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California Prepares For Winter COVID-19 Outbreak;  if not from Omicron, then from Delta

California is bracing for a winter outbreak of COVID-19 – if not the newly identified Omicron variant, then the Delta variant, which still poses a serious threat and has already caused outbreaks in other states.

It is still far from clear what kind of increase California will experience, and the state is doing better than other parts of the country. But officials say they want to be ready.

Surge planning is also well underway in central California, which recently experienced a borrow from COVID-19-related hospitalizations, falling nearly 30% since mid-November.

Still, the most populous county in the San Joaquin Valley, Fresno, has a COVID-19 hospitalization rate more than three times that of Los Angeles County, and Fresno officials expect the winter surge. either bad again.

“An anticipated winter wave … could strike in the coming weeks,” said Dr Rais Vohra, acting health officer for Fresno County. But unlike last year, there are no plans for alternative care sites or cots at the convention center. “So if we have a raise, we’re really just left with the resources that hospitals can leverage just on their own campuses. “

If hospitals are extremely busy, they may be forced to implement crisis care standards, Vohra said, potentially forced to ration healthcare to patients based on who is most likely to survive.

“December is going to be a very critical month for us to watch the numbers,” Vohra said. “Because if we get a winter wave, I think it will appear during the month of December. And if it does start, it can last through the winter months, because that’s exactly what happened last year. “

Nursing homes have become an area of ​​interest in Los Angeles County. The county public health department on Monday ordered that all residents, workers, and skilled contractors of nursing homes who may encounter residents must take a coronavirus test once a week, regardless of their immunization status, between December 15 and January 31.

In addition, all visitors to these nursing homes will be required to provide a recent negative coronavirus test before entering. Rapid test kits will be made available to establishments. People who have recovered from a coronavirus infection in the past 90 days will not need to test every week or show proof of a negative test to enter a nursing home.

It is still too early to know for sure whether the rates of coronavirus cases will rise in California following Thanksgiving rallies. But officials in at least one county, San Diego, suspect that a slight increase in locally reported cases late last week could be the initial sign of an increase in transmission linked to Thanksgiving.

“Increases like these after the holidays are not unexpected,” San Diego County deputy public health officer Dr. Cameron Kaiser said in a statement.

“Thanksgiving just happened. People just had their gatherings. And sometimes it takes a long time for people to test, ”said Dr Regina Chinsio-Kwong, assistant health worker for Orange County. “We can see an increase [in cases], and maybe we won’t. But it’s important for all of us to take precautions, as we see other states seeing an increase in cases, and we want to protect our loved ones. “

Health officials have suggested a multi-pronged strategy for a safer vacation – getting vaccinated and boosted, testing regularly and potentially reducing holiday gatherings by limiting guests to those who are vaccinated, keeping them smaller, and taking measures to reduce the risk, such as keeping them outdoors.

For the celebrations scheduled for December, “you might want to narrow that down to smaller, safer gatherings,” Chinsio-Kwong said. “I hope most of the guests are vaccinated and even then really limit the number of people who are going to gather… or have the gathering outside.”

People should also consider testing more frequently, given the wide availability of coronavirus testing by healthcare providers as well as rapid tests that can be purchased at a drugstore and taken anywhere, with results available in 15 minutes.

For example, it makes sense for older people to ask guests – including those who are fully vaccinated and boosted – to get tested with a rapid test before entering their homes, said Barbara Ferrer, county public health director. from Los Angeles.

“We have to be careful – as careful as possible while we get more information about Omicron. But I also want to note: Delta [is still] highly contagious, ”Ferrer said.

Although vaccinations reduce the risk of infection and serious illness, it is still possible for people who are fully vaccinated to become infected and pass the virus on to others.

“And when we travel, we have to be more careful. And we have to test, test, test, ”said Chinsio-Kwong.

Testing for the coronavirus is free in California to anyone who needs it, and everyone should get tested if they experience symptoms, regardless of their vaccination status, according to the California Department of Public Health. Free test sites can be found on the state website,

The Los Angeles County Department of Public Health has started offering free rapid tests to inbound international passengers. Orange County will begin offering free test kits to inbound air passengers at John Wayne Airport on Wednesday, where they can send their sample via FedEx for analysis. Orange County also allows residents and people who work there to request free tests online, which come with a prepaid return.

In Los Angeles, a coronavirus test site has reopened at Dodger Stadium.

LA County is demanding that residents who test positive for the coronavirus, or that a health care provider suspects they have been infected, go into self-isolation and notify their close contacts that they have been exposed. People must remain in their place of isolation, except to receive necessary medical care.

People should self-isolate for at least 10 days since the onset of symptoms or, if they were not, 10 days after the date of their first positive coronavirus test.

There are several signs of progress in the fight against COVID-19.

Health officials across California are reporting an increase in interest in vaccinations, including among young children, as well as booster shots.

“I’m really happy to see that we’ve seen an increase in demand for vaccines, at least after the Thanksgiving holiday,” Chinsio-Kwong said. Concerns over the spread of Omicron may also have helped people finally decide to get the vaccine or get the vaccine.

And some regions are now reporting sufficient supply and resources for those newly infected to be treated with monoclonal antibodies, a treatment for COVID-19 that can counter the coronavirus before it can start destroying organs in the body. Monoclonal antibodies should be administered in a medical facility by intravenous infusion.

“At this point, our supply is actually exceeding demand” in Fresno County, Vohra said. “While we were very concerned at the beginning that we didn’t have enough providers donating the monoclonal antibodies, today we have over a dozen fully functional clinics operational with monoclonal antibodies. “

The National Institutes of Health say monoclonal antibodies can be used to treat mild to moderate COVID-19 in outpatients at high risk of progression to serious illness. But drugs only work if given early – it’s usually too late to get monoclonal antibodies once an infected person has trouble breathing and suffers from pneumonia, Vohra said.

Per 100,000 people, Fresno County has 20 hospital patients with COVID-19, while Los Angeles County has 6, and Orange and Ventura counties have 5. The San Francisco Bay Area has a rate of 4.

Other counties in Southern California have higher hospitalization rates. San Diego County has a rate of 9; Riverside County, 10; and San Bernardino County, 16. Some experts say it is a sign of concern when the rate is 5 or worse.

Most counties in California are reporting heavy or high transmission of the coronavirus, the two worst levels on the US Centers for Disease Control and Prevention’s four-point scale.

Los Angeles Times

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