Indoor masking in public facilities could return to Los Angeles County in a week as the spread of the hyperinfectious BA.5 omicron subvariant continues to spike the number of coronavirus cases and send more people to the hospital.
The potential return of a mask mandate — a move only LA County is contemplating — is the latest flashpoint in the long-running pandemic.
Proponents say the move is an effective and low-impact way to curb coronavirus transmission.
LA County – the most populous in the nation – is like no other county in California. With its higher poverty rate and overcrowded housing, it has been hit harder than most other parts of the state.
“Of all the means we have used in this pandemic to help stem the spread of COVID, indoor masking is one of the simplest and is proving very effective,” said Barbara Ferrer, the county’s director of public health, Thursday.
Nevertheless, critics question the need for a new mask order. Fear of the disease is lower than a year ago, and thanks to vaccinations and anti-COVID drugs, many who have tested positive are not reporting serious illness. In addition, hospitals and intensive care units are nowhere near as stressed as in previous waves.
Businesses have expressed concerns, fearing workers will have to enforce a mask rule that many no longer want to follow and that the order could prompt shoppers to spend money elsewhere.
A renewed mandate would apply to everyone aged 2 and over in a variety of settings 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.
LA County officials long ago set the criteria for this health ordinance revision — they said they would reissue a mask mandate if the region transitioned to the high COVID-19 community level, as per the US Centers for Control and disease prevention, and stay there for two consecutive weeks.
To be in this category, a county must have an increased spread of the coronavirus and at least 10 new coronavirus-positive hospitalizations per 100,000 people. LA County surpassed that threshold last week and did so again on Thursday, recording 11.4 cases for every 100,000 people.
Unless that hospitalization rate drops below 10 next week, a new mask regulation will go into effect on July 29.
Across the county, 1,329 coronavirus-positive patients were hospitalized as of Wednesday — a 34% increase from two weeks ago.
In comparison, the nationwide patient count increased by 23% to 4,762 during this period.
In both LA County and California as a whole, hospitalizations remain well below those seen during previous peaks. And officials are noting that a significant proportion of those patients — about 58% in LA County — are not receiving treatment for COVID-19 but have tested positive on admission for other reasons.
That the number of patients, despite the increase, has remained relatively low given the high transmission rate is a testament to how the pandemic has changed.
LA County is reporting about 6,700 new cases per day, almost double the peak of the delta surge last summer. But most of those who do become infected now don’t get seriously ill, a trend officials and experts attribute to robust vaccine coverage and ready availability of treatments.
According to the CDC, 50 of California’s 58 counties are at the high COVID-19 community level. The newest are Riverside, San Bernardino, Colusa, and Modoc counties.
Overall, 98.5% of Californians — or 38.6 million people — live in counties with high COVID-19 community levels.
The nature of the virus itself has also changed. The omicron subvariants fueling this recent surge are hyperinfectious but tend to cause less severe disease. For example, at the peak of the delta rise, about 5.6% of LA County’s coronavirus cases required hospitalization. In the first Omicron wave last autumn and winter, this proportion was only around 1.2%.
During an internal town hall last week published online, Los Angeles County-USC Medical Center chief medical officer Dr. Brad Spellberg said around 90% of the hospital’s coronavirus-positive patients were admitted because of other issues.
“Virtually none of them go to ICU – and if they do go to ICU, it’s not for pneumonia. You won’t be intubated,” he said, citing other issues like electrolyte abnormalities.
He added, “A lot of people have bad colds, we see that.”
Some have pointed to this split as evidence against the introduction of a new mask mandate. If the hospitals are nowhere near overwhelmed, what’s the justification?
“For two years, Californians wore masks indoors. They were vaccinated at high rates. Many have been fed. Rates of serious illness are so decoupled from hospital admissions and it’s so obvious to the public,” said Dr. Monica Gandhi, an infectious disease expert at UC San Francisco.
But officials from both the LA County Department of Public Health and the Department of Health Services, which oversees county-USC, say the surest way to shore up hospitals is to stop transmission. And wearing high-quality, well-fitting masks, it is said, remains one of the least disruptive interventions available to the public.
“Although we are currently not seeing any increase in ICU admissions [County-USC], we are seeing a significant increase in the number of infections among our patients, staff and the communities we serve,” Health Department officials wrote in a statement this week. “Rising infection rates are extremely worrying because as more people become infected, there is a greater likelihood that ICU admissions for COVID-19 will increase in the future.”
And while mask orders have been off the books for months, many officials have kept pushing for the use of face coverings in indoor public spaces. The California Department of Health strongly recommends the practice.
As anyone on the road can attest, many Californians don’t heed that call. That has led some to question who exactly would enforce a new LA County order and what kind of compliance to expect.
“LA’s restaurants, retail stores, museums, amusement parks, sports centers and so many other facilities are working every day to recover from the pandemic while simultaneously confronting labor shortages, supply chain challenges and more,” Maria Salinas, President and CEO The Los Angeles Area Chamber of Commerce and Jessica Lall, president and CEO of Central City Assn., a downtown business group, wrote in a letter to Ferrer last week. “Companies should not be expected to enforce a mask mandate on top of these ongoing restrictions. Companies cannot shoulder this compliance burden alone as they have had to do so in the past.”
Hailey Branson-Potts, a Times contributor, contributed to this report.
https://www.latimes.com/california/story/2022-07-21/l-a-county-mask-mandate-likely-a-week-away L.A. County COVID mask mandate likely a week away