COVID 19 (and more) Update for November 7, 2022-Cases, RSV, the Economy and More

Cases: After months of decline, Los Angeles County health officials have reported a sharp increase in the average daily number of new COVID-19 infections, again raising concerns about an impending winter spike in cases.

But in Pasadena, no such increase has materialized. In fact, the Pasadena Public Health Dept. reported Nov. 3’s 10-day average of new cases was 19.1 cases — compared with Oct. 3’s 10-day average of 19 new cases and Sept. 3’s 10-day average of 24 new cases.

Huntington Health reported an increase in COVID-related hospitalizations, but the 7-day moving average of new hospitalizations was just 3 patients as of Nov. 3.

Outside Pasadena, the county said the seven-day average daily number of infections rose by 10% over the past week, according to the county Department of Public Health, jumping from 988 new cases per day to 1,083.

The number of coronavirus patients in county hospitals has been rising too in recent days, increasing by another 34 people as of Saturday to 453, according to the latest state figures. Of those patients, 44 were being treated in intensive care, down from 50 the previous day.

She also urged residents to receive a flu shot and practice infection-control measures such as hand-washing, mask-wearing and staying home if sick.

According to the county, while 85% of residents aged 5 and older have received their initial COVID vaccinations, only 11% of those eligible have taken advantage of the new bivalent booster, which is designed to combat the currently circulating Omicron variants of the virus.

The county on Friday reported 1,447 new COVID infections and seven new virus-related fatalities. The new cases gave the county an overall total from throughout the pandemic of 3,493,150, while the cumulative death toll rose to 33,999.

Health officials have said the majority of people who die from COVID- 19 are either elderly, have underlying health conditions, or both.

The average daily rate of people testing positive for the virus also ticked up slightly, reaching 5% as of Friday.

On Thursday, November 3rd, the City of Pasadena reported 26 new COVID cases and no new fatalities. Since the pandemic began the city has confirmed 35,632 cases and 434 fatalities. Pasadena has a nearly 100% vaccination rate of persons with at least one dose. More than 93% of Pasadena's eligible residents are fully vaccinated.

LA County reported 1,332 new cases of COVID on Thursday and seven fatalities. So far, LA County has recorded 33,992 deaths and 3,491,716 COVID infections. 80% of LA County eligible residents have received at least one dose of vaccine.

California has 10,519,175 confirmed cases of COVID-19, resulting in 96,185 deaths since the pandemic began. California reported 16,778 new cases on November 3rd and 88 fatalities resulting from COVID infections. 82% of Californians have received at least one dose of vaccine. 

COVID: Health officials eye rise of subvariants- By Luke Money and Rong-Gong Lin II for the LA Times. The rise of new coronavirus subvariants is continuing to erode the grip the Omicron strain BA.5 has held for months, worrying health officials that a winter resurgence of COVID-19 may be ahead.

Eating into BA.5’s long-running dominance are a pair of its own descendants: BQ.1 and BQ.1.1. Like BA.5, the two are subvariants of the original Omicron coronavirus strain that walloped the world last fall and winter.

According to data from the U.S. Centers for Disease Control and Prevention, BA.5 has long accounted for the vast majority of new coronavirus cases nationwide. That these two other strains are increasing in their respective share of cases, however, could indicate they enjoy an additional growth advantage.

But what that ultimately means for this fall and winter — a period when many health experts have already predicted some degree of COVID-19 resurgence — remains to be seen.

At this point, BA.5 remains the most common version of the coronavirus in circulation in the U.S. — making up an estimated 49.6% of new cases over the weeklong period ending Saturday, CDC data show. As recently as a month ago, federal health officials estimated it was the culprit behind nearly 82% of new cases.

During that same time, BQ.1 has increased its estimated share from 1.2% to 14%, CDC data show. BQ.1.1 has swelled from an estimated 0.5% to 13.1%.

There are no epidemiological data currently suggesting that BQ.1 or its descendants are associated with increased disease severity or that they will significantly diminish vaccine protection against serious illness, according to the statement.

Even if BQ.1 or BQ.1.1 don’t make people sicker, that’s not to say their rise is riskless. As has been seen throughout the pandemic, higher numbers of infections threaten to put additional stress on the healthcare system.

Coronavirus-positive patients, whether admitted for COVID-19 illness or with an incidental infection , require particular attention and resources to keep them from spreading the virus to others. Greater community transmission also can sicken healthcare workers, causing staffing interruptions and even shortages.

The circulation of other respiratory illnesses — namely influenza and respiratory syncytial (sin-SISH-uhl) virus, or RSV — also could compound any challenges presented by a coronavirus rebound. Both RSV and the flu are much more active now than typical for this time of year, a development some worry could foreshadow particularly severe seasons.

Because vaccine protection wanes over time, many could be at higher risk, depending on how long it’s been since they were last inoculated.

As of mid-October, the California Department of Public Health said about 21.9 million people — roughly 78% of all vaccinated recipients — were at least six months removed from their last dose.

Uptake of the updated bivalent boosters, designed to protect not only against the original coronavirus strain but also the Omicron subvariants BA.5 and BA.4, also has been slow.

About 11.4% of eligible Californians have gotten the additional dose, state data show. Nationwide, bivalent coverage among eligible recipients is 7.3%, according to the CDC .

In L.A. County, coronavirus cases are no longer declining at the rate seen over the summer and appear to have plateaued. For the seven-day period that ended Monday, L.A. County was averaging 979 cases a day, a 7% increase from the prior week. On a per capita basis, L.A. County was recording about 68 cases a week for every 100,000 residents.

Statewide, cases also may be starting to increase. The daily average number of cases in California rose by 18% for the most recent week of data available, from 2,681 to 3,152. On a per capita basis, the state was recording 56 cases a week for every 100,000 residents.

Viral levels in wastewater — a key metric as many coronavirus cases are being self-diagnosed using at-home tests and aren’t officially reported to public health departments — also are increasing in L.A. County. The level is now 31% of the summer peak recorded in July, up from 21% a week earlier.

L.A. County’s death rate has remained largely stable for the last month, averaging 65 to 84 COVID-19 deaths per week. That’s an improvement from the summer Omicron peak of 122 deaths a week but still well above the springtime lull in May, when weekly deaths fell to a low of 24 COVID-19 deaths a week.
The U.S. averaged roughly 400 COVID-19 deaths a day in October, higher than the springtime lull of about 300 daily deaths.

Thus far, however, they remain at low levels in L.A. County. For the week that ended Oct. 8, both accounted for only 2.7% of weekly specimens in L.A. County.

Vaccines: A new study by Pfizer and BioNTech suggests that their updated coronavirus booster is better than its predecessor at increasing the antibody levels of people over age 55 against the most common version of the virus now circulating.

Federal officials are hoping that the encouraging results will improve what has so far been a dismal public response to the retooled shots. Only about 8 percent of Americans ages 5 and up have received the new boosters from Pfizer and Moderna since they were introduced in September.

Pfizer and BioNTech announced the study results in a news release on Friday. The companies said that one month after getting the new booster, clinical trial participants over 55 had antibody levels that were about four times as high as those who received the original booster. The study measured the levels of neutralizing antibodies against two sister subvariants of Omicron known as BA.4 and BA.5.

R.S.V.: You may have seen respiratory syncytial virus, or R.S.V., in the news recently, as rates of the virus have ticked up across the United States. R.S.V. usually circulates from late December to mid-February. But this year, an early spike in cases is resulting in markedly higher numbers of infections and hospitalizations.

As rising R.S.V. rates coincide with the expected wintertime surge in Covid-19 as well as an early flu season, experts are worried about a “tripledemic” and the strain it could place on hospitals and emergency departments that are already stretched thin.

Here’s what to know about R.S.V., who is most at risk and what you can do to avoid getting sick.

But many experts believe masking, social distancing, school closures and other precautions taken during the first year or two of the pandemic protected most children from exposure to the virus and other germs. “As a result, there are still many children who are less than 3 years old who’ve never been exposed to R.S.V.,” said Dr. James Antoon, an assistant professor of pediatrics and pediatric hospitalist at Monroe Carell Jr. Children’s Hospital at Vanderbilt University in Nashville, Tenn. “The virus is now playing catch-up in all these kids.”

Can adults get R.S.V.? They can. “Adults still get R.S.V. fairly regularly and they can get reinfected multiple times throughout adulthood,” Dr. Martin said. Because adults already have a lot of antibodies against the virus from previous exposures, their illness tends to be much milder. In fact, it can be almost indistinguishable from the common cold or even a mild case of the flu or Covid-19, she said.

Most adults with R.S.V. are able to shake off an infection in a week or two, but seniors and those who have weakened immune systems, as well as those with chronic lung or heart disease, can develop more severe cases. According to the Centers for Disease Control and Prevention, an estimated 177,000 older adults are hospitalized with R.S.V. each year and 14,000 of them die.

What are the symptoms of an R.S.V. infection? In adults and children, R.S.V. typically causes mild symptoms like a cough, runny nose and fever. These appear gradually, four to six days after getting exposed. In young babies, the only signs of an infection may be general lethargy, irritability and a decreased appetite, said Dr. Priya Soni, a pediatric infectious disease specialist at Cedars-Sinai Guerin Children’s in Los Angeles. Parents should also be on the lookout for signs that their child is having difficulty breathing, Dr. Soni said. For example, if an infant or toddler is breathing faster than usual, if you notice more of their ribs or belly moving as they breathe or if their nostrils are flaring, those are all signs that you should take them to see a doctor.

Young children tend to struggle more, not just because their immune systems are still learning to recognize and fight off viruses, but also because their airways are so small, Dr. Soni said. An R.S.V. infection can dramatically increase mucus secretions in the airways, which older children and adults are able to cough or sneeze out. But infants and toddlers do not yet have strong enough muscles to cough up all the extra fluid, so parents or health care providers need to do the job for them by suctioning their airways.

If mucus collects in the small airways in the lungs, it can cause blockages and inflammation known as bronchiolitis, which is one of the most common complications that results in hospitalization. Another outcome of severe R.S.V. in young children is pneumonia. Several studies have also linked severe R.S.V. to an increased risk of recurrent wheezing and asthma later in life. “R.S.V. can be extremely disruptive to young lungs,” Dr. Martin said.

Those at highest risk for severe infections include premature infants, babies under 6 months of age, and infants and toddlers with chronic lung disease or congenital heart disease, as well as children with weakened immune systems and those who have neuromuscular disorders that make it difficult to clear out mucus.

Is there a test for R.S.V.? There are rapid antigen tests and P.C.R. tests to check for R.S.V., but they are typically reserved for young children or older adults, because there is no treatment for an infection if you do not need hospitalization, Dr. Soni said. If a patient is showing signs of a severe infection, a health care provider may also check their breathing with a stethoscope and order a white blood cell count or other tests, such as a chest X-ray or CT scan.

What can you do to avoid R.S.V.? Unlike Covid, R.S.V. can spread when people touch contaminated surfaces. It also spreads through respiratory droplets, Dr. Martin said. So it’s a good idea to disinfect surfaces, particularly in settings like day care centers, where young children are constantly touching things, sneezing on things and sticking them in their mouths.

Premature infants and children with certain medical conditions can also take a monthly monoclonal antibody medication called palivizumab during R.S.V. season to help keep them out of the hospital.

Although several vaccines in clinical trials have started to show promise for R.S.V., none are available yet. That’s why experts recommend more general measures to prevent infection, such as frequent hand-washing — and for those who are sick, staying home.

The Economy: Rent delinquency rates among US small businesses increased significantly this month, a new report shows.

About 37% of small businesses, which between them employ almost half of all Americans working in the private sector, were unable to pay their rent in full in October. That’s according to a survey from Boston-based Alignable, a network of 7 million small business members. It’s up seven percentage points from last month and is now at the highest pace this year, the survey showed.

Chuck Casto, head of research, at Alignable, said that small business owners are resilient but incomes are “basically being eaten away by inflationary pressures.”

The survey of 4,789 small business owners was conducted between Oct. 15 and Oct. 27. The findings partly reflect how inflation is affecting small businesses. More than half say their rent is at least 10% higher than it was six months ago, and in seven say rents have increased at least 20%.

The Federal Reserve on Wednesday raised its benchmark policy rate by 0.75 percentage points for the fourth time in a row as it advanced its long-running battle to bring down persistently high US inflation.

The Federal Open Market Committee voted unanimously to increase the federal funds rate to a new target range of 3.75 per cent to 4 per cent following its latest two-day meeting. The fourth successive rate rise comes as the US central bank tries to stamp out price pressures in an economy that is proving more resilient than expected in the face of its monetary tightening campaign.

Stocks seesawed on Wednesday, but eventually ended the day lower, after Jerome H. Powell, the Federal Reserve chair, dashed investors’ hopes that an end to the central bank’s rate increases may soon be over.

Wall Street’s benchmark S&P 500 index ended the day 2.5 per cent lower and the Nasdaq Composite fell 3.4 per cent after a volatile afternoon of trading.

Stocks had started the day lower as investors braced for the Fed to raise interest rates a further 0.75 percentage points. The central bank followed through on that expectation, but attention quickly shifted to what the Fed was thinking about interest rate increases to come.

The Fed’s initial statement, released alongside its rate decision, appeared to point to a more cautious approach, accounting for the large rate increases that have already happened and noting that it may still take time for the economic effect of those rate increases to be felt.

US stocks sank after Federal Reserve chair Jay Powell cautioned that it was still “very premature” to think about pausing interest rate rises as the central bank delivered its fourth supersized increase in a row.

Those higher loan costs have weakened the home market, in particular. The average rate on a 30-year fixed-rate mortgage, which was just 3.14% a year ago, topped 7% last week for the first time since 2002, mortgage buyer Freddie Mac reported. Nationwide, sales of existing homes have fallen for eight straight months.

Fed officials have emphasized that they need to raise rates significantly to tame inflation, which has caused hardships for millions of households. High inflation has also become a central point of attack for Republicans in the midterm congressional elections.

Yet some economists have said the Fed should soon consider scaling back the fastest pace of rate increases since the early 1980s.

Total nonfarm payroll employment increased by 261,000 in October, and the unemployment rate rose to 3.7 percent, the U.S. Bureau of Labor Statistics reported. Notable job gains occurred in health care, professional and technical services, and manufacturing.

From the New York Times: Two measurements tell two stories about the strength of U.S. employment.

Job alerts: Here’s something pretty much anyone who follows economic data closely can agree on: The U.S. labor market is hot, but cooling.
What’s less clear is just how hot it is, or how fast it’s cooling down. That question matters a lot to Federal Reserve policymakers trying to find a way to bring inflation under control without causing a recession.

Supply and demand-The biggest problem facing the economy right now is that prices are rising much too quickly. That dynamic stems partly from the lingering effects of the pandemic, which continue to disrupt international supply chains, and global forces, like the war in Ukraine, which has pushed up the price of food and energy. Most economists agree that rapid inflation is also at least partly the result of excessive demand: American consumers want more cars, airline tickets and restaurant meals than companies can produce, pushing up prices.

The Fed is trying to tamp down demand by raising interest rates, which makes borrowing money more expensive for consumers and businesses. Yesterday, the central bank announced it would raise rates by three-quarters of a point for the fourth time since June.

That move was widely expected. But experts are less in agreement about what the Fed will do in the months ahead. Some economists argue it should hold off on further rate increases and see whether inflation begins to ease. Others say the Fed should keep going until its efforts clearly have an effect.

Which path policymakers choose depends in part on how Jerome Powell, the Fed chair, and his colleagues view the labor market. If companies keep adding jobs and raising pay, inflation is likely to remain high, and the Fed is likely to remain aggressive in its fight to tame it. If job growth stalls and unemployment rises, the Fed could pause sooner to avoid causing a recession.

So far, the Fed seems firmly on the side of those who see the job market as too hot. Powell said yesterday that any talk of a pause in rate increases is “premature.”

Job openings-For the past year, the Fed has been focused on one measure of the labor market in particular: job openings. Powell has repeatedly noted that there are roughly twice as many vacant jobs as unemployed workers available to fill them.

The logic behind Powell’s attention on job openings is simple. They are a direct measure of demand, since employers typically don’t try to hire when no one is buying their products. And they have a clear connection to wage growth — and therefore inflation — because when lots of companies are hiring, they have to pay more to compete for workers.

Fed officials have been hoping that as interest rates rise, companies would respond by cutting back on recruitment. So far, we’ve seen only limited evidence of such a trend.

Some economists, however, have begun questioning the Fed’s focus on job openings. Other signals, like the unemployment rate, show the labor market is strong, but not nearly as strong as openings would imply.

Quitting time-Which brings us to our second indicator: what economists call quits.

You probably read about the “great resignation,” the surge in people leaving their jobs as the economy re-emerged from Covid-induced lockdowns. The phenomenon was real, but the narrative often missed a crucial element: Most weren’t quitting to sit on the couch. They were taking other, usually better-paying, jobs.

Economists see quitting as a sign of confidence among workers: Changing jobs is a risk, so people avoid doing so if they’re worried about the economy. And since people typically don’t jump employers without a bump in pay, job-switching contributes to wage growth. Data released yesterday from ADP, the payroll-processing giant, showed that people who switched jobs in October saw their pay rise roughly twice as quickly as people who stayed put.

In late 2020 and early 2021, resignations and job openings rose roughly in tandem. But then the number of people quitting began to level off, even as openings kept rising. Americans are still changing jobs more than they were before the pandemic, but only modestly so.
So if openings suggest the labor market is a raging inferno, resignations imply it is more like an uncomfortably hot day.