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L.A. County Prepares For ‘Red’ Tier As COVID-19 Cases Continue To Decline

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Los Angeles County public health officials are preparing for the “red” tier of the California reopening blueprint as COVID-19 cases decline.

Last Friday, the state announced updates to their Blueprint for a Safer Economy.  In addition to assessing county case rates, positivity rates and positivity rates in neighborhoods with the lowest scores in the Healthy Places Index (HPI), the state is now taking into consideration the number of vaccinations that have been administered in the lowest-resourced neighborhoods statewide.  

Unlike the other three metrics, vaccination numbers will be calculated statewide and used to change the case rate thresholds for counties to move from one tier to another, according to the Los Angeles County Department of Public Health.

Once 2 million vaccine doses have been administered in the state to the communities with the lowest score in the Healthy Places Index, the threshold to move from the purple tier to the red tier will go from 7 new cases per 100,000 people to 10 new cases per 100,000 people.  

To move to the orange tier, the threshold will remain at 4 cases per 100,000 people, and to move to the yellow tier, the threshold will remain at 1.

Once 4 million vaccine doses have been administered in the state to the communities with the lowest score in the Healthy Places Index, the threshold to move from the purple tier to the red tier will remain at 10 per 100,000 people, but the threshold will change for moving to the orange tier, from 4 new cases per 100,0000 residents to 6 cases per 100,000 people.

The state anticipates administering 2 million doses to residents in hard-hit communities by the end of the week.  

Last week, the case rate in L.A. County was below 10 new cases per 100,000 residents. If this week’s adjusted case rate remains below 10 new cases per 100,000 people, within 48 hours of the state announcing the vaccine trigger has been met, Los Angeles County, along with other counties with qualifying case rates, would move into the red tier.  

“We will be working with the Board of Supervisors and our sector partners to prepare appropriate modifications to the Health Officer Order reflecting the County’s move to the red tier,” said public health officials on Monday.

The state also announced plans to permit the reopening of outdoor sporting events, live outdoor concerts and theme parks.

 Starting April 1, outdoor sporting events and outdoor live concerts will be permitted with significant capacity and infection control modifications.  For counties in the purple tier, capacity at these outdoor events will be limited to 100 people or less, reservations will be required, and concessions will not be allowed. 

 Only people who live in the region where the event is taking place will be permitted to attend.  Once in the red tier, these outdoor events can open at 20% capacity, limited to in-state visitors only; concessions will be allowed only while seated.  As counties move into less restrictive tiers, the allowed capacity will increase, according to public health officials.

The department is also preparing for schools to be permitted, in the red tier, to open for on-site learning for grades 7 through 12. 

As schools prepare for these students, they must have an updated State COVID-19 Safety Plan (CSP), including the Cal/OSHA COVID-19 Prevention Program and the CDPH COVID-19 School Guidance Checklist posted to the school or district website no less than 5 days before their planned opening date.  

Schools will also have to file an updated L.A. County Reopening Survey and an updated L.A. County Reopening Protocol for K through 12 Schools at least 5 days before the proposed reopening date for grades 7 through 12.  

“We are at a point in the pandemic where we have a great deal of optimism,” said Dr. Barbara Ferrer, director of public health in a statement. “We are making progress on vaccinating our residents, cases, hospitalizations and deaths are decreasing, and we are likely moving into a less restrictive tier. In order for us to maintain progress, we will need to continue making slowing transmission a central part of our day-to-day lives.”

On Monday, Public Health confirmed 13 new deaths and 880 new cases of COVID-19. To date, the department has identified 1,204,018 positive cases of COVID-19 across all areas of L.A. County and a total of 22,041 deaths. Monday’s death and case numbers represent an undercount associated with lag in weekend reporting.

 “The County has returned to daily case numbers that are at pre-surge levels. The seven-day average number of daily cases by episode date has continued to decrease, and as of Febr. 28 is 700,” said public health officials. 

There are 1,132 people with COVID-19 currently hospitalized and 31% of these people are in the ICU.  Testing results are available for more than 5,900,000 individuals with 19% of people testing positive. The daily test positivity rate is 2.0%.

To date, more than 2,415,000 doses of vaccine have been administered across the county. Of those vaccinated, 814,593 people have received second doses. Currently, people eligible for the vaccine include healthcare workers, residents and staff at long-term care facilities, people 65 or older, education and childcare workers, food and agriculture workers, and emergency service workers and law enforcement.

As of last week, 58% of L.A. County residents 65 and older have received at least one dose of the vaccine and 30% received both doses.

There are over 375 vaccination sites receiving a portion of the 312,690 total doses allocated to the County of L.A. for this week. This allocation includes 54,000 doses of the Johnson & Johnson vaccine.   

“The County’s network of vaccination sites has the capacity for 626,000 appointment slots this week, even with the increased doses, we only have enough doses for about 312,000 appointments,” said public health officials.  “Our large capacity vaccination sites alone could be providing 195,000 additional doses this week if there was sufficient supply.”

For information about vaccine appointments in L.A. County, visit here.

Coronavirus

L.A. County Sees Increase In COVID-19 Cases Among Staff, Residents At Nursing Facilities

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Los Angeles County is now experiencing an increase in cases among staff and residents at skilled nursing facilities, public health officials said Tuesday.

The rise is in part due to the highly transmissible Delta variant and a small number of post-vaccination infections among those fully vaccinated, according to the L.A. County Department of Public Health.

Currently, 86% of residents and 85% of staff at skilled nursing facilities are fully vaccinated. For the week ending July 18, 33 people tested positive for COVID-19: six new cases among residents, and 27 new cases among staff.

 For the previous weeks, an average of 22 new cases were reported among staff and residents at skilled nursing facilities.

Masks have consistently been required in all healthcare settings, including skilled nursing facilities, regardless of vaccination status. Routine testing of staff and residents is also required at skilled nursing facilities, and there are stringent infection control directives, according to the department.

On Tuesday, Public Health confirmed 2,293 new cases of COVID-19. To date, the department has identified 1,307,970 positive cases of COVID-19 across all areas of L.A. County and a total of 24,704 deaths.

There are 1,138 people with COVID-19 currently hospitalized and 22% of these people are in the ICU. This is an increase of 313 daily hospitalizations since last Tuesday.

“Residents at skilled nursing facilities are often medically fragile and throughout this pandemic have been at great risk for serious illness and death from COVID-19. Thankfully, because of their high COVID-19 vaccination rates and infection control measures at facilities, we are not seeing dramatic increases in COVID-19 cases among staff and residents at skilled nursing facilities, nor have we seen significant increases in deaths,” said Dr. Barbara Ferrer, director of public health in a statement. “In order to ensure a continued high level of protection during this surge, staff and residents not yet vaccinated should do so. And we ask everyone who plans to visit someone in a skilled nursing facility to mask up and be fully vaccinated to prevent transmission to very vulnerable residents.”

Anyone 12 and older living or working in L.A. County can get vaccinated against COVID-19. For more information, visit here

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California To Require State, Health Care Workers To Show Proof Of Vaccination Or Testing

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All California state employees, as well as workers in health care and high-risk congregate settings, must show proof of full vaccination or be tested at least once per week, Governor Newsom announced Monday.

The new policy for state workers will take effect on Aug. 2 and testing will be phased in over the next few weeks. The new policy for health care workers and congregate facilities is set to take effect on Aug. 9, and health care facilities will have until Aug. 23 to come into full compliance. 

Unvaccinated workers will be subject to at least weekly COVID-19 testing and will be required to wear appropriate personal protection equipment (PPE). This requirement also applies to high-risk congregate settings, including senior residential facilities, homeless shelters and jails. 

“We are now dealing with a pandemic of the unvaccinated, and it’s going to take renewed efforts to protect Californians from the dangerous Delta variant,” said Newsom in a statement. “As the state’s largest employer, we are leading by example and requiring all state and health care workers to show proof of vaccination or be tested regularly, and we are encouraging local governments and businesses to do the same.”

Despite California leading the nation in vaccinations, with more than 44 million doses administered and 75% of the eligible population has received at least one dose, the state is seeing increasing numbers of people who refused to get the vaccine being admitted to the ICU and dying.

“The Delta variant is up to 60% more infectious than the Alpha strain but many times more infectious than the original COVID-19 strain. If you have been waiting to get vaccinated, now is the time,” said Health and Human Services Secretary Dr. Mark Ghaly in a statement.

As of last week, California’s statewide case rate more than quadrupled from a low in May of 1.9 cases per 100,000 residents a day to at least 9.5 cases per 100,000.

The vast majority of new cases are among the unvaccinated, with 600% higher case rates among the unvaccinated than for those who are vaccinated, according to the state. 

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Los Angeles County COVID-19 Cases Increase 80% In One Week

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Los Angeles County continues to see a rapid rise in COVID-19 transmission countywide with cases doubling over the last 10 days as the Delta variant spreads.

The Los Angeles County Department of Public Health confirmed 2,767 new cases of COVID-19 on Thursday an 80% increase over last week, according to the department. 

On Friday, 3,058 additional cases were reported, marking the third day in a row with more than 2,500 cases reported in a day, according to Public Health.

The County’s daily average case rate, with a 7-day lag, is now 12.9 cases per 100,000 people, an increase from last week’s rate of 7.1 cases per 100,000.

There are 645 people with COVID-19 currently hospitalized and 22% of these people are in the ICU. Last week, there were 406 people hospitalized with COVID-19 illness.

“Public Health has detailed the rise of the Delta variant among strains sequenced in the Los Angeles County area for weeks,” department officials said. “While emerging data affirms that fully vaccinated people are well protected from severe infections with Delta variants, people with only one vaccine are not as well-protected, and there is increasing evidence that a small number of fully vaccinated individuals can become infected and may be able to infect others.”

From July 11 to July 17, the number of sequenced Delta variants was 201, 84% of all sequences collected that week. 

This is consistent with the rise of Delta nationwide: earlier this week, the Centers for Disease Control and Prevention (CDC) estimated that Delta strains accounted for 83% of circulating COVID-19. Given that about 4 million residents in L.A. County are not yet vaccinated, the risk of increased spread of this variant within L.A. County remains high, according to Public Health.

As of July 18, more than 10,845,531 doses of a COVID-19 vaccine have been administered to people across Los Angeles County. Of these, 6,013,569 were first doses and 4,831,962 were second doses.

88% of L.A. County seniors 65 and over, 70% of residents 16 and over, and 69% of residents 12 and over have received one dose of a vaccine including 39% of L.A. County teens between the ages of 12 and 17. 

Of the nearly 10.3 million L.A. County residents, including those who are not yet eligible for the vaccine, 52% are fully vaccinated and 59% have received at least one dose.

“As more people have gotten vaccinated, the proportion of total cases that are among those vaccinated has also increased,” public health officials said. “This is to be expected because as more people are vaccinated, the number of fully vaccinated people becoming infected will increase.”

 In June, fully vaccinated people represented 20% of all cases diagnosed among L.A. County residents, while unvaccinated and partially vaccinated people accounted for 80% of cases.

Public Health estimates if the 52% of County residents that are fully vaccinated were not vaccinated, the number of new cases would perhaps be double because everyone would instead have the same risk of infection as unvaccinated people do. While County numbers have been going up, they would be much higher if there weren’t as many people fully vaccinated.

In Los Angeles County, everyone 2 years of age and older must wear a mask in all indoor public places, regardless of their vaccination status. 

“While the County does not require masking at private gatherings where unvaccinated or immunocompromised people are present, universal masking in these scenarios, particularly indoors, is the best way to protect everyone,” department officials said.

To find a vaccination site in Los Angeles County, visit here.

Note: This story has been updated with new case data from the Department of Public Health.

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