Public Health officials Saturday announced 13,756 new COVID-19 cases and 60 more deaths, as Los Angeles County crossed a landmark 600,000 cases, but also had to modify the department's safety policy regarding places of worship to account for recent Supreme Court rulings.
To date, the Los Angeles County Department of Public Health has reported 610,372 positive COVID-19 cases across and a total of 8,817 coronavirus-related deaths.
On Dec. 11, the county reached 500,000 cases, and since then, more than 100,000 new cases have been reported -- the fastest acceleration of new cases during the pandemic.
The Los Angeles County Health Officer Order was modified Saturday to align with recent Supreme Court rulings for places of worship. The court ruled that such places are permitted to offer faith-based services both indoors and outdoors with mandatory physical distancing and face coverings over both the nose and mouth that must be worn at all times while on site. Attendance is not permitted to exceed the number of people who can be accommodated while maintaining a physical distance of six feet between separate households.
Public Health strongly recommended that places of worship continue to hold services outdoors, with physical distancing and face coverings to prevent the spread of COVID-19.
If there is a light on the horizon, it is that Pfizer's initial vaccine allocation is currently being used by acute-care hospitals to vaccinate frontline health care personnel. A second allotment of Pfizer vaccine is anticipated to arrive next week and will be used to inoculate additional health care workers at acute-care hospitals, Public Health announced.
"While we now see the light at the end of the tunnel, we haven't reached the light yet," said Dr. Brad Spellberg, chief medical officer at Los Angeles County-USC Medical Center. "The pandemic is going to continue for many, many months after we begin vaccinating people. This is not the time to start ignoring public health advice and recommendations. Our hospitals are critically overcrowded in LA County.
"L.A. County is now moving towards becoming the epicenter of the pandemic,'' he said. "We are not at the stage yet at which other parts of the world, including in the United States, have suffered catastrophic consequences, but we are heading in that direction. And if we don't stop the spread, our hospitals will be overwhelmed."
A record 5,424 people were hospitalized with the disease on Saturday -- up more than 300 from Friday -- and 21% of these people are in the ICU. Hospital capacity across the county is very limited, and health care workers are hard-pressed to keep up with the need for care.
"We're getting crushed. I'm not going to sugarcoat this. We are getting crushed," said Spellberg. "For most of the days of the last week, we've had zero ICU beds open in the morning, and we have had to scramble -- 'can we move this patient here,' 'can we move that patient there.' ... We're already expanding care into areas of the hospital we don't normally provide that type of care in.
" ... And it isn't just COVID patients,'' he said. "It's car accidents and heart attacks and victims of violence. They need a place to go to receive critical care. We can only react. We cannot stop the spread. We need the public to listen to these mitigation strategies to slow the spread or we will completely run out of beds."
Spellberg also voiced the frustration felt by health care workers caused by those who deny the severity of the virus and downplay its impact on hospitals.
"The amount of moral courage it takes to run towards the danger makes it very frustrating for our heroes every day to come to our hospitals and care for patients when we see video and hear people not taking the public health strategies seriously,'' he said.
His comments came amid a surge of cases that has exploded across the county since November, exacerbated by the Thanksgiving holiday and accompanying
gatherings that occurred in spite of warnings against them.
Dr. Christina Ghaly said that as of Friday morning, there were 699 total available hospital beds in Los Angeles County -- with a population of 10 million people -- and just 69 ICU beds. That's down from Thursday's figures of 716 overall beds and 92 ICU beds. Ghaly noted that the figures represent a "snapshot in time" from a daily morning poll of the county's 70 "911-receiving'' hospitals with emergency rooms, and the numbers can fluctuate dramatically throughout the day.
In recent days, county hospitals have been operating near their overall licensed capacity of about 2,500 ICU beds.
Last week, county hospitals operated an overall average about 10,360 non-ICU beds per day, based on physical space and available staffing. Overall, county hospitals are licensed to operate about 17,000 non-ICU beds, but that number is restricted by the availability of staffing to treat patients.
Ghaly echoed Spellberg's warning that the crush of patients at hospitals threatens care for everyone, not just COVID-19 patients.
"Everyone has seen first-hand how devastating this pandemic has been and continues to be and knows that we are battling this unprecedented surge that overwhelms our hospitals and really risks undermining the ability ... of hospitals to care for everyone who needs their services,'' she said. "And that's at risk right now."
On Thursday, the state announced that the 11-county Southern California region had formally reached zero capacity in intensive-care units. The designation does not mean there are no beds available, since the state adjusts the capacity figure based on the ratio of COVID patients occupying ICU space.
Ghaly said earlier that Los Angeles County hospitals were averaging about 600 coronavirus admissions per day, up from around 500 last week. Based on current trends, hospitals could be admitting anywhere from 750 to 1,350 new COVID admissions per day by the end of December, she said.
Public Health Director Barbara Ferrer said average daily deaths from COVID-19 in the county have spiked up 267% since Nov. 9, reaching 44 per day as of last week, and likely even higher this week given the recent rising death figures. Ferrer said that equates to two people in the county dying from COVID-19 every hour.
County officials said the local transmission rate for COVID-19 -- the average number of people each COVID-positive person infects with the virus -- is now 1.2, up from 1.16 a week ago. Anytime the rate is above 1, case numbers are projected to grow.
The county also estimates that one of every 80 residents not hospitalized or in quarantine/isolation is infected with the virus, likely without knowing it or showing any symptoms, yet still capable of infecting others.
"Based on the science of transmission of COVID-19, the devastation we are experiencing now is due to people who were unknowingly infected with the virus being in close or direct contact with another person or group long enough to infect them,'' county Health Officer Dr. Muntu Davis said Thursday.
"It may have occurred at work or when they traveled or visited with people outside their homes who they don't live with over the holidays, either here in the county or in another county or another state or another country.
"The science of COVID-19 transmission also indicates that the transmission occurs more easily in crowded spaces with many people nearby, close-contact settings especially where people have conversations very near each other and in confined spaces or closed spaces with poor ventilation,'' he said. "And that the risk of COVID-19 spreading is higher in places where these three conditions overlap."
The Southern California region -- which covers Los Angeles, Orange, Riverside, San Diego, Imperial, Inyo, Mono, San Bernardino, San Luis Obispo, Santa Barbara and Ventura counties -- is under a state-imposed regional stay-at-home order that bars gatherings of people from different households and forced the closure of many businesses, while restricting capacity at others.
Schools with waivers can remain open, along with "critical infrastructure'' and retail stores, which will be limited to 20% of capacity.
Restaurants are restricted to takeout and delivery service only.
Hotels are allowed to open "for critical infrastructure support only,'' while churches would be restricted to outdoor only services. Entertainment production -- including professional sports -- would be allowed to continue without live audiences.
The order will remain in effect until at least Dec. 28.