With the current “tripledemic” very much in full swing this week, LA County Public Health Director Barbara Ferrer reported yesterday that after just one week in the “Medium” community tier for COVID-19, as defined by the CDC, LA County this week surged up into the “High” tier for COVID-19, while positivity rates for Influenza A continued to soar, too. The slightly better news is that RSV positivity rates, which also soared early and exceptionally high this year, do seem to have peaked now and are starting to fall.
Looking at the numbers, LA County saw a 34% increase in daily COVID-19 cases this week (and a 200% increase over the last month), now averaging about 3,800 cases per day. And Ferrer said these numbers are “severely undercounted” due to the fact that many people now rely on home testing, which doesn’t get counted in the daily tallies.
COVID-related hospitalizations also rose this week, Ferrer said, to about 210 per day, though the rate of increase wasn’t as high as it was for case numbers. But deaths are also up this week, Ferrer reported, averaging 12 per day compared to 8 just a week ago.
As Ferrer reported last week, new COVID-19 variants BQ.1 (pink bar on the graph below) and BQ.1.1 , which are both subvariants of BA.5 (the most prevalent variant for most of 2022), are emerging as the dominant strains of the winter season, and bring increased risk of infection because they seem to be more able to evade prior immunities. Ferrer said the BQ.1 variants are expected to be responsible for about 60% of cases in the U.S. by next week. And health officials are also keeping an eye on the XBB variant, Ferrer said, which is a recombinant strain of two BA.2 sub-lineages, and contains a mutation that also helps it resist immunity.
These surging numbers mean, Ferrer said, that after only a week in the “Medium” community tier, as defined by the CDC, LA County has now moved quickly up to the “High” community tier, meaning our health care system is showing some signs of stress. But simply entering the “high” tier doesn’t bring any new restrictions to the community, Ferrer explained. Currently, two of the three CDC-defined metrics for defining the low, medium, and high tiers – our weekly case rate (258 per 100,000 residents), and the number of new COVID-related hospital admissions (14.8 per 100,000 residents) – are at the “high” level. But for the CDC to recommend any new restrictions, Ferrer said, we’d also need the number of staffed hospital beds occupied by COVID-19 patients to exceed 10 per 100,000 residents (we’re currently at just 6.8), and those three metrics would all have to remain “high” for more than two weeks to trigger new restrictions such as indoor mask mandates.
But while we do not yet have any such new restrictions (and we may not even reach that threshold this year), Ferrer stressed that we definitely do have a much higher risk of COVID-19 transmission at the moment, and the virus is much easier to catch. For example, she said, in a gathering of 200 people today, there’s an 80-90% chance that someone there has COVID-19, and in a gathering of at least 300 people, there’s almost a 100% chance that someone there has it. This means that everyone, but especially our most vulnerable residents (those who are older, have underlying health conditions, are frontline workers, or live in poorer neighborhoods), is more likely to get sick when exposed to large groups of people, and there’s more potential for disruptions in things like manufacturing, services, holiday gatherings travel, medical care, and more as people either become sick or are forced to care for those who do.
So even though the situation is not dire enough to enact new masking rules, Ferrer said, the current “strong recommendation” to wear masks in public spaces still holds, and it is definitely time “to layer in sensible protections,” that can help lower transmission now, before it’s too late.
Those protections include wearing masks indoors, washing hands frequently, staying home and testing if you get sick, getting booster shots if you haven’t already done so, and taking therapeutic drugs within the first five days if you have COVID. “Our collective efforts make a difference now more than ever,” Ferrer said. Because while our hospitals are not yet overburdened, about 50% of them are currently reporting staff shortages with people either out sick or staying home to care for someone who is.
Meanwhile, looking at the other two elements of the current “tripledemic,” Ferrer reported that Influenza A test positivity (the red line in the chart below) is still rising, up to 30% from 25% last week…
…and flu concentrations in local wastewater are still increasing, too.
The better news, though, is that while RSV positivity (red line in the graph below) also spiked early and high this year, we’ve now seen drops in positivity for that virus for the second week in a row…
…and wastewater concentrations for RSV are also declining.
Returning to COVID, Ferrer noted that while many people seem to think the worst of the pandemic is behind us, officials do still worry about new infections and deaths…as well as long-term health consequences in people of all ages. Ferrer said we still know very little about “long COVID,” but recent research shows that new incidences of diabetes, Alzheimer’s, Parkinson’s Disease, strokes, intracerebral hemorrhage are all higher in people who have had COVID-19.
So layered protections are essential to help keep transmission as low as possible, Ferrer said, especially among especially vulnerable groups such as the elderly, those with pre-existing health conditions, and those in lower income neighborhoods, where even fully vaccinated people have been shown to be more vulnerable to COVID-19 infections, hospitalizations and death than non-vaccinated people in wealthier neighborhoods.
“Please don’t hesitate to wear a mask in indoor crowded spaces,” Ferrer said, noting that things like mask wearing and hand washing also help protect against all three diseases in the current tripledemic.
“Each day in LA County,” she continued, making one last fervent plea for people to wear masks indoors right now, “I see the ways people care for each other – from frontline workers and business leaders to the person who holds the door when your hands are full of groceries, or the neighbor who asks how your day was when they see you coming home. Our shared goal during this pandemic has always been to share the goal of preventing disease, hospitalizations and death, and we all know it takes a shared effort to do this. When you put on your mask for these few weeks during the surge, it’s about the people of LA County. It’s about every individual, visitor, our health care workers, essential workers, and other people who serve. In addition to vaccination, it’s one of the easiest things everyone can do right now.”
