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Health Officials: L.A. County Facing 'Most Dangerous Moments' of Pandemic

A Passenger Service Representative for Avianca Airlines in the Tom Bradley International Terminal at LAX takes the temperature of Cindy Perla on Nov. 16, 2020 in Los Angeles. | Al Seib / Los Angeles Times
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LOS ANGELES (CNS) - Warning that the county is facing “one of the most dangerous moments in this pandemic,” Los Angeles County health officials today defended new business and social gathering restrictions, stressing that absent an immediate downturn in COVID-19 case numbers, area hospitals could be quickly overwhelmed.

Dr. Christina Ghaly, the county's director of health services, stressed that current projections indicate the county will see its highest number of hospitalizations since the pandemic began in the next four weeks, potentially outpacing hospital capacity.

Driving home the point, public health director Barbara Ferrer walked through statistics showing dramatic increases in the county's case numbers, testing positivity rates and hospitalizations since early November. Ferrer said the county on Nov. 1 was averaging about 1,100 new cases a day, but that figure increased to almost 2,000 one week later, and as of Wednesday, it had risen to almost 4,000 per day.

“I cannot stress enough how concerning this is,” Ferrer said.

The county's seven-day average daily positivity rate among those tested for the virus was 3.9% on Nov. 1, but it rose to 5.1% by Nov. 8 and it now stands at 7.1%. Average hospitalizations were 791 on Nov. 1, rising to 1,010 on Nov. 14. On Wednesday, the county reported 1,188 people in the hospital due to the virus, the ninth straight day of increases.

“We face one of the most dangerous moments in this pandemic,” Ferrer said. “And the only effective path forward requires immediate action, and unfortunately, additional sacrifice. When the rate of increase is as high as it is right now, it can be harder to slow the spread. Heading into colder months and the flu season compounds the sense of urgency.”

On Friday, the county will impose increased restrictions on business and social activity, most notably requiring restaurants, wineries, breweries and non-essential businesses to close between 10 p.m. and 6 a.m. Ferrer clarified that the food and drink establishments will be allowed to continue pick-up and delivery service beyond 10 p.m., but in-person service will be cut off.

Other restrictions set to take effect Friday are:

  • indoor “non-essential'' businesses such as retail stores, offices and personal care services will be limited to 25% occupancy;
  • outdoor service at restaurants, wineries and breweries will be limited to 50% of the maximum outdoor capacity;
  • outdoor cardrooms, miniature golf sites, go-kart tracks and batting cages will be limited to 50% of maximum outdoor capacity;
  • customers at personal-care businesses must make advance appointments, and no services that require customers to remove their face masks can be offered; and
  • outdoor gatherings must be limited to no more than 15 people from a maximum of three households.

The county previously issued guidance limiting gatherings to three households, but there was no numerical limit on attendees.
According to the county, if the five-day average of new cases reaches 4,000, or if hospitalizations top 1,750, outdoor dining at restaurants, breweries and wineries will end, with the businesses restricted to pick-up and delivery service only.

“It is highly likely that we will experience the highest rates of hospitalizations that we have seen in the COVID-19 pandemic to date in the next month, unless we take action immediately to substantially reduce transmission within our communities.”<br>
Dr. Christina Ghaly, L.A. County director of health services

If the five-day case average reaches 4,500 or more, or if hospitalizations top 2,000 per day, the county will re-implement its original Safer At Home order for three weeks, allowing only essential workers to leave their homes, or residents seeking out essential services. The county at that point would also issue a 10 p.m. to 6 a.m. curfew, with only essential workers exempted.

As of Tuesday, the five-day case average was 2,884. But on Wednesday, the county announced 3,944 new cases, mirroring numbers not seen since a mid- summer surge that followed the Fourth of July holiday. The new cases increased the cumulative county total since the start of the pandemic to 348,336.

The county also announced 36 more deaths, although one of those fatalities was actually announced Tuesday by Pasadena health officials. The countywide death toll from the virus stood at 7,335 as of Wednesday.

Unlike all other COVID-19 statistics, the county's rate of coronavirus-related deaths has not yet surged upward. Ferrer attributed that promising fact to improvements in hospital treatment, and the fact that the vast majority of new cases are occurring among younger residents who are less likely to become seriously ill from the virus. But she warned that continued increases in hospitalizations will almost certainly translate to an eventual increase in deaths.

Ghaly warned that an increase in hospitalizations is almost inevitable in the next two weeks, given the virus' incubation period. And the current trend lines indicate that without a dramatic change in case numbers, area hospitals could find themselves quickly overwhelmed with patients.

“While the steep increase in hospitalizations has only been going on for one week, we cannot ignore the facts,” Ghaly said. “... If we look at the range of uncertainty going forward ... then the projected trend over the next four weeks is concerning .... The message is very clear. It is highly likely that we will experience the highest rates of hospitalizations that we have seen in the COVID-19 pandemic to date in the next month, unless we take action immediately to substantially reduce transmission within our communities.”

The estimated rate of COVID-19 transmission in the county — the average number of people every coronavirus patient infects with the virus — was 1.18 as of Wednesday, an increase from last week's 1.03 rate, and rapidly approaching the pandemic-high rate of 1.26 recorded in late July during the summer surge.

Ghaly noted that if hospitals start becoming overwhelmed, they'll be forced to discharge less serious patients and cancel elective procedures. She noted that the onset of flu season will place additional strain on the health system, heightening the need for increased COVID-19 control measures.

County officials stressed that the new measures being implemented are not a deliberate attempt to punish businesses and restaurants, but they are aimed at reducing crowding and reducing potential exposures in settings — such as restaurants — where people are gathered without wearing masks.

“Approximately 95% of businesses that have reopened have been in compliance with public health guidelines,” County Supervisor Kathryn Barger said. “However, we are implementing these precautions to help prevent the ongoing community transmissions. We hope these actions get the attention of individuals who are not using caution in social settings and encourage them to be vigilant.

“... We are at a crucial junction and we need to call on all of our residents, businesses and organizations to do what science tells us is right,” she said.

Health officials have pointed squarely at gatherings of residents — either in public or private settings — for driving the recent surge, which has primarily involved younger residents under age 50.

Ferrer said Monday residents between 18-29 have consistently accounted for a larger proportion of new cases over the last two months, dramatically widening the gap over all other age groups. But while younger people are becoming infected more often, it is older residents suffering the consequences in terms of hospitalizations, she said, meaning young people are becoming infected and passing the virus to older residents who are at higher risk of severe illness.

Top Image: A Passenger Service Representative for Avianca Airlines in the Tom Bradley International Terminal at LAX takes the temperature of Cindy Perla on Nov. 16, 2020 in Los Angeles. | Al Seib / Los Angeles Times

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