“Here in LA County, I feel very comfortable saying we’re in a new phase. Very comfortable.”
– LA County Public Health Director Barbara Ferrer
After several weeks of mostly falling COVID-19 case rates and an expected winter surge that never materialized, it’s starting to feel that a tide is turning in the three-year-old pandemic, said LA County Public Health Director in a mostly-forward looking weekly update on Thursday.  Of course, COVID-19 is still with us, and Ferrer did provide the usual current statistics, but also it looks like officials’ attention is turning increasingly to things like the upcoming ends of federal and state emergency health orders, and FDA discussions of potential new annual vaccination schedules for COVID.
Looking at current numbers over the past week, Ferrer reported that COVID-19 cases and hospitalizations were mostly stable, rising just slightly, but not enough to indicate new trends. And deaths, which have remained stubbornly around 20 per day for the last few months, finally fell to about 15 per day, a welcome decrease.
Also, wastewater sampling (which doesn’t depend on reported test results) showed the same pattern – a slight increase this week, but still small enough to be relatively stable in the larger scheme of things.
Looking at the currently circulating variants of COVID-19, Ferrer said XBB.1.5 (orange bar near the top of the graph below) is the one to watch at the moment. Its share of current cases both locally and nationally has been doubling every week for the last couple of weeks, so it will likely be our dominant strain very soon. Also, another new variant, CH.1.1 (light blue at the top of the graph), which the CDC has only recently begun tracking, is now at just 2% of the total, but has the same mutation as last year’s widespread Delta variant, which could make it worthy of attention…though Ferrer said its increase has been comparatively slow since it was first identified in December.
One sector in which LA County continues to see relatively large new numbers of outbreaks, however, is K-12 schools. But Ferrer said this is fairly normal after returning from the long winter break, and has been seen after other holiday breaks, too, such as Thanksgiving in November. To help minimize this trend, Ferrer urged parents to keep students home when sick, and to have them wear masks at school if they’ve been exposed to the virus, or if the family has been traveling recently.
More good news that continued this week is that the new bivalent boosters, introduced this past fall, are still proving to be very effective against severe illness that can lead to hospitalizations and deaths from COVID-19. For the 30-day period ending January 10 (the most recent numbers available), Ferrer reported that people who received the latest bivalent boosters are almost seven times less likely to be hospitalized with COVID-19 than those who are unvaccinated…and almost eight times less likely to die from COVID-19. Also, those who received previous vaccines but not the bivalent boosters are still about three times less likely to be hospitalized with COVID-19, and four times less likely to die than the unvaccinated.
But Ferrer also acknowledged that the many COVID-19 boosters that have been introduced over the last three years have definitely created some confusion about who should receive which shots and when. And this confusion, she said, is why the FDA met this week to discuss the possibility of introducing a single yearly, or twice-yearly vaccine. Ferrer said, however, that while the FDA did generally endorse the idea, discussions are still ongoing (and the virus is constantly changing, which makes it trickier to develop annual vaccines for COVID than the flu virus), so no policy decisions have been made yet.
If a simplified vaccine schedule is finally instituted, however, Ferrer said it would likely look something like this for people ages 12 and up:
And children would likely be vaccinated according to this schedule:
Ferrer said that if the FDA does institute the yearly vaccine schedule, LA County will be prepared for the change, and will focus on making sure the annual vaccines are distributed equitably, safely, and rapidly to all residents, including those in underserved areas, and those who are homebound.
Some of this may become a bit more challenging, however, said Ferrer, because both state and federal-level emergency orders relating to COVID-19 are scheduled to end soon (the state order at the end of this month, and several federal orders in May). And that means the federal government will no longer provide COVID-19 vaccinations, tests, and treatments for free, so affordability will depend on whether an individual is insured, and what kind of insurance they have. (Medicare and Medicaid will likely still be able to provide free or low cost vaccines, tests and treatments for people who participate in those programs, Ferrer said. But costs for the uninsured, or those insured through private companies, could vary widely.)
Ferrer also explained, however, that the LA County emergency declaration does not automatically expire when the state or federal orders expire, and that LA County is always free to set its own policies, based on local needs, which may be stricter than those implemented by the state or federal government. So she said the LA County Supervisors, who set county policy, are now beginning to discuss whether or not to continue local protections such as the current eviction moratorium, and whether or not certain protective measures instituted during the emergency period over the last three years should be continued into the upcoming “non-emergency times.” (Ferrer also noted that LA County is required to review its own emergency declaration every 30 days, so the health department has ongoing discussions with the Board of Supervisors to provide updates on our local conditions each month. She also said that the department is not “lobbying” one way or another on the question of whether or not to continue the declaration, but is helping the the supervisors look at protections that might disappear after the state and federal orders expire, and how the county might continue some of those protections if they’re still deemed necessary.)
“It’s a great relief to see that LA County remains in the low community level, and my hope is that we’re entering a new phase, with less devastation, less sever illness, and particularly, less death,” said Ferrer near the end of her remarks on Thursday. “It’s important to acknowledge that the changes we’re seeing are a testament to the way residents have adapted, learned and continue to use the new tools and common sense protections when warranted. Over the next few months, as emergency orders lift and new proposals are put into play, there will be a lot of information circulating. Let’s not let go of what we have learned so far, so that we can continue to take advantage of the protections that are available, including the bivalent boosters, therapeutics, and our county resources. And, most of all, because COVID-19 will continue to impact people long after it’s left the spotlight, let’s continue to care for each other.”
Finally, in answer to the question of whether the pandemic is over and we can now safely refer to COVID-19 as “endemic,” Ferrer explained that a “pandemic” is an official worldwide declaration made by the World Health Organization, which has not yet declared an end to the global COVID-19 pandemic. Also, she reminded residents that even if there is no emergency declaration, the virus is still here, and “we will have people who will continue to have unfavorable outcomes if they don’t continue to have access vaccines, protections and therapeutics.” But she also said things are looking good locally right now, and “Here in LA County, I feel very comfortable saying we’re in a new phase. Very comfortable.”
