It’s COVID deja vu. But what does it mean to you?
Los Angeles County residents, it appears to be inevitable. We moved into the “high” level of coronavirus community activity last week, when the average daily rate of virus-related hospital admission rose to 10.5 per 100,000 residents, surpassing the threshold of 10 per 100,000.
Absent a major reduction in hospital numbers over the next week, the county will likely still be in the “high” category on July 28, triggering a new indoor mask mandate beginning a week from today –Friday, July 29.
What’s that mean to me? Shopping in a KN95 again? Kids masked up in class when they go back to school? And will I get a ticket if I forget?
Beyond that, the COVID scene has grown more complex across the board. With persistently high case rates, and new extra-contagious omicron strains, what exactly are you supposed to do now in the growing eventuality that someone in your home tests positive for COVID-19?
Can you and others in your home avoid infection? And when are you in the clear?
The answers to some of these questions have changed with the dominant BA.4 and BA.5 variants often evading immunity for even the double-boosted. So let’s revisit what we know now, and how best to use the new tools available amid this latest, lengthy surge.
Here are some answers to persistent questions arising during this pandemic period in L.A. County.
Q: What precisely would the mask mandate entail? How would it be different from current restrictions?
A: According to the department of public health, if the county implements universal indoor masking, residents and workers will be required to wear masks in all indoor public spaces, including shared office spaces, manufacturing facilities, retail stores, and at indoor events.
Q: How about restaurants and bars? And school classrooms?
A: Both of these areas have been subject to bitter public debate, protests and even lawsuits. But, yes, indoor areas of restaurants and bars, children’s programs and educational settings, would need to institute universal masking.
Q: What kind of face coverings are we talking about? Are fabric masks OK?
A: The county strongly recommends well-fitting respirator-type masks such as N95s, KN95s, and KN94s. People should not double mask with a respirator, the county experts caution.
Q: If L.A. County switches back on its indoor masking requirement next week, will Pasadena — which operates its own independent health department — do the same?
A: Yes, according to city Public Information Officer Lisa Derderian.
The Pasadena Public Health Department, which is separate from Los Angeles County’s public health department, reported __ cases on Friday, July 21.
However, it’s likely that Pasadena has far more cases than counted by Pasadena Public Health officials in recent days, since Southern California residents from different communities intertwine daily, city leaders previously explained.
So when Los Angeles County’s mask mandate comes back, residents in Pasadena will have to follow suit.
Q: How about in Long Beach, which also operates its own public health department?
A:Long Beach has typically been in lockstep with the county throughout the pandemic, but not this time — or at least not yet.
While the number of cases continues rising in Long Beach, as do other metrics, that city has yet to hit the threshold for moving into the high-transmission tier.
Long Beach officials have said the situation in the seaside city differs from the county as a whole and will not follow along with the impending indoor mask mandate for now. But city officials do recommend masking indoors in public places.
And, of course, things can change — including the city’s stance on a mask requirement.
“We do not plan to follow suit, since cases look different here—we are still solidly in the moderate category,” Long Beach health department spokeswoman Jennifer Epstein Rice said in a June 15 email.
“If we move into high transmission,” she added, “we will definitely weigh our options.”
Q: Some places are already required to mask up, right?
A: Yes, masking is already required at all healthcare settings, public transit and transit hubs, long-term care settings, shelters and cooling centers, and correctional facilities. The county also requires masks at worksites with outbreaks for all individuals during the 10 days after a COVID diagnosis or exposure when they are around others.
Q: Are a lot of counties in the same position? Are they implementing the same rules?
A: Although dozens of counties in California are also in the “high” virus-activity category — Riverside and San Bernardino cross that threshold just this week — Los Angeles is the only one considering a mask mandate
Q: Is there a chance we could elude the mandate?
A: The move appears inevitable, although county Health Director Barbara Ferrer offered a slim glimmer of hope that things might change. She noted that the rate of 11.4 admissions per 100,000 is only slightly above the threshold of 10 per 100,000, so things could change. Watch the numbers closely for the next week.
Q: Will sites that don’t comply with the mask rules be punished?
A: The county will likely return to its “education before punishment” approach, a familiar concept during the heat of the pandemic.
Ferrer acknowledged a lack of any formalized enforcement plan, saying the county relies primarily on education in hopes of convincing people to wear face coverings. She also said the county does not expect business owners to become enforcement agents.
“We rely heavily on people understanding why it’s important for us to add in this layer of protection at this point, and most people in the past have gone ahead and been compliant,” she said. “We’ll continue to work with everyone and make sure there’s good information.”
She noted that during previous mandates, very few businesses were cited for violations.
Q: Someone in your home was exposed to a person who tested positive. What should you do?
A: Step one, wear a mask and stock up on at-home rapid tests. Dr. John Swartzberg, clinical professor emeritus of infectious diseases and vaccinology at UC Berkeley’s School of Public Health, says that your response to a COVID exposure or a positive case in your home should depend on how vulnerable members of your house are to severe disease, hospitalizations and death.
He suggests finding a “sweet spot” between isolating and continuing your normal behavior, that matches that vulnerability. Homes with elderly family members, immunocompromised residents, or unvaccinated people should fall on the more careful side of the spectrum, while others might choose to isolate less severely or for less time.
Q: Are you doomed to get COVID if somebody else at home tests positive?
A: Even with close contact with infected family members, secondary infection is not guaranteed. So if someone in your home is sick or tests positive, but others in your house aren’t feeling sick and are negative on a rapid test, it’s worth it to try to prevent further exposure.
Masking, opening windows and using a HEPA air filter are all good tools, as well as isolation when space allows it.
“Best practice is not what everyone can do, which is (to isolate the sick family member in) a dedicated bedroom and bathroom,” said Dr. Peter Chin-Hong, UCSF professor of medicine who specializes in infectious diseases.
Q: What’s the best strategy for testing at home?
A: “If I was exposed, I would test on day three and day five,” Swartzberg said, pointing out that the incubation period for the newer omicron strains is shorter than previous versions, and many people who get infected feel sick within two or three days. “If you’re testing negative after day five, you’ve probably avoided getting infected,” he said, but you might want to be careful for a few extra days, especially if someone close to you is vulnerable.
The CDC recommends five days of isolation and an additional five days of masking for those with known exposures to COVID.
Q: What if you’ve already had COVID?
A: “That one’s easy these days,” said Chin-Hong. “They’re still at risk.” Even if you had COVID as recently as early June, he said, “that’s the superpower of BA.5,” someone who had COVID just four weeks ago is at risk of reinfection, while early in the pandemic those infected could expect up to three months without a possibly reinfection.
Q: Where can I get free rapid tests?
A: Every household in the U.S. should be able to order up to 16 free rapid tests from the federal government, through the Covidtests.gov website, after the Biden administration recently announced a third round of free tests kits.
You might also be able to get free rapid tests through your healthcare provider. People covered by insurance through Kaiser Permanente can request free tests, as can those covered by Medi-Cal and Medicare. And most large pharmacy chains have ways to request free tests from their insurance for those with employer-provided plans.
Q: You took a rapid test that showed negative. Are you in the clear?
A: Not if you’re experiencing symptoms, says Swartzberg. “If you’ve got a cough, sore throat, runny nose,” he said “then you have a respiratory virus. It may not be COVID, but it could be, and if you have an infectious respiratory disease you should be staying away from other people.
Chin-Hong recommends swabbing both the back of the throat and the nose when doing a rapid test, which might help catch the virus earlier, a common practice in the UK but not yet officially recommended here.
Bottom line, if you or a family member has been exposed and is experiencing symptoms, it’s best to assume you have COVID, even if a rapid test has shown negative in the first days of symptoms.
Q: Do you need a PCR test from a lab if you tested positive on a rapid test?
A: Chin-Hong and Swartzberg see little reason to seek a PCR test if you test positive on an at-home test. You don’t need a positive PCR to confirm the infection, or to seek treatment, and false positives are very rare.
Q: Is it important to notify your healthcare provider you tested positive for COVID-19?
A: Yes. “The most important thing is a pragmatic thing, your healthcare provider can help you decide if you need to take paxlovid,” the most common anti-viral for COVID, said Chin-Hong. And even if you aren’t seeking treatments, “you should tell them and they can enter it officially” in your medical record.
Q: You have COVID. How can you best recover?
A: The good news for those getting infected now is that you should be able to access therapeutics that lessen the severity of your illness.
“If you’re a candidate for paxlovid or any of the other three treatments, make sure you avail yourself of them,” Swartzberg recommends. “Get plenty of rest, eat as well as you can, and drink fluids,” he said, sound advice for any viral respiratory infection.
Staff writers Harriet Rowan, Brennon Dixson, Christopher Haire and City News Service contributed to this report
