County closer to fewer restrictions

Public health leader still urges caution as supervisors seek clarification on mandates for red tier

Los Angeles County could move into a less restrictive state tier this week based on falling coronavirus case rates and an adjusted state metric that lowered the threshold required based on how many vaccines were administered in underserved communities.

On Tuesday, L.A. County improved its daily adjusted rate to 5.2 cases per 100,000 people. Last week, the county recorded a daily adjusted case rate of 7.2 per 100,000 people. The scores are updated by the state each Tuesday.

Under current rules, counties must

“Our understanding is that within 48 hours of the state announcing the vaccine trigger is met, then L.A. County and other counties with the appropriate case rates will move into the red tier.”

— L.A. County Public Health Director Barbara Ferrer, at Tuesday’s Board of Supervisors meeting

record fewer than 7.0 cases per 100,000 people for at least two weeks to move into the red tier. Other requirements, related to positivity rates and a health equity metric in underserved communities, are also incorporated. L.A. County already qualifies for the orange tier under those guidelines, but the state requires all three metrics to qualify.

Another path to the red tier is if the state hits a target of administering at least 2 million vaccines to the most underserved communities. When that happens, likely this week, officials said, it raises the threshold for entering the red tier to 10 cases per 100,000.

“We do anticipate (the new adjusted case rate) will be less than 10 new cases,” L.A. County Public Health Director Barbara Ferrer said. “Our understanding is that within 48 hours of the state announcing the vaccine trigger is met, then L.A. County and other counties with the appropriate case rates will move into the red tier.”

L.A. County has been in the most restrictive purple tier, as has most of Southern California, since the

state instituted the tiered system last fall.

Under the red tier, grades 7-12 can reopen for in-person instruction. Gyms, movie theaters, restaurants and places of worship will also be allowed to reopen indoors with restrictions. Concerts can resume at 20% capacity and theme parks can open at 15%. However, the county is not bound by the state guidelines and could continue to impose stricter rules.

Ferrer has hinted the county may not immediately ease all the rules, most notably when it comes to indoor dining. On Monday, she cited a recent study by the U.S. Centers for Disease Control and Prevention that found on-premises restaurant dining contributes to increases in COVID-19 cases and deaths. Ferrer also cited the study in her presentation to the Board of Supervisors on Tuesday.

Some board members said, however, that they’re not in favoring of imposing additional restrictions.

“I feel pretty strongly that I think we should align ourselves with the state’s red tier reopening guidelines,” Supervisor Janice Hahn said. “I think to be different than that right now would cause confusion and probably a lot of anger, because there

are so many venues out there, entities, that have really suffered and are waiting to get a few more of these restrictions lifted. Especially if we’re talking about Disneyland reopening at limited capacity, Opening Day at Dodger Stadium there’ll be inperson fans. … But I really hope that we can stay in alignment so that there is not confusion from one county to the other.”

Supervisor Kathryn Barger agreed with Hahn, saying L.A. County should align its public health order with the state and neighboring counties.

“I believe that clarity and consistency leads to the highest rates of compliance,” Barger said, adding that she wanted to avoid local residents traveling to other counties with lesser restrictions.

Barger also urged Ferrer to get guidance out quickly so businesses can plan ahead to prepare for changing rules.

Ferrer warned the board that while case numbers and positive test rates have declined precipitously in recent weeks, things could worsen if residents become lax about infection-control measures.

“This is the month I would say — the month of March, the early part

of April — where we have to be extraordinarily cautious,” she said. “Because we’ve been here before. We’ve been here with reopenings. We’ve been here with travel around Thanksgiving and Christmas. We’ve seen what happens around holidays if we’re not really careful. … We’ve got to keep everybody alive right now so they can get vaccinated and stay alive. So this would be a time for extreme caution.”

She pointed specifically to the spread of variants of the coronavirus that causes COVID-19, which can spread more easily from person to person. Ferrer said the variant first identified in the United Kingdom has been increasing its reach in L.A. County and is now believed to be responsible for 10% of all COVID-19 cases in the county.

L.A. County this week will administer roughly 312,000 additional doses with more than half going to underserved areas — lower-income neighborhoods and communities of color, places hit hardest by the outbreak — based on the state’s Healthy Places Index. The metric ranks communities based on socioeconomic and health factors. The state has set a goal of allocating at least 40% of vaccine doses for these

communities.

Amid the debate, the outlook appears to be improving for the county.

More vaccines are arriving, as officials hope the sluggish shipments of recent weeks are at an end. This week, roughly 120,000 doses will go toward second doses and 194,000 for first appointments.

More than 100,000 additional doses are distributed directly from federal and state stockpiles through various providers such as health systems, clinics and pharmacies.

So far, more than 2.4 million vaccine doses have been administered in L.A. County.

The average number of cases per day reporting in L.A. County over a sevenday period has dropped below 700. That hasn’t been seen since November, prior to the relentless winter surge.

On Tuesday, the county reported 70 deaths and 1,337 new cases, bringing total deaths to 22,099 and total cases to 1,205,276.

“We are also seeing the average number of people hospitalized with COVID-19 decline,” Ferrer said.

As of Tuesday, there were 1,079 people with COVID-19 in L.A. County hospitals, 320 of them in intensive care, the lowest levels the county has seen since Nov. 14.

“The seven-day average daily deaths, while much higher than we would like it, continues to decline,” Ferrer said. “We are encouraged by this progress of decreasing our cases locally. But I am aware nationally that the decline in cases has reached a plateau and there are states that are showing higher transmission.”