Mask Rules Are Suddenly Back In California As Coronavirus Hits Danger Zone

Palisades Charter High School students ride the Metro E line train on April 21.

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

Suddenly, California officials are moving toward new indoor mask rules as coronavirus cases enter the danger zone in many parts of the state.

The virus has been spreading rapidly across California after a spring of big declines. That is setting up an anxious summer in which officials are now talking about a return to mask wearing to prevent wider spread.

So far, the biggest concerns have been in Northern California. But Los Angeles County officials say mask mandates are possible by the end of the month if conditions continue to deteriorate.

Why are masks back on the agenda?

The U.S. Centers for Disease Control and Prevention recommends universal indoor masking when a county enters the high COVID-19 community level, the worst in a three-tier system.

Entering the high COVID-19 community level means that new weekly rates of hospitalizations, or hospital capacity, are being affected by coronavirus-positive patients to such an extent that the hospital systems may grow strained.

The CDC on Thursday placed 13 California counties in the high COVID-19 community level. It’s the first time since mid-March that any county in the state was in that level.

Nearly 1 in 6 Californians live in a county with a high COVID-19 community level. The affected counties are Santa Clara, Sonoma, Solano, Marin and Napa in the San Francisco Bay Area; Sacramento, Placer, Yolo, El Dorado in the Sacramento Valley area; and Monterey, Mendocino, San Benito and Del Norte elsewhere in Northern California.

What actions are being taken?

Alameda County issued a new mask mandate for most indoor public settings effective Friday, becoming the first California county to do so.

The county, home to Oakland, is the Bay Area’s second-most populous. Its mandate is the first issued in California since the winter Omicron surge faded

The order does not apply to K-12 school settings through the end of the school year, nor does it apply to Berkeley, which is in Alameda County but has its own public health department. Berkeley’s school system, however, has already implemented an indoor mask mandate.

“Rising COVID cases in Alameda County are now leading to more people being hospitalized, and today’s action reflects the seriousness of the moment,” county health officer Dr. Nicholas Moss said in a statement.

“We cannot ignore the data, and we can’t predict when this wave may end. Putting our masks back on gives us the best opportunity to limit the impact of a prolonged wave on our communities.”

Alameda County has one of California’s highest coronavirus transmission rates, reporting about 354 cases a week for every 100,000 residents for the past week. That figure has climbed 20% from mid-May. A rate of 100 cases a week or more for every 100,000 residents is considered high.

What are the details?

The Alameda County order will require masks to be worn at indoor businesses and workplaces, including offices, stores, theaters and conference centers, as well as restaurants and bars when not eating or drinking; on public transportation, including taxis and app-hailed rides; and at Oakland International Airport. Businesses and venue operators are required to post signage at all entrance points to communicate the mask requirement and “make reasonable efforts to ensure compliance in their setting,” the health order said.

The county won’t require masking in schools through the few remaining days in the school year. Masks need not be worn while working alone in a closed office or room, while swimming or showering at a gym or while obtaining a medical or cosmetic service involving the head or face for which mask removal is needed to perform the service.

Alameda County also is allowing masks to be optional for performers at indoor live events, such as the theater, opera, symphony, religious choirs and professional sports; at religious gatherings when necessary to perform rituals; and at indoor gyms and yoga studios by people who are “actively engaged in periods of heavy exertion,” are swimming or diving, or when engaged in sports where masks create a risk to health, like wrestling and judo.

Masks will be required in other youth settings, including child care, summer school and youth programs. Children younger than 2 must not mask because of the risk of suffocation.

What about other places?

The Berkeley school system has already issued a mask order for indoor K-12 classroom settings, as well as indoor graduations.

Other educational institutions in California have done the same, including UCLA and Cal Poly San Luis Obispo. Sacramento schools also announced new mask measures this week.

Where does Los Angeles County stand?

L.A. County could be poised to see a new universal indoor mask mandate lat`er this month if the upward trends continue.

“Our weekly case rate and the rate of increase in hospital admissions are of concern,” L.A. County Public Health Director Barbara Ferrer said Thursday. “If we continue on the current trajectory … we’re likely to move into the CDC high [COVID-19] community level within a few weeks towards the end of June, indicating increased stress on the healthcare system.”

According to CDC data issued Thursday, L.A. County observed 5.3 new weekly coronavirus-positive hospitalizations for every 100,000 residents, an 18% increase from the previous week’s rate of 4.5. A rate of 10 or more would place L.A. County in a high COVID-19 community level.

Elsewhere in Southern California, Ventura County had a new weekly coronavirus-positive hospitalization rate of 7.6; Santa Barbara County, 6.3; Orange County, 5.3; San Diego County, 4.9; and Riverside and San Bernardino counties, 2.9.

What are experts saying?

There is still not a clear sense of how bad the summer COVID-19 wave will be in California. Hospitalizations and deaths are still relatively modest.

Some observers say there’s no sign that California is nearing a peak, as the latest variant’s exceptional contagiousness is thought to be approaching that of measles. State modeling suggests, however, that the spread of COVID-19 is likely still increasing in Southern California, the San Joaquin Valley and Greater Sacramento.

Even if hospitals don’t become burdened, there’s concern that climbing rates of transmission could keep people at home for a week or more, ruining plans for graduations, weddings and vacations and making it difficult for businesses to maintain adequate staffing.

Of all the COVID-19 restrictions that have been issued over the years, a mask order is among the least onerous to the public, said UC San Francisco epidemiologist and infectious-diseases expert Dr. George Rutherford.

“If you’re going to try and stay in front of this and try and restrict the damage that’s going on, this strikes me as a fairly low-level ask, to have people wear a mask,” Rutherford said.

“We’re not talking about lockdowns, we’re not talking about mandatory vaccination, we’re not talking about mandatory testing programs. We’re just talking about wearing masks, which are highly effective, especially if both people are wearing masks. And it’s something we’re used to doing,” Rutherford said.

Coronavirus Cases On The Rise In L.A. County, Prompting Calls For Spring Break Caution

Coronavirus cases on the rise in L.A. County, prompting calls for spring  break caution - Los Angeles TimesSource: Los Angeles Times, by Luke Money, Rong-Gong Lin II

Coronavirus cases are once again on the rise in Los Angeles County, according to data released Monday, prompting officials to urge residents to keep up safety protocols as the spring break holiday season arrives.

Data show that for the seven-day period that ended Monday, an average of 960 new cases were reported daily countywide, which equates to 67 cases a week for every 100,000 residents. That’s up 23% from the previous week, when L.A. County reported an average of 783 cases a day.

Caseloads of this magnitude remain a far cry from the tens of thousands of new daily infections during the height of the Omicron surge. In mid-January, L.A. County was reporting 42,000 new coronavirus cases a day.

Nevertheless, the trendline is the source of some concern, especially given the proliferation of BA.2 — an Omicron subvariant estimated to be 30% to 60% more contagious than the earlier version that swept the globe last fall and winter.

Scientists are also now tracking an even more potentially contagious subvariant, XE, which some early estimates indicate may be 10% more transmissible than BA.2.

“The evidence is becoming clearer that given the current approved vaccines and the reality of a mutating virus, some of us will need to boost our immune systems a couple of times during the year in order to be optimally protected,” county Public Health Director Barbara Ferrer said in a statement. “This includes those infected with Omicron over the winter, since natural immunity … also wanes over time.”

Given that many residents are likely to travel or gather in the coming weeks — either for spring break or to mark holidays such as Easter, Ramadan or Passover — Ferrer said it remains important to “do our very best to make use of the powerful tools at hand, vaccinations, boosters, testing, and masking, to keep ourselves and those most vulnerable to severe illness, as safe as possible.”

There are more than 1.7 million L.A. County residents age 5 and up who haven’t received a single vaccination dose, and an additional 2.8 million vaccinated residents who haven’t received a booster, even though they’re eligible for one.

L.A. County’s coronavirus case rate hit a post-winter surge low of about 609 cases a day from March 18 to 24. That was about two weeks after the region ended its universal requirement to wear masks in indoor public spaces — one of the last counties in California to do so.

Since then, the countywide case rate has ticked upward, a development officials have said is likely fueled by a combination of waning immunity, the loosening of masking rules and the spread of BA.2.

The daily reported caseload is just one of many metrics health officials utilize to track and assess the pandemic’s trajectory. Another, the proportion of conducted tests that are confirming coronavirus infection, has also inched up slightly as of late, but remains low at 1%, county health officials said.

And while cases have crept up a bit, the number of people hospitalized with COVID-19 countywide has continued to trend downward. As of Sunday, 265 coronavirus-positive patients were hospitalized countywide — down about 8% from a week ago.

Experts in California have said there are unmistakable signs of an uptick in coronavirus cases in the state. But whether this latest uptick ultimately proves to be a temporary blip or the harbinger of something more significant, however, remains to be seen.

For the weekly period that ended Thursday, California was averaging about 2,800 cases a day, or 50 cases a week for every 100,000 residents, up 9% over the prior week.

Orange County’s case rate is also increasing. Orange County’s case rate is about 134 cases a day, or 30 cases a week for every 100,000 residents, up 12% over the prior week.

San Francisco, which now has one of California’s highest case rates, on Thursday was recording about 127 cases a day, or 102 cases a week for every 100,000 residents, a 6% increase over the prior week.

A coronavirus case rate of 50 or more cases a week for every 100,000 residents is considered substantial, while a rate of 100 or more is considered high.

Dr. Robert Wachter, chair of UC San Francisco’s Department of Medicine, tweeted Thursday that the percentage of asymptomatic patients testing positive at UC San Francisco’s hospitals had risen to 2%, up from 1% in late March.

“If you’ve let guard down, time to be more careful,” he wrote.

By Monday, the rate had dipped back down to 1.6%, Wachter said in an email. That means that in San Francisco, there’s a 28% chance that at least one person attending a party with 20 asymptomatic people will test positive for the coronavirus.

Some experts are optimistic that the case numbers so far offer glimmers of hope that this spring will not bring a second Omicron surge on the magnitude of those seen elsewhere — such as Britain, where hospitals have once again come under strain.

Dr. Eric Topol, director of the Scripps Research Translational Institute in La Jolla, tweeted Saturday that “it’s clear that wave 6 (BA.2), yet still in the works, will not resemble” the fifth surge of the pandemic, or last winter’s Omicron surge.

But Myoung Cha, chief strategy officer for San Francisco-based Carbon Health, disagreed with “confident takes … that this surge won’t be big.” He noted many people this year are self-diagnosing with at-home tests — the results of which are not reliably reported to the government.

By contrast, lab tests conducted at official facilities are automatically reported to the authorities.

“The current case rates are massively undercounted versus prior surges,” Cha tweeted Sunday.

As is the case anytime COVID-19 shows signs of resurgence, the question on many people’s minds is when, or whether, health authorities may consider reimplementing restrictions.

In Philadelphia, where cases have jumped by more than 50% over the last 10 days, officials on Monday announced the return of an indoor mask mandate, effective April 18.

Philadelphia had preexisting criteria in place that would trigger a return to a mask order when average new cases a day exceeded more than 100 and when cases have risen by more than 50% in the previous 10 days. On Monday, officials reported that the city of 1.58 million people was averaging 142 new cases a day, or 63 cases a week for every 100,000 residents.

Philadelphia Mayor Jim Kenney said the return of the mask mandate in indoor public settings was needed to prevent higher case rates.

“Our city remains open; we can still go about our daily lives and visit the people and places we love while masking in indoor public spaces,” Kenney tweeted.

A number of universities in the Northeast have announced a return to universal mask policies. Columbia University, Georgetown University and American University have announced the return of indoor mask requirements recently.

So far, officials in L.A. County and the state have not indicated that conditions warrant the imposition of new measures or mandates — though, in both cases, they still urge residents to mask up indoors while in public.

Speaking with reporters last week, though, Ferrer said people should be concerned about the rise in the number of school outbreaks countywide. There were 14 new outbreaks in K-12 schools in L.A. County for the week that ended Thursday. For the previous week, there were four.

She noted that in some other settings where masking is still required — like nursing homes and homeless shelters — there has not been an increase in outbreaks.

Ferrer also expressed some optimism that a second increase in Omicron cases this spring wouldn’t be as bad as the winter surge. People who have been infected with the earlier Omicron subvariants earlier this winter, BA.1 or BA.1.1, are likely to have a degree of immune protection against the latest Omicron subvariant, BA.2, at least for the near future.

“I am hopeful … that given what we’ve seen and what we’re doing, we should be able to avoid a really big surge,” Ferrer said.

In a round of interviews with morning network shows, Dr. Ashish Jha, the incoming White House COVID-19 Response Coordinator, said he’s “not overly concerned right now” about the rise in cases nationally.

“Case numbers are rising. … We were expecting this, because we saw this in Europe a few weeks ago,” Jha said on NBC’s “Today” show. “But the good news is: We’re coming off of some very low infection numbers. Hospitalizations right now are the lowest they have been in the entire pandemic.

“So we’ve got to watch this very carefully. Obviously, I never like to see infections rising, I think we’ve got to be careful, but I don’t think this is a moment where we have to be excessively concerned,” Jha said.

Last Updated 06/29/2022

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