With mask mandate, L.A. County now leads national battle against the Delta variant

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Los Angeles Times 17 July, 2021 - 07:00am 41 views

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The easily spread strain has been blamed for increases in infections across the country, and it created a new tightrope for public health officials to walk as they seek to balance the need to protect the unvaccinated while acknowledging that those who are can largely resume pre-pandemic life.

While federal and state authorities continue to urge the unvaccinated to take safety precautions and get their shots, L.A. County has gone a step further: turning to mandatory masking in indoor public settings, even for those who are vaccinated, in hopes of turning the tide.

The effect of the new health order, which goes into effect Saturday night, won’t become clear for a few weeks. Should the strategy prove successful, L.A. County could provide a blueprint for blunting transmission without resorting to the business closures and lockdowns that sparked so much frustration and fear over the last 16 months.

If it fails, though — either on account of public apathy or because it wasn’t aggressive enough — officials acknowledge they may have to take additional action.

“Anything is on the table if things continue to get worse, which is why we want to take action now,” Dr. Muntu Davis, the county’s health officer, said this week.

Officials described the mask mandate as a minimally disruptive tactic to blunt rapidly rising coronavirus transmission. But does it make any sense?

Under the county’s order, effective 11:59 p.m. Saturday, masks will be required to be worn in all indoor public settings, such as theaters, stores, gyms, offices and workplaces, and in restaurants when not eating and drinking. Those exempted include children younger than 2.

Though cases and hospitalizations are on the rise nationwide, officials say new infections and hospital admissions overwhelmingly involve unvaccinated people. In fact, more than 97% of patients entering hospitals nationwide with COVID-19 are unvaccinated, said Dr. Rochelle Walensky, director of the U.S. Centers for Disease Control and Prevention.

Walensky said local policymakers might consider additional masking measures “if you have areas of low vaccination and high case rates,” at least until a community’s vaccination rates improve.

About 52% of L.A. County residents are fully vaccinated, and roughly 60% have gotten at least one shot. But given the region’s enormous population, that still leaves millions vulnerable.

New mask mandate takes effect in L.A. County

Dr. Robert Kim-Farley, medical epidemiologist and infectious diseases expert at the UCLA Fielding School of Public Health, said he’s not worried about the pandemic approaching the same level of devastation seen half a year ago, but is “concerned about the trajectory and the speed of the doubling of new cases.”

He said: “Hopefully, this will be the wakeup call for those who are still vaccine hesitant to roll up their sleeves and get vaccinated.”

Kim-Farley said he did not expect officials to restrict business capacity or reimpose physical distancing measures except as a strategy of last resort.

It’s also unlikely that hospital systems would ever become as strained as they were earlier in the pandemic, he said, “because of the fact that the vast majority of those who are elderly — and at greatest risk of severe disease and death — have been vaccinated. Younger people that are coming down with disease will not have the same high rates of severe illness and death.”

He said L.A. County’s universal mask mandate would probably help deter unvaccinated people from being in public spaces without wearing a mask.

The latest maps and charts on the spread of COVID-19 in Los Angeles County, including cases, deaths, closures and restrictions.

Dr. Peter Chin-Hong, an infectious diseases expert at UC San Francisco, said it’s smart to wear masks in crowded indoor settings, especially “with a bunch of people you don’t know.”

Dr. Monica Gandhi, also an infectious diseases specialist at UC San Francisco, said it can be a reasonable policy to require masks when more than five people are hospitalized for COVID-19 for every 100,000 residents. L.A. County is fast approaching that threshold, now reporting 4.6 hospitalizations for every 100,000 residents; a month ago, it was 2.2.

But Gandhi added that the federal and statewide approach to not require masks for vaccinated people is sound, and demonstrates to vaccine-hesitant people the benefits they can enjoy after getting their shot.

She said she’s concerned that taking away the freedom for vaccinated people to be maskless could further discourage those already reluctant to get their shots.

A recent national survey by the Kaiser Family Foundation found that “a small but meaningful share said the easing of restrictions for vaccinated people made them decide to get a vaccine.”

Chin-Hong said he’s heard from other people who found the call for vaccinated people to resume wearing masks a blow psychologically, as they had hoped COVID-19 was behind them. But “we will continue to be in this boat until people get vaccinated,” he said.

He agreed it was unlikely officials would order businesses to reduce capacity or shut down.

“I think the economy needs to go on — and there are enough people vaccinated,” Chin-Hong said.

There may be regional hot spots in California, but hospitals in other parts of the state will probably be able to lend a hand if one region gets overwhelmed with COVID-19 patients, Chin-Hong said.

Yolo and Sacramento counties recommend keeping masks on while inside.

While other California counties are also taking measures to combat Delta, none has gone as far as L.A.

Earlier this week, Sacramento and Yolo counties called on all their residents to voluntarily wear masks indoors while in public. And a cadre of Bay Area health officials — representing Alameda, Contra Costa, Marin, San Francisco, San Mateo, Santa Clara and Sonoma counties, as well as the city of Berkeley — did likewise Friday, saying in a joint statement that the move would be “an extra precautionary measure for those who are fully vaccinated” and “ensure easy verification that all unvaccinated people are masked in those settings.”

Nearly half of California’s residents, or about 19 million people, now live in counties where health officers are recommending or requiring everyone wear masks in indoor settings.

The Delta variant of the coronavirus has taken on a decidedly American feel, mainly targeting those who just won’t get vaccinated.

Over the last week, L.A. County has reported an average of more than 1,000 new coronavirus cases a day — a tally that, though merely a fraction of the sky-high counts seen during previous surges, is still six times as high as what the county was seeing in mid-June. Daily case numbers have worsened: 1,537 new cases were reported Thursday, and 1,902 more were added Friday.

COVID-19 hospitalizations also doubled over that same time period, from 223 on June 15 to 462 on Thursday. More than 8,000 coronavirus-positive patients were hospitalized countywide during the darkest days of the winter wave.

Requiring masks for all, officials said, provides even more protection to those who are vaccinated while simultaneously ensuring that unvaccinated people can no longer skirt indoor face covering requirements.

Each infection prevented, experts say, is one less chance for the coronavirus to mutate in potentially dangerous ways — as happened with the Delta variant.

That variant, which is believed to be twice as transmissible as the conventional coronavirus strains, is a relative newcomer. But since its presence was confirmed in California in April, it’s rapidly become the state’s dominant strain, and accounted for 48.8% of all cases analyzed in June.

In Davis’ mind, the mask policy also has the benefit of being minimally disruptive to businesses and less confusing for residents.

“There’s a clear, bright line in terms of what needs to be done,” he said. “This is an ‘everybody’ moment in terms of wearing your mask indoors, and it’s something we’ll continue to look at and see how things go. But in general, from what we’ve heard from businesses, it’s easier and better for us to do this and it’s much easier for people to understand.”

With new indoor mask mandate, L.A. County is asking the vaccinated to help the unvaccinated.

For some Angelenos, though, the forthcoming rule is just the latest instance of pandemic-induced whiplash.

“I just think it’s crap,” Vanessa Magaña said before boarding the Metro Gold Line train at the Highland Park stop.

Part of her frustration, she said, was that it seemed like the mask rules were dropped too quickly.

“It was too early to say, ‘No mask anymore,’” she said. Still, she said, “If I have to wear it, I have to wear it. It’s just kind of annoying.”

In Glendale, a man in a red “Scarface” baseball cap who gave his name as Tigran G. said the new rules didn’t make any sense to him.

“What’s the point of being vaccinated if you’re still going to wear a mask?” asked the 25-year-old, who was waiting for a friend down the street from a Starbucks.

He said he hadn’t gotten vaccinated because he hadn’t had time and it seemed “too early” to gauge the side effects.

The mask rules will essentially revert back to where they were before the county lifted them prior to the June 15 reopening.

Some welcomed the forthcoming rule. Brandy Muñiz said the news gave her “a little bit of relief, knowing that number of COVID cases is going up and our vaccination rates aren’t.”

If those trends don’t change, “I’m worried that this could lead back to lockdown,” the 31-year-old said.

Peter Hawks, an apprentice at the Three Kings Tattoo shop on Figueroa Street, said tightening the rules was “long overdue.”

“We shouldn’t have dropped the mask mandate,” Hawks, 26, said while sweeping Friday morning. “It was too early. The city always prioritizes money over health.”

Lillian Castellanos, a cardiovascular technologist who lives in Glendale, said she agrees “100%" with the new, across-the-board rule because it’s impossible to tell at a glance who is vaccinated.

“People that aren’t wearing a mask and haven’t gotten vaccinated — how can you tell?” Castellanos said Friday while walking in Montrose. “It’s not like they’re wearing a sign.”

Outside the South Pasadena Senior Center, Adriana Arroyo sat on a bench, chatting with a friend who gave her name as Mary Ann.

“If they stop at the mask, I’m fine with that,” Mary Ann said. But “stop closing stores, hairdressers ... We’ve gone through enough hysterical shutdowns.”

Doing so would ‘ensure easy verification that all unvaccinated people are masked in those settings,’ officials wrote in a joint statement.

While the prospect of closer-to-normal daily life may be an enticing carrot to some, officials said the resurgence of the coronavirus could also act as a stick.

Over the last week, states with some of the highest case rates in the country — Arkansas, Florida, Louisiana and Missouri — “had a higher rate of people getting newly vaccinated compared to the national average,” according to Jeff Zients, the head of President Biden’s task force on the pandemic response.

“Unvaccinated Americans account for virtually all recent COVID-19 hospitalizations and deaths,” he said during a briefing Friday. “Each COVID-19 death is tragic. And those happening now are even more tragic because they are preventable.”

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Luke Money is a Metro reporter covering breaking news at the Los Angeles Times. He previously was a reporter and assistant city editor for the Daily Pilot, a Times Community News publication in Orange County, and before that wrote for the Santa Clarita Valley Signal. He earned his bachelor’s degree in journalism from the University of Arizona.

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Column: UC’s tough new policy on vaccinations is just what we need. No more begging and pleading

Los Angeles Times 16 July, 2021 - 05:53pm

With more than 600,000 people already dead of COVID-19 in the U.S., with the pace of vaccinations slowing and anti-vaxxers becoming more entrenched, virus infection numbers are creeping back up in California and around the country.

Do we want to go back to lockdowns and panic? If not, it’s time to stop begging and pleading with people to be vaccinated and instead toughen our rules and turn up the heat on those deluded, selfish or misinformed people who are unwilling to take that simple, science-backed step.

Two developments this week helped move us in that direction: the decision by Los Angeles County to reinstate its indoor mask rules for everyone, vaccinated or unvaccinated. And the order from the University of California that its students, faculty and other employees must be fully vaccinated before returning to campus for the fall term.

I get it that the mask mandate is disappointing and that it’s confusing for everyone and onerous for the restaurants, shops, offices and other businesses that have to enforce the rules. The situation is especially frustrating for those of us who have behaved responsibly and now are being lumped in with those who have chosen, for whatever reason, not to get vaccinated.

But there’s no alternative. If we can’t keep the virus numbers down through vaccinations, then we have to try to keep the numbers down by stopping transmission.

As for the new UC rules, they’re really much more important — an admirable show of strength and reasonableness in a country that can’t always be counted on for either. The University of California has more than 280,000 students and more than 227,000 faculty and staff members.

The rules not only will dramatically decrease COVID risks on campus but also will send a powerful message around the country that if we want to stop this virus in its tracks, we’re going to have to set different rules for those who are vaccinated and those who are not.

Here’s the broader situation we’re in. More than 150 million adults in the U.S. are now fully vaccinated, which has helped drive the rate of infection down dramatically. But others are refusing. Some are fearful, some are simply lazy. Increasingly, noted the Washington Post this week, what began as “hesitancy” among a subset of the population is hardening into a conservative political movement; to too many people, not getting vaccinated is a sign of strength, of independence, of resistance to liberal orthodoxy. Misinformation is rife.

The Post quoted Rep. Lauren Boebert (R-Colo.) telling a crowd at the recent Conservative Political Action Conference: “Don’t come knocking on my door with your Fauci Ouchie,” she said. “You leave us the hell alone.”

That’s an extremely dangerous, irresponsible message.

The slowing vaccination rate (combined with the reopening of the country and the spread of the Delta variant) are having the expected effect. Coronavirus cases in the U.S. have more than doubled during the last week, and deaths have risen 28%, almost entirely among unvaccinated people. More than a quarter of Americans say they are unlikely to get vaccinated — and that number appears to be rising.

In Los Angeles County, cases have nearly tripled, overwhelmingly among unvaccinated people. COVID-19 hospitalizations were at 223 on June 15 but had climbed to 452 as of Wednesday.

So bravo for the University of California. We need tough measures.

Look at what happened recently in France. President Emmanuel Macron announced Monday that proof of vaccination (or, alternately, a negative coronavirus test) would soon be required to access public events, movies, restaurants, airports and train stations. Within 48 hours, 2.2 million new appointments for vaccinations had been made.

That’s the power of “nudges,” as they’re known. Basically, France — like the UC system — is saying, “We’re not requiring you to get immunized; we’re just telling you that if you do, the world will be open to you.” Call it the “Fauci Ouchie” if you want, but if you haven’t had one, you shouldn’t have the right to congregate in places where you’re putting others at risk and potentially aiding the development of further variants.

In the United States, I suspect big employers will be particularly important in encouraging people to get vaccinated. Some, including Target and Petco, are choosing to do so by offering monetary incentives and other perks.

But the federal Equal Employment Opportunity Commission has said that nothing in federal law prohibits employers from requiring workers to be vaccinated before returning to the office, unless an employee has legitimate grounds not to be, such as a medical reason, a disability or a “sincerely held” religious objection.

No doubt there will be numerous lawsuits over such mandates. But what isn’t there a lawsuit about?

Already a New Mexico corrections officer has sued to challenge his employer’s right to tell him he has to be vaccinated to return to his job, as has a North Carolina deputy sheriff. Arguments against mandatory immunization often center on the fact that the FDA has not yet given its full official approval to the vaccines.

But, I say, bring those lawsuits on. We’ve gotten beyond the “please, please, please” begging stage. It’s time to turn up the heat.

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Nicholas Goldberg is an associate editor and Op-Ed columnist for the Los Angeles Times. He previously served 11 years as editor of the editorial page and was also a former editor of the Op-Ed page and the Sunday Opinion section. While at New York Newsday in the 1980s and 1990s, Goldberg was a Middle East correspondent and political reporter. His writing has been published in the New Republic, New York Times, Vanity Fair, the Nation, Sunday Times of London and Washington Monthly, among other places. He is a graduate of Harvard University.

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