COVID-19 Update for December 12, 2022-Cases, the Economy and More

Cases: From PasadenaNOW: Mask Mandate Looms in LA County, Pasadena Not Seeing Similar Increase in Hospitalizations, Deaths-County Officially Experiencing ‘High' COVID Activity.

Los Angeles County moved into the federal government’s “high” COVID-19 activity category Thursday, sparking stepped-up warnings of widespread transmission of the virus and moving the area closer to another indoor mask-wearing mandate.

Pasadena, which operates its own public health department, is monitoring increased but not ‘high’ category COVID-19 activity.

The County had been in the U.S. Centers for Disease Control and Prevention’s “medium” COVID activity level. But that changed Thursday when the County’s average rate of new infections rose to 258 per 100,000 people — well above the threshold of 200 per 100,000 to qualify the County for the “high” activity level.

County Public Health Director Barbara Ferrer said the move will not trigger a return to any lockdowns or business closures that were imposed at the height of the pandemic. But she warned that being in the “high” category means the virus is rampant in the area, and the odds of being exposed are growing.

She noted that with the current infection rate, there’s an 80% to 90% chance that at least one person is infected with the virus at an event or gathering of 200 people.

Ferrer has said the County will re-impose an indoor mask mandate if it remains in the “high” category and if the County’s virus-related hospitalization numbers reach two thresholds:

  • if the rate of daily hospital admissions tops 10 per 100,000 residents; and
  • if the percent of staffed hospital beds occupied by COVID patients tops 10%.

 

The County has already surpassed the first threshold, with the rate of daily hospital admissions already at 14.8 per 100,000 residents as of Thursday. The percent of hospital beds occupied by COVID patients was 6.9% as of Thursday, still below the 10% threshold.

Ferrer said the health department’s initial projections showed that the hospital bed percentage would reach 10% by Dec. 20, but she said admission numbers appear to have leveled off in the past three days, meaning it may be longer before the figure reaches 10% — if at all.
 
Mask-wearing, however, continues to be “strongly recommended” by the County at indoor public settings. But Ferrer said that even absent a mandate, residents should start wearing them. Masks are still required indoors at health-care and congregate-care facilities, for anyone exposed to the virus in the past 10 days, and at businesses where they are required by the owner.
 
Ferrer said Thursday the County reported an average of 3,800 new infections per day over the past seven days, a 40% increase from the previous week, when 2,700 new cases per day were reported.
 
Daily virus-related hospital admissions jumped by 9% over that week, and daily death reports rose from eight per day to 12.
 
On Thursday, the County reported 3,450 new cases, giving the County an overall total from throughout the pandemic of 3,573,950. Health officials have noted that the officially reported case numbers are an undercount of actual virus activity in the County, since many residents take at-home tests without reporting the results, and many others don’t bother getting tested at all.
 
The County also reported 17 more COVID-related deaths on Thursday, lifting the cumulative death toll to 34,279.
 
According to state figures, there were 1,306 COVID-positive patients in County hospitals as of Thursday, up from 1,293 on Tuesday and up more than 100 from a week ago. Of those patients, 132 were being treated in intensive care units, down from 142 a day earlier. The seven-day average daily rate of people testing positive for the virus was 13% as of Thursday.
 
From the LA TImes: Hospitals in L.A. hit by a ‘tripledemic’-COVID, flu and RSV put a ‘huge burden’ on Southland emergency departments and staff. A “tripledemic” of COVID-19, the flu and RSV is hitting Southern California hard, sending patients to the emergency room in droves and presenting a steep new challenge for a healthcare system already worn thin by nearly three years of the pandemic.
 
“When you have the convergence of three very serious respiratory viruses, it puts a huge burden on emergency departments and also on the hospital itself,” said Dr. Kimberly Shriner, medical director of infection prevention at Huntington Health.At Pomona Valley Hospital Medical Center, the emergency room recently hit a record high number of patients in a single day — 382 — according to Darlene Scafiddi, executive vice president of patient care.
 
To manage the high numbers, the hospital has set up a makeshift flu clinic in an auditorium near the emergency room, staffed with doctors and nurses who can quickly assess and treat patients who can then recover at home.

At the Huntington emergency department in Pasadena, Shriner estimated that twice as many people as usual were coming in daily. For patients who arrive with less severe illnesses or injuries, that can mean “very long” wait times, ranging from six to 11 hours.

Besides the growing number of people coming to its emergency room, Huntington is also being squeezed as it tries to discharge patients to skilled nursing facilities that are also short on staff, Shriner said.

The situation playing out across the Southland is in some ways the manifestation of a long-held fear.

Officials have worried throughout the pandemic about the potential risks of another disease circulating widely at the same time as COVID-19. But while previous “twindemics” failed to materialize in the face of disastrous coronavirus surges, California is now simultaneously contending with a spike in coronavirus transmission, an early onslaught of respiratory syncytial virus, or RSV, and a historically strong start to the flu season.

According to the U.S. Centers for Disease Control and Prevention, the cumulative flu hospitalization rate nationally is higher for this time of year than every season since 2010. The agency considers flu levels in California to be “very high” and among the worst in the country.
Hospitals have also for weeks grappled with RSV, which can cause significant illness, respiratory distress and even death. Young children and older people are particularly at risk.

At the hospital in Orange, “the numbers are really unprecedented,” and the emergency room is seeing more than 400 children each day, said Cunningham, who is also chair of pediatrics at UC Irvine.

At CHOC, to help move children into hospital rooms more quickly, a theater where hospitalized children had been able to watch movies has been repurposed as a “discharge lounge” for those ready to go home but awaiting a ride or instructions for their families. Playrooms have been converted for patients to use. Beds have been set up in the hallway of the emergency room with privacy screens around them, she said. The viral pile-on means that the hospital has to be careful about rooming children together, complicating its scramble for space.

So far, the current coronavirus wave is nowhere near as large as the last two fall and winter surges. And there is optimism that a high level of vaccine coverage as well as the availability of updated boosters and effective therapeutics will keep this surge from reaching those same harrowing heights.

However, the ultimate confluence of COVID-19, flu, RSV and other respiratory illnesses remains unclear.

In Los Angeles County, coronavirus case and hospitalization rates continue to worsen, raising the possibility of a renewed indoor mask order in indoor public settings as soon as early January.

For the first time since summer, L.A. County on Thursday entered the high COVID-19 community level — in which the CDC recommends universal masking in indoor settings. But there are initial signs the rate of increase in cases and hospitalizations is slowing.

The rate of new coronavirus-positive admissions over the last week climbed by 24%, a softer jump than the prior week-over-week increase of 38%. And the share of staffed hospital beds being used by coronavirus-positive patients climbed 23% from the prior week, a gentler increase than last week’s jump of 40%.

Pomona Valley has seen its numbers of COVID-positive patients roughly triple from a month ago, Scafiddi said, and the majority are sick with COVID-19 rather than incidentally infected. Growing numbers of people are being hospitalized for flu and RSV as well.
This surge has hit children and teens differently. As COVID-19 cases spiked last winter, the Pomona hospital closed its pediatric unit to make room for adult patients, according to Scafiddi. This year, as COVID-19 and other viruses are spreading, it has had as many as 18 pediatric patients at a time — triple the usual number for this time of year, she said.

At Huntington, Shriner said that as hospitals brace for another winter with COVID-19, “we certainly know how to handle it better and we’re in much better shape now than we ever were before. But it’s challenging.” She urged people to get their flu shot and take other precautions.

Kids’ medicine harder to find as viruses surge-Rising COVID, RSV and flu cases boost the demand. No need to stockpile, makers say.
By Salvador Hernandez for the LA Times.

As flu season approached, Antonieta Garcia knew it was time to replenish her supply of cough suppressants and fever reducers. But this year, she often walks into a store and finds only empty shelves.

The 44-year-old East Los Angeles mother of two tries to keep a fully stocked medicine cabinet because her 2-year-old is immunocompromised and her 12-year-old has asthma. One cold or flu could mean a trip to an ER, and with a surge in respiratory illnesses driving up demand for kids’ medicine, Garcia said she feels like she’s fighting a war on all fronts.

With COVID-19, flu and respiratory syncytial virus cases rising in children, drugmakers and retailers say it’s soaring demand — not a shortage in supply — that’s leading to empty shelves. And stockpiling by parents who fear they won’t be able to find medicine when they need it could make the problem worse.

Across the country, pharmacies working to restock quickly are struggling to keep up, echoing the early-pandemic shortages of toilet paper , hand sanitizer and some medicines.

Some parents who dealt with those shortages worry about how long shelves will stay empty. Garcia said she now starts every trip to Target or the supermarket at the medicine aisle.

Johnson & Johnson, the maker of Tylenol, said that it is running production facilities 24 hours a day and that there is no shortage of its products in the United States.

Parents’ difficulty in finding over-the-counter cold medication has been due to a surge on the demand side, not any problems on the supply side, the Consumer Healthcare Products Assn. said.

 

 

From the New York Times: As Covid Cases Rise in a Weary Los Angeles, So Does Apathy - Hospitalizations and Covid cases have increased sharply in Los Angeles since Thanksgiving. But fear — and masks — are missing this time around.

As has happened each December, Covid-19 cases are ratcheting up in Los Angeles County, with hospitalizations nearly tripling in the past month — a signal that another mask mandate could be on the horizon.

The region is no stranger to pandemic orders, having experienced stringent lockdowns and a state-imposed curfew in late 2020.

But this time around, even as the numbers in Los Angeles become the highest in California, many have grown weary of warnings and talk of precautions. Covid updates do not elicit the unease they once did — in part because cases and hospitalizations during the current outbreak are nowhere near where they were during the worst stretches. But also because the subject has grown tiresome, residents said.

“I think it’s just kind of run its course with me,” said Kirk Carter, 60, a retired television writer who lives in Los Angeles. “It’s become normalized.”

When Mr. Carter, who is vaccinated and boosted, recently took a trip to New York to visit his daughter, he felt no need to don a mask while on the plane, which he had always found uncomfortable.

“I’m less worried about getting sick by Covid than I am about being inconvenienced by Covid,” he said.

That feeling is reflected across the nation even as it is once again experiencing an uptick in cases in the weeks after Thanksgiving. New case reports and hospitalizations are up by more than 25 percent, and test positivity rates are rising quickly, particularly in major urban areas.

The virus is likely spreading faster than case numbers suggest because people are increasingly relying on at-home tests and are not reporting the results. And epidemiologists warn that it is too early to declare that this winter will be less severe than during the past two years, especially as Americans gather again for the holidays later this month.

While healthy individuals seem less concerned about Covid this December, the virus spread poses serious risks for older people and those who are immunocompromised.

From the LA Times: Home-price dip stirs worry-As equity drops in Southern California, homeowners may curtail spending. By Andrew Khouri

Surging mortgage interest rates threatened to squash Michael and Christine Hawkins’ dream of home ownership. But this fall when the couple saw a Canoga Park condo languish on the market, they devised a plan.

They’d submit a lowball offer they could stomach if they cut back on vacations, shopping and eating out. In a year, when they hoped interest rates would have dropped, they could refinance and free up their budget.

Last month, amid a decline in overall home values, the Hawkinses, both in their 30s, closed on the two-bedroom condo for 7% less than asking. But they may be stuck with a high payment for the foreseeable future, because if home prices keep falling, they might not have enough equity to refinance.

For the first time in a decade, Southern California homeowners, and those across the country, are seeing their equity fall en masse, the result of higher mortgage interest rates that have sapped purchasing power and sent home values down.

Real estate analysts said the loss in equity — which is expected to deepen — could curtail economic growth as people have less to spend on home renovations, pay for emergencies or invest in a business.

The shift in the market is unnerving some recent buyers who told The Times they worry falling prices will trap them in their mortgages and have personal consequences such as tight budgets and delayed retirement.

Since there’s also thousands — often tens of thousands — of dollars to pay in origination and other fees, even those with some equity left often cannot afford to sell or refinance and can become vulnerable to a credit-damaging foreclosure or short sale, particularly if they lose their job or have a medical emergency.

Underscoring the importance of home equity in a society where many lack savings and face eye-popping medical bills, one study found that cancer patients with no equity are more likely to refuse treatment and die than patients with positive equity, who tend to pull money out of their homes and are more likely to accept treatment.

Overall, U.S. homeowners with a mortgage have lost a collective $1.5 trillion in equity since the May peak, an 8% reduction, according to September data from mortgage services company Black Knight. The number of underwater mortgages — those on which someone owes more than their home is worth — has more than doubled, to roughly 450,000 nationwide.

For now, the number of people with little to no equity is tiny compared with the aftermath of the Great Recession, even if it’s rising.
In 2011, an estimated 30% of mortgaged U.S. homes, or 16 million, were underwater, according to Black Knight data. At the end of September, that percentage stood at 0.84%, about back to where it was at the start of the pandemic.

Those most at risk are people who purchased this year.

Black Knight data show 8% of U.S. households who bought a home with a mortgage in 2022 are already underwater, while nearly 40% have less than 10% equity.

Andy Walden, vice president of research at Black Knight, said he expects more people will fall underwater in coming months as home price declines continue. But the ranks of people with very little to no equity is unlikely to approach levels seen during the last housing bust.
That’s in large part for two reasons, Walden said: Prices shouldn’t fall as much this time around, and people had more equity to begin with. Both those factors are in part due to tighter lending standards imposed after the 2007-08 financial crisis. And a steady rise in home prices since 2012, along with a 43% pop during the pandemic, also buoyed homeowner balance sheets.

According to a recent Reuters survey, economists expect a median decline from peak to trough of 12%, averaged across major U.S. metro areas — about one-third of the drop seen after the early 2000s housing bubble burst.

Estimates within that survey, however, were as high as 30% for today’s declines.

'Black Knight recently modeled what a 15% national decrease would look like. An estimated 3.7% of home mortgages, or 1.9 million, would then be underwater, putting those homeowners at heightened risk of foreclosure. Overall, mortgage holders would see $4.5 trillion in equity erased.
Boston University economist Adam Guren said falling home prices cause consumers to cut back, mostly because they have less equity to tap and spend through home equity lines of credit and cash-out refis, but also because as prices decline some people feel poorer.

Guren, who has studied the so-called housing wealth effect, said a 15% decline is a “pretty big” assumption, but said research suggests it would cause consumers to reduce spending by roughly $193.5 billion to $322.5 billion.