California is gearing up for a winter COVID-19 wave — if not the newly identified Omicron variant, then the Delta variant, which remains a serious threat and has already spiked other states.
It’s far from clear what kind of increase California will see, and the state is doing better than other parts of the country. But officials say they want to be ready.
Peak scheduling is also well underway in Central California, which has recently seen a postponement of COVID-19 hospitalizations, falling nearly 30% since mid-November.
Still, Fresno, the most populous county in the San Joaquin Valley, has a COVID-19 hospitalization rate more than three times that of Los Angeles County, and Fresno officials expect the winter wave to be bad again.
“An expected winter wave … could hit in the coming weeks,” said Dr. Rais Vohra, the interim health officer for Fresno County. But unlike last year, there are no plans for alternative childcare locations or cots in the convention center. “So when we have a wave, we’re really just left with the resources that the hospitals can only use on their own campuses.”
If hospitals get extremely busy, they could be forced to implement crisis standards for care, Vohra said, potentially mandating to ration health care to patients based on who is more likely to survive.
“December is going to be a very critical month for us to look at the numbers,” Vohra said. “Because if we get a winter shock, I think it will come in the month of December. And if it starts, it could last all winter months, because that’s exactly what happened last year.”
Nursing homes have become an area of focus in Los Angeles County. The provincial health ministry ordered on Monday that all skilled residents, employees and contractors of nursing homes who may encounter residents should test for the coronavirus once a week between December 15 and January 31, regardless of vaccination status.
Also, all visitors to such nursing homes will be required to present a recent negative coronavirus test before entering. Rapid test kits will be made available at the facilities. People who have recovered from a coronavirus infection in the past 90 days do not need to test weekly or show a negative test to enter a nursing home.
It’s too early to know for sure if the number of coronavirus cases across California will rise as a result of Thanksgiving gatherings. But officials in at least one county, San Diego, suspect a rise in the number of locally reported cases late last week could be the first sign of an increase in transmission related to Thanksgiving.
“Increases like this after vacations are not unexpected,” said Dr. Cameron Kaiser, a deputy public health officer in San Diego County, said in a statement.
“Thanksgiving has just happened. People just had their meetings. And sometimes it takes time for people to get tested,” said Dr. Regina Chinsio-Kwong, a deputy health officer for Orange County. “Maybe we’ll see an increase” [in cases], and maybe not. But it’s important for all of us to take precautions as we see other states see an increase in cases, and we want to protect our loved ones.”
Health officials proposed a multi-pronged strategy for a safer vacation: get vaccinated and boosted, get tested regularly, and possibly reduce the number of holiday gatherings by restricting guests to those who have been vaccinated, keeping them smaller, and taking steps to reduce the risk, as they say. hold outdoors.
For celebrations scheduled for December, “you may want to tone that down to small gatherings that are safer,” Chinsio-Kwong said. “Hopefully most of the guests are vaccinated and even then they really limit how many people get together…or keep the gathering outside.”
People should also consider testing more frequently, given the wide availability of coronavirus testing by healthcare providers and rapid tests that can be bought at a pharmacy and taken anywhere, with results within 15 minutes.
For example, it makes sense that older people would ask guests — including those who have been fully vaccinated and boosted — to screen themselves with a rapid test before entering their homes, said Barbara Ferrer, director of public health for Los Angeles County.
“We need to be careful – as careful as we can be as we learn more about Omicron. But I also want to note: Delta [is still] very contagious,” Ferrer said.
Although vaccinations lower the risk of infection and serious illness, it is still possible for fully vaccinated people to become infected and transmit the virus to other people.
“And when we travel, we need to be more careful. And we have to test, test, test,” Chinsio-Kwong said.
Testing for the coronavirus is free in California for anyone who needs it, and everyone should get tested if they feel symptoms, regardless of vaccination status, the California Department of Public Health says. Free testing sites can be found on the state’s website, covid19.ca.gov/tested.
The Los Angeles County Department of Public Health has begun offering free rapid tests to incoming international passengers. On Wednesday, Orange County will begin offering free test kits to incoming airline passengers at John Wayne Airport, where they can send their sample through FedEx for analysis. Orange County also offers residents and people who work there the opportunity to request free tests online, which come with prepaid return shipping.
In Los Angeles, a coronavirus testing site has reopened at Dodger Stadium.
LA County requires residents who test positive for the coronavirus, or who a health care provider suspects may be infected, go into isolation and inform close contacts that they have been exposed. People must remain in their isolation except to receive necessary medical care.
People should isolate themselves for at least 10 days since symptoms first appeared or, if they were not symptomatic, 10 days from the date of their first positive coronavirus test.
There are several signs of progress in the fight against COVID-19.
Health officials across California report growing interest in vaccinations, including in young children, and booster shots.
“I’m very happy to see that we’ve seen a surge in vaccine demand, at least after the Thanksgiving holiday,” Chinsio-Kwong said. Concerns about the spread of Omicron may also have contributed to people ultimately deciding to get their vaccination or their booster.
And some areas are now reporting sufficient supplies and resources for newly infected people to be treated with monoclonal antibodies, a treatment for COVID-19 that can counteract the coronavirus before it can destroy the body’s organs. Monoclonal antibodies must be administered in a medical facility by intravenous drip.
“Right now, our supply exceeds demand” in Fresno County, Vohra said. “While we were very concerned early on that we didn’t have enough suppliers providing the monoclonal antibodies, we now have over a dozen clinics that are fully functional, operational with monoclonal antibodies.”
The National Institutes of Health says monoclonal antibodies can be used to treat mild to moderate COVID-19 in unhospitalized patients at high risk of developing serious disease. But the drugs only work if given early — it’s generally too late to get monoclonal antibodies if an infected person has trouble breathing and suffers from pneumonia, Vohra said.
For every 100,000 residents, Fresno County has 20 patients hospitalized with COVID-19, while Los Angeles County has 6 and Orange and Ventura counties have 5. The San Francisco Bay Area has a rate of 4.
Other Southern California counties have higher hospitalization rates. San Diego County has a rate of 9; Riverside County, 10; and San Bernardino County, 16. Some experts say it’s a sign of concern if the rate is 5 or worse.
Most counties in California report substantial or high transmission of the coronavirus, the worst two levels on the U.S. Centers for Disease Control and Prevention’s four-tier scale.