It had a huge build-up. It seemed inevitable. But Los Angeles County’s rekindled mask mandate appears to have come to a halt. Or at least a pause.
It was a close call, the result of a weeks-long surge in the coronavirus that has for two weeks consistently notched in the “high” level category, as defined by federal thresholds.
And that was getting worrisome for LA County public health officials, who have watched as the average daily rate of COVID-related hospital admissions rose above 10 per 100,000 residents, as workplace outbreaks spike, and deaths rise.
By Thursday morning, the region of 10-million-plus people faced an indoor mask mandate, because the county had been in two straight weeks of “high” transmission as defined by the federal government.
And then came Public Health Director Barbara Ferrer’s announcement: No. No universal indoor mask mandate — for now.
Here’s what the decision means for all of us.
Q: So are we home-free on masks? In other words, does this mean no masks are required anywhere?
HAS: Well, no. Despite the decision against a sweeping indoor mandate, masks are still required in some spaces — health care facilities, transit hubs, on transit vehicles, airports, correctional facilities and shelters.
Q: Should I wear a mask indoors?
HAS: It was strongly encouraged on Thursday. Ferrer said that despite the county’s decision against a mandatory mask-wearing mandate, face coverings are still strongly recommended in locations beyond those where they are required.
“While we are still in this surge, indoor masking is strongly advised everywhere else,” she said.
Scores of Southern California medical professionals echoed her sentiments, too.
“From my standpoint,” said Dr. Thomas Yadegar, medical director of intensive care at Providence Cedars-Sinai Tarzana Medical Center, “the mandate should have probably have gone in effect a few weeks ago.”
Yadegar said his unit has seen an “obvious” uptick in COVID-19 patients — along with increases in outpatient office visits, emergency room visits, and hospitalizations.
Q: Does this mean no mask mandates ever?
HAS: Ferrer added that even though LA County’s COVID-19 transmission appears to be on the decline, the department of public health will continue monitoring the data for any significant increases in community spread.
“Should we see another big increase in cases and increases in hospital admissions, which we don’t think is likely for the very immediate future but could happen a week from now,” Ferrer said. “We would have to go back and reassess.”
Due to reduced transmission and hospitalizations, Public Health is not moving forward with universal indoor masking. Wearing masks in indoor public places is still strongly advised to slow the spread of COVID-19.
— LA Public Health (@lapublichealth) July 28, 2022
Q: If we’re in such a high transmission state, why did officials decide against a mandate?
HAS: Things were certainly getting close. But Ferrer had been showing in recent days a potential plateauing in cases, suggesting that the county might not be in a high-transmission state forever.
Consider, for a moment, the Centers for Disease thresholds that put the county in the “high” state in the first place.
The county moved into the high tier on July 14, when hospital admissions hit 10.5 people per 100,000 residents. The proportion of staffed hospital beds occupied by COVID-19-positive patients, meanwhile, was about 5.4%.
A week later, on July 21, the former metric had climbed to 11.7.
The CDC’s data, which accounts for the seven-day period ending on July 25, shows the county’s hospitalization rate at 11.5 per 100,000 people.
But LA County’s own in-house data, ending on July 27, shows a much lower rate at 9.7 per 100,000 people — which, if confirmed by the CDC next week, would move the county back into medium community transmission.
Bottom line: We could be back in “medium” territory by next week, prompting officials to hold off on a mandate.
Q: How about the rest of Southern California? Are other counties considering mandates?
Actually, Los Angeles was one of the few counties in the state considering such a move—until they held off. After climbing into the “high” category last week, Riverside and San Bernardino counties dropped back into the CDC’s medium community level on Thursday. Orange County continues to be ranked “high,” but local officials have not pushed toward a mask mandate.
Q: Meanwhile, the spread of the virus continues out there. Let’s say someone in your home was exposed to a person who tested positive. What should you do?
HAS: Step one, wear a mask and stock up on at-home rapid tests. Dr. John Swartzberg, clinical professor emeritus of infectious diseases and vaccinology at UC Berkeley’s School of Public Health, says that your response to a COVID exposure or a positive case in your home should depend on how vulnerable members of your house are to severe disease, hospitalizations and death.
He suggests finding a “sweet spot” between isolating and continuing your normal behavior, that matches that vulnerability. Homes with elderly family members, immunocompromised residents, or unvaccinated people should fall on the more careful side of the spectrum, while others might choose to isolate less severely or for less time.
Q: Are you doomed to get COVID if somebody else at home tests positive?
HAS: Even with close contact with infected family members, secondary infection is not guaranteed. So if someone in your home is sick or tests positive, but others in your house aren’t feeling sick and are negative on a rapid test, it’s worth it to try to prevent further exposure.
Masking, opening windows and using a HEPA air filter are all good tools, as well as isolation when space allows it.
“Best practice is not what everyone can do, which is (to isolate the sick family member in) a dedicated bedroom and bathroom,” said Dr. Peter Chin-Hong, UCSF professor of medicine who specializes in infectious diseases.
Q: What’s the best strategy for testing at home?
HAS: “If I was exposed, I would test on day three and day five,” Swartzberg said, pointing out that the incubation period for the newer omicron strains is shorter than previous versions, and many people who get infected feel sick within two or three days . “If you’re testing negative after day five, you’ve probably avoided getting infected,” he said, but you might want to be careful for a few extra days, especially if someone close to you is vulnerable.
The CDC recommends five days of isolation and an additional five days of masking for those with known exposures to COVID.
Q: What if you’ve already had COVID?
HAS: “That one’s easy these days,” said Chin-Hong. “They’re still at risk.” Even if you had COVID as recently as early June, he said, “that’s the superpower of BA.5,” someone who had COVID just four weeks ago is at risk of reinfection, while early in the pandemic those infected could expect up to three months without a possibly reinfection.
Q: Where can I get free rapid tests?
HAS: Every household in the US should be able to order up to 16 free rapid tests from the federal government, through the Covidtests.gov website, after the Biden administration recently announced a third round of free tests kits.
You might also be able to get free rapid tests through your healthcare provider. People covered by insurance through Kaiser Permanente can request free tests, as can those covered by Medi-Cal and Medicare. And most large pharmacy chains have ways to request free tests from their insurance for those with employer-provided plans.
Q: You took a rapid test that showed negative. Are you in the clear?
HAS: Not if you’re experiencing symptoms, says Swartzberg. “If you’ve got a cough, sore throat, runny nose,” he said “then you have a respiratory virus. It may not be COVID, but it could be, and if you have an infectious respiratory disease you should be staying away from other people.
Chin-Hong recommends swabbing both the back of the throat and the nose when doing a rapid test, which might help catch the virus earlier, a common practice in the UK but not yet officially recommended here.
Bottom line, if you or a family member has been exposed and is experiencing symptoms, it’s best to assume you have COVID, even if a rapid test has shown negative in the first days of symptoms.
Staff writers Brennon Dixson, Clara Harter, Tyler Evains, Chris Haire, Harriet Rowan and Ryan Carter contributed to this report. City News Service also contributed.