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LA County's COVID Risk Level Moves From Medium To High

A bar graph showing subvariants BA.4 and BA.5 make up 62 percent of sequenced cases, which has risen since they were first detected in April.
Courtesy of the L.A. County Dept. of Public Health)
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You'd be forgiven for letting out a sigh. There's so much going on, from political tensions to rising inflation — and now a summer COVID-19 surge that’s been slowly rising for weeks has come to a head.

“It's unlikely that we're at the peak of this recent surge given the increased circulation of new subvariants of concern, and we already have an average of over 6,400 cases being reported per day,” said county public health director Barbara Ferrer at a press conference Thursday.

Two and half years into the pandemic we're back facing new variants, a surge in hospitalizations and questions about a potentially new countywide indoor mask mandate.

Why Is This New Surge Happening?

The latest L.A. County data show there are more than 10 COVID-positive hospital patients per 100,000 people — that’s an 88% increase compared to one month ago.

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Infectious disease experts partially blame the new omicron double act of BA.4 and BA.5. These two mutated forms are technically subvariants of omicron and now make up 62% of L.A.'s known new cases as of June 25, the most recent data available.

They’ve been on the rise since April. Omicron has an impressive ability to reinfect and overcome immune differences from previous infections or vaccinations. BA.4 and BA.5 are even better. Research in the New England Journal of Medicine showed that the subvariants can “substantially escape” the protection from either vaccination or infection.

But the most important form of protection from becoming severely ill, ending up in the hospital and dying is working, Ferrer said.

“Although vaccines do not prevent all transmission of COVID-19, they are very effective at reducing the risk of developing severe disease and dying….[In June] unvaccinated residents were about one and a half times more likely to get infected than fully vaccinated individuals. And while this difference isn't huge, it suggests that even with the more transmissible subvariants of omicron spreading, vaccines are still providing some protection against infection,” Ferrer said.

During the same time period, unvaccinated L.A. County residents were four times more likely to be hospitalized with COVID and more than seven times more likely to die from COVID than those who are vaccinated.

A chart showing that more people have died from COVID-19 in L.A. County than car crashes, drug overdoses and the flu combined in 2022.
Courtesy of the L.A. County Dept. of Public Health)

What Does The CDC's 'High' Level Mean?

The Centers for Disease Control and Prevention’s community risk levels are a tool “to help communities decide what prevention steps to take based on the latest data."

"Levels can be low, medium, or high and are determined by looking at hospital beds being used, hospital admissions, and the total number of new COVID-19 cases in an area,” according to the CDC website.

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L.A. County dropped to the "low" community risk level in early March, after cases and hospitalizations from the huge omicron surge subsided. That’s also when county health officials dropped the indoor public mask mandate, which had been in place since last July, when cases of the delta variant began to surge.

But in May the number of Angelenos testing positive while hospitalized slowly rose, moving the county up to the “medium” community risk level on May 19.

A data table showing hospitalization numbers high enough for L.A. County to be in the 'high' community transmission category.
Courtesy of the L.A. County Dept. of Public Health)

Now, we’re back in the "high" community risk level as more and more hospitalized patients test positive. More than 1,200 people are in the hospital with COVID in L.A. County. Hospitalizations haven’t been this high since February.

Not everyone is in the hospital due to COVID. Health officials say about 40% of the patients were hospitalized with COVID-19-related illnesses, while the other 60% were in the hospital for another reason but were found to be positive through routine hospital admission screening.

COVID positive patients take more staff and time to treat, due to increased infection control measures putting an added burden on hospital workers, Ferrer said.

“The proportion of emergency room cases that have involved people seeking care for COVID has been steadily increasing. COVID is placing increasing pressure on our medical systems as viral transmission increases and there are many more infected people that are sick enough to seek emergency medical care,” Ferrer said.

When Could A Mask Mandate Return To L.A.?

If L.A.’s COVID infections and hospitalizations remain elevated enough to keep us in the CDC’s high risk category for the next two weeks, a public indoor mask mandate will be reinstated on July 29.

Masks must already be worn in high-risk places such as on public transportation; in emergency shelters; in doctor’s offices and hospitals; in homeless shelters and prisons; and in long-term care facilities, such as nursing homes.

“Since you don't get sick if you don't get infected, slowing the spread will always be an essential strategy for dealing with COVID when transmission is high,” Ferrer said.

A slide listing where masks are currently required and the additional locations that will be added if a public indoor mask mandate is reinstated.
Courtesy of the L.A. County Dept. of Public Health)

“When everyone in the room is masked, safety is enhanced as there's less virus circulating and less likelihood that any virus that is circulating will penetrate the physical barrier of a well-fitting, high-filtration mask,” she said.

Increasing outbreaks in nursing homes are being blamed for the rise in deaths — 14 people are dying every day in L.A. County from COVID-19.

Workplace clusters and outbreaks are also on the rise and contribute to additional spread of the virus, Ferrer said.

“Workplace clusters and outbreaks are disruptive and hazardous, particularly as many more outbreaks now involve 20 or more workers,” she said.

One person in L.A. County has tested positive with BA.2.75, a new subvariant that is gaining ground in India.

What questions do you have about the pandemic and health care?
Jackie Fortiér helps Southern Californians understand the pandemic by identifying what's working and what's not in our health response.

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