Los Angeles Times

Boosting rate of vaccinatio­ns is key to avoiding fall virus surge

New bar and club mandates may push more residents to get the jab, officials say.

- By Rong-Gong Lin II and Luke Money

The pace of COVID-19 vaccinatio­ns in Los Angeles County is so slow that there’s a risk of a “cycle of repeated surges every few months,” Los Angeles County’s public health director warns.

There was an increase in vaccinatio­ns in late July and early August as the effects of the Delta surge became apparent, but that boost in weekly vaccinatio­ns has started to fade, according to data from the county Department of Public Health.

“In order to avoid a cycle of repeated surges every few months, we’ll need to see a significan­t increase in vaccinatio­n coverage,” Public Health Director Barbara Ferrer said as she introduced a forthcomin­g health order to require proof of vaccinatio­n for customers at indoor bars, wineries, breweries, nightclubs and lounges countywide.

In Los Angeles County, 75.7% of residents 12 and older have received at least one dose of vaccine, while 66.9% of residents of all ages have received at least one shot and 59.3% are fully vaccinated.

Dr. George Rutherford, a UC San Francisco epidemiolo­gist and infectious disease expert, has estimated that a community would need to have about 84% of the population vaccinated against COVID-19 to reach “herd immunity,” which occurs when enough people have immunity to interrupt sustained transmissi­on of the disease. Immunity can be obtained not only through vaccinatio­n, but also by surviving an infection.

“It’s going to take some substantia­l amounts of pediatric vaccinatio­n to get there,” Rutherford said at a recent campus forum.

The fact that the Delta variant is so much more infectious than earlier strains means it “is going to require more people getting vaccinated” to reach herd immunity, Ferrer recently told the Board of Supervisor­s.

Even though L.A. County has reported recent reduc

tions in weekly coronaviru­s cases and hospitaliz­ations, the fact that California has endured four surges demonstrat­es “there’s a cyclical nature to this virus. And as long as we have large numbers of unvaccinat­ed people here in the county, we’re at the mercy of the cyclical nature” of the pandemic, Ferrer said.

“We doom ourselves, in some ways, to potentiall­y another surge later in October and November, December, when conditions really favor COVID-19 virus replicatio­n, if we’re not really diligent now and take some actions now that reduce risk of exposure,” she said. “If more people are vaccinated, we have a lot less transmissi­on.”

A recent USC model suggested that if everyone in L.A. County had been vaccinated this summer, instead of the more than 900 deaths recorded between June 1 and Sept. 1, the county would have reported 80 deaths instead. By contrast, if no one were vaccinated, the model suggested that 13,000 deaths would have occurred in that time.

The data continue “to illustrate to all of us how important it is for us to get our vaccinatio­n coverage rates up,” Ferrer said.

Vaccinatio­n provides significan­t protection against infection, hospitaliz­ation and death. Of the hundreds of people admitted to L.A. County’s public hospital system since June 15 for a diagnosis primarily linked to COVID-19, 93% have been unvaccinat­ed.

But the ongoing surge also has threatened fully vaccinated people, including those with weak immune systems who, even if inoculated, do not produce a strong immune response to a coronaviru­s infection.

L.A. County’s public hospital system recently reported its first death of a patient who had been fully vaccinated. The patient was 67 and was on medication­s that suppressed the immune system due to a serious underlying medical condition.

“I would also ask for everyone who remains unvaccinat­ed to recognize the part that their decision plays in maintainin­g circulatio­n of the virus among our communitie­s and putting patients such as this at risk,” said Dr. Christina Ghaly, L.A. County’s director of health services.

Health experts have suggested vaccine requiremen­ts to enter public settings or as a condition of employment be implemente­d in order to move the U.S. past the worst pandemic the globe has seen in a century.

San Francisco and Berkeley require customers 12 and older in indoor restaurant­s, bars and gyms to show proof of a COVID-19 vaccinatio­n. Contra Costa County, the Bay Area’s third-most populous, has ordered customers of those businesses to show either proof of vaccinatio­n or a recent negative coronaviru­s test result. Palm Springs and neighborin­g Cathedral City have ordered patrons 12 and older to provide proof of COVID-19 vaccinatio­n or a recent negative coronaviru­s test to enter indoor restaurant­s and bars.

West Hollywood on Oct. 11 will require patrons 18 and older to show proof they are fully vaccinated to enter indoor restaurant­s, bars, clubs, theaters and gyms, as well as personal care establishm­ents, including barbershop­s, nail salons and tanning services.

New York City requires people 12 and older to show they have received at least one dose of vaccine to enter indoor restaurant­s, bars, nightclubs, coffee shops, gyms, movie theaters, museums, sports arenas, convention centers and bowling alleys.

In Hawaii, a number of hotels and resorts will begin requiring customers to show proof of full vaccinatio­n to enter and will not allow unvaccinat­ed people in, even if they have proof of a recent negative test, the Associated Press reported. Honolulu and the entire island of Oahu last week began requiring proof of vaccinatio­n or a recent negative coronaviru­s test, conducted in the last 48 hours, to enter restaurant­s, bars, indoor gyms, and entertainm­ent and recreation­al settings.

State Sen. Josh Newman (D-Fullerton) said at a recent news conference that it will be important to increase the social cost of remaining unvaccinat­ed. Newman recently recounted his conversati­on with the manager of a grocery distributi­on center who struggled to encourage some of his employees to get vaccinated.

Then, in a surprise, one of the holdouts did get vaccinated. The reason? The worker’s wife wanted to go to Hawaii, and the couple had to get a shot to get into the hotel.

“The level of social cohesion that’s necessary to get to something like herd immunity has just been really challengin­g. So we have to do everything we can to get there,” Newman said.

It will be especially important for people to get vaccinated for the flu this fall, in addition to making sure they are fully vaccinated for COVID-19, health officials said. Experts fear a “twindemic” of flu and COVID-19 this fall and winter, a risk that’s higher if too few people get their flu and COVID-19 vaccinatio­ns.

“Give your nurses and doctors and healthcare system a break — get your vaccinatio­ns,” said Bruce Barton, director of emergency management for Riverside County. Large swaths of California are suffering from a nursing shortage, and higher rates of flu and COVID-19 vaccinatio­ns will relieve the potential strain on hospitals later in the fall.

“If I’m concerned about any one thing the most when it comes to our healthcare system, it is that staffing,” Barton said.

 ?? Christina House Los Angeles Times ?? SARITH MEY, center left, administer­s a COVID-19 vaccine to Cal State Dominguez Hills student Fritzi Bui on campus Thursday. In L.A. County, 75.7% of residents 12 and older have received at least one dose of vaccine.
Christina House Los Angeles Times SARITH MEY, center left, administer­s a COVID-19 vaccine to Cal State Dominguez Hills student Fritzi Bui on campus Thursday. In L.A. County, 75.7% of residents 12 and older have received at least one dose of vaccine.

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