Covid: The number of people hospitalized for Covid, not just individuals who have sought care and then tested positive, has increased to the “high” threshold. While a reversal is technically possible that would prevent the need for a new mask mandate this month, officials said many of the metrics used to determine the need for masks trail behind overall case counts which means it’s unlikely they will rapidly decline without a preceding drop in cases.

With case metrics moving LA County back into the “high concern” category for the spread of COVID-19 as of Thursday, July 14, the LA County Public Health Department is poised to enact sweeping mask mandates as early as July 29. 

A slate of indicators including hospitalizations, workplace and skilled nursing facility outbreaks, and case rates among low-income residents can trigger a move into a higher or lower level of concern, and once the County’s metrics bump the COVID-19 rate of spread into high concern, a timer begins. If the County stays in that high concern category for two weeks, masking orders resume.

The new rules would be a return to the indoor mask mandates of 2020 and 2021, including “all indoor spaces, including shared office spaces, manufacturing facilities, retail stores and at indoor events.” 

“Indoor areas of restaurants and bars, children’s programs and educational settings would also need to institute universal indoor masking as well,” according to Public Health Director Barbara Ferrer. These mandates would be in addition to the ongoing mask rules in place on public transit, in health care and long-term care facilities, in jails, and during the 10 days following COVID-19 diagnosis or exposure. 

Ferrer made the announcement during the weekly COVID-19 virtual public briefing on Thursday. At the briefing, the Director emphasized the department’s reasoning for reinstating the mandates.

“Vaccination is a powerful tool, but when transmission is as high as it is now, vaccination is not sufficient and we need to use additional protective measures to lower the risk, particularly for the most vulnerable,” Ferrer said. “Masking and testing are both tools that can interrupt transmission and thereby reduce risk.”

Ferrer said that while there have been many cases of incidental coronavirus hospitalizations when patients hospitalized for other reasons test positive for COVID-19 upon arrival to medical centers, the rate of virus-related hospitalizations has been steadily climbing since April, and has just hit the “high” threshold.

The weekly briefing always includes a media Q&A, and this week reporters came prepared with questions about the mandate — Is it a done deal? Will people actually follow it? What will it take to drop masks?

“It’s never too late to reverse course,” Ferrer said. But hospitalization rates, one of the metrics that bumped the County into the high concern category, are considered lagging indicators, meaning they are very likely to get worse before they get better. Since both new cases and hospitalizations are rising, it is unlikely that number will go back down before the two-week timer is up.

As for the usefulness of the rules themselves, Ferrer said that from a public health department’s point of view, to not impose a mask mandate would be a misstep.

“You know, I think it’s really hard, if you’re in public health, to look at our data — and that’s our responsibility, to look at the LA County data — and not notice … that we have, like, lots and lots of people with severe illness, lots of people who die, and lots of people with long COVID, and not want to take a fairly straightforward step to try to layer in some additional protections,” Ferrer said. “You know, we are not closing anything down. We are not asking people not to gather with the people they love. We are not asking you to forego activities you love. We’re asking you to take a sensible step. When there’s this much transmission with a highly transmissible variant, to go ahead and put back on a well fitting high filtration mask when you’re indoors around others and I think that’s the prudent thing to do.”

As of latest testing, the omicron variant accounts for 100 percent of all known cases in the county, with the rapidly spreading BA.5 subvariant taking up the largest portion of new cases, at 48 percent of all cases sequenced in the most recent week of available data (ending on June 25) — more than doubling since June 11. 

emily@smdp.com