With coronavirus cases on the rise, California finds itself in a familiar, if frustrating, position — with the threat of another wave looming as summer fast approaches.
Coronavirus cases are increasing, in many areas at an accelerating pace. Authorities have not yet expressed alarm about the state of California’s hospitals or imposed far-reaching new rules to blunt the virus’ spread.
But officials say it is possible healthcare systems could once again come under strain unless the transmission rate is restrained — underscoring how vital it is for residents and businesses to make use of the protective tools at their disposal.
“Residents, workers and businesses need to not shy away from reinstating or adhering to safety practices that are known to reduce transmission,” said Los Angeles County Public Health Director Barbara Ferrer. “This includes indoor masking, testing when people are sick, exposed or gathering, and staying up to date on vaccinations.”
L.A. County on Friday extended its order requiring mask use on public transit, including in rail and bus stations; in indoor areas of airports and seaports; and in ride-sharing vehicles. Vaccine clinics this week also began making available COVID-19 booster shots for children ages 5 to 11, following the U.S. Centers for Disease Control and Prevention’s recommendation Thursday that these youths should get one.
The Berkeley public school system announced Friday a new order to reinstate an indoor mask mandate for students and staff for the remainder of the school year, effective Monday, including indoor graduations. Berkeley schools are seeing an increase in clusters of coronavirus cases, and the surge has proved so disruptive that “we have only been able to fill about 50% of our teacher absences with substitute teachers,” the school district said in a statement.
“This means that in schools across the district administrators are, once again, working in our classrooms as teachers while teachers are forgoing their planning periods to fill in for colleagues who are ill,” the school system said.
What are conditions like?
Fourteen of California’s 58 counties are at the “medium” COVID-19 community level outlined by the CDC.
Counties in this category, the middle on the agency’s three-tier scale, are experiencing elevated levels of coronavirus transmission. In those counties, residents should “consider taking prevention measures based on their own risk, like avoiding crowds, wearing a mask, increasing their testing, especially before gathering with others indoors,” according to CDC Director Dr. Rochelle Walensky.
Los Angeles moved into the medium category on Thursday, and is the only Southern California county at that level. Also in the medium category are eight of the nine counties in the San Francisco Bay Area (the lone exception is Napa County) and the coastal counties north of the Bay Area, as well as Santa Cruz County and Yolo County.
Reaching this category “is concerning, since it could signal that the increases that we’re seeing in our COVID cases may soon put pressure on our healthcare resources,” Ferrer said Thursday.
So far, no California counties are in the worst, or “high,” community level, which denotes a heightened level of coronavirus transmission and hospitals seeing significant impacts from COVID-19.
“We need to do everything we can to stay out of ‘high,’” Ferrer said. “Nobody here wants to see us move to any categorization that could possibly cause stress on our healthcare system or result in more people getting sick or dying.”
What does that mean?
Being in the medium category does not trigger any new widespread rules or health guidance. However, L.A. County officials have said reaching high would prompt the return of a local universal public indoor mask mandate — which hasn’t been in place since early March.
Other counties in California have not outlined specific plans to reinstate a local mask order if cases or hospitalizations continue to worsen.
Masks are still required in healthcare settings, nursing homes, jails and homeless shelters and in certain other settings in some areas of the state. The San Francisco Bay Area Rapid Transit system has enacted a mask mandate. Oakland requires patrons attending indoor events with 2,500 or more people to wear a mask.
On Tuesday, a number of speakers at a health commission meeting urged San Francisco officials to reinstate a universal mask mandate.
But the city’s health officer, Dr. Susan Philip, indicated she was not inclined to pursue that at this time, given the widespread availability of high-quality masks, vaccinations and boosters and anti-COVID drugs.
San Francisco has been at the medium COVID-19 community level for three weeks, sent into this tier because of its high case rate. But coronavirus-positive hospitalizations remain relatively low, Dr. Grant Colfax, the city’s public health director, told health commissioners this week.
“Our hospital capacity … remains relatively robust,” Colfax said.
Even though a face covering requirement hasn’t been on the books for months, officials at the California Department of Public Health have consistently strongly recommended residents mask up indoors in public.
Ferrer has also urged residents to wear high-quality masks — like KF94, KN95 and N95 respirators — while indoors, get vaccinated and boosted, get tested when feeling sick or potentially exposed to the coronavirus, and prioritize gathering in well-ventilated areas or outdoors.
Despite the recent increases, Ferrer reiterated that she feels people can enjoy gatherings and activities, though she suggested taking prudent precautions.
“While we are disheartened that the pandemic hasn’t ended, I am reassured that with the tools at hand, we can continue to enjoy our time with each other and our participation in those activities we love,” she said.
How does California compare to other parts of the country?
The situation elsewhere in the United States is more concerning.
Nationwide, 297 counties have a high COVID-19 community level — including those that are home to New York City; Long Island, N.Y.; Detroit, Honolulu; and Milwaukee, Wis. Other areas in the high category include large swaths of upstate New York, New Jersey, Delaware and New England, including Boston; northern and eastern Pennsylvania; and all of Puerto Rico.
In these areas, which are home to 18% of the nation’s population, federal health officials recommend people wear masks indoors while in public.
While they haven’t ordered a new mask mandate, officials in New York City warned that “pressure on the healthcare system is increasing” and urged seniors and others at high risk of severe COVID-19 to avoid gatherings and wear a mask in crowded outdoor settings.
Officials have said the the dramatic rise in coronavirus cases and hospitalizations in New York City is being fueled by BA.2.12.1, one of a family of Omicron subvariants spawned in the wake of last winter’s surge.
By comparison, 483 U.S. counties — home to 28% of U.S. residents — are in medium., while the vast majority — 2,444 counties, home to 54% of U.S. residents — remain in low.
“As we’re currently seeing a steady rise of cases in parts of the country, we encourage everyone to use the menu of tools we have today to prevent further infection and severe disease — including wearing a mask, getting tested, accessing treatments early if infected, and getting vaccinated or boosted, especially if you’re over 50 and if your last dose was more than five months ago,” Walensky said during a briefing this week.
What are the latest numbers?
Statewide, officials have reported an average of roughly 12,900 new coronavirus cases a day over the last week — a 63% jump from the previous week’s average, according to data compiled by The Times.
In L.A. County, officials have reported an average of about 3,200 cases per day over the last week. That’s a level not seen since mid-February, when the region was still on the downslope of last winter’s Omicron surge.
And officials say these numbers likely fail to capture a large amount of infections, as many people are using at-home tests — the results of which are not reliably reported to health agencies.
Test positivity remains low, but has been creeping upward. Over the last week, that metric has risen from 2.6% to 3.7% in L.A. County.
What about hospitalizations?
As of Thursday, the number of coronavirus-positive patients hospitalized statewide was 1,708. While still significantly lower than at many other points during the pandemic, the count has jumped 28% just in the last week.
The rate of week-over-week increases in hospitalizations is accelerating. The previous statewide week-over-week increase was 19%.
In L.A. County, the most recent coronavirus-positive patient count was 401, an increase of 35% from a week ago. The prior week-over-week increase was 20%.
Many of those patients aren’t necessarily hospitalized for COVID-19, though. On Tuesday, L.A. County Health Services Director Dr. Christina Ghaly said most of those who were are hospitalized with a positive coronavirus test within the county’s public hospital system were there for some other reason — such as a heart attack or stroke — and happened to incidentally test positive upon admission.
However, an increase in hospitalizations, Ferrer said, is “an important reminder that, for many, getting infected with COVID-19 does pose a serious risk.”
COVID-19 deaths remain stable and low at an average of about 38 per day statewide, according to data compiled by The Times.
Deaths are a lagging indicator of coronavirus spread and often don’t rise until weeks after a region starts recording an increase in infections. However, officials have expressed some optimism that the widespread administration of vaccines and availability of therapeutics might blunt and potential uptick in fatalities.
“Our hope is that as more people take advantage of the protections that continue to be offered by vaccinations and boosters, the daily deaths will remain low,” Ferrer said.