County shifts to medium COVID tier

New positive cases are above 4,000 for second day; flu and RSV infections pose `triple threat'

The rate of coronavirus spread has continued increasing throughout Los Angeles County, the Department of Public Health reported on Thursday, moving the region back into the medium community transmission tier as defined by the U.S. Centers for

Disease Control and Prevention.

The county could also move into the high-transmission category as early as next week, health officials said Thursday.

The county reported 4,493 new COVID-19 cases on Thursday, bringing the total since the pandemic began to 3,547,200.

Thursday was the second straight day the county reported more than 4,000 new cases — a sharp increase compared with recent averages. There were an average of 2,700 new COVID-19 cases reported per day over the past week, Department of Public Health Director Barbara Ferrer said during a Thursday briefing. That's an increase of 85% from the seven-day average reported for the week ending Nov. 17 — and 180% increase in cases since Nov. 1.

The average weekly case rate as of Thursday totaled 185 new cases per 100,000 people.

There were 1,164 people in L.A. County hospitals with COVID-19 on Thursday, according to the Department of Public Health, an increase of 32 from the day before.

L.A. County had an average of 192 COVID-19 related hospital admissions per day over the past week, Ferrer said, noting that metric has increased 200% since early November. The average weekly COVID-19 hospital admissions on Thursday totaled

“We're all at very, very big risk . ... So we'd like to make sure that we do everything we can as a county to take some simple steps to get transmission down lower, so people don't end up in the hospital.”

— Barbara Ferrer, director of L.A. County Department of Public Health

11.9 new admissions per 100,000 — prompting the county's re-entry into the CDC's medium community transmission designation.

The move into medium transmission, Ferrer said, doesn't change any of the county's existing health orders.

“We could be in the high community level as soon as next next week,” Ferrer said, “if the upward trend we are seeing continues.”

Previously, the county would have automatically moved into the high transmission tier — which comes along with renewed public health orders, including a mask mandate — with the average weekly hospitalization metric topping 10 per 100,000 residents, per CDC guidance. But the department reevaluated that standard, Ferrer said.

Instead, the Department of Public Health more seriously considers the county's other hospitalization metric — the percent of staffed ICU beds occupied by COVID-19 patients — in its decision to move into the high transmission category. That number, which sat at 5.6% as of Thursday, would have to top 15% to qualify the county for the highest tier.

“The threshold that CDC sets is just to meet one hospital metric, and now we believe we need to meet both hospital metrics — the health care system is not

necessarily stressed when we just see a lot of admissions,” Ferrer said. “So that percent of beds occupied by people with COVID is actually significant — and we'd need to see that we reached both of those metrics in order to go ahead and ask people to do universal indoor masking.”

The county also reported another 14 coronavirus-related deaths on Thursday. The total death toll since the pandemic began was 34,199 as of Thursday.

L.A. County's COVID-19 deaths, Ferrer said, currently average around eight per day — a median that has remained stable since early November. That data, though, tends to lag behind cases and hospitalizations and could rise sharply over the next several weeks, Ferrer said.

Still, the recent uptick in COVID-19 cases, Ferrer added, is less severe than the surge seen in 2020 — but is higher than the omicron-fueled winter surge in 2021. The data being reported to the Department of Public Health likely doesn't reflect the true total of the coronavirus's grip on L.A. County, Ferrer said, because most at-home test aren't reported, and many individuals have stopped testing for the virus all together.

High rates of influenza and RSV — or respiratory syncytial virus — are also concerning, Ferrer said.

“This triple threat, as you may have heard it called, has a lot of potential to cause there to be significant circulating illness and

to strain our health care system,” Ferrer said, “both in terms of the number of beds that are available and the number of health care workers that are impacted by illness, which lowers the hospital's capacity to take care of patients.”

Both the flu and RSV can cause severe illness in young children, older adults and those with underlying health conditions. Because of that, Ferrer said, L.A. County hospitals are already seeing high numbers of hospitalizations relating to complications from both viruses.

“We're all at very, very big risk — you know, car accidents, people who need coronary heart disease care,” Ferrer said. “So we'd like to make sure that we do everything we can as a county to take some simple steps to get transmission down lower, so people don't end up in the hospital.”

To that end, Ferrer urged residents to get the updated COVID-19 bivalent booster shot — which protects against newer, more immune-evasive variants of the virus — and a flu shot. About 6 million eligible L.A. County residents, Ferrer said, have yet to receive an updated coronavirus vaccine.

Residents should also practice frequent hand hygiene, and test for COVID-19 and stay home when sick. To protect against RSV — which can linger on surfaces — Ferrer recommended disinfecting frequently touched surfaces often.