COVID-19 Update for January 16, 2023

Cases

COVID fatalities hit a season high-Rise in L.A. County comes despite a drop in new cases. Experts suggest reasons for it. By Luke Money and Rong-Gong Lin II for the LA Times. The number of COVID-19 deaths reported weekly in Los Angeles County has hit the highest point of the season, underscoring the continued deadly risks of a disease that has ripped through the community for nearly three years.

L.A. County recorded 164 COVID-19 deaths for the seven-day period that ended Wednesday, a new high that exceeds the summer peak of 122 deaths for the week that ended Aug. 6. That tally was the worst in 10 months. The rolling weekly death tally declined slightly for the week that ended Thursday, to 163. But the distressing development comes even as other metrics show a relatively promising picture. L.A. County’s latest death tally is a fraction of last winter’s maximum, when 513 deaths were reported for the week that ended Feb. 9.

The number of coronavirus-positive patients hospitalized statewide and in L.A. County has remained substantially lower than last winter and is showing early signs of decreasing from a potential early winter peak.

A feared COVID-19 wave that officials warned could crest following travel and gatherings over the winter holidays has also failed to materialize. Case rates in L.A. County and across California have fallen in recent weeks, as have coronavirus levels in wastewater.

Still, the recent increase in deaths is concerning. L.A. County has seen more weekly COVID-19 deaths this winter than last summer, despite having significantly fewer coronavirus cases officially reported.

One obvious culprit is the continued proliferation of at-home tests, the results of which are not reliably disclosed to public health authorities. The extent of this reporting gap is impossible to know, but some officials estimate the number of infections is roughly five times the official counts.

The county’s autumn low was 43 COVID-19 deaths in the first week of November, which rose to 153 for the week that ended Dec. 23. Weekly deaths temporarily declined but then rose after winter break, posting new seasonal highs this week. It’s unclear why deaths are higher than in the summer, and Ferrer said the county will probably have to review medical records to see what trends emerge. One possibility is that people dying from COVID-19 more recently were also sick with other respiratory viruses, such as flu and RSV, that weren’t circulating as widely earlier.

Another explanation could be that older residents are more vulnerable because they are far removed from a prior infection or vaccine dose. Only about 38% of eligible county residents 65 and older have gotten the updated bivalent booster — available since September — a figure Ferrer called “sobering.”

Older residents are also more likely to have underlying health conditions that put them at higher risk of developing severe illness from COVID-19 and other respiratory viruses, Ferrer noted.

That California encountered a COVID-19 surge that’s considerably milder than the prior two winters is promising.

But the next few months are still uncertain. Officials have warned that the rise of a new coronavirus subvariant could threaten to reverse trends, as has happened several times. The Omicron subvariant XBB.1.5 , perhaps the most infectious strain yet, has gained a foothold in California — and its spread could send case counts climbing.

Vaccines: For seniors, a booster effect-Those who received Omicron-targeting shots were less likely to be hospitalized, Israeli researchers say.
INITIAL RESULTS from a real-world test of vaccine boosters targeting the Omicron variant that were given to people 65 and older suggest they are more effective than had been documented, the research found. ( Pfizer ) By Melissa Healy for the LA Times.

In the first real-world test of vaccine boosters specially designed to protect against the Omicron variant, Israeli researchers have found that people 65 and older who got an updated jab were 81% less likely to be hospitalized with COVID-19 than those who did not.

The preliminary findings, posted to a website established by the British medical journal Lancet, have not yet been through the peer-review process. They are based on the medical records of more than 85,000 people 65 and older who got a dose of Pfizer and BioNTech’s retooled mRNA booster and more than 537,000 others in the same age group who did not get the shot.

Over a 70-day period between late September and mid-December, 297 people in the larger, unboosted group were hospitalized and 73 died. During the same period, six people in the boosted group were hospitalized and one died. Israeli researchers determined that the boosters reduced a recipient’s risk of hospitalization to about one-fifth that of an unboosted person.

Those results suggest that — in the initial weeks after vaccination at least — the Omicron-specific vaccines are even more effective than had been documented to date. The U.S. Centers for Disease Control and Prevention had assessed their efficacy in preventing hospitalization at between 31% and 73%.

The Israeli findings also suggest that the new boosters may help in fending off COVID-19 deaths as well as hospitalizations. As a statistical matter, however, the small number of deaths in the study population makes it difficult to draw such a conclusion with high confidence.

New viral strain back East could be a threat here- Omicron subvariant XBB.1.5 is more contagious and more resistant to immunity.
By Corinne Purtill for the LA Times.

You may have come home with it after a recent trip to New England. Or you may have gotten it from that friend or family member who flew in from New York over the holidays.

The newest Omicron subvariant of concern is XBB.1.5, and it has arrived in Southern California. This version of the coronavirus is more contagious and more resistant to existing immunity than any of it predecessors.

Along with a related subvariant called XBB.1, XBB.1.5 is a combination of two versions of the BA.2 subvariant of Omicron. Both parents are particularly good at binding to the ACE2 receptor — the part of the cell the virus’ spike protein attacks to initiate an infection — and their descendants seem to have inherited that talent.

In the final week of 2022, about 40.5% of the SARS-CoV-2 coronavirus specimens circulating in the U.S. were of the XBB.1.5 variety, according to the federal Centers for Disease Control and Prevention. It’s especially prevalent in the Northeast, where it first surfaced in early November and now accounts for more than 72% of cases.

XBB.1.5 has so far made less of an impact in the region that includes California, Nevada, Arizona, Hawaii and the Pacific islands, where its coronavirus market share is 9.2%, according to the CDC. (It’s even less prevalent in mountain and Midwestern states from Utah to Ohio, Michigan and Minnesota.)
In Los Angeles County, as in most of the country, the BQ.1 and BQ.1.1 versions of Omicron still dominate, said Dr. Paul Simon , chief science officer for the Los Angeles County Department of Public Health.

Two weeks ago, XBB.1.5 accounted for about 5% of coronaviruses in the county, Simon said. But the county’s data lag real life by about two weeks, he said, and he expects to see a jump in XBB.1.5’s prevalence — and in the total number of coronavirus infections — in the last numbers of 2022.

And when it comes to survival of the fittest, XBB.1.5 has several things going for it. It’s the most infectious subvariant to date. It dodges the immunity conveyed by a vaccine, booster shot or previous infection more effectively than other subvariants . And as was the case with the Delta and original Omicron variants, it emerged in late fall — just in time to proliferate during the frequent indoor gatherings of the holiday season.

XBB.1.5 isn’t just making its mark in the United States. It’s rapidly displacing other Omicron subvariants globally, the World Health Organization confirmed Wednesday.

Though the new strains’ characteristics make it more likely that fully vaccinated or previously infected people will test positive for an infection, the shots are still effective at preventing serious disease, Simon said.

Los Angeles County still has a lot of opportunity to weaken its transmission chains. Disappointingly few people have elected to get the new bivalent boosters , Simon said — only slightly more than one-third of people 65 and older and one-fifth of younger adults have rolled up their sleeves for shots that target Omicron along with the original version of the virus.

XBB.1.5 a worry among health officials-This may be the most infectious Omicron subvariant yet. Here’s what experts say. By Luke Money and Rong-Gong Lin II for the LA Times.

The latest Omicron subvariant — perhaps the most infectious yet — has gained a foothold in California, a potentially problematic development given the possibility of a post-holiday spike.

However, it’s unclear whether the circulation of this latest strain, XBB.1.5, will alter the trajectory of the COVID-19 pandemic.
A slew of alphanumerically designated coronavirus subvariants, each more easily spread than the last, surfaced last year. Those emergent strains, while disruptive, did not come close to spawning the same sort of devastation seen in earlier waves.

But much remains unknown about how — or if — XBB.1.5 may affect disease severity or whether generally waning immunity from vaccines or a previous brush with the coronavirus will leave the population more exposed to infection.

XBB.1.5 “is the most transmissible subvariant that has been detected yet,” said Dr. Maria Van Kerkhove, the World Health Organization’s technical lead on COVID-19. “We are concerned about its growth advantage, in particular in some countries in Europe and in North America — particularly the Northeast part of the United States, where XBB.1.5 has rapidly replaced other circulating variants,” she said during a news conference last week.

In the Northeast, where the subvariant is the dominant circulating strain of the coronavirus, COVID-19-positive hospital admissions have risen in recent weeks and now surpass levels from last summer’s wave, according to data from the U.S. Centers for Disease Control and Prevention.

But given the subvariant’s growth advantage, officials say, the trend warrants a close examination. “We can’t attribute the increase in hospitalizations to XBB.1.5 yet, but we are working with U.S. CDC colleagues closely, and we have asked them for a detailed risk assessment of XBB.1.5 as well — just as we would with any country and any subvariants that are circulating,” Van Kerkhove said. “We need to go deeper and look at the reasons for the increases in hospitalization and determine what is happening.”

Despite its growth elsewhere, XBB.1.5 is nowhere close to dominant in California. The state Department of Public Health estimates it accounts for about 7.8% of cases — the fourth-most-common subvariant circulating in the Golden State. However, the share of cases attributed to it has seemingly risen in recent weeks. In the region that includes California, Nevada, Arizona, Hawaii and the Pacific island territories, an estimated 7.6% of coronavirus cases over the last week were thought to be XBB.1.5, up from 2.4% in the week leading up to Christmas, CDC data show.

XBB.1.5 is a descendant of XBB, which is a recombinant of descendants of the Omicron subvariant BA.2.

In Los Angeles County, coronavirus cases remain high but have been declining since early December after a Thanksgiving-fueled wave. But officials have warned about the possibility of a second peak stemming from winter holiday gatherings and travel.

The L.A. County Department of Public Health is urging people returning to work or school from winter break to mask up in indoor public settings for at least 10 days. That span is the rough incubation period for the coronavirus — the time between when someone is exposed and when they might be contagious, even if they don’t develop symptoms. Doing so could blunt the severity of a wave this month, officials said.
For the seven-day period that ended Tuesday, L.A. County recorded 2,058 cases a day. Per capita, that’s 143 cases a week for every 100,000 residents. A rate of 100 or more is considered high.

The latest case rate represents a 12% decrease from the prior week. Hospitalizations statewide have stabilized after an autumn rise. As of Monday, 4,159 coronavirus-positive patients were hospitalized in California, a 6% decrease from two weeks ago. That figure includes those hospitalized with COVID-19 and a larger segment of patients who test positive after seeking care for other reasons. Officials this season also haven’t had to deal with the late emergence of a dramatically different variant, as they did with the initial version of Omicron in the autumn of 2021, which rapidly spread over the Thanksgiving and winter holidays.

The Economy: Inflation in U.S. may not be so bad after all-Data dating to 1900 suggest that today’s explosion in prices could be short-lived.
By Rich Miller for Bloomberg

The failure of forecasters to foresee the surge in inflation coming out of the COVID-19 pandemic has led many to question the efficacy of the macroeconomic models they use to try to understand what’s going on in the economy.

But maybe the problem is not the models per se but the data that are fed into them. Traditionally they have covered economic developments since World War II and the correlations and patterns that period has exhibited.

Columbia University professor Stephanie Schmitt-Grohe's analysis of the recent run-up in inflation to multi-decade highs. And her number crunching — which stretches back to 1900 — suggests that today’s explosion in prices may not be quite as worrying as many fear.

Inflation was much more variable — widely swinging up and then down — from 1900 to the war years. That raises the possibility that the latest burst of prices may prove as ephemeral as back then and not become ingrained in the economy, as it did from the late 1960s through the 1970s.
The last time the world suffered a pandemic, in 1918, inflation was on the rise. But by 1921 it had collapsed: Prices fell 11% that year.

When Schmitt-Grohe ran her model using data from 1955 to 2021, it showed a 2.5-percentage-point increase in what she called the permanent component of inflation above the Fed’s 2% price target.

When the input was extended back to 1900, the rise was just half a percentage point — a markedly easier price problem for Fed Chair Jerome H. Powell and his colleagues to solve.

That doesn’t mean they shouldn’t raise interest rates to curb the price run-up, Schmitt-Grohe said.

In a separate presentation to the conference that day, Kenneth Rogoff of Harvard used data going back to 1300 to argue that the global economy is unlikely to return to a regime of ultra-low interest rates once the pandemic has passed.

While yields have been declining for centuries, the drop has been at a glacial pace. The steep fall seen in the wake of the 2007-09 financial crisis — which saw yields on some bonds turn negative — was an anomaly that’s now being reversed.

He maintained that a variety of factors — including increased government deficits and debt and upcoming investment to combat climate change — will raise rates on balance above the low levels seen in the years following the financial crisis.

This isn’t the first time Rogoff has reached way back in history to understand the present and forecast the future. In his 2009 “This Time Is Different” book with Carmen Reinhart, Rogoff used eight centuries of data to argue — correctly — that the economic recovery from the financial crisis would be slow and protracted.

Not sure what to make of this: From Peter Coy for The New York Times: Attendance at the world’s biggest conference of economists was down by half this year, and that had some attendees worrying that the annual conclave was at risk of unraveling like a knitted sweater. People who were disappointed not to see their friends at this year’s Allied Social Science Associations conference in New Orleans would be less likely to attend next January’s conference in San Antonio, the theory went, leading to even lower attendance in San Francisco in 2025, and so on in a downward spiral with no obvious stopping point.

That would be bad. The annual three-day meeting is the Coachella of economics. It’s a be-in and a teach-in. In place of music, art and other earthly delights there are PowerPoint presentations featuring innovations in econometrics. Past Nobel laureates rub shoulders with future ones. In any given time slot there might be 60 simultaneous sessions on how economics can fight climate change or reduce income inequality or help people save for retirement or rein in the tech giants. Here’s one I chose at random: Friday, 2:30 to 4:30, Bacchus Room, New Orleans Marriott: “Incentives for Efficient Household Electricity and Water Consumption.”

For economists, this is heaven itself. In a typical year the annual meeting of the Allied Social Science Associations used to draw around 13,000 of them, of which about 30 percent represented institutions outside the United States. The American Economic Association was and is the anchor organization. There are 64 other participating organizations, including the African Finance and Economics Association, the Association of Christian Economists, the Society for Benefit-Cost Analysis and the Union for Radical Political Economics.

Things felt different this month in New Orleans, where the allied associations held their first in-person conference since January 2020, which was right before Covid struck. Hotel and restaurant invitations were easier to get. The hallways were less crowded. Fewer sessions were standing room only. Attendance was a little over 6,000, according to Peter Rousseau, an economist at Vanderbilt University who is the secretary-treasurer of the American Economic Association. (Rousseau said he thinks the conference is still the world’s biggest; I can’t find any official ranking.)

The big factor depressing attendance this year was Covid, which had two effects, one temporary and one most likely permanent. The temporary way is that some people stayed away from New Orleans because they were sick with Covid or were worried about catching it.