But, confusingly, headlines in the popular press tell a different story:

• From ABC-7:  ‘New COVID-19 cases tick upward in LA County; officials warn against spring travel” (link:  https://abc7.com/covid-la-coronavirus-county-cases/10390733/)
• From LA Times: “Los Angeles County Tops 22,000 COVID-19 Deaths” (link: https://www.latimes.com/california/story/2021-03-06/los-angeles-county-tops-22-000-covid-19-deaths)
• And, again, from the LA Times “New Fears of Next Coronavirus Wave as Case Decline Slows” (link: https://www.latimes.com/california/story/2021-02-27/increase-coronavirus-cases-fourth-surge)

The mismatch between press headlines and our epidemiologic reality likely reflects a fear driven reaction from County officials.  As such, they have abandoned the tier system entirely (which may not be a bad thing). But by moving away from such, they no longer have a concrete metric by which they can consistently communicate risk to the general public. I first saw evidence of this abandonment when the December/January surge really took hold and Governor Newsom began using ICU capacity as a metric for reopening.  I think that occurred because the incident case numbers were of such an enormous magnitude that it rendered the tier system moot. 

Why might it not be such a bad thing to move away from the tier system? Well, simply stated, California’s tier system is neither tied to actual data nor coupled with any public health initiatives. A better metric is found in the Harvard / Brown Global Health Initiative (link: https://globalepidemics.org/key-metrics-for-covid-suppression/) which suggests that a rate “on the path to containment” is a rate less than 1 new daily case per 100,000 population. Even at our current rate of 6.7 we are still experiencing significant community spread – so rigorous test and trace programs should be in place.

The fact is that we are getting better and only 2 per 1000 individuals in the county are currently infected with COVID-19.  Of course we need to avoid Spring Break travel and continue with risk mitigation efforts – but why? Because our goal should be to drive that incidence rate below 1. 

Contact tracing in the county is improving but is still abysmal – in the past 7 days 51.2% of cases have completed a tracing interview, as compared to 44.6% cumulatively (link: https://globalepidemics.org/key-metrics-for-covid-suppression/).  But to be truly effective, the Health Department needs to have about a 90% completion rate. I have little confidence that they will achieve this goal, given that they have made themselves responsible for the entirety of the vaccine rollout rather than distributing the load. An already overworked, underfunded and now likely burnt out group is unlikely to do two things well. They should ask for help.