“Anyone who spends any time in public, who goes to the grocery store, who goes to the park, is running into multiple people per day who are COVID positive.”
— Dr. Christina Ghaly, LA County Department of Health Services Director
With another 34,827 COVID-19 cases reported in Los Angeles County yesterday, and more than 250,000 cases reported over the last week, the highly transmissible Omicron variant is still raging, and while it doesn’t seem to be as severe as previous variants, the speed at which it has spread, and continues to spread, is causing a new breed of pandemic-related problems – based on the sheer numbers of people getting sick – and has brought some new, stronger cautions from LA County health officials.
The Numbers
At her weekly briefing with the LA County Board of Supervisors yesterday, Dr. Barbara Ferrer reported that one-day totals of new cases rose from 21,790 on Tuesday, January 4, to 43,582 on Monday, January 10, far surpassing the daily totals from last winter’s big surge. Meanwhile, hospitalizations also rose sharply, from 2,240 on January 4, to 3,472 on January 10. So far, however, Ferrer reported that daily deaths from COVID-19, which do tend to lag about 2-3 weeks behind new cases and hospitalizations, have not yet shown an increase.
Ferrer also noted that the numbers still show very clearly that while vaccinated people are experiencing increasing numbers of breakthrough cases, the number of cases in those who are unvaccinated are still both higher and increasing more rapidly than in people who have been vaccinated or – especially – are both vaccinated and have received a booster shot.
Hospitalization rates are also much lower for those who are fully vaccinated, Ferrer reported…and nearly non-existent so far among those who are both vaccinated and boosted.
And death rates are still 22 times lower for those who are vaccinated vs. those who are not yet vaccinated.
Finally, Ferrer reported that as of January 6, more than 80% of Angelenos ages five and up had received at least one dose of a COVID vaccine, and 71% were fully vaccinated. While those numbers are good, however, Ferrer also pointed out that more than 2 million eligible LA County residents have not yet been vaccinated, and are thus more likely to contract COVID, and more likely to become severely ill or die if they do become infected.
Good News/Bad News from Hospitals
While the bad news is that the Omicron surge is huge, and hospitalizations have been rising quickly, the better news is that people hospitalized because of COVID (as opposed to those hospitalized for other reasons and also turn out to have COVID) are a much smaller share of the overall patient population this year than they were during last year’s surge.
This was confirmed by Dr. Christina Ghaly, Director of the LA County Department of Public Health Services, who also reported to the Supervisors yesterday that the fraction of LA County hospital admissions due to acute COVID has actually remained fairly stable, and even declined slightly in recent weeks.
At the same time, however, Ghaly also pointed out that this does not mean that hospitals are sailing comfortably through the current surge. In fact, she reported, they’re now being badly stressed by Omicron in brand new ways. While last year the major problem was a shortage of beds for severely ill COVID patients, this year it’s a “much more severe” shortage of hospital staff to manage the available beds.
According to Ghaly, the staff shortages are partly due to the large number of health care workers who have retired amid the stresses of the past 18 months, along with a small number of hospital workers (less than 200 in LA County) who have refused to comply with the County’s vaccination and other health requirements. But by far the biggest staffing issue at the moment, Ghaly said, is simply that “health care workers, just like everybody else, are getting infected” and are now out sick.
And the staff shortages are affecting every type and level of health care, including places like dialysis centers and skilled nursing facilities, which then refuse patients they don’t have the staff to serve…and send those patients to the overburdened hospitals, which – unlike the other facilities – are legally required to take them in, even if they don’t have the staff to adequately handle the influx.
For this reason, Ghaly said, the County has relaxed some of its quarantine measures for health care workers who have been ill or exposed to COVID, allowing them to return after just five days of isolation instead of 10, as long as they test negative at that point. Ghaly noted, however, that all such employees are fully vaccinated and bound by other requirements, such as wearing high-quality masks, so the risks that they will spread COVID are likely much lower overall than for other groups of people.
Also, Ghaly said LA County is expediting the hiring of more health care workers for its facilities, as well as establishing several surge centers than can help with patient overflow when hospitals are short-staffed.
And finally, she said, the public can help by going to urgent care and/or emergency rooms only when there’s a true emergency. With those facilities also currently very short-staffed, they should be saved for the patients – both those with COVID and those with other urgent issues – who truly need them and who aren’t just there for a sore throat, a COVID test, or any other comparatively minor issue.
Surge Cautions and Management
Of course, it’s not just hospital staff who are being hit hard by the rapidly-spreading virus this winter. And that’s the real pandemic danger at the moment.
If you are vaccinated and boosted, chances are you won’t wind up in the ICU, or even in the hospital. But if you have been exposed or you are experiencing symptoms, it’s easier than ever to pass it along to more people, and for each of them to pass it on to more people…adding to the sheer overwhelm until there are so many teachers, grocery store workers, retail clerks, truck drivers, emergency responders, and hospital staff out sick that schools, businesses, and other necessary institutions won’t be able to serve those in need of their products or services, and they will have to close again until the current surge abates and people recover.
Also, of course, with all this spread, it’s also probable that some of the people who will get infected are more of those who are most vulnerable, and who are most likely to become severely ill and/or die.
(For more on why caution is still so very important, even though we might want to think of Omicron as less threatening, the Buzz also recommends this recent article in the Atlantic, which explains that: “…a pandemic is more than the sum of individual healthy-adult experiences. Viruses are societal multiplication problems. When a double-digit share of a public-school system comes down with Omicron, school is out, and the effects ripple through local families. When a double-digit share of a medical system comes down with Omicron, doctor and nurse availability plummets, and the effect ripples through the hospital. With workers out across industries, entire cities stop functioning. In Washington, D.C., last week, some schools had to delay opening not because of the virus but because snowplows couldn’t make the roads safe enough to get there—too many snowplow drivers were out sick.”)
To help mitigate these potential problems, Ferrer reported that schools, businesses and other institutions have begun to up their safety game in a number of ways, including adding vaccination requirements, upgrading mask rules, adding increased testing and contact tracing, and more.
Ferrer also announced some new, more general cautions (not yet requirements but strongly recommended) for both avoiding infection and helping to stop Omicron’s overwhelming spread. The new cautions include avoiding activities with others who are unmasked and in close contact, and postponing non-essential gatherings, especially with those who are unvaccinated or otherwise at greater risk for infection (which can include anyone under five years old as well as older people who have chosen to remain unvaccinated).
Testing Questions and Issues
Of course, as the number of COVID cases skyrockets, so has the demand for COVID testing – which is increasingly required for people returning to schools or work after the winter holiday break. But people are now requesting testing for many other reasons, too, including requirements to enter other kinds of events or venues…or when people just want to be reassured that they don’t have COVID, so they can go more freely about their daily business.
As County testing sites and others are increasingly overwhelmed with test requests, however, and at-home test kits continue to sell out at retailers as soon as they’re re-stocked, the officials at yesterday’s briefing also addressed questions of who should get tested and when…and which kinds of tests should be used for which kinds of situations.
First, answering the question of the differences and relative advantages between PCR (lab-processed) and rapid antigen tests, Ferrer explained that rapid tests are best, and relatively reliable, when you need to know right now whether or not you’re contagious and likely to spread the virus to someone. But they’re less likely to be accurate, she said, for identifying whether or not you’ve actually been infected, which requires a much smaller amount of the virus. So if you are experiencing symptoms, or think you have been directly exposed to COVID, Ferrer said, then a PCR test is a better, even though it usually takes 24-48 hours to get the results.
Ferrer also cautioned, however, that because testing resources are still limited, and the county is still building its testing capacity, people should also know when to get tested and when not to. She urged people NOT add to the overload by getting tested every day, and NOT to consider testing a pass to go out and do whatever they want, or to engage in risky activities. Or, as LA County Supervisor Holly Mitchell put it, a negative test is “not a license to go out and party.”
With testing demand likely to continue rising, however, Ghaly reported that LA County is working to increase both the number and capacity of its fixed testing sites, especially in the most vulnerable communities, where infection rates are highest and vaccination rates lowest. Ghaly reported that LA County testing capacity (including the new Pick-Up Testing kits announced earlier this week) has increased by 50% since December 15, and will continue to grow.
Finally on the testing front, Supervisor Kathryn Barger noted that with so many independent street-corner testing sites popping up to supplement those run by the county, drug stores and other more traditional venues, there have been some complaints of fraudulent test operators, including some who seem to be collecting personal information that could be used to commit identity fraud. Barger made a motion to request that several county agencies look into this issue and report back on the instances of such operations, as well as ways to educate the public about fraudulent test operators, and what kinds of enforcement measures are possible.
Blood Donations
Finally, on one last topic covered at yesterday’s meeting, Ghaly reported that the current COVID surge is not only stressing hospitals when it comes to staffing, but there are also “severe shortages” of blood at the moment, with donations needed immediately. Ghaly said people can sign up with the Red Cross at http://www.redcross.org to find a convenient location and make a donation appointment….and we can add that there will also be a Cedars Sinai blood drive from Thursday/tomorrow through Saturday, January 13-15, at the Original Farmers Market. See https://farmersmarketla.com/events/blood-drive for more information or to set up an appointment.
