An upswing in coronavirus infections has spawned a rise in worksite case clusters in Los Angeles County, prompting health officials to recommend additional measures aimed at tamping down transmission, including reducing crowding and, if there's a suspected outbreak, expanding remote work.
"With the continued increase in cases, and now as you're seeing the corresponding increase in hospitalizations … we're really worried," L.A. County Public Health Director Barbara Ferrer said of the region's overall trends.
"Our case numbers, they are staying pretty high," Ferrer said. And she expressed concern about the rising numbers of even more contagious Omicron subvariants, BA.4 and BA.5, at a time when more people have lowered their guard and shed their masks.
Health officials have since April tracked a "fairly steady increase in reported worksite case clusters," including 301 in the past week, up from 251 the week prior, according to Ferrer. That’s a 20% increase between those two weeks, worse than the prior week-over-week increase of 12%.
A cluster means at least three coronavirus cases have been documented at a worksite within a 14-day period.
Under the early-alert framework established by the county, officials consider that number of clusters to be at a level of high concern. The number of worksite outbreaks in a single week is at its highest level since early March.
There are a number of factors likely fueling the increase, Ferrer told reporters Thursday. Those include fewer staff members and customers wearing masks, more meetings and events being held indoors on site and some employees coming to work even though they have COVID-19 symptoms.
"All workplaces should implement sensible safety precautions at this point, including asking everyone to screen for symptoms before they come to work and stay home if they have symptoms, to wear masks when they're indoors and to avoid crowding in common areas such as in break rooms and cafeterias," Ferrer said.
L.A. County already strongly recommends indoor masking in public spaces, but Ferrer said that worksites with three or more coronavirus cases over a two-week period "must implement indoor masking for the entire exposed group of workers. And they need to keep an indoor masking policy until at least 14 days after the last workplace case."
Ferrer said the masking rule for workplace outbreaks is both a requirement by the county and the California Division of Occupational Safety and Health, also known as Cal/OSHA. Workplaces must notify the L.A. County Department of Public Health within 48 hours once they become aware of a cluster of three coronavirus cases over a 14-day period; they can do so by calling (888) 397-3993 or by filing a report online.
At sites with potential outbreaks, county officials also recommend employers consider implementing remote work, when possible — especially for workers at elevated risk of severe COVID-19 illness.
"In worksites where everyone's in their own office and there are closed doors and people aren't mingling a lot, it's a lot easier to keep transmission risk lower. But that's not what happens at most work sites," Ferrer said.
And "in the places where there’s a lot of close contact by the nature of the job, layering in as many protections as possible is just very sensible when transmission has climbed this high," she added.
While there were signs earlier this month that the latest coronavirus wave may have topped out in L.A. County, cases seem to be on the rise again.
Over the last week, the county has reported an average of about 5,100 cases a day, according to Ferrer. That's a 20% jump from a week ago, and one of the highest rates since cases hit a post-winter low in March. On a per capita basis, the latest rate equals 355 cases a week for every 100,000 residents; a rate of 100 or more is considered a high rate of transmission.
Hospitalizations, too, are increasing steadily. As of Wednesday, 808 coronavirus-positive patients were hospitalized countywide — up 34% in the past two weeks.
A greater share of visits to L.A. County's emergency rooms are being blamed on coronavirus-related reasons. Over the last week, 8% of emergency department visits were coronavirus-related; a month ago, it was 5%.
"Providers at both emergency rooms and urgent-care centers have noted that this increased volume of COVID cases is coming at a time when they're also seeing unusually high numbers for the summer of patients with other respiratory illnesses, including flu and [respiratory syncytial virus]," Ferrer said.
Hospitals are reporting staffing shortages related to high rates of coronavirus transmission, which are infecting healthcare workers, Ferrer said.
According to data released Thursday by the U.S. Centers for Disease Control and Prevention, L.A. County observed 8.3 new weekly coronavirus-positive hospital admissions per 100,000 residents; that's the highest such rate since hospitalizations began increasing again in mid-April. A rate of 10 or more would place L.A. County in what federal health officials have designated as the high COVID-19 community level.
Based on current projections, the region could cross that threshold by mid-July.
Should the county fall within that category for two straight weeks, a new mask mandate would be issued for public indoor places.
"With our rising case rates and the hospital admission rates going up, we do have fresh concerns about the impact of COVID. And it's more likely now that we might make it into that high community level sometime this summer," Ferrer said.
L.A. County's latest rate of new coronavirus-related hospitalizations crosses the threshold rate of 8 set by an agreement by the Alliance of Motion Picture and Television Producers and unions over when masking requirements should return in certain workplace settings in the TV and film industry.
"They will resume indoor masking requirements, along with several other safety measures," Ferrer said.
Current trends make it all the more important to take sensible infection-prevention precautions — especially with the long Fourth of July weekend fast approaching. Those include testing before gathering with others and staying home if you're feeling under the weather or have recently been exposed to COVID-19.
Health officials also generally recommend gathering outdoors. For indoor events, residents should consider wearing masks and improving ventilation by opening windows and doors.
"As long as you layer in some common-sense protections, you will reduce the risk associated with those activities pretty dramatically, and that would help all of us at this point," Ferrer said.
"You do not want to be the person who brings COVID to the party."
Times staff writer Anousha Sakoui contributed to this report.
This story originally appeared in Los Angeles Times.