Los Angeles County’s rate of coronavirus cases hit its highest point in nearly five months over the July 4 holiday weekend, a troubling sign of how two super-infectious new Omicron strains are creating the conditions of a busy summer.
Two subvariants of Omicron, BA.4 and BA.5, have become nationally dominant and appear to be among the most contagious in this pandemic to date.
Rates of coronavirus cases have also increased statewide, with the San Francisco Bay Area reporting the highest rate in California. Hospitalizations also increased, but hospitals did not report being overwhelmed. Still, experts fear the next few weeks could see a more rapid spread that would put further pressure on the healthcare system.
“Right now, if we increase further, it’s going to get into a bit more dangerous zone with hospitalizations,” with potential to put pressure on the health care system, said Dr. Peter Chin-Hong, an infectious disease patient. UC San Francisco. -disease specialist.
Too many coronavirus-positive patients can impact hospital operations, even if they are being treated for reasons other than COVID-19, because of the resources needed to isolate them, Chin-Hong said.
One of the biggest concerns with BA.4 and BA.5 is that people can be reinfected even after suffering from an earlier Omicron subvariant. Dr. Robert Wachter, chairman of the department of medicine at UC San Francisco, wrote that this could mean high levels of infection throughout the summer and fall.
“Beyond that, it all depends on whether a new variant emerges to supplant it. Given the pattern of the past year, it would be foolish to bet against that,” he said. wrote during the weekend.
The rise of the last sub-variant, BA.5, he addedis particularly noteworthy because “prior infection – including an Omicron infection as recent as last month – no longer provides strong protection against reinfection”.
“We see such people re-infecting themselves within one to two months,” he added.
Vaccinations and boosters remain “extremely valuable in preventing a serious case that could lead to hospitalization/death”, Wacher wrote:. “But its value in preventing a case of COVID, or preventing transmission, is now far less than it once was.”
The growing dominance of the Omicron BA.4 and BA.5 subvariants could bring LA County, the nation’s most populous county, one step closer to restoring universal mask ordering for indoor public spaces perhaps later this month or next month if trends continue.
Experts are urging people to get up to date on their vaccinations, and that includes getting a first booster, or a second booster if eligible. Vaccinations and boosters have been key factors in keeping hospitalizations relatively modest for now.
Don’t wait for an Omicron-specific recall, they said, as its rollout will likely be delayed until November to incorporate a vaccine formula designed against the newer Omicron subvariants, rather than the older version, which scientists fear is relatively obsolete by then.
“My advice is to go ahead and get ‘a callback now,’ Chin-Hong said. Questions remain about the exact availability of the Omicron-specific fall booster, given that Congress has yet to approve the billions of dollars needed for pandemic efforts, including money to pre-order vaccines. .
If federal officials are still hamstrung by limited funds later this year, the Omicron-specific fall vaccination may “only be available to a limited group of people,” perhaps only to those age 65. and more, Chin-Hong said.
“I don’t know what will happen in November. And we know that BA.4 and BA.5 are starting to rage right now. So might as well go protect yourself from what we know,” Chin-Hong said.
Anecdotally, some residents describe substantial discomfort with recent COVID-19 illness, even though they are not hospitalized. “My heart rate was so high,” wrote one commenter on Reddit, with others describing their children suffering from fevers reaching 104 degrees.
“It’s either chills where you shiver and need a blanket or sweat under the blanket,” another commenter wrote. “The sore throat is like shards of broken glass every time you swallow,” wrote a third.
“It’s very unpleasant for a lot of people,” Chin-Hong said. He said one of his co-workers probably got infected from her children, and during her acute illness “she couldn’t multi-task…for a while she was kind of at her wits end and didn’t feel normal for several weeks.”
Long COVID, in which symptoms like brain fog and fatigue can last for months or years, is also a risk after getting COVID-19, even among vaccinated and boosted people.
Eighty percent of LA County residents have completed their primary vaccination series, but there are still many vaccinated people who have not received a single booster shot. Among those aged 5 and over eligible for at least one reminder, 56% received one.
Among LA County residents age 50 and older eligible for a second booster shot, only 33% received it.
The U.S. Centers for Disease Control and Prevention says anyone age 5 and older should get a booster shot. People 50 and older, and some people 12 and older with weakened immune systems, should get a second booster shot, according to the CDC.
Among those vaccinated, those who did not receive a booster are more likely to need hospitalization, Chin-Hong said.
Doctors are also warning that simply relying on vaccinations alone is not enough to guard against infection, and health officials are strongly recommending the use of masks in indoor public places.
“The increase in positive cases among fully vaccinated individuals likely reflects the dominance of newer Omicron subvariants that spread more easily and are able to evade some of the vaccine protection against infection,” the statement said. LA County Director of Public Health Barbara Ferrer last week.
Unvaccinated people aged 5 and over were only one and a half times more likely to test positive for coronavirus than vaccinated people – a group that includes those who were boosted and who were not boosted — for the 14-day period that ended June 9, Ferrer said.
In contrast, six months ago, unvaccinated people were about three and a half times more likely to test positive for the coronavirus than those vaccinated but not boosted, according to LA County data for the weekly period that s ended December 4.
Protection against hospitalization is still important for those vaccinated, but it has also weakened over time. Six months ago, an unvaccinated person was 13 times more likely to be hospitalized with a coronavirus infection than a vaccinated person. Now, an unvaccinated person is almost 4 times more likely to be hospitalized.
For deaths, six months ago an unvaccinated person was 17 times more likely to die from COVID-19; now an unvaccinated person is 8 times more likely to die.
Despite reduced efficacy, “FDA-approved vaccines actually do exactly what we need them to do. They prevent serious illness and death,” Ferrer said.
In other words, of the nearly 7 million LA County residents who have completed their primary vaccination series, about 13% tested positive in results sent to government officials, 0.2% were hospitalized. and 0.03% died.
Many people now get their positive test results through home test kits whose results are not shared with authorities. But “even if we double that number — so we can account for those who tested using over-the-counter test kits — many fully vaccinated people have not yet been infected,” Ferrer said.
There has been some debate over whether young adults should be eligible for a second booster now. Ferrer was among those calling on the U.S. Food and Drug Administration to conduct a new review of the data to reconsider allowing more people to get a second booster sooner.
Chin-Hong is among the experts who think opening up eligibility for a second recall makes sense.
“At a minimum, it will somehow boost people’s antibodies, even though” boosters aren’t specifically designed to target BA.4 and BA.5, Chin-Hong said. “For me, it will be more convenient to just liberalize it for everyone.”
But federal officials have not signaled they are ready to imminently expand the availability of the second booster to people under age 50 who are not immunocompromised.
On July 4, Los Angeles County averaged about 5,500 daily coronavirus cases over the previous week, the highest number since early February when Omicron’s first surge was waning. On a per capita basis, this equated to 383 cases per week per 100,000 population; a rate of 100 or more cases per week per 100,000 population is considered high.
On Tuesday, the case rate had fallen slightly to 376 cases per week per 100,000 population, but that was likely due to a delay in reporting over the bank holiday weekend. The latest case rate was still 9% higher than the previous week.
Last week, LA County recorded its highest weekly rate of new positive coronavirus hospitalizations since February – 8.3 hospitalizations per 100,000 population, compared to 7.3 the previous week. If that rate reaches 10 or more for two consecutive weeks, LA County health officials plan to impose a new universal mask mandate in indoor public places for anyone age 2 and older.
The mandate would remain until the rate falls below this threshold for two consecutive weeks.
The Omicron BA.4 and BA.5 subvariants accounted for about 70.1% of new cases nationwide for the week-long period ending Saturday, according to the CDC. This completes a stunning surge for the sub-variant duo, which just a month earlier were thought to be responsible for just under 16% of new cases.
Omicron has spawned a number of sub-variants since its emergence late last fall, and these have largely been characterized by increased infectivity. But “BA.5 is a different beast with a new superpower: sufficient spike protein alteration that immunity against prior vax or Omicron infection (including recent infection) does not offer much protection. “, according Washer.
“As BA.5 becomes the dominant American variant, its behavior will determine our fate for the next few months, until it either dies out infecting as many people or is replaced by an even more effective variant for infect people,” Wachter wrote. on Twitter. “It’s not a happy scenario either.”
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