Health

Coronavirus cases are rising elsewhere; what will happen in LA county?

After dramatic declines in coronavirus cases, Los Angeles County hit another plateau this week, amid the spread of the highly infectious Omicron subvariant BA.2.

BA.2 sparked further increases in cases in other areas, from a significant spike in Britain that led to a rise in hospitalizations and deaths, and the apparent start of a wave in New York and Massachusetts.

Similar trends have yet to be seen in Los Angeles County or California in general, and officials can’t say for sure what will happen.

While California may see an echo of what’s happening in Britain, some experts also suggest the state’s winter surge of Omicron, which has put many hospitals in Southern California and the Central Valley under pressure, could provide some protection against a possible surge of BA.2.

Nationwide, the decline in new coronavirus cases may have ended in recent days. The US Centers for Disease Control and Prevention (CDC) reported around 26,000 new episodes per day, a number that has remained essentially flat over the past week. It’s the lowest number since July, but still above the pre-Delta surge of about 12,000 cases a day in June.

The Los Angeles County public health director said the best way to prepare for the coming weeks is to catch up on vaccinations and boosters, and wear masks indoors in public places.

“We knew that cases were likely to stop declining because there is still transmission. There are people who are still exposed,” Los Angeles County Public Health Director Barbara Ferrer said during a briefing Thursday. “Personally, I wish we were at a lower level, but we’ve seen a significant decline, and that’s the good news.”

BA.2 has already caused a new wave of infections in other parts of Europe and Asia. It can still be quite deadly in areas where vaccination rates are relatively low, as is the case among the elderly population of Hong Kong. A devastating surge in cases led Hong Kong to run out of coffins.

BA.2 is believed to be 30% to 60% more contagious than the original Omicron variant, which swept through California last winter. BA.2 is now estimated to be the dominant version of the coronavirus circulating throughout the country, underscoring the need for caution, Ferrer said.

“Given the increased risk of spread of BA.2, it is important that we take action now to maximize protection,” he said. “Encouragingly, the [Organización Mundial de la Salud] reported that in countries with high levels of vaccination, especially among those most vulnerable to COVID-19, the recent increase in cases has not yet translated into high rates of hospitalizations or deaths.

But Ferrer warned that Los Angeles County still needs more people vaccinated and reinforced. In the area, 1.7 million over the age of five have not received a single dose and another 2.8 million residents aged 12 and over have not had their first booster.

According to a county tally, which does not include cases reported late due to a backlog, Los Angeles County is averaging 725 coronavirus cases per day, or 50 cases per week per 100,000 residents, considered on the border between a moderate and substantial level of transmission. The last time cases were consistently this low was last summer, when California was still enjoying its full economic reopening.

The number of hospitalized COVID-19 patients also fell to one of the lowest levels in the entire pandemic. On Thursday, 287 of those people were hospitalized countywide. At the height of the Omicron surge in January, COVID-19 hospitalizations peaked at 4,814.

However, the county’s case rate stopped falling steadily about a week ago. The most recent rate, of 50 cases a week per 100,000 residents, was up from 44 a week earlier. The one prior to that was 60; and before, 77.

A rate below 50 is considered a moderate level of transmission, according to the US Centers for Disease Control and Prevention (CDC). Below 10 is considered a low level of transmission.

Trends vary by region, with case rates in mid-March influenced by a buildup of late-reported cases reflecting infections from the Omicron winter surge. “The California Department of Public Health is aware of these reporting delays, which affect case counts in many parts of the state,” Los Angeles County health officials said on March 21.

Orange County is still seeing its case rates drop. For the week ending Thursday, California’s third-most populous county reported 26 cases per week per 100,000 residents. The rate the week before was 47, and 52 the week before that.

In the San Francisco Bay Area, the trend is essentially flat. The most recent rate was 64, identical to the previous week, but higher than the previous week’s rate of 53.

Some parts of the country where BA.2 previously dominated have seen a sustained rise in cases. New York City’s rate is 104; the week before, it was 83. But hospitalizations are still going down there.

Two leading states are New York and Massachusetts, where BA.2 comprises more than 80% of new cases, according to Dr. Eric Topol, director of the Scripps Research Translational Institute in La Jolla.

In a tweet, Topol commented that the wave of BA.2 in New York and Massachusetts was starting with a case rate about a third of what was seen when the first wave of Omicron began last fall. Topol noted that it’s too early to tell how big a BA.2 wave will be, but he suggested it will be “probably much smaller” than the first wave.

In Britain, health officials estimated a record number of new coronavirus infections in a single week. The Office for National Statistics projected that one in 13 residents tested positive for coronavirus in England between March 20 and 26; while in Scotland, one in 12.

The BBC reported that some hospitals in Britain are under pressure. In Scotland, some are recording a record number of positive coronavirus patients, though few of them are seriously ill.

But not all European countries feel a surge fueled by BA.2. Spain’s case rate has remained essentially stable throughout March.

Although a Delta infection did not necessarily provide much protection against Omicron, the recent survival of the earlier subvariant BA.1 probably provides additional short-term protection against BA.2.

Los Angeles County’s recent experience is not necessarily a surprise. As Ferrer pointed out: “Every time we have reduced the restrictions or the levels of protection that are required, we have always seen an uptick.” “Our job right now is to make sure that this doesn’t lead to a significant increase in cases because that really would be, in a way, an avoidable step,” she said.

Over the past month and a half, Los Angeles County has relaxed its mask-wearing rules outdoors, lifted an order for residents to wear masks indoors in public places, and rescinded the requirement that customers provide proof of vaccination against the virus. COVID-19 in closed bars, wineries, breweries, distilleries, nightclubs and lounges.

On Friday, California also removed the requirement that attendees show proof of vaccination or a negative test result as a condition for entry to indoor events with more than 1,000 people, such as concerts, conventions and sports contests.

Given how widely rules have been relaxed, officials say it’s vital to closely monitor metrics that could point to a resurgence of the virus.

An early indication of a potential increase in confirmed coronavirus cases involves the detection of viral levels in wastewater. So far, there is no clear indication of a high increase in the virus in wastewater in Los Angeles County, Ferrer reported. Some data showed a potential increase in coronavirus levels in wastewater from the city of Los Angeles recently, but it’s also possible that they just represent a wide fluctuation and not indicative of a trend. “There has been a lot of variation in the concentration of wastewater that was observed during the first two weeks of March. And it’s not clear to us right now if this is really an upward trend,” Ferrer said.

“If we see these continued increases,” he added, “it could be an early warning that cases could soon spike.”

Ferrer noted that another early sign of trouble would be a sudden spike in coronavirus-related emergency room visits, which have preceded increases in reported cases in the past.

The good news is that as of Sunday, only 3% of emergency room visits in Los Angeles County were related to the coronavirus, Ferrer said. “This is another positive sign of lower transmission, which despite the BA.2 increases we are starting to see, are not yet resulting in increases in visits. [a emergencia] related to COVID-19,” said the official.

Ferrer urged people to catch up on their vaccinations, including a second booster for those over 50 who are more at risk of complications from COVID-19 if infected.

There are significant complications survivors of a coronavirus infection may face, such as prolonged COVID and increased risk of heart disease and diabetes. That “should really give all of us another reason to redouble our efforts and avoid getting infected as much as possible,” Ferrer added, including wearing a mask indoors in public places, which continues to be highly recommended by state and county health officials. of the Angels.

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