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COVID-19 restrictions may have played a role in San Francisco firefighter’s death

SAN FRANCISCO, CA - OCT. 7: Family and friends of deceased SF firefighter and paramedic Jason Cortez head to SFFD vehicles for a procession to Medical Examiner's office from SF General Hospital in San Francisco, Calif., on Wednesday, October 7, 2020. Cortez died Wednesday morning during a training exercise. (Scott Strazzante/The San Francisco Chronicle via Getty Images)
Family and friends of deceased firefighter and paramedic Jason Cortez prepare for a procession from San Francisco General Hospital. (Scott Strazzante / San Francisco Chronicle)

The San Francisco Fire Department has revealed the circumstances leading to the death of a firefighter during a training exercise last week, noting that restrictions implemented to stem the spread of the coronavirus might have played a role.

Jason Cortez, 42, was knocked off a third-floor fire escape Wednesday by an inadvertent water blast, the report said. He was alone on the fire escape of a training facility at 19th and Folsom streets when he opened the gate of a hose adapter that did not have a hose lined attached, and the stream of water struck him in the chest and pushed him backward.

Although accidental in nature, Cortez’s death could be linked to COVID-19 restrictions, according to the report. His engine company, Station No. 3, was conducting a solo training exercise that typically requires multiple firefighters from two stations.

“Because of COVID 19 concerns, multi-company drills are suspended,” the report said. Engine 3 “was forced to conduct a pump operation drill alone. … Each [firefighter] was required to carry out tasks individually which are normally done as part of a team.”

San Francisco Fire Department firefighter paramedic Jason Cortez.
San Francisco Fire Department firefighter paramedic Jason Cortez. (San Francisco Fire Department )

The San Francisco Fire Department was one of the first in the nation to implement aggressive COVID-19 guidelines in accordance with recommendations from doctors, hazardous-industry specialists and epidemiologists, according to spokesman Lt. Jonathan Baxter. The social distancing measures are meant to ensure the safety of fire crews and the communities they serve.

“We don’t want to cross-pollinate those crews unless we absolutely have to,” Baxter said. “Cross-pollination does occur during actual emergencies, but those are uncontrolled. When we have controlled sessions, such as a training session, we try to limit the exposure as much as possible.”

Baxter said it was likely that those guidelines would be reevaluated in light of Cortez’s death, but he said training and community safety must remain top priorities.

“We can’t put training on hold during COVID-19 because emergencies aren’t going to go on hold,” he said. “We have to be prepared, especially when we have so many new and young firefighters that need to be trained and tested on skill sets. … But one fatality, one injury, is one too many.”

Cortez was a father of two and the son of a retired San Francisco firefighter. He was treated for critical injuries at the scene and transported to San Francisco General Hospital shortly after 10 a.m. Wednesday. He died from his injuries less than an hour later.

Station No. 3, in the Tenderloin neighborhood, is regularly ranked one of the busiest in the country, often with up to 40 calls during a 24-hour shift.

“If you looked at Jason at 3 in the afternoon or 3 in the morning, he had a positive attitude, smile on his face, excellent customer service,” Baxter said.

ACA’s Role as Safety Net Is Tested by COVID Recession



 

The Affordable Care Act, facing its first test during a deep recession, is providing a refuge for some — but by no means all — people who have lost health coverage as the economy has been battered by the coronavirus pandemic.

New studies, from both federal and private research groups, generally indicate that when the country marked precipitous job losses from March to May — with more than 25 million people forced out of work — the loss of health insurance was less dramatic.

That’s partly because large numbers of mostly low-income workers who lost employment during the crisis were in jobs that already did not provide health insurance. It helped that many employers chose to leave furloughed and temporarily laid-off workers on the company insurance plan.

And others who lost health benefits along with their job immediately sought alternatives, such as coverage through a spouse’s or parent’s job, Medicaid or plans offered on the state-based ACA marketplaces.

From June to September, however, things weren’t as rosy. Even as the unemployment rate declined from 14.7% in April to 8.4% in August, many temporary job losses became permanent, some people who found a new job didn’t get one that came with health insurance, and others just couldn’t afford coverage.

The upshot, studies indicate, is that even with the new options and expanded safety net created by the ACA, by the end of summer a record number of people were poised to become newly uninsured.

What’s more, those losses could deepen in the months ahead, and into 2021, if the economy doesn’t improve and Congress offers no further assistance, health policy experts and insurers say.

“It’s a very fluid situation,” said Sara Collins, vice president for health care coverage and access at the Commonwealth Fund, a New York-based health research group. “The ACA provides an important cushion, but we don’t know how much of one yet, since this is first real test of the law as a safety net in a serious recession.”

Collins also noted that accurately tracking health insurance coverage and shifts is difficult in the best of times; amid an economic meltdown, it becomes even more precarious.

Coverage Was Already on the Decline

Some 20 million people gained coverage between 2010 and 2016 under the ACA’s expansion of Medicaid and its insurance marketplaces for people without employer-based coverage. A gradually booming economy after the 2008-2009 recession also helped. The percentage of the population without health insurance declined from about 15% in 2010 to 8.8% in 2016.

But then, even as the economy continued to grow after 2016, coverage began to decline when the Trump administration and some Republican-led states took steps that undermined the law’s main aim: to expand coverage.

In 2018, 1.9 million people joined the ranks of the uninsured, and the Census Bureau reported earlier this month that an additional 1 million Americans lost coverage in 2019.

The accelerating decline is helping fuel anxiety over the fate of the ACA in the wake of the death of

WTO Should Play Role in COVID-19 Medicine Access: Candidate | World News

GENEVA (Reuters) – A key contender to head the World Trade Organization told Reuters on Tuesday she thinks the body should play a role in helping poorer countries access COVID-19 drugs and vaccines, and this topic should be part of negotiations if she wins.

Nigeria’s Ngozi Okonjo-Iweala, seen by delegates as a top candidate to lead the WTO, currently chairs the GAVI vaccine alliance board and stressed her credentials among five remaining candidates “at the intersection between public health and trade”.

“Trade can contribute to public health – seeing that connection, invoking those (WTO) rules, actively discussing COVID-19 issues and how WTO can help,” the former finance minister and World Bank managing-director said. “For me, that would be a priority.”

Okonjo-Iweala, one of two African candidates in the second of three rounds, says she is discussing with members the options for using WTO intellectual property rules to get special licences to deliver COVID-19 medicines to poorer countries.

“This is wonderful because it could also contribute to more accessibility and affordability eventually for vaccines and for therapeutics,” she said, adding she hoped such discussions would be part of a planned 2021 trade negotiations package.

She also said she would urge the at least 80 countries and territories which have raised barriers in response to the COVID-19 crisis, including on medical equipment, to lower them.

Interest in COVAX – the joint programme between GAVI and WHO to distribute COVID-19 vaccines equitably – is growing, she said. A GAVI spokesman confirmed there were 167 now committed to the plan – 75 wealthier economies and 92 poorer economies.

“Countries have been coming on their own … We are getting close to to the immediate goal (of $2 billion) which is very comforting because that means we can make advanced purchase commitments for vaccines,” she said, referring to the initial fund-raising goal to supply low- and middle-income countries.

China, Russia and the United States remain outside the plan.

Okonjo-Iweala urged African countries not to hedge their bets and sign separate procurement deals to COVAX, at least not in the initial phase which anticipates giving them enough doses to vaccinate up to 20% of their populations.

“If you make a mistake and procure the wrong thing people will run away,” she said, referring to vaccine scepticism.

She repeated pledges to reform the WTO and said she was having “constructive conversations” with Washington – a deep critic of the body and whose support is vital for any DG’s future tenure.

In a possible turning point in the race last week, two delegates said she received a standing ovation at a presentation before African ambassadors at which her rival, Kenya’s Amina Mohamed, also presented.

(Reporting by Emma Farge; editing by Stephanie Nebehay and Giles Elgood)

Copyright 2020 Thomson Reuters.

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