LOS ANGELES (CNS) - Thanks to decreased case numbers and changes implemented by the state in response to vaccination efforts, Los Angeles County officials say they are preparing to advance to a less-restrictive tier of the state's COVID-19 economic reopening blueprint as early as next week.
But whether the county will approve all the reopenings permitted in the “red'' tier of that blueprint -- such as indoor dining – remained unclear.
Moving from the restrictive “purple'' tier into the “red'' tier will authorize the county to increase capacity limits at retail establishments and reopen indoor dining, fitness centers and movie theaters. However, the county is not bound by the state guidelines and could continue to impose stricter rules.
For instance, while the county currently allows outdoor dining in the “purple'' tier, it still forbids restaurants from turning on television sets on their patios, as a way of preventing gatherings of sports fans. The state has no such restriction on restaurants.
County Public Health Director Barbara Ferrer said Monday that while the county is fully committed to implementing one key element of the “red'' tier -- the reopening of in-person classes for students in grades 7 through 12 - - she would only say health officials are in discussions with the Board of Supervisors about other business reopenings. And she again insisted that in-person dining at restaurants presents a high risk of COVID-19 transmission.
“We are working with the Board of Supervisors and all of our sectors to plan for what will be a sensible and safe reopening as permitted by the state, but as appropriate for our county,'' Ferrer said. “And we'll be sure to share that information not only with all of you but really importantly with all of the sectors in a very timely way later this week.''
She said the county is working “to make a reasonable plan for how to move forward.''
While discussing possible reopenings under the “red'' tier, however, Ferrer pointed to a recent study by the U.S. Centers for Disease Control and Prevention that specifically discussed the danger of COVID spread posed by “on-site dining at restaurants.'' The county has been reticent at times during the pandemic to allow on-site dining -- indoors or outdoors -- leading to lawsuits filed by individual restaurants and the California Restaurant Association.
“As we plan to move into the `red' tier, where additional reopenings will be permitted, we're looking closely at the science to understand what practices can help reduce community transmission of COVID-19,'' Ferrer said.
According to Ferrer, the CDC study evaluated government policies in more than 3,000 counties and their impact on COVID case and death rates.
“The study found that allowing on-site dining at restaurants is associated with significant increases in case growth rates ... after reopening, and increases in death rates 60 to 100 days after restrictions had been lifted,'' Ferrer said.
She added: “Allowing on-premises restaurant dining was associated with increases in county-level case and death rates, and that's something that we'll need to take into account as we begin more reopenings in our restaurants. Mask mandates and prohibiting on-premises dining at restaurants have been shown ... to limit potential exposures to the virus, and that resulted in less community transmission.''
The county was initially anticipated to advance into the “red'' tier later this month, with the rate of new daily COVID-19 infections expected to fall below the state-mandated threshold of 7 cases per 100,000 residents as early as Tuesday. If the county maintained that level for two weeks, it would move out of the “purple'' tier and into the “red'' tier.
The state, however, changed the thresholds for advancing through the four-tier Blueprint for a Safer Economy last week, taking into account the volume of vaccines being administered in hard-hit, lower-income communities across the state. The new thresholds could take effect as early as this week, when the state reaches the milestone of administering 2 million vaccine doses in those hard-hit neighborhoods.
When that happens, advancing to the “red'' tier will require a county to have a new case rate of 10 per 100,000 residents -- a rate Los Angeles County will have already met for the required two weeks. Ferrer said that means the county will likely advance to “red'' by the middle of next week.
Under the “red'' tier, state guidelines also allow capacity to be increased to 50% at retail stores, while movie theaters, museums and aquariums could open at 25% capacity. Indoor dining at restaurants is permitted up to 25% of capacity, and indoor fitness centers at 10% of capacity. Again, all of the guidelines are subject to the approval of the county.
Despite continued improving conditions, Ferrer warned that the downward trends aren't guaranteed to continue, and offered a reminder of the pandemic's grim toll.
“The Thanksgiving and winter holidays provided us with ample evidence about the dangers of travel and gatherings,'' she said. “We had made great progress, late summer and early fall, and we lost a lot of ground over the holidays. The consequences in our community were horrific. It's estimated that one out of every three county residents knows someone that they were close to that passed away or was hospitalized with serious illness from COVID-19.''
The county reported another 13 COVID-19 deaths on Monday, lifting the countywide death toll from throughout the pandemic to 22,041.
Another 880 cases were announced by the county, while Long Beach health officials added 41 more and Pasadena 10, raising the cumulative pandemic total to 1,204,069.
Numbers of new deaths and cases are typically low on Mondays due to lags in reporting from the weekend.
According to state figures, there were 1,119 people hospitalized in the county due to COVID as of Monday, with 334 people in intensive care.
As of Friday, 2,415,460 doses of COVID vaccine have been administered in the county. That includes 814,593 second doses, representing the number of people who have been fully vaccinated.
The county this week is expected to receive about 312,000 doses of COVID-19 vaccine, its highest weekly allotment to date. Health officials are hoping the number will continue to increase as more people become eligible for shots and as more businesses and activities reopen, leading to more mingling of residents.
Roughly 1.7 million essential workers, including teachers, became eligible for vaccines last week, on top of the health care workers and residents aged 65 and over who were already eligible.
And starting March 15, the county will adhere to new state guidance that expands eligibility to everyone aged 16 to 64 with an underlying health condition that makes them susceptible to severe illness or death from COVID-19.
The state guidance says vaccinations will be offered to people between ages 16 and 64 who suffer from:
-- cancer;
-- chronic kidney disease;
-- chronic pulmonary disease;
-- Down syndrome;
-- weakened immune system from solid organ transplant;
-- pregnancy;
-- sickle cell disease;
-- heart conditions;
-- severe obesity; and
-- Type 2 diabetes mellitus.
Also becoming available for vaccines will be anyone 16 or over who suffers from a “developmental or other severe high-risk disability'' that leaves the person susceptible to serious illness or death from COVID; if acquiring COVID will limit the person's ability to receiving necessary ongoing care or services; or if the disability would hamper the person's ability to be treated for COVID.
County Chief Science Officer Dr. Paul Simon said last week county officials are still awaiting more guidance from the state on how to determine who will fall into that eligibility category.
He said that, ideally, people with such disabilities or health conditions would be able to get the vaccine from their own doctors.
“At a large community (vaccine site), where people are presenting and we don't know anything about their medical history, it's challenging,'' Simon said. “I think we might have to rely on a letter from the provider, of course, those letters could be forged.''
The city of Long Beach began offering vaccines to those aged 16 to 64 with physical or developmental disabilities beginning Monday – under permission granted by the state to start the program a week early.
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