Los Angeles County reached a grim milestone Tuesday, with a total of 1,000 deaths linked to the coronavirus after 59 more fatalities were reported.
But despite increasing fatalities and hundreds of new cases added each day, L.A. is still on track to ease some outbreak restrictions around May 15, when the local stay-at-home order is set to expire, county public health director Dr. Barbara Ferrer said Tuesday.
The county Department of Public Health canceled its usual daily briefing Tuesday due to a Board of Supervisors meeting. But Ferrer still spoke with reporters in a video conference.
“I do share the governor’s optimism,” Ferrer said, referring to Gov. Gavin Newsom saying earlier on Tuesday that California is “a few weeks away, not months away” from reopening while he unveiled a plan to reopen schools and businesses.
Ferrer says the county is headed toward recovery, and there aren’t currently plans to extend the stay-at-home order beyond May 15. But, she added, we’ll have a better idea of what can be relaxed once we get further into May.
County officials have previously indicated beaches, parks and retail stores will be the first to reopen, and Ferrer said Tuesday she wants to focus on allowing people to exercise and get back to work.
While the health director doesn’t think large gatherings will be permitted in the near future — because it would be impossible to ensure physical distancing — it’s possible some big events could return before the end of the year.
In his update Tuesday, Newsom said California students won’t return to class this year, but the next school year could start in late July or early August.
But Ferrer cautioned that when schools do reopen, they won’t operate exactly the same as before. She said public health officials would be advising school districts with guidance.
All reopening plans will be contingent on four benchmarks the county laid out last week: more widespread testing and patient tracing; increased health care capacity; protections for at-risk groups; and continued physical distancing.
Officials reported another 597 confirmed COVID-19 cases Tuesday, for a total of 20,976 in L.A. County. That’s about 47% of the 45,031 cases reported statewide, though the county accounts for only a quarter of California’s population.
Most of the new fatalities reported Tuesday were people over 65 years old, and 70% of them had underlying conditions. The sole person under 40 who died also had underlying health conditions, according to Ferrer.
Throughout the course of the outbreak, 92% of people who died in L.A. County had underlying health conditions.
But African Americans, Pacific Islanders and people living in poorer communities continue to experience outsized death rates compared to other groups, Ferrer said.
The death rate among African Americans is 14%, though they make up only 9% of the county’s population. Pacific Islanders and Hawaiians, meanwhile, make up just 0.4% of the county population but 1% of virus-related deaths.
Information about race and ethnicity is now available for 98% of those who died from coronavirus.
Ferrer said Tuesday that access to testing and health services must be increased for people of color and in lower-income areas before all restrictions can be lifted.
But overall, the county continues to increase its testing capacity. Testing is now available to anyone with symptoms, as well as many groups of essential workers, and same- or next-day testing can be scheduled online.
The county is also working to test all residents and staff at its more than 300 nursing homes, regardless of whether they have symptoms.
Overall, more than 133,000 Angelenos have been tested, with 14% of them testing positive. In the past week, results have been delivered in about three days, Ferrer said.
The county also has staff working on contract tracing with confirmed cases, and is working with the state on training more people for the job, according to Ferrer.
The county has also been conducting antibody testing in conjunction with USC in hopes of identifying people who unknowingly caught the virus.
The first preliminary round of testing determined as many as 442,000 people in county may have contracted COVID-19 by early April, and Ferrer says officials are now recruiting individuals for a second round of antibody testing in early May. Participants are selected using a random sampling strategy.
Officials have also indicated coronavirus hospitalizations are tapering off, and Ferrer said there are low rates of COVID-19 patients being admitted to intensive care.
But another area that will need improvement is the response in institutional settings. These include shelters, jails, nursing homes and other assisted-living facilities. Ferrer said 333 such institutions with at least one coronavirus case have been identified countywide.
Deaths in these settings account for 46% of the county’s virus fatalities, and the situation is the worst at nursing homes, which account for the majority of institutional deaths. Residents have been the hardest hit, but of the 11 health care workers who have died countywide, eight have worked in skilled-nursing facilities.
“With over 400 deaths from COVID-19 occurring among nursing home residents, the pandemic has amplified the cracks in our society, including the care and protection of people who are older and medically fragile,” Ferrer said in statement.
The health director said that, in hindsight, officials should have worked more swiftly to address to vulnerability of elderly people — many with preexisting conditions — living in close quarters. And despite public health staff visiting every nursing home in the county in February, they thought there would be a couple cases in each, at most.
Now, the county is working to identify asymptomatic staff and residents with the virus so they can be quarantined. When more widespread testing began at nursing homes, officials said most of those who tested positive were asymptomatic.
