29. Special Update on California: Main Message – Don’t Be Stupid, Wear a Mask!

(1/18/21) CA and particularly Los Angeles County are exploding exponentially and are now among the hottest spots in the world for Covid-19. Orange County is not far behind.

It feels so long ago when COVID-19 first broke out. When I first started this blog in mid-March 2020 Europe was just beginning to go through what became an unimaginable outbreak only to be exceeded by the carnage in the northeastern United States. California and particularly Orange County were relatively spared the initial wave of the pandemic. At that time New York City had experienced 1,985 deaths per million people (about 1 in 500) while CA was at 51 and OC at 16. No one thought it could ever again be as bad as it was for those deadly hot spots. Wrong. Today we focus less on total deaths (that is the past) and instead on death rate, which has now grown to 161 per million people in Los Angeles County and 88 per million people in OC per week! By comparison, CA is at 94 and the US is at 70, so all of CA is above the US death rate, which is only exceeded for major countries worldwide by the U.K. (110 deaths per million per week). So, CA including OC are now among the deadliest spots in the world and LAC is off the charts! Not sure I can put enough exclamation points on that statement.

So, I will give the local statistics and provide commentary below. But first I need to get on my soapbox. Let me start by saying that, although I am a staunch supporter of social restrictions, I do not agree with all the government health advisories. The problem is we are told what we can’t do rather than what we can do. But let me also say that we need to stop being deniers. That behavior is foolish, selfish, and will kill you. Before COVID-19 I used to counsel people to take care of their health and get checked out whenever any health issue small, but unusual occurs. I have known many intelligent people who were too busy to heed the warning signs only to find out too late that they have a terminal disease. That is a wrenching way to die knowing that it was avoidable. I call those stupid deaths. Don’t die stupid! Well, that is happening now at inconceivable frequency. You’ve heard of people saying on their death bed that they wished they took COVID-19 more seriously. Even worse are the young people who now account for a large percentage of elderly deaths and have to live with the guilt for the rest of their lives of having caused the death of a family member. Don’t let that happen!

Well yes, this column so far is a real downer, but the point is to try to save lives. Fortunately, it is not that hard. There are two ways to reduce the virus transmission by over 80%, taking the vaccine and wearing a mask. What can we do now? Wear a mask! Don’t be stupid. So, what about social isolation? Anyone who drives down PCH on any given day knows that people are not going to stay home and hibernate. So, if you have to go out then take basic precautions. Wear a mask, keep reasonable distance, always keep a hand sanitizer with you, …. and enjoy the outdoors! There are a lot of fun things you can do safely. Just don’t be stupid!

OK, so how bad are things? The Figures below show the infection (case) rate, total hospitalizations, and death rate for LAC and OC.

Case rates, hospitalizations, and death rates for LAC (left) and OC (right) as of 1/15/21.

The first thing you notice is wholly cow, that looks really bad right now. Yes, it is! Here are some other key observations:

  • One can see the three waves of the epidemic.
  • OC and to a lesser extent LAC avoided the first wave of the epidemic that viciously hit Europe and the northeast US from March through May. We can thank Governor Gavin Newsom for rapidly implementing social distancing mandates.
  • The second wave hit both LAC and OC in July and August as social restrictions were perhaps lifted too soon.
  • The second wave diminished to relative tranquility in September and October, but then burst into an intense third wave starting in December with case rates, hospitalizations and death rates currently about 10 times greater than 2 months ago.

If you look closely at the third wave you’ll notice that cases rise first, then hospitalizations, and then deaths. Maybe encouragingly we are seeing a peak and rollover in cases and hospitalizations and hopefully that will translate into a similar rollover in the death rate in the next couple of weeks.

The main takeaway is that infections in LAC and OC are 10 times greater than they were just 2 months ago. There is currently an infected and contagious person for every 50 people in LAC and 70 people in OC. That is a lot of exposure. That means no matter how safe you continue to be you are still 10 times as likely to catch COVID-19 as you were 2 months ago. It is that bad out there!

The percentage of hospitalized COVID-19 patients who die tells a gloomy story. The Figure below shows this percent for total and ICU COVID-19 hospitalizations for two 4-week periods. In less than 2 months the death rate in LAC has about doubled for all hospitalized patients and those in ICU, the latter reaching a staggering 60%. I should caution that this type of data is not reported, but I calculated it based on hospitalization and death rates and an assumption for average days in the hospital. So, the absolute number is uncertain but the trend can be trusted. One can only surmise that the reason for this increase in mortality is due to a patient load that has so overwhelmed the medical staff that the level of care has either deteriorated or hospitals are having to turn away the less ill or both. Don’t let anyone tell you that the jarring reports of besieged hospitals is a media exaggeration!

Estimated death rate for all patients hospitalized and for those in ICU in LAC (left) and OC (right) as of 1/15/21.

So, what now and will vaccines save us? Yes, but…. We have all been reading how slow vaccine deployment has been. This will improve, but at best no more than 10% of the population will get vaccinated each month. We need to get to over 50% vaccination to add to about 10% of those who have already caught COVID-19 and are now immunized. That will still not get us to herd immunity, but it will slow down the epidemic enough to help restore some semblance of normal life. I am not making any predictions when we will return to full normalcy because society will always find a way to prolong the problem.