Los Angeles Times

Why do we need to mask again?

L.A. officials say they hope reinstitut­ing face masks will help curb Delta transmissi­on.

- By Rong-Gong Lin II and Luke Money

A Q&A on vaccines and why L.A. County officials reinstated the rule for indoor public spaces.

Health experts agree the COVID-19 vaccines have proved to be extremely effective against the virus, including providing protection from the highly contagious Delta variant.

Those safeguards are highlighte­d by the percentage of people who are now testing positive for the coronaviru­s in Los Angeles County, where more than 10,000 new cases have been reported in the last week. In an alarming surge in cases, 99% of new infections involve people who have not been vaccinated.

And now, in the wake of that increased transmissi­on, local officials are requiring not only the unvaccinat­ed but also those who have been inoculated against the disease to wear masks in public indoor settings.

Why?

All those hospitaliz­ed for COVID-19 in L.A. County’s public hospitals have not been fully vaccinated

L.A. County’s massive public hospital system has not had to hospitaliz­e anyone for COVID-19 who has been fully vaccinated, Health Services Director Dr. Christina Ghaly said.

“We have not admitted any single person for COVID who is fully vaccinated — with either the J&J, Pfizer or Moderna vaccines,” Ghaly told the county Board of Supervisor­s last week.

L.A. County’s public hospital system has a vast reach and primarily serves people especially vulnerable to COVID-19. There are four county-run hospitals.

Those hospitaliz­ations could be mitigated by the vaccines, health experts say.

“The vaccines are extraordin­arily effective (even against the delta variant),” tweeted Dr. Monica Gandhi, an infectious disease expert at UC San Francisco.

99.8% of COVID-19 deaths in L.A. County have been among unvaccinat­ed people

Between Dec. 7 and June 7, unvaccinat­ed people in L.A. County made up 99.6% of the region’s coronaviru­s cases, 98.7% of COVID-19 hospitaliz­ations and 99.8% of deaths.

San Diego County has reported similar numbers.

Residents there who are either unvaccinat­ed or partly vaccinated represent 99.1% of coronaviru­s cases, 99.88% of COVID-19 hospitaliz­ations and 99.8% of deaths.

Of fully vaccinated people in L.A. County, 0.06% subsequent­ly tested positive for the virus

In Los Angeles County, about 4.67 million residents have been fully vaccinated.

Of them, 0.06% have subsequent­ly tested positive; 0.004% were later hospitaliz­ed for COVID-19; and 0.0004% died.

The vaccines are as effective against the Delta variant as other strains

Among L.A. County coronaviru­s cases that were further analyzed to identify its strain in June, only a small percentage were among fully vaccinated people.

Officials said that 89% of identified Delta variant cases in June were among people who weren’t fully vaccinated.

The results were similar to the Alpha variant: 91% of identified cases were among people who weren’t fully vaccinated.

Well-done studies elsewhere point to high effectiven­ess against Delta

Data from Britain cited by Dr. Anthony Fauci, the U.S. government’s top infectious disease expert, say that the two-dose course of the Pfizer-BioNTech vaccine is 96% effective in preventing hospitaliz­ation from COVID-19, 88% effective in preventing symptomati­c infection and 79% effective in preventing lab-confirmed infection. Experts believe the Moderna vaccine — because it’s based on the same technology as Pfizer’s — is similarly effective.

Fauci also expressed confidence in the Johnson & Johnson vaccine’s effectiven­ess. The Johnson & Johnson vaccine uses technology similar to one used in the AstraZenec­a vaccine, which studies in Britain show is 92% effective against hospitaliz­ation and 60% effective against either symptomati­c disease or lab-confirmed infection.

Invariably, there have been scattered reports that have occasional­ly raised questions about whether vaccines have lowered effectiven­ess against the Delta variant, including one that emerged out of Israel suggesting that the effectiven­ess of vaccines available there to protect against symptomati­c illness had fallen to 64%, although they remained 93% effective in preventing hospitaliz­ation.

The differing results of the Israeli report may be caused by different methodolog­ies, such as rigorously testing vaccinated people for a coronaviru­s infection even though they had no symptoms, while other studies might test only those who are visibly ill, said Dr. Robert Kim-Farley, a UCLA epidemiolo­gist and infectious disease expert.

“Bottom line, however, is that all these studies continue to show very good efficacy against severe disease and death,” Kim-Farley said. “The vaccines continue to do what we need them to do most.”

In addition, the Israeli report reviewed just 300 patients, and small studies can be inaccurate, said Gandhi, of UC San Francisco. Studies from Britain, Canada and Singapore — reviewing records of many more people — showed 80% to 90% vaccine effectiven­ess against any symptomati­c infection and 93% to 96% effectiven­ess against severe disease.

How can children be protected if they’re too young to be vaccinated for now?

Children younger than 12 do not have access to vaccines for now, and it’s important that as many adults around them get vaccinated, Gandhi tweeted.

“The best thing we can do for children right now is to get as many adults vaccinated as possible while young children clinical trials of [vaccines] are ongoing, especially anyone who will be teaching children or sending them to school (e.g. teachers/parents),” Gandhi wrote.

Young children already are less likely to contract the coronaviru­s because they have far fewer proteins called ACE2 receptors in their noses that the coronaviru­s needs to access to infect the body.

So why wear a mask?

L.A. County officials say there’s a real need to take action now. Though infections and serious COVID-19 illness are still only a fraction of what was seen over the fall and winter, daily coronaviru­s cases are now six times what they were on June 15, when California fully reopened, and COVID-19 hospitaliz­ations have doubled since then.

In its reopening last month, California implemente­d a statewide honor system: Unvaccinat­ed people still had to wear masks in indoor public spaces, even though businesses were under no obligation to verify their inoculatio­n status.

L.A. County officials are now worried that unvaccinat­ed people instead responded by not masking up in required settings. And with cases and hospitaliz­ations growing, authoritie­s say they hope reinstitut­ing masking as a social norm will help reduce disease transmissi­on.

“We’re not where we need to be for the millions at risk of infection here in Los Angeles County, and waiting to do something will be too late given what we’re seeing now,” said Dr. Muntu Davis, the county’s health officer.

In essence, they hope requiring everyone to wear masks indoors will force the unvaccinat­ed to do so, giving them more protection.

 ?? Francine Orr Los Angeles Times ?? A MASKED WOMAN does laundry in South Pasadena. Los Angeles County’s massive public hospital system has not had to hospitaliz­e anyone for COVID-19 who has been fully vaccinated, a county health official says.
Francine Orr Los Angeles Times A MASKED WOMAN does laundry in South Pasadena. Los Angeles County’s massive public hospital system has not had to hospitaliz­e anyone for COVID-19 who has been fully vaccinated, a county health official says.

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