Coronavirus Today: The CDC’s new ‘in’ crowd

Good evening. I’m Thuc Nhi Nguyen, and it’s Wednesday, April 28. Here’s what’s happening with the coronavirus in California and beyond.

The pandemic has revealed many instances of haves and have-nots. Some people have benefited from years of good access to healthcare while others have not. Some people have had the luxury of staying at home to avoid the coronavirus while others have had to put their lives at risk to make a living.

The Centers for Disease Control and Prevention is drawing another line in the sand between disparate groups, but this time there’s an easy way to make the jump: Get vaccinated.

The CDC’s newly revised mask guidelines divide people based on whether they’ve received a COVID-19 vaccine, my colleagues Amina Khan and Karen Kaplan report. The move shifts its messaging away from the negative ramifications of skipping the shot to the positive outcomes of rolling up your sleeve.

Officials hope the new emphasis will help persuade hesitant Americans to make the jump to the vaccinated kids’ table (where they won’t need to wear a mask).

“If you are fully vaccinated, things are much safer for you than those who are not yet fully vaccinated,” Dr. Rochelle Walensky, director of the CDC, said when she explained the agency’s new advice. “This guidance will help you, your family, and your neighbors make decisions based on the latest science and allow you to safely get back to things you love to do.”

The guidance allows fully vaccinated people — those who are at least two weeks removed from the final dose of their full vaccine regimen — to go without masks in most outdoor settings, including while dining outdoors at a restaurant. The same act would be considered risky for unvaccinated people, even while wearing a mask.

Likewise, eating and drinking indoors is safe for vaccinated people who wear masks, but not for unvaccinated people no matter how many precautions they take.

The CDC used to discourage everyone from heading inside for a spin class, a pilates workout or a date with a treadmill. Now it says high-intensity exercise is safe for vaccinated people who wear masks but still unsafe for those who lack the protection of the shots.

Drive-in movies and DIY backyard theaters used to be preferred across the board. As of Tuesday, vaccinated people alone have the CDC’s blessing to return to movie theaters with masks.

Vaccinated people with masks are also cleared for indoor worship services — and can even sing in a choir. Without the vaccine, neither activity is considered safe.

Offering a little reward by loosening restrictions “can serve as a motivating factor to get vaccinated for those still on the fence,” said Dr. Monica Gandhi, an infectious disease specialist at UC San Francisco.

There’s good reason for the CDC to make the vaccines seem more enticing. Although more than 54% of all U.S. adults have now received at least one shot of COVID-19 vaccine and more than 37% are fully vaccinated, vaccination rates have slowed in recent weeks. According to CDC data, the seven-day moving average of daily vaccinations peaked well above 3 million per day on April 11, but dropped to just above 2.5 million last week.

By the numbers

California cases, deaths and vaccinations as of 4:29 p.m.:

Track California’s coronavirus spread and vaccination efforts — including the latest numbers and how they break down — with our graphics.

(Thuc Nhi Nguyen)

Across California

With worrisome coronavirus variants threatening to drag out the pandemic, officials are looking for any way to help persuade people to get vaccinated. In some L.A. County jails, that means dangling the prospect of an easier transfer into the state prison system.

“Who do you think they’ll take first from here — those who’ve been vaccinated or those who haven’t?” asked sheriff’s Lt. Dwight Miley as he made a pitch to detainees. “Common sense says they’ll choose those who’ve been vaccinated.”

Many people who have been convicted and sentenced to long terms in state prison are eager to get there — they can have visitors and take courses that may shave time off their sentences, among other advantages. But a completed vaccination card might not actually help. Decisions on sending prisoners from county jail to state prison are based more on legal factors than vaccination status, said Vanessa Nelson-Sloane, director and founder of Life Support Alliance, an advocacy group for people serving life prison terms.

Still, with overcrowding rampant in jails and prisons, getting incarcerated people vaccinated is a priority for their own immediate health, and adding the possible perk of a quicker move has been a convincing argument at Men’s Central recently.

Arturo Mendoza, 42, sentenced to six years in prison for illegal firearms possession, said he got the injection to avoid getting sick, but added: “I prefer to be upstate because the living is better.”

So far, just over 4,000 people in L.A. County jails have been fully vaccinated, said Dr. Sean Henderson, chief medical officer of L.A. County’s Correctional Health Services. That’s about 26% of the jail system’s average daily population. In the California state prison system, 60% of incarcerated people are fully vaccinated.

In other infection-prevention news, L.A. County officials announced they will heed the CDC’S relaxed advice regarding masks, calling the changes “appropriate and science-based.”

The county will adjust its health orders to align with the new federal guidance, but added that more than half of L.A. County residents aren’t fully vaccinated yet. That means it’s far too soon to be throwing our masks to the wind.

“Because COVID-19 can still easily spread, unvaccinated people, who remain at highest risk of becoming infected, need to continue wearing masks in all settings where they are around people not in their household,” the county Department of Public Health said in a statement.

The guidelines stipulate that even fully vaccinated people should wear masks outdoors in crowded areas. With Disneyland reopening, many could find themselves in such a situation — since even a galaxy far, far away can’t escape the coronavirus.

Disneyland officials had to revamp parts of the popular Star Wars: Rise of the Resistance ride to fit pandemic protocols for the park’s reopening Friday. It’s only the start of many changes waiting for fans upon their return to “the happiest place on earth,” my colleague Hugo Martín reports. (Stay tuned this week for more on Disneyland’s return.)

The Rise of the Resistance ride will be shortened to fit into the 15-minute time limit for indoor rides. Usually, the space adventure that lets riders join the resistance and fight against the evil First Order lasts for 18 minutes.

The bane of every amusement park patron — lines — will look much different as well. The Star Wars ride regularly demanded waits of well over an hour. Fans snaked through meticulously decorated indoor hallways with video screens and props that enhanced the ride’s plot while trying to make the long wait bearable.

Now lines must be outdoors. To prevent crowding, Disneyland is allowing visitors to join the line through the park’s app twice a day (at 7 a.m. and at noon) instead of just once.

For those who have waited more than a year to return to Disneyland, the changes are welcome as long as the ride’s story remains intact.

“If it’s a case of just improving operations so there’s less standing around, that’s a win in my book,” said Hastin Zylstra, a theme park fan from Santa Ana.

See the latest on California’s coronavirus closures and reopenings, and the metrics that inform them, with our tracker.

Around the nation and the world

In the United States, we’re starting to see the light at the end of this COVID-19 pandemic tunnel. But doctors are worried that another health crisis is just beginning.

A study in Nature found high rates of opioid use among people at Veterans Health Administration facilities living with long COVID, the syndrome that affects about 10% of people who have recovered from a coronavirus infection. Previous studies have shown people can experience persistent health problems after recovering from COVID-19, but this is the first to show those patients are also using more addictive medications, said Dr. Ziyad Al-Aly, the lead author.

Doctors are supposed to shy away from prescribing opioids because of the potential for addiction, Al-Aly said. Yet for every 1,000 long COVID patients who were treated at a Veterans Affairs facility, doctors wrote nine more prescriptions for opioids than they otherwise would have. They also wrote 22 additional prescriptions for benzodiazepines, which include Xanax and other addictive pills used to treat anxiety.

Doctors need to act before “it’s too late to do something,” Al-Aly said. “We do not want this to balloon into a suicide crisis or another opioid epidemic.”

While some parts of life in the U.S. may be returning to normal, India’s current crisis should be a cautionary tale for declaring premature victory against the coronavirus.

A trail of death and misery is devastating the country after its ruling Bharatiya Janata Party claimed COVID-19 had been “defeated” earlier this year, my colleagues David Pierson and Parth M.N. report.

Furnaces used to cremate bodies are starting to melt because they’ve been burning for so long. Firewood used for funeral pyres is rationed. Rakesh Srivastava, who lost his 45-year-old wife to COVID-19, said he waited in line for five hours to cremate her body.

The explosion of new cases could be fueled by a so-called double mutant coronavirus variant first discovered in India. One of the mutations is part of a highly infectious variant prevalent in California, and the other is closely related to a mutation first found in South Africa that may make the virus resistant to vaccines.

Experts are still trying to pinpoint how variants have impacted the outbreak. What they do know is that the aggressive variant is now overwhelming a healthcare system that is “is broken even during normal times,” said Ruben Mascarenhas, a social activist in Mumbai.

The situation is taking a toll on India’s healthcare workers, many of whom are postgraduate medical students. The young doctors make up the majority of frontline workers at government hospitals that are adding beds but not doctors. At Sassoon Hospital, a state-run facility in Pune, administrators increased the number of COVID-19 beds from 525 to 700 this month but hired only 11 new physicians.

“Increased beds without manpower are just beds. It’s a smokescreen,” said a medical student at the hospital.

To make things harder on the students, some senior physicians are refusing to treat COVID-19 patients.

“We’re cannon fodder, that’s all,” another student said.

Your questions answered

Today’s question comes from readers who want to know: What will change when L.A. County moves to the yellow tier?

At the risk of jinxing things, this question may be on your mind after the county posted numbers yesterday that were good enough to qualify for the least-restrictive tier of California’s four-stage re-opening plan. If the adjusted case rate holds for another week, we’ll make the move.

Even in the yellow tier, there are still some limits on how indoor businesses can operate. My colleagues Rong-Gong Lin II and Luke Money give you the full breakdown.

Some of the changes include:

• Gyms and yoga and dance studios can increase indoor capacity from 25% to 50%. For gyms, the limit can increase to 75% if all guests show proof of full vaccination or a negative coronavirus test.
• Saunas and steam rooms are allowed to reopen at 50% capacity. In the orange tier, they must remain closed.
• Restaurants can have more than 200 people, but still can’t go over 50% of capacity.
• Bars that don’t serve food can reopen indoors with a maximum of 25% of capacity or 100 people, whichever is fewer. If everyone is fully vaccinated or provides a negative coronavirus test, the limit can increase to 37.5%.
• Museums, zoos and aquariums will still have some modifications indoors, but they won’t need to stick to the orange tier’s limit of 50% capacity.
• With baseball and MLS picking up, crowds for Dodger, Galaxy and LAFC games can expand to 67% of a stadium’s capacity. Outdoor seated live events are capped at 33% in the orange tier.
• If you’re eyeing a seat at an NBA or NHL game, indoor venues like Staples Center that can hold more than 1,500 people can reach 10% of capacity or 2,000 guests, whichever is fewer. But if everyone has a negative test or proof of full vaccination, that limit can rise to 50%. For smaller indoor venues, attendance can go up to 25% of capacity or 300 people, whichever is fewer, or up to 50% if everyone shows a negative test or proof of full vaccination.

If things continue to progress well, we could be ditching the tier framework soon. California hopes to fully reopen the economy by June 15 as long as COVID-19 vaccine supply is stable and hospitalizations remain low. Some rules may still apply, though — for instance, testing or vaccine verification could be required to attend certain indoor events.

We want to hear from you. Email us your coronavirus questions, and we’ll do our best to answer them. Wondering if your question’s already been answered? Check out our archive here.