear during the pandemic. Asian Americans are more concerned about other American’s hate than they are of a pandemic that has killed over half a million Americans.  That’s how widespread and traumatizing the racism is.  

Here in the Bay Area, there were higher incidents of hate crime against Asians in the beginning of the pandemic. This is likely because Northern California, more dependent on public transportation, the likelihood of different communities and different cultures interacting with one another is greater versus Southern California, which is very steeped in the car culture. 

 

Help is At Hand

In Oakland, a volunteer service has been activated where a volunteer comes within 10-15 minutes of a call to accompany you to the bus stop, help you to a grocery store or back to your home. 

Professor Jeung is angry and sad and distressed about the state of America although he is heartened that the Asian American community is standing up and “seeing our community really mobilize and working in unity with other allies.”

But he questions what healing looks like?  And “as we experience racism, we might become racists – how do I stop this within my own self and how do I stop this for my students? What prescriptions do we have for our society so that we can stop that cycle of violence and racism?”

These are questions that do not have easy answers for us in the South Asian community either.  Many of us faced stigmatization and violence in the aftermath of 9-11 but how do we become better allies and show support to our discriminated Asian brethren now? 

A simple check up on your Asian American friends and neighbors, says Yoon, will go a long way.  Her patients report feeling invisible and alone.  Other strategies include intervening if you can when you see an incident, report what is happening and donate when you can.

Words matter, says Professor Jeung as the world watched Trump’s hate speech about the “China Virus” going viral, and normalizing hate towards the Asian American community.  “We need official statements to normalize love and respect.  It is sort of obvious but it is really needed.” 

So, whatever organization you belong to or work at, pressure them to put out official statements about supporting the AAPI community because it helps them be seen and heard and acknowledge their pain and suffering.  

President Biden’s new actions to respond to the increase in acts of anti-Asian violence have been celebrated in the community as a movement in the right direction. But in order to address the root case will require “ more education, more expanded civil rights protections and more restorative justice models”, says Professor Jeung.

Anjana Nagarajan-Butaney is a Bay Area resident with experience in educational non-profits, community building, networking, and content development and was Community Director for an online platform. She is interested in how to strengthen communities by building connections to politics, science & technology, gender equality and public education.

Edited by Meera Kymal, contributing editor at India Currents

Photo by Matthew Ball on Unsplash

Did It Feel Like A Truck Hit You After Your Covid Vaccination?

If you think vaccination is an ordeal now, consider the 18th-century version. After having pus from a smallpox boil scratched into your arm, you would be subject to three weeks of fever, sweats, chills, bleeding and purging with dangerous medicines, accompanied by hymns, prayers and hell-fire sermons by dour preachers.

That was smallpox vaccination, back then. The process generally worked and was preferred to enduring “natural” smallpox, which killed around a third of those who got it. Patients were often grateful for trial-by-immunization — once it was over, anyway.

“Thus through the Mercy of God, I have been preserved through the Distemper of the Small Pox,” wrote one Peter Thatcher in 1764, after undergoing the process in a Boston inoculation hospital. “Many and heinous have been my sins, but I hope they will be washed away.”

Today, Americans are once again surprisingly willing, even eager, to suffer a little for the reward of immunity from a virus that has turned the world upside down.

Roughly half of those vaccinated with the Moderna or Pfizer-BioNTech vaccines, and in particular women, experience unpleasantness, from hot, sore arms to chills, headache, fever and exhaustion. Sometimes they boast about the symptoms. They often welcome them.

Suspicion about what was in the shots grew in the mind of Patricia Mandatori, an Argentine immigrant in Los Angeles, when she hardly felt the needle going in after her first dose of the Moderna vaccine at a March appointment.

A day later, though, with satisfaction, she “felt like a truck hit me,” Mandatori said. “When I started to feel rotten I said, ‘Yay, I got the vaccination.’ I was happy. I felt relieved.”

While the symptoms show your immune system is responding to the vaccine in a way that will protect against disease, evidence from clinical trials showed that people with few or no symptoms were also protected. Don’t feel bad if you don’t feel bad, the experts say.

“This is the first vaccine in history where anyone has ever complained about not having symptoms,” said immunologist Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia.

To be sure, there is some evidence of stronger immune response in younger people — and in those who get sick when vaccinated. A small study at the University of Pennsylvania showed that people who reported systemic side effects such as fever, chills and headache may have had somewhat higher levels of antibodies. The large trial for Pfizer’s vaccine showed the same trend in younger patients.

But that doesn’t mean people who don’t react to the vaccine severely are less protected, said Dr. Joanna Schaenman, an expert on infectious diseases and the immunology of aging at the David Geffen School of Medicine at UCLA. While the symptoms of illness are undoubtedly part of the immune response, the immune response that counts is protection, she said. “That is preserved across age groups and likely to be independent of whether you had local or systemic side effects or not.”

The immune system responses that produce post-vaccination symptoms are thought to be triggered by proteins called toll-like receptors, which reside on certain immune cells. These receptors are less functional in older people, who are also likely to have chronic, low-grade activation of their immune systems that paradoxically mutes the more rapid response to a vaccine.

But other parts of their immune systems are responding more gradually to the vaccine by creating the specific types of cells needed to protect against the coronavirus. These are the so-called memory B cells, which make antibodies to attack the virus, and “killer T cells” that track and destroy virus-infected cells.

Many other vaccines, including those that prevent hepatitis B and bacterial pneumonia, are highly effective while having relatively mild side effect profiles, Schaenman noted.

Whether you have a strong reaction to the vaccine “is an interesting but, in a sense, not vital question,” said Dr. William Schaffner, a professor of infectious disease at Vanderbilt University Medical Center. The bottom line, he said: “Don’t worry about it.”

There was a time when doctors prescribed cod-liver oil and people thought medicine had to taste bad to be effective. People who get sick after covid vaccination “feel like we’ve had a tiny bit of suffering, we’ve girded our loins against the real thing,” said Schaenman (who had a slight fever). “When people don’t have the side effects, they feel they’ve been robbed” of the experience.

Still, side effects can be a hopeful sign, especially when they end, says McCarty Memorial Christian Church leader Eddie Anderson, who has led efforts to vaccinate Black churchgoers in Los Angeles. He helps them through the rocky period by reminding them of the joyful reunions with children and grandchildren that will be possible post-vaccination.

“I’m a Christian pastor,’’ he said. “I tell them, ‘If you make it through the pain and discomfort, healing is on the other side. You can be fully human again.”

This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

image credit: getty images at KHN

Don’t Call The Police! What Will People Say?

In traditional South Asian families, women trapped in abusive situations don’t leave for fear of  societal scorn.

“What will people say?”

Our social structure, based on arranged marriages and multi-generational households, regard family as sacrosanct – staying intact is prioritized over individual wellbeing.

“Culturally in the AAPI community, …victims may be encouraged to stay in their situations for their families, for their communities, for the larger family,” said Monica Khant, at an April 23  EMS briefing on domestic violence (DV).

Khant worked for years with DV clients as an immigration lawyer before joining Asian Pacific Institute of Gender-based Violence (API-GBV) as its Executive Director.

“That was something I had seen first-hand, that leaving their situation might being shame or embarrassment to the family.”

So, victims stay to avoid disrupting family dynamics, losing status, financial security, or children, but mainly because they have very few alternatives.

But during the pandemic, quarantining at home with an abusive partner because of stay-at-home orders, has made a difficult situation even worse for DV survivors. In fact, studies by the NIH reported increasing risk of family violence during the Covid-19 pandemic, stating that “domestic abuse is acting like an opportunistic infection, flourishing in the conditions created by the pandemic.”

According to the CDC, approximately 1 in 4 women and 1 in 10 men report experiencing some form of IPV each year. But with the COVID-19 pandemic, law enforcement agencies across the country are reporting an alarming upward trend in domestic violence.

By March 2020, compared to March 2019,  calls reporting DV increased by 18 % (San Antonio Police Department),  27% (Jefferson County Alabama) and 10% (New York City Police Department).

DV rates have spiked among women of color and immigrants who face additional structural and cultural challenges trying to access support from the government and community, even before the pandemic.

Narika, a 30-year-old, Fremont-based, domestic violence advocacy group with 90 % of South Asian clients connected to the Bay Area, reported a 3x  increase in DV calls since the pandemic began, while the API-GBV has found that 64% of Indian and Pakistani  women had reported intimate partner violence IPV.

Yet fewer survivors are calling for help despite being trapped at home in abusive situations. At API-GBV which recorded a 76% drop in calls and in people seeking shelters, Khant explained that survivors are unable to access phones or information on computers, so less calls are coming in for assistance.

You Can’t Tell the Police!

In South Asian communities, inaction and compliance by DV survivors has its roots in a patriarchal society which views DV as a taboo subject. Though we worship goddesses and powerful  female icons (Mother India, Kali), female stereotypes in secondary roles to men are equally revered (dutiful, submissive, wives like Parvati, Draupadi), and DV remains a systemic, pervasive  issue. Families are expected to stay intact. In fact, by raising awareness, Narika has been accused  of breaking up families and planting ideas in survivors to move out.

Bindu Fernandes, the Executive Director of Narika explained that survivors don’t want to ‘out’ their family.

Survivors who reach out will say,

 “I don’t want to cause any trouble, but if I die, I just want someone to know what’s happened,” and,  “I’m probably going to be pushed down some stairs so I want somebody to know that could happen,”, and unequivocally add,

‘BUT YOU CAN’T TELL THE POLICE.’

In many cases in South Asian community says Fernandes, this is the story.

Findings from an ATASK (Asian Family Violence Report: South Asian) survey in Boston supports her claim. In the survey, 44% percent of South Asians said they knew a woman who has been physically abused or injured by her partner. Yet 5% of male and female respondents said that a woman who is being abused should not tell anyone about the abuse. Even though they overwhelmingly endorsed battered women seeking help – from a friend 82%, the police (74%), a family member (66%), a shelter (50%) or a therapist (48%); in reality, very few women from their communities actually do.

Their dependency and  passivity, steeped in inflexible tradition, propels a vicious cycle of IPV and in-law violence.

Cultural norms and traditional roles force women to stay silent. Attitudes expressed in the ATASK focus group convey the insular mindset within South Asian families which prohibit survivors from coming forward and seeking help. Focus group members felt that the woman in a marriage becomes the property of her husband and no longer belongs to her parents. The group  felt that in-laws play a critical role in ‘family violence’ within South Asian families especially in cases of dowry disputes. A woman cannot turn to her own family for help once she is married and parents are not supposed to intervene in the daughter’s marriage. Sometimes parents don’t take divorced daughters back.

Survivors face challenges accessing assistance because of a complex mix of family dynamics, immigration status, cultural mores, lack of English proficiency and technology access, and financial dependence.

In the AAPI community, when survivors with limited English proficiency call law enforcement, said Khant, the officer may speak to the abusive partner who has the dominant English proficiency which enables them to control the narrative. The same language access issue applies when survivors who seek help from medical or hospital facilities need interpreters; having to rely on translation services adds time to getting the attention they need, so sometimes they just may not go. In Brooklyn for example, a nurse said it took over an hour to get a translator for a survivor who used a less mainstream Asian language.

Women who do not have valid immigration status or are on temporary status are not eligible for assistance, for example, even  Covid19 testing.

In the Bay Area, many immigrant women are dependents of H1B visa holders employed by  Silicon Valley’s tech sector. When the Trump administration revoked their EAD 4 work permits, they lost their right to work and experienced increasing abuse, domestic servitude, and  financial dependency.

Khant said that for AAPI community members who work in the service industry, the loss of jobs and lack of work increased financial dependency on abusive partner who is earning income, a key factor in DV survivors not being able to leave. Some of the immigrant DV survivors are ineligible for unemployment benefits because they don’t have valid work authorization permits and may not be allowed to apply for other benefits

Survivors who have lost jobs face eviction. According to the Census Bureau’s housing survey added Khant, 1 in 5 Asian renters reported that they were behind in rent payment as of September 2020. This forces DV survivors to stay with partners in violent and unsafe situations because they cannot afford to pay back rent. Narika said they issued $50,000 in cash assistance requests to survivors in the past year.

Transnational abandonment is the new manifestation of DV inflicted on immigrant women  already besieged by the pandemic and loss of EAD-4 work permits. Narika reports 2 to 3 cases of transnational abandonment a  week, where vulnerable immigrant women  are abandoned in their country of origin by their husbands. This phenomenon is particularly  prevalent within the SA community, in marriages where victims face domestic violence, emotional abuse, cultural alienation, or financial exploitation. Once they are deliberately  removed from the US, these disposable women lose legal protections, rights to their homes, finances and even children. Narika reports an instance where a woman was dropped off at a  grocery store and never saw her husband again.

There is no accountability as courts do not prosecute perpetrators or accept cases  when victims are absent. Narika reports that abusers take advantage of differences in laws  governing marriage and assets between the US and the victim’s country of origin. Nor is help available through  VAWA which has few protections for abandoned victims who don’t reside in the US.

Where do we go next?

While there is a compelling need for broader language service access and more food pantry and housing relief, there’s a growing demand from South Asian families about addressing DV outside the traditional systems in place.

Khant’s work has involved observing existing laws (or a lack of laws and assistance in place during certain administrations), and recognizing the nuances in immigrant cases related to the legal system of DV. But first, she said, we need to acknowledge biases in responses to communities of color. In the land of opportunity with its many resources for DV survivors,  Khant suggested a new approach is necessary to address DV in the South Asian community.

Traditionally DV survivors have been encouraged to follow the traditional systems in place – law enforcement, justice system, filing a complaint and following through with the courts.

But the pandemic has made it difficult for families to seek help from law enforcement or the justice system, so many families would rather go a new route to find resolution. At Narika, Bindu Fernandes shares that restorative justice is one approach that could form a pathway to helping families heal.

“DV is a delicate subject because it involves intimate relationships, family secrets, and it’s a subject many of us are reluctant to raise either publicly or in private. It’s embarrassing, sometimes even shameful to talk about. But we also know that staying silent (about the topic),  won’t make it go away. Suffering in silence makes people give up….lose hope,” remarked Sandy Close, EMS Director, at the briefing.

Khant said her experience as  an immigration attorney shows that, “If divorce or leaving the abusive situation is not the first choice, it’s the choice survivors only take after many attempts at reconciliation.”

Using social services or less criminally endorsed systems, “may get better traction in AAPI community,” said Khant, and help families find a path to reconciliation.

Meera Kymal is the Contributing Editor at India Currents.

NARIKA 1-800-215-7308 or 1-510-444-6048

MAITRI Toll Free Helpline: 1-888-862-4874

SAVE’s 24-hour crisis line at 510-794-6055

The National Domestic Violence Hotline is available to assist victims of intimate partner violence 24 hours a day, 7 days a week by calling or texting (800) 799-SAFE (7233).

https://www.thehotline.org/wp-content/uploads/media/2020/09/The-Hotline-COVID-19-60-Day-Report.pdf

Links to SCC District Attorney’s Office Victim Service Unit brochures in multiple languages: https://www.sccgov.org/sites/da/publications/DistrictAttorneyBrochures/Pages/default.aspx

Family Justice Center Location in San Jose, SCC: https://www.sccgov.org/sites/da/VictimServices/FamilyJusticeCenter/Pages/FJC-SJ.aspx

Family Justice Center Location in Morgan Hill, SCC: https://www.sccgov.org/sites/da/VictimServices/FamilyJusticeCenter/Pages/FJC-MH.aspx

https://eastwindezine.com/mosf-vol-15-5-queer-and-black-asian-and-young-drama-del-rosario-tchoupitoulas-and-ocean-vuong/

Image by Gerd Altmann from Pixabay

Store Your Energy, Go Green & Save Money Says Campbell Scott

Our Climate is Changing. Why Aren’t We?

Climate Reality activist Campbell Scott talks to DesiCollective about why Energy Storage is important for a sustainable economy.

When Texas lost power after two devastating winter storms  mid-February 2021, over 4 million homes and businesses lost power for several days. In Austin,  people were burning their furniture to cook food and to keep warm. 

 Campbell Scott says  this disaster was preventable. The  Texas electrical grid failed to keep up with the demand, and Texas repeatedly failed to protect its power grid against extreme weather.

What is the  science behind energy storage?

Can California halt the frequency of its rolling blackouts?

How do you store green energy when  the wind doesn’t always blow, and the sun doesn’t always shine? Are there energy storage solutions?

And what can communities do to advocate for a greener future?

We asked Campbell for answers.

https://audioboom.com/posts/7863188-store-your-energy-go-green-save-money-says-campbell-scott

 

Climate Reality Activist, Campbell Scott

A Primer on Green Energy Storage by Campbell Scott

Energy Storage is Key to Green Energy

Why should we start using green energy rather than fossil fuels? 

Renewable, carbon-free electric power, generated by solar panels and wind turbines, is now cheaper than from any other source.  If we are to reach zero carbon-dioxide emission,  fossil fuels, coal, oil and gas, must  be phased out. 

How do we store renewable energy when  sunshine and wind are intermittent sources: the sun sets every night or may be clouded over; the wind does not always blow.  

The solution is to store electrical energy when supply exceeds demand and to use that stored energy as demand increases.  It is just like “saving for a rainy day.”

Peak demand usually occurs in the evening as people get home from work, cook dinner and turn on other electric appliances.  Most generating stations providing on-demand power are typically natural gas powered “peaker plants.” So as electric utilities transition to renewable energy sources, it is necessary to provide a green backup power supply.

What are different ways to store energy?

Energy comes in many forms, and each can be stored in several ways.  

Wood, coal, oil and gas
These familiar fuels store chemical energy that is released when the fuel burns. It combines with oxygen to form, mostly, carbon dioxide and water.  Burning converts the chemical energy into heat, i.e., thermal energy, that we use to heat homes, cook food, heat water, power vehicles, generate electricity and run factories.  They are easy  to store in bunkers, railcars or tanks, and the fluids, oil and gas, can also be distributed in pipes.

Electrochemical Storage
Batteries are the most convenient way to store energy from electricity. 

From the end of the 19th century, the most common battery was lead-acid.  Lead-acid batteries can deliver high electric current during discharge and so are still in use today to start cars and trucks with internal combustion engines.  In  the mid-20th century, they powered vehicles, such as milk-trucks, that travelled short distances with heavy loads.  But lead is one of the heaviest metals, making lead acid batteries unsuitable for long-range transport. Gasoline and diesel were dominant until the recent development of affordable lithium-ion batteries that power today’s electric vehicles (EVs).

When a battery is being charged, current is passed through it and changes the chemical composition of the material at each electrode.  When the charged battery is connected to an external circuit (a motor, a cell phone etc.), it delivers the energy used in charging back into that circuit.  Lithium-ion batteries offer a greater advantage because they are extremely lightweight and can be recharged.

Thermal energy
For centuries, people stored heat by “banking the fire” at night:  blazing evening fires were partially smothered with ashes at bedtime to keep the embers hot, while slowing down combustion overnight.  

Today storage space-heaters and water-heaters do the same thing. In the electrical era, we heat bricks or water overnight when electricity is less expensive and then use the stored heat during the day for hot water or to warm the house.

German and Danish companies are developing thermal storage for utility companies, by heating rocks, bricks, or concrete blocks to well above 1,000 deg. C during the day when solar energy is plentiful. At night, high pressure steam is generated to drive turbines.

Gravitational energy
Gravitational energy is the storage mechanism  used in pumped hydroelectricity.  When excess energy is available, water is pumped uphill from a lower reservoir to an upper reservoir.  When electrical demand increases, the water is allowed to flow back downhill through turbines to generate electricity.  

At the O’Neil Forebay at the bottom of the San Luis Dam near Los Banos for example, the lower reservoir is also used to distribute water for other needs such as irrigation.  So, the lack of water availability may limit  electrical generation.  Also, this form of storage needs dams and there are not enough places suitable for building an upper reservoir. 

One solution is to ‘ invert’ the roles of upper and lower reservoirs. That means installing the lower reservoir deep underground, in old mines for example, and  building a shallow upper reservoir on the surface to create a large gravitational “head.”

Hydro plants are expensive. So, a Swiss-based start-up called Energy Vault, has developed a method to store gravitational energy, not with water, but with massive concrete blocks.  The unit uses a six-armed crane to raise and lower the blocks,  recapturing the energy used in raising to turn a generator during lowering.  The cost is much less than a hydro-plant and power can be ramped up in just a few seconds.

Hydrogen
Hydrogen, like oil and gas, can be stored in a container or distributed through pipes. It’s the lightest of all gases and burns in air/oxygen to produce only water.  

Hydrogen is colorless, but it has acquired several colorful labels depending on how it is produced.  Black or brown hydrogen is made from coal of different types and water, and has been used in industrial processes for two hundred years.  Nowadays natural gas and water are used  to produce grey hydrogen, as with coal, carbon dioxide is still a byproduct. If it is captured and stored underground you get blue hydrogen.  An abundant supply of cheap renewable energy makes it economically feasible to produce green hydrogen directly from water by electrolysis; the byproduct is oxygen which can be captured for industrial and medical use or safely released to the atmosphere.  

Ammonia
Ammonia is made by reacting hydrogen and nitrogen in a catalytic converter. Like propane, ammonia is easily liquified and stored under modest pressure. It’s used in many industrial processes such as fertilizer production, but it is also a fuel in its own right, burning under appropriate conditions in air to yield water and nitrogen.  

Both hydrogen and ammonia can also be used in fuel cells to generate electricity and thus to provide backup power for the grid, or to run motors in electric vehicles.  It seems increasingly likely that hydrogen, in some form, will play a major role in long-haul, heavy duty transportation: trucks, trains and shipping.  

Biofuel
Everything that grows under the sun is a potential biofuel, from algae and seaweed to crops and trees.  Even waste foliage from vegetables can be dried and burned.

Biofuels directly harness sunlight via photosynthesis, taking CO2 from the atmosphere.  However, in order to avoid soot and other pollution,  many schemes are being developed to process crops to yield more pure fuels, such as fermenting corn sugar to produce ethanol, or extracting oils from canola or soy.

Microbes and synthetic catalysts are being evaluated to “digest” various types of biomass to make better fuels, -the stretch goal being  jet-fuel.  Ideally,  biofuels will be used in facilities that capture CO2 and store it deep underground or use an industrial process that fixes it in a solid such as concrete. 

The future of our energy supply looks increasingly clean and bright, but we must urgently make full use of these new technologies in order to meet net-zero carbon-dioxide commitments in the coming decades.

Meera Kymal & Anjana Nagarajan Butaney produce the climate change podcast ‘Our Climate is Changing, Why Aren’t We?’ at DesiCollective.
Photo by Denny Müller on Unsplash

 

 

‘Don’t Turn Your Back on Immigrant Essential Workers’ Says Sen. Alex Padilla

When Sen. Alex Padilla took the California Senate seat left by V.P. Kamala Harris, the American immigrant story achieved two remarkable milestones.

Harris’ election to the vice presidency marked the unprecedented ascendancy of the first woman, Black and Asian, to a top political office, while Padilla became the first ever Latino to represent California in the United States senate.  After twenty seven years of fighting for immigrant rights, Alex Padilla is finally in a position to achieve the immigration reforms he has long pursued.

Senator Alex Padilla, CA

Padilla now chairs the Senate Judiciary Committee’s Immigration Subcommittee and will have jurisdiction over key immigration issues.

In his new role Padilla has promised to restore humanity, dignity and respect to the immigration process, a commitment reflected in the new title he’s given to the immigration subcommittee. It will now be known as the Subcommittee on Immigration, Citizenship and Border Safety.

At an ethnic media briefing on April 16th, Padilla was proud to announce ‘The Citizenship for Essential Workers Act‘ – the first bill he has introduced as a United States Senator to honor “immigrant essential workers with action”.

Padilla’s focus on immigration reform begins with a proposal to deliver a pathway to citizenship to frontline workers – a ‘long-overdue recognition’ that ‘they have earned, and they deserve.’

He described the Bill as legislation that “urges a fair, secure, and accessible pathway to U.S. citizenship for over 5 million immigrant essential workers in critical infrastructure sectors such as health care, agriculture, construction, food, energy, emergency response, and care-giving.”

Padilla explained that during the COVID19 pandemic, frontline workers have been critical to keeping the country running and saving American lives, despite the risk of COVID19 to their health and that of their families. “They continue to show up to work every day.”

Essential workers put food on our tables, take care of our loved ones, clean the hospitals, restaurants, and offices. They ensure “that communities stay healthy, and that the economy continue to move,” added Padilla.

To him, COVID Relief not only means addressing the health impact of the pandemic. It also means rebuilding and stimulating an economic recovery that is “much more inclusive.”

Padilla’s home state of California has the highest concentration of immigrants (11 million) of any state in the US, but Padilla sees CA’s diversity “as a tremendous strength” and, that “the entire nation stands to benefit from thoughtful immigration reform.”

Immigration reform had stalled for decades, until the Trump administration declared war on immigrants with a slew of restrictive policies – setting limits on legal immigration and family-based immigration, building border walls, and enforcing child separation. Now immigration reform is also tasked with overturning the anti-immigration directives from the Trump era.

Padilla believes the Citizenship for Essential Workers Act will mark a ‘rather pivotal moment in the nation’s history’ when it’s in the best interest of the country to rebuild from the economic impact of the pandemic.

He reiterated his commitment to “bringing the urgency to immigration reform that this moment demands and millions of hard working immigrants have earned. I look forward to working with my colleagues on both sides of the aisle to restore dignity and humanity to our immigration policies and to respectfully uphold America’s legacy as a nation of immigrants.”

“The Bill will help boost our economic recovery and will benefit communities across the country.”

The vast majority of current and future workforce growth will be met by immigrants and the children of immigrants, said Padilla. He referred to a 2016 study by the Center for American Progress which found that undocumented workers contribute $4.7 trillion to the United States GDP, while undocumented immigrants contribute $11.7 billion in state and local taxes, and $12 billion in social security revenue every year.

Given their financial contributions,  “We can no longer ignore the 11 million plus people who have been living…’in the shadows’ in this country but working and paying taxes and contributing,” added Padilla.

They have earned their right to citizenship through their service and sacrifice, said Padilla, who together with Congressman Joaquin Castro (D-Texas), Senator Elizabeth Warren (D-Mass.), and Congressman Ted Lieu (D-Calif.), sent a letter to President Biden, urging the inclusion of the Bill in next infrastructure package.

Padilla was optimistic about helping President Biden move forward with a comprehensive immigration reform package to congress and ‘making significant progress.”

“It is personal for me,” he said, drawing parallels between his immigrant parents and the service of essential workers. “These workers – they remind me of my own parents who worked jobs considered ‘essential today.”

A ‘proud son of immigrants,’ Padilla grew up in the northeast San Fernando Valley, where his parents raised three children in whom they instilled strong values of service to others, in their pursuit of the American dream.

Padilla came to public service following the example of his Mexican immigrant parents.

“It was through their activism and community organizing that in many ways led me to public service”, he remarked, describing how his family worked with neighbors to curb violence in heir neighborhood.

Padilla paid tribute to his parents – for 40 years  his father worked as a short order cook and his mother cleaned houses. Their inspiring ‘journey and life experience’ is the backstory to Padilla’s fight for immigration rights from his time on Los Angeles City Council through to the California Senate and his  2015election  as secretary of state

“I firmly believe that we can’t simply rely on hardworking people to keep our nation afloat and keep our communities safe in times of  crisis and then turn our backs on them as soon as the pandemic is over. That would just be wrong.”

“I believe its time need to honor them and their work and their service with more than just our words”

Meera Kymal is the Contributing Editor at India Currents

Photo by Arron Choi on Unsplash

I Walk With My ForeMothers When I Wear My Streedhan

Desi Roots, Global Wings – a monthly column focused on the Indian immigrant experience

On Mother’s Day, as on all others, I was thinking of my mother and grandmother. Even though they are no more, they are very much present in my everyday life. This is partly thanks to the gold jewelry—a chain, a pair of small earrings, and bangles—that they bequeathed to me. These items matter to me not because of their (modest) monetary value but because of what they signify.

In Marathi, streedhan means “woman’s wealth” (stree=woman, dhan=wealth). The term means “woman’s capital” and, traditionally, it was endowed upon the bride at the time of her wedding. It was comprised of gold and jewelry, household items, and cash. This was the contribution that her birth family made towards helping her get settled in life. Sometimes, the groom’s family also made a contribution towards the streedhan.

This was a way to provide capital that would serve as insurance or investment. If the marriage did not last—early death of the husband was common—the helpless widow would not be entirely at the mercy of fate or her in-laws. Uneducated and unable to earn a living, she could sell the jewelry to pay for her children’s educations, or to buy a small home of her own.

I wear my gold chain, hoops, and bangles all the time—despite the fact that the pieces don’t match my American outfits. Over the decades lived in this adopted land, I have changed about as much as I want to, especially regarding attire. On the few occasions that I bow to the dictates of fashion and take these items of jewelry off, I sense emptiness. My wrists feel manly, my neck seems bare, and my face—unframed by two little hoops—looks as if it is sickly or in mourning. And so, I avoid taking them off; on the few occasions I do, I put them back on at the earliest opportunity.

I walk in this world with my foremothers holding my hand in the form of the jewelry that they wore throughout their lives.

Indian bride

But the chain, hoops, and bangles are not my literal streedhan. My womanly capital is my education. It is what makes me a critical thinker and a lifelong learner. It gives me self-confidence as well as emotional independence. My mother (and father) and grandmother (and grandfather) invested as much thought and energy into making this streedhan available to me as previous generations of parents might have to gather the gold that they bestowed on their young, about-to-be-married daughters. Having witnessed or suffered the havoc that resulted when women were un-empowered, my elders were determined to change course.

Despite my being female, I was excused from doing chores like cooking and cleaning. My elders set expectations of high educational achievement and applauded me when I achieved my potential. So convinced were they about the rightness of this that they did not allow themselves to worry about the consequences such as the challenge of balancing work and family. That would be my battle to fight—using the capacities with which I was being equipped.

They conveyed the reason for the focus on education in clear-eyed and empowering terms. Yes, it was so that I would be spared the hardships and indignities that women of earlier generations had suffered. But, with discipline, determination, and their encouragement it was achievable. All that mattered was making me the most empowered person I could be.

So, the streedhan that I will hand down to my children will be the jewelry that symbolizes a way of being in this world—the courage and sacrifices of our ancestors over outdated and crippling customs; their commitment to nurturing the children and to seek to flourish through unsparing hard work.

Last year I moved 3,000 miles—from the east coast to the East Bay. The pull was my deep desire to be present to my infant grandson. The push was the pandemic which made travel impossible for the foreseeable future.

As he awakens into consciousness and learns about the world around him, sundry items catch his eye. He tugs at my gold bangles and when I hand them to him, he touches and, invariably, puts them in his mouth. Sometimes I twirl them on the floor and they spin like dervishes. He watches enthralled.

The bangles that were worn by my mother and by her mother before her have become the beloved toys of their great-grandson/great-great-grandson. The distance—across five (!) generations and multiple continents—is being bridged through an outdated but repurposed tradition.

Nandini Patwardhan is a retired software developer and cofounder of Story Artisan Press. Her writing has been published in, among others, the New York Times, Mutha Magazine, Talking Writing, and The Hindu. Her book, “Radical Spirits,” tells the deeply-researched story of Dr. Anandi-bai Joshee, India’s first woman doctor. 

Image Tehzeeb Kazami Pixabay

 

We Can’t Go Back Once Climate Change Hits A Tipping Point, Warns Climate Reality Activist Bill DeVincenzi

Our Climate is Changing. Why Aren’t We?

What happens when ice caps melt, forests die, the permafrost thaws and microbes multiply?

Climate Reality Activists Bill DeVincenzi and Erin Zimmerman join DesiCollective to clear up some misconceptions  about the pace of climate change. Scientists warn that we are in 6th extinction and that some of these changes are irreversible. Humans only have a ten year window to reverse the chain reaction of ‘feedback loops’ that are escalating the climate change crisis. The world is at a tipping point which can put us over the top to runaway climate change.

 

A Short Primer on Feedback Loops with Bill DeVincenzi & Erin Zimmerman

Climate Reality Leader Bill DeVincenzi

What’s A Feedback Loop?

A feedback loop is defined as a certain set of circumstances that can become self-perpetuating. They are present in everything from machines, and economics, to biological processes. They can be both positive and negative; however, in the case of climate change the consequences would be bad. Very bad.

Why Feedback Loops are Bad

Feedback loops are important to consider when trying to halt the climate crisis. And while entire books can, and have, been written about them, here’s a short primer on why climate action is essential now, and not at some point in the future.

When Earth Loses Its Best Reflector, that’s The Albedo Effect

You wouldn’t think the earth’s reflectively matters but it does. The Albedo effect, or loss of earth’s reflectivity is probably one of the most dangerous, and little known feedback loops. While much of the sunlight that hits the Earth is absorbed, some is reflected into space. You’ve probably experienced the Albedo effect if you have gone skiing or visited the high mountains in the winter. Snow and ice reflect around 85% of the sunlight that hits it and keeps the planet from getting too warm. But the volume of ice around the world has decreased by 75% in the last 40 years. According to scientists, we could lose Arctic sea ice completely by the end of this century. The ocean absorbs about 90% of the sunlight that hits it. So, we are replacing the best reflector, sea ice, with the worst absorber, open ocean. If you add in the loss of snow and ice on land as well, this adds up to approximately 40% loss of reflectivity. More heat absorbed means a warmer planet and results in even more ice melt and the cycle repeats itself.

Climate Reality Leader Erin Zimmerman

Permafrost Melt Releases Methane – It’s Wrapping Earth in a Warm, Toxic Blanket

Thousands of years ago, an icy cover in the North froze billions of tons of biological material to create Permafrost.  When permafrost melts, the biological materials thaw and then decompose, releasing the greenhouse gasses (GHGs) carbon dioxide (CO2) and Methane. GHG’s are like a blanket that covers the Earth, keeping it warm. As the blanket gets thicker (more GHG’s), the planet gets warmer. Today, permafrost keeps twice as much CO2 in the ground as there is CO2 in the atmosphere right now. If this CO2 is released, the consequences could be devastating. It’s vicious cycle. As global temperatures rise, the permafrost thaws, which increases greenhouse gasses and more warming. The cycle then repeats itself. The carbon dioxide is bad enough, but the Methane is 30 times more potent than CO2 in terms of trapping heat in the atmosphere.

The Jet Stream’s Deadly Loop De Loop

The Jet Stream ironically, is an actual loop of air current. It circles high above the earth around the Northern hemisphere between the colder north and the warmer south. The temperature differential between the two keeps the jet stream in place; however, the temperature in the North is increasing 2 to 3 times as fast as the temperature in the South. This is pushing the jet stream South; the further South it wanders, the more it picks heat from the South to carry North. This reinforces the cycle and causes wild and unpredictable changes in weather, from extreme cold spells in the South (ice storms inTexas!) to hotter days in the Arctic (or 100.4F in Siberia!). Dry areas become drier, and wet places get wetter.

Stand Up to The Folly of Fossil Fuels

As you have probably noticed, all the feedback loops start with fossil fuel emissions. If we reduce fossil fuel emissions, stop deforestation, and re-green the Earth, we can prevent or start to reverse these feedback loops.

Advocate for Climate Action or Elect Leaders Who Will

The single most important thing we can do is elect leaders who will move us in the right direction. We must vote in political leadership that will take on this problem and collaborate with other countries around the world. It is up to us to continue to put pressure on our local legislators to support the administration in the effort.

Regardless, the planet will continue to exist just fine, albeit a lot warmer, like in the time of the dinosaurs. We humans may not exist, nor would many of the species that now exist with us. So, we can sit back and let global warming wipe us out. Or we can act now to save ourselves and our fellow species. We have total control over this.

Let’s make it happen!

Meera Kymal & Anjana Nagarajan Butaney produce the climate change podcast ‘Our Climate is Changing, Why Aren’t We?’ at DesiCollective.

Photo by Hans-Jurgen Mager on Unsplash

In Santa Clara County, Nearly 67% Of Residents 16 + Have Had A Vaccine Shot

The Number of Californians With at Least One Covid Vaccine Dose Continues to Rise.

More than 75% of California’s seniors have had at least one dose, which makes epidemiologists hopeful that other age groups will follow suit

Demand for covid vaccines is slowing across most of California, but as traffic at vaccination sites eases, the vaccination rates across the state are showing wide disparities.

In Santa Clara County, home to Silicon Valley, nearly 67% of residents 16 and older have had at least one dose as of Wednesday, compared with about 43% in San Bernardino County, east of Los Angeles. Statewide, about 58% of eligible residents have received at least one dose.

The differences reflect regional trends in vaccine hesitancy and resistance that researchers have been tracking for months, said Dean Bonner, associate survey director at the Public Policy Institute of California, a nonpartisan think tank.

In a PPIC survey released Wednesday, only 5% of respondents in the San Francisco Bay Area and 6% of those in Los Angeles said they wouldn’t be getting vaccinated. But that share is 19% in the Inland Empire and 20% in the Central Valley.

“More urban areas might be hitting a wall, but their number of shots given is higher,” said Bonner. “The rural areas might be hitting a wall maybe even before, but their shots given isn’t quite as high.”

Infectious disease experts estimate that anywhere from 50% to 85% of the populationwould need to get vaccinated to put a damper on the spread of the virus. But overall state numbers may mask pockets of unvaccinated Californians, concentrated inland, that will prevent these regions from achieving “herd immunity,” the point at which the unvaccinated are protected by the vaccinated. Epidemiologists worry that the virus may continue to circulate in these communities, threatening everyone.

The regional differences could be attributed, at least in part, to political opposition to the vaccine, said Bonner, as about 22% of Republicans and 17% of independents in the survey said they wouldn’t be getting the vaccine, compared with 3% of Democrats.

But officials and epidemiologists see some encouraging signs that the state has yet to hit a wall of vaccine refusal. “As a strongly blue state, one would expect that California is less likely than red states to hit a relatively low ceiling of vaccination, assuming that the access is good and the messaging is strong,” said Dr. Robert Wachter, chair of the department of medicine at the University of California-San Francisco School of Medicine.

As of Wednesday, 77% of seniors in California, and 68% of those ages 50 to 64, had received at least one dose of covid vaccine, according to a KHN analysis. These large percentages reflect the early vaccine eligibility of these age groups and are a hopeful sign considering how difficult it was to get a shot in the beginning of the year, said Rebecca Fielding-Miller, an assistant professor at the University of California-San Diego specializing in infectious diseases and public health.

“I’m very hopeful that addressing access would pick up at least another 10-15% before we need to really start addressing myths and hesitancy issues,” she said.

The state could see a new jump in vaccinations as workplaces, schools and event organizers begin to require the shots, Wachter said. For example, the University of California and California State University systems announced April 22 that their 1 million-plus students and staff members will be required to get vaccinated against covid once the shots are formally licensed by the Food and Drug Administration, likely to occur this summer.

Still, the red-blue political distinction on vaccination is meaningful within California as well as nationally. Despite depressed vaccine demand across the board, counties that lean conservative have lower rates of vaccinations.

In true-blue Los Angeles, 4.5 million first covid vaccine doses have been administered, meaning that about 55% of eligible Angelenos have gotten at least one shot.

But first-dose appointments at county-run sites were down at least 50% last week, said public health director Barbara Ferrer on Thursday. The county has opened several sites where people can walk in and get vaccinated without an appointment, but these walk-ins don’t make up for all of the unfilled spots.

Last week probably marked the first time the county did not administer 95% of the doses distributed to it, she said.

In San Diego and Orange counties, meanwhile, vaccination appointments are going unfilled or taking days to get booked up.

About 20% of appointments in Orange County started going unclaimed on April 25 and the slack has persisted, said Dr. Regina Chinsio-Kwong, deputy health officer.

However, based on survey data from last winter indicating that about 58% of Orange County residents plan to get vaccinated against the coronavirus, the county is still expecting more residents to seek out appointments. As of Sunday, about 49% of residents had received at least one dose.

In San Diego, officials expect all appointments to be filled despite the slowdown, said county spokesperson Michael Workman. About 54% of eligible residents had received at least one dose as of Wednesday.

In San Bernardino, the slowdown started in late March, said county spokesperson David Wert. Only 42% of county residents had gotten at least one dose as of Monday.

Across the state, officials are unclear on the extent to which hesitancy or lack of access to a vaccine are responsible for the slowdown.

Campaigns to educate, convince and reach out to people have started to pick up throughout the country, including targeted messaging for conservatives. Ten GOP doctors in Congress recently issued an ad urging their constituents to get vaccinated.

Santa Clara is shifting most county-run sites to enable walk-ins and expanding evening and weekend hours to make it easier for working people to get a shot. San Diego and San Bernardino are also allowing walk-ins.

Other counties are returning unused doses to the state to be redistributed, a bounty from which Los Angeles County has benefited, according to Barbara Ferrer, director of the county public health department. Representatives from Blue Shield and the California Department of Public Health would not say which counties are sending doses back.

California’s good pandemic news, which has enabled counties to reopen many businesses, is one of the challenges to getting less-than-enthusiastic people in for their shots right now, said Wachter of UCSF.

As of Thursday, California has one of the lowest case rates in the U.S. at 31.3 cases per 100,000 and a covid-test positivity rate of 1.3%.

“My hope is that a strong communication campaign, perhaps coupled with some degree of vaccine requirements, will get some people to jump off the fence,” Wachter said.

This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

Image: County of Santa Clara Public Health Department

To book your appointment go to https://covid19.sccgov.org/covid-19-vaccine-information