Last week, Los Angeles County remained at Tier 1 of the State’s Blueprint. The County continues to experience a slight increase in its new case rate per 100,000 residents, with an average of 7.6 new cases per 100,000 in the past week. Given current levels of new cases, it is unlikely that the County will be able to move to Tier 2 until at least the second week of December, at the earliest. The County’s transmission rate is now also above 1.0, at 1.03, indicating the likelihood of rising community transmission.
In a news release issued at the beginning of the week, on Monday, November 9, 2020, the County Department of Public Health stated that “L.A. County is experiencing a surge in COVID-19 transmission.” On Tuesday, November 10, 2020, at the Los Angeles County Board of Supervisors meeting, County Director of Public Health Dr. Barbara Ferrer said that the County is experiencing “an acceleration that now amounts to a surge.” She also said the County would be continuing compliance efforts in response to outbreaks, as well as proactive inspections at high-risk businesses and in high-risk industries. Dr. Ferrer warned that entering the holiday season at current rates could easily result in overwhelming the County’s hospital system.
As of Friday, November 13, 2020, the County experienced new case numbers of over 2,000 per day for almost every day of the prior two weeks, and hospitalization rates had climbed to more than 900 per day, the highest level since August. And over the weekend, new case rates spiked higher, with the County reporting 3,780 and 3,061 new cases on Saturday and Sunday, respectively. Saturday’s total was the highest single-day number of new cases since mid-July, during the County’s summer surge. Case counts may continue to rise this week, as numbers are typically lower over the weekend due to lags in testing and data reporting.
In response to this surge, the County is considering additional restrictions and a return to earlier shutdowns. At a press conference on Thursday, November 12, 2020, Dr. Ferrer said that the County’s short-term test positivity rate rose to 5.9% and called the recent increase “deeply disturbing.” She added that if the County fails to make significant changes in behavior, the Department of Public Health “will be forced to look at additional restrictions.” However, the Department of Public Health has not yet provided any additional information on what sectors may be impacted.
In addition to any potential new restrictions, Dr. Ferrer strongly recommended that Angelinos not travel or gather for the Thanksgiving holiday. At the press conference on Thursday, she urged people to have a “stay-at-home Thanksgiving” this year and, if they do travel for the holiday, to quarantine for 14 days after returning. She also reiterated that the County’s current health guidance permits gatherings of a maximum of three households, outdoor only and for no more than two hours. Physical distancing and facial coverings are also required at any such gatherings.
Over the weekend, several LA County Supervisors and Dr. Ferrer floated the possibility of instituting curfews. Both Supervisors Sheila Kuehl and Mark Ridley-Thomas indicated that they would consider instituting curfews as a way to avoid a full shutdown of significant sectors of the economy. The Department of Public Health is expected to submit recommendations for any new restrictions to the Board of Supervisors this week.
Enforcement
At the Board of Supervisors meeting on Tuesday, the Board unanimously approved a motion to implement a Public Health Council (PHC) Program, based on a series of report recommendations calling for actions to be carried out by the Department of Public Health. These PHCs are intended to allow employees at private companies to assist the Department of Public Health with compliance and enforcement of COVID-19-related safety requirements and Health Officer Orders. The report recommendations note that under the program, violations of Health Officer Orders could result in the issuance of administrative citations, the assessment of “reinspection fees,” permit or license suspensions or revocations, ordered business closures, and/or referral for additional civil or criminal enforcement by appropriate law enforcement agencies.
The PHC program will be implemented on an accelerated timetable, with training curricula to be developed this month and PHC formation and implementation to begin as early as January 2021. Initially, the program phase-in will focus on the food manufacturing, apparel manufacturing, warehousing and storage, and restaurant industries.
Vaccination and Testing
Given the recent news about a potentially highly effective vaccine, there is rising interest in the County’s level of preparedness for vaccine distribution. At the Board of Supervisors meeting on Tuesday, Dr. Ferrer said that despite recent good news, there would still be some time before vaccinations were widely available in Los Angeles and that they will initially be in short supply. She pointed out that L.A. County will need approximately 20 million doses, because the Pfizer vaccine requires two doses per person to be fully effective. The County will be ready to distribute a vaccine once it is available, but that will be several months from now at the earliest. Dr. Ferrer noted that the County was continuing to develop a distribution plan. County Health Director Dr. Christina Ghaly did note that the County hospital systems do not currently have freezers sufficient to handle the Pfizer vaccine’s extreme cold requirement, but they are working to secure this equipment, and equipment for transport, in advance of any vaccine becoming available.
On testing, Dr. Ghaly said that there has been an increase in utilization of testing sites over the past two weeks, which she said was “encouraging” and reversed a trend from the prior month. However, approximately one-third of the County’s available daily testing slots remains unfilled. The County added capacity at some sites to meet demand and is looking at rolling out mobile testing to targeted communities.
In a briefing on Tuesday, November 10, 2020, Los Angeles Mayor Eric Garcetti stressed the seriousness of recent increases in COVID-19 metrics and urged Angelinos to get tested if they think they may have been exposed, especially considering rising rates in the City. To accommodate additional testing, the City has expanded capacity and hours at City-operated testing sites.
Education
The County continues to successfully reopen schools for in-person education. As of Thursday, November 12, 2020, 1,571 schools have reopened for small cohorts of high-needs students, with over 75,000 students and 30,000 staff on campuses. Of those schools, over 50% are in full compliance with all health and safety regulations, and over 82% are in good compliance. There have only been 12 outbreaks, primarily among staff, and 11 of those outbreaks involved no more than four cases. The remaining outbreak involved a sports team that traveled to Arizona.
In addition, the County has received 238 applications for waivers to reopen schools and has granted 74 waivers as of November 12, 2020.