Los Angeles County plans to start testing people without symptoms of COVID-19 at nursing homes in an effort to curtail outbreaks that have emerged at the facilities countywide, officials said Wednesday.
About 40% of people who died of the respiratory illness in L.A. County have been residents in institutional settings, most of which were skilled nursing homes, the county’s public heath director Dr. Barbara Ferrer said.
Nearly half of the county’s over 300 skilled nursing facilities have had coronavirus cases among staff and residents, according to a list released by the California Department of Public Health.
One East Hollywood nursing home, Brier Oak on Sunset, had 62 cases among residents and 80 among staff — among the highest numbers reported by the state.
“In the past, we have done a lot of our infection control protocols around the assumption that we needed to worry about people who are symptomatic and test people who are symptomatic …,” Ferrer said at a news conference. “But it turns out that we were wrong, and with new information it’s become clear that asymptomatic people are capable of spreading the virus.”
With the number of people infected at the nursing facilities rising and more deaths being reported, officials hope testing staff and residents without symptoms will help with immediately isolating those infected in an effort to prevent major outbreaks.
But L.A. County’s officials are still working on calculating how much testing can really be done at the facilities, given some supplies remain limited.
“We are working to better understand that volume of testing that’s needed at skilled nursing facilities as compared to the available supply of tests,” the county’s director of health services Dr. Christina Ghaly said.
There are over 300 nursing homes across county, together having around 40,000 beds, according to Ghaly.
So far, 90,000 people in L.A. County have been tested for the coronavirus, and 15% of them were found to be positive. Testing is no longer limited to vulnerable groups, but only people with symptoms can get tested at the county’s drive-up and walk-in sites.
Los Angeles Mayor Eric Garcetti said beginning Thursday, testing will be available to all essential workers who may or may or not be experiencing symptoms of the virus. Any worker interested in getting tested should contact their employers for priority testing.
Between 10,000 to 11,000 L.A. County residents are tested each day, and the health department is working on increasing those numbers to make sure people in underserved communities also have access to testing.
In addition to increased testing at nursing facilities, the Centers for Disease Control and Prevention is sending members to help the county improve infection control at the homes.
The state has also been helping with trying to curb the spread of the virus at nursing facilities, including by training nurses on what to do in case of an infection.
Ferrer also announced the the county has distributed additional personal protective equipment to staff at the facilities.
This week, 2.8 million masks, 8,000 gowns, 200,000 gloves and 50,000 face shields are being distributed to over 300 skilled nursing facilities.
Each will get between 5,000 and 16,000 masks depending on their capacity, Ferrer said.
Meeting demand for hospital care amid the pandemic
After L.A. County officials announced 66 new deaths and 1,318 new cases Wednesday, numbers climbed to 16,435 cases countywide with a total of 729 deaths.
The spike in daily reported cases was mainly attributed to data coming back late from labs for three days in a row.
So far, 3,902 of all the county’s COVID-19 patients had been hospitalized at some point while battling the illness. On Wednesday, there were 1,791 coronavirus patients still being treated at hospitals in L.A. County, Ferrer said.
In anticipation of a surge in cases, officials across the state have been scrambling to add more hospital beds to the system and bring in more health care workers, including by getting medical professionals out of retirement and having a U.S. Navy hospital ship dock in L.A. to help lessen the load on local hospitals.
Ghaly said that current projections show local hospitals will be able to meet the demand, even at the virus’ projected peak. This includes demand for intensive care hospitalizations and ventilators.
“Data shows that, to date, there continues to be a leveling off of the cases of COVID-19, however new infections are not yet decreasing and we continue to have a need to maintain physical distancing measures to prevent an increase in cases of COVID-19 and to avoid an excessive strain on the hospital system across the county,” Ghaly said.
She attributed the leveling off in COVID-19 cases to the county’s residents, who have largely been complying with social distancing measures.
The county’s model found that though the number of daily COVID-19 hospitalizations have not decreased, they are projected to remain fairly steady.
But Ghaly emphasized the data and circumstances continue to change, and so will projections.
It all depends on how much residents adhere to social distancing guidelines and whether there is a spike in cases, she said.
Ghaly said the supply of available hospital beds in L.A. County is finite and is affected by the hospitals’ ability to adequately staff those beds.
“Health care workers have been one of the many heroes of the COVID-19 response in this county, across California, and nationwide,” Ghaly said. “But we have to remember that they’re also human, and if a hospital’s ability to staff its beds changes, then we have to reduce the available bed capacity.”
Physical distancing at the core of stopping COVID-19 spread
Ghaly again on Wednesday stressed that if social distancing measures stopped or were reduced too soon, most of the county’s population could become infected by Aug. 1.
If people continue to stay home at current levels, county officials expect around 11% of the population will be infected by that date, she said.
Some neighboring counties have started easing some restrictions on movement, like Riverside and Orange counties allowing golf courses to open, or San Bernardino County opening up parks and trails in addition to golf courses.
Ferrer urged L.A. County residents to not flock to other counties while restrictions are still in place in their home county.
“We remain committed with our health partners to safely ease restrictions so people can return to work and reunite with loved ones. Keep in mind, science and data will guide our decision,” said chairwoman of the L.A. County Board of Supervisors Kathryn Barger said.
Statewide, 1,268 people had died of COVID-19 as of Tuesday, and the number of people hospitalized for the illness continues to increase incrementally, according to Gov. Gavin Newsom.
Nearly 36,000 people had tested positive for the coronavirus across California as of Wednesday, according to a tally by the Los Angeles Times.
