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

we are in for a very dark winter. today we appear to be on that am doorstep picica's case numbers are among the worst reported in the world. over the past week or that 200,000 new cases were reported every single day u.in the intensive care units around the state are on the verge of patients suffering frcovid- 19. despite months of social 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 make the vaccine? how will hospitals cope until it is widely adopted? >> joining us from san francisco chair the department of medicine atuc san francisco. also joining us's president and ceo of the california hospital y association. both joined by skype. carmella come i am going to start with you. the california hospital association represents re

than 4lifornia hospital. has a various the demand on california hospitals right now? >> the numbers we are seeing right now thare more alarming. we have more than 30,000 californians who are becoming covid eapositive and every 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 car 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 it county we have hos whose icu capacity right now is filled to its limit. >> bob, wespoke with you just before thanksgiving and you warned us of a post- thanksgiving this year. of that surge in hospitals and is it as bad as you do?

>> the time is such that the effects of thanksgiving are now being seen terms ofhospital admission. it is interesting because that shape of the curve, the chat directory is not up that much ks more after thving than it was before. i think the surge is mostly reflected in thfact we are not seeing a decrease in cases. the power surges saw in california and that they had en elsewhere usually la about six weeks and then people hear the messages from ouci health ofs and from our political leaders and they's what is going on around them and then they chang their behavior. and then we start seeing things come down. we are not seeing any signs of admissions or new cases coming down. itr is scary the christmas holidays because it may mean that the search goes on until mid-january. >> carmel, many hospitals have

not canceled elective procedldes yet. it wseem 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 sig ation. it is goto be really important for us to provide care and to everyone else who has essential needs. heart attack patients, struck agent, caer patient. so what every hospital is doing literallon at daily basis is monitoring what their cast be is in the icu and then shifting, balancing that with the patient needs at the have in thr community. we want to make certain we can care for californians equitably. i think the other piece that question is what we are really sure on are those all imponuant critical-cares. those nurses who work in the icus. the is so availability fo us to move nurses from other places. it does not mean we need to

stop caring for patients who need a different . level of we are going to have to try to do it all. >> carmella, what happens when the beds to fill up? >> it is really import think about if that is more than just bad. this is not just an issue of owmattresses and pi our limiting factor is step. so we can take a typical bed in a medical or surgical wa and convert it to an icu bedwith the technology and specific equipment. at the end of the day what we need is the correctly appropriately trained nurse, doctor, therapist, whatever that need is at the of the bed side. that is our limiting factor for. that is what is so thfferent in search than what we saw in the summer. there simply is no calvary coming of additional nurses to caliarrnia. >> the cawe are looking for is in the vaccine that it sounds like. california should be getting the first doses of the vaccine

and then next week. you may be among the first to be inoculated. can you tell us abo for distribution and if you agree with the. >> first of all, i caot overstate howonderful and exciting this is. it was just a month ago that we learned the pfer vaccine was as effective as it is. people do not get this but two days before that it was not a lamb duck. we not sure we would find a vacce that work. it is really thrilling that the vaccines have worked and nsbeen deated to be safe and effective this quickly. the distribution plan says thatw go to frontline health care workers first which is why i wi be not the very front the line but will get it probably within the next week and people in nursing homes.ap that seemsopriate to me. the groups afr that are going to be essential workers, folks i have to go out of the house to work it might be teachers, firefighters, police men and women, ople who work

grocery stores. once it goes beyond that the you start getting it to people over 65 and people with other conditions that put them higher risk. groups across the united states you get to 144 million people. almost 1/3 of the populati of the country we need to cover ma before you it generally available to everyone. that is probably going to take about three months before we have enough vacce to get through those high-priority groups. carmella, as the california hospital association happy with the distribution plan? >> we have been rt of the planning in terms of tithe distri of this vaccine. it is not without its logistical challenges. especially with this pfizs vaccine which some special conditions in terms of storage and handling. it requires those ultra storage capabilities which mean initially, in california there will be 30 places where the vaccine will be distributed. 18 of those are hot deals.

>> as new vaccine coalong and those that may have less special conditions we hope to be able to distribute it even more quicy. >> why do tochildren come play here? are they going to be vaccinated at some point. dr. i will k you the this first. >> the hope was thvaccine was not tested and anyone under about 16. ul so, it be premature to make the vaccine availae to kids until we tested and the tests are beginning and i suspect that ey will proven to be safe and effective. the kids probably will not come online until probably the spring. it turns out that we kn the kids have a lower rate of getting very sick and actually the younger kids have a olow raspreading the infection. even if we had the vaccine

available for kids right now they probably would not be rsin the group. if you want to keep the schools open the most important things are getting the rate of virus mm in the ity down as low as possible and protecting the adults in the school we may find ourselves in the spng where if all the 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 yoconcerns about access to this vaccine in terms of equity? how are money and power going to influence the situation? i understand there have already been donors and supporters who l haved asking to get access to this vaccine. >> yes, we are getting a lot of calls from everyone. that will last foa month two while there is a severe shortage and then i think it will lighten up. this is an ethical test for our entire st. we have the highest risk from getting covi is going to be veryimportant that we stick with that. i am not too worried about the

first groups about have your ab workers and t people in nursing homes per go pretty clear who is in those grass. it gets a little dicier once you start getting wn to the third group which will be people at higher risk. either over 65 or people who are essential workers orpeople who have pre-existing condition. most of those folks will probably be getting there vaccines for their local lofrom theil walgreens or cvs. whether the clerk at walgreens the people at gocvs is g to luckier i.d. to see if you are in fact a teacher or if you have tia pre- ex condition. there was a report today in the press that said may just be the honor system. if there is enough vaccine around that is fine. if there is not there is probably going to be s shenanigans that we will have watch very carefully. >> 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 know the person in front of you is the person who is supposed to be in that line, in that place in thqueue. 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 work together and make certain weave the best information as we are administering those doses. pr>> bob wendy ect we are going to get back to a state of normalcy, herd immunity as we often talk about it question mark >> is a little hard to tell because we do not know if there will be additional vaccines for e the pipeline. st guess is there will be enough vaccine to vaccinate 70% of the population sometime around this summer. that isthe magic number.

if we can get to 70% of the population being vaccinated acbecause of the christics of the virus it will not be able to find enough vulnerable noses and mouse in order to inct more people and it e begins to out in a community. the two things that will determine the 70% are the vaccine supply and whether topeople are willing take it. now we are talking about 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 they are am hoping they will pick i hoping by then they will see that the vaccine, it is clear thrkvaccine is rely effective. the evidence is it is quite safe although some people may want to wait a little bit. tee spring ha of millions of people vaccinated and i am hoping it will not be that hard to reach the 70% threshold. get back tosomething be able to resembling normal. >> carmella are you feeling comfortable in taking the vaccine? i >> yes. am at this point. i will not be far down that list i am certain. if there is a critically

atimportant addition to the doctor just said, that is how ma do we certain that with this initial delivery of some doses of vaccines we do not as californians let down our guard unsking of social distancing. while itis a relief to have some of that vaccine starting to flow, it is not until we get to the point inthe summer or maybe the fall of next year we have got to maintain masking, social is nothing. if we continue search as is vaccine is delivered we will again continue to face over whelming numbers of elements. >> carmella, this ceo and location. of california the chair of medicine at uc fs, thank you both for your time and insight today. next essential workers fale many chales during the pandemice . not least of which is childcare. the news that playgrounds can d reopen throughout the state providing a much-needed outlet

for children and their caregivers to stay sane. many strugglers are struggling to find reliabhelp child care. nearly 2500 family childcare facilities have closed permanently in thstate since the pandemicga be 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 to make a living. let ustake a ok. >> i been doing it for 22 years. i have seen all tys of families of my day care. i have some that comment 6:00 in the morning that works until. 8:30 at ni i have some that come 10:30 until 12:30. i have some that comes in overnight. i see a lot of parents comein and break down. they do not want to do this but they need to work and take care

of their falies. set up at this point. rld is >> i am joinnow by the filmmaker of this heartbreaking documentary. the institute of san officer francisco. you live in new york, arthis docume was filmed in new york. but you live in puerto rico now. tell us about your own personal situation. >> yup, i am a single mother of two children, a seven-year-old and a nine-year-old. nine months into this pandemicly compleorn down with the impossibility we are asking mothers and working mothers to do. i am from new york amam i from the proxy my community is a community that has been disproportionately imcted by this pandemic. my own mother had coted. just exhaon every level and not being able to patch together support at home and

knowing that i d had family friends here in puerto rico who were in a position to help me. i figured, you know, we are all fending for ourselves a moment. i had to do the same. otherwise we were going to fall apart as a family >> this isa personalruggle. i feel the struggle. amy, you have children. i know that we feel that has. amy, can you tell us about how we got here in america. what was the history that brought us to this point where the system seems to be so broken and so hard for women to make work? >> the system has developed 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. it is so visible to all of us now. we are on these virtual

meetings, we see children in the background. we can see it. ir how one of our workforce has oneyoung children, reli on childcar 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 provider might have 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 real crisis. it was in crisis before he even got into the pandemic and the people really carrying the load are the working parents. to childcare providers, many of them working out of their homes, putting their o at risk, their own families lives at risk in order to hold up other thfamily so they can

keep earning a living. what did yolearn about this crisis as you were going about the process of researching and filming this documentary? >> well, so himanys. first, we are having a conversation about childcare but really it is a structural, larger issue around our economy period. you take the parents that use daycare but they are rking sometimes multiple jobs because an employer refuses to give them full-time hours so that they do not have to pay fo health insurance and other be fits. even in professions like nursing and sother professi that e well paid and, you know, respected, visible profession. there are needs that no one accounts for. if you are a nurse and you ipha mu children and you have to work the night shift who cares for your children? sometimes we have this conversation in terms of is

daycar herehappening around the clock. it almost indicates how outdated the conversations that we hait about the reof our economy. who does the work that is truly essential and what do they actually need? we do not really have that conversationin the united states. there is this happeni in so many different counities at a lot of different levels. >> can you put s this in teof the state of california and how significant this childcare crisis is? >> we already had a shortage ofn childcare coming the pandemic. it is costly, it costs as much as a uc education annually to california. ild in childcare in thinyou are working nontraditional hours you are reallyoing to struggle to find care. 30% of the families that we serve who are very low income so they qualify for ila

careicsubsidy, a pusubsidy, 30% of those are looking for nontraditional hours. weather we overnight, or early moing shift or night shift. this really needs to be a public good. we need to treat the care that we give our children when they are zero 25 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 really beina conversation about early childhood. that starts at pre-k when they are four or five but what are you pposed to dowith your children between zero and four or zero and five? again, this work is sure of work done by black women, immigrant women, be

folks. it is taken for granted it is resourced appropriatelot i think that is a huge part of it. i would also add that parents and caregivers, the providers are the expert arouthis issue and what working families iding the social safety net that the government refuses to provide. so as the experts they need to be at ththtable. are the ones that are in the best position to create solutions that work for everyone. >> i think is a matter of expanding imaginations of who leaders are and what leadership looks like. >> let us talk about the e leadership h california. very clearly the leader. governor newsom has often spoken about the importance of investment in the first years

of children's lives. the state is also going through a big budget crisis due to th. pandem amy, how have childcare providers and how has early childhood education fared in terms of the budget, in terms of nding at thistime question >> so, governor newsom came out right away with his first budget with a really strong invet ment in the fifive years of life for children whether that is home visiting during the early days, prenatalc support, preol, universal preschool 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 e far fromthe kind of universal support, universal care we need during those years. every county in california has a waiting list of really low inme families that do qualify for government subsidies. 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. >> what actions are you hoping

to spur through the release of this documentary? >> i think on one level asi mentioned, the sort of imagination peace. one is making a visible this iverse that has been invisible and sore of get us actually sit anbehold these nd 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 piece of it for me. i think part of wanting to make this work and the value of th work legible to 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 ha an opportunity to sort of move the edle on our understanding about this. we have deemed this women's

work in air quotes and we have devalued it. we needto put back at the center. cares something we all need and it is something we are al capable of ving and it is our collective responsibility. 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 dothis work in the community. >> amy, how do you measure the value of this care and investment in particular early childhood care? >> if we are gointo look it from an economic standpoint we have research that shows us now from our noble economist the investment in early childhood years gives off manyfold for every dollar we commit to this wally care and

education for children when see a $13 turn over the old we course of their lifetime as a society in terms of other things we do not have tor. pay in addition, that number goes up if you are talking about certain sections of the population. you will see $18 retuin some population. it is an incredible response and more effective than any poverty soremediatiotion we have. when you think about brain development we know that if you can provide children with nurturing re when they e little in the 0 to 5 years, that brain development really flourishes, they are set up for success in hool. they arset up for success in life. we really need to be putting that investment into that time so children n succeed over there life time. and so our society really sees those benefits. amy but the saildren's counsel of francisco and e filmmaker of

through the night. thank you both for joining us. >> the film premieres online tonight and will stream until december 24th. for more information on the documentary and how to watch go to through the night.com/events. >> now for this week' look at something beautiful. weight travel to the north end of the golden gate bridgeand visit kabbalah point. name for the thwild horses 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 good night.

captioning sponsored by wnet >> sreenivasan: on this edition for sunday, december 13, a watershed moment towards combating covid-19, as the firsn vashipments are rolled out; jeff greenfield on the electoral college te; and care-- after decades of providing aid overseas, it's now turning to need in its own backyard. next on "pbs newshour weekend." >> pbs newshoureekend is made possible by: sue and edgar wachenheim iii. the anderson family fund. bernard and denise scartz. the cheryl and philip milstein family. barbara hope zuckerberg. the jpb foundation. barba