California has ‘good COVID weather’, but winter may bring surprises

California enters fall as the coronavirus recedes.

Cases have dropped significantly from the peak of the Omicron wave in the spring and summer, and this has allowed government officials to relax rules and recommendations.

But health experts warn that these conditions may change as the weather cools, people head home and new variables and sub-variables may emerge. As the state moves deeper into the fall and winter — seasons that have previously seen the two worst waves of COVID-19 to date — Los Angeles County officials say they can’t rule out a return of mask orders if conditions deteriorate significantly.

Although the situation is much better than it was earlier in the year, there are early signs that the coronavirus is once again on the rise in Europe, a development that previously foreshadowed increases on the American side. In England, cases of coronavirus during the last week rose by 13% compared to the previous week, and hospitalizations were up by 17%. Belgium and Denmark have also seen their numbers rise, Dr Peter Chen Hong, an infectious disease expert at the University of California, San Francisco, said.

“Enjoy the good COVID weather,” said Chen Hong. But “I know we have to be flexible.”

Experts are also monitoring a number of emerging Omicron subvariants that lab studies suggest can still infect people who have been vaccinated or previously infected, and may render some anti-COVID treatments known as monoclonal antibodies ineffective.

And on a local level, the levels of coronavirus that were observed are no longer decreasing in Los Angeles County wastewater, indicating that significant transmission continues.

Officials regularly note that thanks to high levels of vaccine coverage and the availability of treatments, California could be well placed to handle a potential rebound of the coronavirus this year. This effort helps release updated booster shots specifically designed to target BA.5 – which is still by far the most common version of the circulating coronavirus.

But COVID-19 has been regularly surprising and mocking the speculation. Given California’s past winter experience, some officials and experts say it would be foolish to rule out the need for a cover-up in the coming months. The world in modern times has never dealt with a global pandemic caused by the coronavirus, and it will likely be some time before a predictable pattern emerges.

“When we see things get out of hand, we need to go back to the strategies that worked before we get the vaccines and boosters,” said Barbara Ferrer, director of public health for Los Angeles County. “If our vaccines don’t work, because we have a new species or the new variant evades a lot of protection, you’ll need to put your mask on again, because that will give you the protection you want and need to stay safe.”

Dr. Eric Topol, director of the Scripps Research Translational Institute in La Jolla, said he doubted “we’re going to see more problems with this virus — I mean, if there’s one thing you can bet on, it’s that.”

Topol said there are at least four sub-variables that scientists are watching closely that are likely to cause problems in the coming months.

Experts also note, however, that attitudes and recommendations can and should change depending on the pandemic’s playing field. Chen Hong, for example, said it makes sense to go out and enjoy many activities without a mask when case rates are lower. But if that changes, people should be prepared to access that extra layer of protection.

But with most of the mandatory masking rules now tucked away in the rearview mirror, and many people eager to escape a two-and-a-half-year-old pandemic, it remains to be seen whether residents are willing to wear face coverings again in certain situations.

Los Angeles, for example, was for several months the only California county that still needed to wear a mask while on public transportation and in indoor transit hubs. But anyone who boarded a train or flew from Los Angeles International Airport before this rule was lifted Friday can tell you compliance has been spotty, to say the least.

However, Ferrer said she hopes residents will respond to the call “if we are surrounded by people who are seriously ill” again.

“When we are in a situation where there are threats to the health care system, and we are surrounded by people who get very sick … I think people will go ahead and comply,” she said. “These are reasonable public health precautions.”

For his part, Qin Hong said he believed people would hide again “when things go wrong”.

As of last June — when the spring-summer Omicron wave was gaining momentum — most Los Angeles County respondents to a survey by the University of Southern California’s Center for COVID-19 Epidemic Research said they still wear a mask at least occasionally when they leave the house.

Additionally, the majority of survey respondents said fully vaccinated and boosted people should wear a face mask in crowded indoor spaces and agreed that doing so reduces the risk of contracting coronavirus infection, Ferrer said.

Whether California as a whole, or even a large number of counties, will return to mandatory masking remains to be seen.

Last week, the California Department of Public Health largely rescinded its general recommendation that everyone hide when in indoor public spaces and businesses — guidelines that have been in place since mid-February.

Instead, state health officials are now recommending global masking only for counties with a high community level of COVID-19, a category defined by the US Centers for Disease Control that indicates that transmission of the coronavirus has risen to the point that it is likely to begin to negatively affect hospitals. .

Masks remain required in health care facilities, long-term care settings, and seniors under a state health order. The state also requires that businesses and venues, including K-12 schools, “shall allow any individual to wear a mask if they so desire.”

However, the state’s new guidance says nothing about when, or whether, widespread public masking becomes mandatory again.

But Los Angeles County, which this summer moved to the brink of re-establishing a new system of public indoor masks, has shown a willingness to do so in the event of a serious surge in fall and winter.

Los Angeles County has chosen to raise its requirement to hide public transportation, including passenger services such as Uber and Lyft, and in inland transportation hubs such as airports after the area’s coronavirus case rate fell below the threshold of 100 new cases per week per 100,000 residents. . .

But if the rate exceeds that mark again, and stays there for 14 consecutive days, the mask requirement will be brought back into the transfer settings, Ferrer said.

The last time Los Angeles County had a 50-day low case rate was between March 5 and April 23, before a series of Omicron subvariables drove case rates up during late spring and summer. Last fall, the county’s case rate remained below that limit for 67 days, between September 29 and December 4.

However, levels of coronavirus in Los Angeles County wastewater are no longer as low as they were before, and in Antelope Valley, they may be on the rise. The trends of the virus in wastewater in other areas of the county appear to be flat.

“The fact that we are no longer seeing a decline in wastewater data is a reminder that transmission remains significant across the county, and that sensible precautions will help reduce risks,” Ferrer said.

Topol said he thinks it’s too early to end the mask mandate for public transportation.

“It’s not that we’ve reached very low levels of the virus, like we have [did in] in June 2021. “We still have a lot of issues.”

In the event of another surge, Los Angeles County could switch to a blanket general indoor mask mandate for residents age two and older. Such an order has not been in effect since early March.

However, the criteria for pulling this crane back are strict, and it is unclear whether the county will reach this point, even if the transmission picks up again in the fall and winter.

Conditions must deteriorate to an extent that has only been seen twice before in the epidemic – during the first wave of fall and winter that began in late 2020, when the morgue was very crowded, the National Guard was called in; And the first increase in Omicron occurred after Thanksgiving in 2021, which flooded emergency rooms, ambulances faced delays in hospitals and canceled scheduled surgeries for patients.

Specifically, LA County will need to hit two thresholds to return to the blanket mask order.

Assuming a high case rate of coronavirus, blanket mask mandate would only return if Los Angeles County saw at least 10 positive new hospital admissions per week per 100,000 residents and had at least 10% of all staffed hospital beds occupied Coronavirus – positive patients.

According to the latest available data, the county is reporting 6.5 new hospital admissions with coronavirus per week for every 100,000 residents, and these patients occupy only 3.6% of hospital beds.

During the height of this summer’s wave, Los Angeles County topped 7.2% of hospital beds taken by patients with coronavirus, though it temporarily outpaced another hospitalization measure.

There are reasons for optimism heading towards the colder months. For starters, no new worrisome subvariants have convincingly appeared in L.A. County to a significant degree, and the updated COVID-19 booster matches the dominant circulating strain. Treatments to treat COVID-19 are also widely available.

Ferrer said children ages 5 to 11 are expected to have access to the updated booster as soon as mid-October. The updated booster has been available since early September for those age 12 and older.

But Dr. Anthony Fauci, President Biden’s chief medical advisor on the pandemic, said in an interview hosted by the Center for Strategic and International Studies that he expects “it’s possible we’ll see another variable emerge.” Health officials have long warned that continued transmission could trigger another problematic variant — one that may be more transmissible or better avoid the protection offered by vaccines or previous infections.

LA County monitors a number of newer and lesser known sub variants of Omicron, but they are not circulating in significant numbers.

One of the new variants being tracked is called BF.7. It is actually a substring of BA.5 and therefore it is also known by a more complex name: BA.5.2.1.7. Officials collected one sample of BF.7 in Los Angeles County in early August, but no additional cases were found.

Fauci expressed concerns about the other alternative, BA.2.75.2, and referred to it as “on the horizon, looking suspicious”.

from San Jose News Bulletin https://sjnewsbulletin.com/california-has-good-covid-weather-but-winter-may-bring-surprises/