Los Angeles County's stay-at-home and business closure orders were extended Friday to May 15, with health officials saying that while physical-distancing requirements have dramatically slowed the spread of coronavirus, lifting them now could lead to nearly 96% of the population being infected by August.
The orders had been set to expire April 19.
Citing a detailed analysis of cases to date and modeling of future case projections, county health officials said the numbers show that existing social-distancing practices have "flattened the curve'' of infections. But lifting the stay-at-home requirements and business closures would quickly reverse that trend.
"If you were to reduce physical distancing to the pre-health officer order levels, virtually all individuals in Los Angeles County, 95.6% per the model, would be infected by the pandemic by Aug. 1, 2020,'' said Dr. Christina Ghaly, the county's director of health services. "That number is starkly reduced, down to about 30%, if we maintain the current levels of physical distancing.
"If we're able to increase the level of physical distancing -- people are able to remain at home more than they are today -- then we could reduce the number of infected individuals even further, down to an estimated 5.5%,'' she said.
The county health orders were implemented in mid-March, requiring people to stay at home as much as possible and to avoid large public gatherings. The orders also shuttered non-essential businesses, leaving only retailers such as grocery stores, restaurants, pharmacies and other outlets open.
The orders were issued in an effort to limit human interaction, particularly in response to the ability of people to transmit COVID-19 to others even before they know they are infected with the virus.
"Physical distancing is working,'' Ghaly said, pointing to projections showing there would have been a sharp rise in cases if such measures had never been implemented. "... It has worked to date and it is working now, and it is important that physical distancing remain in place ... to reduce not just the strain on the hospital system but to reduce the number of infections.
"... What we need to do is continue to slow the acceleration of the virus and make sure we are limiting its impact on society, limiting the infections,'' she said.
Dr. Roger Lewis, director of emergency medicine at Harbor UCLA Medical Center and head of the county Department of Health Services' hospital "demand-modeling'' efforts, said that while there remains a "tremendous amount of uncertainty'' about the virus' spread, current projections show the county should have adequate hospital space to handle future patients. He noted that only about 3% of people who test positive for the virus will require hospitalization. Lewis said roughly 1% of those people will require intensive-care unit treatment, which could potential run short if cases spike upward and no additional efforts are made to add ICU beds.
He said if physical-distancing efforts continue, it will have a dramatic impact on hospital demand. But he also warned that it remains possible that more stringent social-distancing measures might ultimately be needed.
"We know that physical distancing has taken a tremendous toll on our entire community, and that some of us are tragically mourning the loss of loved ones due to the COVID-19 epidemic,'' Lewis said. "Moreover, there remains substantial risk that the need for hospital-based services will exceed the system capacity -- even by large margins -- if there is any reduction in our physical-distancing behavior and other public health control efforts.
"Current data suggests that physical-distancing and public health directives have clearly slowed the spread of the epidemic and that has gained us valuable time to prepare for what lies ahead,'' he said. "However, it remains likely that the current measures are not sufficient to lead to a reduction in illness over times, and that more effective measures will be required.''
Along those lines, the county public health director, Barbara Ferrer, said that beginning Wednesday, essential businesses that remain open will be required to provide cloth face coverings to all employees who interact with other employees or the general public. Businesses also must develop and publicly post a plan for meeting social-distancing and cleaning requirements in the workplace, Ferrer said.
The county will also require the general public to wear face coverings when mingling with other people outside the home, and when going into a business.
Some of those new requirements mirror ones that took effect in many individual cities, including Los Angeles, on Friday.
While the public health orders will remain in place until May 15, officials could not provide any insight on whether they will actually end at that point, saying they will simply have to reevaluate the situation at that time. The orders, however, could easily extend into the summer months depending on the virus' rate of spread.