COVID-19 Update: Delta, Delta, Delta

The COVID-19 news this week is mostly the tale of the Delta variant of the virus and how it’s fueling the current surge in the pandemic.  LA County had 4,000 new cases reported on Saturday, August 7…the highest daily total since last winter (also much higher than at the same time last year, when new cases were closer to 2,000 per day).   And while the County reported a small downturn in test positivity rates on the same day, hospitalizations have continued a steady upward trend over the last week.

LA County COVID Cases, Deaths & Hospitalizations - August 2-8, 2021

Delta

As the Washington Post reports today, the current cases are now almost all Delta.  According to the Post, “Today, [Delta] has nearly wiped out all of its rivals. The coronavirus pandemic in America has become a delta pandemic. By the end of July, it accounted for 93.4 percent of new infections, according to the Centers for Disease Control and Prevention.”

The Post story explains that there are three major factors in Delta’s growing success:  behavior (people both vaccinated and not got too comfortable removing masks and gathering too closely), vaccine resistance (while many people are now fully vaccinated, those who have not yet been vaccinated are the most resistent to the idea, so overall vaccination rates have slowed to a crawl), and the much more contagious Delta strain (which seems to be more than twice as contagious than the original strain that fueled last winter’s huge surge).

So scientists are increasingly alarmed.  Or, as Texas A&M University virologist Benjamin Neuman said in the Post story, “To see delta just running laps around these other strains is very concerning…It’s like ‘Jurassic Park,’ the moment you realize the dinosaurs have all got loose again.”

Locally, at a press conference on Thursday, August 5, LA County Director of Public Health Barbara Ferrer, presented a series of slides that show Delta’s progress.

First of all, according to Ferrer, LA County is once again in a “high transmission” period, with more than 100 new cases per 100,000 people per week, and test positivity greater than 10%.

New case rates are up 22% in LA County in the last week…

…and hospitalizations (the orange line below) are trending up as well.

But there are some differences between the current surge and those we’ve seen previously. One of those is that, this time, unlike in the past, younger adults are being hit harder, with case incidence rates up the most in the 18-29 and 30-49 age groups.

More information about the local COVID picture, and the Delta variant, will be available at an LA County virtual Town Hall meeting on Wednesday, August 11 at 6 p.m.  The session will be available @lapublichealth on Twitter, Facebook and YouTube.  If you would like to ask a question during the meeting, visit tinyurl.com/lacountytownhall.

Vaccines and Requirements

The good news from the surge is that while we are seeing more “breakthrough” cases of COVID among the fully vaccinated, the numbers show that the vaccines are still very effective, with only 446 of more than 5 million fully vaccinated people in LA County getting sick enough to be hospitalized…and only 41 (.0008%) have died.

In contrast, while case rates for fully vaccinated people have risen (green line in the graph below), case rates for the unvaccinated and partially vaccinated have risen much faster.

And the contrast in hospitalization rates for the vaccinated and unvaccinated are even more stark.

As are death rates.

So officials say increasing the percentage of fully vaccinated individuals is even more important than ever right now.  At the moment, only about 5.4 million of LA County’s 10.3 million residents are fully vaccinated:

And the percentage of people getting first vaccinations has slowed way down since the first wave of people sought shots when they first became available this spring:

So the less good news on the vaccination front is that the combination of the more virulent Delta strain and the entrenched resistance of the remaining unvaccinated individuals means that the long-hoped-for goal of vaccine-sparked herd immunity – originally thought to be achievable when about 80% of the population is vaccinated, and which was thought to be achievable by late this year – may need even higher percentages and take even longer to reach.  According to the Washington Post story mentioned above:

“Epidemiologists had hoped getting 70 or 80 percent of the population vaccinated, in combination with immunity from natural infections, would bring the virus under control. But a more contagious virus means the vaccination target has to be much higher, perhaps in the range of 90 percent.

Globally, that could take years. In the United States, the target may be impossible to reach anytime soon given the hardened vaccine resistance in a sizable fraction of the country, the fact that children under 12 remain ineligible and the persistent circulation of disinformation about vaccines and the pandemic.”

So local officials are starting to clamp down with new vaccine rules for city and county employees.

On August 5, Hilda Solis, chair of the LA county Board of Supervisors, issued an order that all LA County employees – including those who work for the Sheriff’s office and the Los Angeles Fire Departmetn, must be vaccinated by October 1.   And last Wednesday, Los Angeles City Council Members Nury Martinez and Mitch O’Farrell introduced a motion that would require patrons to show proof of vaccination to enter bars, restaurants, theaters, stadiums, and other kinds of public gathering places.

“Enough is enough already,” Martinez said in a statement about the action. “Hospital workers are exhausted, moms who have put aside their careers are tired, and our kids cannot afford the loss of another school year. We have three vaccines that work and are readily available, so what’s it going to take? Our kids are about to return to school, and the unvaccinated are putting their lives at risk every day. Ask your questions, talk to your doctor and get the vaccine. Let’s put this behind us.”

Of course, a motion isn’t a final action, and as the LA Times explains, the City Attorney’s office will now have to draft a potential ordinance, which will come back to the Council for further discussion and votes before it can be enacted.   As we reported last week, however, the city has already declared that its employees will be required to be vaccinated or tested weekly, and LA County has issued a similar order, and is considering similar rules for people in public spaces.  (For a full overview of the city and county measures being considered and already approved, see https://www.latimes.com/california/story/2021-08-09/what-to-know-la-considers-more-covid-vaccine-mandates )

Finally, it’s worth noting that in addition to vaccines, masks are still an important deterrent to infections, once again required in indoor spaces, and recommended even among crowds outdoors.

Also, even if you have already had COVID-19, the LA County Health Department strongly urges you to get vaccinated, and not rely on what some people refer to as “natural” immunity, because it can vary widely from person to person, and may not be strong enough or last long enough to prevent future re-infections or new variants taking hold.

Finally, if you have been vaccinated, and want to be ready to easily comply with new rules that might ask you to show your vaccination status in certain places or at certain kinds of gatherings, the California Department of Public Health has a new website where you can look up and download your personal vaccination record.   Just go to https://myvaccinerecord.cdph.ca.gov/, fill in the very brief form (name, phone number, and birth date), select a 4-digit PIN, and you’ll be sent a QR code with your vaccination history.  You can take a screen shot of the code and save it to your phone, so it’s easy to pull out whenever you might need it for proof of your vaccination status.

Kids & Schools

Finally in this week’s wrapup, with LAUSD schools set to open for full in-person instruction just a week from today, the topic of COVID in children (especially those too young to be vaccinated yet), and what will be done to protect them when they return to school, is very much on people’s minds.  Currently, at least in part because vaccines for children and teens became available later than for those in older age groups, the vaccination percentages for children ages 12-17 is lower than for older groups…while vaccines still have not yet been approved for those younger than 12.

So it may not be too surprising that the 7-day average for new COVID-19 cases in all children ages 0-17 has been rising along with the rest of the population:

The LAist news blog called this a “troubling rise,” noting that “Young adults are continuing to drive L.A. County’s surge in COVID cases, but children who aren’t old enough to be vaccinated are increasingly testing positive.”

And Ferrer also mentioned the issue in her press conference last week.  “While rates are relatively low across the board,” Ferrer said, “all [pediatric] age groups experienced five- to six-fold increases in case rates between the end of June and the beginning of July.”

Ferrer also provided data on outbreaks at LA County schools, which have – along with cases everywhere else – been spiking in the last few weeks…with most of the outbreaks associated with sports activities.

According to Ferrer, school outbreaks tend to have several causes, including inconsistent mask wearing, lack of social distancing, mixing of student cohorts, and not excluding people who have symptoms of COVID.  And sports activities are similar, with the addition of group socializing after sporting events, and team members traveling and lodging together.

To help blunt the spread of COVID, and especially the Delta variant, LAUSD will be instituting serveral strict protocols for its students and staff when school opens next week, including required face coverings for all on-campus students, staff and visitors, daily health checks, and weekly COVID-19 testing, for all students, staff, visitors, and volunteers, regardless of vaccination status.  (Individual schools are also hosting baseline testing events this week, on their own campuses, to make it easier for students and families to get the required tests.  Call your local school for testing days and times.)  All students ages 12 and older who have not yet been vaccinated will also be encouraged to make vaccine appointments as soon as possible.  Families can call the Los Angeles Unified Family Vaccination Hotline at (213) 328-3958 for support and to have their questions answered.

Finally, for more school information from LA County (where some protocols will differ slightly from the LAUSD rules outlined above), you can watch the Health Department’s Town Hall meeting on schools at https://www.facebook.com/lapublichealth/videos/1149227845584239.