Amid Rising COVID-19 Transmission, Common-Sense Safety Practices Urged for Skilled Nursing Facilities, Schools
After a relatively calm summer, the Los Angeles County Department of Public Health (Public Health) is reporting a rise in measures of COVID-19 transmission for the fifth consecutive week. To help mitigate the spread, Public Health is working with institutions and partners to provide information about and access to vaccinations, tests, and therapeutics. Public Health continues to provide support and resources to skilled nursing facilities, where people are at higher risk for severe illness, and schools, where students and staff are indoors, in close contact with each other, for long periods of time.
The increase in COVID-19 circulation is likely the combined result of multiple factors, including summer travel, return to school, and the emergence of new COVID-19 variant strains. Compared to other points during the pandemic, hospitalizations and deaths remain relatively low. However, people more vulnerable to severe illness and death, including people who are immunocompromised, older or in skilled nursing facilities, and the people they spend time with, should consider precautions to protect against COVID infection. These protections include wearing a well-fitting high filtration mask when in poorly ventilated and/or crowded indoor spaces and on public transit, testing when symptomatic and/or after a known COVID-19 exposure, remaining home when sick, and seeking therapeutics if infected.
In Los Angeles County this week, an average of 512 daily cases was reported, a nearly 35 percent increase from the week before. Reported cases do not include home tests, so the actual number of COVID infections in the community is much higher.
Wastewater concentrations of SARS-CoV-2, the virus that causes COVID-19, provide a more complete picture of virus levels in the community. This week, wastewater concentrations are at 28 percent of the 2022-23 winter peak and have been steadily increasing since July 12, when they were at 8 percent of the peak.
Based on the most recent COVID-19 variant sequencing in Los Angeles County as of July 22, XBB.1.5 and EG.5 now account for nearly equal proportions of COVID-19 cases, combined making up 31 percent of the total sequenced cases. XBB.2.3 accounts for the next highest proportion of sequenced cases followed by XBB.1.16.1.
Ninety-eight percent of currently circulating strains in Los Angeles County are descendants of Omicron XBB, including EG.5, which is what the fall COVID-19 vaccine, likely to be released next month, will target. Los Angeles County has not detected BA.2.86 in recently sampled sequences. BA.2.86 is being closely monitored because it has many mutations that may affect how our body responds to an infection.
Currently, Los Angeles County is reporting a daily average of 422 hospitalizations, a 30 percent increase from the week prior and there has also been a consistent, small increase in the proportion of emergency department visits attributed to COVID-19 over the past month. While hospitalizations are increasing, the current levels are still far lower than what was seen in 2022 during the summer peak, when there was an average of 1,287 COVID patients hospitalized each day.
When COVID-19 transmission increases, people residing in skilled nursing facilities are especially vulnerable. This week, the number of new outbreaks opened in skilled nursing facilities rose to 39, up from 20 the week prior and 13 four weeks ago. And while resulting hospitalizations and deaths among skilled nursing facility residents are lower than at other points during the pandemic, nonetheless, increased transmission of COVID-19 at nursing homes carries heightened risk for frail elderly.
As a result of the increased outbreaks, Public Health is working closely with local skilled nursing facilities to encourage adequate cleaning, infection control, and ventilation in the facility, as well as to communicate the importance of staff and visitors staying home when sick.
Public Health currently strongly recommends masking for staff in skilled nursing facilities and requires it during outbreaks. All residents should have access to clean well-fitting masks with good filtration and these should be worn by anyone suspected positive when not in their rooms. It is also strongly recommended that all residents, staff, and visitors remain up to date with COVID vaccines. Visitors should test before going into a skilled nursing facility and should strongly consider wearing a mask while inside.
Public Health provides support at all skilled nursing facilities during outbreaks and a Paxlovid prescription is encouraged, where appropriate, for residents who test positive.
With increased COVID-19 transmission in the community, schools are another place where outbreaks are possible due to large groups of people being indoors together for extended periods of time. And while many children may not experience severe illness associated with a COVID-19 infection, other family members and school staff may be at higher risk.
Parents and guardians are encouraged to keep children home if they are sick, including when they have a fever, bad cough, extreme fatigue, or a sore throat. Those with respiratory symptoms or a known exposure should test for COVID-19; many school districts have already received test kits for free distribution to students and their families. If a child tests positive for COVID-19, it is important to report that to the school as soon as possible so that others can be informed of the exposure. Anyone who tests positive for COVID-19 needs to isolate at home for a minimum of 5 days.
Public Health is committed to working with schools to provide support during outbreaks in addition to distributing free antigen tests and tool kits with resources and information about reducing transmission.
Those infected with COVID-19 should talk to their health care provider about treatment options, such as Paxlovid, as soon as possible. Treatment must begin within five days of the onset of symptoms. To access free telehealth services for treatment, contact the Public Health Call Center, seven days a week from 8 a.m. to 8:30 p.m., at 1-833-540-0473.
Los Angeles County remains in the U.S. Centers for Disease Control and Prevention’s Low Hospital Admission Level with 5.2 weekly COVID-19 hospital admissions per 100,000 people, reported on Aug. 21 for the seven-day period ending Aug. 12, an increase from 4.1 hospital admissions last week.
Public Health reports COVID-19 data weekly. The following table shows case, wastewater, emergency department, hospitalization, and death data in Los Angeles County over the past four weeks:
Metric
Date of Weekly Report
8/23/2023
8/16/2023
8/9/2023
8/2/2023
Daily average cases
512
384
333
264
SARS-CoV-2 wastewater concentration as a percentage of the Winter 2022-2023 peak concentration value
28%
22%
19%
12%
Daily average of the percent of Emergency Department (ED) encounters classified as coronavirus-related
4.4%
3.9%
3.5%
3.2%
Daily average number of COVID-positive hospitalizations
422
330
295
245
Daily average deaths
1.7
1.0
1.7
0.7
Percent of all deaths due to COVID-19
1.1%
0.9%
1.3%
0.8%
All daily averages are 7-day averages. Data for past weeks are subject to change in future reports. Time periods covered by each metric: cases = week ending each Saturday; wastewater = week ending each Saturday, with a one-week lag; ED data = week ending each Sunday; hospitalizations = week ending each Saturday; deaths = week ending each Monday, with a three-week lag; death percentage = week ending Monday, with a one-week lag. Hospitalization counts do not include Prospect Hospitals, which on average make up 2% of hospitalizations in LA County.
Case data is presented by episode date, an approximation of the date the illness began, and death data is presented by date of death. This is a change from how case and death data were presented prior to July 26, 2023, which was by date of report. Daily average cases and deaths do not include Long Beach and Pasadena.
A wide range of data and dashboards on COVID-19 from the Los Angeles County Department of Public Health are available on the Public Health website at http://www.publichealth.lacounty.gov/COVIDdata including:
COVID-19 Locations & Demographics (data by demographic characteristics and geography, active outbreaks, and citations)
COVID-19 Response Plan
COVID-19 Vaccinations
Skilled Nursing Facility Metrics
Always check with trusted sources for the latest accurate information about novel coronavirus:
Los Angeles County Department of Public Health:
http://publichealth.lacounty.gov/media/Coronavirus/
California Department of Public Health: https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/nCOV2019.aspx
Centers for Disease Control and Prevention: https://www.cdc.gov/coronavirus/2019https://www.cdc.gov/coronavirus/2019-ncov/index.htmlncov/index.html
CDC Spanish https://espanol.cdc.gov/enes/coronavirus/2019-ncov/index.html
World Health Organization https://www.who.int/health-topics/coronavirus
LA County residents can also call 2-1-1
Cases through 12:00pm 8/21/2023
Total Cases
Laboratory Confirmed Cases (includes LB and Pas through 6/27/23; excludes LB and Pas after 6/27/23)
3,777,831
Deaths (includes LB and Pas)
36,618
Cases by Age Group (Los Angeles County Cases Only-excl LB and Pas)
– 0 to 4
113,593
– 5 to 11
283,829
– 12 to 17
278,529
– 18 to 29
763,174
– 30 to 49
1,143,624
– 50 to 64
621,546
– 65 to 79
270,017
– over 80
95,954
– Under Investigation
2,572
Cases by Gender (Los Angeles County Cases Only-excl LB and Pas)
– Female
1,845,342
– Male
1,636,395
– Other
1,860
– Under Investigation
89,241
Cases by Race/Ethnicity (Los Angeles County Cases Only-excl LB and Pas)
– American Indian/Alaska Native
6,781
– Asian
266,863
– Black
188,843
– Hispanic/Latino
1,523,637
– Native Hawaiian/Pacific Islander
17,870
– White
497,616
– Other
411,441
– Under Investigation
659,787
Hospitalization (Los Angeles County Cases Only-excl LB and Pas)
– Hospitalized (Ever)
182,917
Deaths by Race/Ethnicity (Los Angeles County Cases Only-excl LB and Pas)
– American Indian/Alaska Native
79
– Asian
4,542
– Black
3,262
– Hispanic/Latino
16,939
– Native Hawaiian/Pacific Islander
116
– White
9,270
– Other
429
– Under Investigation
92
