LA County authorities cautious despite declining COVID numbers

Reviewed by Emily Henderson, B.Sc.Sep 3 2020

In Los Angeles County, California’s main COVID-19 hot spot since early in the pandemic, key indicators of the disease have taken an encouraging turn recently.

New cases, hospitalizations, deaths and the rate of positive test results have all been dropping.

But because of the surge of infections after the lifting of restrictions in May, followed by a spike after Memorial Day — and another one after July Fourth — health officials and other experts are wary of loosening restrictions too quickly this time. The approaching Labor Day holiday weekend, when people traditionally gather in groups, reinforces their caution.

The daily number of new cases in the county, despite bounces in each direction, has trended sharply lower in recent weeks — from peaks well above 4,000 in July to numbers well under 2,000 by late August.

The seven-day average of daily coronavirus deaths has dropped steadily, from 44 in late July to 19 as of Aug. 25. And the seven-day average rate of positive COVID tests, another widely watched measure, fell from over 9% in early July to about 5% as of Monday.

Barbara Ferrer, L.A. County’s top public health official, expressed guarded optimism but urged caution with regard to any further loosening of restrictions on business or recreation.

“Please, let’s not let down our guard,” she said at a news conference last week. “We did have a surge after each of the other large holidays, so it would not be a good idea to move with haste on reopening plans until we can make sure that we get through Labor Day with people acting appropriately.”

The recent data is “very encouraging,” said Dr. Ravi Kavasery, medical director of quality and population health at AltaMed, one of the nation’s largest community clinic chains. But “it is very clear we are making this progress because we have made these changes to our behavior, and it provides all the more reason for us to stay the course.”

Indeed, a new plan for reopening businesses and other activities, unveiled Friday by California Gov. Gavin Newsom, shows L.A. County has a long way to go before it is out of the woods.

The new plan replaces the state’s previous county “watchlist” with a four-tier, color-coded system that ranks counties by their risk, based on how prevalent the coronavirus is.

Counties with more than 7 new daily cases per 100,000 people, or positive COVID test rates of more than 8%, are defined as highest-risk, with the danger of infection deemed “widespread” (purple). Three lower tiers are defined as counties of “substantial” (red), “moderate” (orange) and “minimal” risk (yellow).

L.A. County is in the “widespread” tier, as are 38 of the 57 other California counties. The state blueprint prohibits many nonessential businesses from operating indoors in these counties, though hair salons and barbershops can open indoors, and retail — including shopping centers — can operate while limited to a maximum of 25% capacity.

Counties must remain in each tier for at least three weeks before advancing to a less risky one. If a county’s indicators worsen for two consecutive weeks, it will be moved to a more restrictive tier.

L.A. County got some welcome news last week when another widely monitored indicator, the 14-day average COVID case rate, dropped below 200 per 100,000 residents — the state’s threshold under which elementary schools can apply for waivers to reopen for in-person classes.

“We are grateful to see this number come down,” Ferrer said, noting that just a few weeks ago the county was at 400 cases per 100,000 residents.

On Wednesday, the county health department announced that K-12 schools can reopen in a limited way to provide services for “small cohorts” of students with special needs, such as individualized education plans and instruction in English as a second language. Schools won’t fully reopen yet for general instruction, the department said.

It’s not certain the county’s case rate will hold under 200, Ferrer said last week, and for all its progress “we are still considered one of the hot spots.”

Hence, her pre-Labor Day message to the public: “Whether you are traveling or staying at home, you need to be mindful of the fact that we all have to reduce our transmission, and the way to do that is to reduce our exposure to other people. So please, always wear that face covering, always keep your distance, always be washing your hands, and make sure you’re avoiding those crowded situations.”

This KHN story first published on California Healthline, a service of the California Health Care Foundation.