latimes--2020-11-29--California sets record with most COVID-19 hospitalizations since pandemic began

California has more people hospitalized with COVID-19 than at any time since the pandemic began , an ominous sign that comes as officials warn of further virus spread after the long holiday weekend .
The rising numbers raise new concerns about hospitals filling up in the coming weeks , which has been predicted as coronavirus cases surge to unprecedented levels across the state and , particularly , in Los Angeles County .
A wave of new restrictions on personal gatherings and capacity levels at stores takes effect Monday .
But there are concerns that the surge will get worse before @ @ @ @ @ @ @ and Black Friday shopping — which , while less robust than in normal years , is likely to have caused new infections .
“ We were prepared for an increase , ” Barbara Ferrer , the L.A. County health director , said .
“ None of us really thought the increase would be so big across such a short period of time.
” There were 7,415 COVID-19 patients in California hospitals on Saturday , according to the latest numbers released by the state , surpassing the previous high of 7,170 , set in @ @ @ @ @ @ @ on Oct. 28 , there were about 2,400 COVID-19 patients in state hospitals .
L.A. County had the most COVID-19 patients in hospitals , reporting 2,185 ; the county is rapidly nearing its all-time high of 2,232 , set in July .
The death rate is also rising — in Los Angeles , an average of 30 people are dying each day from COVID-19 , triple the rate from the period around election day .
Statewide , an average of 75 deaths were reported daily over the seven-day period before Thanksgiving , compared @ @ @ @ @ @ @ County Department of Health on Sunday reported 5,014 new cases of the coronavirus and 19 related deaths .
The high tally came despite the fact that case numbers usually drop on the weekends , when some labs don ’ t report results , and despite officials saying they expected the number of new cases to be lower than usual for several days because no community testing was performed on Thanksgiving , and only limited testing was offered the day after .
Officials say that if conditions continue to deteriorate , it may be @ @ @ @ @ @ @ the stay-at-home orders imposed in the spring .
“ More restrictive measures ?
I can ’ t imagine what that would look like at this point , ” said Maria Salinas , president and chief executive of the Los Angeles Area Chamber of Commerce .
She said the business community is concerned with the spike in cases , but many feel the move to shut down outdoor dining was not based on data that proved the virus was spreading among people eating at restaurants .
Health officials have said there ’ s an @ @ @ @ @ @ @ with others and eat , drink and linger without wearing masks .
“ Here we go again .
I am not convinced that shutting down , reopening and shutting down again is effective , ” said L.A. County Supervisor Janice Hahn , who , together with Supervisor Kathryn Barger , put forth a proposal that called for the board to allow restaurants to continue to offer outdoor dining .
The motion was voted down last week .
“ Nothing we have done so far has worked , ” Hahn said in a statement @ @ @ @ @ @ @ Kids aren ’ t back at school .
Our healthcare system is about to be overwhelmed.
” Other supervisors have said they back the tougher measures recommended by health officials .
“ When the case rate reaches a certain point , it takes drastic measures to slow down the spread of this tremendously deadly virus , ” Supervisor Hilda Solis said in a statement .
Physicians , epidemiologists and infectious disease experts have been clear : Outdoor restaurant dining is risky , and practices that seemed safe just a few weeks ago are @ @ @ @ @ @ @ levels of virus spreading throughout L.A. County .
Outdoor dining has likely become even more risky as restaurants have set up plastic sheeting to shield diners from wind — the very breezes that help blow away virus particles exhaled by those infected .
Without those drafts , the virus hangs in the air longer , facilitating infection .
“ I have yet to see someone eat dinner with their mask on , ” said Dr. George Rutherford , epidemiologist and infectious disease expert at UC San Francisco .
“ Mixing across households — @ @ @ @ @ @ @ just the way it is.
” Dr. Robert Kim-Farley , medical epidemiologist and infectious disease expert at the UCLA Fielding School of Public Health , said Sunday that there ’ s renewed tension between those who wish to save every life possible and those concerned about a devastated economy .
But those two goals aren ’ t mutually exclusive , he said — a recovering economy requires a virus under control .
“ The current increasing of restrictions is trying to find a way to break the back of this current surge , @ @ @ @ @ @ @ we are not endangering our hospital system , ” said Kim-Farley , a former senior official with the L.A. County Department of Public Health and U.S. Centers for Disease Control and Prevention .
The surge in coronavirus cases began late last month , and new cases are rising more rapidly than they did during the peak of the crisis in mid-July , officials say .
Across California , an average of 13,000 people are testing positive for the virus daily , more than quadruple the rate in late October , when the average @ @ @ @ @ @ @ an average of 4,300 people are testing positive daily ; the figure was about 1,000 in mid-October , according to county records .
Southern California as a whole has a particularly high infection rate .
Over the seven-day period before Thanksgiving , Southern California counties reported a daily average of 40 new coronavirus cases per 100,000 residents , the most on record so far and more than twice as many as in the Bay Area , which reported an average of 17 per 100,000 residents .
The case numbers have been climbing so @ @ @ @ @ @ @ warning that hospital beds could run short in a matter of weeks unless something is done to drastically reduce the spread of disease .
Should staffing at intensive care units be stretched beyond capacity , the mortality rate will worsen dramatically .
The shortage would affect not only COVID-19 patients but those who need emergency treatment after accidents or for appendicitis , heart attacks or strokes .
Because hospitalizations reflect cases that were identified two to three weeks earlier , officials are certain they ’ ll continue to increase for the next two @ @ @ @ @ @ @ case numbers .
If so , Ferrer said , “ we ’ re in for a very rough time , because we will have a surge on top of a surge.
” An influential model run by the University of Washington Institute for Health Metrics and Evaluation says that , without major changes in current policies or behavior , California is on track to double its cumulative death toll by the end of winter , from more than 19,000 to more than 37,000 by March 1 .
It ’ s still possible to @ @ @ @ @ @ @ , professor of epidemiology at the UCLA Fielding School of Public Health .
“ Every illness , hospitalization and death at this point is avoidable , if we all do our part , ” she said .

California has more people hospitalized with COVID-19 than at any time since the pandemic began, an ominous development that comes as officials warn of further virus spread after the long holiday weekend.
The rising numbers raise new concerns about hospitals filling up in the coming weeks, which has been predicted as coronavirus cases surge to unprecedented levels across the state and, in particular, Los Angeles County.
Multiple new restrictions on personal gatherings and capacity levels at stores take effect Monday. But there are concerns that the surge will get worse before it gets better because of Thanksgiving celebrations and Black Friday shopping — which, though less robust than in normal years, are likely to have caused new infections.
“We were prepared for an increase,” said Barbara Ferrer, the L.A. County public health director. “None of us really thought the increase would be so big across such a short period of time.”
There were 7,415 COVID-19 patients in California hospitals on Saturday, according to the latest numbers released by the state, surpassing the previous high of 7,170, set in July. Only a month earlier, on Oct. 28, about 2,400 COVID-19 patients were in state hospitals.
L.A. County had the most COVID-19 patients in hospitals, with 2,185; the county is rapidly nearing its all-time high of 2,232, also set in July.
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The death rate is also rising — in Los Angeles County, an average of 30 people are dying of COVID-19 every day, triple the rate from the period around election day. Statewide, an average of 75 deaths were reported daily over the seven-day period before Thanksgiving, compared with 40 in mid-November.
The L.A. County Department of Public Health on Sunday reported 5,014 new coronavirus cases and 19 related deaths. The high tally came despite the fact that case numbers usually drop on the weekends, when some labs don’t report results, and despite officials’ predictions that the number would be lower than usual for several days because no community testing was performed on Thanksgiving, and only limited testing was offered the day after.
Officials say that if conditions continue to deteriorate, it may be necessary to issue stricter rules that recall the stay-at-home orders imposed in the spring.
“More restrictive measures? I can’t imagine what that would look like at this point,” said Maria Salinas, president and chief executive of the Los Angeles Area Chamber of Commerce.
She said the business community is concerned with the surge in cases, but many feel the move to shut down outdoor dining was not based on data that proved the virus was spreading among people eating at restaurants.
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Health officials have said there’s an elevated risk of spread anywhere people gather with others and eat, drink and linger without wearing masks.
“Here we go again. I am not convinced that shutting down, reopening and shutting down again is effective,” said L.A. County Supervisor Janice Hahn, who, together with Supervisor Kathryn Barger, put forth a proposal that called for the board to allow restaurants to continue to offer outdoor dining. The motion was voted down last week.
“Nothing we have done so far has worked,” Hahn said in a statement. “Our businesses are hurting. Kids aren’t back at school. Our healthcare system is about to be overwhelmed.”
Other supervisors have said they back the tougher measures recommended by health officials.
“When the case rate reaches a certain point, it takes drastic measures to slow down the spread of this tremendously deadly virus,” Supervisor Hilda Solis said in a statement.
Physicians, epidemiologists and infectious-disease experts have been clear: Outdoor restaurant dining is risky, and practices that seemed safe just a few weeks ago are more dangerous now because of the greater levels of virus spreading throughout L.A. County.
Outdoor dining has probably become even more risky as restaurants have set up plastic sheeting to shield diners from wind — the very breezes that help blow away virus particles exhaled by those infected. Without those drafts, the virus hangs in the air longer, facilitating infection.
“I have yet to see someone eat dinner with their mask on,” said Dr. George Rutherford, epidemiologist and infectious-disease expert at UC San Francisco. “Mixing across households — that creates transmission. It’s just the way it is.”
Dr. Robert Kim-Farley, medical epidemiologist and infectious-disease expert at the UCLA Fielding School of Public Health, said Sunday that there’s renewed tension between those who wish to save every life possible and those concerned about a devastated economy. But those two goals aren’t mutually exclusive, he said — a recovering economy requires a virus under control.
“The current increasing of restrictions is trying to find a way to break the back of this current surge, to bring us to a level where we are not endangering our hospital system,” said Kim-Farley, a former senior official with the L.A. County Department of Public Health and U.S. Centers for Disease Control and Prevention.
California’s surge in coronavirus cases began late last month, and new cases are rising more rapidly than they did during the peak of the crisis in mid-July, officials say. Across the state, an average of 13,000 people are testing positive for the virus daily, more than quadruple the rate in late October, when the average was 3,000.
In L.A. County, an average of 4,300 people are testing positive daily; the figure was about 1,000 in mid-October, according to county records.
Southern California as a whole has a particularly high infection rate. Over the seven-day period before Thanksgiving, Southern California counties reported a daily average of 40 new coronavirus cases per 100,000 residents, the most on record so far and more than twice as many as in the Bay Area, which reported an average of 17 per 100,000 residents.
The case numbers have been climbing so quickly that officials across the state are warning that hospital beds could run short in a matter of weeks unless something is done to drastically reduce the spread of disease. Should staffing at intensive care units be stretched beyond capacity, the mortality rate will rise. The shortage would affect not only COVID-19 patients but also those who need emergency treatment after accidents or for appendicitis, heart attacks or strokes.
Because hospitalizations reflect cases that were identified two to three weeks earlier, officials are certain they’ll continue to increase for the next two to three weeks, given the recent case numbers.
If so, Ferrer said, “we’re in for a very rough time, because we will have a surge on top of a surge.”
An influential model run by the University of Washington Institute for Health Metrics and Evaluation says that, without major changes in current policies or behavior, California is on track to double its cumulative death toll by the end of winter, from more than 19,000 to more than 37,000 by March 1.
It’s still possible to change that trajectory, said Anne Rimoin, professor of epidemiology at the UCLA Fielding School of Public Health.
“Every illness, hospitalization and death at this point is avoidable, if we all do our part,” she said.


latimes--2020-11-29--Attacker is fatally beaten and stabbed by victim's mother and sister, authorities say

A man who broke into a South Pasadena home and attacked his estranged girlfriend died after he was stabbed and beaten by the woman ’ s mother and sister Saturday morning , authorities said .
The man threw a large concrete paver through the front window of a home in the 500 block of Five Oaks Drive , stepped inside and began choking the woman and punching her in the face , said Los Angeles County Sheriff ’ s Lt. Barry Hall .
The woman ’ s mother and sister came to her aid , stabbing the man with a @ @ @ @ @ @ @ golf club , Hall said .
“ They tried to pull him off , and it didn ’ t work ; he was too strong , ” Hall said .
“ So they had to resort to using weapons.
” South Pasadena police officers responding to a report of domestic violence entered through the shattered window and found the man , who was pronounced dead at the scene by the South Pasadena Fire Department , authorities said .
The L.A. County coroner ’ s office identified him as Justin Goss , 40 , @ @ @ @ @ @ @ , was taken to a hospital , treated for injuries to her face and released , officials said .
Her mother and sister were not facing charges , according to authorities .
“ They were well within their right to act in defense of their sister and daughter , ” Hall said .

Officers walk near the South Pasadena home where a man was killed, officials say, after he threw a paver through a window, entered the home and attacked a woman.
A man who broke into a South Pasadena home and attacked his estranged girlfriend died after he was stabbed and beaten by the woman’s mother and sister Saturday morning, authorities said.
The man threw a large concrete paver through the front window of a home in the 500 block of Five Oaks Drive, stepped inside and began choking the woman and punching her in the face, said Los Angeles County Sheriff’s Lt. Barry Hall.
The woman’s mother and sister came to her aid, stabbing the man with a kitchen knife and beating him with a golf club, Hall said.
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“They tried to pull him off, and it didn’t work; he was too strong,” Hall said. “So they had to resort to using weapons.”
South Pasadena police officers responding to a report of domestic violence entered through the shattered window and found the man, who was pronounced dead at the scene by the South Pasadena Fire Department, authorities said. The L.A. County coroner’s office identified him as Justin Goss, 40, of Glendale.
The woman, 37, was taken to a hospital, treated for injuries to her face and released, officials said.
Her mother and sister were not facing charges, according to authorities.
“They were well within their right to act in defense of their sister and daughter,” Hall said.


latimes--2020-11-29--Earthquake: Magnitude 3.7 quake hits near Fortuna, Calif.

A magnitude 3.7 earthquake was reported Sunday at 7:46 a.m. 23 miles from Fortuna , Calif. , according to the U.S. Geological Survey .
The offshore earthquake occurred 33 miles from Eureka , 40 miles from Arcata and 99 miles from Ukiah , Calif .
In the last 10 days , there have been no earthquakes of magnitude 3.0 or greater centered nearby .
An average of 234 earthquakes with magnitudes between 3.0 and 4.0 occur per year in California and Nevada , according to a recent three year data sample .
The earthquake occurred at a depth of 12.1 @ @ @ @ @ @ @ ?
Consider reporting what you felt to the USGS .
Even if you didn ’ t feel this small earthquake , you never know when the Big One is going to strike .
Ready yourself by following our five-step earthquake preparedness guide and building your own emergency kit .
This story was automatically generated by Quakebot , a computer application that monitors the latest earthquakes detected by the USGS .
A Times editor reviewed the post before it was published .
If you ’ re interested in learning more about the system , @ @ @ @ @ @ @ .

An earthquake was reported at 7:46 a.m. Sunday 23 miles from Fortuna, Calif., the U.S. Geological Survey reported.
A magnitude 3.7 earthquake was reported Sunday at 7:46 a.m. 23 miles from Fortuna, Calif., according to the U.S. Geological Survey.
The offshore earthquake occurred 33 miles from Eureka, 40 miles from Arcata and 99 miles from Ukiah, Calif.
In the last 10 days, there have been no earthquakes of magnitude 3.0 or greater centered nearby.
An average of 234 earthquakes with magnitudes between 3.0 and 4.0 occur per year in California and Nevada, according to a recent three year data sample.
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The earthquake occurred at a depth of 12.1 miles. Did you feel this earthquake? Consider reporting what you felt to the USGS.
Even if you didn’t feel this small earthquake, you never know when the Big One is going to strike. Ready yourself by following our five-step earthquake preparedness guide and building your own emergency kit.
This story was automatically generated by Quakebot, a computer application that monitors the latest earthquakes detected by the USGS. A Times editor reviewed the post before it was published. If you’re interested in learning more about the system, visit our list of frequently asked questions.


latimes--2020-11-29--L.A.'s rising COVID-19 deaths point to a horrific December. Can the trend be reversed?

Los Angeles Mayor Eric Garcetti made a dire prediction last week : If the coronavirus continues to spread so rapidly , the death toll from COVID-19 in Los Angeles County will reach 11,511 by the end of the year .
Garcetti ’ s projection would mean that more than 4,000 Angelenos will die of COVID-19 in the next five weeks alone , more than were lost in L.A. County ’ s first four months of the pandemic .
The mayor pleaded with Angelenos to stay home over the next few weeks and cancel Thanksgiving plans with people outside their households @ @ @ @ @ @ @ could do something to make sure those lives were saved , ” Garcetti said in a briefing Monday .
“ Isn ’ t that something worth fighting against ?
Aren ’ t those lives worth saving ?
You and I both know that answer.
” Coronavirus cases are increasing at an alarming rate in L.A. County , with a record number of people being infected last week .
Though it can take several weeks for a sick person to succumb to the virus , an uptick in deaths has already begun , with @ @ @ @ @ @ @ average daily deaths than it saw on election day .
On Tuesday , county health officials announced that 51 people had died of COVID-19 , the highest number of deaths on a single day in more than two months .
Experts say that with advancements in medical treatments and knowledge of the disease gained over the last nine months , they are hopeful that a smaller proportion of people who are infected with the coronavirus will die during this wave compared with the spring or summer .
But those improvements could be jeopardized @ @ @ @ @ @ @ staffs are stretched thin and unable to provide the healthcare desperately needed to save the lives of the sickest patients , experts say .
“ It looks like the mortality rate is going down over time , ” said Dr. Christopher Petrilli , assistant professor of medicine at New York University , who recently published a paper that found large drops in mortality among patients hospitalized with COVID-19 in New York .
“ But we could see mortality rates go up as hospitals across the country get overwhelmed again.
” So does the @ @ @ @ @ @ @ 4,000 more people here will die before 2021 ?
Though entirely possible , such an outcome is avoidable .
Garcetti ’ s projection assumes that the virus will continue to spread at the same rapid rate it has shown in the last two weeks , so that by the end of the year an additional 180,000 people will have become infected , roughly 2 % of whom will die of COVID-19 .
But it is not likely that spread will continue unabated for the next several weeks , given that county officials have @ @ @ @ @ @ @ likely that if transmission of the virus slows in the coming days , there will be fewer fatalities than Garcetti foretold .
But hundreds , if not thousands , could still die .
Any changes in behavior Angelenos make now to reduce transmission of the coronavirus probably won ’ t bend the curve on hospitalizations for a few more weeks , because people infected last week can still end up in the hospital .
On Friday , 2,049 people in the county were hospitalized with COVID-19 , 501 of whom were sick enough @ @ @ @ @ @ @ , according to The Times ’ coronavirus tracker .
Among people in the ICU , two-thirds are typically on ventilators that help them breathe , according to L.A. County Health Services Director Dr. Christina Ghaly .
Of those requiring ventilation , about half do not survive , she said .
“ This is a serious disease and it should not be taken lightly , ” Ghaly said in a recent news conference .
Ninety-three percent of the people who have died of COVID-19 in the county had underlying health conditions , such as @ @ @ @ @ @ @ percent were 80 or older , according to county data .
“ Once hospitalizations go up , it ’ s inevitable that deaths go up , ” L.A. County Public Health Director Barbara Ferrer said in a recent news conference .
“ Our hope is that they don ’ t go up as much as they did earlier in the pandemic.
” Over the last eight months , nurses and physicians have become better at treating COVID-19 patients .
Doctors have learned that hydroxychloroquine , once touted as a lifesaver , isn ’ @ @ @ @ @ @ @ — while remdesivir and dexamethasone can improve patients ’ outcomes .
Early in the pandemic , approximately 4 % of people with COVID-19 in L.A. County died of the disease .
But with improved treatments , increased availability of testing and a younger population becoming infected , the fatality rate has dropped below 2 % , according to county data .
( Though in line with national estimates , 2 % is considered an overestimate of the virus ’ true lethality because many coronavirus infections go undiagnosed , particularly those that are asymptomatic @ @ @ @ @ @ @ at the Institute for Health Metrics and Evaluation at the University of Washington , said his research team analyzed data from 150 U.S. hospitals and found that the chance of a patient hospitalized with COVID-19 dying had dropped by 30 % between April and August .
He cited a variety of possible explanations , including physicians being more prepared for complications such as strokes and blood clots .
“ Basically , when you make it to the hospital now , the chance of survival is much higher across all age groups , ” @ @ @ @ @ @ @ ’ t offset the unprecedented number of cases being reported daily , he said .
The number of new coronavirus cases nationwide each day is about 200,000 , more than double the previous record from July of roughly 75,000 .
“ Because the numbers are increasing rapidly , even with some improvement [ in death rates ] , just sheer numbers are going to overcome that , ” he said .
“ December and January are going to be very difficult for us in the U.S. ” Many experts warned that an already @ @ @ @ @ @ @ become overwhelmed and are unable to treat all the patients in need .
In L.A. County , current projections by health officials show that if the steep upward trends persist , hospitals will run out of beds in two to four weeks .
Garcetti warned Monday that the tipping point could come around Christmas .
He mentioned the possibility of inviting medical teams from the military to help in the event of a continuing surge and said the Los Angeles Convention Center could be available for use as a field hospital .
“ @ @ @ @ @ @ @ four months ago whether we permanently closed that down or kept it on life support , ” he said , “ and we have kept it on life support .
”

Los Angeles Mayor Eric Garcetti made a dire prediction last week: If the coronavirus continues to spread so rapidly, the death toll from COVID-19 in Los Angeles County will reach 11,511 by the end of the year.
Garcetti’s projection would mean that more than 4,000 Angelenos will die of COVID-19 in the next five weeks alone, more than were lost in L.A. County’s first four months of the pandemic. The mayor pleaded with Angelenos to stay home over the next few weeks and cancel Thanksgiving plans with people outside their households.
“Imagine if somebody said we could do something to make sure those lives were saved,” Garcetti said in a briefing Monday. “Isn’t that something worth fighting against? Aren’t those lives worth saving? You and I both know that answer.”
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Coronavirus cases are increasing at an alarming rate in L.A. County, with a record number of people being infected last week. Though it can take several weeks for a sick person to succumb to the virus, an uptick in deaths has already begun, with the county reporting triple the number of average daily deaths than it saw on election day.
On Tuesday, county health officials announced that 51 people had died of COVID-19, the highest number of deaths on a single day in more than two months.
Experts say that with advancements in medical treatments and knowledge of the disease gained over the last nine months, they are hopeful that a smaller proportion of people who are infected with the coronavirus will die during this wave compared with the spring or summer.
But those improvements could be jeopardized by overcrowding at hospitals, as medical staffs are stretched thin and unable to provide the healthcare desperately needed to save the lives of the sickest patients, experts say.
“It looks like the mortality rate is going down over time,” said Dr. Christopher Petrilli, assistant professor of medicine at New York University, who recently published a paper that found large drops in mortality among patients hospitalized with COVID-19 in New York. “But we could see mortality rates go up as hospitals across the country get overwhelmed again.”
So does the crushing surge in L.A. County mean that 4,000 more people here will die before 2021? Though entirely possible, such an outcome is avoidable.
Garcetti’s projection assumes that the virus will continue to spread at the same rapid rate it has shown in the last two weeks, so that by the end of the year an additional 180,000 people will have become infected, roughly 2% of whom will die of COVID-19.
But it is not likely that spread will continue unabated for the next several weeks, given that county officials have imposed new restrictions. It’s likely that if transmission of the virus slows in the coming days, there will be fewer fatalities than Garcetti foretold.
But hundreds, if not thousands, could still die. Any changes in behavior Angelenos make now to reduce transmission of the coronavirus probably won’t bend the curve on hospitalizations for a few more weeks, because people infected last week can still end up in the hospital.
On Friday, 2,049 people in the county were hospitalized with COVID-19, 501 of whom were sick enough to be in the intensive care unit, according to The Times’ coronavirus tracker.
Among people in the ICU, two-thirds are typically on ventilators that help them breathe, according to L.A. County Health Services Director Dr. Christina Ghaly. Of those requiring ventilation, about half do not survive, she said.
“This is a serious disease and it should not be taken lightly,” Ghaly said in a recent news conference.
Ninety-three percent of the people who have died of COVID-19 in the county had underlying health conditions, such as chronic lung disease or diabetes. Forty percent were 80 or older, according to county data.
“Once hospitalizations go up, it’s inevitable that deaths go up,” L.A. County Public Health Director Barbara Ferrer said in a recent news conference. “Our hope is that they don’t go up as much as they did earlier in the pandemic.”
Over the last eight months, nurses and physicians have become better at treating COVID-19 patients. Doctors have learned that hydroxychloroquine, once touted as a lifesaver, isn’t beneficial — and sometimes is dangerous — while remdesivir and dexamethasone can improve patients’ outcomes.
Advertisement
Early in the pandemic, approximately 4% of people with COVID-19 in L.A. County died of the disease. But with improved treatments, increased availability of testing and a younger population becoming infected, the fatality rate has dropped below 2%, according to county data. (Though in line with national estimates, 2% is considered an overestimate of the virus’ true lethality because many coronavirus infections go undiagnosed, particularly those that are asymptomatic.)
Ali Mokdad, a professor at the Institute for Health Metrics and Evaluation at the University of Washington, said his research team analyzed data from 150 U.S. hospitals and found that the chance of a patient hospitalized with COVID-19 dying had dropped by 30% between April and August. He cited a variety of possible explanations, including physicians being more prepared for complications such as strokes and blood clots.
“Basically, when you make it to the hospital now, the chance of survival is much higher across all age groups,” he said.
California corona L.A.’s problems are thorny and building consensus on how to fix them is tough. If I were Garcetti, I’d wave goodbye and head east.
But those gains can’t offset the unprecedented number of cases being reported daily, he said. The number of new coronavirus cases nationwide each day is about 200,000, more than double the previous record from July of roughly 75,000.
“Because the numbers are increasing rapidly, even with some improvement [in death rates], just sheer numbers are going to overcome that,” he said. “December and January are going to be very difficult for us in the U.S.”
Many experts warned that an already devastating situation could be exacerbated if hospitals become overwhelmed and are unable to treat all the patients in need. In L.A. County, current projections by health officials show that if the steep upward trends persist, hospitals will run out of beds in two to four weeks.
Garcetti warned Monday that the tipping point could come around Christmas. He mentioned the possibility of inviting medical teams from the military to help in the event of a continuing surge and said the Los Angeles Convention Center could be available for use as a field hospital.
“I had to make the decision about four months ago whether we permanently closed that down or kept it on life support,” he said, “and we have kept it on life support.”
Times staff writer Thomas Curwen contributed to this report.


latimes--2020-11-29--Column: For a man long afflicted with an illness made riskier by COVID-19, hope for the holidays

Evie Junior has been living with the pain and limitations of sickle cell disease for almost all of his 27 years .
He ’ s been hospitalized too many times to count with infections , exhaustion and excruciating pain , spawned by the incurable illness embedded in his genes .
“ You try and adjust to the demands of the disease , but it ’ s never clear when the attacks are going to occur , ” Junior explained .
“ You start to make progress on something , then you get sick and it takes you out , and @ @ @ @ @ @ @ one .
“ It ’ s one step forward and three steps back all the time.
” But the Anaheim man has good reason to feel thankful this holiday season : An experimental gene therapy being tested on him shows promise in disarming the debilitating disease .
Junior ’ s doctors at the UCLA Broad Stem Cell Research Center say the genetically modified stem cell infusion that he received last summer seems on track to correct the genetic error responsible for his sickle cell disorder .
“ If we can get enough of @ @ @ @ @ @ @ [ new ] gene … the idea is he won ’ t have sickle cell anymore , ” explained Dr. Donald Kohn , a UCLA professor and physician who has been studying gene therapy for 35 years and leads the medical trial , along with Dr. Gary Schiller .
So far Junior ’ s body has responded well enough that doctors are “ pretty confident ” the trial will help alleviate his suffering — and may light the way for new treatments of other incurable diseases , Kohn said .
For the doctors @ @ @ @ @ @ @ ” medical prospect .
For Junior , it ’ s a sign that a life of promise — perpetually stalled by illness — may finally shift into high gear .
“ I feel like something big is coming out of this , ” Junior told me last week , as he prepared for a holiday celebration with his girlfriend .
“ I want to be cured of this disease , ” he said .
“ And I wish the world was more understanding about the people who are struggling with it.
” Sickle @ @ @ @ @ @ @ blood disorder in the United States .
It results from a mutation on a single hemoglobin gene , which causes red blood cells to take on a rigid sickle shape that clogs blood vessels and starves bones , brains and other organs of the blood they need .
Its trademark symptom is prolonged episodes of pain so severe “ that on a scale of 1 to 10 , it ’ s off the charts , ” Kohn said .
Patients are also prone to premature strokes , heart disease , kidney failure and @ @ @ @ @ @ @ Californians with the disease is only 36 years .
And while the vast majority of those with the disease are Black Americans , 5 % of the people suffering from sickle cell in California are Latino .
Research into the disease has ramped up in recent years , and new medications to help manage symptoms are available .
But the only way to disable the disorder is a bone marrow transplant , and that comes with considerable risks and complications .
And fewer than 1 in 10 sickle cell patients end up finding @ @ @ @ @ @ @ what makes this new route to a cure so exciting — and the process so calculatedly slow .
“ These trials going on now are under very tight supervision and scrutiny , ” said Schiller , co-leader of the UCLA trial , which began in 2015 .
“ Because we are introducing a new gene into the patient ’ s own cells , they are unlikely to be rejected and [ will ] stay for the life of the patient .
So we have to make sure we are not creating some kind @ @ @ @ @ @ @ .
The trial is funded by the California Institute for Regenerative Medicine , the stem cell agency created by voters in 2004 and infused with $ 5.5 billion in new research money by voters who narrowly approved Proposition 14 this fall .
The initial trial attempt failed because the corrective gene didn ’ t make its way into enough of the patient ’ s stem cells .
Still , it had value , Kohn said .
“ We learned where we were on the map .
We were in the middle of the @ @ @ @ @ @ @ dry land.
” They hope to add a new patient to the trial every three months , Schiller said .
Unlike other blood-related illnesses , “ this is a disease we understood very well , but we could not fix it.
” Prospective trial subjects face long odds of being selected .
“ We have to choose people who have had a lot of symptoms , but their organs are not so damaged ” they ’ re beyond recovery , Schiller explained .
That ’ s not easy with a disease as destructive @ @ @ @ @ @ @ re inundated with requests from people who will do anything to get past the disease , ” said Schiller .
Junior was one of those people , desperate for a way to live a productive life .
As a child , he grew accustomed to frequent hospital stays .
But the disease got progressively worse as he moved through his teens ; the bone pain was so disabling , he often had to be sedated with heavy-duty opioids .
Still , he tried not to let the illness rule his life .
“ @ @ @ @ @ @ @ , ” he recalled .
But the capricious nature of the disease made that hard .
He played high school football growing up in New York City , even when workouts left him struggling to breathe .
But a long stint in the hospital the summer before his senior year spurred the coach to drop him from the team .
He still feels bitter about that .
A few years later , he moved to Portland , Ore. , and enrolled in college .
He was working and attending classes when his illness @ @ @ @ @ @ @ out .
“ I couldn ’ t keep up the pace , ” he said .
And when COVID-19 worsened in the spring , Junior had to leave a job he loved — he was an emergency medical technician — because his compromised immune system made the risk of getting sick too high .
“ It was rough for me , realizing that I have to adjust my future to what the disease requires , ” Junior said .
At one point , the bones in both his legs were so damaged by @ @ @ @ @ @ @ not ever walk normally again .
Junior battled back .
But when his doctors in Portland told him there was nothing more they could do , Junior began researching alternative treatments and clinical trials .
“ There was one study in Boston and another in Los Angeles , ” he said .
“ Los Angeles was closer , ” so he and his girlfriend packed up and left for Southern California .
Before long , Junior was back in the hospital again , as a subject in the UCLA trial .
But this @ @ @ @ @ @ @ chemotherapy regimen that wiped out damaged cells and primed his bone marrow to accept genetically altered replacements — was a signal of progress , not a setback .
“ So yeah , it was bad , but not as bad as the pain of sickle cell , ” Junior told me .
In the four months since then , he ’ s had fewer painful episodes and his modified stem cells seem to be producing healthy red blood cells , a sign that the treatment is working .
As the study goes on @ @ @ @ @ @ @ years and monitored as long as he ’ s alive .
But Junior is not waiting for the “ all-clear ” to reimagine his life .
“ My goal is to be a firefighter , if my cardiovascular system is strong and I can still push myself , ” he said .
“ The doctors hope some of my organs go back to the way they used to be .
That some of the damage that ’ s been done will be healed.
” Junior admits he ’ s not quite clear on @ @ @ @ @ @ @ the doctors have put him through .
But he ’ s grateful for the hope their research is delivering to people with sickle cell disease .
“ From my understanding , the sickle cell gene is still there , ” he said .
“ They didn ’ t correct it ; it ’ s like there ’ s a crack and they put tape over it … so my cells are less sticky and will be able to function more effectively.
” And that , for now , is good enough for him @

Evie Junior has sickle cell anemia. An experimental gene therapy he is getting as part of a UCLA trial shows promise in disarming the disease.
Evie Junior has been living with the pain and limitations of sickle cell disease for almost all of his 27 years.
He’s been hospitalized too many times to count with infections, exhaustion and excruciating pain, spawned by the incurable illness embedded in his genes.
“You try and adjust to the demands of the disease, but it’s never clear when the attacks are going to occur,” Junior explained. “You start to make progress on something, then you get sick and it takes you out, and you have to start over at square one.
“It’s one step forward and three steps back all the time.”
But the Anaheim man has good reason to feel thankful this holiday season: An experimental gene therapy being tested on him shows promise in disarming the debilitating disease.
Advertisement
Junior’s doctors at the UCLA Broad Stem Cell Research Center say the genetically modified stem cell infusion that he received last summer seems on track to correct the genetic error responsible for his sickle cell disorder.
“If we can get enough of the stem cells to pick up our [new] gene … the idea is he won’t have sickle cell anymore,” explained Dr. Donald Kohn, a UCLA professor and physician who has been studying gene therapy for 35 years and leads the medical trial, along with Dr. Gary Schiller.
So far Junior’s body has responded well enough that doctors are “pretty confident” the trial will help alleviate his suffering — and may light the way for new treatments of other incurable diseases, Kohn said.
For the doctors, that’s an “earthshaking” medical prospect. For Junior, it’s a sign that a life of promise — perpetually stalled by illness — may finally shift into high gear.
“I feel like something big is coming out of this,” Junior told me last week, as he prepared for a holiday celebration with his girlfriend.
“I want to be cured of this disease,” he said. “And I wish the world was more understanding about the people who are struggling with it.”
Advertisement
Sickle cell disease is the most common inherited blood disorder in the United States. It results from a mutation on a single hemoglobin gene, which causes red blood cells to take on a rigid sickle shape that clogs blood vessels and starves bones, brains and other organs of the blood they need.
Its trademark symptom is prolonged episodes of pain so severe “that on a scale of 1 to 10, it’s off the charts,” Kohn said.
Patients are also prone to premature strokes, heart disease, kidney failure and cognitive decline. The median lifespan for Californians with the disease is only 36 years.
And while the vast majority of those with the disease are Black Americans, 5% of the people suffering from sickle cell in California are Latino.
Research into the disease has ramped up in recent years, and new medications to help manage symptoms are available.
But the only way to disable the disorder is a bone marrow transplant, and that comes with considerable risks and complications. And fewer than 1 in 10 sickle cell patients end up finding a suitable donor.
That’s what makes this new route to a cure so exciting — and the process so calculatedly slow.
“These trials going on now are under very tight supervision and scrutiny,” said Schiller, co-leader of the UCLA trial, which began in 2015.
“Because we are introducing a new gene into the patient’s own cells, they are unlikely to be rejected and [will] stay for the life of the patient. So we have to make sure we are not creating some kind of genetic monster,” Schiller added.
The trial is funded by the California Institute for Regenerative Medicine, the stem cell agency created by voters in 2004 and infused with $5.5 billion in new research money by voters who narrowly approved Proposition 14 this fall.
The initial trial attempt failed because the corrective gene didn’t make its way into enough of the patient’s stem cells. Still, it had value, Kohn said. “We learned where we were on the map. We were in the middle of the ocean. Now we’re on dry land.”
They hope to add a new patient to the trial every three months, Schiller said. Unlike other blood-related illnesses, “this is a disease we understood very well, but we could not fix it.”
Prospective trial subjects face long odds of being selected. “We have to choose people who have had a lot of symptoms, but their organs are not so damaged” they’re beyond recovery, Schiller explained. That’s not easy with a disease as destructive as sickle cell.
“We’re inundated with requests from people who will do anything to get past the disease,” said Schiller.
Junior was one of those people, desperate for a way to live a productive life.
As a child, he grew accustomed to frequent hospital stays. But the disease got progressively worse as he moved through his teens; the bone pain was so disabling, he often had to be sedated with heavy-duty opioids.
Still, he tried not to let the illness rule his life. “I always found ways to stay active,” he recalled. But the capricious nature of the disease made that hard.
He played high school football growing up in New York City, even when workouts left him struggling to breathe. But a long stint in the hospital the summer before his senior year spurred the coach to drop him from the team. He still feels bitter about that.
A few years later, he moved to Portland, Ore., and enrolled in college. He was working and attending classes when his illness flared up and he had to drop out. “I couldn’t keep up the pace,” he said.
And when COVID-19 worsened in the spring, Junior had to leave a job he loved — he was an emergency medical technician — because his compromised immune system made the risk of getting sick too high.
“It was rough for me, realizing that I have to adjust my future to what the disease requires,” Junior said.
At one point, the bones in both his legs were so damaged by the disease, doctors thought he might not ever walk normally again. Junior battled back.
But when his doctors in Portland told him there was nothing more they could do, Junior began researching alternative treatments and clinical trials.
“There was one study in Boston and another in Los Angeles,” he said. “Los Angeles was closer,” so he and his girlfriend packed up and left for Southern California.
Before long, Junior was back in the hospital again, as a subject in the UCLA trial.
But this time, his treatment — a weeklong chemotherapy regimen that wiped out damaged cells and primed his bone marrow to accept genetically altered replacements — was a signal of progress, not a setback.
“So yeah, it was bad, but not as bad as the pain of sickle cell,” Junior told me.
In the four months since then, he’s had fewer painful episodes and his modified stem cells seem to be producing healthy red blood cells, a sign that the treatment is working.
As the study goes on, he will be tested monthly for years and monitored as long as he’s alive. But Junior is not waiting for the “all-clear” to reimagine his life.
“My goal is to be a firefighter, if my cardiovascular system is strong and I can still push myself,” he said.
“The doctors hope some of my organs go back to the way they used to be. That some of the damage that’s been done will be healed.”
Junior admits he’s not quite clear on the medical aspects of all the procedures the doctors have put him through. But he’s grateful for the hope their research is delivering to people with sickle cell disease.
“From my understanding, the sickle cell gene is still there,” he said. “They didn’t correct it; it’s like there’s a crack and they put tape over it … so my cells are less sticky and will be able to function more effectively.”
And that, for now, is good enough for him.


latimes--2020-11-29--L.A. County's holiday COVID-19 restrictions face skepticism from a weary public. Will people obey?

It was a Black Friday contrast that spoke to the immense challenge facing public health officials as they try to slow an unprecedented coronavirus surge during a holiday season that many hoped would be a reprieve from a year of pandemic restrictions .
Los Angeles County public health officials announced a slew of new restrictions Friday afternoon , banning most gatherings and placing new limits on businesses .
At that very moment , shoppers were swarming the Citadel Outlets in Commerce searching for holiday deals .
Videos showing long lines of hundreds of shoppers trying to get into stores and @ @ @ @ @ @ @ with cars circling looking for an empty space , went viral on social media .
More than eight months into the pandemic that ’ s upended everyday life , Californians are exhausted by the disruptions and becoming more vocal about the new rules despite swelling hospitalization numbers and forecasts of rising death tolls .
Until now , L.A. County residents have by and large accepted the rules , especially compared with other parts of the country .
But the county ’ s decision to suspend outdoor restaurant dining last week sparked a major @ @ @ @ @ @ @ cure was worse than the disease .
The latest round of restrictions also brought groans , especially the closure of playgrounds , which some parents say have been a lifeline for their stir-crazy kids .
Health experts hope the public can make yet another sacrifice — and alter their holiday norms — for the greater good .
But they also know it ’ s getting harder as some grow skeptical of the rules and others simply need more human contact .
“ Everything that people do , you have to ask yourself : @ @ @ @ @ @ @ worth losing somebody that I love ?
” said Anne Rimoin , professor of epidemiology at the UCLA Fielding School of Public Health .
“ I think people forget that these decisions are life-and-death decisions.
” Officials have warned that even more strict rules — perhaps a more formal stay-at-home order — are likely if L.A. can ’ t begin to bend the curve on this third wave .
A lot will rest on whether people followed the public health pleas and avoided large Thanksgiving gatherings and crowds .
Barbara Ferrer , the @ @ @ @ @ @ @ Saturday that the “ big unknown ” was how people were spending the holiday weekend : Were they engaging in behaviors and activities considered to be safe or risky ?
“ If they ’ re the latter … we ’ re in for a very rough time because we will have a surge on top of a surge , ” she said .
The scene at the Citadel Outlets near downtown Los Angeles was more subdued Saturday but still lively .
Things were a little different from normal for Santa Claus inside his @ @ @ @ @ @ @ behind a plexiglass screen and his lap was off-limits .
And there were not many children .
On the Saturday after Thanksgiving , things started slowly — with one child in a 30-minute late morning span .
Usually 40 to 50 people would be lined up out the door , said Jose Marroquin , one of Santa ’ s helpers .
And though most of the visits hit the normal touch points of naughty , nice and what do you want , one 6-year-old girl had a special request .
“ She didn @ @ @ @ @ @ @ for herself at Christmas , ” said Santa , played by Ray Hamlett .
“ She just wanted COVID to go away.
” But transmission of the coronavirus is on the rise in L.A. County , mirroring a trend seen statewide and elsewhere in the country .
Two months ago , officials estimated that 1 in 880 L.A. County residents were infected with the coronavirus ; now , they believe it ’ s 1 in 145 and climbing , meaning the activities that people once enjoyed safely now pose more risk .
Public @ @ @ @ @ @ @ cases of the virus and 19 deaths but said that the numbers were low because no community testing was offered on Thanksgiving , and only limited testing was performed the day after .
Nonetheless , officials said , the proportion of tests coming back positive doubled over the last two weeks , reaching 7.4 % .
L.A. County has now recorded 391,225 cases of the virus , and 7,623 people have died .
Public health officials are especially worried that hospitalizations are increasing at a rapid clip .
There were 2,049 confirmed COVID-19 @ @ @ @ @ @ @ Friday , an increase of 173 % from a month before , when there were 700 patients , according to data from the state .
The number is now approaching the figure seen during the peak of the crisis in mid-July , when hospitalizations topped 2,200 .
Because hospitalizations reflect cases that were identified two to three weeks earlier , officials are certain they ’ ll continue to increase for the next two to three weeks , given the recent case numbers .
The pace of the increase has officials scrambling to take @ @ @ @ @ @ @ while avoiding more draconian measures that could see broad swaths of businesses shut down entirely , as they were in March .
Most recently , on Friday , L.A. County announced a limited stay-at-home order , which takes effect Monday and will be in place through Dec. 20 .
The order prohibits all public and private gatherings with people from multiple households except for religious services and protests , which officials say are constitutionally protected rights .
It also reduces occupancy limits on businesses .
In some cases , the reductions are modest @ @ @ @ @ @ @ and personal care services are permitted to operate at 20 % of maximum capacity , down from 25 % earlier in the month .
In other cases , the limits are more significant : Grocery stores saw their occupancy limits slashed from 50 % to 35 % of the maximum .
Still , many business sectors that were shut down during the last round of stay-at-home orders , such as indoor malls , shopping centers and other nonessential retail stores , were permitted to remain open .
The only new closures announced Friday @ @ @ @ @ @ @ In the late morning at the Citadel Outlets , seven customers were inside Claire ’ s , all under the watchful eye of Fernanda Beiza , who is always counting .
The new limit , based on the size of her store , is 10 , she said , down from 16 .
“ It is stressful , ” Beiza said , “ because there ’ s only a certain amount of people.
” At Ecco , which sells shoes , handbags , belts and wallets , normal customer flow at this time @ @ @ @ @ @ @ in the pandemonium of 2019 .
In the pandemic of 2020 , circa Thanksgiving weekend , the comparative number is 150 , said store manager Ivan Ramirez .
Ramirez doesn ’ t minimize the health risk and worries when customers don ’ t respect the six-foot “ bubble ” that is supposed to exist between people .
He says the rules regarding percentage of occupancy allowed by the county can feel “ arbitrary.
” “ Once you have people inside a location , they don ’ t measure themselves six feet away , @ @ @ @ @ @ @ be a moment where everyone is just going to crowd up.
” Members of his work hard to sanitize throughout the day and keep people apart — a common theme among store workers who are trying to play by the rules and are concerned about protecting themselves from unnecessary risk .
Ramirez is grateful his company has tried to hold on to workers , but he worries about the economic effect of the county health orders .
“ If we were a mom-and-pop , definitely , there would be no way we would @ @ @ @ @ @ @ said .
“ Employees would be getting cut left and right.
” By 12:30 p.m. , both the temperature and the crowd size had risen at the Citadel .
Lines started forming outside the more popular stores , including Tommy Hilfiger .
People were waiting an hour or more to get in .
The line outside Coach was even longer .
And throngs were milling about a central decoration called “ Tallest Christmas Tree.
” Most of the Flores family was exhausted after just one stop and ready to go home .
But @ @ @ @ @ @ @ who was braving one more line .
The scene began to look like the queue for the most popular rides at Disneyland , where people wait in line for ages in exchange for a few minutes of bliss — and part of the bliss was the relatively uncrowded indoor spaces of the stores .
Miguel Flores , 17 , thought the good prices were too much to pass up .
His brother Jose , 19 , questioned that logic , wondering if the prices were just jacked up to make things look like @ @ @ @ @ @ @ job in retail because of the pandemic .
Jose Sr. sat nearby , a little anxious about the entire adventure because he ’ s in his 60s and worried about catching the virus .
Nearly everyone seemed to be wearing masks , but they ’ d pull them down to eat or drink , and many were walking around with ice cream , shakes , chocolates and other snacks .
Even though she works outside at a kiosk — just outside Skechers — Anabel Velazquez worries about the health risk .
She says @ @ @ @ @ @ @ to wear a mask or wear it properly — which is ironic because she sells masks and was herself sporting one with a Playboy logo .
And people are still buying masks , one for $ 10 , three for $ 20 .
“ There are days where people come to just buy masks , ” Velazquez said .
“ Like they will take $ 300 worth of masks home.
” Velazquez says the mall requires rent payments whether her stand opens or not , so she feels as bonded to her job @ @ @ @ @ @ @ her customers , she thinks , “ are playing with their unemployment money .
I think that ’ s why there ’ s been that boom for sales .
Because if you look around , it ’ s almost like any other year .
There ’ s no decrease in how many people have come out to shop.
” Ferrer said officials hoped the more narrowly tailored restrictions would be sufficient to slow the spread of the coronavirus without having to give way to stricter stay-at-home orders .
The county is “ at @ @ @ @ @ @ @ in March and April when we didn ’ t have the science around masking and distancing , ” she said .
“ Now that we do , it offers us a slightly different path forward , ” she added .
“ But I ’ ll be honest : It only offers us a different path forward if everyone ’ s doing it.
” If people don ’ t follow safety precautions , she said , it ’ s possible the county could find itself back where it was in the early spring .
@ @ @ @ @ @ @ , and two to three weeks from now we find ourselves in a worse place than we are , we ’ re going to have to go back and look at what else do we have as options , because we can not continue to risk overwhelming the healthcare system , ” Ferrer said .
“ I don ’ t think there ’ s any disagreement about that — that that ’ s a disaster that we have to avoid at all costs .
”

Alex Wigglesworth, Howard Blume, Rong-Gong Lin II

Catherine Mejia, left, Damian Rocha and Lizzette Mejia have their photo taken Saturday at the Citadel Outlets with Santa Claus, played by Ray Hamlett. Santa’s new setup included plexiglass shields.
It was a Black Friday contrast that spoke to the immense challenge facing public health officials as they try to slow an unprecedented coronavirus surge during a holiday season that many hoped would be a reprieve from a year of pandemic restrictions.
Los Angeles County public health officials announced a slew of new restrictions Friday afternoon, banning most gatherings and placing new limits on businesses. At that very moment, shoppers were swarming the Citadel Outlets in Commerce searching for holiday deals. Videos showing long lines of hundreds of shoppers trying to get into stores and parking lots filled nearly to capacity, with cars circling looking for an empty space, went viral on social media.
More than eight months into the pandemic that’s upended everyday life, Californians are exhausted by the disruptions and becoming more vocal about the new rules despite swelling hospitalization numbers and forecasts of rising death tolls.
Advertisement
Until now, L.A. County residents have by and large accepted the rules, especially compared with other parts of the country. But the county’s decision to suspend outdoor restaurant dining last week sparked a major backlash, with some questioning whether the cure was worse than the disease. The latest round of restrictions also brought groans, especially the closure of playgrounds, which some parents say have been a lifeline for their stir-crazy kids.
Health experts hope the public can make yet another sacrifice — and alter their holiday norms — for the greater good. But they also know it’s getting harder as some grow skeptical of the rules and others simply need more human contact.
“Everything that people do, you have to ask yourself: Is it worth it? Is it worth losing somebody that I love?” said Anne Rimoin, professor of epidemiology at the UCLA Fielding School of Public Health. “I think people forget that these decisions are life-and-death decisions.”
Most shoppers wore face coverings Saturday at the Citadel Outlets in Commerce. (Francine Orr / Los Angeles Times)
Officials have warned that even more strict rules — perhaps a more formal stay-at-home order — are likely if L.A. can’t begin to bend the curve on this third wave. A lot will rest on whether people followed the public health pleas and avoided large Thanksgiving gatherings and crowds.
Barbara Ferrer, the L.A. County public health director, said Saturday that the “big unknown” was how people were spending the holiday weekend: Were they engaging in behaviors and activities considered to be safe or risky?
“If they’re the latter … we’re in for a very rough time because we will have a surge on top of a surge,” she said.
Advertisement
The scene at the Citadel Outlets near downtown Los Angeles was more subdued Saturday but still lively.
Things were a little different from normal for Santa Claus inside his cottage. For one, he sat behind a plexiglass screen and his lap was off-limits.
And there were not many children. On the Saturday after Thanksgiving, things started slowly — with one child in a 30-minute late morning span. Usually 40 to 50 people would be lined up out the door, said Jose Marroquin, one of Santa’s helpers.
And though most of the visits hit the normal touch points of naughty, nice and what do you want, one 6-year-old girl had a special request.
“She didn’t want to wish for anything for herself at Christmas,” said Santa, played by Ray Hamlett. “She just wanted COVID to go away.”
The scene at the Citadel Outlets near downtown L.A. was more subdued Saturday but still lively. (Francine Orr / Los Angeles Times)
But transmission of the coronavirus is on the rise in L.A. County, mirroring a trend seen statewide and elsewhere in the country. Two months ago, officials estimated that 1 in 880 L.A. County residents were infected with the coronavirus; now, they believe it’s 1 in 145 and climbing, meaning the activities that people once enjoyed safely now pose more risk.
Public health officials on Saturday reported 3,143 new cases of the virus and 19 deaths but said that the numbers were low because no community testing was offered on Thanksgiving, and only limited testing was performed the day after. Nonetheless, officials said, the proportion of tests coming back positive doubled over the last two weeks, reaching 7.4%.
L.A. County has now recorded 391,225 cases of the virus, and 7,623 people have died.
Holiday shoppers mill about at the Citadel Outlets. (Francine Orr / Los Angeles Times)
Public health officials are especially worried that hospitalizations are increasing at a rapid clip. There were 2,049 confirmed COVID-19 patients in L.A. County hospitals as of Friday, an increase of 173% from a month before, when there were 700 patients, according to data from the state. The number is now approaching the figure seen during the peak of the crisis in mid-July, when hospitalizations topped 2,200.
Because hospitalizations reflect cases that were identified two to three weeks earlier, officials are certain they’ll continue to increase for the next two to three weeks, given the recent case numbers.
After taking a lunch break, Santa Claus, played by Ray Hamlett, walks to his workshop at the Citadel Outlets on Saturday. (Francine Orr / Los Angeles Times)
The pace of the increase has officials scrambling to take steps to slow the virus’ spread while avoiding more draconian measures that could see broad swaths of businesses shut down entirely, as they were in March.
Most recently, on Friday, L.A. County announced a limited stay-at-home order, which takes effect Monday and will be in place through Dec. 20.
The order prohibits all public and private gatherings with people from multiple households except for religious services and protests, which officials say are constitutionally protected rights. It also reduces occupancy limits on businesses.
In some cases, the reductions are modest — for instance, nonessential retail stores and personal care services are permitted to operate at 20% of maximum capacity, down from 25% earlier in the month. In other cases, the limits are more significant: Grocery stores saw their occupancy limits slashed from 50% to 35% of the maximum.
Still, many business sectors that were shut down during the last round of stay-at-home orders, such as indoor malls, shopping centers and other nonessential retail stores, were permitted to remain open. The only new closures announced Friday were of card rooms and playgrounds.
In the late morning at the Citadel Outlets, seven customers were inside Claire’s, all under the watchful eye of Fernanda Beiza, who is always counting. The new limit, based on the size of her store, is 10, she said, down from 16.
“It is stressful,” Beiza said, “because there’s only a certain amount of people.”
A masked Melvin Campos, 41, waits for his family at the Citadel Outlets in Commerce. (Francine Orr / Los Angeles Times)
At Ecco, which sells shoes, handbags, belts and wallets, normal customer flow at this time would have been 2,000 an hour — in the pandemonium of 2019. In the pandemic of 2020, circa Thanksgiving weekend, the comparative number is 150, said store manager Ivan Ramirez.
Ramirez doesn’t minimize the health risk and worries when customers don’t respect the six-foot “bubble” that is supposed to exist between people. He says the rules regarding percentage of occupancy allowed by the county can feel “arbitrary.”
“Once you have people inside a location, they don’t measure themselves six feet away,” Ramirez said. “There could be a moment where everyone is just going to crowd up.”
Members of his work hard to sanitize throughout the day and keep people apart — a common theme among store workers who are trying to play by the rules and are concerned about protecting themselves from unnecessary risk.
Ramirez is grateful his company has tried to hold on to workers, but he worries about the economic effect of the county health orders.
“If we were a mom-and-pop, definitely, there would be no way we would be making ends meet,” Ramirez said. “Employees would be getting cut left and right.”
By 12:30 p.m., both the temperature and the crowd size had risen at the Citadel. Lines started forming outside the more popular stores, including Tommy Hilfiger. People were waiting an hour or more to get in.
The line outside Coach was even longer. And throngs were milling about a central decoration called “Tallest Christmas Tree.”
Masks for sale at the Citadel Outlets in Commerce. (Francine Orr / Los Angeles Times)
Most of the Flores family was exhausted after just one stop and ready to go home. But they were still waiting for Mom, who was braving one more line.
The scene began to look like the queue for the most popular rides at Disneyland, where people wait in line for ages in exchange for a few minutes of bliss — and part of the bliss was the relatively uncrowded indoor spaces of the stores.
Miguel Flores, 17, thought the good prices were too much to pass up. His brother Jose, 19, questioned that logic, wondering if the prices were just jacked up to make things look like a sale. Jose lost his own job in retail because of the pandemic. Jose Sr. sat nearby, a little anxious about the entire adventure because he’s in his 60s and worried about catching the virus.
Nearly everyone seemed to be wearing masks, but they’d pull them down to eat or drink, and many were walking around with ice cream, shakes, chocolates and other snacks.
Even though she works outside at a kiosk — just outside Skechers — Anabel Velazquez worries about the health risk. She says people take offense when she reminds them to wear a mask or wear it properly — which is ironic because she sells masks and was herself sporting one with a Playboy logo.
And people are still buying masks, one for $10, three for $20.
“There are days where people come to just buy masks,” Velazquez said. “Like they will take $300 worth of masks home.”
Velazquez says the mall requires rent payments whether her stand opens or not, so she feels as bonded to her job as an essential worker.
Most of her customers, she thinks, “are playing with their unemployment money. I think that’s why there’s been that boom for sales. Because if you look around, it’s almost like any other year. There’s no decrease in how many people have come out to shop.”
Ferrer said officials hoped the more narrowly tailored restrictions would be sufficient to slow the spread of the coronavirus without having to give way to stricter stay-at-home orders. The county is “at a different place now than we were in March and April when we didn’t have the science around masking and distancing,” she said.
“Now that we do, it offers us a slightly different path forward,” she added. “But I’ll be honest: It only offers us a different path forward if everyone’s doing it.”
If people don’t follow safety precautions, she said, it’s possible the county could find itself back where it was in the early spring.
“If this doesn’t work, and two to three weeks from now we find ourselves in a worse place than we are, we’re going to have to go back and look at what else do we have as options, because we cannot continue to risk overwhelming the healthcare system,” Ferrer said.
“I don’t think there’s any disagreement about that — that that’s a disaster that we have to avoid at all costs.”


latimes--2020-11-29--COVID-19 continues to roil California prisons, jails as officials face new criticism

Inside the state prison system ’ s Substance Abuse Treatment Facility in Kings County , David Cauthen has spent nearly five weeks on a hunger strike to protest what he sees as indifference and ineptitude by the California Department of Corrections and Rehabilitation at stopping a coronavirus outbreak there that has infected more than 1,089 inmates and killed one in recent days .
“ Officers , nurses and even doctors only wear masks when it is convenient , ” he stated in an email , “ and the only time it is convenient for them is when the facility has @ @ @ @ @ @ @ Dist .
Atty .
Lisa Smittcamp is equally unhappy with how state prison officials are handling the virus behind bars .
Her jail , she said , was overwhelmed with convicted inmates who normally would be moved to state prisons but who were now stuck in limbo as prison officials again halted those transfers Wednesday .
With limited space in county jails , she said , people arrested are often quickly released to keep the local facility at a safe capacity .
“ You can not shut off the prisons , ” Smittcamp @ @ @ @ @ @ @ it has impacted public safety.
” Over eight months into a pandemic that has been especially virulent in crowded settings , the Department of Corrections and Rehabilitation is still grappling with new outbreaks and old criticisms as the coronavirus continues to surge in some of its 35 prisons .
With a large wave of cases hitting across the state , some say the corrections department has failed to enforce its own policies and protective measures , and worry that further flare-ups could wind up filling community hospital beds in places already stressed .
@ @ @ @ @ @ @ active cases of the virus , with six facilities across the state having outbreaks with over 100 cases among inmates .
The Substance Abuse Treatment Facility has reported more than 900 new infections in the last two weeks , the department says .
Nearly 6,000 guards and other staff including nurses and administrators have also tested positive since the pandemic began — including 117 in the last two weeks at High Desert State Prison in Lassen County — a source of consternation as the department concedes that its staff is carrying the virus @ @ @ @ @ @ @ some employees have refused testing and resisted effective masks .
Recently , 13 workers were sanctioned for noncompliance with regulations on personal protective equipment at Pelican Bay State Prison in Del Norte County in California ’ s far north , according to the corrections department , as county officials worried about a lack of information for contact tracing of coronavirus-positive prison staff .
The situation prompted state Sen. Mike McGuire ( D-Healdsburg ) to complain at a Nov. 19 oversight hearing that the lack of enforcement and cooperation was “ not good for @ @ @ @ @ @ @ at Pelican Bay have contracted the virus , 18 of them in the last two weeks , according to the department .
Though prison officials are quick to point out they have reduced the inmate population by 22,000 since March , bringing it to its lowest number in three decades — and recently have begun more disciplinary actions for PPE failures — lawmakers , advocates , incarcerated people and county government officials contend that the agency has been too slow to learn lessons .
There is little transparency about how decisions are being @ @ @ @ @ @ @ walls , they say .
Most alarming is the glacial pace of releases for elderly and medically vulnerable inmates , say advocates and some lawmakers — and the lack of answers as to why .
It ’ s a population that some argue presents the least risk for committing new crimes but has the highest risk for serious COVID-19 illnesses .
“ It sounds like the decision maker is somewhere up in the ether , ” said state Sen. Hannah-Beth Jackson ( D-Santa Barbara ) at the oversight hearing , speaking of how @ @ @ @ @ @ @ seems there is way too much authority here within prisons to make those decisions unilaterally and frankly without a whole lot of accountability.
” Faced with the stark reality that vulnerable inmates in California ’ s crowded prisons would die unless he reduced the incarcerated population , Gov .
Gavin Newsom pledged to examine how to let some of them go early in the pandemic .
But Newsom and corrections officials instead largely have cut the prison ranks in two ways .
First , they released about 7,400 inmates who had only a @ @ @ @ @ @ @ Then they left more than 8,000 inmates due to begin prison sentences stockpiled in the county jails — passing the burden to California ’ s sheriff ’ s departments .
About 7,000 of those prison-bound inmates remain in county jails , according to the state corrections department .
Since resuming accepting county jail inmates Aug. 28 , state prisons have received about 3,300 inmates from 38 counties using a strict protocol of quarantining and testing , according to the agency .
But in Los Angeles County alone , nearly 3,000 prisoners await transfer @ @ @ @ @ @ @ Wednesday ’ s freeze .
Since spring , the jail population has soared from 11,700 to more than 15,000 .
“ That is a large chunk of people who are sitting in our jails when they should be in state prison , and they are a double problem because these are people we can not release any other way , ” Sheriff Alex Villanueva said during an online news conference Wednesday .
“ This is harming our ability to keep the jail population decompressed and raises the risk of COVID-19 to inmates and @ @ @ @ @ @ @ than 8,200 medically at-risk inmates who live in settings that make airborne transmission of the virus hard to control — such as cells with open bars — less than 1 % , or about 80 people , have been released , according to James King , a state campaigner for the Ella Baker Center for Human Rights , who testified at the Senate hearing .
“ We have increased the proportion of highly vulnerable [ people ] in prison by letting out the less vulnerable , ” said Dr. Stefano Bertozzi , UC @ @ @ @ @ @ @ .
“ We haven ’ t actually let the people out who most should be let out.
” The corrections department did not provide state numbers for medical releases despite multiple requests .
Michael Bien , an attorney who represents inmates in federal litigation , said the effects of not releasing incarcerated seniors will be felt publicly in nearby communities if prison infections continue to soar .
“ They will begin to fill the hospital beds near these prisons in the next three to four weeks if COVID continues to spread , ” @ @ @ @ @ @ @ from now on in the prisons will be on the [ medically fragile ] list.
” Bien and others contend the decision to keep the medically vulnerable inmates incarcerated has political overtones .
Many of those under consideration were violent criminals , he said .
Their average age is 63 , and many have indeterminate sentences that have left them behind bars for decades .
Bien and Bertozzi said politicians including Newsom , who has weathered scathing press in recent weeks , seem to be weighing the risk of releasing violent offenders .
@ @ @ @ @ @ @ department has undergone a change of leadership , with its head retiring in September and Kathleen Allison , a former warden at the Substance Abuse Treatment Facility who began her career at the agency in 1987 as a medical technical assistant , taking over .
“ Frankly , I don ’ t understand the political logic , ” Bertozzi said .
“ You watch someone without legs rolling across the yard in a wheelchair , you think to yourself , yeah I can imagine a scenario where that person is a danger to @ @ @ @ @ @ @ ” Some legislators are also asking for answers about how the department is ensuring its employees are taking necessary precautions — concerned that resistance among their ranks is a danger to preventive efforts and has not been adequately handled by state authorities .
Bertozzi said this month that the outbreak at the Substance Abuse Treatment Facility had started in an area where civilian staffers in a facility that packages food mixed with inmate workers in a kitchen .
That food packaging facility , run by the California Prison Industry Authority , which operates @ @ @ @ @ @ @ is likely to remain open as an essential business , despite other outbreaks linked to factory operations and a decision by the corrections department to shut Prison Industry Authority facilities deemed nonessential .
Neither state agency answered a request for clarification .
Dr. Joseph Bick , statewide director of healthcare service for the corrections department , also testified this month that until a recent order requiring all staffers to wear surgical masks provided by the department , guards and other staffers had been using “ bandannas and gaiters and masks with valves and @ @ @ @ @ @ @ really going to achieve our goal.
” State Sen. Nancy Skinner ( D-Berkeley ) replied , “ It ’ s never too late , but it is rather late ” to be requiring staff to use effective PPE .
“ It ’ s disappointing.
” Lawmakers also questioned Bick and Connie Gibson , director of the department ’ s Division of Adult Institutions , about the number of guards who had refused coronavirus testing , but neither was able to provide details on how many state employees fell into that category .
Gibson @ @ @ @ @ @ @ , ” but she was “ very concerned about staff that refuse to test.
” The corrections department did not provide a number or percentage of employees who had refused testing despite multiple requests .
Families of those behind bars , who have been forbidden from seeing their loved ones for months , said the real toll of the prison system ’ s failure to control the virus was on them .
“ I feel it in my soul and my stomach , ” said Shondra Caldwell , a mother of two teenage @ @ @ @ @ @ @ COVID-19 .
The diagnosis , she said , made her “ hysterical , ” and she sees anxiety wearing on her girls .
“ There is nothing right now about the situation that is under control , ” she said .
“ No one deserves that .
”

California’s prison system has more than 3,600 active coronavirus cases, with six facilities having outbreaks with more than 100 infected inmates. Above, the California Correctional Health Care Facility in Stockton.
Inside the state prison system’s Substance Abuse Treatment Facility in Kings County, David Cauthen has spent nearly five weeks on a hunger strike to protest what he sees as indifference and ineptitude by the California Department of Corrections and Rehabilitation at stopping a coronavirus outbreak there that has infected more than 1,089 inmates and killed one in recent days.
“Officers, nurses and even doctors only wear masks when it is convenient,” he stated in an email, “and the only time it is convenient for them is when the facility has visitors.”
For the record: An earlier version of this story stated that 6,000 CDCR guards had tested positive statewide, including 117 guards at High Desert State Prison and 72 at Pelican Bay. Those figures include guards and staff.
Nearby in Fresno County, Dist. Atty. Lisa Smittcamp is equally unhappy with how state prison officials are handling the virus behind bars. Her jail, she said, was overwhelmed with convicted inmates who normally would be moved to state prisons but who were now stuck in limbo as prison officials again halted those transfers Wednesday. With limited space in county jails, she said, people arrested are often quickly released to keep the local facility at a safe capacity.
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“You cannot shut off the prisons,” Smittcamp said. “One hundred percent, it has impacted public safety.”
Over eight months into a pandemic that has been especially virulent in crowded settings, the Department of Corrections and Rehabilitation is still grappling with new outbreaks and old criticisms as the coronavirus continues to surge in some of its 35 prisons. With a large wave of cases hitting across the state, some say the corrections department has failed to enforce its own policies and protective measures, and worry that further flare-ups could wind up filling community hospital beds in places already stressed.
The department currently reports more than 3,600 active cases of the virus, with six facilities across the state having outbreaks with over 100 cases among inmates. The Substance Abuse Treatment Facility has reported more than 900 new infections in the last two weeks, the department says.
California California kept prison factories open. Inmates worked for pennies an hour as COVID-19 spread Inmates who made masks and furniture for as little as 35 cents an hour say they felt pressure to stay on the job, even as the coronavirus spread through the prison factories.
Nearly 6,000 guards and other staff including nurses and administrators have also tested positive since the pandemic began — including 117 in the last two weeks at High Desert State Prison in Lassen County — a source of consternation as the department concedes that its staff is carrying the virus behind bars, even as it admits some employees have refused testing and resisted effective masks.
Recently, 13 workers were sanctioned for noncompliance with regulations on personal protective equipment at Pelican Bay State Prison in Del Norte County in California’s far north, according to the corrections department, as county officials worried about a lack of information for contact tracing of coronavirus-positive prison staff. The situation prompted state Sen. Mike McGuire (D-Healdsburg) to complain at a Nov. 19 oversight hearing that the lack of enforcement and cooperation was “not good for the community.” Seventy-two guards and staff at Pelican Bay have contracted the virus, 18 of them in the last two weeks, according to the department.
Though prison officials are quick to point out they have reduced the inmate population by 22,000 since March, bringing it to its lowest number in three decades — and recently have begun more disciplinary actions for PPE failures — lawmakers, advocates, incarcerated people and county government officials contend that the agency has been too slow to learn lessons. There is little transparency about how decisions are being made and what is happening behind prison walls, they say.
Most alarming is the glacial pace of releases for elderly and medically vulnerable inmates, say advocates and some lawmakers — and the lack of answers as to why. It’s a population that some argue presents the least risk for committing new crimes but has the highest risk for serious COVID-19 illnesses.
“It sounds like the decision maker is somewhere up in the ether,” said state Sen. Hannah-Beth Jackson (D-Santa Barbara) at the oversight hearing, speaking of how those determinations are handled. “It seems there is way too much authority here within prisons to make those decisions unilaterally and frankly without a whole lot of accountability.”
Faced with the stark reality that vulnerable inmates in California’s crowded prisons would die unless he reduced the incarcerated population, Gov. Gavin Newsom pledged to examine how to let some of them go early in the pandemic.
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But Newsom and corrections officials instead largely have cut the prison ranks in two ways. First, they released about 7,400 inmates who had only a few months remaining on their sentences. Then they left more than 8,000 inmates due to begin prison sentences stockpiled in the county jails — passing the burden to California’s sheriff’s departments. About 7,000 of those prison-bound inmates remain in county jails, according to the state corrections department.
Since resuming accepting county jail inmates Aug. 28, state prisons have received about 3,300 inmates from 38 counties using a strict protocol of quarantining and testing, according to the agency. But in Los Angeles County alone, nearly 3,000 prisoners await transfer, a number likely to grow with Wednesday’s freeze. Since spring, the jail population has soared from 11,700 to more than 15,000.
“That is a large chunk of people who are sitting in our jails when they should be in state prison, and they are a double problem because these are people we cannot release any other way,” Sheriff Alex Villanueva said during an online news conference Wednesday. “This is harming our ability to keep the jail population decompressed and raises the risk of COVID-19 to inmates and staff alike.”
But of the more than 8,200 medically at-risk inmates who live in settings that make airborne transmission of the virus hard to control — such as cells with open bars — less than 1%, or about 80 people, have been released, according to James King, a state campaigner for the Ella Baker Center for Human Rights, who testified at the Senate hearing.
“We have increased the proportion of highly vulnerable [people] in prison by letting out the less vulnerable,” said Dr. Stefano Bertozzi, UC Berkeley professor of health policy and management. “We haven’t actually let the people out who most should be let out.”
The corrections department did not provide state numbers for medical releases despite multiple requests.
Michael Bien, an attorney who represents inmates in federal litigation, said the effects of not releasing incarcerated seniors will be felt publicly in nearby communities if prison infections continue to soar.
“They will begin to fill the hospital beds near these prisons in the next three to four weeks if COVID continues to spread,” he said. “Everyone who dies from now on in the prisons will be on the [medically fragile] list.”
Bien and others contend the decision to keep the medically vulnerable inmates incarcerated has political overtones. Many of those under consideration were violent criminals, he said. Their average age is 63, and many have indeterminate sentences that have left them behind bars for decades.
Bien and Bertozzi said politicians including Newsom, who has weathered scathing press in recent weeks, seem to be weighing the risk of releasing violent offenders. At the same time, the corrections department has undergone a change of leadership, with its head retiring in September and Kathleen Allison, a former warden at the Substance Abuse Treatment Facility who began her career at the agency in 1987 as a medical technical assistant, taking over.
“Frankly, I don’t understand the political logic,” Bertozzi said. “You watch someone without legs rolling across the yard in a wheelchair, you think to yourself, yeah I can imagine a scenario where that person is a danger to society, but it’s doubtful.”
Some legislators are also asking for answers about how the department is ensuring its employees are taking necessary precautions — concerned that resistance among their ranks is a danger to preventive efforts and has not been adequately handled by state authorities.
Bertozzi said this month that the outbreak at the Substance Abuse Treatment Facility had started in an area where civilian staffers in a facility that packages food mixed with inmate workers in a kitchen. That food packaging facility, run by the California Prison Industry Authority, which operates about 100 commercial enterprises inside prisons, is likely to remain open as an essential business, despite other outbreaks linked to factory operations and a decision by the corrections department to shut Prison Industry Authority facilities deemed nonessential. Neither state agency answered a request for clarification.
Dr. Joseph Bick, statewide director of healthcare service for the corrections department, also testified this month that until a recent order requiring all staffers to wear surgical masks provided by the department, guards and other staffers had been using “bandannas and gaiters and masks with valves and all types of things that are not really going to achieve our goal.”
State Sen. Nancy Skinner (D-Berkeley) replied, “It’s never too late, but it is rather late” to be requiring staff to use effective PPE. “It’s disappointing.”
Lawmakers also questioned Bick and Connie Gibson, director of the department’s Division of Adult Institutions, about the number of guards who had refused coronavirus testing, but neither was able to provide details on how many state employees fell into that category. Gibson said it was only “a few,” but she was “very concerned about staff that refuse to test.”
The corrections department did not provide a number or percentage of employees who had refused testing despite multiple requests.
Families of those behind bars, who have been forbidden from seeing their loved ones for months, said the real toll of the prison system’s failure to control the virus was on them.
“I feel it in my soul and my stomach,” said Shondra Caldwell, a mother of two teenage daughters whose husband is incarcerated and contracted COVID-19. The diagnosis, she said, made her “hysterical,” and she sees anxiety wearing on her girls.
“There is nothing right now about the situation that is under control,” she said. “No one deserves that.”