COVID-19 cases are still trending down this week, though hospitalizations have plateaued, and there are two new variants of interest, reported LA County Public Health Director Barbara Ferrer in her weekly address yesterday. But there was slightly better news about monkeypox, which is also continuing its downward trends.
COVID-19
Ferrer reported that the daily average number of new COVID-19 cases in LA County this week was down another 8%, to 1,185 cases per day, which keeps us firmly in the “low” community tier, as defined by the CDC, for the sixth straight week.  Less good news, though, was that the County did have one pediatric death from COVID-19 this week, the 14th death of a child since the start of the pandemic. And that provides a good reminder, Ferrer said, that although older adults and those who are immunocompromised are usually at the greatest risk for COVID-19 complications, the virus can still be dangerous for some younger people, too.
Ferrer also reported that while 100% of local COVID-19 cases are still due to the Omicron variant, there are several new sub-variants – BA.4.6, BA.2.75, and BF.7, that are now showing slight increases. Ferrer stressed that these all represent very small portions of the overall number of local COVID-19 cases, but officials are watching them closely because they are currently spreading faster in Europe and Asia, and may be resistent to current COVID-19 treatments.
“The new variants appear to have mutations that could help them spread easily,” Ferrer said. But so far they do not seem to be crowding out the currently dominant BA.5, and because they are all sub-lineages of the current BA.5 strain, this fall’s new bivalent booster (which specifically targets BA.4.5 and BA.5 subvariants) seems “well matched” to also provide protection against the newcomers.
Ferrer spent part of her presentation this week providing updated information on COVID-19 complications, including what is now known about “Long COVID” – symptoms that persist for a month or more after an initial infection.
First of all, referring back to this week’s death of an LA County child, Ferrer said that one of the biggest risks to children is the development of Multisystem Imflammatory Syndrome in Children (MIS-C) after a COVID-19 infection. MIS-C is “is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs,” according to the CDC, and while most children do recover, the condition can be serious, or even deadly. 319 children in LA County so far have been diagnosed with MIS-C after a COVID-19 infection.
In adults, Long COVID symptoms can include fatigue, reduced exercise capacity, breathing problems, brain fog, loss of taste and/or smell, and more…lasting for weeks or months after a COVID-19 infection. According to Ferrer, about 5-40% of adults who get COVID-19 (depending on the population studied) experience some symptoms of Long COVID.
Ferrer also reported that, according to recent studies, the risk for Long COVID increases if a person has had multiple COVID-19 infections. Also, people who have had COVID-19 may have a 42% higher risk of neurological disorders after their infections, including stroske, cognitive problems, migraines, seizures, and more.
And, finally, new studies also show that multiple cases of COVID do not mean less severe infections. In fact, Ferrer reported, those reinfected with COVID after having had it before are twice as likely to die from a new infection, three times more likely to need hospital care, and 2.5 times more likely to develop other specific complications.
The good news, Ferrer said, is that we also now know that COVID-19 vaccines help to reduce the risks for Long COVID, and that boosters increase this protection. For example, in a study of Italian health care workers, those who had two doses of COVID-19 vaccine were 75% less apt to develop Long COVID after a COVID-19 infection, and those who had three doses were 84% less likely to develop Long COVID.
Local numbers also continue to show the “undisputed” benefits of vaccinations, Ferrer said. In fact, those who who have had two doses of vaccine are 4.1 times less likey to die from COVID-19 than those who are unvaccinated…and those who have had three doses of vaccine are 6.7 times less likely to die than those who are unvaccinated. (So boosters definitely make a difference, too.)
Ferrer strongly urged those who have not yet received a new bivalent booster shot this fall to get one soon. Although some people are getting tired of more and more boosters, she said, the shots remain important because immunity wanes over time, and as the viruses evolve, too, our new vaccines more specifically target current variants. This fall’s boosters particularly target the Omicron BA.4 and BA.5 variants (and all their subvariants), just as our current annual flu shots target four different strains of influenza – so they will likely be highly effective, especially as new BA.4 and BA.5 subvarients move in.
As previously reported, Ferrer noted that anyone age 12 and up who has not been vaccinated or boosted for at least two months, is eligible to receive the new bivalent fall booster. And shots for children ages 5-11 may be available as soon as October 19.
The less good news in all of this, however, Ferrer reported, is that although more than seven million Angelenos are currently eligible for the new boosters, only about 355,000 have so far received them. “The low numbers are a cause for concern,” Ferrer said, especially as the weather cools down and people are more likely to move activities indoors, where people are packed together more closely and thus more likely to transmit the virus.
Finally, Ferrer also reminded people that LA County does still offer transportation to vaccination sites, and even in-home vaccinations, for people who need them. For more information, call the LA County vaccine hotline at (833) 540-0473.
Monkeypox
As with the COVID-19 report, this week’s update on monkeypox, from LA County Chief Medical Officer Rita Singhal, was mostly good news. One sad note was a report of the second U.S. death from monkeypox, in Ohio, but otherwise, including locally (as shown below), reports of new monkeypox cases, which have been declining since late August, are still trending down.
Singhal attributed the continuing decline to new vaccinations, changes in behavior among those most likely to be infected, and widening immunity in those who have already been infected. Singhal said all of those factors began kicking in around the same time in August, and since then have combined to help prevent wider spread of the disease.
Although LA County is now experiencing only about nine new monkeypox cases per day, however, Singhal said we can’t let our guard down too much. Los Angeles is an international hub, she said, so new people continue to arrive here every day, from all around the globe, and there are many places where infection rates are still higher than ours, so our situation will always be changing.
Singhal said the good news, though, is that LA County continues to request its maximum share of available vaccines, and doses are now widely available to those who are eligible.
For more information on monkeypox, or getting vaccinated, contact the Department of Public Health at ph.lacounty.gov/Monkeypox or (833) 540-0473.
