Time is a flat circle: L.A. County on brink of reinstating indoor mask mandate

AP Photo/Marcio Jose Sanchez

This is a county policy, not a state one, so Gavin Newsom isn’t responsible for it.

Still, this is one reason I think he’s unelectable as a potential Democratic presidential nominee. He’d be viewed widely by the electorate as the poster boy for overlong, overzealous blue-state COVID controls, beginning of course with the shuttering of California’s public schools in 2020-21.

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We’re now well into year three of the pandemic. When will the age of mandates end?

If it seems crazy to you that a mandate is being imposed due to aggressive community spread but won’t take effect for two weeks, well, it is crazy. At that rate, the policy could theoretically kick in around the time the wave is peaking and already beginning to recede. The two-week delay appears to be a concession by the country to the public’s COVID fatigue, though. The new mandate was triggered by “high” rates of hospitalization locally, as seen in the orange zones on this CDC map

…but hospitalization rates fluctuate from day to day. The county doesn’t want to impose an immediate mandate on Monday, then have to lift it the next day when hospitalizations dip below the “high” threshold, then have to reinstate it again on Wednesday when it nudges past “high” again. They want to see two solid weeks of “high” hospitalizations before forcing people to mask up again.

Which seems like a policy destined to please no one. The mandate might be too late to help at that point, assuming it would help at all, yet will demoralize locals anyway by making them feel like they’re backsliding on exiting the pandemic era.

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The county health director put her best spin on it. “We are not closing anything down. We are not asking people not to gather with the people they love. We are not asking you to forgo activities you love,” she said yesterday. “We’re asking you to take a sensible step when there’s this much transmission, with a highly transmissible variant, to go ahead and put back on a well-fitting, high-filtration mask when you’re indoors around others. She cited three different studies that support the idea that mask mandates really do help limit transmission, which is cute in its naivete. After 28 months of COVID, literally no one is still open to persuasion either way on the value of mask mandates.

The mandate seems like overkill but there’s no question that L.A., and California more broadly, are seeing aggressive spread right now. A few days ago I wondered whether the U.S. might quietly be in the midst of its worst wave of COVID ever when measuring by infections. There’s circumstantial evidence that the Bay Area is experiencing the same thing, as scientists there have found levels of the virus in wastewater that rival the levels during this past winter’s insane Omicron wave. Down in L.A., case counts yesterday were the highest since January with *double* the positivity rate, 17 percent at the moment versus 8.5 percent over the winter.

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Meanwhile, hospitalizations in L.A. County have roughly quintupled since mid-May:

Because so many people are testing at home, it’s anyone’s guess how many cases of COVID there truly are locally. That’s why the hospitalization trend is a better gauge of community spread at this point than case counts, and why the CDC transitioned to it as a barometer of transmission months ago.

To make matters worse, the heavily mutated new Omicron subvariant from India, BA.2.75, has also just been detected in California. Scientists don’t know yet whether that one will have a meaningful advantage over BA.5 but they’re watching it closely, with concern.

All in all, you get the sense that L.A. is clamping down with another mandate mainly to communicate to locals as quickly and starkly as it can that the threat level has risen sharply lately and is still rising. Most Angelenos probably don’t know that because most Americans are completely tuned out of COVID at this point. In my home state, cases have been trending upwards for six weeks and barely a word is mentioned about it. Now that the virus is no longer much of a killer, the public seems to be treating it as background noise a la flu season.

Precautionary policies are gone; several governments are focused on counting hospitalizations and deaths, allowing infections to skyrocket as long as the health-care system stays intact. “Everyone just wants some sense of normalcy,” UW’s Roychoudhury said. Even many people who consider themselves quite COVID-conscious have picked up old social habits again. “The floodgates just opened this year,” Martinez said. He, too, has eased up a bit in recent months, wearing a mask less often at small gatherings with friends, and more often bowing to peer pressure to take the face covering off. Ajay Sethi, an infectious-disease epidemiologist at the University of Wisconsin-Madison, still works at home, and avoids eating with strangers indoors. He masks in crowded places, but at home, as contractors remodel his bathrooms, he has decided not to—a pivot from last year. His chances of suffering from the virus haven’t changed much; what has is “probably more my own fatigue,” he told me, “and my willingness to accept more risk than before.”

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There is good news for L.A. even amid the current surge, though. Hospitalizations may be climbing but deaths are about on par with early April, which suggests that many people landing in ERs post-Omicron are doing so “with” COVID but not “for” COVID:

Another clue that BA.5 hospitalizations are more of a “with” phenomenon than a “for” phenomenon is California’s state hospitalization data. In previous waves, bumps in the number of people who landed in the ICU for COVID would track with bumps in overall hospitalizations. Not anymore.

There are many, many cases in the population, a growing number of positive tests among hospital patients, but few examples of people who are suffering truly severe illness or death. Do we need a mandate in those circumstances?

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David Strom 6:40 PM | April 18, 2024
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