Los Angeles Times

Back to school? Get your shots

Amid low pediatric COVID vaccinatio­n rates, health officials aim to keep kids safe.

- By Luke Money and Rong-Gong Lin II

As summer vacation draws to a close, health officials are urging parents to get their children vaccinated against COVID-19, with some warning that the start of the school year could bring an increase in cases.

Infections and hospitaliz­ations are declining after a prolonged summer wave, but that progress could be challenged as schools reopen.

This will be the first time during the pandemic that the traditiona­l school year will begin in California with

out a statewide school mask mandate in place, and vaccinatio­n rates — though robust for the general public — are low among children.

While COVID-19 deaths are rarer among youths than among adults, they do happen. Los Angeles County on Friday reported its 12th COVID-19 death in a person younger than 18.

“COVID-19 is here to stay, but we have learned methods and gained tools to decrease its impact on our health and well-being,” the state Department of Public Health wrote in its latest guidance for schools. “California’s schools can manage this disease in sustainabl­e and adaptive manners.”

Among the strategies state health officials recommend are ensuring that students and staff stay up to date on vaccinatio­ns, improving indoor air quality, promoting proper hand hygiene and supporting access to coronaviru­s testing.

“Not only do vaccinatio­ns provide individual-level protection, but high vaccinatio­n coverage reduces the burden of disease in schools and communitie­s and may help protect individual­s who are not vaccinated or those who may not develop a strong immune response from vaccinatio­n,” the guidance states.

About 41% of 5- to 11-yearolds in California have received at least one vaccine dose, according to data compiled by The Times.

The figure is roughly the same for both Los Angeles and Orange counties. By comparison, among 12- to 17year-olds, 87% in L.A. County have received a dose, while 74% have in Orange.

Vaccinatio­n rates are higher in the San Francisco Bay Area. In San Francisco, 83% of 5- to 11-year-olds have had at least one dose, as have more than 90% of 12- to 17-year-olds.

“I’m predicting that after the kids come back to school ... we probably will have another wave in early fall,” Dr. Clayton Chau, director of the Orange County Health Care Agency, said at a briefing Thursday. He noted that the number of children vaccinated in Orange “is quite low, like every other county.”

Chau said he thinks there will be “perhaps, God forbid, another wave in the winter.”

“We can’t predict whether or not we’ll have another variant, and whether or not the new variant is going to be more severe and more transmissi­ble than others,” he said.

There’s a possibilit­y of a small increase in cases as the academic year begins — especially at elementary schools, due to the lower vaccinatio­n rates — but there are ways to reduce risk, said Los Angeles County Public Health Director Barbara Ferrer.

“I think everybody knows what we can do to create as much safety as possible in schools, so that children can have all of the learning opportunit­ies that they need,” she said, noting that it would be prudent to continue wearing masks indoors in schools.

“Masks do work, and they work well,” she said. “And this would be an appropriat­e, time-limited approach to [add] in a layer of protection when transmissi­on rates are still high.”

The California Department of Public Health also strongly recommends masking in indoor public settings.

While L.A. County is still contending with substantia­l coronaviru­s spread, it is slowing.

Officials reported an average of 4,700 new cases a day over the last week, down 17% from the prior week. The latest per capita weekly case rate is 327 for every 100,000 residents; a rate of 100 or more is considered high.

Earlier this week, there were fewer than 10 new coronaviru­s-positive hospital admissions for every 100,000 residents of L.A. County, according to the U.S. Centers for Disease Control and Prevention; by Thursday the rate had ticked up to 10.1. That keeps the county in the “high” community transmissi­on level as defined by the CDC. A sustained rate of less than 10 would allow L.A. County to enter the “medium” category.

“We do remain hopeful” that L.A. County will soon exit the high level, Ferrer said.

Given the declining case counts and improved hospitaliz­ation rates, county health officials have ruled out reinstatin­g an indoor mask mandate.

Overall, 1,206 coronaviru­s-positive patients were hospitaliz­ed across L.A. County’s 92 hospitals as of Thursday. That’s down about 9% from the apparent peak of the wave, two weeks ago. About 43% of those patients are hospitaliz­ed with COVID-associated illness, health officials estimate; the remainder are coronaviru­s-positive but are in the hospital for unrelated reasons.

The percentage of emergency room visits in L.A. County associated with COVID-19 is also decreasing, as are the number of outbreaks at nursing homes and homeless shelters and the number of workplaces reporting clusters of cases.

“The California Department of Public Health reports that overall hospital admissions have peaked across the state, including in Southern California,” Ferrer said. “Their modeling predicts further declines in hospital admissions, along with some plateauing and fluctuatio­ns throughout the month of August.”

Deaths related to COVID-19, however, are increasing. Over the week that ended Friday, L.A. County recorded 121 COVID-19 deaths, the most since the end of March. This is the byproduct of earlier increases in cases and hospitaliz­ations, and it will probably take some time before deaths begin to decline, in line with other metrics.

The latest pediatric COVID-19 death in L.A. County, announced Friday, was in a patient between the ages of 12 and 17.

There have been seven COVID-19 deaths in L.A. County among that age group, three among 5- to 11year-olds and two among those younger than 5.

A pediatric COVID-19 death is defined as occurring in someone who suffered symptomati­c disease before dying or had pathologic evidence of a coronaviru­s infection in the heart, lung or other tissues during an autopsy.

Orange County has reported five COVID-19 deaths among children. One who died was a previously healthy, unvaccinat­ed teenager who suffered from multisyste­m inflammato­ry syndrome, which can be a deadly complicati­on of COVID-19, according to an interview her father gave to KCBS-TV.

California overall has reported 73 pediatric COVID-19 deaths: 48 among 5- to 17-year-olds and 25 among those younger.

Meanwhile, some California counties are exiting the high COVID-19 community level — the worst on the CDC’s three-tier scale.

The number of counties with a high community level has dropped over the last two weeks from 50 to 28. As of Thursday, 74% of California­ns lived in counties with a high level, down from 83% a week earlier and 99% the week before that.

Those that most recently exited the high level are Sacramento, Kern, Tulare, Marin, Butte, Yolo, Shasta, Yuba, Tehama, Siskiyou, Amador, Mariposa and Trinity. A week earlier, Riverside, San Bernardino, Santa Barbara, Placer, San Luis Obispo, El Dorado, Nevada, Calaveras, Lassen, Del Norte, Colusa, Plumas and Inyo exited the high level.

Much of coastal Southern California remains in the high level, including San Diego, Orange and Ventura counties. So too are most counties in the Bay Area, along with some highly populated counties in the San Joaquin Valley, including Fresno, San Joaquin and Stanislaus.

Statewide, there were about 14,500 coronaviru­s cases a day during the week to Thursday, down 18% from the week prior. On a per capita basis, that’s 260 cases a week for every 100,000 residents.

In the last week, there were 293 deaths. In early June, there were weeks when there were fewer than 200.

The Omicron subvariant­s BA.5 and BA.4 continue to worry health officials, because both have shown the ability to reinfect people who have recovered from older Omicron subvariant­s or earlier coronaviru­s strains, such as Delta.

According to the CDC, BA.5 made up an estimated 85.5% of new cases nationwide for the week ending July 30. BA.4 was a distant second, at 7.7%.

But officials also are closely watching a new Omicron subvariant, BA.4.6. A descendant of BA.4, it has made up only 1% of coronaviru­s samples in L.A. County but is attracting attention because “it’s accelerati­ng at a similar rate as BA.5,” Ferrer said. “The question is really whether it’s going to outcompete BA.5 and really start taking over.”

Nationwide, an estimated 4.1% of cases were most recently attributed to BA.4.6 — up from 2.3% in early July, CDC figures show.

“We’re paying attention to it,” Ferrer said. “We’re watching it carefully, because it looks like it’s got some advantages in the rate at which it is proliferat­ing. We’ll just have to see.”

A different Omicron subvariant, BA.2.75, which raised concerns in India, has yet to make an impact in L.A. County. Only one case has been identified, “and this is an encouragin­g sign that this strain is not gaining dominance in L.A. County like it did in India,” Ferrer said.

Ferrer said there’s an expectatio­n that boosters that are designed specifical­ly against BA.5 and BA.4 may become available perhaps as early as next month. It’s unknown, however, whether eligibilit­y for the Omicron booster will be restricted by age or other criteria.

 ?? Luis Sinco Los Angeles Times ?? PAOLO CANIZALES gets vaccinated in March at Helen Keller Elementary School. About 41% of 5- to 11-year-olds in California have gotten a COVID shot.
Luis Sinco Los Angeles Times PAOLO CANIZALES gets vaccinated in March at Helen Keller Elementary School. About 41% of 5- to 11-year-olds in California have gotten a COVID shot.
 ?? Alisha Jucevic For The Times ?? REBECCA KELLEN, 7, gets vaccinated on May 21 in Encino. Los Angeles County on Friday reported its 12th COVID-19 death in a person younger than 18.
Alisha Jucevic For The Times REBECCA KELLEN, 7, gets vaccinated on May 21 in Encino. Los Angeles County on Friday reported its 12th COVID-19 death in a person younger than 18.

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