More contagious variants of COVID-19 increase anxiety in California

Confirmed cases of the coronavirus in California surpassed the 3 million mark on Tuesday, amid growing optimism that the epidemic could finally level off, even as officials noted some alarming factors that could complicate projections .

Cases continued to flatten across California – including hard-hit Los Angeles County, after two months of record outbreaks. COVID-19-related hospitalizations also flattened out and started to decline slightly, giving desperately needed wiggle room to medical facilities still overwhelmed by COVID-19 patients.

After a slow start, California is beginning to step up distribution of the coronavirus vaccine, which officials see as the best hope of bending the curve and bringing the struggling economy back. The limited supply of the vaccine will likely mean that many will still have to wait weeks or even months to get vaccinated, but there is growing hope that the incoming Biden administration can speed up vaccination efforts.

But despite these positive developments, officials are expressing growing concerns about new, potentially more contagious variants of the coronavirus that have been detected in California and beyond. One of the newer variants is believed to be 50% more transmissible than the conventional variety of the coronavirus, which, if widespread, would lead to more infections, hospitalizations and deaths.

It’s possible that one of the new mutant variants will become the dominant version of the coronavirus that is spreading in the state in the coming months – at the same time, many Californians are hoping to see the economy reopen significantly if conditions continue to improve. Much of the state has been on the verge of staying home for six weeks, leaving many owners of small businesses, including restaurants, hair salons and gyms, on the verge of financial ruin.

The Sacramento area saw its stay-at-home order lifted last week, giving counties the option of allowing barber shops to reopen in limited capacity and resumption of outdoor dining. The continued improvement in the pandemic elsewhere will likely put further pressure on government officials to allow other businesses to reopen, although the expected available capacity of intensive care units remains extremely limited in Southern California in the Valley. from San Joaquin and in the Bay Area.

State officials say stay-at-home orders in one region will be lifted once available ICU capacity is expected to be 15 percent or more over the next four weeks.

Health experts have said they would like to see significant decreases in both cases and hospitalizations before they realize California is breaking out of the wave. The decrease in daily coronavirus cases in recent days could have been affected by notification delays over the three-day Martin Luther King Jr. Day weekend.

“Cautious optimism may be in order,” said Dr. Robert Kim-Farley, medical epidemiologist and infectious disease expert at the UCLA Fielding School of Public Health. “Still, even though we’re flattening at this point, it’s way too high a level to just flatten the curve. We must drastically reduce the number of cases, hospitalizations and deaths. “

The mark of 3 million cases, confirmed by an independent investigation by the Times of county and city health departments, shows how far the coronavirus has spread in the country’s most populous state.

Removing this threshold means that about 1 in 13 Californians have tested positive at some point during the pandemic. But officials have long believed that the test captures only a certain percentage of those who are infected, as many people with the virus show mild symptoms, if any.

Despite this, the growth in the number of documented cases has been dramatic. he took about 10 months for the state to reach 1 million confirmed cases, which happened in mid-November. California continued to reaches 2 million cumulative infections shortly before Christmas.

Now, just about four weeks later, the state has added another million cases to its total.

California has recorded more than 34,400 cumulative coronavirus deaths, and the daily death toll is still high. A Times tally found 696 deaths were reported on Tuesday, the second-highest single-day tally in the entire pandemic. An average of about 500 Californians have died daily from COVID-19 recently. So many people die every day in LA County that air quality officials have lifted the limits on cremations.

Dr Tomás Aragón, state public health official and director of the California Department of Public Health, called the case number a “serious reminder that COVID-19 is widespread statewide.” He added, “We all have to do our part by staying at home; wear a mask; avoid congregating, especially indoors; wash your hands frequently and get vaccinated when acceptable and available.

“As we see encouraging signs as hospitalizations and case rates decline, California remains relentless in its commitment to the battle against COVID-19,” Aragón said. “We cannot get complacent because a vaccine is now available.”

California has also seen a flattening, if not a slight decline, in the number of people requiring hospitalization for COVID-19. State hospitalizations peaked about two weeks ago, Jan. 6, at 21,936; As of Monday, there were 20,062 Californians positive for the coronavirus in hospitals across the state.

COVID-19 hospitalizations have dropped in 10 of the past 12 days.

The number of people sick enough to require intensive care also rose from a high of 4,868 on January 10 to 4,693 on Monday. The number of people with COVID-19 in California ICUs has fallen in seven of the past eight days.

While small, any drop is good news for ailing hospitals and healthcare workers in California, who have had to contend with sharp and sustained increases in the number of COVID-19 patients since early November.

“These are rays of hope that shine,” said Dr. Mark Ghaly, California secretary of health and human services.

Many intensive care units statewide, however, remain under stress – particularly in Southern California and the San Joaquin Valley, both of which have reported 0% availability in their intensive care units for weeks. . This forced critically ill patients to wait for intensive care unit beds in the emergency room, which then forced sick patients to wait for hours in ambulances right outside the hospital doors.

The drop in the daily case rate, as well as the percentage of people tested who were found to be infected, raises hopes for a corresponding drop in the number of COVID-19 patients required to attend hospital, Ghaly said on Tuesday. Another promising data point, he added, is that the statewide modeled transmission rate, or R-efficient, has now fallen below 1 – meaning those that are testing positive will, on average, infect less than one other person.

When the effective R is less than 1, the number of cases gradually decreases.

“The good news is … the spread of COVID is not growing in the state, but is decreasing – just a little slower than we would like,” Ghaly said.

The variant that has recently gained the most attention has been the one known as B.1.1.7 – a mutated variant first identified in Britain in September and has since been identified in Los Angeles counties. , San Diego and San Bernardino. It’s not one of the more dominant variations in California, but that could change soon.

But the new mutant variants pose new threats.

Research suggests that B.1.1.7 is about 50% more transmissible than the standard variety of the coronavirus, and the U.S. Centers for Disease Control and Prevention has warned that this variant could be predominant by March. A more transmissible virus means people are even more likely to be infected with the virus if they are exposed to it and don’t wear masks and practice physical distancing.

Scientists believe that existing coronavirus vaccines are effective against variant B.1.1.7. But the fact that it is considered more contagious means that the variant, under which it would potentially infect more people, would then lead to increased hospitalizations and deaths.

A second, much more common variant in California that started to gain more attention over the weekend is known as the L452R. The L452R variant is relatively old, first described in Denmark in March but also identified in Alameda County in May. He suddenly became more identified in California.

Genetic analysis of virus samples studied in 12 counties in California – mostly northern California – found that while L452R was identified in about 4% of virus samples studied in late November and early December, L452R suddenly made up 25% of virus sample studies between -December and early January.

“That’s why it’s worrying,” said Dr Charles Chiu, virologist and professor of laboratory medicine at UC San Francisco, at a rare press conference on Sunday night hosted by the public health department. from California. “It is concerning that it could potentially be more infectious.”

The mutation involves a critical part of the virus that regulates its adhesion to the part of the human cell that it locks onto, from which it can inject its genetic material and divert it to make copies. This raises the question of whether vaccines that currently exist will remain effective, and more studies will be needed to determine the answer.

Lin reported from San Francisco, Money from Long Beach.