LA Cases Decline, COVID Treatments Trickle In

A week after federal health officials dropped Los Angeles County into the “low” transmission category, new COVID cases and hospitalizations continue to fall.

The average number of daily new cases reported over the past seven days in the county declined to about 1,100, down from about 1,700 the prior two weeks. The seven-day average daily test positivity rate also declined to slightly under 1%. About 40 people are reported dead each day from the virus and 650 people are currently hospitalized.

“The designation at a low community risk level doesn't mean that there's a low rate of community transmission or reflect personal risk,” said Barbara Ferrer, director of the L.A. Department of Public Health, at a media briefing on Thursday. “Rather, it signals that we've successfully reduced the pressure on the healthcare system.”

She urged people to continue to wear masks indoors, especially those who have not been vaccinated or boosted, or who are considered high risk. The county dropped the indoor mask requirement last week.

The state school masking requirement ends March 11, though individual school districts can decide to require them. LAUSD will keep masks for the rest of the school year.

“Our hope is that many people will keep those masks on. It offers a layer of protection that we think is still important in schools, especially in our elementary schools where there are so many people not yet vaccinated,” Ferrer said. “Our community transmission is still at a substantial rate, which means there's just a fair amount of virus still circulating.”

Ferrer said there were four classroom outbreaks in the past week. Schools must continue to require that COVID-19 cases isolate, and a negative test result is required If they want to exit isolation after day five. Whenever there's an exposure at a shared indoor space, schools can opt for group or individual contact tracing. But in either case, quarantine must continue for five days.

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Courtesy of the L.A. County Dept. of Public Health

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COVID Treatments Arrive At Some L.A. Pharmacies

Starting this week, high-risk patients with COVID symptoms will be able to walk into 20 pharmacy-based clinics for a free test in L.A. — and if they’re positive, walk out with a free course of COVID treatment pills.

It’s the first wave of President Biden’s “Test to Treat” initiative and a key feature of the administration’s national COVID preparedness plan.

Ferrer said the county health department is working to increase awareness and access to COVID therapeutics, calling them “critical” for county residents at high risk of contracting the virus.

“These treatments can help prevent serious illness, hospitalization or death,” Ferrer said.

Angelenos can already get the COVID pills prescribed by their doctors, but "Test to Treat" is an additional pipeline for COVID pills that intends to streamline the process for high-risk patients who need to start the treatment quickly for it to work. But it is limited by the requirement to have a prescriber on-site — which most pharmacies don't have — and will initially only reach a few hundred of the thousands of retail pharmacies nationwide.

Two COVID treatment pill options are currently authorized by the FDA — Paxlovid from Pfizer and molnupiravir from Merck and Ridgeback Pharmaceuticals. The pills are antivirals, which means they stop the virus from making copies of itself in the body.

For both, "it's really important to start treatment within three-to-five days or so of the onset of infection," Ferrer said. "They work best if there’s very little time between when you get an assessment by a provider and the time you get the medicine."

• Paxlovid (available for anyone 12 and older weighing more than 88 pounds) and 
• molnupiravir (available for adults 18 and older) are oral therapeutics that must be taken within five days of the first COVID-19 symptoms and require a prescription from a healthcare provider. 

Pfizer's Paxlovid is considered highly effective, reducing the risks of hospitalization by nearly 90%, but it can interfere with many commonly prescribed drugs and cause health problems if the drug dosages aren't adjusted. Merck's molnupiravir is less effective — cutting the risks of severe COVID by around 30%, according to data reviewed by the FDA — and it comes with reproductive risks.

Most pharmacies don't have them on-site because supplies are limited. Since the county began receiving therapeutics, Ferrer said “64% of Paxlovid doses and 82% of molnupiravir doses have been allocated to providers in the most under-resourced communities.”

There are also monoclonal antibody treatments available, including Evulsheld, authorized by the FDA as a preventative treatment for people who can’t get the coronavirus vaccinations for medical reasons. The shots are given before a person is exposed to COVID-19.

The medications are currently free, but a facility may charge for administering Evulsheld. Medicare and Medi-Cal recipients are completely covered, and larger insurance plans may cover the costs. If you don’t have insurance, the L.A. County Health Department recommends asking the treatment facility if there are fees.

Ferrer said her department is working to enroll providers in a network of sites “that can provide information to residents and have sufficient supply of these life-saving therapeutics, particularly in those communities with residents at elevated risk of poor COVID-19 outcomes.”

A telehealth option will also be launched, aimed at residents who are unable to access care or who are uninsured. Under the pilot program, patients testing positive at select testing sites in under-served areas of the county will be linked to a telehealth option and, if they are eligible, will be shipped medications overnight at no cost.