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Public Health Update: Winter Respiratory Illnesses Ramping Up – Time to Get COVID Boosters & Flu Shots

LA County Public Health Director Barbara Ferrer describes an early and strong start to the respiratory syncytial virus (RSV) season in her weekly public health update yesterday. Influenza is also spiking early this year, Ferrer reported, and signs of a new COVID-19 variant are also signaling a potential winter surge, all of which make getting up to date on vaccines extremely important.


It’s now less than two weeks until Thanksgiving and the large, cozy indoor gatherings it brings, and this week’s update from LA County Public Health Director Barbara Ferrer made it clear that getting up to date on vaccinations and taking other simple measures to protect your health at those events will be extremely important this year.  Just a month into this winter virus season, Ferrer reported, LA County is already seeing strong, fast starts to the flu and respiratory syncytial virus (RSV) seasons, as well as quick growth of several new COVID-19 variants, which may be setting the stage for a new winter surge.


Flu & RSV


As she did last week, Ferrer compared this year’s flu data to that virus’ trajectories for the last few years.  Ferrer explained that every flu season (which runs from October through the following September) plays out differently, but positive specimens often peak between January and March.  This year, however, Ferrer reported that the percentage of specimens testing positive for flu started to rise sharply in September, and by the official start of the season in October were already nearly as high as the peaks of the 2018/2019 and 2021-2022 seasons.  She said there’s no way to know yet whether the flu season will be long or short this year, but it is starting early, with an unusually high number of cases, which increases the need for everyone to get their flu shots as soon as possible.



Also, like flu, Ferrer reported that RSV season this year has started with a much higher number of specimens testing positive than usual at this point…and we have already passed the peak levels of the last four RSV seasons.  Ferrer said that, as with flu, we have no way of knowing yet how long the season will last this year, but there is definitely a lot more RSV around than usual at this point in the season.





Looking at the COVID-19 numbers this week, Ferrer said LA County has reported an average of 1,300 new COVID-19 cases per day (the green line in the chart below), a 24% increase from the week before, and a continuation of the “slow but steady increase since November 1.”  And because more people are relying on home testing these days, and not officially reporting their test results, Ferrer also said this number is only “a fraction” of the actual number of cases at the moment.

Hospitalizations (the gold line below) were also up 18% this week, while deaths remained relatively stable (though they tend to lag behind the other two major indicators when those numbers start to rise or drop).



Despite the increasing number of cases, Ferrer said, our current case rate – 86 cases per 100,000 residents – still keeps us at the “low” community level for COVID-19, as defined by the CDC.  But the case rate has been rising too, for the last two weeks, and if/when it reaches 100 cases per 100,000 residents, we will again reach the “medium” community level, and the county will return to strongly recommending that everyone wear masks in most indoor public spaces.  (Currently, masks are strongly recommended only on public transit and in transit hubs, and required only in places like health care facilities.)



And there are several other signs that a new surge may be brewing.  First, Ferrer said, three of LA Count’s early alert signals – including the percentage of emergency department encounters related to COVID-19, and the number of new outbreaks in TK-12 schools – have risen to a medium level of concern, while one signal – the number of new outbreaks in skilled nursing facilities – has risen to a level of high concern.

But also quite telling, she said, is the growing presence of several new COVID-19 variants.  While the BA.5 version of the Omicron strain (the red bars in the chart below) has been the dominant strain both locally and in much of the U.S. for most of this year, its prevalence is now shrinking, down to just 68.6% of specimens sequenced locally.  This continues a steady, 20% drop since the beginning of October, Ferrer said.

But cases caused by two newer variants, BQ.1 (light pink in the chart below) and BQ.1.1 (purple), both also subvariants of Omicron BA.5, have both more than doubled in the last week.  And there’s also a new BF.7 subvariant (blue), which has been growing quickly since early October.



Ferrer said that if we do have a winter surge this year, it will likely be fueled by one or more of these newer variants.  And that may already be happening – Ferrer said that given the trends in the last couple of weeks, and the two-week lag in reporting this information, it’s likely that by the end of this week, the BQ.1 and BQ.1.1 variants may be responsible for as much as 35% of all COVID-19 cases nationally, and perhaps 37% in California.

The good news, however, she said, is that because these new variants are all sub-lineages of the BA.5 strain, it’s also likely that our current bivalent booster vaccine, which specifically target the BA.4 and BA.5 varieties of COVID-19, will be a good match.  So that makes it even more important for people to get the new booster this winter (in addition to their flu shots).

Unfortunately, though, Ferrer also reported that very few people have done that yet.

In fact, while the oldest LA County residents (ages 65+) are the most vulnerable to severe illness and death from COVID-19, only 25% of that age group has received the bivalent booster.  And that number falls as you go down the age spectrum, ending with only 4% of children ages 5-11 who have received the shots.



And also particularly worrisome, Ferrer said, is that the parts of LA County with the lowest vaccination rates (the yellow areas in the map below), also tend to be the most disadvantaged parts of the county, where people are more densely packed in housing, have less easy access to quality health care resources, and tend to work in more front-line jobs, meaning greater opportunities for exposure to COVID-19.



Ferrer said there seem to be several reasons why people are not getting their booster shots, if they’re even aware of them in the first place.  In fact, she said, LA County outreach staff have reported that at some gatherings they’ve attended, as many as 25% of the people they encounter “have no idea they’re supposed to get another booster dose,” or are confused because they’ve heard the pandemic is over, or that they only needed one booster.

Ferrer agreed that it’s definitely unusual for health care providers and officials to ask people to get a fifth or sixth booster shot for any disease, but that means they need to continue an “all out effort” to get the word out, and to help people “get comfortable with the idea of staying up to date with [multiple] COVID vaccinations.”

Ferrer said there also seem to be a lot of other myths and misinformation circulating about COVID-19 vaccinations.  For example, she said, some people think they don’t need the new booster shot because they either had a previous vaccination or they’ve already had COVID, so they’re adequately immune now.  Ferrer explained, however, that immunity from both previous vaccinations or boosters, and from having COVID itself, both wane over time (starting about 3-4 months after either kind of inoculation) and need to be renewed to remain effective. And the constant emergence of new variants, Ferrer said, may also mean that previous immunity won’t be as effective against new strains, which the latest boosters specifically target.

Also, Ferrer said, many people believe a “natural” immunity gained from catching and fighting off a mild case of COVID is better than the type of immunity stimulated by vaccination, so it’s worth getting sick instead of getting vaccinated.  But that, too, is untrue, she said.  First of all, you never know how sick you may get if/when you catch COVID, and 1 in every 13 people who gets COVID also winds up with symptoms of “long COVID” lasting weeks or even months beyond their initial infection.  And neither of those risks are present with vaccinations, which provide equivalent levels of immunity.

Still other people, Ferrer said, keep hearing that “the pandemic is over,” and/or that the current strains of the virus are milder than those at the start of pandemic, so there’s no longer any risk in getting it. But, again, neither of these is true.  COVID-19 is still very much with us, she said, and people do still get sick and die.  Getting vaccinated can help prevent infections, is proven to significantly reduce risks of severe illness and death, and also helps prevent spreading the virus to others who may be more vulnerable.

And finally, Ferrer said, some people don’t think they qualify for the new boosters, but that, too, is usually untrue.  Almost everyone over the age of 5, whose last booster was more than two months ago,  is eligible for the new bivalent boosters, and there are plenty of doses available for anyone who wants one.



Ferrer said, there are more than 1,000 vaccination sites available in LA County, including both public and private providers. And the shots are free, don’t require disclosure of immigration status, and often don’t even require an appointment.  To find a vaccination site near you, see



And, yes, free transportation to vaccination sites, and even in-home vaccinations, are still available for those who need them.



In closing, Ferrer said that while a winter surge in COVID-19 is likely again this year, as are pretty severe flu and RSV seasons, we should be able to stay much safer this year than in the last couple of years…if people are careful.  “We ought to be able to do a better job this time around, as long as people take advantages of the tools available” (like vaccination/boosters, masking, therapeutics), Ferrer said.

And Thanksgiving is less than two weeks away, so now’s the time to get your shots, if you haven’t already done so.


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Elizabeth Fuller
Elizabeth Fuller
Elizabeth Fuller was born and raised in Minneapolis, MN but has lived in LA since 1991 - with deep roots in both the Sycamore Square and West Adams Heights-Sugar Hill neighborhoods. She spent 10 years with the Greater Wilshire Neighborhood Council, volunteers at Wilshire Crest Elementary School, and has been writing for the Buzz since 2015.

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