Public Health Update: Back to Medium Tier for COVID-19; Monkeypox Vax Criteria Removed

In a brief pre-holiday public health update this week, LA County Public Health Director Barbara Ferrer reported that COVID-19 cases (though still underreported) continued to trend down this week with a “welcome decrease” of about 12 percent from last week.  Hospitalizations were also down slightly, she said, though there was a “troubling increase” in COVID-19 deaths, more than 74% of which occurred in people age 70 or older.

But while most of this is good news, Ferrer also reported that flu and RSV infections, while similarly trending downward at the moment, still remain abnormally high for this point in the season, with fewer hospital beds available than at any time in the last four years.  And that reminds us, she said, that “COVID-19 has not evolved into a benign virus,” and it’s still important for people to use common sense protections during their holiday activities this week.  This includes wearing masks in crowded indoor spaces, getting vaccinated or boosted if you haven’t done so already, testing before and after gatherings, and staying home if you’re sick.

On the positive side again, however, this week’s decreasing cases did move LA County back down from the “high” to the “medium” community risk tier, as defined by the CDC, though Ferrer also said she expects that we will continue to move back and forth between medium and high over the next few weeks after the December holiday season.  “There is a very real possibility,” she said, “that transmission will increase again after the holiday.”

Finally, Ferrer reported that the BQ.1 and BQ.1.1 variants remain the dominant strains of the COVID-19 virus in LA County, accounting for about 60% of all current cases. The BA.5 variant, which dominated for most of 2022, now accounts for only about 20% of local cases…and the newer XBB variant was responsible for about 6% of local cases during the week of December 10, and may be up to about 8% now.

Monkeypox

For the first time in several weeks, yesterday’s health update also included an update on monkeypox. Dr. Andrea Kim, LA County Director of Vaccine Preventable Disease Control, reported that new “mpox” cases in LA County are now averaging less than one per day, with some days having no new cases.

Kim also announced that eligibility requirements for the monkeypox vaccine have been removed, so shots are now available to anyone who wants them, with no disclosure of personal risk information.  So far, Kim said, more than 74,000 LA County residents have received at least one dose of the two-dose vaccine, and about half of those have also received their second shots.

Finally, Kim noted that certain groups of people are still at high risk for infection, and should definitely still get vaccinated if they haven’t already done so.  These groups include:

• Any man or transgender person who has sex with men or transgender persons
• Persons of any gender or sexual orientation who engage in commercial sex work
• Persons living with HIV
• Persons who had skin-to-skin or intimate contact with persons with suspected or confirmed mpox
• Sexual partners of people in any of the above groups
• People who anticipate being in any of the above groups