Everywhere you look, it seems, there’s a fight over whether the COVID crisis is over.
In Washington, President Biden is reportedly determined to extend the national COVID emergency into January but has faced dissent inside his administration. Politico reported that some Biden officials “questioned whether it was time to let the designation lapse.”
Then the Centers for Disease Control made a surprise announcement that the agency is “streamlining its COVID-19 guidance” to reflect that “there is significantly less risk of severe illness, hospitalization and death compared to earlier in the pandemic.”
No more quarantining after an exposure to COVID-19, the CDC said, and no screening tests of asymptomatic people who have not had an exposure. Don’t worry about social distancing, either.
The CDC seems to think it’s time to calm down. “This guidance acknowledges that the pandemic is not over, but also helps us move to a point where COVID-19 no longer severely disrupts our daily lives,” the agency wrote.
Meanwhile in Los Angeles County, there is dissonance between the leading medical doctors at the county’s largest public hospital and the county’s Public Health director, Barbara Ferrer.
At last week’s town hall meeting for employees of LAC+USC Medical Center, chief medical officer Dr. Brad Spellberg cheerfully reported that the hospital’s COVID-positive cases were in the “fourth straight week of decline, and fairly substantial decline.” He said there were “approximately 40 COVID-positive patients in the hospital of whom five were admitted due to COVID and three of those don’t really need to be in the hospital any more.”
Dr. Spellberg reminded the staff that high “case” rates result from the fact that “the RNA will stay positive in someone for months after the time they’re exposed to the virus,” resulting in “a bunch of people who get admitted who have no symptoms of COVID who test positive for COVID.” He said it will take several months “for all that RNA due to acquired infections over the last several months to just wane from peoples’ bodies and get clear.”
One employee asked if there’s an end date to the policy of testing every admitted patient for COVID, regardless of the reason they’re in the hospital.
“Most of our staff don’t want us to stop testing,” Dr. Spellberg answered. “That’s how much fear there is around the virus. That’s one of the reasons we try to offer Soothiness Wednesdays.”
“Soothiness Wednesdays” is what the doctors call their weekly town hall meetings, where for several weeks they have been making news by revealing that there is “nobody” in the hospital with COVID-19 disease as they saw it in the past, nobody with COVID pneumonia, nobody on a ventilator.
The L.A. County Public Health Department is telling a different story. In her Thursday media briefing, Ferrer reported a countywide decline in cases but hurried to add, “Among those hospitalized who are infected with COVID, 43% are hospitalized with COVID-associated illness, 11% are in an ICU and 6% are on a ventilator.”
What’s going on here? On Wednesday, the chief medical officer at the county’s largest public hospital was so relaxed and upbeat that he opened his remarks by joking that he should wear a Hawaiian shirt and have a drink with a little umbrella in it. Then on Thursday, Public Health Director Barbara Ferrer seemed determined to be gloomy and frightening.
Ferrer reported “an average of 14 deaths per day” and, as always, interrupted the data presentation to share her grief and sympathy. “These deaths continue to take family members away from those who love them,” Ferrer said. “We do recognize the heartache that’s associated with these losses and we send wishes for healing and peace to all who have lost a loved one.”
Expressions of sympathy are appropriate when people have suffered a loss, but it’s also appropriate to clearly explain whether these deaths were caused by COVID, or by something else with COVID only slightly associated. It might also be appropriate, for context, to point out that the population of L.A. County is 10 million and there are typically 60,000 deaths per year from all causes.
“The data” collected by the CDC and public health authorities can help to track the path or intensity of the pandemic, but the numbers are not precise or timely enough to be used like a stoplight at an intersection. Yet that is what Ferrer has been doing. If the county crosses a numerical threshold, she stops traffic, so to speak, regardless of the harms or consequences.
For example, in her August 4 media briefing, Ferrer announced that the CDC’s latest calculation of L.A. County’s hospital admission rate was a “disappointing” 10.1 per 100,000 people instead of 10, “keeping L.A. County in the high community level,” a metric she had previously chosen as the trigger for a return to mandatory indoor masking if it continued.
A few weeks earlier, Ferrer had geared up to reimpose an indoor mask mandate based on the CDC’s metrics. That enraged local parents of school-age kids and resulted in a lawsuit against Ferrer and the Public Health Department. Although Ferrer backed down from the mask mandate, the lawsuit continues.
Attorney Julie Hamill is representing the Alliance of Los Angeles County Parents, which seeks “to remove all unnecessary, harmful, and unjustified restrictions against children and provide children with a full return to normalcy.” The lawsuit alleges that L.A. Public Health has demonstrated decision-making that is “arbitrary, capricious and entirely lacking in evidentiary support,” and that the rights of children to the equal protection of the law are being violated.
It’s time for Los Angeles County officials to stop deferring to CDC frameworks that were designed to guestimate potential stress on the county’s hospitals. The people actually running the hospitals can answer those questions, and they’re not guessing.
And it’s long past time for the COVID state of emergency to be ended, both nationally and in California.
Write Susan at [email protected] and follow her on Twitter @Susan_Shelley