Although health officials say the risk of H5N1 bird flu infection is still low for the general population, they announced on Monday a $5-million plan to offer seasonal flu vaccine to livestock workers.

Nine poultry workers in Colorado are reported to have been infected; the symptoms were described as “mild,” with conjunctivitis, or pink eye, as the predominant symptom. The official case total across the U.S. since April now stands at 13.

“These cases highlight that certain groups who focus on depopulating” — like the poultry workers in charge of killing the animals — “are at heightened risk of infection,” said Nirav Shah, principal deputy director at the U.S. Centers for Disease Control and Prevention.

Officials said they are launching this program for seasonal flu vaccine to protect the health of farmworkers, and also to reduce the chance of a human flu mixing with an H5N1 virus, which could ignite a new pandemic threat.

The reassortment and recombining of flu viruses is a concerning scenario.

The 1918 “Spanish flu,” which killed more than 50 million people worldwide, was likely the recombined product of a human and avian flu. So too was the 2009 H1N1 swine flu, which led to a pandemic estimated to have caused the death of more than 280,000 people across the globe.

“We’ve seen that livestock workers are at risk for H5 infection because of their exposure to animals,” Shah said. “They are also at risk for infection with seasonal flu. … As such, it’s possible that they could be coinfected with both seasonal influenza viruses … and with H5 virus.”

He said that although such dual infections are rare, they could “potentially result in an exchange of genetic material between the two different influenza viruses … that could lead to a new influenza virus that could pose a significant public health concern, a virus that has the transmissibility of seasonal influenza and the severity of H5N1. We want to do everything we can to reduce the risk that the virus may change because of this coinfection and reassortment.”

Shah said health officials are not considering offering a vaccine for H5N1 bird flu because so far it hasn’t been associated with severe illness or with transmission between people.

The seasonal vaccination program will be established in states that have been affected by the H5N1 in both cow and poultry populations.

California has not had any reported infections in dairy herds; however, several poultry farms and wild birds have been struck by the virus in recent months and years.

Lyla Abuebaid needs to check on her 5-year-old son through the night to make sure he keeps breathing.

Sayfideen has a rare and serious syndrome that leaves him unable to walk. He relies on a ventilator and has to be monitored 24 hours a day, his mother said. Nurses once helped handle his care at home.

But for months now, that work has instead fallen to his mother, who is also juggling her job as a project manager.

“I’m not functioning,” the San Jose resident said. “I’m not doing well at work. I’m not doing well at home.”

Abuebaid said it feels as though she has to “beg the state for services which he absolutely deserves.”

Lyla Abuebaid has waited for months for help from the state with the care of her son. She sometimes gets help from a family friend, but 5-year-old Sayfideen needs a fulltime caregiver. (Peter DaSilva / For The Times)

She is among thousands of Californians who have been trying to get Medicaid benefits for services to help medically vulnerable people remain at home through the Home and Community-Based Alternatives waiver.

Demand for the HCBA waiver, which helps people who might otherwise have to live in nursing facilities, has far outstripped the available spots. Last summer, California stopped accepting applications for the program as it hit an enrollment cap. Amid an outcry from disability rights advocates and families, California got federal approval to gradually add 7,200 slots over four years to eventually serve more than 16,000 people at a time.

Yet thousands of Californians remain on the wait list. As of June, more than 4,900 people were waiting, according to the Department of Health Care Services — more than twice as many as last summer.

When people have to wait, either “aging adults or disabled people who need services are going without them, or family caregivers are left to fill in the gaps,” said Nicole Jorwic, chief of advocacy and campaigns for Caring Across Generations. Some could end up in nursing facilities “because there just aren’t alternatives.”

Disability rights advocates had warned the state last year that the planned increase in slots would not clear the existing wait list for years, let alone reach more Californians who might find themselves in need of care as they face unexpected illness or injury.

“I don’t know that they’ve done anything to solve the problem,” said Clovis resident Sarah Scharnick, who first spoke with The Times about the wait list last fall and is still on it. Her husband requires round-the-clock care, including being turned at night to prevent bedsores, after a bicycle crash.

Long hours of nursing care at home are not typically covered by private insurers, forcing many families to resort to placing their loved ones in nursing facilities or to shoulder their care themselves, advocates say. Abuebaid said her private insurance would not cover her son’s nursing care. He had previously gotten assistance through Medi-Cal, the California Medicaid program, then lost his coverage.

Paying for such care out of pocket “would bankrupt a millionaire,” said Katelyn Ashton, executive director of Loretta’s Little Miracles, which cares for medically fragile children. For many families unable to access the waiver, “their only option is to quit their job and provide that care themselves at home.”

State officials said that with the added slots, nearly 10,800 people could be in the program at a time this year. Despite the demand for the program, however, more than 1,500 HCBA slots remained unfilled as of June, according to the healthcare services department.

The reason: The department said it is currently releasing only about 200 slots a month. Throwing open all the slots at once, it said, “would cause administrative backlogs” for both local agencies that take applications and for the state, “due to the high number of applications to process.” The state agency said it has limited resources, “including staff, to review the existing volume of enrollment packets.”

It has seven nurses who work on reviewing the enrollment packets — only two of them doing so full time — and four other staffers who assist with the wait list, the agency said. DHCS said the process can also be delayed by scheduling difficulties at local agencies that field applications.

The lag has alarmed groups like Disability Rights California and Justice in Aging. U.S. Rep. Nanette Barragán (D-San Pedro) said she had called for Gov. Gavin Newsom “to put the resources there to make sure that they’re filling slots as quickly as they can.”

“Putting people in this program saves the state money in the long run,” she said.

Providing such care for someone at home is far less expensive than moving them into a nursing home, state figures show: The Department of Health Care Services estimated in a May report that the average nursing facility costs more than $134,000 annually, compared with roughly $53,000 for each person in the program.

“We step over a dollar to pick up a dime a lot of times,” said Jim Frazier, a former California Assembly member and director of public policy for the Arc of California, which advocates for people with intellectual and developmental disabilities. “We don’t look at the long-term cost savings.”

The healthcare department estimated 40% of people accessing the program were not coming from nursing homes, but “from the community.” Researchers have found that longer waits for such programs can prove costly even if people aren’t already living in institutions: In Iowa, older people were more likely to end up spending time in a nursing home within a few years if they had applied for such waivers when waits were long, researchers found.

The logjam has also undercut efforts to help homeless people who are medically vulnerable, advocates said. In the Bay Area, Cardea Health Chief Executive Alexis Chettiar said the unhoused clients that her nonprofit serves “are too sick to live in a home without support, they are disallowed from shelters because they may be incontinent or have malodorous wounds,” and nursing homes are often unwilling to take them.

Her nonprofit has instead worked to enroll them in the HCBA program as they are housed. The group said it has saved over $7 million annually by reducing emergency room visits, hospitalizations and other medical costs for such patients.

“It really works,” Chettiar said. “Or I should say — it was working really magnificently until we hit the cap.”

More than 90 of their clients are now on the waiting list, where some have languished over a year and a half. Cardea Health has been footing the bill for their care, but Chettiar said it cannot do so forever: It has relied on a few years of “seed funding” from local governments when it starts services at a site, but had planned to get patients onto the HCBA waiver for continued care.

As California releases slots, it has been prioritizing people under the age of 21, as well as people who have already been stuck for months in health facilities, among others. DHCS said opening up slots month by month has allowed it to continuously ensure that those applications go to the front of the line. Abuebaid said that after months of waiting, her child had recently been scheduled for an intake appointment.

For Californians who do not fit those criteria, however, the waits can be especially punishing. As of June, more than 90% of those on the HCBA wait list were not in the priority groups, according to the state.

Jenina Marik has ALS. The family applied through the state nearly a year ago for in-home care, and husband Tyler Marik worries he may have to stop working to focus on caregiving.

(Myung J. Chun / Los Angeles Times)

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Among them is Jenina Marik, who was diagnosed roughly a year and a half ago with the neurodegenerative disorder ALS. Within a few years, the 40-year-old Valencia woman went from running a half marathon, operating her wedding photography business and corralling her young sons to being unable to feed or dress herself.

Her husband, Tyler Marik, turned to a caregiving service to assist her while he went to work, but “I was going broke.” After months of struggle, the family eventually got some help through a government program for in-home care, but “it’s nowhere near enough.”

Because Jenina, now quadriplegic, still needs care throughout the night, “I get maybe five hours of sleep a night. … And when I’m tired that can compromise her safety,” Tyler Marik said.

The HCBA waiver could afford them more care, but it’s been nearly a year since they applied. Marik fears he may have to stop working if nothing changes. Moving his wife into a facility “would be a nightmare,” he said.

“That would be even worse than ALS.”

Eli Marik, 7, cools off in the backyard with father Tyler, brother Owen, 4, and mother Jenina.

(Myung J. Chun / Los Angeles Times)

Every clear night for the last three weeks, Bob Stephens has pointed his home telescope at the same two stars in hopes of witnessing one of the most violent events in the universe — a nova explosion a hundred thousand times brighter than the sun.

The eruption, which scientists say could happen any day now, has excited the interest of major observatories worldwide, and it promises to advance our understanding of turbulent binary star systems.

Yet for all the high-tech observational power that NASA and other scientific institutions can muster, astrophysicists are relying on countless amateur astronomers like Stephens to spot the explosion first.

The reason? It’s just too costly to keep their equipment focused on the same subject for months at a time.

“I think everyone will look at it while it happens, but sitting there just looking at it isn’t going to make it happen,” said Tom Meneghini, the director of telescope operations and executive director emeritus at the Mt. Wilson Observatory. “It’s like a watched pot,” he joked.

The star is so far away that it takes 3,000 years for its light to reach the Earth, meaning the explosion occurred before the last of the Egyptian pyramids were built. It will appear about as bright as the North Star for just a few days before fading into the darkness.

Once it’s spotted, some of the most advanced observatories on Earth and in space will join in watching, including NASA’s James Webb Space Telescope.

“A lot of people are eagerly waiting to spot the new jewel in the crown,” said Mansi Kasliwal, the Caltech astronomy professor who is planning to use the Palomar Observatory in northeast San Diego County to observe the event. The nova will erupt in the Corona Borealis, or Northern Crown, constellation.

T Coronae Borealis, also called the Blaze Star, is actually two stars — a hot, dense white dwarf, and a cooler red giant.

The dwarf star, which ran out of fuel long ago and collapsed to roughly the size of Earth, has been siphoning hydrogen gas from its larger neighbor for about a human lifetime.

This stolen gas has accumulated in a disk around the dwarf like a hot, messy version of Saturn’s rings. Soon, the disk will grow so heavy that it will become violent and unwieldy, and inevitably, explode like a thermonuclear bomb.

Neither star is destroyed however, and the process repeats itself roughly every 80 years.

Stephens has data from T Coronae Borealis going back years. The oscillations in the data represent the two stars orbiting around each other.

(Robert Gauthier/Los Angeles Times)

This time around, there’s an army of enthusiasts like Stephens ready to sound the alarm when the star goes nova.

Far from mere hobbyists, a number of these amateur observers have published their own scientific research. Stephens even built his own observatory as an addition to his house in Rancho Cucamonga.

“The city thinks it’s a sunroom,” Stephens said. After the inspector stopped by, he removed the screws securing the roof, allowing him to roll it off to reveal the clear sky to his telescope.

Every night, he turns on the telescope and spends more than an hour taking data, which he later posts to an online community of amateur astronomers who monitor the star almost nonstop.

Major observatories simply cannot keep such constant watch. Hundreds of scientists compete for time to look at a wide range of astronomical targets every night. For them, keeping these telescopes glued to the Blaze Star is a waste of valuable observation time.

Estimates on when the nova will occur vary, but most astrophysicists agree it will happen before the end of the year, and likely by the end of August.

Once it blows, there are a few alert systems set up to notify amateurs and professionals. Some observatories have even programmed their telescopes to autonomously ditch their current observation plan and look at the star when the notification comes in, Stephens said.

Major observatories also face another complication. Many of their telescopes are designed to look at the faintest and dimmest targets, but the Blaze Star nova will be anything but faint. Pointing these telescopes at the nova would overwhelm sensors, resulting in a washed-out, overexposed picture.

That’s why Palomar Observatory, Caltech’s research station in north San Diego County, isn’t using its iconic 16-foot-wide Hale telescope under its massive white dome. Instead, it’s using a much smaller telescope, called Gattini-IR, located in a small brick building about a quarter mile down the road.

Once the nova happens, Gattini-IR will go from observing the Blaze Star every couple nights to every couple hours.

Steve Flanders enters the small building on the Palomar Observatory grounds where the Gattini-IR telescope is set up. The Gattini-IR telescope is monitoring the Blaze Star, which is expected to go nova.

(Hayne Palmour IV/For The Times)

Scientists say they still have a lot to learn about novas. For example, physicists are still unsure why some erupt every decade while others likely don’t for millennia.

Some researchers suspect that novas like the Blaze Star could be precursors to supernovas. These explosions — billions of times brighter than the sun — destroy the star, often leaving behind a black hole. Supernovas are also a useful tool for astronomers to measure distance.

Studying similar events has already led to discoveries, however.

Recently, scientists determined that novas tend to fling material into space at faster speeds than what would be predicted based on the intensity of the explosion.

“We want to understand the physics of novae, so having a nova that’s as close as T Coronae Borelias, which will hopefully be very well studied by all telescopes … we can get a very full picture,” said Caltech professor Kasliwal.

Some of that understanding will be due in part to amateur astronomers.

Thanks to the rapid development of telescopes, amateurs are working with technology that professionals didn’t have just 20 years ago, let alone 80, said Forrest Sims, an amateur astronomer from Apache Junction, Ariz., who is also observing the star every clear night.

And the amateurs can achieve better coverage than the big telescopes because “we typically have complete control over when and where we can point [our telescopes],” said Sims. “A professional may have to write a grant to get a half hour or two hours time on a big telescope.”

That allows them to collect a lot of data. And with hundreds in the community observing from around the world, they can achieve almost continuous coverage of the Blaze Star. Many, including Sims and Stephens, post their data to the American Assn. of Variable Star Observers website, allowing everyone to use the data.

Stephens remembers reading a journal article from a professional who managed to observe five asteroids over two years. “I thought, I could do that in a month,” Stephens said. He went on to publish a paper with 10 observations.

In his at-home observatory, Bob Stephens is using a Borg 101 telescope. “Resistance is futile!” Stephens said when introducing the telescope, a reference to the phrase uttered by “the Borg” in “Star Trek.”

(Robert Gauthier/Los Angeles Times)

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One professor was so shocked by the number Stephens was able to see that she reached out and agreed to fly to Puerto Rico for an asteroid conference just to meet him. They ended up working together — Stephens had the telescopes; she had the connections in the field.

Today, amateur astronomers’ work is getting so sophisticated, many in the field have a hard time calling them amateurs.

“We call ourselves ‘small telescope scientists,’ ” said Sims. “It sounds more fun, and in some respects, professionals — and not even grudgingly — will admit that the work we’re doing is often professional caliber.”