tonight on kqed newsroom. what happens when all of california's intensive care hospital beds i have failed when will the state begin receiving esvacc we asked to healthcare workers is burning questions mr. >> struggling parents waste oak withhow the ld care. coronavirus has exposed the unsustainable. is natural splendor in california history combine for o this week's at something beautiful. >> welcome to kqed newsroom. i am priya david clemens.

we are in for a very dark winter. today we appear to be on that doorstep pick america's case reported in the world. over the past week or that 200,000 new cases wereerreporte evsingle day in the u.s. intensive care units around the state are on the verge of rw becoming olmed with patients suffering from covid- 19. despite months of social distancing, wearing, and now fresh like g restricions affectarly all of california's 40 million residents. ile the hopeof a vaccine is closer to reality w every day. hoickly can we make the vaccine? it is widely adopd? ope >> frjoining us san francisco chair the department of medicine at uc cisan fro. also joining us's president and cernof the cali hospital association. they both joined by skype. carmella come i am going to start with you.

the california hospital association represents more than 400 california hospital. has a variouonthe demand california hospitals right now? >> the numbers we are seeing right now are more than alarming. we have re than 30,000 californians who are becoming covid positive each and every da that is three times more than anything we saw at the peak of our last surge in the summer. 12% of those individu means our hospitals are l care 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 ght now is filled to its limit. >> bob, we spoke with you just g before thaing and you warned us of a post- thanksgiving this year. are we seeing the full effect of that surge in hosp als and

as bad as you do? >> the time is such that the effects of thanksgiving are now being seen in terms of hospital it is interesting becaat shape of the curve, the chat directory is not up that much more after thanksgiving than it was before. i think the surge is mostly reflected in the fact we are denot seeing a ease in cases. the power surges we saw in fo caia and that they had seen elsewhere usually last hear the messagfrom our eople health officials and from our political leaders and they's what is going on around them and then they change their d then we start seeing things come down. we are not seeing any signs of admissions or new cases coming down. it is scary for the christmas holidays mecause it may that the search goes on until mid-january. >> carmel, many hospitals have

not canceled elective procedures yet. it would seem to indicate the pandemic is noso dire that we are running out of beds for patient is that a fair assessment of the situat >> that would be a misunderstanding of the situation. it is going to be really to important for usprovide care and to everyone else who has essential needs. heart attack patients, struck agent, cancer patient. so what every hospital is doing literally on at daily basis monitoringwhattheir cast be is in the icand then shifting, balancing that with the patient needs at the have in their wacommunity. we to make certain we can care for californians equitably. i think the other piece to that question is whatrewe are ly sure on are those l important critical-care nurses. those nurses who work in the icus. there is some availability for us move nurses from other

plt es. it does mean we need to stop caring for patients who need a different level of care. we are going to y have to to do it all. >> carmella, what happens when the beds to fill up? >> it is really importk t we thout if that is more than just bad. this is not just an issue of mattresses and pillows. our limiting factor is step. so we can take a typical bed in a medical or surgical ward and convert it to an beic with the technolo and specific equipment. at the end of the day what we need is the correctly appropriately trained nurse, doctor, therapist, whatever atthat need is the of the bed side. that is our limiting factor for. that is what is so different in this search than what we saw in the summer. there simply is no calvary coming of additional nurses to california. >> the calvary we are looking e r is in vaccine that it sounds like. california should be getting

the first doses of the vaccine and then next ek. you may be among the first to be inoculated. can you tell us about foe plan distribution and if you agree with the. >> first of all, i cannot overstate how wonderful and exciting this . it wjust a month ago that we learned the pfizer vaccine was as effective as it leis. peo not get this but two days before that it was not a lamb duck. we not suwe would find a vaccine that work. it is really thrilling that the vaccines have worked and been demonstrated to be safe and effective this quickly. the distribution plan says that it will go to frontline health care workers first which is why i will be not at the very front of the line but will get it prob ly within the neweek or two. rsd people in g homes. that seems appropriate to me. the groups after that are going to be essential workers, folks i have to go out of the house to wor it might be teachers, firefighters, police men and women, people who work in

grocery stores. on it goes beyothat the you start getting it ov people 65 and people with other conditions that put them at higher risk. when you add up all those groups across the united states you get 144 million people. almost 1/3 of the population of the country we need to cover before you make it generally available to everyone. that is probably going to take about three months hafore we enough vaccine to get through those high-priority e oups. carmella, as californ hospital association happy with the distribution plan? >> we have been part of the planning in terms of the distribution of this vaccine. it is not withoutits logisticallychallenges. especiwith this pfizer vaccine which has some special conditions in terms of storage and handling. it requires those ultra storage capabilities which means, initially, in california there will be 30 places where the vaccinbuwill be distd. 18 of those are hot deals.

>> as new vaccine come along and those that ssmay have special conditions we hope to be able to distribute it even more quickly. >> why children come into play here? are they going to be vaccinated at some point. dr. i will ask you the this first. >> the hope wathe vaccinwas not tested and anyone under about 16. so, it would be premature to maai the vaccine ble to kids until tested and the tests are beginning and i suspect that they will be effective. e safe the kids probably will not come online until probably the spring. it turnout that we know that the kids ve a lower rate of getting very sick and actually the younger kids have a low rate of spreading the

infectiod even if we the vaccine available for kids right now they probably would not be in the first group. if you want thto keep schools open the most important things are getting the rate of virus in the community down as low as possible anotecting the adults in the school we may find ourselves in the spring where if all e adults in the schools are vaccinated on the rate of virus in the community goes way, way down that the schools are plenty safe even though the kids have not yet been vaccinated. >> bob what are your concerns about access to inthis vaccine terms of equity? how are money and power going to influence the situation? i understand there have alread been donors and pporters who have called asking to get access to this vaccine. >> yes, we are getting a lot of calls from everyone. that will last for a month or two while there reis a se shortage and then i think it will lighten up. this is an ethical test for our entire system. getting covid. hest risk from is going to be very important that we stick with that.

i am not too worried about the first groups about ve your workers and about people in nursing homes per go pretty clear who is in those grass. it gets a little dicier once you start getting down to the third group which wibe people at higher risk. either over 65 or people who are essentiaworkers or people who have pre-existing condition. most of those folks will probably be getting there th vaccines for r 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 acher or if yohave a pre- existing condition. there was a report today in the pressthat said it may just be the honor system. if there is enough vaccine around that is fine. is if there not there is probably going to be some shenanigans that we will have watch very carefuy. >> carmella would you like to add to that question might >>there is some concern on

hospitals par as far as disturbing the vaccine. how do you onknow the pein front of you is the person who is supposed to be in that line, in that place in the i think we as a state will watch that very carefully. i think the governor has said t we w make certain those early doses goat to the right people. those at greatest risk. will have to work togeth and martain we have the best information as we are administering those doses. >> bob wendy project we are going to get back to a state of normalcy, herd immunity as we often talk about question mark >> it is a little hard to tell because we do not know if there will bfoadditional vaccines the pipeline. the best guess is there will be enough vaccine to vaccinate 70% of the population sometime that is the magic number.

if we can get to 70% of the va population beininated because of the characteristics of the virus it will not be able to find enough vulnerable noses and mousin order infect more people and it begins to die out in a community. the two things that will determine the 70% are the vaccine supply and whether people are willing to take it. now weg are talkabout how we triage in the face of scarcity. by late spring we will be talking about how do we get people to take it if thare still hesitant. i am hoping they will pick i hoping by then they will see that the vaccine,eait is the vaccine is remarkably effective. the evidence is it is quite safe although some people may want to waitbi a little the spring had tens of millions of people vaccinated and i am hoping it will not be that hard to reach the 70% threshold. after that we should be able to get back to something resembling normal.u >> carmella are feeling comfortable in taking the vaccine? >> yes. i am at this ipoin will not be far down that list i am certain. if there is cra ically

important addition to what the doctor just said, that how do we make certain that with this initial delivery of some doses of vaccines we do not asr calins let down our guard unmasking of social distancing. while it is a relief to have some of that vaccine starting to flow, it is not geuntil we to the point in the summer or maybe the fall of next year we have got to maintain maskinno social iing. if we continue to search as is vaccine is delivered we will again continue to face over whelmingnumbers of elements >> carmella, this ceo and president of california location. the chair of medicine at uc fs, thank you both for your time and insight day. next essential workers face many challenges during the pandemic. not the least of which is childcare. this week many parents welcomed the news that playgrounds can en rehroughout the state

providing a much-needed outlet for children and their caregivers to st sane. many strugglers are struggling to find reliable help ild care. nearly 2500 family childcare fa lities have closed permanently the pandemic began. advocates are calling for vemor ment support for childcare providers on the system as a whole. a new documentary film faces the painful childcare choices parents often face in order to g make a li 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 in the morning that works until 8:30 at night. i have some that until 12:30. overnight. that comes in i see a lot of parents come in and break down. they do not want to do this but they need to work and taof care

their families. this is the way the world is set up at this point. >> i am joined now by the filmmaker of this heartbreaking documentary. amy chief advancement officer of the institute of san francisco. you live in new york, this documentary was filmed in new york. but you live in puerto rico now. tell us about yourown personal situation. >> yup, i am a single mother of two children, a seven-year-old and a nine-year-old. nine months into this pandemic completely worn down with the impossibily we are asking mothers and working mothers to do. i am from new york am i am from the proxy mycommunity is community that has be disproportionately impacted by this pandemic. my own mother had covid. just exhausted on every level and t being ableto patch together support at home and

knowing that i had family and were in a position to help me. i figured, you know, we are all fending for ourselves at this moment. i had to dothe same. otrwise we were going to fall apart as a family. >> this is a personal struggle. i feel the stggle. amy, you have children. i know that we feel that has.am can you tell us about how we got here in america. what was the history that the system seems to be so broken and so hard for women to make it work? >> the systemhas develope 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 in the pandemic has laid there that women really bear the brunt of caregiving for their children. vi is so ble 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 younchildren, relies on childcare to get to work and to run our economy. essential workers are also struggling really with this. in order to access child care their regular childcare prosider might have during the pandemic were temporarily closed or having to change other regulations that they are falling. the whole system is stssed. the whole childcare infrastructure is really in crisis. it was in crisis before he even got into the pandemic and the ng people really carrthe load are the working parents. to childcare providers, many of them working out of their homes, putting their own lives at risk, their own families lives at risk in ordeto hold up other family so that they can

keep earning a whliving. did you learn about this crisis as you were going about the process of researching and filming this documentary? >> well, somany things. first, we are having a conversation about childcare but really it is a structural, larger issue you take the parents th use daycare but they are working sometimes multiple jobs because an employer refuses to give them ll-time hours so that they do not have to pay for heal insurance and othe benefits. even in professions like nursing and other professions that are well paid yoand, know, respected, visible profession. there are needs that no one accounts for. if you are a nurse and you have multiple children and you have to work the nit shift who cares for your children? sometimes we have this

conversation in terms of daycare. here is happening around the ock. it almost indicates how outdated the conversations that we have about the reality of our economy. who does the work that is nttru esl and what do they actually need? we do not real have that conversation in the united states. there is this happening in so many different communities at a lot of different levels. >> u can yoput this in terms of the state of california and how significant this childcare cris is? >> we alreadshhad a tage of childcare coming into the pandemic. it is costly, it costas much as a uc education annually to have your child in childcare in california. thing, if you are raworking notional hours you are really going to struggle to find care. 30% of e families thatwe serve who are very low income so they qualify for a child

care subsidy, a public subsidy, 30% of those are looking for nontraditional hours. weather we eaovernight, or y morning shift or night shift. this really needs to be a public good. we need to treat the care that we give our childrenwhen they are zero 25 we need to treat that as a public good like we do our k-12 education.it sounds like we are talking about government intervention. about government support for childcare. 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 about early childhood. at starts at pre-k when they are four or five e but what you supposed to do with your children between zero and four or zero and five? work done by black women, f

immigrant women, by lower incomk it is taken for granted it is not respected and is not resourced appropriately. i think that is a huge part of it. i would also add that parents anovcaregivers, the ers are the expert around this issue and what working families need because they have been providing the social safety net that the government refuses to provide. so as the experts they need to be atthe table. they are the ones that are in the best position to create solutions that work for i everyone. >>think it is a matter of expanding imaginations of who leaders are and what leadership looks like. >> let ouus talk the leadership here in california. very clearly the leader. governor newsom has often spoken about the importance of vestment in the first years

of children's lives. a big budget crisis duto the gh pandemic. amy, how have childcare providers and how has early childhood education fared in terms of the rmbudget, in of funding at this time question >> so, governor newsom came out right away with his first budget withroa really investment in the first five years of life for children whether that is home visiting during the early days, prenatal support, preschool, universal eschool and making sure all kids get to kindergarten. they have come forward with relief dollars during the pandemic. there is so much further to go. we are far from the kind of sauniversal support, univ care we need during those years. every county california has a waiting list of really low income families that do qualnty for governsubsidies. we are not even meeting the very low threshold that we have already set who could get free or reduced cost childcare. we have a long ways to go. on

>> what acare you hoping to spur through the release of this documentary? >> i think on one level as i mentioned, the sort of imagination peace. one is making a visible this universe that has been invisible and re of get us beyond statistics and data and actually sit and behold these peop and really take inhow amazing and not to overuse the word but how is such a what they do is. that is one piece r of it me. i think part of wanting to make this work and the value of this work legibleto more people is about us as a society understanding that care is something that we all need. in this covid-19 moment i think we do have an opportunity to sort of 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 center. cares something we all need and it is something we are all capable of giving and it is oure collectiesponsibility. once people are in that place of care my hope is that they begin to care about our caregivers and connect with the campaigns and organizations and the folks doing this work in >>the community. amy, how do you measure the value of this care and investment in particular early >> if we are going to look at it from an economic standpoint we have research that shows us now from our thble economist investment in early childhood years gives off manyfold for every dollar we commit to this wally care and

education for children when they are under siyears old we see a $13 return over the course of their lifetime as a society in terms of other thingswe do not have to pay for. in addition, that number goes up if you are talking about certain sections of the wi population. yo see an $18 return in some population. it is an incredibleresponse and more effective than any poverty remediation solution we have. when you think about brain development we know that if you can prove children with nurturing care when they are little in the 0 to 5 years, that brain development ally ccess in school. are set for they are set up for success in life. we really need to be putting that investment into that time so children can succeed over and so our society really sees those benefits. amy but e children's counsel of san francisco and the filmmaker of

through the night. thank you both for joining us. >> the film prtoieres online ght and will stream until december4th. for more information on the documentary and how to watch go tothrough 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 sit kabbalah point. name for the wild horses that once roamed the region. i 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 good night.

robert: president trump's pressure campaign tests republicans and the nation. president trump: we won in the swing states. robert: days before the present trump keeps making basele statements about his defeat and about the virus.tr presidenp: 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 inet. ld his cab all as congress o biggersver government funding and covid relief. >> the american people are hurting. outhey need the. and the senate to stop chasing our tails and make