“This is a hopeful moment in the COVID pandemic, with the WHO noting that with continued attention to reducing risk, and increasing vaccine coverage, there is a possibility of ending the pandemic.”
— LA County Public Health Director Barbara Ferrer, September 15, 2022
No, the COVID-19 pandemic is not over yet. But with new cases numbers and hospitalizations continuing to fall (though not quite as fast this week as they have for the last few weeks), and new, more specifically-targeted vaccines widely available, LA County Health Director Barbara Ferrer, in her weekly address yesterday, sounded more hopeful about a potential end to the pandemic than she has at almost any time in the last two and a half years. And the news on monkeypox was pretty good this week, too, with Chief Medical Officer and Director of LA County’s Disease Control Bureau Dr. Rita Singhal reporting that new cases monkeypox cases continue to slow, and may even be starting to decline.
COVID-19
Ferrer reported that during the past week, LA County averaged about 1,700 new COVID-19 cases per day. This was a small drop from the week before, and continued the pattern of decline that’s been ongoing since mid-July. (The decline was, however, less than in other recent weeks, a possible indication that the trend could be slowing, depending on how things go over the next week or two.) Hospitalizations also appear to have leveled off, and the number of daily deaths has held relatively steady since the beginning of September, Ferrer said.
Ferrer also reported that there was – as expected – an increase in school-based clusters of COVID-19 cases after schools re-opened in August, but those numbers, too, have been falling since late August.  This week, she said, there were just 129 clusters of school-based cases, down from the peak of 445 in the last week of August.
With the numbers continuing to decline, and LA County remaining in the “low” community tier for the third week in a row, indicating a low level of stress on our health care system, Ferrer said the County is preparing some possible revisions to its indoor masking recommendations.
Currently, Ferrer said, LA County has a weekly case rate of 127 cases per 100,000 residents. But if that rate drops below 100 cases per 100,000 residents, the County will remove the mask requirement for public transit and at transit hubs, replacing it with a strong recommendation to wear masks (though individual transit agencies would still be allowed to set stricter policies if they chose to do so). Individuals who have higher risks of infection or complications from COVID-19, Ferrer said, would still be strongly recommended to wear masks indoors, in crowded spaces, and when in close contact with others…but indoor masking for others – including in schools and workplaces – would go from being highly recommended to merely a matter of “individual preference.” (Health care and congregate living facilities, however, would continue to require masks for everyone.)
Ferrer said that if current trends continue, these changes could come before the end of the month…though, as always, unexpected developments could either accelerate or lengthen that timeline.
Currently, Ferrer said, much of health officials’ current optimism comes from the fact that 93.2% of all local cases are caused by the Omicron BA.5 variant of COVID-19, and the new bi-valent booster vaccines specifically target both the BA.4 and BA.5 subvariants. Also, Ferrer said, unlike last year, the only other major variant on the horizon is BA.4.6, which grew from 2.2 to 2.7% of all local cases last week. But that variant has been around for three months now, Ferrer said, has grown very slowly, and is also targeted by the new bi-valent boosters, so it doesn’t seem poised to become a much bigger threat.
Ferrer noted that BA.4.6 has grown a bit more in other parts of the country than it has here, including some more centrally-located states where it now accounts for 10-18% of cases. But even that growth, she said, has been fairly slow over the last three months, and does not look at all like the rapid spread we saw with other variants before last winter’s surge.
So given the current situation – case numbers declining, no new variants of concern beyond those we’ve been monitoring for a while with no explosive growth, and new vaccines that specifically target the most prevalent strains of the virus – Ferrer said, “This is a hopeful moment in the COVID pandemic, with the WHO noting that with continued attention to reducing risk, and increasing vaccine coverage, there is a possibility of ending the pandemic.”
To make sure we stay in that hopeful place, however, and to help prevent dangerous winter surges of COVID-19, flu, and monkeypox, Ferrer urged everyone who is eligible (see below) to get up to date on all relevant vaccines as soon as possible.
Monkeypox
Meanwhile, Singhal noted that the state of California continues to report more monkeypox cases than any other state in the U.S. This week, she said, there was a cumulative total of 1,820 reported cases in Los Angeles County, including one health care worker (who was infected on the job), seven people in congregate living settings for people experiencing homelessness, two cases in local jails, and six cases in children. There have so far been 75 monkeypox hospitalizations in LA County, and one confirmed death. (Singhal said the person who died was “severely immunocompromised,” and had been hospitalized…and she recommended that anyone who is immunocompromised and becomes infected with monkeypox seek treatment immediately.)
The good news this week, though, is that – like last week, and even though numbers for the week were incomplete due to lags in reporting – the growth rate for new monkeypox cases seems to be slowing, and may even be starting to decline. And the doubling rate for new cases, which peaked at 8 days in July, is now up to 46 days.
This week, Singhal also provided a new graphic showing how the race and/or ethnicity of those infected with monkeypox has changed since officials first started tracking it in July. At that time, she said, more than 50% of those infected were white, and about 30% Hispanic or Latino…and now more than 40% are Hispanic or Latino, and less than 30% are white.
There are also disparities, Singhal reported, when looking at what the county calls “Healthy Places Index Quartiles,” which rank the healthiest to least healthy parts of the county. And as the chart below shows, infections in healthier parts of the county have decreased significantly in the last few months, while infections in the least healthy areas have grown…making it particularly important to target those areas for education, vaccinations, and treatments
Finally, Singhal reported that LA County has now received more than 113,000 doses of monkeypox vaccines, and has administered more than 73,000 of those.
She noted, however, that only 40% of people who have been vaccinated have so far returned for the necessary second dose of the vaccine, and urged those who are eligible to get both their first and second shots, which are now widely available through commercial and private providers, or through LA County vaccination sites (many of which no longer require appointments). Also, Singhal reported, minors ages 12-17 no longer require parental consent for monkeypox vaccines, though children ages 6 months to age 12 do need consent, and must to be accompanied by a parent, guardian, or responsible adult.
