tonight on kqed newsroom. what happens when all of california's intensive care hospital beds i have failed? when will the state begin receing vaccines? we asked to healthcare workers is burning questions mr. struggling parents struggling to find child re. waste oak with how the coronavirus has exposed the system they say is unsustainable. >>natural splendor in california history combine for this week's look at something beautiful. >> welcome to kqed newsroom. i am priya david clemens.

we are in for a very dark winter. today weappear to on that doorstep pick america's case numbers are among the worst reported in the world. over the past wee or that 200,000 new cases were reported every single day in the u.s. intensive care units around the coming overwhelmed with patients suffering from covid- 19. despite months ofsocial distancing, wearing, and now fresh like restricions affecting nearly all of california's 40 million residents. while the hope of a vaccine is closer to reality every day. how quickly can we m vaccine? how will hospitals cope until it is widely adopted? >> joining us from san francisco chair the department of medicine at uc san francisco. also joining us's president and ceo of thcalifornia hospital association. they both joined by skype. carmella come i am going to start with you.

association represents more than 400 california hospital. has a various the demand on california hospitals right now? >> the numbers we are seeing right now are more than alarming. we have more than 30,000 californians who are becoming covid positive each and y ev day. that is three times more than anything we saw at the peak of our last surge in the summer. 12% of those individuals are in need of hospital care and that means our hospitals are stretched to their limits right now. statewide about 85% of our icu beds are filled. california is a big state what that means is in some places, san diego, imperial county, the los angeles area, san joaquin county we have hospitals whose icu capacity right now is filled to its limit. >> bob, we spoke with you just before thanksgiving and you warned us of a post- thanksgiving this year. are we seeing the full effect of that surge in hospitals and

is it as bad as you do? >> the time is such that the effects of thanksgiving are no being seen in terms of hospital admission. it is interesting because that shape of the curve, the chat di ctory is not upthat much more after thanksgiving than it was before. i think rgthe is mostly reflected in the fact we are not seeing a decrease in cases. the power surges we saw in california and that they had seen elsewhere usually last about six weeks and then heople hearmessages from our health officials and from our political leaders and they's what is going on around them and then they change their behavior. and then we start seeing things are not seeing any signs of admissions or new cases coming down. holidays because it may mean that the search goes on until mid-january. >> carmel, many hospitals elhav

not ca elective procedures yet. it would seem to indicate the pandemic is not so dire that we are running out of beds for patient is that a fair assessment of the situation? >> that would be a misunderstanding of the situation. it is going to be realrt imt for us to provide care and to everyone else who has essential needs. heart attack patients, ruck agent, cancer patient. so what ery hospital isdoing literally on at daily basis is monitoring what their cast be is inthe icu and then shifting, balancing that with thpatient needs at the have we want to make certain we can care for californians equitably. i think the other piece to that qution is what we are really sure on are those all important critical-care nurses. those nurses who work in the icus. there is some availability for us to move nurses from other it

places. oes not mean we need to stop caring for patients who need a different level of care. we are gointo have try to do it all. >> carmella, what happens when the beds to fill up? >> it is real important we think about if that is more than just bad. this is not just an issue of mattresses and pillows. our limiting factor is step. medical or surgical ward and convert it to an icu bed with spe technology and ific equipment. at the end of the day what we need is the correctly appropriatelnutrainee, doctor, therapist, atever that need at the of the bed side. that is our limiting factor for. that is what is so different in this search than what inwe saw the summer. there simply is no calvary coming of additional nurses to california. >> the calvary we are loining for is the vaccine that it sounds like. california should be getting

the first doses of the vaccine and th next week. you may be among the first to be inoculated. can you tell us about the plan for distribution and if you agree with the. >> first ofall, i cannot overstate how wonderful and exciting this is. it was just a month ago that we learned the pfizer vaccine was people do not get this but two days before that it was not a lamb duck. not sure we would find a vaccine that work. it is really thrilling that the vaccines have worked and been demonstrated to be safe and effective this qutikly. the distri plan says that it will go to frontline health care workers rst which iswhy i will be not at the very front of the line but will get it th probably withinnext week or two. and people nursing homes. that seems appropriate to me. the groups after that are going i have to out of the house ks firefighters, pomen and hers,

women, people who work in grocery stores. once it goes beyond that the you start getting it to people over 65 and people with other conditions that put them at higher risk. when you add up all those groups across the geited states yoto 144 million people. almost 1/3 of the population of the couny we need to cover available to everyogenerally that is probably going to take about three months before we have enough vaccine to get through those -phiority groups. carmella, as the california hospital association happy with the distributi w plan? have been part of the planning terms of the distribution of this vaccine. it is not without its pecially with this pfizer vaccine which has some special conditions in terms of storage and handling. it requires those ultra storage capabilities which means, initially, incalifornia there will be 30 places where the vaccine will be distributed. 18 of those are hot deals.

>> as new vaccine come along and those that may have less special conditions we hope to di able to ribute it even more quickly. >> why do children come into play here? are they going to be vaccinated at some point. dr. i will ask you the this first. >> the hope was thvaccine was not tested and anyone under about 16. so, it would be premature to make the vaccine available to kids until we tested and the e tests ginning and i suspect that they will be proven to be safe and effective. the kids probably will not come online until probably the spring. it turns out that we thow that kids have a lower rate of getting very sick and actuallyds the younger have a low rate of spreading the

infection. even if we had the vaccine available for kids right now they probabuld not be in the first group. if you want to keep the schools open the most important things are getting the rate of virus in the community down as lopoas ible and protecting the adults in the school we may find ourselves in the spring where ifall the adults in the schools are vaccinated on the rate of virus in the community goes way, dowa that the schools are plenty safe even though the kids have not yet been vaccinated. >> bob what are your concerns abouaccess to this ccine in terms of equity? how are money and power going to influence the situation? i understand there have alorady been dand supporters who have called asking to get access to this vaccine. >> yes, we are getting a lot of at will last for a month or two while there is a severe shortage and then i think it is is an ethical test for our entire system. we have the highest risk from getting covid. is going to be very important that we stick with that.

i am not too worried about th first grouabout have your workers and about people in nursing homes per go pretty clear who is in those grass. it ts a littdicier once you start getting down to the third group which will be people at higher r k. either over 65 or people who are essential workers or people who have pre-existing condition. most of those folks will probably be gettccg there es for their local from their local walgreens or cvs. whether the clerk at walgreens the people at cvs is going to luckier i.d. to see if you are in fact a teacher or if you have a pre- existing condition. there was a report today in the es that said it may just be the honor system. if there is enough vaccine around that is fine. ere is not there is probably going to be some shenanigans that we will have watch very carefully. carmella would you like to add to that question might >> there eis s concern pa

hospitalas far as disturbing the vaccine. how do you know the person in front of you is the person who is supposed to be in that line, in that place in the queue. i think we as a state will watch that very carefully. i think the governor has said we want to make certain those early doses goat to the right people. those at greatest risk. will have to wo together and make certain we have the best information as ad are nistering those doses. >> bob wendy project we are going to get back to a state of normalcy, herd immunity as we often taout it question mark >> it is a little hard to tell because we do not know if there will be additionccines for the pipeline. the best guess is there will be enough vaccine to vaccinate 70% of the population so time around thsummer. that is the magic number.

if we can get to 70% of lathe poon being vaccinated because of the characteristics of the virus it will not be able to find enough vulnerable orses and mouse in r to infect more people and it begins to die out in a community. the two things that will determine the 70% are th vaccine suppand whether people are willing to take it. now we are talking about how we triage in the face by scarcity. late spring we will be talking about how do we get people to iftake it they are still hesitant. i am hoping they will pick i hoping by then they will see thatishe vaccine, it clear the vaccine is remarkably effective. the evidence is it is quite safe although some people may wa to wait little bit. the spring had tens of millions of people vaccinated and i am hoping it will not be thhard to reach the 70% threshold. after that we should be able to get back to something resermling normal. >> la are you feeling comfortable in taking the vaccine? >> yes. i am at this point. i r will not be down that list i am certain. if there is a critically

important addition to what the door just said, that is how do we make certain that with this initial delivery of some californians let down our guard unmasking of social distancing. some of that vaccine starting to flow, it is not until we get to the point in the summer or fa maybe the of next year we have got to maintain masking, social is nothing. if we continue to search as is vaccine is livered we will again continue to face over whelming numbers of elements. >> carmella, this ceo and president of california e chair of medicine at uc fs, thank you both for your ti and insight today. xt essential workers face many challenges during the pandemic. not the least of this week many parents welcomed the news that plgrounds can reopen throughout the state

providing a much-needed outlet for children and their caregivers to stay sane. many strugglers are struggling to find reliable help rechild nearly 2500 family childcare facilities have closed permanently in the state since the pandemic began. advocates are calling for more government support for childcare providers on the system as a whole. a new documentary film faces the painful childcare choices parents often face in order tok living. let us take a look. >> i been doing it for 22 years. i have seen all types of families of my day care. i have some that comment 6:00 thin the morning works until 8:30 at night. i have some that come 10:30 until 12:30. i have some tha comes in overnight. i see a lot of parents come in and break down. they do not want to do this but they need to work d take care

of their families. this is the way the world is set up at this t.po >> i am joined now by the filmmaker of this heartbreaking documentary. amy chief advancement officer of the institutof san francisco. you live in new york, this documentary was filmed in new york. but you live in puerto rico now. tell us about your own personal situation. >> yup, i am tha single of two children, a seven-year-old and a nine-year-old. nine months into this pandemic completely worn down with the impossibility we are king mothers and working mothers to do. i am from new york am i am from the proxy my commun a community that has been disproportionately impacted by this pandemic. my own mother had covid. just exhausted on every level and not being able to patch together support at home and

knowing that i had family and friends here in whpuerto rico were in a position to help me. i figured, you know, we are all fending for ourselves atntthis mo i had todo the same. otherwise we were going to fall apart as a family. >> this is a personal struggle. i feel ame struggle. you have children. i know that we feel that has. amy, can you tell us about how got here america. what was the history that brought us to whthis point e the system seems to be so broken and so hard for women to make it work? >> t system has veloped over time as a patchwork. we started off by assuming that caregiving was women's work. we have not moved beyond that as a society. in so many ways that plays out ndin the ic has laid there that women really bear the brunt of caregiving for their children. o it is visible to all of us now. we are on these virtual

meetings, we see children in the background. we can see it. how one third of our workforce has one young children, relies on childcare to get to work and to run our economy. essential workers e also struggling really with this. in order to access child care their regular childchae provider migh closed during the pandemic were temporarily closed or having to change other regulations that they are falling. the whole system is stressed. the whole childcare infrastructure is really in crisis. it was in crisis before he even got into the pandemic and rethe peoplely carrying the load are the working parents. to childcare providers, many of them working out of their homes, putting their own lives atsk, their own families lives at risk in order to hold up other family so that they can

keep earning a living. what did you learn about this crisis as you were going about the process of researching and filming this lldocumentary? >> so many things. first, we are having a conversation about childcare but really it is a structural, larger issue arou our economy period. you take the parents that use daycare but they are working sometimes multiple jobs because an employer refuses to give s them full-time hoso that they do not have to pay for an health insurancother benefits. even in professig s like nursd other professions that are well paid and, you know, respected, visible pression. there are needs that no one accounts for. if you are a nurse and you have multiple children and you have to work t e night shwho cares for your children? sometimes we have this

conversation in terms of daycare. here is happening around the it clock. lmost indicates how outdated the conversations that we have about the reality of our ecomy. who does the work that is truly essential and what do they actually need? we do not really have that conversation in the united ates. there is this happening in so t of different levels. ies at a >> can you put this in terms of the state anof californiahow significant this childcare crisis is? >> we already had a shortage of childcare coming into the pandemic. it is costly, costs asmuch as a uc education annually to have your child in childcare in california. thing, if you are inwo nontraditional hours you are really going to struggle to find care. mi30% of the es that we serve who are very low income so they qualify for a child

care subsidy, a public subsidy, 30% ofokthose are g for nontraditional hours. weather we overnight, or early morning shift or nighshift. this really needs to be a public good. we need to treat the care that we give our children when theyare zero 25 we need to treat that as a education. like we do our k-12 it sounds like we are talking aboutgovernment intervention. about government support for is that where you see the policy changes needing to happen? >> absolutely. a lot of the conversation about childcare and childcare policy ends up really being a conversation d.out early childh that starts at pre-k when they are four or five but what are you supposed to do with your chd dren between zero four or zero and five? again, this work is sure of work done by black women,

immigrant women, by lower income folks. it is taken for granted it is not respected and is not resourced appropriately. i think that is a huge paof it. i would also add that parents and caregivers, the providers are the expert around this issue and miwhat working es need because they have been providing the social safetythne thatgovernment refuses to provide. so as the experts they need to be at the table. they are the ones that are in the best position to create solutions that work for everyone. >> i think it is a matter of exo nding imaginations of leaders are and what leadership looks like. >> let us talk about the leadership here in california. very clearl the leader. governor newsom has spoken about the importance of investment in the first ldars

of cn's lives. the state is also going through a big budget crisis due to the pandemic. amy, how have childcare providers and hohas early childhood education fared in terms of the budget, in terms of funding at this time questionws >> so, governor came out right away with his first budget with a really strong investment in the first five years of life for children whether that is home visiting during the early days, prenatal support, preschool, unersal preschool and making sure all kids get to kindergarten. they have come forward with relief dollars during the pandemic. there is so tomuch furthego. we are far from the kind of universal support, universal care we need during those yes. every county in california has a waiting list of really low income families that dofo quali government subsidies. we are not even meeting the very low threshold that we have already set who could get ucee or r cost childcare. we have a long ways to go.

>> what actions are you hoping to spur through the release of this documentary? >> think on one level as i mentioned, the sort of imagination peace. one is making a visible this universe that has been invisibland sore of get us d beyond statistics data and actually sit and behold these people and really take in how amazing and not to overuse the word but how is such a what they do is. that is one itpiece of for me. i think part of wanting to make this work and the value of this work legible to more people is about us as a society understanding that care is something that we all need. in this covid-19moment i thin we do have an opportunity to sort move the needle on our understanding about this. we have deemed this women's

work in air quotes and we have devalued it. we need to put it back at the res something we all need and it is something we are all capable of giving and it is our collective responsibility. once people are in that place of care my hois that they begin to care about our caregivers and connect with ait cas and organizations and the folks doing this work in the community. >> amy, how do you measure the value ofthis care d investment in particular early childhood care? >> if we are going to look at it from an economic standpoint we have research that shows us now from omour noble ect the investment in early childhood years gives off manyfold for every dollar we commit to this wally care and

education for children when they are s der six yeold we see a $13 return over the course of their lifetime as a society in terms of other things we donot have to pay for. in addition, that number goes up if you are talking about certain sections of onthe popula you will see an $18 return in some population. it is an incredmole response and effective than any poverty remediation solution we when you think out brain development we know that if you can provide children with nurturing care when they are little in the 0 to 5 years, that brain development flreally rishes, they are r set up success in school. they are set up for success in life. we really need to be putting that investment into that so children can succeed over there life time. and so our society really sees thnefits. amy but the children's counsel of san francisco and the filmmaker of

through the night. thank you both for joining us. >> the nefilm premieres on december 24th. for more until information on the documentary and how to watch to through the night.com/events. >> now for this week's look at something beautiful. weight travel to the north end of the golden gate bridge and visit kabbalah point. name for the wild horses that once roamed the region.

i am priya david clemens. you can reach me on facebook, instagram and twitter. from all of us at the kqed newsroom thank you for joining us. have a goodnight.

robert: president trump's pressure campaign tests republicans and the nation. president trump: we won in the swing states. robert: days before the electoral college convenes, president trump keeps making baseless statements about his defeat and about the virus. president trump: you do have an immunity. i hear where close to 15%. president-elect president-elect -- vaccination, masking, opening schools, key goals for my first 100 days. robert: meanwhile as the pandemic worsens, president-elect biden continues to build his cabinet all as congress biggers over government funding and covid >> the american pe are hurting. they need the house. and the senate to stop chasing our tails and make