The warning is part of the county-by-county attestation process whereby local health officials can certify their region has met certain benchmarks and has a proper response plan in place should the virus begin to spread again. Los Angeles is one of 50 counties who filed such an attestation.
The state has stepped in because there is concern over the status of one or more of the aforementioned benchmarks. Given that, according to the California Department of Public Health web site, “The state will work closely with local health departments to identify action steps and timelines for addressing issues that impact indicators of concern.”
If the issues are not appropriately addressed, the next step in the state’s process is to “reinstitute community measures,” meaning renewed prohibitions, including the possibility of another stay-at-home mandate.
“If the county has insufficient progress, over a 14-day period, on containing their disease transmission and hospitalization rates,” according to the CPHD web site, “a county should consider reinstituting sector limitations or more general Stay-at-Home provisions. If the county makes insufficient or no progress, the State Public Health Officer may take action.
Here is the official watch list entry on Los Angeles County and the concerns about it:
Los Angeles County “is experiencing the possibility of elevated disease transmission.” The county has a “high case rate that is highly related to high testing capacity and volume countywide, which also includes testing all residents and staff at over 235 skilled nursing facilities.” Key actions to monitor the situation include “monitoring positivity rate among those tested to ensure that there isn’t a significant increase that may signal more community transmission,” providing infection prevention expertise at nursing homes, and working on improving supply chains for personal protection equipment.
The “possibility of elevated disease transmission” seems to jibe with comments on Friday from Los Angeles County Health officials.
“This has been a slight increase over the last three days in the number of people hospitalized,” said Los Angeles County Public Health Director Barbara Ferrer, “and we’ll need to make sure that we’re not starting to see a significant increase in the number of people requiring hospitalizations.”
The hospitalization rate is a crucial number because one of the greatest concerns with COVID-19 is that its rapid spread may quickly overwhelm health care systems leading to more infected people going untreated and, presumably, a greater mortality rate.
Dr. Christina Ghaly, the director of Health Services for L.A. County, noted that another key indicator of virus spread, the “R” or effective transmission rate, seems to be rising slightly. Based on modeling, Ghaly warned, “The number of ICU beds may become inadequate in 4 weeks. DHS is watching this number on a daily basis very closely.”
The other eight counties included on the state watch list are Fresno, Imperial, Kings, Sacramento, San Bernardino, San Joaquin, Santa Clara and Tulare.
According to the Washington Post on Monday, “more than a dozen states and Puerto Rico are recording their highest averages of new cases since the pandemic began, hospitalizations in at least nine states have been on the rise since Memorial Day.” Among those states is California.
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