Hours before a much-debated ban on in-person dining takes effect, Los Angeles County health officials Wednesday painted a dire picture of the current COVID-19 surge, saying the transmission rate has reached its highest point since March and could overwhelm hospitals within a month.
"We continue to be at a very difficult time in this pandemic, as is so much of the United States,'' county Health Officer Dr. Muntu Davis said. "In fact, our situation is getting worse each day."
According to current county estimates, every COVID-19 patient in the county is passing the virus to an average of 1.27 people -- the highest transmission rate the county has seen since March, before any safety protocols such as face coverings and social distancing were in place.
Based on that transmission rate, health officials estimate that one of every 145 people in the county are now infected with the virus and transmitting it to others.
"This doesn't include people that are currently hospitalized or isolated at home,'' county Health Services Director Dr. Christina Ghaly said. "This is the estimate of people that are out and about and infecting others. They may not know they're infected. They may know they're infected and not be isolating. But they're out there and they're exposing other people to the virus."
Ghaly said the number of people hospitalized due to the virus has jumped by 70% in the past two weeks, with the county now averaging about 300 new admissions daily.
"Based on the current estimate for (the virus transmission rate) and assuming that there's no change in people's behavior that would affect transmissions, there will likely be shortages in the number of hospital beds, and especially in ICU beds or intensive-care unit beds, over the next two to four weeks," she said.
As of Wednesday, the county was reporting 1,682 people in hospitals due to COVID-19, filling roughly half of currently available bed space. Ghaly noted that given the current transmission rate, the number of hospitalized patients could double in two weeks, and quadruple in a month. She said hospitals have "surge" plans to increase the number of beds, but the availability of health care workers to staff those beds and treat patients is more limited.
Davis outlined other dire numbers -- including a 67% increase in coronavirus outbreaks reported at general worksites in the first two weeks of November and a 200% jump in outbreaks at food facilities in that same period. He said 42 new outbreaks were reported to the county in the past day alone.
The county's state-adjusted seven-day average testing positivity rate was 6.6% as of Wednesday, up from 5.3% a week ago. The county was reporting a roughly 3.9% rate at the beginning of November.
The county announced another 4,311 coronavirus cases on Wednesday, lifting the countywide cumulative total since the pandemic began to 378,323.
The county also announced another 49 deaths, although four of those fatalities were actually reported Tuesday by Long Beach health officials. The countywide death toll stood at 7,543 as of Wednesday.
On Sunday, the county's five-day average of new daily COVID-19 cases topped 4,000, crossing a threshold set the previous week to trigger a closure of in-person dining at county restaurants, which were already limited to outdoor seating. That closure will take effect at 10 p.m. Wednesday and remain in place for three weeks.
Davis on Wednesday again emphasized the need for the restriction, saying the current surge in cases makes it imperative to limit the potential for virus spread.
"To slow this disease at this point, limiting certain activities that can easily result in many additional cases, like outdoor dining in restaurants, and reducing the numbers of people indoors in other settings is trying to get our case rate lower so we can move to a less restrictive tier and reopen more businesses,'' Davis said. "We all know what we need to do, but with cases increasing as they have, not enough people are doing it."
The elimination of in-person dining, even on a temporary basis, has business owners fuming. The county Board of Supervisors on Tuesday upheld the restriction on a 3-2 vote, sparking an outcry from restaurateurs and others who call it a death knell for small businesses.
"The Board of Supervisors just laid off tens of thousands of people, including many West Hollywood residents, based on junk science and a need to make it look like they're doing something,'' West Hollywood City Councilman John D'Amico said at a news conference outside The Abbey on Robertson Boulevard. "All of this one month before Christmas. To that I say 'bah humbug.'
"In fact, what they should be doing is opening up businesses for more hours, with strong operating regulations, careful code compliance efforts, smarter options for everyone -- worker, resident, business owner alike. We don't need to destroy this county to save it. We need to save it."
David Cooley, owner of The Abbey, fought back tears, saying he fears the three-week dining ban could stretch into New Year's Day, which "will probably put me out of business.'' Cooley said he closed his business early in the pandemic but was able to reopen after making substantial investments in safety measures.
"We learned more about the virus and how to operate our business safely without contributing to its spread,'' he said. "As the state and county constantly changed the safety protocols and regulations, we adopted to every one of them. And believe me it was extremely costly for small businesses to keep up with these guidelines."
But now, he said, "all that investment is wasted."
County Supervisors Kathryn Barger and Janice Hahn introduced a motion Tuesday seeking to un-do the restriction on in-person dining. They argued the ban will be too onerous on restaurants that are already struggling during the pandemic and could cost as many as 700,000 people to lose their jobs. They also said the restriction was being imposed with no evidence pointing to eateries as a major source of virus spread.
But Supervisors Sheila Kuehl, Mark Ridley-Thomas and Hilda Solis stood behind the ban, saying the rate of virus transmission it so high that the county must take option to stop it.
The city of Long Beach, which maintains its own health department separate from the county, announced that it will follow in the county's footsteps and also end in-person dining Wednesday night.
Pasadena, which also has its own health agency, has not enacted the restriction, saying as a smaller municipality it can better enforce infection-control standards and a smaller number of restaurants.
The county, meanwhile, could soon be enacting even more stringent restrictions on a wider array of businesses. On Monday, the county's five-day average of new cases topped 4,500, a threshold that was expected to trigger a "targeted Safer At Home order" that would prohibit all public and private gatherings an impose strict capacity limits at stores.
It was unclear when the county might enact such an order, and despite stressing the urgency of controlling virus transmission, Davis was non-committal on Wednesday about when it would happen. He said health officials were still in discussions with the Board of Supervisors about specifics of the order.
County Public Health Director Barbara Ferrer told the board Tuesday that health officials were recommending that the order:
-- prohibit all public and private gatherings of people not in the same household except for outdoor church services and outdoor protests, which will require masks and social distancing;
-- set occupancy limits for outdoor retail businesses at 50% capacity with masks and social distancing required;
-- set occupancy limits for essential indoor retail businesses at 35% capacity with masks and social distancing required;
-- set occupancy limits for non-essential indoor retail businesses at 20% capacity with masks and social distancing required;
-- keep beaches, trails and parks open with masks and social distancing required, except while swimming;
-- permit walking, running, biking and playing outdoors with masks and social distancing;
-- keep outdoor recreational facilities open for members of a single household using masks and social distancing;
-- close pools that are open to more than one household other than for regulated lap swimming;
-- close or keep closed some non-essential businesses, including office-based businesses, card rooms, clubs, bars, lounges, playgrounds other than at child care centers or schools, theaters, spectator performances, sporting events, bowling alleys and arcades;
-- allow child care and day care centers, K-12 schools and day camps, institutions of higher education, libraries, youth sports and spectator-free pro sports to operate largely under current rules; and
-- continue to adhere to the state curfew prohibiting all gatherings with members of other households from 10 a.m. to 5 a.m. other than essential activities, exempting homeless individuals.