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California health officials are beginning to mull what the next phase of reopening may look like, offering a glimmer of hope for places like Los Angeles County.
For more than a month, the bulk of the state’s 58 counties have been on a watchlist of municipalities with worrisome COVID-19 statistics. Health officials weigh key metrics to gauge the virus’ spread in the community and the county’s ability to respond to it. Counties that don't meet the state's criteria are restricted from fully opening all parts of the economy.
There are several benchmarks that must be met before a county can be removed from the list, and Los Angeles County has hit most of them: the average daily number of infections; hospitalizations and deaths are all declining; and it has enough intensive care beds and ventilators to conceivably handle a sharp rise in patients.
But L.A. County is far removed from the required 14-day average of fewer than 100 infections per 100,000 residents. As of Tuesday, the county’s rate was 239.2 positive cases per 100,000 people. Still, the average is a marked improvement from last week's 335 per capita.
Gov. Gavin Newsom on Tuesday said state public health officials are crafting a new set of state-mandated protocols on how counties, once off the state’s monitoring list, can begin to reopen their economies and relax coronavirus restrictions in this second go-round.
“The last time we did this we empowered local health officers to make decisions for themselves,” Newsom said. “We're going to be focusing a much deeper emphasis on the how this time, not just the when.”
L.A. County health officials announced 1,003 new cases Tuesday and 64 more deaths, pushing the county's overall totals to 224,031 cases and 5,335 deaths since the outbreak began. Hospitalizations have dropped by more than a third in the last month.
"I hope we can stay on this trajectory," said County Supervisor Hilda Solis, whose district has recorded many of the area's cases. "We've been hitting it very hard, letting people know that they have got to be a part of the solution and the only way we're going to get the economy back and get the people back to work is to lower these rates."
More than 2.1 million people in Los Angeles County have been tested for COVID-19, with about 10% testing positive, county health officials said in a statement Tuesday.
"As we work together to prevent more illness and death from COVID-19, it is important to note that while testing can help identify people who are infected, testing alone cannot prevent all transmission," Public Health Director Barbara Ferrer said in a statement.
"Individuals who test positive are capable of infecting others 48 hours before they have any symptoms or a positive test result. The best way to prevent transmission is to take universal precautions — keep six feet apart from others, wear a face covering outside your home and wash hands often."
On Monday, Santa Cruz County was removed from the state's watchlist, and Amador, Mendocino, Inyo and Calaveras counties were added. San Diego County, which has been reporting less than 100 new coronavirus cases per 100,000 residents for days now, was removed from the list Tuesday.
“Many counties across the state are doing things really well,” said state health officer Dr. Mark Ghaly, citing the success of mask requirements, isolating the sick and tracking down new cases as part of the reason. “Some of those that are nearing coming off the monitoring list have likely been at some of these efforts potentially a little longer.”
On Monday, there were nearly 10,000 new cases reported and nearly 100 more deaths. And while infections and deaths have dropped in recent days, hospitalizations increased Tuesday for the first time in two weeks, Ghaly said.
“One day is not a trend, but it’s an important number that we’ll continue to watch to make sure it doesn’t become a trend,” he said.
As of Tuesday, California had recorded 632,667 coronavirus cases and 11,342 deaths. A data backlog that had kept the results of up to 300,000 tests off the state's tally has since been resolved and most of the positive cases have been included in the state's total, Ghaly said. Los Angeles County officials, on the other hand, said they anticipate more of the backlogged cases to appear into future totals.
Looking ahead, Ghaly urged the public to prepare for the flu season, which is imminent. Because the illness is also a respiratory disease, many of the precautions people are taking against the transmission of COVID-19 should work to slow the spread of the flu.
“But unlike for COVID, we actually have a vaccine,” Ghaly said. “Not only will it protect you and your communities, but it may be exactly what you need to avoid a visit to the emergency room. We know that additional movement in the ER and urgent care centers might create an exposure risk to COVID-19.”
Vaccination trends against the flu don’t look promising, though, he said.
Initially, the public was being vaccinated in 2020 at a similar rate to last year, Ghaly said. But as the COVID-19 pandemic spread, flu vaccinations dropped dramatically in the spring. Only recently have the numbers ramped up.
“The fact that we are still fairly low relative to the peak in August, gives us concern and allows me to encourage families — and caregivers, parents — to use this time to schedule that critical appointment and catch up on vaccinations so we don’t lose some of those important gains California has made,” Ghaly said.
Times staff writer Phil Willon contributed to this report.