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4 California counties behind spike in COVID hospitalizations - Los Angeles Times

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Four suburban Southern California counties are among those primarily responsible for a dangerous rise in California’s coronavirus hospitalizations, according to a Los Angeles Times data analysis. The four counties have seen significant upticks in hospitalized COVID-19 patients in recent weeks.

Increases in Ventura, Orange, San Bernardino and Riverside counties have contributed to an overall rise in hospitalizations recorded statewide that began after Memorial Day, just as officials were rapidly reopening the economy.

The causes for the spikes are not fully known, but some health officials are blaming social gatherings. A barbecue at a mobile home park in Oxnard recently resulted in 19 people testing positive for the virus, and authorities are now monitoring an additional 40 people who are close contacts of those who are infected.

Ventura County health officials have urged residents to enjoy reopened restaurants, which are governed by strict safety and social distancing rules, rather than having parties and other private events.

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“It’s like we’re cheating on our diet, and angry or baffled that we can’t lose weight,” said Dr. Robert Levin, the Ventura County health officer, on Tuesday. “There’s all those times that we’re not cheating. But [in] the few times we do, all that effort is for naught. So what is the price we pay? Where are we headed? More cases of COVID-19. More people hospitalized. More people in our ICUs. More people dead.”

While L.A. County saw an average of 62 fewer hospitalized patients daily for confirmed or suspected cases of COVID-19 between the week of Memorial Day and last week, Riverside County saw an average daily increase of 85 patients; San Bernardino, 70; Ventura, 33; and Orange, 32, according to The Times’ analysis.

In Ventura County, there was a daily average of 85 people hospitalized with illnesses related to COVID-19 last week; four weeks ago, it was 52.

During the week of May 25, California recorded a new low in weekly coronavirus hospitalizations since the start of the pandemic, with an average daily count of 4,385 patients. Last week, that number climbed to 4,603 — an increase of 218 patients.

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The eight-county San Joaquin Valley is also an area of concern, recording 160 additional patients over the same period, as is Santa Barbara County, with 25 more patients.

And there are other signs of trouble in the state: Orange County recently recorded its deadliest week in the pandemic, with 48 deaths reported in the seven-day period that ended Sunday. The county has seen three consecutive weeks in which the death toll has been higher than the previous week’s.

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The Bay Area’s third most populous county, Contra Costa County, saw its weekly death toll shoot up to 18 last week, its worst since the week of April 13, when nine people were reported to have died.

The pandemic also continues to ravage rural counties, which are critical for the nation’s food supply.

Imperial County recorded 21 deaths last week, its highest weekly death toll, and more than double the previous week’s fatality number of 10. Kings County, where a severe coronavirus outbreak occurred at a meatpacking plant, recorded 10 deaths among its residents last week, more than doubling its previous cumulative death toll.

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San Quentin State Prison in Marin County is now the site of an outbreak that has infected 365 people — more than all of the residents of Santa Cruz County who have been diagnosed with COVID-19.

The outbreak occurred after 121 inmates were transferred from the California Institution for Men in Chino.

“The fact that 121 men were transferred to San Quentin from Chino without being tested is stunning,” state Sen. Scott Wiener (D-San Francisco) said in a statement.

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There also are troubling signs that hospitalizations may be starting to rise again in both L.A. County and Santa Clara County, Northern California’s most populous county, centered in Silicon Valley.

L.A. County on June 13 logged its lowest daily coronavirus hospitalization numbers since April — 1,768 for patients with confirmed or suspected infections — following weeks of consecutive declines. But by Monday, there were 2,090 hospitalized, an 18% increase.

Some of that rise might be caused by more widespread testing. But officials say the jump in the number of cases is also caused by greater transmission of the disease in recent weeks, in part caused by the wider reopening of the economy and increased gatherings, whether they be social or a result of political protests.

“The numbers do tell us that we’re seeing an increase in community transmission,” L.A. County’s public health director, Barbara Ferrer, said this week. Nearly two weeks ago, only 5.8% of coronavirus tests were coming back positive over the previous week in L.A. County. But on Monday, that number had risen to 8.4%.

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The latest projections from the University of Washington’s Institute for Health Metrics and Evaluation say that California may see more than 15,100 deaths by Oct. 1, a 170% increase from the current death toll, which was over 5,600 as of Tuesday night. Nationwide, the institute projects more than 201,000 deaths by that same date, a 65% increase from the current death toll of over 121,000.

Santa Clara County has done much better in controlling the spread of the virus than L.A. County. Santa Clara County has eight coronavirus deaths per 100,000 residents, while L.A. County has 31 deaths per 100,000 residents. Part of that success is related to the Northern California county’s earlier implementation of a regional stay-at-home order, which is credited with saving many lives.

Yet even Santa Clara County is starting to see a rebound in cases as the economy reopens.

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On Tuesday, Santa Clara County recorded its highest number of cases amid the pandemic — 121 — after spending much of last month with a seven-day average of new daily cases hovering around 25.

“Now, we’re going back up at a pattern similar to the rest of the state,” Dr. Jeffrey Smith, the county executive officer, said. “We’re at our highest peak at this point.”

The root of the problem is that Californians are gradually returning to old habits, with mobility rates starting to increase and a projected return to normal by October, said Smith, citing forecasts posted on the website Covid Act Now.

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Dr. Sara Cody, the health officer for Santa Clara County, said the increase in cases was “worrisome.”

“This increase may be accelerating. This increase reflects both widespread testing — we’re finding more of the cases that do exist — but it also reflects an increase in cases because the virus continues to spread. It’s a bit early to tell if this will translate to a significant increase in hospitalizations and deaths going forward,” Cody said.

Although there are fewer cases associated with nursing homes and other long-term care facilities since May, there are now more outbreaks associated with workplaces or in the community, Cody said.

Workplace outbreaks started being detected a week after the county allowed construction firms to get back to work, according to Cody.

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Of 89 worksites that have reported at least one coronavirus infection, 34 of them have been in construction, 10 in food service or restaurants, eight in retail stores and businesses and six in food processing plants.

In outbreaks with three or more cases with exposures in the workplace, 54% of them have occurred at construction work sites; but the largest outbreaks have occurred at food processing centers.

The coronavirus pandemic is like a wildfire, Cody said. “If you contain it when it’s small, you can keep it under control. But once COVID transmission begins to accelerate, it is very, very difficult to contain and to slow down,” she said.

It’s important to ensure that as society gets back to work, that people adhere to strategies to reduce the risk to the virus, she added.

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“None of us want to be forced to return to a full shelter-in-place. So it’s critical that we have strong protocols and risk reduction strategies firmly in place as we continue to reopen,” Cody said.

In Ventura County, officials are increasingly worried about gatherings as hospitalization numbers rise to record levels. Levin, the health officer, said he was dismayed over the weekend seeing people packed, shoulder-to-shoulder, watching a skateboard competition.

Besides additional infections in long-term care facilities, “we believe that there’s also increased community transmission going on in the community, causing individuals to get sick enough that they warrant being admitted to the hospital for acute care, and that is very concerning,” said Rigoberto Vargas, the Ventura County public health director.

If people don’t improve on social distancing, Levin said he’s worried about Ventura County’s hospitals eventually becoming so overwhelmed with coronavirus patients that those with other illnesses, such as those suffering a heart attack, could “die needlessly for lack of a hospital bed.”

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Levin said Ventura County can avoid this future — and a re-implementation of stricter stay-at-home orders — if the public rededicates itself to keeping distance from other people.

“We should avoid gatherings. I think we should stop going out to do frivolous and unnecessary things,” Levin said. “We deserve our freedom. But the reality is we just can’t have it yet. This is a classic case of deferring our reward, deferring our reward until this damn situation lets up and allows us to have our freedom again.”

Younger adults are becoming a pathway for the virus to spread. In L.A. County, 40% of coronavirus cases are occurring among those 18 to 40.

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That matches the experience in Japan, where a study published by the U.S. Centers for Disease Control and Prevention found that the people probably spreading the coronavirus in more than 60 clusters were mostly young adults, age 20 to 39. Most were asymptomatic or presymptomatic when they transmitted the virus, and almost none had a cough.

Transmission likely happened at places like restaurants, bars, workplaces, healthcare facilities, gyms and music events. Many clusters were associated with heavy breathing in close proximity to others, such as singing at karaoke parties, cheering at a concert, chatting in a bar or exercising at a gym.

Lin reported from San Francisco, Lee from Los Angeles and Greene from Thousand Oaks.

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