Los Angeles County appears to have avoided a coronavirus surge associated with Labor Day, with officials hailing an ongoing reduction in weekly coronavirus cases, which have fallen to their lowest level since mid-July.
"Higher vaccination rates and safety precautions at Labor Day celebrations helped avert the usual increase in cases we experience after major holidays," L.A. County Public Health Director Barbara Ferrer said.
But officials said now is not the time to let up on efforts to further increase vaccination rates. Neglecting inoculation campaigns risks a new cycle of surging cases, hospitalizations and deaths in the autumn and winter, officials said.
Only 60.4% of L.A. County residents of all ages are fully vaccinated, a rate far below what is thought to be needed for a community to achieve "herd immunity," in which enough of the population has immunity to COVID-19 to stanch substantial ongoing transmission of the virus.
Some experts think it may take rates of immunity — either through vaccination or surviving a coronavirus infection — of at least 84% among residents of all ages to achieve herd immunity. It's an estimate based on the guess that a person infected with the Delta variant, on average, transmits the virus to six other people in an unvaccinated population, a testament to its ultra-infectious nature.
These are some of the reasons why health officials say now is the time to double down on getting more people vaccinated — including through targeted requirements — and sticking with the indoor mask mandate until officials are more certain the danger has passed.
"Waiting until spread again is once more very high before acting doesn't reflect the reality of this pandemic and the destructive potential of the virus," Ferrer said.
Experts also recommend that people who have survived COVID-19 still get vaccinated. A study conducted in Kentucky found that among those previously infected with the coronavirus in 2020, unvaccinated residents had more than twice the odds of being reinfected with the coronavirus than people who were fully vaccinated.
At an online town hall meeting Thursday night, Ferrer offered strong support for school districts that decide to make vaccinations mandatory for students who are eligible to receive them, and she spoke positively about the idea of a statewide vaccination requirement for eligible schoolchildren and school employees.
"As it gains more support amongst parents and students, it's much more likely to happen," Ferrer said. "Whether that comes through a state health officer order or that comes through some legislative process, or that comes through the Office of Education and then superintendent of schools, I think there is a recognition that [on] some of these decisions, it's best to have uniformity."
Because the COVID-19 vaccine has so far received only emergency use authorization from the Food and Drug Administration for children ages 12 to 15, and not full approval, "it really has been left up to the districts" to decide on vaccine requirements, Ferrer said.
Still, the vaccines are safe, and districts have long required many other vaccinations as a condition for entering schools, Ferrer said. The national COVID-19 death toll has exceeded 684,000, making COVID-19 even deadlier than the 1918 flu pandemic in the United States.
"This pandemic is the most devastating health crisis that we have faced in our lifetimes. And one of the ways to get over the pandemic is to have more people protected with the vaccines," Ferrer said. "It's also the way we save a lot of lives. So … we're in strong agreement that it makes sense" for schools to require everyone eligible for the vaccination to receive it.
Currently, California has directed only school employees — not students — to be either vaccinated or tested weekly for the coronavirus.
The L.A. Unified School District has ordered that children 12 and older must be fully vaccinated against COVID-19 by January to enter campuses. In the Bay Area, the Oakland Unified School District's board voted Wednesday to pass a similar requirement, while offering some exemptions.
Some infectious-disease experts have lined up behind mandatory vaccination policies, saying they are essential to defeating the worst respiratory pandemic in a century. Lackluster rates of immunity will otherwise doom communities to a "twilight state of partial COVID-19 restrictions" and will delay the pandemic's end, Dr. Monica Gandhi, an infectious-disease expert at UC San Francisco, wrote in a recent op-ed, adding that "vaccines will actually lead to greater freedom from public health restrictions."
"It's just imperative for us to use them," Gandhi said in an interview about vaccination mandates. "We need to get our vaccination rates up. And this is the right approach."
There are both signs of promise and concern in L.A. County's latest case data. Weekly coronavirus case rates among unvaccinated people have fallen substantially since mid-August, which appears to have been the peak for new coronavirus cases.
Still, unvaccinated younger people continue to be a major source of coronavirus transmission, and unvaccinated adults 50 and older are at a much higher risk of requiring hospitalization or dying of COVID-19.
Younger L.A. County residents are less likely to be vaccinated. Between 64% and 75% of eligible residents up to age 49 are vaccinated, compared with 80% or more of those 50 and older.
Though L.A. County still has a long way to go in improving overall vaccination rates, Ferrer said, there has been considerable improvement in the Long Beach area, the San Gabriel Valley and parts of the Antelope Valley.
The good news comes as California is one of only two states not in the U.S. Centers for Disease Control and Prevention's worst category of coronavirus transmission. Forty-eight states are considered to have high community transmission, colored red in the CDC's maps. California and Connecticut were the only two states as of Sunday to be in the second-worst category, in which community transmission is defined as substantial, or orange.
As of Sunday, California had the lowest weekly coronavirus case rate among all states: 82.6 cases for every 100,000 residents. Weekly coronavirus case rates vary widely among the nation's most populous states: For every 100,000 residents, Texas reports 270.8; Florida, 248.3; New York, 173.3; Illinois, 171.9; Pennsylvania, 254.5; Ohio, 379.1; Georgia, 305.4; North Carolina, 226.6; and Michigan, 230.4.
This story originally appeared in Los Angeles Times.