Supreme Court nominee Barrett readies for meetings this week on Capitol Hill

By Lawrence Hurley and Andrew Chung

WASHINGTON (Reuters) – President Donald Trump’s nominee to the Supreme Court, Amy Coney Barrett, will begin meeting with senators this week as Republicans push ahead with a rapid Senate confirmation process ahead of November’s presidential election over the objections of Democrats.

Barrett will meet Senate Judiciary Committee Chairman Lindsey Graham on Tuesday at 5:30 p.m. EDT (2130 GMT) at the U.S. Capitol, Graham’s office said. She will meet with several other committee Republicans earlier in the day.

Trump on Saturday announced Barrett, 48, as his selection to replace liberal Justice Ruth Bader Ginsburg, who died on Sept. 18 at age 87. Barrett, who would be the fifth woman to serve on the high court, said she would be a justice in the mold of the late staunch conservative Antonin Scalia.

Her confirmation by the Senate would result in a 6-3 conservative majority on the court.

Republicans hold a 53-47 advantage in the Senate and are aiming to hold a vote before the Nov. 3 election, in accordance with Trump’s wishes.

Trump, who is running for a second term against Democrat Joe Biden, has said he wants nine justices on the court so that it will have a full complement to tackle any election-related legal issues and possibly decide the outcome in his favor.

The only time in U.S. history the Supreme Court has had to resolve a presidential election was in 2000.

Barrett’s meetings with senators are taking place ahead of a multiday confirmation hearing scheduled to begin on Oct. 12, when she will face questions about her judicial philosophy and approach to the law.

Graham told Fox News on Sunday that the panel will likely vote on the nomination on Oct. 22, setting up a final vote on the Senate floor by the end of the month.

Democrats object to Republicans pushing through the nomination so close to the election, saying that the winner of the contest should get to pick the nominee.

Trump’s nomination of Barrett is the first time since 1956 that a U.S. president has moved to fill a Supreme Court vacancy so close to an election.

Democratic opposition to Barrett has so far been focused on her possible role as a deciding vote in a case before the Supreme Court in which Trump and fellow Republicans are asking the justices to strike down the Obamacare health law known formally as the Affordable Care Act. If confirmed quickly, Barrett could be on the bench when the justices hear oral arguments on Nov. 10.

A key provision of the law that would be thrown out if the court struck it down requires insurance companies to provide coverage to people with pre-existing conditions.

Some Democrats have said they will refuse to meet with Barrett but others, including some on the committee, have said they intend to engage in the process so they can ask Barrett directly about issues such as healthcare and abortion. Senator Chris Coons, a Democrat, will talk to her by phone or in a Zoom meeting, a spokesman said.

Conservative activists are hoping that a 6-3 conservative majority will move the court to the right by curbing abortion rights, expanding gun rights and upholding voting restrictions.

(Reporting by Lawrence Hurley; Editing by Tim Ahmann, Daniel Wallis and Jonathan Oatis)

House Democrats file bill to fund U.S. government but leave out new farm money

By Richard Cowan and Susan Cornwell

WASHINGTON (Reuters) – The

By Richard Cowan and Susan Cornwell

WASHINGTON (Reuters) – The U.S. Congress this week will consider legislation funding the federal government through mid-December, with lawmakers hoping to avoid the spectacle of a government shutdown amid a pandemic and just weeks before the Nov. 3 elections.

House Democrats announced Monday they had filed the legislation, which leaves out new money that President Donald Trump wanted for farmers. A Democratic aide said the bill could be on the House floor as soon as Tuesday. The Senate could then act later this week.

The new federal fiscal year starts on Oct. 1.

The bill is designed to give lawmakers more time to work out federal spending for the period through September 2021, including budgets for military operations, healthcare, national parks, space programs, and airport and border security.

The spending proposal “will avert a catastrophic shutdown in the middle of the ongoing pandemic, wildfires and hurricanes, and keep government open until December 11, when we plan to have bipartisan legislation to fund the government for this fiscal year,” House Speaker Nancy Pelosi said in a statement.

But the measure’s December end date will require Congress to return to the government funding question again during its post-election lame-duck session, either during or after what could be a bruising fight to confirm Trump’s third Supreme Court nominee after the death of Supreme Court Justice Ruth Bader Ginsburg.

And the legislation does not include $21.1 billion the White House sought to replenish the Commodity Credit Corporation, a program to stabilize farm incomes, because Democrats considered this a “blank check” for “political favors,” said a House Democratic aide who asked not to be named. Trump promised more farm aid during a rally in Wisconsin last week.

Republicans were not happy. “House Democrats’ rough draft of a government funding bill shamefully leaves out key relief and support that American farmers need. This is no time to add insult to injury and defund help for farmers and rural America,” Senate Majority Leader Mitch McConnell wrote on Twitter. Republicans could seek to amend the document to add in the provision.

The bill proposes spending $14 billion to shore up a trust fund that pays for airport improvements and air traffic control

operations. It also proposes extending surface transportation funding for another year, directing $13.6 billion to maintain current spending levels on highways and mass transit.

Pelosi said the bill would also save America’s older citizens from an increase in Medicare health insurance premiums of up to $50 per month.

Congressional Democrats have had a stormy relationship with the White House over federal funding since Trump took office early in 2017. He has sought deep cuts in domestic spending while ramping up military funds.

(Reporting by Richard Cowan and Susan Cornwell; additional reporting by David Shepardson and Doina Chiacu; Editing by Scott Malone and Steve Orlofsky)

this week will consider legislation funding the federal government through mid-December, with lawmakers hoping to avoid the spectacle of a government shutdown amid a pandemic and just weeks before the Nov. 3 elections.

House Democrats announced Monday they had filed the legislation, which leaves out new money that President Donald Trump wanted for farmers. A Democratic aide said the bill could be on the House floor as soon as Tuesday. The Senate could then act later this week.

The new federal fiscal year starts on Oct. 1.

The bill is designed to give lawmakers more time to work out federal spending for the period through September 2021, including budgets for military operations, healthcare, national parks, space programs, and airport and border security.

The spending proposal “will avert a catastrophic shutdown in the middle of the ongoing pandemic, wildfires and hurricanes, and keep government open until December 11, when we plan to have bipartisan legislation to fund the government for this fiscal year,” House Speaker Nancy Pelosi said in a statement.

But the measure’s December end date will require Congress to return to the government funding question again during its post-election lame-duck session, either during or after what could be a bruising fight to confirm Trump’s third Supreme Court nominee after the death of Supreme Court Justice Ruth Bader Ginsburg.

And the legislation does not include $21.1 billion the White House sought to replenish the Commodity Credit Corporation, a program to stabilize farm incomes, because Democrats considered this a “blank check” for “political favors,” said a House Democratic aide who asked not to be named. Trump promised more farm aid during a rally in Wisconsin last week.

Republicans were not happy. “House Democrats’ rough draft of a government funding bill shamefully leaves out key relief and support that American farmers need. This is no time to add insult to injury and defund help for farmers and rural America,” Senate Majority Leader Mitch McConnell wrote on Twitter. Republicans could seek to amend the document to add in the provision.

The bill proposes spending $14 billion to shore up a trust fund that pays for airport improvements and air traffic control

operations. It also proposes extending surface transportation funding for another year, directing $13.6 billion to maintain current spending levels on highways and mass transit.

Pelosi said the bill would also save America’s older citizens from an increase in Medicare health insurance premiums of up to $50 per month.

Congressional Democrats have had a stormy relationship with the White House over federal funding since Trump took office early in 2017. He has sought deep cuts in domestic spending while ramping up military funds.

(Reporting by Richard Cowan and Susan Cornwell; additional reporting by David Shepardson and Doina Chiacu; Editing by Scott Malone and Steve Orlofsky)

Senate to vote on COVID-19 aid as soon as this week: McConnell

WASHINGTON (Reuters) – The Republican-led U.S. Senate will introduce a new proposal on coronavirus relief legislation on Tuesday and could schedule a vote as soon as this week, Senate Majority Leader Mitch McConnell said.

He said the new proposal would target “some of the very most urgent healthcare, education, and economic issues.”

“It does not contain every idea our party likes. I am confident Democrats will feel the same. Yet Republicans believe the many serious differences between our two parties should not stand in the way of agreeing where we can agree and making law that helps our nation,” McConnell’s statement said.

Earlier, White House chief of staff Mark Meadows said he was hopeful there would be another round of federal COVID-19 stimulus funding before the Nov. 3 presidential election, but signaled no breakthrough in talks with congressional Democrats.

Interviewed on Fox Business Network, Meadows said he hoped legislation put forward by Senate Republicans would provide a basis for a future agreement with Democratic lawmakers and that negotiations were ongoing.

(Reporting by Susan Heavey and Doina Chiacu; Editing by Howard Goller)

COVID-19 often goes undiagnosed in hospital workers; virus may impair heart functions

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

COVID-19 often undiagnosed in front line hospital workers

A high proportion of COVID-19 infections among U.S. healthcare personnel appear to go undetected, according to a report on Monday in the Morbidity and Mortality Weekly Report of the U.S. Centers for Disease Control and Prevention. Between April and June, among more than 3,000 front line workers in 12 states, roughly 1 in 20 had antibody evidence of a previous COVID-19 infection, but 69% of those infections had never been diagnosed. Among those with antibodies to the novel coronavirus, about one-third did not recall having symptoms in the preceding months, nearly half did not suspect that they had been infected, and some two-thirds had never had a positive COVID-19 test. Infections among front line healthcare personnel may be going undetected, the study authors say, because some infections may be only minimally symptomatic or asymptomatic and also because personnel with symptoms may not always have access to testing. COVID-19 antibodies were less common among workers who reported using a face covering for all patient encounters and more common among those who reported a shortage of personal protective equipment. The researchers call for more frequent testing of healthcare personnel and universal use of face coverings in hospitals.

Virus may impair heart’s beating, contracting

Following recent reports that the new coronavirus can invade heart muscle cells comes the discovery that infected cells show impairments in function. In test tube experiments, researchers infected “myocytes,” or heart muscle cells, with the new coronavirus and found that before the infected cells die, they progressively lose their “electrophysiological and contractile properties.” This means they have trouble transmitting the electrical impulses that regulate heartbeats and shortening or lengthening their fibers so the heart can expand and contract to pump blood. In a paper posted online Sunday on bioRxiv ahead of peer review, the researchers note that their test tube experiments likely do not exactly replicate what happens with cells in the body, and more research is needed to confirm their findings. Still, they say, their results suggest that cardiac symptoms in COVID-19 patients are likely a direct effect of the virus and warn that “long-term cardiac complications might be possible … in patients who recover from this illness.”

Eye symptoms common in children with COVID-19

Children with COVID-19 often have non-serious eye symptoms like itching, discharge, or pink eye, a study from China suggests. Among 216 children hospitalized with COVID-19 in Wuhan, the epicenter of the outbreak there, 23% had these kinds of eye issues, doctors found. Eye problems were more common in children with other symptoms such as cough or fever. In all cases, the eye problems were mild and eventually went away either without treatment or with “minimal” eye drops, researchers reported in JAMA Ophthalmology. It is reassuring that most of the children had other symptoms first, said Dr. Douglas Fredrick, chief of pediatric ophthalmology at the Mount Sinai Health system in New York City, who was not involved in the study. If conjunctivitis, or pink eye, were always among the first symptoms, “we’d be more worried that children could spread this by pink eye from one child to another,” he told Reuters. Still, he said, the study doesn’t completely rule out that type of transmission.

Cell phone activity may predict COVID-19 spread

Cell phone use patterns suggest that when people stay home, coronavirus infection rates go down, researchers say. For a study published on Monday in JAMA Internal Medicine, they analyzed publicly available de-identified cell phone activity and location data collected between January and May from 2,740 counties across the United States. After mid-February, when the coronavirus outbreak began, cell phone activity declined significantly in workplaces, stores and restaurants, and mass transit stations and increased in homes – with the greatest initial changes seen in areas with higher rates of COVID-19. Two weeks after cell phone activity shifted away from workplaces and retail locations, the counties with the most pronounced changes had the lowest rates of new COVID-19 cases. “Perhaps reassuringly,” the researchers said, cell phone activity at grocery stores and in areas classified as parks was not strongly associated with rates of growth in COVID-19 cases. They speculate that publicly available cell phone location data might help health offices better predict COVID-19 growth rates and inform decision about where to implement shutdowns and re-openings.

(Reporting by Nancy Lapid and Linda Carroll; Editing by Bill Berkrot)

COVID-19 can wipe out health care progress in short order: WHO

By Emma Farge

GENEVA (Reuters) – More than 90% of countries have seen ordinary health services disrupted by the COVID-19 pandemic, with major gains in medical care attained over decades vulnerable to being wiped out in a short period, a World Health Organization survey showed.

The Geneva-based body has frequently warned about other life-saving programs being impacted by the pandemic and has sent countries mitigation advice, but the survey yielded the first WHO data so far on the scale of disruptions.

“The impact of the COVID-19 pandemic on essential health services is a source of great concern,” said a report on the study released on Monday. “Major health gains achieved over the past two decades can be wiped out in a short period of time…”

The survey includes responses from between May and July from more than 100 countries. Among the most affected services were routine immunizations (70%), family planning (68%) and cancer diagnosis and treatment (55%), while emergency services were disturbed in almost a quarter of responding countries.

The Eastern Mediterranean Region, which includes Afghanistan, Syria and Yemen, was most affected followed by the African and Southeast Asian regions, it showed. The Americas was not part of the survey.

Since COVID-19 cases were first identified in December last year, the virus is thought to have killed nearly 850,000 people, the latest Reuters tally showed.

Researchers think that non-COVID deaths have also increased in some places due partly to health service disruptions, although these may be harder to calculate.

The WHO survey said it was “reasonable to anticipate that even a modest disruption in essential health services could lead to an increase in morbidity and mortality from causes other than COVID-19 in the short to medium and long-term.” Further research was needed.

It also warned that the disruptions could be felt even after the pandemic ends. “The impact may be felt beyond the immediate pandemic as, in trying to catch up on services, countries may find that resources are overwhelmed.”

(Reporting by Emma Farge; Editing by Mark Heinrich)

New York City ahead of curve on COVID-19, but faces risks going into fall: experts

By Carl O’Donnell

NEW YORK (Reuters) – New York City, once an epicenter of the novel coronavirus outbreak, has managed to contain the virus as it reopens, but faces risks of an uptick in cases in the fall, public health experts told Reuters.

The city’s success comes from a mix of high rates of compliance with local and federal public health guidance and also substantial immunity among the general population, a result of the severity of the outbreak in March and April, according to public health experts based in New York City.

“There was an alignment in New York with the state government, the healthcare system and the media on what to do – namely, lock everything down,” said Mark Jarrett, chief quality officer at Northwell Health. “The lockdown didn’t please everyone but was really well accepted.”

That contrasts with other parts of the country, where political opposition to mask wearing and lockdowns is more widespread, Jarrett added.

The rate of contagion also declined more quickly because the initial outbreak left between 25% and 50% of New Yorkers with some level of immunity, said Maria Lima, associate dean for research at the City University of New York School of Medicine.

New York is at risk for an uptick in cases as schools reopen and cold weather pushes more people indoors, the experts said.

“The big challenge is schools reopening, recreating that density anew,” which had been reduced by social distancing, said Troy Tassier, a professor of economics at Fordham University who specializes in epidemiology.

After peaking in early April at a seven day average of more than 5,000 cases per day, New York City has reduced its daily case count to an average of less than 200, according to city data.

The percentage of people tested who turned out to have the virus declined from around 70% in late March to less than 1%, and confirmed deaths have declined from over 500 per day in April to the low single digits.

The United States as a whole continues to struggle to contain the virus, clocking upwards of 45,000 cases per day. Total cases have surpassed 5.5 million and more than 170,000 people have died.

(Reporting by Carl O’Donnell in New York; Editing by Daniel Wallis)

U.S. unfreezing Venezualan assets to help opposition fight COVID-19: Guaido

CARACAS (Reuters) – Venezuela’s opposition said on Thursday the United States has granted it access to millions of dollars of frozen Venezuelan government funds to support efforts to combat the spread of COVID-19 in the country.

The U.S. Treasury Department had approved the release of the funds, the opposition said in a statement without specifying the total amount.

The statement said part of the released funds would go to pay some 62,000 health workers $300. During a live appearance on Twitter on Thursday night, opposition leader Juan Guaido said health workers could register accounts to receive payments of $100 a month starting Monday.

Healthcare workers in Venezuela can earn as little as $5 a month.

Guaido first announced the additional support for healthcare workers four months ago, but distribution required a permit from the Office of Foreign Assets Control (OFAC), as the frozen funds were held by the New York Federal Reserve.

The opposition plans to distribute the funds using AirTM, a digital payment platform, but on Thursday, the website was blocked in Venezuela.

“You have to be very bad to block an account for men and women who are giving everything with conviction to protect our people when they are going to receive a bonus,” said Guaido.

The opposition leader added healthcare workers would be sent a manual with the steps to download a virtual private network (VPN) so they could circumvent the restrictions. AirTM also tweeted instructions how to use a VPN.

Guaido has been recognized by more than 50 countries as Venezuela’s rightful president after assuming an interim presidency in 2019 on the grounds that Maduro’s 2018 re-election was fraudulent.

In July, the opposition obtained permission to distribute $17 million in funds frozen in the United States that would be channeled through international health organizations to purchase supplies for medical workers.

The license also approves another $4.5 million to support Venezuelans at risk of death, an opposition press release said.

Venezuela is suffering economic collapse and its crumbling health system has so far registered 37,567 cases of COVID-19 and 311 deaths, although experts say the number is likely to be higher due to widespread insufficient testing.

(Reporting by Sarah Kinosian; Editing by Simon Cameron-Moore)

Flu season prep, complicated by COVID-19, starts early this year

By Carl O’Donnell

(Reuters) – Healthcare providers, including CVS Health Corp., are kicking off flu vaccinations early, ordering extra shots and aiming to add tests that check for both the annual flu and COVID-19, pharmacy executives and experts told Reuters.

Flu vaccination for the fall has taken on increased urgency because of the potential for serious complications if patients contract both viruses at once.

Vaccine makers will provide nearly 200 million flu vaccines to the United States this year, potentially 20% more than is typical, said LJ Tan, chief strategy officer for the Immunization Action Coalition, a nonprofit that promotes vaccination.

CVS expects to more than double the number of flu shots it provides to around 18 million people and Walgreens Boots Alliance Inc. is stockpiling extra vaccines, the companies told Reuters.

Drugmaker AstraZeneca Plc. on Thursday announced its first shipment of its FluMist vaccine in the U.S. and said it has increased production of doses in the U.S. by over 25% more than previously planned.

Failure to inoculate for the flu could also strain the United States COVID-19 testing capacity, which is still below the 6-10 million daily tests needed, Reuters has reported.

“If we can eliminate the dynamic of people getting symptoms and their first reaction is ‘is this the seasonal flu or is this COVID,’ it can take demand off of COVID-19 testing,” CVS Chief Executive Larry Merlo told Reuters.

Merlo added that CVS is working to obtain tests that screen for both viruses simultaneously. U.S. regulators approved a joint COVID-19 and flu test in July.

The same people who are most vulnerable to risks from COVID-19, such as the elderly and those with respiratory conditions, are also at greatest risk for the flu, Tan added.

The U.S. healthcare system is already expected to be strained in the fall by a resurgence in COVID-19. The Institute for Health Metrics and Evaluation is anticipating an uptick in COVID-19 cases in the coming months, resulting in around 300,000 total deaths by December, up from the current figure of roughly 160,000, and a nearly 75% increase in hospitalizations.

There is evidence that social distancing measures for COVID-19 reduce the transmission rate of the flu as well, according to the U.S. Centers for Disease Control and Prevention, meaning that continued measures in the U.S. could potentially slow flu transmission this season.

However, efforts to inoculate patients for the flu could be complicated by the need to safeguard patients and healthcare workers from COVID-19.

“If a patient has a fever or other symptoms associated with illness, they will be referred to their healthcare provider and immunizations will be deferred,” a Walgreens spokeswoman told Reuters.

CVS plans to begin inoculating patients earlier than usual – possibly by the end of this month – to get a jump start on preparing for this year’s flu season, which usually starts around October.

However, studies show there is a risk that getting inoculated against the flu too early can leave a patient vulnerable to contracting the virus later on in winter, if the shot wears off.

Other physicians are also starting this month, though it will still take months to fully distribute all the needed inoculations, Tan said.

The flu vaccine “comes out over time so you want to make sure people continue to seek flu vaccines” through Thanksgiving and beyond, Tan said.

(Reporting by Carl O’Donnell; Editing by Peter Henderson, Aurora Ellis and Bernadette Baum)

Google’s $2.1 billion Fitbit deal hits roadblock as EU opens probe

By Foo Yun Chee

BRUSSELS (Reuters) – Alphabet unit Google’s bid to take on Apple and Samsung in the wearable technology market by buying Fitbit hit a hurdle on Tuesday as EU antitrust regulators launched an investigation into the $2.1 billion deal.

The move by the European Commission on Tuesday came despite Google’s pledge last month not to use the fitness tracker’s data for advertising purposes in a bid to address competition concerns.

The EU antitrust enforcer said the data pledge was insufficient to allay its worries.

“The proposed transaction would further entrench Google’s market position in the online advertising markets by increasing the already vast amount of data that Google could use for personalization of the ads it serves and displays,” the Commission said.

It singled out online search and display advertising services and ad tech services, where analytics and digital tools are used in digital advertising, as two areas that would be affected by the deal.

It said data collected via wrist-worn wearable devices appeared to be an important advantage in online advertising, and the deal would give Google an edge in personalizing search engine ads and making it difficult for rivals to compete.

Ultimately this would result in higher prices for advertisers and publishers.

The investigation will also focus on digital healthcare and whether Google would make it difficult for rival wearables to function with its Android smartphone operating system.

The Commission will decide by Dec. 9 whether to clear or block the deal.

Google said the combination of its and Fitbit’s hardware would increase competition in the sector where players include Apple, Samsung, Xiaomi, Huawei and others.

“This deal is about devices, not data. We’ve been clear from the beginning that we will not use Fitbit health and wellness data for Google ads,” Rick Osterloh, senior vice president for devices and services, said in a statement.

“As we do with all our products, we will give Fitbit users the choice to review, move or delete their data.”

The deal has drawn criticism from healthcare providers, wearables rivals and privacy advocates.

Fitbit has a 3% share of the global wearables market as of the first quarter of 2020, far behind Apple’s 29.3% share, and also trailing Xiaomi, Samsung and Huawei, data from market research firm International Data Corp showed.

(Reporting by Foo Yun Chee; Editing by Jan Harvey)

Military helps worn-out nurses, sicker patients in California COVID-19 effort

By Sharon Bernstein

SACRAMENTO, Calif. (Reuters) – All day long, as Air Force nurse Major Pinky Brewton cares for patients struggling to breathe in California’s COVID-19 ravaged San Joaquin Valley, fears for her family simmer underneath her cool exterior.

Once back in her Stockton hotel room, seeing her seven-year-old on Facetime, the relief is overwhelming.

“He’s breathing!” Brewton said. “That’s the first thing I see as a nurse. How well is my son breathing?”

Over the past two weeks, the U.S. Department of Defense has sent nearly 200 medics and logistics experts to the Valley. The military has also sent nearly 600 personnel to Texas, where a surge in COVID-19 cases is crushing hospitals along the Rio Grande Valley and elsewhere in the state.

The teams of nurses, doctors and technicians work extra shifts, treating sicker-than-usual hospital patients. Many are so weak from oxygen deprivation they can barely eat.

In the San Joaquin Valley agricultural region, intensive care units overflowed as cases surged earlier this summer. In some counties, as many as 28% of test results were positive.

At Dameron hospital in Stockton near the state capital of Sacramento, every nurse was soon deployed on a new COVID-19 floor, said Jennifer Markovich, the facility’s chief nursing officer.

“There wasn’t a slow ramp up. In the space of two weeks we just saw a significant increase in patients … and really started to see those staffing needs really escalate.”

CHAPLAINS, MENTAL HEALTH EXPERTS

When staffing agencies lacked healthcare workers, the hospital turned to the state, Markovich said. Under the Federal Emergency Management Agency, Brewton’s team of 20 military nurses and respiratory therapists came on board in mid-July.

About 160 Air Force medical staff have been sent to California so far, with about 100 in San Joaquin Valley, coordinated by 25 U.S. Army logistics experts trained in responding to nuclear, chemical and biological attacks.

Chaplains and mental health experts were added to relieve stress in a system stretched to its limits.

The teams, mostly stationed at Travis Air Force Base north of San Francisco, were easily absorbed into the rotations and work cultures of the Valley hospitals, said Lieutenant Colonel Ryan Gassman, who commands the California teams.

“It’s not like we have any Air Force tents that are set up outside,” Gassman said. “We are truly jumping into the staff in each of these hospitals to help support in any way, shape or form that we can.”

In addition to five hospitals in the San Joaquin Valley, military teams have also been deployed to the Los Angeles area and Rancho Mirage in Riverside County east of Los Angeles.

COVID-19 cases in California began climbing after Memorial Day, which health officials attributed in part to family gatherings without masks or physical distancing measures. Statewide, cases have topped 500,000, and over 9,000 Californians have died.

California, Texas, Florida and Arizona are among several hotspot U.S. states for a second wave of coronavirus cases.

FRAGILE HOSPITALS

In the San Joaquin Valley, a perfect storm of cultural, political and economic issues led to a crush of cases in a fragile rural and smaller-city hospital system.

The region is heavily Latino, a group making up 39% of California’s population but accounts for 56% of COVID-19 infections and 46% of deaths in the most populous U.S. state. Agricultural businesses that have not provided protective equipment to workers, or implemented social distancing or rules requiring masks has led to increased infections. Large family gatherings and multi-generational households have led to fast and deadly transmission, often to vulnerable older relatives.

The Valley, which includes the oil drilling and agricultural area around Bakersfield, and farmlands around Fresno, is generally more conservative than the rest of the state, and many local and congressional leaders have opposed rules requiring masks and social distancing.

The resulting toll is stark. As of Friday, only 20 intensive care unit beds were available for new patients in all of San Joaquin County, which has a population of nearly 800,000.

“The first thing I saw were really, really sick patients,” nurse Brewton said, describing her first day at Dameron. “The acuity of these patients are far more than what we see on a typical medical floor.”

(Reporting by Sharon Bernstein; editing by Bill Tarrant and Richard Chang)