L.A. County coronavirus cases rise to new risk level, sparking concern

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May 19, 2022 Updated 4:22 PM PT

Los Angeles County hospitals are once again seeing a marked increase in the number of coronavirus-positive patients requiring their care — triggering new concern that healthcare systems could once again come under strain unless the region gets its arms around the latest resurgence of the virus.

The case rate in the nation’s most populous county is now high enough to land it within the “medium” COVID-19 community level outlined by the U.S. Centers for Disease Control and Prevention. Reaching this category, the middle on the agency’s three-tier scale, “is concerning, since it could signal that the increases that we’re seeing in our COVID cases may soon put pressure on our healthcare resources,” said county Public Health Director Barbara Ferrer.

Fourteen California counties are now in the medium community level, but L.A. is the only one in Southern California. The others are eight of the nine counties in the San Francisco Bay Area (the lone exception is Napa County), the coastal counties north of the Bay Area, as well as Santa Cruz County and Yolo County, home to UC Davis.

So far, no California counties are in the worst, “high,” community level. Getting to that point would require not only an elevated level of coronavirus transmission, but for hospitals to begin seeing significant impacts from COVID-19.

“To avoid moving to the high community level, which signifies very high transmission and stress on the healthcare system, residents, workers and businesses need to not shy away from reinstating or adhering to safety practices that are known to reduce transmission,” Ferrer told reporters Thursday. “This includes indoor masking, testing when people are sick, exposed or gathering, and staying up to date on vaccinations.”

As of Wednesday, the number of coronavirus-positive patients hospitalized countywide was 379. While still significantly lower than many other points in the pandemic, the census has jumped by 42% just in the last week.

Many of those patients aren’t necessarily hospitalized for COVID-19, though. Earlier this week, county Health Services Director Dr. Christina Ghaly said most of those who were are hospitalized with a positive coronavirus test within the county’s public hospital system were there for some other reason — such as a heart attack or stroke — and happened to incidentally test positive upon admission.

However, an increase in hospitalizations, Ferrer said, is “an important reminder that, for many, getting infected with COVID-19 does pose a serious risk. Our hope is that as more people take advantage of the protections that continue to be offered by vaccinations and boosters, the daily deaths will remain low.”

So far, COVID-19 deaths remain stable, at about seven a day countywide.

Moving into the CDC’s medium community level does not trigger any new countywide health measures. Reaching high, however, would bring the return of a universal public indoor mask mandate — the likes of which hasn’t been in place since early March.

Even though a face covering requirement hasn’t been on the books for more than two months, county health officials have consistently strongly recommended residents mask up indoors while in public as an extra layer of protection against coronavirus transmission.

One setting in which Angelenos are still required to wear face coverings is public transit, including buses and trains, or indoor transportation hubs, such as airports.

That requirement was formerly in place nationwide, but was voided by a federal judge in mid-April. Since then, aside from a few days after the court order, L.A. County has kept its own local requirement in place.

Ferrer had said the county order would be reassessed when community transmission falls back to the moderate level, when the CDC determines transit masking is no longer necessary, or in 30 days, whichever happened first. The first two criteria haven’t been met, but with the 30-day deadline just around the corner, she indicated it’s likely the requirement will remain in place for now.

“It would really be at this point, I think, foolhardy to not extend those protections,” she said. “We need to do everything we can to stay out of ‘high,’ I’m just going to be honest. Nobody here wants to see us move to any categorization that could possibly cause stress on our healthcare system or result in more people getting sick or dying. I think we all share that common goal.”

Assuming transmission remains at present levels, L.A. County would enter the high COVID-19 community level if it recorded 10 or more new coronavirus-positive hospital admissions weekly for every 100,000 residents. Despite recent increases, the county’s rate is still about one-third of that.

The county could also be assigned to the high category if at least 10% of its staffed inpatient beds were occupied by COVID-19 patients over a weeklong period. That share is presently much lower, at about 1.7%.

Officials have long noted that the pandemic has plotted a predictable, if painful, path — with increases in new infections triggering corresponding rises in hospitalizations a few weeks later, and in deaths a few weeks after that.

However, the typical connection between cases and hospitalizations has been more muted this time around. Though cases have been climbing steadily for weeks, hospitalizations have until just recently remained at some of the lowest levels ever recorded.

But unless the trendline reverses, officials say it’s likely just a mathematical reality that hospitals will have to care for more patients.

In L.A. County, officials have reported an average of nearly 3,400 new cases per day over the last week — a level not seen since mid-February, when the region was still on the downslope of last winter’s Omicron surge.

According to a Times data analysis, the county is now reporting 233 weekly cases for every 100,000 residents, high enough to clear the bar of 200 the CDC has set for the medium community level.

Test positivity remains low, but has been creeping upward. Over the last week, that metric has risen from 2.6% to 3.5% in L.A. County.

“The task in front of us is similar to work we’ve had to do at other points over the past 2½ years: Slowing transmission,” Ferrer said. “We know what works — masking, testing and vaccination, along with systems and policies that support the use of these and other effective safety measures.

“If each of us takes advantage of the good access we have to these effective resources, I’m hopeful that we can slow transmission again, prevent strain on our healthcare system and protect each other.”

Areas in the U.S. with a high COVID-19 community level include New York City; counties that are home to Detroit, Long Island, N.Y., Honolulu and Milwaukee; large swaths of New Jersey, Delaware and New England, including Boston; northern and eastern Pennsylvania; and all of Puerto Rico.

While they haven’t ordered a new mask mandate, officials in New York City warned that “pressure on the healthcare system is increasing” and urged seniors and others at high risk of severe COVID-19 to avoid gatherings and wear a mask in crowded outdoor settings.

It’s possible that New York City offers a preview for what L.A. County can expect, but it’s also true that “the East Coast took off their masks before we did, and seem to be doing a lot less masking than we’re seeing around here,” Ferrer said.

“We know that masks work. We’ve seen it over and over and over again. Our hope is that with the encouragement that we’re providing, the easy access to high-quality masks at work sites, that people will go back to putting those masks on while transmission is high,” Ferrer said.

Officials have said the the dramatic rise in coronavirus cases and hospitalizations in New York City is being fueled by BA.2.12.1, one of a family of Omicron subvariants spawned in the wake of last winter’s surge.

Last week, there was some hope that the circulation of other Omicron subvariants, like BA.2.3, were essentially capping the rise of BA.2.12.1 in L.A. County.

But data emerged this week that the latter is making up a growing share of L.A. County’s infections. As of the last week of April, it made up more than one-quarter of analyzed coronavirus cases.

It’s also becoming clear that it is possible for those infected over the winter to become infected again with a different Omicron subvariant. One high-profile recent example is Savannah Guthrie, the NBC “Today” show co-anchor, who tested positive for the coronavirus in January, and then again just before Mother’s Day.

“That’s the problem that we have with a virus that mutates both so easily and with a lot of capacity to actually look very different,” Ferrer said.

In the case of dramatic mutations, she said, the immune system “no longer recognizes that new strain as something that [it is] already familiar with, and that’s why we see reinfections.”

Ferrer said she is hopeful L.A. County can avoid hitting a high COVID-19 level if residents take steps to reduce risk, like wearing masks, getting up to date on vaccinations and boosters, testing when appropriate and gathering in well-ventilated areas, such as outdoors.

She is also offering recommendations that don’t go as far as those of New York City.

“We’re not suggesting that people avoid gatherings, but we are suggesting that people gather with a lot of safety layered in,” Ferrer said.

Tips include wearing masks in indoor settings and getting everyone tested right before gathering if older people or people with underlying health conditions are present — or if people attending have frequent contact with older or vulnerable people.

“Please don’t be shy about telling people you’d like them to test” before a gathering, Ferrer said.