An unusually long coronavirus surge appears to have peaked in Southern California, with new cases and hospitalization numbers finally starting to decline.
On Wednesday, July 20, there were 2,154 people with confirmed COVID-19 cases in the hospital in Los Angeles, Orange, Riverside and San Bernardino counties. By Monday, Aug. 1, the latest day available, that had ticked down to 1,967.
And in the week ending Tuesday, Aug. 2, health departments in those four counties reported just over 60,000 new cases, down from about 72,000 the week ending Tuesday, July 19.
Dr. Robert Kim-Farley, an infectious-disease expert and professor at UCLA’s Fielding School of Public Health, said those are encouraging signs.
“In the weeks and months ahead, we should continue to see this pattern of decline, and, hopefully, we will come back to a low-level baseline where we can all begin to go back to a more business-as-usual approach,” he said.
The recent case and hospitalization data helped persuade L.A. County officials not to reinstate a universal indoor mask mandate last week, but health officials are still urging people to take precautions.
“We have to understand that we are still at high levels of community transmission, and it behooves all of us to continue to practice good prevention measures, such as being vaccinated, being boosted if eligible and wearing masks in crowded indoor settings,” Kim-Farley said. Such measures, he said, are especially important for people who are older or have conditions that make them more vulnerable to severe disease.
“Also, we have to realize that we can all play our part in helping to drive transmission even lower if we do wear masks, which will then help others who may be more vulnerable,” he said.
“The real curveball could be the rise of other variants in the future,” Kim-Farley said, “but we have to just take those as it comes and adjust our vaccines and our masking behaviors according to levels of transmission of the disease.”
More cases, fewer hospitalizations
The current wave started building in mid-March, when an offshoot of the original Omicron variant — which caused so much illness last winter — became the dominant strain of the virus. That subvariant, known as BA.2, was quickly followed by another cousin, BA.2.12.1, which took over in May.
There was a brief period in June when Southern California’s cases started to dip, but then yet another omicron subvariant dubbed BA.5 roared into the picture. Extremely transmissible and able to evade immune system protections, it was infecting even people who were fully vaccinated or had just recently had an infection.
All told, health departments in Los Angeles, Orange, Riverside and San Bernardino counties have reported almost a quarter-million cases since mid-March — and those are only the ones confirmed by lab tests.
But fewer people got severely sick this time around than previous surges. The recent hospitalization peak saw about 40% fewer people hospitalized with COVID-19 in those four counties than last summer’s delta wave and 75% fewer than the most recent winter omicron wave.
Dr. Thomas Yadegar, medical director of the ICU at Providence Cedars-Sinai Tarzana Medical Center, also said a fair number of patients have what he calls “coincidental COVID,” meaning they came to the hospital for something else but tested positive when they were screened.
Still, Yadegar warns that people shouldn’t have a false sense of security.
“I think there is this kind of misperception out there that COVID has become a minor flu or bad cold,” Yadegar said. “I want to push back on that.”
He said that in his 20 years of practicing medicine, “This is still far worse than any other virus that we have encountered. Yes, we’re not seeing people end up on ventilators or dying at the same rate (as earlier in the pandemic), but it’s still playing a lot of havoc with a lot of patients’ lives.”
He said studies of long COVID show that about 20-30% of patients are still experiencing symptoms months later, and some of those symptoms can be debilitating, even if the patient’s original case was mild.
“Fortunately, the vast majority do get better as time goes by, but I know of patients still dealing with symptoms a year or two after,” Yadegar said.
‘No one can predict this virus’
This year’s parade of new subvariants kept cases on the rise for four straight months, longer than most previous surges. The original omicron surge started in late November 2021 and peaked in early January, for example, while the delta surge started in June 2021 and topped out about two months later.
New variants appear to have been the drivers of recent surges, but there’s also a strong seasonal pattern: Throughout the pandemic, California has seen medium waves in the summer and large ones in the winter.
If this year follows the same pattern, Southern Californians can expect a little respite this fall before things pick back up again in the winter. But, of course, there’s no guarantee that another variant able to find newly susceptible populations won’t come along sooner.
Kim-Farley said he’s “guardedly optimistic” about the future: New vaccines are expected this fall that could not just protect against severe disease but could also be better at preventing infection in the first place, as the vaccines originally did against earlier variants.
Also, he said, that while it’s to a virus’ benefit to evolve to be more and more contagious, it can also be to a virus’ advantage to be less severe, so it’s not killing or debilitating its hosts. So future variants could become milder.
That hasn’t always been the case with this coronavirus, though; Yadegar pointed out that last summer’s delta variant was “vastly more severe” than the original virus.
“The one thing that has been constant is that no one can predict this virus, both in terms of what it may do and how it may affect you if you get infected,” Yadegar said.