Scope of Delta variant’s strength grows clearer, scarier; impact on LA County deepens

Coronavirus-related hospitalizations climbed over 1,000 in Los Angeles County on Friday, July 30, hitting that level for the first time since May, as the Delta variant expanded its resurgent spread and new insight emerged on just how newly dangerous it has become. Another 3,606 new cases were reported — a daily number not seen since February.

Five additional deaths brought the county’s overall human toll  to 24,676, and the total infected rose to 1,297,032, according to the Public Health Department.

Across the county, the burgeoning outbreak has not yet resulted in the kind of overwhelming hospitalization numbers last reported in January, when local medical centers were were filled with more than 8,000 people sickened by the virus. And experts say it likely never will.

But the increase in the caseload nonetheless has public health experts deeply worried, and hospitals gearing up for more visits as they’re already seeing upticks in their emergency rooms and ICU’s.

Key factors at work in the latest outbreak that has officials on edge:

–Nearly 4 million people remain unvaccinated in the county;

–The Delta mutant is much more contagious and spreads more rapidly; and

–Federal officials now confirm that vaccinated people can not only catch the Delta variant, but they can also unwittingly spread it.

Total hospitalizations stood at 1,008, according to the state’s Friday tally, an increase of 17 from Thursday.

Such daily increases have ranged between 10 and 80 in recent weeks, on the heels of the state lifting most COVID-19 restrictions back on June 15.

L.A. County Public Health Director Barbara Ferrer said the current spike does not appear to be climbing at the same rate as the newly spiraling daily case count, at least not at the moment: While infections have increased by 740% over the last month, hospitalizations have increased by 180%.

“Fewer of our cases are becoming severely ill,” Ferrer added.

But officials are watching closely the number of admissions to intensive care units at public and private hospitals. On June 8, the number of patients admitted to ICUs stood at 45. By Friday, that number had grown to 232.

Ferrer noted that 0.21% of positive cases are actually hospitalized, a far cry from the nearly 6% of positive cases that were ultimately hospitalized during the mammoth winter surge.

Ferrer also noted this week that some patients hospitalized with COVID-19 initially came to the hospital for an ailment unrelated to the virus. It was only in the initial admission screening was it discovered they had been infected.

“This is unrelenting”

Nevertheless, hospitals did appear to be readying for further increases, fueled by a blunt fact: As Ferrer noted this week, “The science on this variant shows that it is different from earlier variants of COVID. It replicates faster and more efficiently in respiratory tract cells, which means that infected people may now spread up to a 1,000 times more virus particles with every cough, sneeze or shout than they did a year ago.”

At Providence hospitals in Torrance and San Pedro, canopies have been added outside of the emergency departments again — as a precaution — but they are not actively deployed right now, according to spokeswoman Patricia Aidem.

“There were to prepare for external triage if we get to that point,” Aidem said.

California Department of Public Health officials Tuesday advised hospitals not to alter their visitation guidelines at this time, Aidem said. Still, administrators were assessing.

In Pasadena, Huntington Hospital was getting busy again as the number of admitted COVID-19 patients has been ticking upward, with 16 admitted patients and three in the ICU.

“It is our strong preference to never have to close to visitors, as we were compelled to during the terrible winter surge, Lulu Rosales, RN and director of the hospital’s Excellence, Engagement and Patient Experience. “However, our overarching priority is the safety of our patients and staff. As we have done throughout this pandemic, we will rely upon science, clinical knowledge and available risk information to inform safe visitation practices.”

At Diginity Health’s hospitals, a similar assessment was ongoing.

“With new cases there may be a need to limit access, but currently the majority of Dignity Health hospitals are allowing visitors,” said Dr. Nicholas Testa, chief physician executive at Dignity Health Southern California Division. “Each hospital reassesses the need to limit access and change process on a daily basis and restrictions in place are to ensure the safety of everyone.”

In the meantime, staffs are adjusting to the uptick.

At Keck Medicine of USC, the staff reinstated its weekly briefings — just as they had when the pandemic was at its early peaks, according to Dr. Stephanie Hall, chief medical officer.

“This is unrelenting,” Hall said Friday. “It’s a continued effort that every day, as information becomes available, we work to make sure we are responding to it timely, and we educate our health care workers to make sure they understand the latest information.”

The trend in hospitalizations appears directly related to the Delta variant and its significantly higher viral load, Hall said.

“What that tells us is because there is so much virus, it’s creating symptoms even in vaccinated individuals,” Hall said.

All of those who died since were unvaccinated, Hall said. Many of those who recover from serious illness, she said, have regrets about not getting vaccinated.

“What we’re seeing with patients who got sick, we are seeing the regret that they should have gotten vaccinated,” Hall said. “I would hope that for those who see this as a political issue they would really set that aside and look at the scientific evidence.”

At MemorialCare Long Beach Medical Center,  Dr. Graham Tse, physician in charge for COVID operations, said the hospital has seen a “slight” uptick in the number of COVID-19 admissions, fueled by the Delta variant, particularly among the unvaccinated.

“But overall, the number of admitted COVID patients remains much lower than seen during the December/January surge,” Tse added, noting that the hospital was prepared for increasing numbers.

Alarm about the speed of the virus’ spread in recent weeks triggered L.A. County’s push to reinstate an indoor mask requirement earlier this month.

People with so-called breakthrough infections of the Delta variant may spread the virus to others just as easily as unvaccinated people, the Centers for Disease Control and Prevention said in a report published on Friday.

The vaccines remain powerfully effective against severe illness and death, and infections in vaccinated people are thought to be comparatively rare. But the revelation follows a series of other findings this week about the Delta variant, all of which have upended scientists’ understanding of the coronavirus.

In the report published on Friday, the agency described a single outbreak in Provincetown, Mass., that quickly mushroomed to nearly 469 cases in the state as of Thursday, three-quarters of whom were fully immunized.

Studies of outbreaks have shown that Delta is much more contagious than the original virus or the seasonal flu and as contagious as chickenpox, according to the internal document circulated within the C.D.C.

Such recent developments have prompted U.S. health officials to consider changing advice on how the nation fights the coronavirus, internal documents show, the Associated Press reported.

While L.A. County is already there, on a national scale the report notes that recommending masks for everyone and requiring vaccines for doctors and other health workers are among measures the Centers for Disease Control and Prevention is considering, according to internal documents obtained by the Washington Post.

The documents appear to be talking points for CDC staff to use in explaining the dangers of the Delta variant and “breakthrough″ infections that can occur after vaccination. Noted under communications: “Acknowledge the war has changed.”

Changing battle, morphing virus

In L.A. County, the war shifted weeks ago. The decision to revive masking indoors sparked pushback from many, however.

“With the success of Operation Warp Speed, we’ve seen an immense decrease in rates of serious illness and death, said Rep. Mike Garcia, R-Saugus, earlier in the week. “Sweeping government mandates on vaccination and mask wearing, like those we’ve seen from Sacramento, the City of Los Angeles and the CDC, based on unpublished studies that have not been subjected to peer review are simply not warranted – especially when it could cost Americans their jobs and livelihoods. When will it end?”

For Dr. Robert Kim-Farley, at UCLA’s Fielding School of Public Health, recent statistical trends were affirmation that the county’s masking mandate was the right move.

But the reports from the CDC on Friday also put a punctuation mark on why stopping the virus is so urgent.

“From an evolutionary point of view, it is to the virus’s benefit to be more transmissible and ultimately less deadly, because it doesn’t help the virus if it kills you, because then it can’t transmit to others,” he said.

On the other hand, if it can’t be squashed through vaccinations and immunity, he said, and “we may see other variants that could be rising in the future.”

For survivor Adrian Alvarez, who was hospitalized with COVID-19 and nearly placed on a ventilator, those who choose not to get the vaccine are being selfish, he said.

“You just have to be more considerate of other people,” said Alvarez, 58, who lives in Downey. “ A lot of people will die because of people’s ignorance.”

Alvarez was hospitalized at Long Beach Medical Center for six days in December near the height of the pandemic. He was given oxygen for several days in an emergency room bed before a room opened in the acute care area.

He is still unnerved by the memories, he said. There he lived for frightening days, he said, without his family, preparing to possibly die alone.

Seven months later, Alvarez still suffers from “long haulers syndrome,” characterized by fatigue and continued symptoms. He got the vaccine the first chance he could get, but the damage had been done, he said.

Alvarez urged the unvaccinated: Get the shot.

“I just hope people are not so selfish,” he said, “and think only about themselves.”

The message: Get your shot

Getting that message out in a way that convinces more people to get a vaccine is easier said than done, officials have learned.

Kim-Farley noted that Friday’s reports on seriousness of the Delta variant prompted his own disappointment that the public health community hasn’t always been able to assuage the fears of many Americans, who don’t trust the vaccine and worry about potential side effects.

More transparency at the highest levels wouldn’t hurt, said Andrew Noymer, a professor at UC Irvine’s school of public health.

The fact that federal officials have a more dire view of the variant was not a shock to Noymer.

“But what has caught my attention is that, according to these documents the CDC is quite worried behind the scenes,” he said, “perhaps more than they led on.”

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