What kind of army is this?

It’s been 49 days since California’s Governor Newsome announced details of his bold executive order N-39-20 giving the Director of the Department of Consumer Affairs (DCA) the authority to waive professional licensing requirements for the healing arts boards under DCA during the COVID-19 State of Emergency, hoping to produce a flow of recruits to the newly created California Health Corps, a new army charged to staff an additional 66,000 hospital beds, now closed, but expected to be needed as the COVID-19 pandemic spreads.  I wrote about this on my blog April 5 https://theviewfromharbal.com/2020/04/05/come-back-west-old-man/.  With 37,000 medical professionals in the state who had let their license lapse within the previous 5 years, the pool seemed deep.  Already licensed professionals could also apply to the Corps.  The whole thing was to be funded, with no budget stated, out of the state’s Disaster Relief fund, which has provision for substantial reimbursement from the feds.  The response was phenomenal, with 25,000 applying in the first 24 hours, to 34,000 in first 48 hours, up to 82,000 a week later, and totaling 93,000 after a month.  But problems ensued.  2/3ds – 60,000 – didn’t have a valid license.  20,000 haven’t filled out a license renewal application despite being sent a reminder.  Part of this might have arisen from some confusion in the application process.  There are two websites at which one can apply to the Corps.  The one accessed from the California government’s Coronavirus (COVID-19) Response https://covid19.ca.gov/healthcorps/ has only the Corps application with no mention of the license renewal program.  For that, you need to go to the California Medical Board https://www.mbc.ca.gov/Licensees/License_Renewal/Physicians_and_Surgeons.aspx#COVID19_Temporary_CME_Waiver, where the license renewal program is explained as something to be done first before applying to the Corps, the button to the application placed just after.

As of April 30, 10,500 applicants were in final review and 4,900, about 5% of the volunteers have been cleared to participate, 2/3ds of which are nurses with 417 doctors.  Pay is not bad, but pretty lowball by California standards. 

 From the CalHR Pay Scales (pages 5.12 and 5.13)


Section V applies to employees appointed by EMSA. Employees entitled to the HAM authorizations identified below include all new hires as of 04/17/20 in the following classifications listed.

  Class Code    Class    CBID  Department Location(s)    RangeHiring-Above- Minimum Total Salary Rate
7551Physician and SurgeonR16EMSARg A Rg B Rg C Rg D$10,161 $12,310 $12,904 $13,278
8165Registered NurseR17EMSARg A$6,572
8212Nurse PractitionerR17EMSARg A$8,394

No beach house will be bought with these state checks, which don’t start till you’re deployed.  233 soldiers in this army – doctors, nurses, respiratory specialists and support personnel – landed in Sacramento April 20 where they staff the 363 bed emergency hospital set up at Sleep Train Arena, let by the state for $500K a month expecting to get 75% of that back from the feds.  So far there are no patients.  600 more nurses will soon be deployed, formed into regional “strike teams” to help control the infectious disease in skilled nursing facilities.  So that still leaves over 4,000 soldiers sitting on the bench.  But at least they have an inspiring flag:

Does that doc have a beard?  Doesn’t that render your N-95 mask essentially worthless?  And masks they’ll need.  When you figure this army is composed of quite a few retirees, you’ve got the elderly facing up to patients with active COVID infections: a recipe for disaster if there ever was one.  The youngsters will be sitting on the sidelines making book on which side will have more fatalities.

But the war smoulders on.  When I first wrote about this on 4/5, there had been 5,304 confirmed cases in LA county.  As of this morning, according to the Johns Hopkins site, there had been 37,360 confirmed cases in LA county, a little over 745/day since my last post.  There’ve been 1,793 deaths at a rate 369.7 per 100K population. 1,044 new cases since previous day, all in an area with a total population of 10,098,052 (1,299,277 age 65 or over).  Some of the increase could stem from improved testing.

Down south in San Diego county, where Kathy and I want to go, there have been 5,662 confirmed cases, 209 deaths at a rate of 169.35/100K and 27 new cases since the previous day. Total population 3,302,833 (439,595 age 65 or over).  But on May 13 County Supervisor Jim Desmond, a conservative, pointed out that only 6 deaths of the 194 ascribed to COVID-19 to date in the county could be considered “pure” COVID deaths, in that the victims had no other underlying medical condition. https://www.sandiegouniontribune.com/news/politics/story/2020-05-13/supervisor-jim-desmond-says-san-diego-has-only-had-six-pure-coronavirus-deaths

The entire Golden State holds 39,510,000 and has had 78,725 confirmed cases (0.2% of the population), 3,208 deaths (about 1/3d are nursing home patients), with 1,179,126 tested so far.

Back home, my Michigan has had it worse.  Of 9,987,000 Michiganders, 50,538 had confirmed COVID-19 (0.5% of the population) with 4,881 deaths (1.5 times as many as California, which is nearly 4 times as populous as Michigan) with 357,921 tested so far.  Wayne County, population 1,761,382 (258,954 age 65 and over), home of Detroit, has seen the worst of it, with 19,016 confirmed cases (0.43% of the population) with 2,212 deaths and 134 new cases since previous day.

But the docs and nurses of this state have handled it with aplomb.  At U Hospital, the number of new cases and deaths have been going steadily down and occupancy is creeping up.  We never had to use the 500 bed field hospital they set up in the Track and Tennis building.  And the only “army” I’ve seen are the rednecks with their AR-15s marching on Lansing with a message for Governor Whittmer.

When I first wrote about this, I said I’d pass on taking Governor Newsome’s offer of a freebie renewal of my lapsed California license.  There would be opportunities to serve in the war on COVID just a short walk away.  Fortunately, I never had to put the white coat back on.  And it looks like I won’t be needed in California, either.  I still filled out the renewal form this morning, just to see what will happen.  It’s a two part process to get in the Corps, so I think I’m safe, which is how everyone these days wishes me to stay.

Published by rike52

I retired from the Rheumatology division of Michigan Medicine end of June '19 after 36 years there. Upon hitting Ann Arbor for the second time (I went to school here) it took me almost 8 months to meet Kathy, 17 months to buy her a house (on Harbal, where we still live), and 37 months to marry her. Kids never came, but we've been blessed with a crowd of colleagues, friends, neighbors and family that continues to grow. Lots of them are going to show up in this log eventually. Stay tuned.

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