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Should doctor-patient confidentiality still apply when the patient is the president?

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Should doctor-patient confidentiality still apply when the patient is the president?

In a typical presidential election year, voters might wonder how the candidates’ views stack up on issues such as abortion, tax cuts, gun rights and immigration policy.

But this year, as a 78-year-old Republican Party nominee campaigned to replace an 81-year-old Democratic incumbent, a different question rose to the forefront of many voters’ minds: What’s in their medical files?

That issue eclipsed all others after President Biden’s blundering performance in last month’s debate against Donald Trump, triggering widespread concern about Biden’s physical and cognitive health. It became even more salient after Trump sustained a gunshot wound to his ear and Biden came down with COVID-19.

Members of the Secret Service tend to former President Trump’s bloody ear after he was shot at a campaign event in Butler, Pa., on July 13.

(Gene J. Puskar / Associated Press)

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When Biden withdrew from the presidential race Sunday, House Speaker Mike Johnson (R-La.) kept the health question alive by calling on the commander in chief to resign.

“If Joe Biden is not fit to run for President, he is not fit to serve as President,” Johnson wrote on the social media platform X.

Biden’s doctors have denied speculation that the president is being treated for Parkinson’s disease or another neurological disorder. Meanwhile, Trump’s campaign has released limited information about the former president’s condition after he was grazed by a rifle round.

Is the public entitled to know more than either man has willingly disclosed?

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“In the ideal world, it would be great if there were full transparency,” said Dr. Robert Klitzman, a psychiatrist and bioethicist at Columbia University. But no patient — not even a president — should be forced to share medical information they’d rather keep between themselves and their doctor, he and other experts said.

The reason is simple: A successful relationship between a doctor and patient relies on trust, and that includes trusting a doctor to not share information that might be considered embarrassing, unflattering or stigmatizing.

“To be able to help a patient as much as possible, we need the whole story,” Klitzman said. “We need to know if the patient is depressed, if the patient can’t pee, if the patient’s in pain, if the patient is forgetting things. We need that information to make an accurate diagnosis and figure out the best treatment to help.”

Without the assurance of confidentiality, a president might well decide he’s better off steering clear of doctors altogether, said George Annas, a professor of health law, bioethics and human rights at Boston University.

“You want him to have access to whatever treatment there is, and he ain’t going to get it if he’s not going to get tested,” Annas said. “That’s why we keep this stuff confidential, and why it makes perfect sense to do it even though everything in you screams, ‘I want to know what’s the matter with him.’”

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The principle of doctor-patient confidentiality goes back to ancient Greece and is enshrined in the Hippocratic oath: “Whatever I see or hear in the lives of my patients, whether in connection with my professional practice or not, which ought not to be spoken of outside, I will keep secret, as considering all such things to be private.”

About 2,400 years later, the notion that a patient’s medical information should remain private was codified into federal law as part of the Health Insurance Portability and Accountability Act of 1996, better known as HIPAA.

There are limited circumstances where doctors have a duty to disclose a certain amount of information about their patients.

For example, if a patient presents a danger to himself or others, a doctor has a duty to warn law enforcement or potential victims of the threat, said Dr. Bandy X. Lee, a forensic psychiatrist and educator in Harvard Medical School’s program on psychiatry and the law.

If a patient has a reportable sexually transmitted infection such as syphilis or HIV, that diagnosis must be shared with a public health department, along with the names of the patient’s past partners so they can be informed and get tested, Klitzman said.

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And if doctors notice a spike in cancer cases among people clustered in a geographic area, that too is passed along for public health officials to investigate.

Beyond cases such as these, the consensus fades, Annas said.

Congress could try to carve out an exception to HIPAA and require presidents and presidential candidates to release their medical records to the public. But in the unlikely event that the law were to change, it’s unclear whether it would survive a challenge in court, said Bert A. Rockman, a professor emeritus of political science at Purdue University who specializes in the American presidency.

“It raises a lot of questions to which we don’t know the answers,” he said.

Besides, forcing sitting and would-be presidents to waive their right to doctor-patient confidentiality wouldn’t guarantee that voters learn the truth, Rockman said. A president could simply shop around for a doctor willing to obfuscate in a medical report, for instance.

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“There are always going to be ways to get a work-around,” he said.

Even if a president is forthcoming, knowing their diagnosis wouldn’t necessarily tell you much about their ability to function. A White House occupant could have a mild case of Parkinson’s but be able to carry out the job just fine with proper treatment, Klitzman said.

Voters should also keep in mind that there’s a difference between the president and the presidency, Rockman said.

“The presidency can work even if the president is diminished,” he said. “In all likelihood, unless the president is completely out to lunch for some reason or another, either physically or mentally, the office itself functions.”

Indeed, U.S. history is rife with examples of presidents concealing serious medical problems from the public.

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John F. Kennedy was taking narcotic painkillers, amphetamines and steroids to treat his Addison’s disease and other ailments while trying to avert a nuclear crisis with the Soviet Union in the early 1960s.

Grover Cleveland said he was going on a four-day fishing trip when he boarded a yacht in 1893 to have a malignant tumor — along with part of his jaw and five teeth — surgically removed from the roof of his mouth.

Woodrow Wilson suffered a stroke in 1919 that left him partially paralyzed, bedridden and unable to feed himself for the remainder of his presidency. When pressed for details about Wilson’s condition, his doctor said “the President’s mind is not only clear but very active.”

It’s not OK to lie to preserve a patient’s privacy, Klitzman said, but that doesn’t necessarily mean a doctor must reveal “the truth, the whole truth, and nothing but the truth.”

“You can say, ‘The President’s not feeling well today,’ or you can say, ‘The President has COVID,’” he said. “You want people to trust the government, and if people feel the government is lying all the time and we can’t trust anything they say, that’s not good.”

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A retired teacher found some seahorses off Long Beach. Then he built a secret world for them

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A retired teacher found some seahorses off Long Beach. Then he built a secret world for them

Rog Hanson emerges from the coastal waters, pulls a diving regulator out of his mouth and pushes a scuba mask down around his neck.

“Did you see her?” he says. “Did you see Bathsheba?”

On this quiet Wednesday morning, a paddle boarder glides silently through the surf off Long Beach. Two stick-legged whimbrels plunge their long curved beaks into the sand, hunting for crabs.

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But Hanson, 68, is enchanted by what lies hidden beneath the water. Today he took a visitor on a tour of the secret world he built from palm fronds and pine branches at the bottom of the bay: his very own seahorse city.

The visitor confirms that she did see Bathsheba, an 11-inch-long orange Pacific seahorse, and a grin spreads across Hanson’s broad face.

“Isn’t she beautiful?” he says. “She’s our supermodel.”

If you get Hanson talking about his seahorses, he’ll tell you exactly how many times he’s seen them (997), who is dating whom, and describe their personalities with intimate familiarity. Bathsheba is stoic, Daphne a runner. Deep Blue is chill.

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He will also tell you that getting to know these strange, almost mythical beings has profoundly affected his life.

“I swear, it has made me a better human being,” he says. “On land I’m very C-minus, but underwater, I’m Mensa.”

Hanson is a retired schoolteacher, not a scientist, but experts say he probably has spent more time with Pacific seahorses, also known as Hippocampus ingens, than anyone on Earth.

“To my knowledge, he is the only person tracking ingens directly,” says Amanda Vincent, a professor at the University of British Columbia and director of the marine conservation group Project Seahorse. “Many people love seahorses, but Roger’s absorption with them is definitely distinctive. There’s a degree of warm obsession there, perhaps.”

Rog Hanson posing in his gear on the beach.

Rog Hanson keeps watch over a small colony of Pacific seahorses.

(Carolyn Cole / Los Angeles Times)

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Over the last three years, Hanson has made the two-hour trek from his home in Moreno Valley to the industrial shoreline of Long Beach to visit his “kids” about every five days. To avoid traffic, he often leaves at 2 a.m. and then sleeps in his car when he arrives.

He keeps three tanks of air and his scuba gear in the trunk of his 2009 Kia Rio. A toothbrush and a pair of pink leopard print reading glasses rest on the dash.

Hanson makes careful notes after all his dives in a colorful handmade log book he stores in a three-ring binder. On this Wednesday he dutifully records the water temperature (62 degrees), the length of the dive (58 minutes), the greatest depth (15 feet) and visibility (3 feet), as well as the precise location of each seahorse. His notes also include phase of the moon, the tidal currents and the strength of the UV rays.

“Scientists will tell you that sunlight is an important statistic to keep down,” he says.

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He has given each of his four seahorses a unique logo that he draws with markers in his log book. Bathsheba’s is a purple star outlined in red, Daphne’s is a brown striped star in a yellow circle.

A detailed log of seahorse sightings written in a notebook with colorful inks.

Rog Hanson makes careful notes after all his dives. He has given each of his four seahorses a unique logo.

(Carolyn Cole / Los Angeles Times)

He’s learned that the seahorses don’t like it when he hovers nearby for too long. Now he limits his interactions with them to 15 to 30 seconds at a time.

“At first I bugged them too much,” he says. “I was the paparazzi swimming around.”

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Hanson traces the origins of his seahorse story back nearly two decades to the early morning of Dec. 30, 2000.

He was diving solo off Shaw’s Cove in Laguna Beach when a slow-moving giant emerged from the abyss. It was a gray whale whose 40-foot frame cast Hanson in shadow.

The whale could have killed him with a flick of its tail, Hanson says, but he felt no fear. The two made eye contact and, as Hanson tells it, he felt the whale’s gaze peering directly into his soul.

It was all over in 10 seconds, but Hanson was altered. He had always wanted to live at the beach, but after this encounter, he vowed to make it happen. It took years —15, in fact — but he finally got a job as a special education teacher in the Long Beach public school system. He bought a van and parked it on Ocean Boulevard. He lived at the beach and dived every day for 3½ months before moving to Moreno Valley.

To amuse himself while he lived at the beach, he built an underwater city he called Littleville out of discarded toys he found at the bottom of the bay.

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Hanson saw his first seahorse in January 2016 while checking on Littleville. It was bright orange, just 4.5 inches long, and Hanson, who had logged over a thousand dives in the area, knew it didn’t belong there.

A red seahorse surrounded by sealife under water.

Daphne is one of the seahorses that Rog Hanson is studying in Alamitos Bay.

(Carolyn Cole / Los Angeles Times)

The range of the Pacific seahorse is generally thought to extend from Peru to as far north as San Diego. This seahorse ended up about 100 miles north of that.

Scientists said the seahorse and others that joined her had probably ridden an unusual pulse of warm water up the coast, along with other animals generally found in southern waters.

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“We were getting a lot of weird sightings in the fall of 2015,” says Sandy Trautwein, vice president of husbandry at the Aquarium of the Pacific. “There was a yellow-bellied sea snake, bluefin tuna, marlin, whale sharks — a lot of animals associated with warm water.”

Most of these animals eventually left after ocean temperatures returned to normal, but Hanson’s seahorses stayed.

That may be because Hanson had built them a home.

It happened like this: In June 2016 he watched in horror as more than 100 high school football players splashed in the shallow waters, right where his seahorses usually hung out.

“I thought, I gotta do something, I gotta do something,” he says.

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“On land I’m very C-minus, but underwater, I’m Mensa.”

— Rog Hanson

Then he remembered that, back in the Midwest where he grew up, he used to help the city park service make “fish cribs.” In early spring they would use brush and twigs to build what looked like a miniature log cabin with no roof on an ice-covered lake. When the ice melted, the cribs would fall to the bottom, creating a habitat for fish and other animals.

“So I said to myself, build them a city that’s deeper, where feet can’t get to it even at low tide,” Hanson says.

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And he did.

By July 2016 two pairs of seahorses had moved into the new habitat. Daphne, the runner, was named after the nymph from Greek mythology who flees Apollo, Kenny’s name came from the proprietor of a local kayaking company. “Bathsheba” was inspired by a Bible story, and her mate, Deep Blue, named after a dive shop that has helped sponsor Hanson’s work since he launched his seahorse study.

He’s seen Kenny’s and Deep Blue’s bellies swell with pregnancy and noted how their partners check in on them daily, frequently standing sentinel nearby. He’s visited the fish at odd hours to see how their behavior changes from morning to night. And he mourned when Kenny disappeared in January. He still hasn’t come back. (A new member, CD Street, arrived June 29.)

“It feels like I’m reading a book, the book of their life, and I can’t put it down,” he says.

He’s also reached out to seahorse scientists across the globe to compare notes. “I won’t say I know the most about seahorses in the world, but I know the people who do,” he says.

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Amanda Vincent, the director of Project Seahorse, says that seahorses spark an emotional reaction in almost everyone.

Daphne is one of the seahorses that Rog Hanson is studying in Alamitos Bay.

Daphne is one of the seahorses that Rog Hanson is studying in Alamitos Bay. Hanson and Ashley Arnold keep watch over a small colony of Pacific seahorses.

(Carolyn Cole / Los Angeles Times)

“Remember those books with three flaps where you can mix the head of a giraffe with the body of a snake and the tail of a monkey? That’s what we’ve got here,” she says. “They appeal to the sense of fancy and wonder in us.”

When Mark Showalter, a planetary astronomer at the SETI Institute, recently discovered a moon orbiting Neptune, he named it Hippocamp in part because of his love of seahorses.

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“I’ve seen them in the wild and they are marvelously strange and interesting,” he says. “It’s a fish, but it doesn’t look anything like a fish.”

Pacific seahorses are among the largest members of the seahorse family. Males can grow up to 14 inches long, while females generally top out at about 11. They come in a variety of colors, including orange, maroon, brown and yellow. They are talented camouflagers that can alter the color of their exoskeleton to blend into their environment.

“I won’t say I know the most about seahorses in the world, but I know the people who do.”

But perhaps their most distinguishing characteristic is that they are the only known species in the animal kingdom to exhibit a true male pregnancy. Females deposit up to 1,500 eggs in the male’s pouch. The males incubate the eggs, providing nutrition and oxygen for the growing embryos. When the larval seahorses are ready to be released, he goes into labor — scientists call it “jackknifing” — pushing his trunk toward his tail.

After three years of observation, Hanson has collected new evidence about seahorse mating practices. His research suggests that although most seahorses are monogamous, a female will mate with two males if there are no other female seahorses around.

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He also found that males, who are in an almost constant state of pregnancy, tend to stick to an area about the size of a king-size mattress, while the females roam up to 150 feet from their home during a typical day.

Eventually, he may be able to help scientists answer another long-standing question: What is the lifespan of Pacific seahorses in the wild? Some researchers say about five years; others think it could be up to 12.

“It will be interesting to see what Roger finds out,” Vincent says.

In June 2017, about one year after Hanson began formally tracking the seahorses, he took on a partner: a young scuba instructor named Ashley Arnold.

Arnold, who has short red hair and a jocular vibe, is a former Army staff sergeant who served in Iraq and Afghanistan. She learned to dive as part of a program the Salt Lake City Veterans Affairs hospital offered to female veterans suffering from post-traumatic stress disorder and military sexual trauma. Arnold suffered from both. Diving became her salvation.

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Dive instructor Ashley Arnold sitting at the bed of a truck.

Dive instructor Ashley Arnold is a former Army staff sergeant who says that diving at least twice a week helps her deal with PTSD and MST.

(Carolyn Cole / Los Angeles Times)

“All the irritation on the surface disappears when you go under the water,” she says. “It’s like, ‘What was I concerned about?’ You forget about everything else. Nothing else matters.”

She used her GI Bill to pay for a scuba instructor course and to set up her own business. Now, she finds that if she dives at least twice a week and has a dog, she does not need to take medication.

“All the irritation on the surface disappears when you go under the water.”

— Ashley Arnold

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“That’s a pretty big statement in my opinion,” she says.

Arnold and Hanson met in June 2016 on a dive trip to Catalina. Hanson mentioned his seahorses. Arnold was intrigued, but still lived in Salt Lake City.

One year later, Arnold moved to Huntington Beach and gave Hanson a call.

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“I said, ‘Hey Roger, let’s chat. Any chance I could join you at the seahorses you talked about?’” she says. “And he decided I was acceptable.”

Now, Arnold and her boyfriend, Jake Fitzgerald, check in on the seahorses about once a week and help Roger rebuild the city he created for them.

Rog Hanson and Ashley Arnold posing in their gear on the beach.

Rog Hanson, 68, teamed up with dive instructor Ashley Arnold two years ago to keep watch over a small colony of Pacific seahorses.

(Carolyn Cole / Los Angeles Times)

“We call them our kids because we love them so much,” Arnold says.

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Hanson and Arnold are very protective of their seahorse family. They tell visitors to remove GPS tags from their photos. They swear them to secrecy.

There is little chance anyone would find Hanson’s seahorses without a guide. Also, diving in these waters off Long Beach can be a challenge.

The water is shallow. It’s hard to get your buoyancy right. A misplaced flipper kick can stir up blinding sand and silt.

But if Hanson wants to show you his underwater world, nothing will stop him. He will hold you firmly by the hand and guide you down to the forest he built at the bottom of the bay.

Rog Hanson rinses off Ashley Arnold in her gear on the beach.

Ashley Arnold, right, gets rinsed off with a hose by Rog Hanson after a dive Alamitos Bay.

(Carolyn Cole / Los Angeles Times)

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He will use a plastic tent stake, jabbing it into the bottom to propel himself — and you holding on — across the ocean floor. When he spots a seahorse he will use the stake as a pointer. Through the murky water you strain to see. Then it appears.

Orange and rigid. Thin snout. Bony plates. Stripes down the torso. Totally still.

And if you’ve never seen a seahorse in the wild before, you will feel honored and awed, as if you’ve just seen a unicorn beneath the sea.

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California’s summer COVID wave shows signs of waning. What are the numbers in your community?

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California’s summer COVID wave shows signs of waning. What are the numbers in your community?

There are some encouraging signs that California’s summer COVID wave might be leveling off.

That’s not to say the seasonal spike is in the rearview mirror just yet, however. Coronavirus levels in California’s wastewater remain “very high,” according to the U.S. Centers for Disease Control and Prevention, as they are in much of the country.

But while some COVID indicators are rising in the Golden State, others are starting to fall — a hint that the summer wave may soon start to decline.

Statewide, the rate at which coronavirus lab tests are coming back positive was 11.72% for the week that ended Sept. 6, the highest so far this season, and up from 10.8% the prior week. Still, viral levels in wastewater are significantly lower than during last summer’s peak.

The latest COVID hospital admission rate was 3.9 hospitalizations for every 100,000 residents. That’s a slight decline from 4.14 the prior week. Overall, COVID hospitalizations remain low statewide, particularly compared with earlier surges.

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The number of newly admitted COVID hospital patients has declined slightly in Los Angeles County and Santa Clara County, but ticked up slightly up in Orange County. In San Francisco, some doctors believe the summer COVID wave is cresting.

“There are a few more people in the hospitals, but I think it’s less than last summer,” said Dr. Peter Chin-Hong, a UC San Francisco infectious diseases expert. “I feel like we are at a plateau.”

Those who are being hospitalized tend to be older people who didn’t get immunized against COVID within the last year, Chin-Hong said, and some have a secondary infection known as superimposed bacterial pneumonia.

Los Angeles County

In L.A. County, there are hints that COVID activity is either peaking or starting to decline. Viral levels in local wastewater are still rising, but the test positivity rate is declining.

For the week that ended Sept. 6, 12.2% of wastewater samples tested for COVID in the county were positive, down from 15.9% the prior week.

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“Many indicators of COVID-19 activity in L.A. County declined in this week’s data,” the L.A. County Department of Public Health told The Times on Friday. “While it’s too early to know if we have passed the summer peak of COVID-19 activity this season, this suggests community transmission is slowing.”

Orange County

In Orange County, “we appear to be in the middle of a wave right now,” said Dr. Christopher Zimmerman, deputy medical director of the county’s Communicable Disease Control Division.

The test positivity rate has plateaued in recent weeks — it was 15.3% for the week that ended Sept. 6, up from 12.9% the prior week, but down from 17.9% the week before that.

COVID is still prompting people to seek urgent medical care, however. Countywide, 2.9% of emergency room visits were for COVID-like illness for the week that ended Sept. 6, the highest level this year, and up from 2.6% for the week that ended Aug. 30.

San Diego County

For the week that ended Sept. 6, 14.1% of coronavirus lab tests in San Diego County were positive for infection. That’s down from 15.5% the prior week, and 16.1% for the week that ended Aug. 23.

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Ventura County

COVID is also still sending people to the emergency room in Ventura County. Countywide, 1.73% of ER patients for the week that ended Sept. 12 were there to seek treatment for COVID, up from 1.46% the prior week.

San Francisco

In San Francisco, the test positivity rate was 7.5% for the week that ended Sept. 7, down from 8.4% for the week that ended Aug. 31.

“COVID-19 activity in San Francisco remains elevated, but not as high as the previous summer’s peaks,” the local Department of Public Health said.

Silicon Valley

In Santa Clara County, the coronavirus remains at a “high” level in the sewershed of San José and Palo Alto.

Roughly 1.3% of ER visits for the week that ended Sunday were attributed to COVID in Santa Clara County, down from the prior week’s figure of 2%.

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Early adopters of ‘zone zero’ fared better in L.A. County fires, insurance-backed investigation finds

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Early adopters of ‘zone zero’ fared better in L.A. County fires, insurance-backed investigation finds

As the Eaton and Palisades fires rapidly jumped between tightly packed houses, the proactive steps some residents took to retrofit their homes with fire-resistant building materials and to clear flammable brush became a significant indicator of a home’s fate.

Early adopters who cleared vegetation and flammable materials within the first five feet of their houses’ walls — in line with draft rules for the state’s hotly debated “zone zero” regulations — fared better than those who didn’t, an on-the-ground investigation from the Insurance Institute for Business and Home Safety published Wednesday found.

Over a week in January, while the fires were still burning, the insurance team inspected more than 250 damaged, destroyed and unscathed homes in Altadena and Pacific Palisades.

On properties where the majority of zone zero land was covered in vegetation and flammable materials, the fires destroyed 27% of homes; On properties with less than a quarter of zone zero covered, only 9% were destroyed.

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The Insurance Institute for Business and Home Safety, an independent research nonprofit funded by the insurance industry, performed similar investigations for Colorado’s 2012 Waldo Canyon fire, Hawaii’s 2023 Lahaina fire and California’s Tubbs, Camp and Woolsey fires of 2017 and 2018.

While a handful of recent studies have found homes with sparse vegetation in zone zero were more likely to survive fires, skeptics say it does not yet amount to a scientific consensus.

Travis Longcore, senior associate director and an adjunct professor at the UCLA Institute of the Environment and Sustainability, cautioned that the insurance nonprofit’s results are only exploratory: The team did not analyze whether other factors, such as the age of the homes, were influencing their zone zero analysis, and how the nonprofit characterizes zone zero for its report, he noted, does not exactly mirror California’s draft regulations.

Meanwhile, Michael Gollner, an associate professor of mechanical engineering at UC Berkeley who studies how wildfires destroy and damage homes, noted that the nonprofit’s sample does not perfectly represent the entire burn areas, since the group focused specifically on damaged properties and were constrained by the active firefight.

Nonetheless, the nonprofit’s findings help tie together growing evidence of zone zero’s effectiveness from tests in the lab — aimed at identifying the pathways fire can use to enter a home — with the real-world analyses of which measures protected homes in wildfires, Gollner said.

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A recent study from Gollner looking at more than 47,000 structures in five major California fires (which did not include the Eaton and Palisades fires) found that of the properties that removed vegetation from zone zero, 37% survived, compared with 20% that did not.

Once a fire spills from the wildlands into an urban area, homes become the primary fuel. When a home catches fire, it increases the chance nearby homes burn, too. That is especially true when homes are tightly packed.

When looking at California Department of Forestry and Fire Protection data for the entirety of the two fires, the insurance team found that “hardened” homes in Altadena and the Palisades that had noncombustable roofs, fire-resistant siding, double-pane windows and closed eaves survived undamaged at least 66% of the time, if they were at least 20 feet away from other structures.

But when the distance was less than 10 feet, only 45% of the hardened homes escaped with no damage.

“The spacing between structures, it’s the most definitive way to differentiate what survives and what doesn’t,” said Roy Wright, president and chief executive of the Insurance Institute for Business and Home Safety. At the same time, said Wright, “it’s not feasible to change that.”

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Looking at steps that residents are more likely to be able to take, the insurance nonprofit found that the best approach is for homeowners to apply however many home hardening and defensible space measures that they can. Each one can shave a few percentage points off the risk of a home burning, and combined, the effect can be significant.

As for zone zero, the insurance team found a number of examples of how vegetation and flammable materials near a home could aid the destruction of a property.

At one home, embers appeared to have ignited some hedges a few feet away from the structure. That heat was enough to shatter a single pane window, creating the perfect opportunity for embers to enter and burn the house from the inside out. It miraculously survived.

At others, embers from the blazes landed on trash and recycling bins close to the houses, sometimes burning holes through the plastic lids and igniting the material inside. In one instance, the fire in the bin spread to a nearby garage door, but the house was spared.

Wooden decks and fences were also common accomplices that helped embers ignite a structure.

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California’s current zone zero draft regulations take some of those risks into account. They prohibit wooden fences within the first five feet of a home; the state’s zone zero committee is also considering whether to prohibit virtually all vegetation in the zone or to just limit it (regardless, well-maintained trees are allowed).

On the other hand, the draft regulations do not prohibit keeping trash bins in the zone, which the committee determined would be difficult to enforce. They also do not mandate homeowners replace wooden decks.

The controversy around the draft regulations center around the proposal to remove virtually all healthy vegetation, including shrubs and grasses, from the zone.

Critics argue that, given the financial burden zone zero would place on homeowners, the state should instead focus on measures with lower costs and a significant proven benefit.

“A focus on vegetation is misguided,” said David Lefkowith, president of the Mandeville Canyon Assn.

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At its most recent zone zero meeting, the Board of Forestry and Fire Protection directed staff to further research the draft regulations’ affordability.

“As the Board and subcommittee consider which set of options best balance safety, urgency, and public feasibility, we are also shifting our focus to implementation and looking to state leaders to identify resources for delivering on this first-in-the-nation regulation,” Tony Andersen, executive officer of the board, said in a statement. “The need is urgent, but we also want to invest the time necessary to get this right.”

Home hardening and defensible space are just two of many strategies used to protect lives and property. The insurance team suspects that many of the close calls they studied in the field — homes that almost burned but didn’t — ultimately survived thanks to firefighters who stepped in. Wildfire experts also recommend programs to prevent ignitions in the first place and to manage wildlands to prevent intense spread of a fire that does ignite.

For Wright, the report is a reminder of the importance of community. The fate of any individual home is tied to that of those nearby — it takes a whole neighborhood hardening their homes and maintaining their lawns to reach herd immunity protection against fire’s contagious spread.

“When there is collective action, it changes the outcomes,” Wright said. “Wildfire is insidious. It doesn’t stop at the fence line.”

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