Med School during the pandemic

Good Morning, I’m Annica Colbert….it’s Thursday October 28th.

Med-school….during a pandemic. More on that next. But first... let’s do the headlines….

New coronavirus cases in California have flattened after a two-month surge in cases. Right now California boasts the lowest infection rate in the nation. But, Governor Newsom is urging caution as state models predict a gradual increase in hospitalizations next month amid the holiday season. Currently, 88% of those 18 and older in California have received at least one dose of covid-19 vaccine. But that still leaves millions who are not vaccinated….

#########

San Diego County public health officials are increasing efforts to get county residents flu shots before the flu season gets further along. It takes about two weeks after vaccination to develop protection against the flu. The vaccine is covered by most health insurance, but if you don't have insurance, you can get it at one of the county's six public health centers.The number of flu cases in the county remains relatively low thus far, but health experts believe this season will be more severe than last year.

########

Another recall effort is underway… this time in poway, against Mayor Steve Vaus. The recall drive - called “save Poway” - started wednesday. Recall leader Christopher Olps says their reasons for recalling the mayor include development projects they claim are questionable.

“at the end of the day it’s about removing a mayor that is not listening when we say yes affordable housing and you get market rate housing and you get no community parks and no community park in this process it’s a big disconnect.”

Vaus declined an interview but issued a written statement calling the recall” phony” and urging people not to sign the petition.

#########

From KPBS, you’re listening to San Diego News Now. Stay with me for more of the local news you need.

The San Diego County Health Department reports more than 365-thousand people in our region have been infected with COVID-19 since the pandemic began. That’s created enormous challenges for doctors and other medical professionals.

But what about students who were just entering into medical school...like UC-San Diego...as the coronavirus ravaged communities and crippled hospitals?

KPBS Education Reporter M.G. Perez has their story.

“we can take you somewhere quiet.”

This is the sound of doctors practicing medicine. At least a dozen of them working with support staff and experienced colleagues.

“I’m a second year, you’ll probably be seeing 4th years who are a little bit more knowledgeable.”

Some of these doctors are second year students from the UC-San Diego Medical School. The classroom on this particular Wednesday evening is the free clinic housed in rooms and an auditorium at Pacific Beach United Methodist Church.

Justine Panian is the designated clinic general manager. She’s a second year medical student who survived her first year program gripped in the chaos of COVID-19.

CG: Justine Panian / UCSD Medical Student

“It was just really inspiring to see everybody really unite to address this pandemic. It showed me that you didn’t have to be directly in the front lines in order to fight the pandemic.” (:13)

“hand and wrist...negative.”

Dr. Natalie Rodriguez is the UCSD Associate Clinical Professor and mentor to these students. She was a young medical student herself when she started volunteering at the free clinic 20-years ago. 13-years ago, she became the attending physician who now beams with pride when talking about her students.

CG: Dr. Natalie Rodriguez/UCSD Associate Clinical Professor

SOT: MATT0016 :16-:28 “They bring their enthusiasm, their compassion, their passion, their innovation...especially this last year with COVID.” (:12)

CG: M.G. Perez/KPBS News

“This church building provides a lifeline of healthcare for those who need it the most. It is a free clinic, but the quality of care is professional and would not be possible without the backbone of medical students who show up every week to run it.”

“The only time Justin was ever in the hospital was for his birth.” (

Dr. Rodriguez and her students are back to in-person classes on the UCSD campus this fall after a year of distance learning...the critical first year of medical school.

“No business that I can see.”

Morgan is happy to finally be in-person and in community with her other classmates who also trudged through a year of ZOOM classes. Morgan preferred to give only her first name as she shared personal memories and her experience like the first day of medical school at home.

CG: Morgan/UCSD Medical Student

“Our education, some people would say, was disrupted.” “we value all of the clinical work that we have so much now...working at the free clinic, getting to see a patient, getting to do a physical.” “it does just make you appreciate the opportunities that you have when you understand that they could be taken away and they could have been very different.” (:17)

Despite the challenge, second year student Urvi Gupta never gave up hope. After spending the first critical year of medical school in distance learning, she also dealt with the devastation caused by COVID-19 in her family’s home country of India. If anything, she says the experience will make her a better doctor.

CG: Urvi Gupta/UCSD Medical Student

“no matter what the medium and the platform our first priority is just making the patients feel comfortable and making sure we are providing excellent care. This past year has shown us no matter what the situation we are put in, we can do that.”

“Looking for things that are more concerning…”

The COVID shutdown did not stop the Wednesday weekly free clinic in Pacific Beach. And these then-first year students also encountered a sudden lesson in social justice.

“We had just come off the Black Lives Matter protests. It really just exploded this entire introspection into racial injustice and health equity.” (:13)

In fact, the racial divide triggered in 2020 inspired the creation of a new enhanced health equity curriculum at the UCSD Medical School...engaging students in how to treat people of different beliefs and backgrounds. Dr. Rodriguez could not be more proud of their accomplishments.

“It just gives me such hope for the future of medicine knowing that they are going to go out there and make such a difference in the world and healthcare.” (:09)

That’s some good medicine we can all use.

######

Opioid overdoses have spiked throughout San Diego county. Narcan is a medication that can reverse that overdose if administered in time. A North County man has made it his mission to distribute Narcan to the homeless. KPBS Reporter Tania Thorne introduces us to “Narcan Nate.”

“Oh it’s Narcan Nate…”

Nathan Smiddy is better known as ‘Narcan Nate’ these days.

That’s because he trains people on administering Narcan and distributes the medication free of charge.

NATHAN SMIDDY

“I'm giving 2 or 3 kits out, sometimes 4 to a person and they're going through it faster than I can get to them.”

But he wasn't always an advocate for harm reduction.

“I overdosed for the first time when I was 19 infront of most of my family and they didn't really know what to do.”

Smiddy had a spiraling battle with drug use.

He’s originally from Tennessee, but a treatment center brought him to North County.

He is now 29 and will be three years sober on Thursday.

Now he is the North County liaison for the organization A New PATH, Parents for Addiction Treatment and Healing.

They supply him with the Narcan he distributes.

“It happens every day where people just walk away because they’re not educated on the laws or know how to respond or they don't have Narcan, its not available to them. So that’s why I do it”

“The Narcan that Nate distributes comes in these single dose nasal sprays. Although small they are powerful and could determine life or death on someone experiencing an opioid overdose. In the last 10 weeks, 46 lives have been saved from Nate’s distribution.”

“This person had the death rattle, a sound that you can never really forget. Fluid in the lungs, struggling to breathe, eyes peeled in the back of his head, blue.

This person has saved someone from overdosing with Narcan he got from Smiddy.

He didn’t want to share his identity.

I administered Narcan, waited a couple of minutes, nothing was happening, he wasn't breathing for like 4 mins, administered 2 more, 3 total. He came back.”

Smiddy gives training and Narcan to anyone that requests it.

But most of his Narcan supply goes to the homeless community at the shower events he attends.

Smiddy says homeless people are one of the groups with the least access to Narcan due to its cost.

“You could go to the pharmacy if you don't have insurance. It's a pretty hefty price to pay 100 and something dollars.

Smiddy does have critics who say his Narcan distributions enable drug use.

To them he says...

“I'm like helping giving them a second chance is what I'm doing. Like, you can't recover if you're dead.”

All of Smiddy’s work is voluntary and he doesn’t get paid for transportation.

So he has started a Go Fund me to help him expand.

“I would like to be mobile. I would like to have a van and have a mobile distribution, because right now I'm covering just a couple of mile radius in Ocean Side, and that's where those lives have been saved at.”

TT KPBS News.

##########

On Wednesday, Mayor Todd Gloria announced a commitment to net zero carbon emissions by 2035.

KPBS metro reporter Andrew Bowen explains what that really means…

AB: Net zero emissions means what it sounds like — when you do the math on the city’s emissions, it comes out to zero. So San Diego will probably still be burning fossil fuels through gas powered cars and buildings. But all those emissions would be offset by removing greenhouse gases from the atmosphere. Gloria says the goal can be achieved witho a more aggressive shift away from cars in favor of biking, walking and public transit, and with tougher renewable energy standards for newly constructed buildings.

TODD GLORIA / SAN DIEGO MAYOR

TG: Our region faces severe threats from extreme heat, wildfires, drought, flooding and sea level rise. San Diegans see it around them every single day. We experience it, we know it's happening and we have to take action to prevent it.

AB: The city's Climate Action Plan already requires a 50% reduction in greenhouse gas emissions by 2035. The more aggressive goal of net zero emissions would be legally enforceable, meaning if the city misses its targets, it could be sued. City Councilmember Sean Elo-Rivera says climate action is often framed as a burden, but that there's a lot more for people to gain.

SEAN ELO-RIVERA / SAN DIEGO CITY COUNCILMEMBER

SEL: With equitable climate action, we can improve communities so all residents can get to school and work and run errands without a car. We can provide for park space in every neighborhood. We can ensure clean air is not just for wealthy areas, but for all residents.

AB: The City Council will begin its review of the mayor's proposal next month.

##########

Mexican officials in Sonora are claiming success in a cloud seeding effort carried out in the state over the summer. from the fronteras desk in hermosillo, kjzz’s murphy woodhouse reports.

murphy: as in many parts of arizona, sonora enjoyed a wet monsoon season, a welcome change from last year’s disappointing summer that left many in the state’s critical agricultural sector desperate. federal and state officials are chalking some of that up to cloud seeding.

seventeen flights were made over an area of several million acres in sonora, over which 1,500 liters of silver iodide were dropped, according to a state release.

leading up to the monsoon season, nearly the entire state was experiencing extreme or exceptional dryness. now none of the state is, with about 20 percent at moderate or severe levels. reservoirs have also rebounded from historically low levels that came close to compromising hermosillo’s access to drinking water.

##########

As early as December, non-citizens in San Francisco will get a permanent voice in some city elections. From KALW in Oakland, Sunni Khalid has more.

The San Francisco Board of Supervisors voted unanimouslyTuesday to permanently extend non-citizen voting in school board elections. They’re reauthorizing a charter amendment originally approvedby voters in 2016.Supervisor Connie Chan authored the new legislation. It confirms thatnon-citizen residents will be able to vote in the upcoming recall elections ofthree members of the San Francisco Unified School District’s Board ofEducation in February.Tuesday’s vote comes amid a growing movement to expand non-citizenvoting rights across the country. Since San Francisco became the first cityto do so in 2016, 11 additional municipalities in Maryland and Vermont haveapproved legislation allowing non-citizen residents to vote in local or schoolboard elections. Similar proposals are being debated in Washington D.C.,Illinois, Massachusetts, and New York.Nearly one-third of the city’s 60,000 public school students have animmigrant parent, according to data from the San Francisco think tankSPUR, though many are already citizens.

##########

Coming up.... covid-19 vaccines for kids ages 5-11 could be approved by the FDA as early as next week. We have an interview with a local expert on the impact of that decision here in San Diego – that's next, just after the break.

A key FDA advisory panel has recommended a lower dose of the Pfizer vaccine for the nation’s 28 million children aged 5-11. A final decision from the agency is expected within days. Roughly 300- thousand unvaccinated children in that age group live here in San Diego. That makes the recent authorization a major step forward in efforts to contain the COVID-19 pandemic.

Dr. Eric Topol is director of the Scripps Research Translational Institute in La Jolla. He spoke with Midday Edition Host Jade Hindmon.

So can you break down this final authorization process for us? What needs to happen before parents can sign their kids up for their doses?
Speaker 2:
Well, it won't be long now anticipating the first week of November, when we have final go-ahead for these five to 11 year olds to get the 10 micrograms Pfizer dose. And then also in the queue is the Madonna vaccine. So that is a higher dose of the AMR and a half of the adult dose. And that is a bigger trial, almost twice the size. And so we're expecting that one to also get approved sometime in the month of November
Speaker 1:
Vaccinating, this younger age group, one of the final pieces in getting through this pandemic.
Speaker 2:
Well, it's certainly an essential part of building our Delta community wall and then potentially subsequent versions of the virus because we're well short of the population level immunity that we need to block this virus to get prevent the chain of spread that isn't just among children, but of course, uh, adults as well. So children are an important part there, a vector or a conduit in this process. And so even though most children, if they got COVID would get through it, okay, some will get quite ill. And also, I think what's important to not forget is that those should get a COVID infection can be effective with the so-called long COVID that is chronic symptoms, not as frequent as adults, but still it can occur. And then most importantly, this transmission chain that we can block. So if we can get a good portion of those 28 million children of this age group, uh, vaccinated, it's going to really help a lot to get the U S and the San Diego in great shape.
Speaker 1:
What key data findings were reviewed by the panel with regards to side effects and efficacy for children?
Speaker 2:
Well, the side effects were similar as two adults and teens. Uh, they're really the same sort of thing as a local reaction, arms, uh, discomfort, uh, and you know, fatigue and other symptoms that are kind of a mild flu case that can last a day or two. So the symptoms and the side effects are very similar.
Speaker 1:
Can parents expect eventual approval of the vaccine for children under five? And if so, what's the timeline on that? That's the
Speaker 2:
Last step? So this isn't the last one. There's one more group a, that one is not going to be probably until
Speaker 1:
Early next year because, uh, those trials, uh, even younger children are ongoing health officials are currently monitoring a sub variant of Delta known as Delta plus, should this be a cause of concern?
Speaker 2:
The nomenclature is a Y dot four dot two, not to get too fancy, but it's about 10% of the cases in the UK, but it has very little change in mutations from the original Delta stream. I just don't see it as a threat because Delta is so hyper contagious and there's minimal changes in this structure of this virus, a strain or, or a variant to make it any worse than Delta. We're going to have a, hopefully not see anything worse than Delta right now. It's taken over the whole world. As far as the dominant strain, it's going to be tough for another virus version to overtake it. I don't see this one as the one that could do that.
Speaker 1:
Well, overall cases are down since the September surge, we are seeing a slight uptick in deaths nationally. What does this say about how we're handling the fourth wave of this panic?
Speaker 2:
Well, we certainly haven't handled it as well as we could have. I mean, San Diego has done fairly well, but if you look around the country, there's still a lot of deaths over 1500 per day, as you noted. And it's partly because we didn't vaccinate the high-risk people nearly as well as other countries, many countries got people over age, 60, 65, 90 9% vaccinated. We're well short of that. And those are the people who are accounting for a large proportion of the deaths. So we have had to deal with anti-vaccine anti-science hesitancy misinformation, all these factors that have prevented the high-risk people from getting vaccinated. In addition, we have the problem of waning immunity. Those who are out more than six months, where if they are in a high-risk group, such as over age 50 or 60, they are the ones that are getting sick and some of them getting hospitalized. So we've got to get the boosters in those people as soon as possible. Once they've reached around that six month timeframe,
Speaker 1:
And as you mentioned, many Americans still remain unvaccinated ahead of the holidays. What guidance would you give to those who are vaccinated about being around unvaccinated people?
Speaker 2:
This is a concern because as everyone knows, you could have the virus and not ever be symptomatic or be happening before you develop this symptom and spread it. And even vaccinated people at a lower level can do this. So if you're going to be getting together with people over the holidays, this is a cause for concern. If you're in areas where there's very low circulating virus, we're fortunately, uh, in many parts of California, that's the case. It's not as much of a worry, but if you're in places like Montana and Idaho, Alaska, many places where the virus is still raging, it's all over the place. That would not be a good place to take any chances. Of course, if we have rapid tests and you could get each person that you're going to get together with with a rapid home test and know the answer in minutes, that would help add security and confidence. But a lot of those rapid tests are too darn expensive. They're not widely available. And this is another shortcoming of the U S strategy.
Speaker 1:
Hmm. And, and I want to circle back to, uh, parents with children under the age of five, since the vaccine for them could be much further down the line. What advice do you have for them in terms of limiting exposure to those children under the age of five?
Speaker 2:
Well, th th the children under the age of five, shouldn't be a concern. As long as the older children and the adults are vaccine. The best protection we can have for the youngest is for everyone else in a household, they get vaccinated. So if parents have not been vaccinated and they're worried about their young children, they better get it now. And also if they are, um, in a waning immunity category, that'd be another reason to stay maximally protected and, and get a booster shot. So there shouldn't be a concern for the youngest kids. As long as household members are all vaccines.

That’s it for the podcast today. Be sure to catch KPBS Midday Edition At Noon on KPBS radio, or check out the Midday podcast. You can also watch KPBS Evening Edition at 5 O’clock on KPBS Television, and as always you can find more San Diego news online at KPBS dot org. I’m Annica Colbert. Thanks for listening and have a great day.