In her now bi-weekly public health update yesterday, LA County Public Health Director Barbara Ferrer provided an update on COVID-19 numbers and status, and also clarified some things that will change – and some that may not – as our various state and county emergency orders expire.
First, as shown in the graph above, Ferrer reported that COVID-19 continues to loosen its grip on LA County, with new cases, hospitalizations, and deaths continuing to drop slightly since her last report two weeks ago. And even though new COVID cases continue to be underreported, thanks to the rise of at-home testing, wastewater sampling confirms virus levels “substantially lower than at our peak,” and Ferrer said we remain in the CDC’s “low” community tier for the eighth week in a row.
Meanwhile, however, COVID-19 has not disappeared, and Ferrer reported that, as expected, the XBB.1.5 variant of Omicron, which now represents as much as 90% of all cases nationwide, has also increased its percentages in LA County — from 49% at the last report to 66% in the most recent period for which numbers are available. Ferrer said the good news, though, is that when previous new variants quickly achieved dominance, they also tended to bring increases in new cases, hospitalizations and deaths, which isn’t happening with XBB.1.5. Ferrer said this is most likely because people’s immunity is much greater now, thanks to both vaccinations and prior infections. And those factors have been even more influential, Ferrer said, because all our currently prevalent variants are still in the Omicron family, so existing immunity to that form of the virus remains strong.
Ferrer said hospitalization and death numbers confirm the vaccines’ continued effectiveness, too. She noted that hospitalization rates for those who have been vaccinated without a booster are more than three times lower than for those who are unvaccinated. And those who have had the updated boosters are almost five times less likely to be hospitalized than those who are unvaccinated.
Also, people who have been vaccinated but not boosted are almost four times less likely to die from COVID-19 than those who are unvaccinated. Those who have received the latest boosters are almost six times less likely to die from COVID than those who are unvaccinated.
All of this is great news, especially since various county, state, and federal emergency health orders are now expiring, which means many protections put in place at the height of the pandemic will sunset soon. Ferrer reported that two federal health declarations will end on May 11, California’s state order expired on February 28, and LA County’s order will expire at the end of this month.
The expirations, said Ferrer, are indicative of the fact that “we no longer need to rely on emergency orders to ensure we have lifesaving tools and mitigation strategies”…though if future developments warrant it, she said, LA County Health Officer Dr. Muntu Davis still has “non-emergency communicable disease control authority” to issue future orders to help protect the public from risks presented by COVID-19.
Ferrer said the emergency orders, in place since 2020, allowed LA County to act quickly, and to reach as many residents as possible with information, essential services, and vaccinations at the time they were most needed. Since that time, however, she said we have developed tracking methods, ample health care capacity, effective vaccinations and therapeutics that now more effectively protect ourselves, our most vulnerable community members, and our health care system. And all of those things will remain with us as we transition away from the emergency orders. (The one thing that may change a bit, she said, is how things like vaccines and therapeutic drugs are funded. So Ferrer said LA County will be working to ensure that even residents without health insurance will retain full access to these essential tools.)
Moving forward, Ferrer said LA County will focus on keeping COVID-19 transmission low and protecting the most vulnerable residents. This includes ensuring that people continue to have access to vaccines, boosters, testing, therapeutics and telehealth services, monitoring early alert signals and COVID activity in high risk settings, helping to deal with future outbreaks, and continuing to keep residents informed.
Ferrer also reported that as of Monday, March 13, LA County will align with the State of California’s guidelines for COVID-19 isolation and quarantine. This includes asking people to stay home for at least five days after the onset of symptoms or a positive test. Isolation can end after day five if symptoms are improving or gone, and if the person has been fever-free (without fever-reducing medication) for at least 24 hours. There will also be a strong recommendation that people have a negative test to end isolation between days five and 10 of an infection.
Also, after close contact with someone who has COVID-19, Ferrer said it will be recommended that people wear a mask in public for 10 days, or when near someone at high risk for infection, and to test as soon as the exposure is confirmed, and then again 5-10 days later.
Ferrer said that as long as LA County remains in the low community tier, it will align with the State of California’s recommendations for masking. That means masks will be a matter of individual preference, but they will be recommended in indoor public spaces for the elderly, immunocompromised, and those who have underlying health conditions.
(Asked about her own choice to continue wearing a mask during public briefings, Ferrer re-emphasized the importance of personal decisions, whether they involve taking masks off or keeping them on. “I want to make this crystal clear,” she said. “People who are wearing masks don’t need to justify why they’re wearing a mask…We could be wearing it for a lot of reasons. We could be sick. We could have people in our families who could be very vulnerable. We could be under some treatment. We could be immunocompromised. We could just be an older person. We could just be someone who wants to be super careful.”)
Unlike the state, however, Ferrer said LA County will continue to require masks for all healthcare workers who provide patient care, and those who work in patient care areas. (Employees in other areas of healthcare-related businesses will not be required to wear masks.) Visitors and patients in health care settings will no longer be required to wear masks…though masks will still be strongly recommended.
Finally, vaccinations (a primary vaccine and booster) will continue to be required for all health care employees except those whose jobs are 100% remote and who are never present at health care facilities. (Ferrer explained that this is a federal rule, not something local policies can override.)
Despite the fact that many rules are changing in many settings, however, Ferrer said LA County will continue to require that workplaces, schools, and healthcare facilities continue to report case clusters and outbreaks, so the County can track COVID-19 transmission to determine whether additional protections are needed in specific settings.
In the end, Ferrer said the main goals are to help keep COVID-19 transmission low, and to continue to protect the county’s most vulnerable residents. That includes encouraging people to stay up to date on vaccines and boosters, encouraging people to continue testing for COVID-19 when they have symptoms or are attending activities with high-risk individuals, accessing therapeutic drugs quickly and easily when sick, and wearing masks in crowded indoor spaces, when infected, or when they have many potential exposures to COVID.