COVID-19 Update: LA County Hits “Low” Risk Tier – Here’s What that Means (and Doesn’t)

In her weekly community address yesterday, LA County Public Health Director Barbara Ferrer shared the good news that as of yesterday, LA County has qualified for the CDC’s “Low” risk tier for the transmission of COVID-19, which means that many indoor masking rules become “strongly recommended” instead of required, and many businesses can choose whether or not to continue their masking rules for employees and/or customers, depending on their comfort levels and factors that most directly affect them.

That said, however – as per state and federal regulations – masks will still be required in indoor settings with high trasmission risks, such as schools (until March 12), as well as on public transit, in transit hubs (airports, etc.), health care settings, long term and adult/senior care facilities, corrections facilities, and homeless and emergency shelters.

But masks will now be just strongly recommended in other public settings and businesses…though employers are still required to at least offer medical grade masks and respirators to employees who work indoors and with other people.

Also, vaccination and negative test verifications will no longer be required at outdoor mega events, and vaccine verification is now recommended, and no longer required, inside bars, breweries, wineries, distilleries, nightclubs or lounges.  Vaccine verification is still required, however, in health care and congregate care facilities, and for entrance to indoor mega events.

While outlining the new rules, however, Ferrer was careful to explain that although we are now well into our post-winter surge period, with case rates almost but still not quite equal to those right before the most recent surge, it does not mean the pandemic is over, and we should not act like it is.  Ferrer said she also resists using the term “endemic” instead of “pandemic” now, as many people have suggested, because too many people interpret that to mean we can fully resume pre-pandemic behavior, which isn’t true.

“Being cautious [still] makes a lot of sense,” Ferrer said, noting that our current decisions and behavior will greatly influence the future spread of the disease, and COVID-19 is definitely still a deadly disease, still very much with us, and still not at all like a “common cold.”  So we do still need to encourage the use of our three best tools – masking, testing, and vaccinations – as much as possible, to prevent further spread or future surges.  “We don’t think of “endemic” as being “no more work left to do”,” Ferrer said.  “There’s still a lot of work” and “there’s a lot of things about “endemic” that are [still] super dangerous,” she said.

Where We Are Now

Ferrer explained that the new CDC guidelines, determining the three new risk levels for individual counties across the country, start with case rates per 100,000 people over the last seven days.  If a county’s average case rate is fewer than 200 cases per 100,000 people, AND it meets certain thresholds for two other factors – new hospital admissions for COVID per 100,00 people over the last seven days and the proportion of staffed inpatient hospital beds occupied by COVID-19 patients – those numbers will determine whether the county transmission risis are low, medium or high.

This week, as shown in the light green box in the chart below, LA County has a case rate of 111.4 per 100,000 people, only 7.4 COVID-19 hospital admissions per 100,000 people, and only 5.5% of hospital beds occupied by COVID-19 patients, all of which qualify us for the new “Low” risk tier.

Next Focus: Prevention and Monitoring

Now that we’ve moved into this lower risk tier, and we’re much less focused on dealing with an overabundance of new cases, Ferrer said the County will now focus on strategies – such as masking, testing, and vaccinations – to help prevent future outbreaks…and these strategies, too, will differ depending on whether we’re currently in a Low, Medium or High risk tier.

Right now, in the “Low,” tier and as noted above, masking will be required in K-12 schools until March 12, on public transit, and in health care and corrections facilities, and also for those who exit quarantine early via testing.  But  also as noted above, masking will still be strongly recommneded for all invididuals, vaccinated or not, in indoor spaces, and for those with higher risks, or for those who are gathering with people with higher risks of infection and complications from COVID.

Also, among other prevention strategies, testing will still be required for those wishing to exist quarantine after five days instead of 10…and for those who have been exposed to and/or have symptoms of COVID-19. And vaccination verification will still be required for entry into indoor mega events, and at health care and congregate care facilities…but are just strongly recommended for outdoor mega evennts and indoor areas at bars, nightclubs, etc.

In addition to these prevention strategies, LA County will also continue to monitor a variety of “early alert signals,” shown below, that may warn of surges to come.  (This week, only one of the indicators – new outbreaks in TK-12 schools – is in the “moderate” range; all others are currently of “Low Concern.”)

Health officials will also continue to monitor the different variants of COVID-19, to be aware, as soon as possible, of any new threats on the horizon.  At the moment, Ferrer said, 100% of our cases seem to be some version of the Omicron variant, and there are no new variants being reported.  There are different versions of Omicron, however, and the BA.2 variant, which is 30% more transmissible than the current BA.1, is starting to make inroads, though its severity seems to be about the same as that of BA.1.

During the new post-surge period, Ferrer said the County will work to maximize its preparedness by focuing on managing current and new outbreaks, keeping testing available for those who need it, making sure new therapeutic drugs are available, distributed and used as equitably as possible across the County, continuing to focus on getting as many people as possible vaccinated, and sequencing as many virus specimens as possible, to accurately monitor virus variants.

And in all of these areas, Ferrer said, there will be a focus on equity, to try to address disparities between advantaged and disadvantaged communities in all of these metrics.  The goal will be to protect everyone, and to maintain our current “Low” transmission risk for everyone, as we move forward past our winter surge.

Finally, Ferrer said she doesn’t foresee us returning to masking requirements at this point, but if we do see any early signals of greater resurgences, then “everything is on the table” again to meet whatever new challenges may arise.