On Thursday, May 5, LA County announced 3,003 new cases of COVID-19, which was up sharply from just a day earlier, when LA County Director of Public Health Barbara Ferrer, in her weekly address, announced 2,484Â new cases of COVID-19.
The increase was not unexpected, however, since, as Ferrer also pointed out on Wednesday that the 7-day average of new cases in LA County has risen more than 200% in the last month and has not yet leveled off. But while that’s a big number and “you have to take notice,” Ferrer also pointed out that while hospitalizations and deaths have also started to rise in other parts of the country, they’ve so far remained fairly stable here. So she characterized the current increases as slow and steady, rather than the kind of spike or surge we saw over the winter, when the upward trend was much sharper.
Also on the positive side, Ferrer reported that our CDC-defined “community levels” also remain low this week, which means that our health care system is not currently being strained, even with the continuing rise in new COVID-19 cases.
Among early indicators of possible problems, however, Ferrer noted that 96% of our cases are now caused by the BA.2 variant of Omicron, which is identified by the World Health Organization as a “variant of concern.” Also, outbreaks in both schools and workplaces this week were elevated to a level of “medium concern,” prompting Ferrer to urge renewed cautions for common-sense protective measures in those locations.
Addressing the first of these issues – our current variants – Ferrer reported that while 96% of our current cases have been identified as the BA.2 Omicron variant, the BA.2.12.1 variant, which may be 25% more transmissible than BA.2 (which was itself 25-30% more transmissible than the original Omicron variant) is taking off quickly – currently representing 8% of local cases, and 39% of cases nationally. And there are now also several more BA variants (including 4 and 5) currently being monitored in South Africa.
But while case numbers are rising steadily based on reported test results, Ferrer reported that wastewater monitoring in both LA County and the city of Los Angeles, which provides a “fair amount of certainty” even when test data may not capture all local cases, does not yet ring any alarm bells. In fact, she said, COVID-19 levels in wastewater from both systems continue to run at about the same average level as two weeks ago, and have not risen to anywhere near twice that average, which would be the major level of concern for the County Health Department.
Where concern is rising, however, are schools and workplaces, where Ferrer reported an increased number of case clusters this week.
As shown in the graph below, Ferrer said there were 108 new workplace clusters this week (largely in various kinds of retail settings), which although nowhere near the levels from this past winter, does rise to a level of “medium” concern and has prompted the health department to increase its outreach and education efforts in workplace settings.
To help manage these increases and reduce the risk of transmission in workplaces, Ferrer strongly recommended indoor masking for all workers, requiring symptomatic workers to isolate and get tested, encouraging physical distancing in communal areas, continuing to inform workers about areas of high risk, and making sure to report any incidents of three or more cases within a 14-day period.
Meanwhile, there were 13 new clusters of cases reported in TK-12th grade schools this week, also rising to the level of “medium” concern, and mostly associated with seasonal events like proms and field trips.
The good news, however, is that school testing volume is still high, and although test positivity also rose a bit at schools this week, it’s still significantly lower than the general rate in the community.
Ferrer also noted, however, that the rising case numbers among both students and staff are not surprising, given the fact that indoor mask requirements for schools were lifted on March 12 (the low point on the curve in the graph below), which was likely a big factor in cases quadrupling during the four weeks between March 27 and April 24. And she said she expects to see further increases as seasonal and end-of-school-year events increase over the next few weeks, providing even more opportunities for exposure.
To help reduce risks of further outbreaks in schools, Ferrer strongly recommended indoor masking for staff and students, and requiring masks for staff and students who have been exposed to the virus. She also urged testing of those who have been exposed or are experiencing symptoms, and weekly testing for those who are not fully vaccinated. (Note: LAUSD schools still require weekly testing for all students and staff.)
At the same time, however, Ferrer said she does not think extracurricular activities should be curtailed. In fact, she said, “I think we can do this with lots of safety.” She did however, suggest that some modifications might be in order, such as moving proms from indoor to outdoor locations, requiring attendees to be tested before attending large events, and keeping masks on as much as possible during those events.
“You don’t want to wreck a good time by getting sick, or getting somebody else sick later on,” she said. “We want everyone to enjoy those extracurricular activities, but enjoy them with some additional safety precautions in mind.”
Finally, given the current rise in cases and the increasing number of new variants, Ferrer noted that “we will continue to see these increases in cases unless people are willing to be more careful than they are at the moment.” Cautioning that we need to adapt to this reality to avoid more steep increases, she once again provided a much more general recommendation for residents to wear masks when in close contact with others in indoor spaces (“that’s just common sense” because if you’re in a room with 200 people, odds are that at least a couple of them are infected), get vaccinated or boosted if you haven’t done so yet (especially because vaccine effectiveness has so far held up through at least five major variants), stay home and get tested if you’re experiencing symptoms, and talk to your doctor about therapeutic drugs if you have symptoms and risk factors for more severe illness, and/or if you live with someone who has increased risk factors.
In conclusion, Ferrer said she has “no crystal ball answers” for what will happen next, except to be as prepared as possible. But she said she doesn’t foresee the need for more severe mandates now or in the near future, unless or until there are serious threats to our health care system, in which case we’ll have to use “all tools available” to help get the situation under control again.
