LOS ANGELES, CA — A surge in coronavirus cases has Los Angeles County health experts concerned, urging people to do their part to stop the spread of the virus just weeks from the holiday season and winter months.
Again warning of a "real and alarming" surge in COVID-19 cases, Los Angeles County's public health director said Monday the county is expanding its community outreach efforts to educate residents about slowing transmission of the virus, particularly in hard-hit areas.
Barbara Ferrer noted that some individual communities within the county are seeing disturbingly high case rates. Pacoima topped the list of most- impacted communities, with an adjusted rate over two weeks of 506 cases per 100,000 residents. That's more than double the countywide rate of 188 cases per 100,000 residents.
Sun Valley was second on the list, with 456 cases per 100,000 residents, followed by Palmdale at 406. Other communities on the list were East Los Angeles, Van Nuys, El Monte, Downey, Pomona, North Hollywood, Glendale, Santa Clarita, South Gate, Florence-Firestone, Canoga Park and Panorama City.
"For everyone who's living in these communities, please note you need to take extra precautions," Ferrer said. "And if you've had an exposure, you should know that there's plenty of testing available so you can go in immediately and find a place to get tested."
She said no specific reasons have been identified in the hard-hit communities to explain why they have such higher case rates. But the county is expanding its Community Health Worker Outreach Initiative, which sends health workers to interact with residents and provide them with virus information or connect them with resources.
The county had roughly 60 people assigned to that effort, but last week it trained another 170 staffers who will begin fanning out this week, "to amplify our messaging and provide general education to everybody who lives in communities experiencing a disproportionately high burden of disease," Ferrer said.
A large part of that messaging will be warnings against gatherings that public health officials are blaming for fueling the surge that has seen the county reporting more than 2,000 virus cases daily since late last week, including 4,600 over the weekend.
"These numbers are demonstrating real and alarming increases, and the next two weeks will be crucial," she said. "As we go into our cooler months and many holidays, we are increasingly worried about more and more transmission of the virus and more hospitalizations and deaths from COVID-19."
The county reported a relatively low 1,413 new cases on Monday, but Monday case numbers are typically low due to lags in test-result reporting from the weekend. The new cases lifted the county's cumulative total to 323,625 since the pandemic began.
Another five coronavirus-related deaths were reported by the county Monday, lifting the overall death toll to 7,177. There were 855 people hospitalized with the virus as of Monday.
Ferrer made another public plea for residents to adhere to health restrictions and avoid gatherings.
"This isn't a blip any longer," she said. "This isn't, `Oh we had one bad weekend and we're now getting it back under control.' This is now a surge in our cases and if it continues it will be quite alarming to go into our coldest months seeing this level of increase of cases."
She said the county doesn't want to be in a position of having to shut down more businesses, saying if residents take infection-control measures seriously, it will slow the spread of the virus. But if they don't, action could be taken.
"Otherwise, we're really looking at very troubling times for the winter ahead, times that could in fact threaten our healthcare system again. And that's something that we would not be able to tolerate."
Ferrer said the county is at a "pivotal point."
"There is no real path forward until we get back to slowing the spread," she said. "We don't have the luxury of ignoring our individual and collective responsibilities if we want to see more children go to school and our businesses remain open. Recovery just doesn't continue when you have thousands of new cases each day, and many of these cases stem from people taking risks that are frankly not appropriate. It isn't that hard to play by the rules, especially since these rules are what keep some people alive and allow our economy to improve."
The number of cases at skilled nursing facilities have decreased and remained relatively low and stable levels—until recently, she said. And this remains a cause for concern. These facilities are now paying particular attention to workers so they can get tested and have adequate access to testing.
"An outbreak at a skilled nursing facility can be one case," Ferrer said.
“Again, we urge everyone to be part of the effort to slow the spread. That helps us protect our most vulnerable residents at the skilled nurses facility," she said.
Ferrar also warned of health care workers facing high risk of exposure to the virus.
"This is the community’s front line defense during this unprecedented time," she said, adding that 73% of health care workers who have tested positive are under 50. More than half are Latino, Latinx and 68% of cases are among women.
"Sadly health care workers have also lost their lives," she said.
Among the health care worker deaths, more than half are men. Although a majority of the coronavirus cases are among women, and 45% are among Latino and Latinx workers. Among those who died, 83 percent of health care workers had underlying health conditions.
Exposure was often at the facility, she said.
“Recovery just doesn’t continue when you have thousands of new cases each day and many of these cases stem from people taking risks that are frankly not appropriate,” she said.
Ferrer noted outbreaks had recently happened with people traveling from California to Arizona and Nevada for competitive sports.
“Let’s not stretch this," she said. "We all want to celebrate these holidays and we have to make good decisions. We are definitely seeing a surge in cases. I couldn’t look at this data any other way."
"This is a surge in our cases and if it continues it will be quite alarming to go into our coldest months seeing this increase in cases," she said. "You saw our numbers last week, they were horrific."
Last week, Los Angeles County spiked in cases from 1,300 to 2,000 cases.
"Mondays are relatively low because of a lag in weekend reporting," she said. "If we continue to see cases each day over 2,000 this is an alarming surge."
"Early on it was confusing, it think for all of us, what exactly it would make sense to do," she said. "Now it's not confusing."
The recommended strategies still work, she added. People should still continue wearing face masks, social distancing and gather with no more than two households—outside.
"You can’t have this many cases without transmission going on," she said.
"Businesses need to do their part but at this point every single person needs to do their part, otherwise we’re looking at troubling times ahead and times that could in fact threaten our health care system again," she said. "Patterns we’ve seen in other places in the United States and other places in the world need to serve as a reminder that that can be our reality as well. The virus actually is relentless.”
People who attend gatherings, large celebrations where people don’t wear masks are encouraged to get tested and quarantine, Ferrer added. Protests are not illegal but there is health guidance for these events.
"So one thing is protests are allowed across the state by law," she said. "And what we’ve done, because protests are done, we’ve put out guidance that if you are protesting to wear face covers."
As far as what comes next and news of a possible vaccine, Ferrer is hopeful.
And by 2021, it could be a path ahead, Ferrer said.
As for the surging cases, it's a tough reality for the county that worked hard to stop the spread of. the virus following high cases in July.
“I think we’re not where we want to be," Ferrer said. That’s the hard reality, or the harsh reality."
"People might have gotten too relaxed," she said. "The sad reality is that doesn’t work. We cannot relax the protections we’re taking just because things are going better.”
The face coverings, social distancing, not getting together with other households, stops transmission.
"We let down our guard," she added.
However, it can be done.
"I know we can do it because we did it before," she said. "We had very high rates. It scared all of us. We were way more careful and we got back to slowing the spread. That’s what we have to do right now."
Gov. Gavin Newsom announced Monday that the statewide numbers are sobering and could hold counties back from reopening.
California recorded 7,212 cases Monday, the largest spike in new daily cases since late summer. The state also reported a new 14-day 3.7% positivity rate, up from 2.5% in less than a month.
- City News Service and Patch Editor Nicole Charky contributed to this report.