Blog 13 March 2021: Musings from the Department of Cautious Optimism

COVID-19 case rates in Los Angeles County declined for the 9th consecutive week and now stand at 5.4 new daily cases per 100,000 (Figure 1). Any guesses on the last time we had a rate that low?

March 31st – 2020!

So it is with good reason that the County will be moving into the red tier beginning Monday and allowing indoor dining and gyms (among others) to reopen at reduced capacity.  Although, technically, we should have two consecutive weeks of incidence rates below 7. Upon re-analysis, I discovered that we did not quite meet that criteria the week ending 3/2/2021 with a rate of 7.5. There still remains a not insignificant delay in case reporting from the County which is curious because in our clinic COVID-19 PCR results are now returning within 24 hours.

Similarly mortality rates have dropped to 0.3 new daily deaths per 100,000 – a rate last seen just before our Thanksgiving surge (Figure 2). This, as we have covered previously, is a lagging indicator so will undoubtedly decline further. 

The estimated prevalence (individuals with active COVID-19 infection) has dropped to 1 in 1000 County residents (Figure 3). And any guesses the last time we had a prevalence this low?

March 17th – 2020!

But none of these numbers are why I am cautiously optimistic about reopening. It seems, for once, the County Health Department has their timing right.  Here is a record of their prior staged reopening attempts:

  1. May 8th, 2020:  Cases stood at 8.4 which was down from the week prior (8.9) but no clear downward trend given cases had been 7.4 and 5.8 in the two weeks prior.
  2. June 12th, 2020:  Cases stood at 12.9 but had risen from 12.0 and 8.9 in the two weeks prior
  3. October 1st, 2020:  Cases stood at 10.4 but had risen from 9.8 and 9.3 in the two weeks prior

My optimism with reopening this time around is that it has (finally) been done in a manner supported by data. At no other point in this pandemic has the County had the good sense to reopen in the context of declining rates. This downward pressure on cases as well as the rising protective effect of vaccines is, hopefully, sufficient to reopen safely.

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