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New figures from the Los Angeles Department of Health Services seem to confirm one of health experts’ worst fears. Officials have long warned of an exponentially rising death toll if hospitals were overwhelmed with Covid-19 cases and patients could no longer receive the same high standard of care.
Estimates released by LA Health Services on Wednesday showed that since November 3, around 23% of people hospitalized with Covid-19 have died – up from 12% in September and October. The average hospital stay for patients rose to more than nine days, from less than seven in October.
Public Health Director Barbara Ferrer said the county’s seven-day daily average death rate was 179 on January 10, rising to 174 on January 12. .
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Hospital intensive care units have been inundated with patients infected with the virus for at least a month. Last week, Director of Health Services Dr Christina Ghaly revealed that 75% of patients in the county’s intensive care units had Covid. And the capacity of these rooms had been extended to almost double their usual limit. At some point, such stresses compromise care and lead to more deaths.
But as deaths persist, the county has started to see a drop in the daily number of new cases, along with declines in overall hospitalizations and the test positivity rate. Ferrer reported 6,492 new cases on Wednesday, the lowest total in weeks, although she said the number could be low due to notification delays and the lack of availability of tests over the holiday weekend.
Ferrer said the county averaged more than 15,000 new cases a day on Jan.8, with the average dropping to around 10,000 a week later.
The seven-day average rate of people testing positive for the virus was 14% on Wednesday, up from more than 20% at the end of December. The number of people hospitalized averaged more than 8,000 on January 5, falling to 7,383 on January 15. As of Wednesday, 7,263 people were hospitalized in the county, according to state figures, including 1,692 in intensive care.
“While it is too early to tell if we are actually seeing a significant decline in the outbreak… we are optimistic that the actions taken by many are starting to work,” she said. “Unfortunately, even as the cases start to drop, these numbers are still very high and they continue to lead to overcrowding of hospitals and high numbers of deaths.
“The reality for us is that Covid-19 is still rampant in our workplaces, in our neighborhoods and really in every corner of this county,” she said.
Ferrer also pointed out that while the number of hospitalizations has dropped, it remains dangerously high.
“So the end is not yet in sight,” she said. “With a high number of daily cases, hundreds more people will need to be hospitalized each week.”
Of greater concern could be the virus variants that could once again increase the number of people, even as the state makes progress. Chief among these are the new strains of the virus that were recently discovered in the state.
Over the weekend, the Los Angeles Department of Public Health announced that the UK variant of Covid-19, known as B.1.1.7, had been identified in the region. B.1.1.7 is thought to be up to 50% more transmissible than the most common form of the virus. The number of Los Angeles residents infected with the British variant was believed to be still low.
Then on Monday, the California Department of Public Health revealed that another lesser-known strain was also circulating in the county. Dubbed CAL.20C, the variant is said to have appeared in the state in July, but it didn’t start to spread significantly until November.
According to The New York Times, CAL.20C was found in more than half of the California test samples genomically analyzed in mid-January. It should be noted that the number of these samples analyzed is significantly lower than the total number of daily Covid-19 tests in the state.
But Eric Vail, director of molecular pathology at Cedars-Sinai, told The Times that CAL.20C may have played a role in the spike in cases that overwhelmed hospitals in Southern California earlier this month. “I have no doubts that this is a more contagious strain of the virus,” said Dr Vail. Other experts were less sure.
The 6,492 new cases reported on Wednesday increased the county-wide cumulative total throughout the pandemic to 1,038,092.
Ferrer continued to urge patience among people trying to make appointments for COVID-19 vaccines, acknowledging website issues that destroyed the system for several hours on Tuesday after the county announced the elderly 65 years and over could be vaccinated.
The website – vaccinatelacounty.com – is working again, but due to the limited supply of vaccines, available appointments are limited.
The county has also expanded the capacity of its on-call reservation system and urged residents to use the call system only if they cannot make an appointment through the website.
Appointments beyond this week remain murky, given the dramatic shortages in the county’s supply of vaccine doses.
Ferrer said on Wednesday the county now expected to receive about 143,900 additional doses of the vaccine next week. However, as people are due to receive two doses of the drug, spaced three to four weeks apart, most of the vaccine coming next week will be used to give second doses to people who have already received the first vaccine.
She estimated that only 37,900 of the doses coming next week will be available for people to receive their first dose.
Ferrer also said that, with the elderly included, the number of county residents now allowed to receive the vaccine is 4 million. To date, she noted, Los Angeles has received 650,000 doses.
“That’s what I mean by a serious supply problem,” Ferrer said. “We are just not getting enough doses of the vaccine to act as quickly as us and you would like.”
She said that as of the end of last week, the county had received 685,000 doses, of which 307,000 were used so far for the first doses and 87,000 for the second doses. The county is still working to complete vaccinating hundreds of thousands of health workers with the remaining doses, even though it is expanding access to people 65 and older.
Ferrer noted that about 30,000 doses of Moderna vaccine the county received have been withdrawn from circulation by state order, following allergic reactions suffered by half a dozen people in San Diego. Ferrer said some doses of this same batch had previously been administered in Los Angeles County, with no reports of an allergic reaction. But the remaining doses of the batch remain on hold until the state completes its investigation into the San Diego cases.
County Supervisory Board Chairman Hilda Solis this week signed an executive order opening the doors to older residents.
“We know COVID-19 has been particularly hard on those 65 and over,” Solis said Tuesday. “Look at our numbers. More than 99,000 residents aged 65 and over have been infected with COVID-19; 30,000 of these residents aged 65 and over have been hospitalized due to COVID-19; and tragically, 9,802 residents of this age group have died from COVID-19. That’s out of 14,000 people who died.
“It’s a matter of fairness,” she said. “The elderly have been unfairly affected by the virus. They stayed home for months in isolation, which as you know is a problem in itself. But the COVID-19 vaccine is here. Hope is there.
Solis admitted that “there isn’t enough vaccine for everyone over 65,” but said she hoped the Biden administration would make more doses available. “Let’s stop there,” she said.
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