LOS ANGELES - Los Angeles County health officials are defending new business and social gathering restrictions, stressing that absent an immediate downturn in COVID-19 case numbers, area hospitals could be quickly overwhelmed as the county confronts "one of the most dangerous moments in this pandemic."
In addition, health officials are urging people to modify their holiday plans by staying home and to host smaller gatherings.
Dr. Christina Ghaly, the county's director of health services, stressed Wednesday that current projections indicate the county will see its highest number of hospitalizations since the pandemic began in the next four weeks, potentially outpacing hospital capacity.
Driving home the point, public health director Barbara Ferrer walked through statistics showing dramatic increases in the county's case numbers, testing positivity rates and hospitalizations since early November. Ferrer said the county on Nov. 1 was averaging about 1,100 new cases a day, but that figure increased to almost 2,000 one week later, and as of Wednesday, it had risen to almost 4,000 per day.
"I cannot stress enough how concerning this is," Ferrer said.
The county's seven-day average daily positivity rate among those tested for the virus was 3.9% on Nov. 1, but it rose to 5.1% by Nov. 8 and it now stands at 7.1%. Average hospitalizations were 791 on Nov. 1, rising to 1,010 on Nov. 14. On Wednesday, the county reported 1,188 people in the hospital due to the virus, the ninth straight day of increases.
"We face one of the most dangerous moments in this pandemic," Ferrer said. "And the only effective path forward requires immediate action, and unfortunately, additional sacrifice. When the rate of increase is as high as it is right now, it can be harder to slow the spread. Heading into colder months and the flu season compounds the sense of urgency."
On Friday, the county will impose increased restrictions on business and social activity, most notably requiring restaurants, wineries, breweries and non-essential businesses to close between 10 p.m. and 6 a.m. Ferrer clarified that the food and drink establishments will be allowed to continue pick-up and delivery service beyond 10 p.m., but in-person service will be cut off.
The county previously issued guidance limiting gatherings to three households, but there was no numerical limit on attendees.
According to the county, if the five-day average of new cases reaches 4,000, or if hospitalizations top 1,750, outdoor dining at restaurants, breweries and wineries will end, with the businesses restricted to pick-up and delivery service only.
If the five-day case average reaches 4,500 or more, or if hospitalizations top 2,000 per day, the county will re-implement its original Safer At Home order for three weeks, allowing only essential workers to leave their homes, or residents seeking out essential services. The county at that point would also issue a 10 p.m. to 6 a.m. curfew, with only essential workers exempted.
Ghaly warned that an increase in hospitalizations is almost inevitable in the next two weeks, given the virus' incubation period. And the current trend lines indicate that without a dramatic change in case numbers, area hospitals could find themselves quickly overwhelmed with patients.
"While the steep increase in hospitalizations has only been going on for one week, we cannot ignore the facts," Ghaly said. "... If we look at the range of uncertainty going forward ... then the projected trend over the next four weeks is concerning. ... The message is very clear. It is highly likely that we will experience the highest rates of hospitalizations that we have seen in the COVID-19 pandemic to date in the next month, unless we take action immediately to substantially reduce transmission within our communities."
The estimated rate of COVID-19 transmission in the county -- the average number of people every coronavirus patient infects with the virus -- was 1.18 as of Wednesday, an increase from last week's 1.03 rate, and rapidly approaching the pandemic-high rate of 1.26 recorded in late July during the summer surge.
Ghaly noted that if hospitals start becoming overwhelmed, they'll be forced to discharge less serious patients and cancel elective procedures. She noted that the onset of flu season will place additional strain on the health system, heightening the need for increased COVID-19-control measures.
County officials stressed that the new measures being implemented are not a deliberate attempt to punish businesses and restaurants, but they are aimed at reducing crowding and reducing potential exposures in settings -- such as restaurants -- where people are gathered without wearing masks.
"Approximately 95% of businesses that have reopened have been in compliance with public health guidelines," County Supervisor Kathryn Barger said. "However, we are implementing these precautions to help prevent the ongoing community transmissions. We hope these actions get the attention of individuals who are not using caution in social settings and encourage them to be vigilant."
Health officials have pointed squarely at gatherings of residents -- either in public or private settings -- for driving the recent surge, which has primarily involved younger residents under age 50.