L.A. County could avoid mask mandate this week as coronavirus cases decline

Recent drops in cases and coronavirus-positive hospital admissions could bring Los Angeles County back from the brink of a new universal indoor public mask mandate.

Although a decision on whether to issue the long-threatening order won’t come until later this week, health officials on Tuesday noted improvements in some COVID-19 metrics may merit a delay.

Such a pause would mark a major turnaround for the nation’s most populous borough. A mask mandate seemed likely late last week, much to the chagrin of some local residents, business groups and elected leaders, who called it an unnecessary and ineffective hype.

While it’s too early to tell if this latest wave has peaked – especially since the ultra-contagious BA.5 omicron subvariant is still prevalent – there are some hopeful signs.

As of July 20, 1,329 coronavirus-positive patients were hospitalized across the country. That total fell to 1,200 by Friday before rising again over the weekend to 1,286 on Monday.

As of Tuesday afternoon, LA County had an average of about 6,000 coronavirus cases per day for the previous week, down 11% from the previous week’s average of 6,700 cases per day. On a per capita basis, the latest rate is 417 cases per week per 100,000 population. A fall rate of 100 or more is considered high.

In the middle of last week, a flattening out in LA County’s coronavirus cases was noted, and on Friday, LA County began to see a week-on-week decline.

Cases are also declining across the country. California reported an average of 17,000 per day last week, down 17% from the previous week.

“It’s important to note that we had three cases this spring and summer where we saw dips in cases followed by spikes shortly thereafter,” Barbara Ferrer, director of public health, told the county board of trustees on Tuesday. “It is therefore important that we remain cautious and prepared to build in additional safeguards.”

Ferrer had previously said the county could withhold a mandate if transmission showed clear signs of slowing.

Ferrer had said LA County would re-enact an indoor mask mandate if it reached the high COVID-19 community level set by the US Centers for Disease Control and Prevention and stayed there for two consecutive weeks.

Placement in this category means that a county has both a significant amount of community transmission and at least 10 new weekly coronavirus-positive hospital admissions per 100,000 residents.

LA County entered the high COVID-19 community level on July 14 and stayed there last week. LA County determines at which municipal level it sits every Thursday using criteria established by the CDC.

But “should we see a sustained decline in cases or the hospitalization rate approach the moderate threshold, we will pause the implementation of universal indoor masking while we closely monitor our transmission rates,” Ferrer said.

If granted, a renewed face-covering order would come into effect Friday and would apply indoors to everyone aged 2 and over in a variety of facilities and venues, including shared office spaces, manufacturing and retail environments, event spaces, restaurants and bars, gyms and Yoga studios, educational institutions and children’s programs.

Public health officials are largely characterizing face coverings as a low-impact method to curb transmission indoors, where the risk of spreading the coronavirus is generally higher. Both the LA County Department of Health and the California Department of Health strongly recommend residents dress up indoors in public.

However, as the coronavirus spreads widely and sends more people to the hospital, Ferrer has argued it makes sense to move from a recommendation to a requirement. She said this would not only protect customers and patrons, but also the county’s workforce and its more vulnerable residents.

“Nobody is suggesting that we have to wear masks forever, rather that [there] are probably just short periods of time where it makes sense,” she said.

But opponents have balked, arguing that such a measure is unnecessary at a time when vaccines and therapeutics are plentiful, testing is readily available and hospitals are nowhere near as stressed as earlier in the pandemic. Of particular concern to some is the possible return of masking in schools, which has long been a hotly debated concept across California and the nation.

Critics say it makes no sense for LA County to consider a new order when no other part of California is doing the same. And some business groups have expressed concerns that the move could hamper their operations, prompt shoppers to look elsewhere for money or empower workers to enforce rules many no longer want to follow.

Although she’s personally “anything for masking,” supervisor Kathryn Barger said Tuesday that she firmly opposes a mandate “because I really believe it’s going to have the opposite effect.”

In an open letter on Monday, Barger wrote that she believes such orders are polarizing, unenforceable and “actually distracting from our collective efforts to bring down COVID-19 infection rates.”

“We have not fully investigated nor understood the costs associated with imposing mask requirements on our children and youth,” Barger wrote. “I’ve heard loud and clear from parents and caregivers who are witnessing the social-emotional toll our county’s children are shouldering. Her anxiety and depression are palpable.”

Supervisor Janice Hahn said she would prefer to remain in line with the state – which strongly recommends but does not require masking indoors in public.

She suggested that new mask rules should also be more restricted at first, maybe just places like grocery stores and pharmacies.

“Local businesses that I know have told my office that they are concerned about having to enforce this mask requirement when such a large segment of the population opposes it,” Hahn said. “They just don’t feel like that’s why they went into a small business to fight with their customers.”

Hahn also said she was concerned that implementing a mandate now could jeopardize the county’s ability to convince people to dress up should a more severe surge occur in the future.

“To be honest, I’m concerned that this time around we’re going to lose the trust of a section of the public that has actually stood by us up to this point,” she said.

Supervisor Sheila Kuehl, however, said she was struck by “the backlash from a number – albeit not really significant – of snowflake whiners about how depressing it is to wear a mask.”

Ferrer has said she is confident many residents would comply should a mask ordinance be reinstated. She said the rules would require businesses to put up signs informing the public of the requirement to wear masks and that the county health department would not ask employees to enforce the rules.

One of the main objections to a new mask requirement is the fact that most of those who become infected these days don’t get seriously ill — a trend officials and experts attribute to robust vaccine coverage and the ready availability of treatments, as well as general shifts in the nature of the disease coronavirus itself.

So far, the peak of hospital admissions in this latest wave is lower than the peak of all previous increases. And officials are noting that many coronavirus-positive patients are not being treated specifically for COVID-19, but incidentally tested positive upon admission for other reasons.

“I think now that we’re seeing fewer people getting serious cases of COVID, they just don’t really believe that this mandate is necessary,” Hahn said.

Though the overall burden of the disease is far less than it was earlier in the pandemic, health officials note that doesn’t mean it’s not having an impact.

dr Christina Ghaly, director of health services for the county, said she was not concerned that any of the county’s four public hospitals were at risk of being overwhelmed. However, due to the high level of transmission in the community, a number of staff have been infected and are unable to work, she said.

“In hospitals, that means beds are closed or it may take longer to be seen in an emergency room,” she said. “It has multiple ways in which it affects facilities.”

And even if they don’t end up needing hospitalization, many patients with symptoms consistent with COVID-19 still visit emergency rooms and emergency centers.

“The vast majority does not need to be included. You will be sent home. But that’s still a lot of volume coming into the ER,” Ghaly said. “We also see this backup in the [Emergency Medical Services] System with long “wall times” – waiting times for ambulances in emergency rooms. This has a negative effect on the system as a whole because the ambulances are no longer on the road.”

Supervisor Holly Mitchell, who chairs the board of supervisors, said she was concerned that such human resource impact “could really put us in a situation where our healthcare infrastructure is at risk.”

For some, COVID-19 also remains a serious and dangerous enemy.

In the first half of this year, nearly 4,400 people died from the disease in LA County — double the typical six-month average number of deaths from drug overdoses, the flu and car accidents combined, Ferrer said.

LA County’s weekly coronavirus death toll is beginning to rise again. As of Tuesday, LA County recorded 106 COVID-19 deaths per week, up 23% on the week. A month ago, LA County was reporting about 50 deaths a week.

The weekly per capita death rate for LA County — 105 deaths per week per 10 million people — is 67% worse than the San Francisco Bay Area, which reports 63 deaths per week per 10 million people.

“Tragically, if you have such a high transmission rate, it will lead to more deaths,” Ferrer said. “And I think the question everyone needs to ask is: How much death are you willing to tolerate before asking people to put their masks back on during these extraordinary times of high transmission?”

https://www.latimes.com/california/story/2022-07-26/l-a-county-could-pause-mask-mandate-if-cases-hospitalizations-improve L.A. County could avoid mask mandate this week as coronavirus cases decline

Alley Einstein

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