2021 Begins With Highest COVID-19 Rates to Date
Los Angeles County began the first full week of the New Year with the highest daily numbers of new COVID-19 deaths, cases and hospitalizations reported throughout the pandemic. This included record highs of case counts in excess of 10,000 on several days and several days with total daily deaths above 200. In a press release issued on Wednesday, January 6, 2021, the County Public Health Department noted “a disastrous increase in the number of people with severe COVID-19 symptoms being sent to our local hospitals.” The County pointed out:
On November 1, the three-day average number of people hospitalized with COVID-19 was 791. On January 4, the three-day average increased to 7,873. Hospitals are accepting more patients than they can discharge, and this is causing a huge strain on our emergency medical system.
In addition, the County’s overall test positivity rate rose to 17% on Wednesday, January 6, 2021. By comparison, the rate had remained below 10% for most of 2020. In addition, the daily test positivity rate on November 1, 2020, was 3.8%; last week, it reached 21.8%.
New infections and hospitalizations are anticipated to rise in the coming weeks.
The County remains in Tier 1 of the State’s Blueprint, along with 54 of the state’s 58 counties, covering approximately 99% of the state’s population.
Testing
On Monday, January 4, 2021, the FDA issued an advisory “alerting patients and health care providers of the risk of false results, particularly false negative results” with COVID-19 tests issued by Curative Inc. Since April 2020, Curative tests had been used throughout Los Angeles. However, late Sunday, January 10, 2021, the L.A. Times reported that the County would no longer be using Curative tests.
Hospital Capacity
Los Angeles County and the entire Southern California region also started the year with an ICU capacity of 0.0%.
In a briefing presented to the County Board of Supervisors on Tuesday, January 5, 2021, County Director of Health Services Dr. Christina Ghaly noted that over half of all hospital patients have COVID-19, and over approximately 75% of ICU patients are COVID-19 patients. She said that the County system was working hard to maintain staffing levels. Dr. Ghaly added that while several hospitals in the County were having issues with oxygen flow, some of them have been resolved, and the County is working with the Army Corps of Engineers to resolve the rest. However, Dr. Ghaly stated that the County currently has sufficient levels of supplies and does not anticipate any supply problems.
Finally, Dr. Ghaly reported that no hospitals have declared crisis care, although offload times (from ambulances to ERs) remain high. According to Dr. Ghaly, a “crisis care” declaration would allow hospitals to allocate or ration care in order to try to save the most viable patients and to potentially reduce the level of care for patients not expected to survive.
Vaccinations
Distribution and administration of Pfizer and Moderna vaccines continue in the New Year.
As of January 7, 2021, Los Angeles County’s Vaccine Dashboard indicated the County had received 490,995 combined total doses of the Pfizer and Moderna vaccines, with 145,621 received vaccine doses administered as first doses and 6,151 as second doses.
At the Board of Supervisors meeting on Tuesday, January 5, 2021, County Director of Public Health Dr. Barbara Ferrer reported that approximately 35% of the County’s Pfizer doses have been administered to frontline healthcare workers, and the majority of Moderna vaccines have also been distributed to non-hospital frontline staff (such as EMTs and those at federally qualified health centers (FQHCs)). She added that the County is scheduling distribution beginning the week of January 11, 2021, for non-acute long-term care facilities. Dr. Ferrer anticipated that if the County gets enough vaccine doses, it can complete vaccinating Phase 1A (including healthcare workers in acute hospital and community settings, as well as residents and staff at long-term care facilities) by early February at the latest. She said that the numbers of doses the County anticipates receiving this week are “much smaller” than anticipated based on previous announcements from the federal government.
More broadly, Dr. Ferrer said that she did not anticipate availability for the general public until the summer. Dr. Ferrer also stated that we will be in “vaccine scarcity” for at least several weeks, and noted that several sites have already seen dozens or hundreds of people showing up who are not healthcare workers in the current priority groups. Dr. Ferrer noted that the various vaccination phases would begin to run concurrently as Phase 1A individuals receive second doses and lower-priority populations begin to receive initial doses, and also as the number of available vaccinators and vaccination sites expands.
The County is currently providing vaccinations at 19 Points of Dispensing (PODs) across the county for persons within Phase 1A to receive vaccination. Beginning Monday, January 11, 2021, the County registration system is expected to include all individuals who qualify within Phase 1A. In addition, the County plans to open 75 additional sites for these priority groups, including four FQHCs, a community hospital and 70 retail pharmacies throughout the county to help administer vaccinations to individuals within Phase 1A.