A newly-identified COVID-19 strain has been found in over one-third of COVID-19 cases in Los Angeles and may be contributing to the acceleration of the recent surge of cases across Southern California, according to new research from Cedars-Sinai Hospital.
The strain, which the investigators designated as CAL.20C, is believed to be in part responsible for the dramatic increase in cases over the last two months. The Cedars-Sinai findings did not indicate whether the strain is more deadly than current forms of the coronavirus, according to the study.
CAL.20C is distinct from the virus version identified in the United Kingdom (U.K.) —known as B.1.1.7—that is spreading in the U.S. and is believed to be highly transmissible. In Southern California, the U.L strain has been found in scattered coronavirus cases in Los Angeles, San Diego and San Bernardino counties. In contrast, the CAL.20C strain was identified in 36.4% of cases in the Cedars-Sinai study.
“The recent surge in COVID-19 positive cases in Southern California coincides with the emergence of CAL.20C,” said Eric Vail, MD, assistant professor of Pathology and director of Molecular Pathology in the Department of Pathology and Laboratory Medicine at Cedars-Sinai.
CAL.20C includes a virus variant that the California Department of Public Health reported on Jan. 17 based on data submitted by Cedars-Sinai and other investigators. This variant, dubbed L452R, is one of five recurring mutations that constitute the CAL.20C strain, which is propagating across the country, starting in Los Angeles.
L.A. County has emerged as one of the nation’s COVID-19 hotspots. Through mid-January, the county had reported more than 1 million COVID-19 cases and nearly 14,000 deaths since the start of the pandemic. More than two-thirds of the cases were added since the beginning of November, according to the study.
Investigators have also detected the CAL.20C strain in multiple recent patient samples in Northern California, New York, Washington, D.C., and even abroad.
To identify the CAL.20C strain, the Cedars-Sinai investigators examined SARS-CoV-2 virus samples from 192 patients at Cedars-Sinai who tested positive for coronavirus between Nov. 22 and Dec. 28, 2020.
Using an advanced technique known as next-generation sequencing, they analyzed the genes of the viruses. They combined this data with 4,337 gene profiles of SARS-CoV-2 viruses obtained from patients throughout Southern California, also using publicly available databases.
While the CAL.20C strain was almost nonexistent in October, by December, 36.4% of virus samples from Cedars-Sinai patients were determined to be the strain, as were 24% of all samples from Southern California, defined by Imperial, Kern, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Luis Obispo, Santa Barbara and Ventura counties.
L.A. County Sees Increase In COVID-19 Cases Among Staff, Residents At Nursing Facilities
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.
California To Require State, Health Care Workers To Show Proof Of Vaccination Or Testing
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.
Los Angeles County COVID-19 Cases Increase 80% In One Week
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.