California Senior Citizens Are Hit Hard As COVID-19 Surges This Winter

Senior citizens are hit hard as COVID surges across state - Los Angeles  Times

Source: Los Angeles Times, by Rong-Gong Lin II

There has been a troubling spike in coronavirus-positive hospital admissions among seniors in California, rising to levels not seen since the summer Omicron surge.

Hospitalizations have roughly tripled for Californians of most age groups since the autumn low. But the jump in seniors in need of hospital care has been particularly dramatic.

Officials in Los Angeles County have said increases in hospitalizations could lead to an indoor mask order, possibly in early January. Still, there is optimism that any winter surge will not be as bad as those of the last two years.

Rising hospitalization rates are a reason health officials are urging people, especially seniors, to get the updated COVID-19 booster shot and, if they test positive and are eligible, to access therapeutic drugs that likely will reduce the severity of any illness.

Only 35% of California’s vaccinated seniors age 65 and up have received the updated booster since it became available in September.

Among eligible 50- to 64-year-olds, about 21% have received the updated booster. The rate is 12% for younger adults, 9% for adolescents and 8% for 5- to 11-year-olds. The updated booster rate for all vaccinated Californians age 5 and up is 18%.

“We are doing a pathetic job of protecting seniors (and age 50+) from severe COVID in California,” tweeted Dr. Eric Topol, director of the Scripps Research Translational Institute in La Jolla.

Immunity against COVID-19 weakens over time. The booster is especially important for older people, who are at higher risk for severe illness and death.

“The people who are dying today are principally people who are unvaccinated or haven’t gotten an up-to-date vaccine,” Xavier Becerra, the U.S. Health and Human Services secretary, said Thursday in an online forum with the Public Policy Institute of California.

COVID-19 deaths in the state have remained stable at 100 to 200 a week. However, there is concern that increases in cases and hospitalizations could lead to more fatalities.

Of all age groups, 70-plus is the only one that is seeing its hospitalization rate in California exceed that of the summer Omicron peak, according to the U.S. Centers for Disease Control and Prevention.

New coronavirus-positive hospitalizations have doubled in just 2½ weeks to 8.86 for every 100,000 Californians age 70 and up. The summer peak, in July, was 8.36; the autumn low, just before Halloween, was 3.09.

During the seven days to Friday, 2,450 coronavirus-positive Californians age 70 and up were admitted to hospitals — 44% more than in the prior week.

Meanwhile, the hospitalization rate for 60- to 69-year-olds has doubled since Nov. 11, from 1.28 to 2.59. The summer peak for that age group was 3.03.

Concerned about the rise in cases and hospitalizations, state health officials issued an alert to remind doctors that there are plenty of drugs available for newly infected people.

“There is ample supply of COVID-19 therapeutic agents, but they have been underused — especially among populations disproportionately impacted by COVID-19, including communities of color, low-income communities, and residents of long-term care facilities,” the California Department of Public Health said.

The drugs can reduce the risk of hospitalization and death by 88% among unvaccinated people and by 45% among vaccinated or previously infected people, the agency said.

The drugs “are free and widely available,” said Orange County Health Officer Dr. Regina Chinsio-Kwong in a statement. “Medications such as the Paxlovid pill can stop the virus from multiplying in your body, help you test negative sooner, and may lower the risk of developing long COVID symptoms. Additionally, you do not need to have insurance or U.S. citizenship.”

Other therapies against COVID-19 are becoming effectively useless. On Wednesday, the U.S. Food and Drug Administration said it was no longer authorizing the monoclonal antibody bebtelovimab to treat the disease because it’s not expected to work against the Omicron subvariants BQ.1 and BQ.1.1.

 

CDC data released Friday estimate that BQ.1 and BQ.1.1 account for 62.8% of coronavirus cases nationwide. The parent strain, BA.5, now accounts for just 13.8% of cases.

The coronavirus outlook has deteriorated rather suddenly since Thanksgiving around swaths of California.

The worsening rate “indicates a higher risk for more individuals to catch COVID-19 this winter,” Chinsio-Kwong said. She urged people to mask up in indoor public settings.

On Nov. 17, all but one of California’s 58 counties — Imperial — was in the low COVID-19 community level as defined by the CDC, which measures case and hospitalization rates. On Thanksgiving, three more counties — Fresno, Madera and Del Norte — joined Imperial in the medium category.

On Thursday, 23 counties entered the medium level: Los Angeles, Orange, Santa Clara, Sacramento, Stanislaus, Sonoma, Monterey, Placer, Merced, Marin, Yolo, Butte, El Dorado, Kings, Nevada, Mendocino, Tehama, San Benito, Tuolumne, Siskiyou, Glenn, Mariposa and Sierra.

About 22 million people, 55% of Californians, live in counties now at the medium level.

In L.A. County, coronavirus cases rose nearly 50% during the last week, from 2,049 to 3,053 a day. The county’s rate has been increasing since late October and is more than triple what it was in the autumn. For the week that ended Friday, L.A. County was recording 212 cases for every 100,000 residents; a rate of 100 or more is considered high. The COVID-19 death rate in L.A. County is stable at around 60 per week.

Besides COVID-19, L.A. County is contending with rising flu cases and a high level of respiratory syncytial virus, which is stressing children’s hospitals. The flu positivity rate in L.A. County is 25%, the highest for this time of year for at least six years.

For L.A. County to reinstate a mask mandate, two hospitalization thresholds need to be met. One has already been reached.

There were 1,285 admissions of coronavirus-positive patients to county hospitals for the week that ended Wednesday — more than triple the rate from the beginning of November. That’s 12.8 for every 100,000 residents, and a rate of 10 or greater is one of the thresholds for a mask mandate.

The other threshold is reached if the percentage of hospital beds used by coronavirus-positive patients is 10% or greater, an indication of strain on the hospital system. This level was reached during the 2020 and 2021 winter surges, the deadliest of the pandemic.

 

The current figure is 5.9%, up from around 2% at the start of November. The earliest the level could hit 10% would be late December, L.A. County Public Health Director Barbara Ferrer estimated last week.

If that happens, there would likely be a two-week countdown before a mask order would take effect — thus, early January at the soonest.

Elsewhere, Orange County’s coronavirus-positive hospitalization rate has doubled since mid-November to 432 per week, according to the CDC, or 13.6 for every 100,000 residents. Orange County reports that 4.9% of hospital beds are being used by coronavirus-positive patients.

‘Off The Charts’: California Hit With Very High Flu Activity, Among Worst In U.S.

California is now experiencing very high influenza-like illness levels.

Source: Los Angeles Times, by Rong-Gong Lin II

California is now reporting very high flu levels, according to the U.S. Centers for Disease Control and Prevention, as the respiratory illness continues to surge nationwide.

The CDC uses five overall levels, from minimal to very high, to measure influenza-like illnesses across the U.S. and its territories. On Friday, the agency’s color-coded map showed California and 10 other states, along with New York City, shaded purple, the worst of the three shades in the very high flu level.

Since the start of October, CDC officials estimate, there have been 78,000 flu hospitalizations and 4,500 deaths nationally.

The California Department of Public Health classifies all of Southern California as having high flu levels, while Central and Northern California are rated moderate. Flu is the reason for nearly 4% of hospitalizations each week at Kaiser’s Northern California facilities, the highest in any of the prior four flu seasons.

In Los Angeles County, flu and COVID-19 cases are surging, and RSV — or respiratory syncytial virus — also remains at a high level.

“This triple threat … has a lot of potential to cause there to be significant circulating illness and to strain our healthcare system — both in terms of the number of beds that are available and the number of healthcare workers that are impacted by illness, which lowers the hospital’s capacity to take care of patients,” L.A. County Public Health Director Barbara Ferrer said in a recent briefing.

The flu positivity rate in L.A. County has reached 25%, a level not seen at this time of year in the last four years. “Clearly, we’re … off the charts,” Ferrer said.

“We already are seeing many individuals hospitalized for flu-related illness and complications. So please, we urge people to not just think of this as ‘just the flu.’ It’s not too late to get your seasonal flu shot,” she added.

 

California has recorded at least 36 flu-related deaths since the start of October, based on death certificate data. That figure is probably an undercount.

The positivity rate for RSV also remains elevated — around 15%, higher than in any of the four prior cold-and-flu years, which run October through September.

There are some indications that RSV activity may have peaked in L.A. County in early November and is starting to decline. In late October, the positivity rate exceeded 20%, according to county data. But it’s possible the 15% rate is simply a result of more people being tested for the virus, Ferrer said.

 

“The current percent positivity, even while it’s dropped, still surpasses the highest percent positivity values seen for our last five seasons,” Ferrer said. “So, still an alarming number of people who are testing positive for RSV.”

At Children’s Hospital Los Angeles, the RSV positivity rate is 23%. That’s dropped considerably from Nov. 1, when the rate was 38%. But the latest figure is still quite high and is about the same as during the peak for all of last winter, which was 24%. The emergency room at CHLA is so busy that it cannot always accommodate patient transfers from other hospitals.

 

The positivity rate for flu at CHLA is 19%; before Thanksgiving, it was 12%.

Orange County’s RSV situation remains the same as it was the prior week, according to its Health Care Agency, where officials declared a public health emergency over RSV and other viral illnesses stressing children’s hospitals.

Increasing coronavirus-positive hospitalizations are exacerbating the RSV situation, as a rise in COVID-19 hospital patients means there’s fewer hospital beds available, the agency said.

 

At Kaiser’s Northern California hospitals, about 2.2% of hospital admissions are related to RSV, down from 2.3% last week, according to the most recent available data. Those rates are higher than in the five preceding cold-and-flu seasons.

There have been at least 14 RSV-related deaths, according to California death certificate data, since the start of October. The figure is probably an undercount.

“Given the high levels of RSV activity, caution is warranted,” Ferrer said. “RSV often impacts young children most severely and causes bronchiolitis [inflammation of the airways] and pneumonia. It’s important to take precautions to prevent respiratory illnesses. This includes washing your hands often, and for RSV in particular, wiping down frequently touched surfaces.”

In addition to wearing a mask, health experts say one of the easiest ways to reduce your risk of catching the flu or other viral illnesses is to avoid touching your face.

The CDC notes that people can be infected with flu and RSV by touching contaminated surfaces, where some viruses can survive for days, and then their face.

“The one point I want to reemphasize is … avoiding touching your eyes, nose and mouth,” Dr. Ralph Gonzales, a UC San Francisco associate dean, said at a recent campus town hall. “Very good studies have shown that if we can double down our efforts to be vigilant about this, that will increase our chances of staying flu-free.”

Still, this simple-sounding advice may be easier said than done. Touching your face can be a spontaneous or even subconscious act that some research indicates can help us deal with anxiety and discomfort, or be related to negative or dissatisfactory feelings.

 

And it’s something that happens a lot. A study from 2015 caught medical students in class touching their faces 23 times per hour on average.

Here are some tips on how to train yourself to avoid touching your face.

  • * Be mindful when you do touch your face, and catch yourself when — and, preferably, before — you do it.
  • * If you catch yourself before touching your face, consider folding your hands or doing something else with them.
  • * Got an itch? Try to ignore it. If that’s bothersome, wash your hands, then scratch it, then wash your hands again. Or buy sterile wooden tongue depressors to use as a tool to scratch itches.

Regular hand-washing is also an important step to help thwart viral spread, officials say. When soap and water aren’t available, hand sanitizer can be used as a substitute.

Last Updated 12/07/2022

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