How LA public health officials are handling flu season plus COVID

Indoor malls and casinos can now reopen — with limited capacity — in LA County. Breweries and wineries can resume outdoor operations too. New COVID-19 cases and deaths have declined since the peak this summer. But there could be a spike this fall. Plus, it’s flu season.

On Wednesday, LA County recorded the biggest single-day spike of COVID-19 infections since August 22 — 1645 infections. That’s an anomaly, says Dr. Christina Ghaly, director of LA County Department of Health Services (DHS).

“The data that we saw the following day was much lower, more in line with data that we’ve seen previously. Generally, more importantly, we’ve seen stable hospitalization rates. And really, those hospitalization rates are much lower than they were over the summer. … We’ve had a decline since then, and they’ve been stable for now several weeks. And that’s quite encouraging.”

She adds, “The deaths also have been declining and have held relatively stable.”

LA County is still in the most restrictive tier in the governor’s reopening plan, tier one. That means COVID-19 is still considered widespread. For more businesses to open back up, what must the county do?

Ghaly says the county is doing well on the test positivity rate, but the overall case rate is preventing the county from reaching the next tier.

Ghaly is concerned about flu infections plus COVID-19 infections, and the county having a double strain on its resources.

“We haven’t had a flu season yet with COVID. We just don’t know how the two viruses will interact. We don’t know what will happen when someone is co-infected with both,” she says. “What we do know is that they’re both respiratory viruses. They both can cause a lot of the same symptoms in people. And they both can cause, in serious cases, respiratory compromise to the point where someone can’t breathe and needs to be put on a ventilator.”

However, this flu season could be mild because people have been sheltering in place. “If people have been wearing their face coverings, they’re washing their hands more, they’re keeping their distance, those same things that help prevent transmission of COVID can help prevent transmission of the flu. And combined with vaccination, we’re optimistic that potentially the flu season can remain mild this year.”

Earlier this week, Press Playinterviewedtwo LA Times reporters who investigated wait times to see a specialist in the county’s safety net healthcare system. The reporters combed through more than 800,000 requests for specialty care at DHS and found that between 2016 and 2019, the average wait time was three months. They reported on patients dying while waiting for care.

The LA County Department of Health Services has called their reporting “misleading,” and Ghaly disputed the paper’s findings. She said wait times have dropped and the reporters cherry-picked their data from before changes at DHS went into effect.

“We at DHS … take our job very seriously. Nothing means more to us than the health of our patients. And we work everyday to improve the services across DHS, and are really dismayed when they are so clearly distorted, such as they were in the case of the LA Times,” Ghaly says.

The LA Times did publish an extensivearticleafter their investigation, detailing exactly how they did their reporting. They said they interviewed dozens of current and former county health care providers, patients and outside medical experts and were told their work was “spot-on.”

But Ghaly says the county’s data shows the wait time is shorter than that.

“What the truth is — is that for less than for 50% of the cases … patients are seen in less than 15 calendar days,” Ghaly says. “And for 75% of the cases, they're seen in less than 30. And in fewer than 5% of the cases are we actually scheduling appointments later than what the provider intended because of capacity issues. And then in those cases, it's only by about two weeks because the focus is on scheduling the patient when they need to be seen.”

She continues, “Our focus is on making sure ... the system that's been developed today serves the patient's needs.”

— Written by Amy Ta, produced by Nihar Patel