After nearly four weeks of social distancing and isolating at home, new modelling revealed Wednesday, April 22, that Los Angeles County hospitals will be able to adequately meet the needs of patients with the most severe cases of the coronavirus, experts said — but only if the county’s 10 million residents continue to adhere to “Safer at Home” orders for at least the next three weeks.
The positive prognosis for “flattening the curve” arrived on the fourth-deadliest day for the county since the crisis began: 66 new COVID-19-linked deaths brought the county’s total to 729 people.
Among deaths reported Wednesday, 48 were over the age of 65 and 38 of whom had preexisting conditions. Thirteen were between 41 and 65, nine of whom had underlying health problems. And two people were between 18 and 40, both with underling conditions.
The mid-day report did not include updated numbers for Pasadena or Long Beach, cities that operate their own health departments.
Also on the high side for the third straight day: the number of new cases — 1,318, which brought to city’s total 16,435. But as recent antibody tests have determined, far more people — perhaps around 4% of the general population — could have already been infected, officials said.
In the latest modelling presented Wednesday, if current isolation measures continued, roughly 11% of LA County residents would be infected by August. If measures were strengthened over the next three weeks, just 5% of residents would contract the virus. And without any social distancing or stay-at-home order 96% of residents would be infected, according to county health officials.
Dr. Christina Ghaly, who heads the county’s Department of Health Services, said there was still significant uncertainty on how things would play out. It’s all largely dependent, she said, on how well people maintained social distancing, still deemed the best tool to fight outbreaks, given that treatments and a vaccine were some time off yet.
“We can’t be absolutely sure,” Ghaly said, “and no model is a crystal ball.”
The good news was that the rate of hospitalizations, currently close to 1,800 patients, was expected to stay about the same, hovering around 1,500 until mid-May.
The number of ICU patients is expected to remain at around 600 if the trendline endures. And available ventilators, once feared to be in desperately short supply, are expected to remain at around 400.
As of Wednesday, 30% of those hospitalized were in intensive care units and 19% were on ventilators.
On April 10, when a similar predictive modelling was presented, the outlook appeared much worse. Ghaly said the county fortunately ended up experiencing the low end of the estimates of cases requiring hospitalization at that time.
“We weren’t sure how rapid that rise would be or how steep that slope would be,” she said Wednesday. “Our current best projection is the number of cases will remain steady. We’ll continue to see an increase, but we will be able to meet the demand for hospital beds.”
The number of deaths at institutional settings continued to rise on Wednesday, now up to 292 people, most of whom lived at skilled nursing facilities.
Health Director Barbara Ferrer said the county continued to work closely with facility operators. Starting Thursday, local efforts will be enhanced by a team with the U.S. Centers for Disease Control and Prevention, arriving to help contain certain outbreaks and share best practices.
Nursing homes were also being provided this week with many more supplies of personal protective equipment, said Ferrer. She conceded that what health officials first knew about the virus has changed — both about how it spreads among asymptomatic people and how prevalent it is in the general population.
“With new information emerging that there are many more people positive for COVID-19 who are not sick, we have to change our strategies,” Ferrer said. “In the past we did our protocols worrying about people who were symptomatic. But it turns out we were wrong.”
Another thing health officials were likely wrong about, admitted Ferrer on Wednesday, was how early the virus could have initially started its spread in Los Angeles.
Ferrer said in January — as they watched outbreak numbers worsening in China — she and her peers in other parts of the U.S. suspected the coronavirus had already arrived in the U.S. But they did not have the diagnostic ability to know for certain.
“In January we were all suspicious that we weren’t seeing cases that were not diagnosed,” Ferrer said.
“We would anticipate that places across the country, especially in travel hubs that we were likely seeing infections much earlier than we could diagnose,” she added. “In hindsight, we maybe should have looked more closely at deaths. But hindsight is 20-20.”