County scales back nursing home tests
Goal to check 100% of residents and staff for virus is one-third met.
A month after vowing to test all nursing home residents and staff for the novel coronavirus, Los Angeles County health officials have completed the effort in only about a third of homes and have dramatically scaled back testing plans.
The abrupt change — which calls for testing only a small sample of residents in nursing homes that have not had an outbreak — is outlined in a letter county health officials sent to nursing homes last week, as the death toll continued to mount at facilities across the county.
Health officials defended the decision as the most efficient way to get a quick handle on what is happening in the homes. But some experts fear the move could allow the virus to continue to spread undetected, resulting in more fatalities among a vulnerable population that is already the hardest hit by the pandemic.
The COVID-19 death toll at county residential facilities topped 1,000 this week, with the vast majority at nursing homes.
“More people will die than necessary based on this policy,” said Dr. Michael Wasserman, president of the
California Assn. of Long Term Care Medicine, which represents doctors, nurses and others working in longterm care facilities.
Since the start of the pandemic, most nursing homes have been testing only residents and staff who show symptoms. But in late April, as the COVID-19 death toll approached 300 in L.A.
and labor groups together with science, the numbers will always guide us forward, there is nothing else.”
Garcetti said there were “no games” being played with health restrictions. “We were able to do this and save lives. Now it’s time for us to test things moving forward and I think the proof ’s in the pudding. We’ve been doing that, we’ve been doing it safely and we will monitor those numbers because people’s lives are at stake.”
Los Angeles-area health restrictions were also mentioned by White House coronavirus response coordinator Dr. Deborah Birx on Friday. After giving a mostly upbeat assessment of the nation’s progress, Birx said the Los Angeles metropolitan area, which includes Orange County, is continuing to see a high number of new cases reported each day. Washington, D.C., and Chicago also remain hot spots of the virus, she said.
“Even though Washington has remained closed, L.A. has remained closed, Chicago has remained closed, we still see these ongoing cases,” she said.
Birx asked the Centers for Disease Control and Prevention to work with those areas “to really understand where are these new cases coming from, and what do we need to do to prevent them in the future.”
Garcetti responded by saying the city had shown “very steady progress” against the disease.
“We’ve got the capacity, the ventilators, the beds available,” Garcetti said. “We’ve seen a plateau and we share that data publicly with everybody about the sevenday average. It’s holding where it is, which is dramatically different than where it was a month and a half, let alone two months ago.”
Los Angeles County is the epicenter of the coronavirus outbreak in California, accounting for about 56% of the state’s total deaths and almost half of more than 90,000 confirmed infections. Public health officials on Friday announced 1,072 new cases of the coronavirus and 35 related deaths, bringing the county’s total to 43,070 cases and 2,051 deaths.
But Los Angeles County officials on Friday also pointed to positive signs that the region was making progress and stressed they were already working with CDC officials on ways to slow the spread of the coronavirus.
Ferrer said that though deaths remain a grave concern, “our overall data points are looking pretty good in terms of being on the recovery journey.”
Those figures include a 12% decrease in the county’s latest seven-day average of deaths per day and a 15% decrease in its most recent three-day average for hospitalizations per day, she said.
The coronavirus transmission rate in the nation’s most populous county is now in its best position since the magnitude of the outbreak became clear in March, officials announced earlier this week. “We are moving in the right direction, and I want to acknowledge CDC has been a strong source of support for L.A. County since the beginning of the pandemic,” she said.
A total of 1,506 coronavirus patients are currently in county hospitals, with 26% in intensive care and 19% on ventilators.
Outbreaks at institutional facilities remain a particular source of concern. About a quarter of the county’s total cases — 10,885 — were associated with such facilities, including nursing and assisted-living homes, shelters, treatment centers, correctional facilities and workplaces. They included 7,046 residents and 3,840 staff.
Los Angeles County has been hit far less severely than coronavirus hot spots such as New York City, where more than 16,000 have died. But as other regions, including the Bay Area, have seen the coronavirus curve flatten, progress has been much slower in L.A.
Officials remain concerned that warm temperatures and quarantine fatigue could drive people from their homes over the Memorial Day weekend, resulting in crowding at parks and beaches that could threaten to undo some of the progress the state has made.
As part of the city’s slow reopening, the city will open two designated recreation zones on Monday and two more slow street areas in Eagle Rock and Mid-City, where traffic is limited to local residents, freeing up space for pedestrians and bicyclists, the mayor announced.
The city also announced the immediate reopening of parking lots at Cabrillo and Venice beaches as well as their bike paths. Officials said those actions were being done in coordination with the county’s partial opening of parking lots and paths at Dockweiler, Will Rogers, Zuma and Surfrider beaches.
“It feels like sacrifice is in all our minds these days,” Garcetti said, referencing the upcoming Memorial Day holiday. “But each day, each one of us in this city, the largest city and the largest state in this great union, we continue to do the work. To protect ourselves, to protect our families and protect our nation.”
Ahead of the weekend, L.A. County announced it was reopening beach bike paths and some parking lots, and said indoor malls could resume operations for curbside pickup services. The county also lifted a ban on car parades to celebrate events such as graduations.
“I know we are lifting restrictions in certain areas,” Supervisor Kathryn Barger said. “Please be responsible because this is the only way we are going to move toward the next phase of opening.”
Officials urged residents to continue to stay home when possible, stay six feet apart from others when in public and wear cloth face coverings when others are around.
“As a reminder, the job we do protecting each other affects how many new cases, how many new hospitalizations and how many new deaths we see several weeks from now,” Ferrer said. “So over the weekend, let’s continue to use all the tools that we have available to slow the spread of COVID-19.”
In Orange County, several coastal cities expanded their beach hours and planned to open more parking lots connected to the shoreline ahead of the holiday.
That comes as the coronavirus-related death toll there continues to rise. The county reported 108 additional cases and six deaths Friday, bringing its total to 4,941 cases and 118 deaths. Of the fatalities, more than a quarter have been recorded in the last three days.
Orange County reported 14 deaths Thursday and 10 Wednesday. Before Wednesday, the county hadn’t reported more than five deaths in a single day.
Elsewhere in the state, cities were continuing to urge social distancing, even as stay-at-home restrictions are further relaxed. In San Francisco, the parks department painted 10-foot circles on the grass of four city parks ahead of the holiday weekend to remind visitors to keep their distance from one another.
In the Santa Monica Mountains, park rangers are encouraging visitors to wear face coverings and maintain social distancing on newly reopened trails.
But in the San Bernardino National Forest, officials will close a 2.5-mile stretch in Deep Creek in the Lake Arrowhead area for a year to deal with chronic overcrowding.