California Governor Gavin Newsom has ordered the entire state to shelter in place. “Newsom said, with the hospitalization rate predicted by some models, the state would need an additional 19,543 hospital beds over and above current capacity. That need could be reduced, he said, by changing behavior. “If we meet this moment, we can truly bend the curve to reduce the need to surge, to reduce the need to have to go out and cobble all those assets together,” the governor said. “Though I want you to know we are doing just that.” This shelter-in-place order mirrors what's happening in the Bay Area and elsewhere. Californians can go out for essential errands such as medical appointments, grocery shopping or to do critical jobs, but are otherwise advised to stay away from others. “You can still take your kids outside, practicing common sense and social distancing. You can still walk your dog,” Newsom said of the state order.”

Morning Consult reports on the status of community health centers that already operate on meager budgets: “With the number of U.S. cases of the coronavirus surging past 10,000, the federal government will distribute $100 million in funding for the embattled community health centers serving the most vulnerable patients in the country. But for clinics operating on razor-thin budgets, that may not be sufficient in preventing widespread layoffs, closures and bankruptcy… Community health centers, like providers across the nation, are buckling under tremendous demand for care with sparse resources. But unlike most facilities, the clinics rely heavily on revenue from patient visits to operate — most of which have been canceled, compliant with federal recommendations to suspend all non-emergent care. Consequently, for clinics with hardly a few months of cash on hand, coronavirus has sparked a fresh wave of fears about bankruptcy as leadership anticipates months of operating at a loss. “You’re going to see a lot of layoffs, a lot of site closings, a lot of reductions in hours,” said Jim Mangia, president of St. John’s Well Child & Family Center in Los Angeles, which serves roughly 6,000 patients a week in California. As of now, the organization has enough cash to operate for roughly 80 days, but Mangia said visits have dropped by about 20 percent over the last few weeks as patients cancel physicals and routine visits to lessen their risk of exposure to COVID-19.”

The Guardian reports on Native American health leaders outreach to the federal government, warning that COVID-19 could overwhelm underresourced tribal health services: “Tribes are reporting shortages of essential protective gear and testing services, as well as medical manpower and emergency planning expertise which were already severely lacking in many communities due to insufficient federal investment… Native communities are disproportionately affected by health conditions that the Centers for Disease Control and Prevention (CDC) has specifically identified increase the risk of serious complications from Covid-19… Covid-19 is exposing gaping political and healthcare chasms in countries across the globe. The deep-seated deficiencies in tribal health services in the US – and inequalities in Native health outcomes – were already stark. The US government is required to ensure adequate healthcare, education, housing, economic development and agricultural assistance for tribal nations, as part of its treaty obligations. But it has never adequately funded these treaty provisions, according to the National Congress of American Indians. In 2016, the government spent $8,602 per capita on healthcare for federal inmates compared with $2,843 per patient within the IHS. A quarter of medical positions within the IHS – including doctors, dentists and nurses – are vacant, according to an investigation by the New York Times. In some areas, the vacancy rate is as high as 50%... The elderly play a unique role in tribal communities, according to Vanesscia Cresci, research and public health director at CRIHB. “Our elders are the keepers of culture and tradition, and often the last speaker of native languages, to lose them could mean losing a language, we have to keep them safe.”

In PI's Policy Portal, find federal policy actions to address COVID-19.

Here are a few stories about social-support efforts: Coronavirus sparks an epidemic of people helping people in Seattle and a look at how groups are organizing for mutual aid, especially people with disabilities and compromised immune systems and families affected by school closures.  

john a. powell of the Othering and Belonging Institute writes: “The response to this crisis can easily slip into two opposing narratives. The first narrative is of a deep othering, and the second, of belonging. I am concerned about the language around the calls for social distancing and/or social isolation. There is certainly a public health need for physical distance. But this is not the same as social isolation. What is needed is social solidarity along with spatial separation. There have been more than a few stories stating that isolation comes with a different set of costs… The current situation also underlines the interconnectedness between all of us and our planet. It reveals, as we have been trying to show for many years, that when one person suffers, we all experience the effects of that suffering. We do belong to each other and to the earth. Now more than ever we see how it is in everyone's best interest, including those who are more privileged, to ensure the well-being of all. Our collective health is only as strong as the weakest and most vulnerable members of society.”

Some bright spots:

Yo-Yo Ma is sharing what he calls “songs of comfort” on his Twitter feed every day.

The Met Opera is streaming past performances. 

Across hard-hit Italy, residents have taken to their balconies to sing together. Here’s a short video from Siena.