COVID-19 Rates Continue Encouraging Trend
At the L.A. County Board of Supervisors meeting on Tuesday, January 26, 2021, County Director of Public Health Dr. Barbara Ferrer said that she was “encouraged by the significant reduction in new cases.” In recent weeks, daily average cases have dropped from approximately 15,000 to 7,000. This trend line is evident in hospitalizations. The County’s death rate remains very high, as it is a lagging indicator, and high numbers of deaths will likely continue for the next several weeks but should begin to drop in February.
However, on January 30, 2021, the L.A. County Department of Public Health confirmed the second case of the U.K. COVID-19 variant (B.1.1.7) detected in the County. According to the County, “presence of the B.1.1.7 variant in Los Angeles County means virus transmission can happen more easily, and residents and businesses must more diligently implement and follow all of the personal protective actions and safety measures put in place to prevent additional cases, hospitalizations, and deaths.”
Restrictions Eased
On January 25, 2021, California Governor Gavin Newsom and the California Department of Public Health (CDPH) announced that the state lifted the regional Stay-at-Home Orders put in place on December 3, 2020. With the Regional Stay-at-Home Orders terminated, counties are returning to the color-coded tiers under the state’s Blueprint for a Safer Economy.
L.A. County remains in Tier 1 of the State’s Blueprint, along with 54 of the state’s 58 counties, covering approximately 99% of the state’s population.
In response to the Governor’s change, County officials announced that the Health Officer Order initially put in place on November 25, 2020, would come back into effect. This Order brings County restrictions in line with those of Tier 1:
On January 29, 2021, L.A. County released updated regulations for outdoor dining, which was permitted to reopen as of that date. New regulations include the following:
- Employees who may come in contact with customers must wear both a face covering and a face shield at all times when interacting with customers and when in customer service areas.
- Outdoor dining table seating must be limited to no more than six people per table, all of whom must be from the same household. All establishments must post signage and verbally inform customers that everyone sharing a table must be from the same household.
- Outdoor dining and wine service seating must be reduced by 50%. Outdoor tables must be repositioned or removed so that all tables are at least 8 feet apart.
- Televisions or other screens that broadcast programming must remain off until further notice.
- Restaurants must follow the California Department of Public Health’s mandatory guidance on the Use of Temporary Structures for Outdoor Business Operations.
- Outdoor structures may have roofs, but must be open on at least three sides to permit ventilation.
In addition, the County lifted its 10 p.m. to 5 a.m. curfew on “non-essential” activities.
Hospital Capacity
At the L.A. County Board of Supervisors meeting on January 26, 2021, County Director of Health Services Dr. Christina Ghaly provided updates on the county’s hospital demand. She said that hospitalizations are down significantly, having dropped by one-third since the mid-January peak. She also noted that new hospitalizations will drop faster than total hospitalizations, due to longer lengths of stay for some individuals. Hospitals continue to rely on a “very large” number of staff who have been redeployed to deal with COVID-19 patients, as well as additional staff from national and state registries. No hospitals were experiencing an internal disaster, and no hospitals have had to declare crisis care. EMS demand also improved last week, with fewer than half and closer to one-third of hospitals on diversion at any given time, and length of time on diversion down to under 20%.
In a presentation released on January 27, 2021, the L.A. County Department of Health Services (LADHS) noted a continued decrease in hospital demand:
- The number of new patients with COVID-19 requiring hospitalization each day across L.A. County, although still very high, has decreased. The illness severity in hospitalized patients remains very high, with high demand for intensive care and mechanical ventilation, as well as high mortality.
- Based on hospitalization information that reflects transmission in early January, the estimated transmission number (R) last week was 0.85 with an uncertainty of 0.81 to 0.88. LADHS’ prior estimate for one week earlier was 0.94 with an uncertainty of 0.90 to 0.97.
- However, this may be an underestimate, because the model’s projected transmission rate is based on the number of hospitalizations. During surge peak, people who might have previously been admitted were sent home so that the sickest could get beds. Therefore, a lack of beds may have resulted in fewer hospitalizations, driving down the model’s transmission rate.
- Based on the pattern in hospitalizations, LADHS expects a continued high but decreasing demand for hospital-based services with a limited supply of hospital beds and continued shortages in ICU beds over the next four weeks. The number of ventilators in L.A. County appears adequate over the next four weeks. LADHS expects average daily mortality to continue to be very high but then fall in the next one to two weeks.
LADHS’ model predicted that 0.39% of people (1 in 260) in the county were currently infected and infectious. This was down from 1 in 130 the previous week.
Vaccinations
At the L.A. County Board of Supervisors meeting on January 26, 2021, County Director of Public Health Dr. Barbara Ferrer announced that the County had administered approximately 77% of vaccine doses received. According to a release issued by Dr. Ferrer on January 27, 2021, this included 662,963 doses, with 544,049 being first doses and 118,914 being second doses. Average weekly deliveries are between 110,000 and 165,000 doses. Dr. Ferrer noted that there are approximately 2 million people who qualify for vaccination in the County under Phase 1A (health care workers and long-term care residents) and 1B (individuals age 65 and over) of the County’s vaccination plan.
On Monday, January 25, 2021, Dr. Ferrer confirmed that all individuals who receive a first dose at one of the County’s vaccination sites will automatically receive an appointment for a second-dose appointment. She said that every vaccination site is “guaranteed” the required number of doses for second appointments. She did, however, cite recent CDC guidance that any delayed second dose vaccination would not impact immunity.
New County Paid Sick Leave Ordinance
At the L.A. County Board of Supervisors meeting on January 26, 2021, the Board approved a motion by Board Chair Supervisor Hilda Solis to extend Supplemental Paid Sick Leave protections in unincorporated areas of the County. The ordinance extends the Board’s previous Paid Sick Leave law, which had covered only employers with more than 500 employees, and expired on December 21, 2020. The new ordinance covers all employees in the unincorporated areas of the County, regardless of the number of employees. The ordinance requires employers to provide supplemental paid sick leave to employees as follows:
- For employees who work at least 40 hours per week or are classified as full-time: no more than 80 hours of Supplemental Paid Sick Leave under either the Families First Act or the ordinance. Supplemental Paid Sick Leave shall be calculated based on an Employee’s highest average two-week pay over the period of January 1, 2020, through January 1, 2021.
- For employees who work less than 40 hours per week and are not classified as full-time: an amount of Supplemental Paid Sick Leave no greater than the employee’s average two-week pay over the period of January 1, 2020, through January 1, 2021, reduced by the supplemental paid sick leave paid under the Families First Act.
Employees are entitled to a maximum of $511 per day and $5,110 in total.
Under the ordinance, an employer may not require an employee to use any other paid or unpaid leave, paid time off, or vacation time provided by the employer before the employee uses Supplemental Paid Sick Leave, or in lieu of Supplemental Paid Sick Leave.
The ordinance is retroactive to January 1, 2021, and remains in effect until two weeks after the expiration of the County’s COVID-19 local emergency.