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There are cases of coronavirus in Los Angeles County, but this is different

Super-contagious sub-variants of Omicron that can re-infect people in a matter of weeks are fueling a new wave of the pandemic in California.

Hospitalizations are rising and Los Angeles County is moving toward an indoor mask-wearing mandate, perhaps by the end of the month.

But this wave is different from the previous ones.

Many of those who become infected do not become seriously ill. While hospitalizations are up, patients are generally less sick and intensive care units are less crowded than during previous wave peaks.

Experts cite the availability of vaccines and treatments, as well as changes with the virus itself, for improvements.

But that does not mean that COVID-19 has become a toothless tiger. Deaths in Los Angeles County have risen significantly over the past month, as has the number of positive coronavirus patients in intensive care, which has reached the same level as almost exactly a year ago, the last time Los Angeles County Los Angeles enacted an indoor mask mandate.

This double-edged reality, where the risk of serious illness for each case may be lower but there are considerable numbers of deaths, is causing confusion as the pandemic extends into its third summer.

The latest buzz comes from Los Angeles County-USC Medical Center, the largest of the four public hospitals run by the county. During an internal town hall on Wednesday, which was posted onlineMedical Director Dr. Brad Spellberg noted that while positive coronavirus cases have increased, “this is not because we’re seeing a lot of people coming in with symptomatic illness.”

Spellberg said about 90% of the hospital’s coronavirus-positive patients were admitted for other problems.

“Virtually none of them go to the ICU, and when they do go to the ICU, it’s not for pneumonia. They are not intubated,” he said, citing other problems, such as electrolyte abnormalities.

“It’s just not the same pandemic it was, despite all the media hype to the contrary. … A lot of people have bad colds, that’s what we’re seeing.”

Epidemiologist Dr. Paul Holtom chimed in that, as of Wednesday, “we don’t have anyone in the hospital who has had lung disease due to COVID.”

Holtom noted the possibility of a mask mandate, but said “there is no reason, from the perspective of hospitalization due to COVID, to be concerned at this time.”

As the town hall video spread online, some highlighted the couple’s comments to repudiate the concept of a masking order, or to argue that the dangers associated with the current wave of coronavirus are exaggerated or unfounded.

But in a statement to The Times on Monday, the Los Angeles County Department of Health Services, which oversees County-USC, said the pandemic “remains a very serious public health threat that we must continue to combat with all available tools, including vaccines. , masking, social distancing and treatment.

“Using our weekly internal town hall to suggest that such measures are unnecessary is fundamentally contrary to our position as a medical center,” the statement continued.

While it is true that many positive coronavirus patients do not have severe symptoms requiring ICU admission, the Department of Health Services attributed that trend in part to the high level of vaccination coverage in Los Angeles County.

“While we are not currently experiencing an increase in ICU admissions in [County-USC], we are seeing a significant increase in the number of infections among our patients, staff and the communities we serve,” officials wrote in the statement. “Increasing infection rates are extremely concerning, as the more people who become infected, the greater the likelihood that COVID-19 ICU admissions will increase in the future.”

While not as severe as previous surges, hospitalizations have increased. In Los Angeles County, 1,299 positive coronavirus patients were hospitalized as of Monday: an increase of 60% since the beginning of the month.

And County-USC’s experience in its ICU may not be representative of Los Angeles County as a whole. There were 137 positive coronavirus patients in Los Angeles County intensive care units on Monday, well below the highs of previous waves but a nearly 51% increase since July 1. there were 134 positive coronavirus patients in ICUs.

As of the end of June, approximately 20% of coronavirus-positive patients at Los Angeles County’s four public hospitals were being treated for COVID-19 disease.

Across all hospitals, public and private, in Los Angeles County, approximately 42% of coronavirus-positive patients are being treated for COVID-19 disease. Statewide, turnout is around 50%.

On Thursday, Los Angeles, the nation’s most populous county, reported 10.5 new coronavirus-positive hospitalizations per 100,000 residents, up from 8.4 the previous week.

Movement above 10 per capita pushed Los Angeles County to the top Community level COVID-19 as defined by the US Centers for Disease Control and Prevention. Health officials have long said that if the county reaches that threshold, they would prepare to institute a mask mandate in closed public settings. That order could go into effect on July 29 for people over the age of 2, unless conditions improve.

COVID-19 deaths across Los Angeles County have risen significantly in the past month, from about 50 a week to between 86 and 100. That’s the first significant increase since the end of Omicron’s winter spree. During the peak of that surge, weekly deaths topped 500.

There are a number of other indicators to explain why the Los Angeles County Department of Public Health and institutions across Southern California are concerned about rising levels of infection, which is causing large numbers of workers to get sick. , sometimes for weeks.

The rising number of cases at County-USC, for example, has put pressure on hospital staff, Chief Executive Jorge Orozco said during last week’s town hall.

“We have a significant number of employees who are testing positive,” he said, adding that those employees may not be very sick, but they need to isolate. “It causes significant challenges in terms of coverage, in terms of providing adequate care.”

Last week, Los Angeles County Public Health Director Barbara Ferrer said that while COVID vaccines, boosters and medications make it less likely that large numbers of people will need intensive care or ventilators, there are still some who need those resources.

“Between 5% and 10% of people hospitalized with COVID still end up in the ICU, and some of them need ventilators. So there are still some serious illnesses associated with COVID,” he said. “But nothing like what we were seeing during the Omicron surge.”

Still, he said, “we also have a lot of unknowns with BA.5 and whatever else comes our way. What is happening in our hospitals could change.”

Ferrer said that emergency departments, urgent care centers and community clinics are telling his department “that they feel very tied down. They’re understaffed, because a lot of them are sick with COVID and they’re out, and they also have a lot of their patients who, while they don’t need to go to the hospital, do need medical attention, and that creates some stress. .”

Two months ago, 5% of emergency room visits countywide were related to the coronavirus; now, it’s 10%.

Workplace case clusters “are disruptive and dangerous,” Ferrer said during a recent briefing. “Workplace outbreaks create a concerning risk to vulnerable employees and often contribute to further spread of the virus in the homes and communities where our workers live.”

Countywide, 371 workplaces reported clusters of coronavirus cases in a recent seven-day period. At the beginning of May, there were 100.

The county is also seeing an impact on nursing homes. Over the past week, outbreak investigations have been conducted at 41 nursing homes in Los Angeles County, five times as many as in early May.

“In May, about 5% of all deaths occurred among nursing home residents,” Ferrer said. “Sadly, this number increased to 12% in June.”

So far in 2022, Los Angeles County has reported 4,390 deaths from COVID-19. There were nearly 12,000 COVID-associated deaths in 2020 and 14,500 in 2021.

By contrast, in the pre-pandemic era, about 1,500 county residents died each year from the flu, more than 2,000 from accidental drug overdoses, and nearly 900 from car accidents.

Coronavirus infection also presents the risk of prolonged COVID, in which the risk of death from cardiac, gastrointestinal, or neurological system complications can persist for years.

Some question the wisdom of a new mask order, or what kind of compliance Los Angeles County might expect. Maria Salinas, president and CEO of the Los Angeles Area Chamber of Commerce, and Jessica Lall, president and CEO of Central City Assn., a downtown business group, sent Ferrer a letter last week expressing their concerns.

Requiring masks, they wrote, “puts employees in the increasingly challenging position of enforcing a mandate that many customers no longer want, or are unwilling to comply with.”

“Los Angeles restaurants, retail stores, museums, amusement parks, sports venues and many other establishments are working every day to recover from the pandemic, while facing labor shortages, supply chain challenges supply and more,” they wrote. “Companies should not be expected to enforce a mask mandate on top of these current restrictions. Companies cannot shoulder this compliance burden on their own, as they have been required to do so in the past.”

If Los Angeles County mandates indoor public mask wearing and no other county does the same, “residents and visitors may choose to take their spending power to businesses in other parts of Southern California, which would only hurt our economy.” local,” they wrote.

Ferrer noted that “we have always benefited in Los Angeles County from the majority of people going ahead and adhering to what we say are sensible precautions.” Health officials, he added, will spend the time leading up to a new mask order “working with our businesses so they are clear on their need to supply those masks to all of their employees, make sure their employees are properly masked inside, and do Do your best to send messages to your customers.

“We need an additional layer of protection, and this is the additional layer,” he added. “So our hope is that people will go ahead and do their best to comply.”

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