New variant and overcrowded housing turned Los Angeles into coronavirus epicenter

• Los Angeles has seen more cases and deaths of the coronavirus than any other county in the United States.
• The majority of LA infections have been recorded during a deadly winter outbreak in the past two months.
• Epidemiologists say a few factors have made Los Angeles a coronavirus epicenter: the emergence of a local variant, escalating pandemic fatigue, and a high share of overcrowded multigenerational homes.
• Visit the Business Insider homepage for more stories.

Scientists have repeatedly warned that the winter vacation will lead to disastrous spikes in coronavirus cases across the United States. But few places have suffered as badly as Los Angeles, now the epicenter of the outbreak in the country.

To date, LA County has recorded nearly 1.1 million cases and 16,000 deaths – more than any other county in the United States.

Things got particularly dire in early December, when Los Angeles entered California’s “extremely high risk” tier – an indication the virus was spreading widely in the community. This meant that most schools would have to suspend in-person learning. The next day, Governor Gavin Newsom instituted a regional stay-at-home order that put an end to al fresco dining and forced businesses like barbers and nail salons to close.

Average daily coronavirus deaths in Los Angeles quadrupled from December to January, while hospitalizations rose from around 2,500 per day to 7,500 per day.

By mid-December, intensive care units in Southern California were at full capacity. Daily new cases in LA County hit an all-time high of over 22,500 on January 4. Two days later, the county recorded more than 8,000 hospitalizations and 227 deaths – the highest number on record.

Epidemiologists say there is no simple answer as to why the crisis has worsened so quickly.

“Nothing happens in a vacuum and there were probably a number of different factors at play here, including a more contagious variant,” Dr. Anne Rimoin, professor of epidemiology at UCLA Fielding, told Insider. School of Public Health.

“Los Angeles is a complex city,” she added. “We have a great geography, a dense population, but above all, overpopulation plays a major role here.”

Like many people across the country, Rimoin said, Los Angeles residents can also suffer from pandemic fatigue, making them less likely to comply with public health recommendations.

“All of this together creates the perfect storm,” she says.

This storm isn’t necessarily over, although daily cases in Los Angeles declined last week.

“Just because we see this vacation wave starting to wane,” Rimoin said, “doesn’t mean we’re out of the woods”.

A variant of LA was spreading rampantly in December

FREDERIC J. BROWN / AFP via Getty Images

The majority of Los Angeles coronavirus infections have been recorded in the past two months. This deluge of cases coincided with the emergence of a local variant called CAL.20C.

In a study still awaiting peer review, researchers at Cedars-Sinai Medical Center in Los Angeles suggested that “the CAL.20C strain may be partly responsible for the scale of the COVID-19 outbreak on the west coast of the United States ”.

As of December, 36% of virus samples from patients with COVID-19 at Cedars-Sinai were identified as CAL2.0C. The variant also accounted for nearly a quarter of all samples from Southern California.

Researchers still don’t know if CAL.20C spreads more easily than the original strain, but it has a hallmark of more infectious variants: mutations that alter the spike protein, which the coronavirus uses to invade cells.

Still, scientists warn against blaming the LA outbreak on just one variant, as it’s impossible to know how many variants are in circulation at the moment.

“We haven’t had situational awareness for so long because we haven’t had enough sequencing, and funding for sequencing has been non-existent,” Rimoin said. “We were fortunate that Cedars-Sinai was able to do some of this on their own.”

Other more infectious variants, like the B117 variant first discovered in the UK, could also have spread well, too, than scientists thought.

LA reported its first case of B117 on January 16, but Mayor Eric Garcetti told the Los Angeles Times he suspected B117 was a factor in Los Angeles’ number of cases doubling in December.

“Everyone I’ve spoken to has said this acceleration is beyond any pattern and beyond expectation, so people are like, ‘What the hell went wrong?’ and I have to think that’s part of the strain that was there, ”Garcetti said.

Even with the vaccinations underway, Rimoin added, new variants could make the LA epidemic even worse.

“We now know that there are more contagious variants circulating and we could very well see this trend continuing,” she said. “We could see another push as the British variant or the Brazilian or South African variants become more dominant.”

Overcrowded multigenerational homes likely fueled transportation

Irfan Khan / Los Angeles Times / Getty Images

With more than 10 million residents, LA County is the most populous county in the country. Unsurprisingly, most of its cases have been concentrated in high-density urban areas where many people live and work. The nature of these living environments may have played a key role in facilitating the spread of the virus.

On average, each household in LA County consists of about three people, more than the national average of 2.5 people per home.

A 2016 analysis of the Trulia real estate website found that 7% of households in the city of Los Angeles had two or more generations. Only five other cities in the United States had a higher share of multigenerational homes at the time. Yawar Charlie, director of the Aaron Kirman Group’s real estate division in Los Angeles, recently told Forbes that demand for multigenerational homes in Los Angeles has only increased since the start of the pandemic.

In many cases, these homes are overcrowded, which means they have more than one person per room, excluding bathrooms. Data from the US Census Bureau suggests that 11% of homes in LA County are overcrowded – the highest share of any major metropolitan area in the United States.

Studies have suggested that overpopulation is a key factor in the transmission of the coronavirus. A June analysis found that California neighborhoods with the worst coronavirus outbreaks had three times the rate of household overcrowding than neighborhoods largely spared.

But households still have to interact with other members of the public for community transmission to occur. Rimoin said it was possible for essential LA workers to be exposed at work and then bring the virus home. Over half of LA County’s workers are employed in the service industry, in fields such as restaurants, hotels, home construction or personal services.

“We have a lot of essential workers, so they return home to multigenerational, overcrowded households, and have nowhere to properly quarantine,” Rimoin said. “Then of course the virus is going to spread rampantly.”

Pandemic fatigue continues to drive cases

Aydin Palabiyikoglu / Getty Images

As the pandemic continued into October, public health experts began to worry that people were becoming more lax about personal safety measures. A WHO report last month found that a growing share of European residents are not following lockdown restrictions sufficiently or are scaling back their efforts to stay informed of the pandemic. The researchers also detected similar trends in the United States.

“It seems that people wear masks and socially distance themselves more frequently as infections increase, then after a while, as infections decrease, people let their guard down and stop taking these measures to protect themselves and protect themselves. the rest – which, of course, leads to more infections, ”Dr. Christopher Murray, director of the University of Washington Institute for Health Measurement and Evaluation, said in October.

Pandemic fatigue only appears to have worsened since then, with some Los Angeles residents actively challenging local mask recommendations.

In early January, anti-mask protesters stormed the Century City mall in Los Angeles with megaphones, demanding that customers and employees remove their masks. The incident, along with several others, prompted LA City Council to seek an order that would fine those who refused to wear masks in a covered public place.

“Widespread non-compliance is behind this unimaginable spread and there are no signs of slowing down anytime soon,” LA City Council member Paul Koretz said in a Jan. 13 meeting. “People who are alive and well right now, today, have a disastrously high risk of being infected – or dying – by Valentine’s Day.”

Rimoin also warned that pandemic fatigue was a predominant danger in Los Angeles.

“When more contagious variants circulate and people now feel free to do things they haven’t been able to do for a while, we risk having another flare-up in the near future,” he said. she declared.

This epidemic, she added, would not be relegated to LA alone.

“In fact, this pandemic has really made it clear that infection anywhere is infection everywhere,” Rimoin said. “It would be foolish to think that what happens in LA County stays in LA County.”