Numerous Potential Causes, Daily Average Jumps To 512 Cases
By Dolores Quintana
After a summer that saw slow but steady increases in Covid cases, the Los Angeles Department of Public Health (Public Health) has reported a continual rise in COVID-19 transmission metrics over the past five weeks. In response, Public Health is collaborating with various institutions and partners to disseminate vital information and facilitate access to vaccinations, testing, and therapeutic resources. The department remains dedicated to offering support and assistance to skilled nursing facilities and schools, recognizing the elevated risks associated with these settings.
The upswing in COVID-19 circulation appears to stem from multiple factors, including summer travel, the resumption of school activities, and the emergence of new COVID-19 variants. While hospitalizations and fatalities remain comparatively low in contrast to earlier pandemic phases, individuals more susceptible to severe illness and death, such as the immunocompromised, older adults, skilled nursing facility residents, and their close contacts, are urged to take extra precautions. These precautions encompass the use of well-fitting high filtration masks in poorly ventilated indoor spaces, regular testing in case of symptoms or known exposure, staying home while unwell, and seeking appropriate therapeutics if infected.
Recent data for Los Angeles County indicates an average of 512 daily reported cases, reflecting a nearly 35 percent increase from the preceding week. It’s important to note that reported cases do not encompass home-based test results, suggesting that the true extent of COVID infections in the community may be significantly higher.
Wastewater analysis of SARS-CoV-2, the virus responsible for COVID-19, offers a more comprehensive view of viral levels within the community. Current data shows wastewater concentrations at 28 percent of the peak observed during the 2022-23 winter season, steadily escalating since July 12, when they stood at 8 percent of the peak.
As of July 22, the latest COVID-19 variant sequencing in Los Angeles County reveals XBB.1.5 and EG.5 accounting for nearly equal proportions of sequenced cases, making up 31 percent of the total. XBB.2.3 follows as the next most prevalent variant, trailed by XBB.1.16.1.
Notably, 98 percent of presently circulating strains in Los Angeles County are descendants of Omicron XBB, including EG.5, the anticipated target of the forthcoming fall COVID-19 vaccine, expected to launch next month. While closely monitoring, BA.2.86 has not been detected in recent sequences. BA.2.86 is of particular concern due to its numerous mutations that may impact immune responses to infection.
Currently, Los Angeles County reports a daily average of 422 hospitalizations, marking a 30 percent increase from the previous week. Over the past month, there has been a consistent, slight rise in the proportion of emergency department visits attributed to COVID-19. Nevertheless, current hospitalization levels remain notably lower than those witnessed in 2022 during the summer peak when daily hospitalizations averaged 1,287 COVID patients.
With increasing COVID-19 transmission rates, individuals residing in skilled nursing facilities face heightened vulnerability. In the current week, new outbreaks in these facilities have surged to 39, up from 20 the previous week and 13 four weeks ago. Although subsequent hospitalizations and fatalities among skilled nursing facility residents are less than in earlier phases of the pandemic, increased transmission poses elevated risks for elderly residents.
In response to the escalating outbreaks, Public Health is closely collaborating with local skilled nursing facilities to promote effective cleaning, infection control, and ventilation within the facilities. The importance of staff and visitors staying home when unwell is being emphasized. Staff at skilled nursing facilities are strongly recommended to wear masks, with masking mandatory during outbreaks. Furthermore, residents should have access to well-fitting masks with effective filtration, particularly for those suspected of being positive but not in their rooms.
All residents, staff, and visitors are strongly urged to stay current with COVID vaccines. Visitors should undergo testing before entering skilled nursing facilities and consider wearing masks while indoors. Public Health is actively engaged in providing support during outbreaks at skilled nursing facilities, with a focus on encouraging Paxlovid prescriptions for eligible residents who test positive.
Schools are another environment where outbreaks are possible due to the congregation of individuals indoors for extended durations. While many children may experience mild COVID-19 symptoms, other family members and school staff may face higher risks.
Parents and guardians are encouraged to keep unwell children, including those with fever, severe cough, extreme fatigue, or sore throat, at home. This is contrary to the policy put forth by LAUSD Superintendant Alberto Carvalho and LAUSD’s Chief Medical Director, Dr. Smita Malhotra. LAUSD’s stated policy is akin to policies before the pandemic, where people sent children to school when they were sick regularly, and infections regularly tore through schools and the families of children who were infected during class.
Those with respiratory symptoms or known exposures should undergo COVID-19 testing. Many school districts have received free antigen test kits for distribution to students and families. In the event of a positive COVID-19 test for a child, prompt reporting to the school is crucial for contact tracing and notification.
Individuals testing positive must isolate at home for at least 5 days.
Public Health remains committed to supporting schools during outbreaks, providing free antigen tests, and distributing resource toolkits to reduce transmission. Individuals infected with COVID-19 are advised to consult their healthcare provider about treatment options, such as Paxlovid, within five days of symptom onset. Free telehealth services for treatment are accessible via the Public Health Call Center, operating seven days a week from 8 a.m. to 8:30 p.m., at 1-833-540-0473.
As of August 21, Los Angeles County retains its Low Hospital Admission Level classification, as per the U.S. Centers for Disease Control and Prevention, with 5.2 weekly COVID-19 hospital admissions per 100,000 people. This marks an increase from the previous week’s 4.1 hospital admissions.
