COVID-19 Update: Cases Increasing Again after Memorial Day Reporting Delay

We’re a bit late catching up with last week’s COVID-19 numbers, presented by LA County Public Health Director Barbara Ferrer in her weekly address last Thursday, June 9, but since cases are still rising pretty quickly, it’s definitely worth a brief update.  First and foremost, after a bit of a lull in the previous week, which Ferrer attributed to a lag in reporting over the Memorial Day holiday weekend, cases resumed their increasing trend last week, up 13% from the previous week and 193% over the last four weeks.  Ferrer also noted, as she has been doing for the last few weeks, that these numbers represent a significant undercount, due to the number of people who are now testing at home and not reporting their results.  The actual numbers, she said, may be at least three times those officially reported.

Also, according to Ferrer’s report, the trend lines for both new cases and hospitalizations rose significantly over the last week, while deaths remained pretty stable.

While new cases did rise, however, LA County still remains in the CDC-defined “Medium” community level, which means that while it’s possible our health care system could soon become stressed by the latest wave of cases, we’re not at that point yet.  A move up into the “High” community level, at which our hospitals are being stressed, and which could be on the horizon if the current upward trends continue, would bring a return to indoor mask mandates for most public spaces. But that won’t happen, Ferrer confirmed, as long as we remain at the “Medium” level (or unless a new variant emerges that escapes the protections of our current vaccines.)

Given the current trends, Ferrer said, the LA County Department of Public Health estimates we could reach the “High” community level by the first week in July, if we don’t find a way to slow the current rate of transmission.  This is about a week later than previous predictions, though, because the rate of hospital admissions did slow a bit last week.  But Ferrer noted that the predicted timeline could change again if the transmission rate shifts again, either up or down.  Also, Ferrer said, while we are on a trajectory to hit the “high” community level again, “we’re not there yet, and we don’t have to get there,” if we take careful precautions, such as wearing masks as much as possible and moving events outdoors whenever possible.

Over the last week, Ferrer said, most of the early alert signals being tracked by the County remained at the “Medium” or “High” level of concern.  The one exception was the number of sewer systems with a two-fold or greater increase in virus concentration, which was zero this week.  Of high concern, however, were the case rates in the parts of the county with the lowest incomes (which are usually hit first with new waves of infection, and can be a harbinger of things to come for other areas), and the number of new outbreaks (40 this week) in skilled nursing facilities, another early indicator of possible trouble to come in other areas.

As noted above, new waves of COVID-19 tend to hit first and hardest in low income communities, and watching trend lines in these areas can help predict what may lie ahead for the rest of the county. And this week, after a brief dip over the Memorial Day weekend, numbers in the county’s poorest neighborhoods did rise quickly again.

Numbers were also up sharply at skilled nursing facilities, another location that often predicts trends in other kinds of environments.  At the same time, however, outbreaks in settings that serve homeless individuals were fairly low over the past week.

As for which variation of the bug is most prevalent this week, Ferrer reported that we’re still at 100% Omicron and its sub-lineages, with about 98% of cases sequenced identified as some version of the BA.2 strain of Omicron.  Because the virus’s mutations are unpredictable, however, Ferrer reminded people that it’s important to take measures that protect against all variants, which again includes things like wearing masks,  holding events outdoors as much as possible, maintaining good ventilation, and staying home when sick.

Ferrer also reported continued increases in new workplace outbreaks, which are now approaching “high” levels.  23% of the new workplace clusters were in retail settings, with both manufacturing and the science/technology sectors reporting outbreaks as well…which prompted Ferrer to encourage employers to help maintain a “culture of safety” for workers.

As schools wound down for the year, however, outbreaks in classrooms remained at the “medium” level last week, with 11 new classroom outbreaks, and 15 outbreaks associated with school-related events of various kinds.

Most of these outbreaks were among students, with staff outbreaks relatively steady, or even a bit lower over the last week.

Ferrer cautioned, however, that just because COVID-19 cases among children have not been as widespread or serious, generally, as they have been in adults, children are still vulnerable.  “Make no mistake,” she said, “COVID is a concerning childhood illness,” with 1,500 children killed by COVID-19 in the U.S. and 11 in LA County since the start of the pandemic. (While only one child in LA County died from influenza during the same period.)  Also, Ferrer said, one in three children hospitalized with COVID-19 ends up in intensive care, and there are risks of Multisystem Inflammatory Syndrome in Children (MIS-C), which can cause serious inflammation of various body parts and organs.  Ferrer also said a new nation-wide study ranks COVID-19 as the #9 cause of death overall among children since 2020, and the #1 cause of death from respiratory illnesses.

As we’re now moving from the end of the school year into summer camp season, Ferrer also offered advice for maintaining COVID-19 safety at summer camps, and urged parents to make sure the camps they choose have appropriate COVID-19 protocols in place.

Ferrer also reminded parents to make sure their kids’ vaccinations are up to date before sending children to camp, not to send kids to camp if they’re not feeling well, and to make sure the camp reports ALL cases of COVID-19 to the County Health Department, if either students or staff get sick.

Finally, speaking of vaccines, Ferrer reported that the FDA has recommended use of the Novavax vaccine in adults 18 and older under the Emergency Use Authorization.  This vaccine uses a more traditional recombinant technology (the same method used in the Hepatitis B vaccine), and does not have such stringent temperature control requirements as the Pfizer and Moderna MRNA vaccines.  Also this week, Ferrer said, the FDA and CDC will be reviewing the use of Pfizer and Moderna vaccines for children under the ages of five or six, and vaccines for that age group could be available as soon as June 21.  Ferrer recommended checking the VaccinateLACounty.com website for updates, and – soon – a map of locations where those vaccines for young children will be available.

In summary, Ferrer said we are beginning the summer season with “a lot of uncertainty about the trajectories and severity of Omicron,” but she said she is also hopeful that the situation will be more manageable than the last couple of summers because we now have more knowledge and more tools to protect ourselves and those who are most vulnerable, so people can feel more comfortable doing most of their normal summer activities…as long as they take appropriate cautions and do them safely.