Los Angeles County in California, which implemented some of the country’s strictest COVID-19 mandates during the pandemic, recently was on the verge of returning to an indoor mask mandate thanks to the tripledemic of respiratory viruses proliferating in the area.
Ultimately, the county opted to highly recommend masking, especially within all long-term care facilities and congregate care settings, according to Pingting Karen Nie, MD, associate chief of the Healthcare Outreach Unit at the Los Angeles County Department of Public Health.
Nie addressed the county’s infection prevention and control efforts, and recommendations for older adults and long-term care facilities, during a LeadingAge membership call on Wednesday.
“A lot of us agree with [outgoing director of the National Institute of Allergy and Infectious Diseases] Dr. Anthony Fauci that regardless of whether there is a mandate or not, the messaging is still the same: It’s definitely highly encouraged to wear masks at this point, not just because of COVID, but because of other viruses like RSV and influenza,” she said. “We just want to do what’s best for our communities.”
The Centers for Disease Control and Prevention is reporting that COVID-19 cases, hospitalizations and deaths have gone up in recent weeks. More than 44% of all US counties are experiencing medium to high community levels of COVID, Nie said.
Los Angeles County has been experiencing high community levels of COVID-19 since Dec. 8, along with high levels of influenza. In addition, she said, several nursing homes in the county have experienced RSV outbreaks.
Because the area healthcare system is not as strained as it has been in recent years, the county opted to highly recommend indoor masking for the general public rather than requiring it.
But the county is maintaining masking recommendations for senior living communities and all other long-term care facilities, and testing recommendations for skilled nursing facilities. The county is sending out COVID-19 test kits to nursing homes every two weeks to be used for both visitors and staff. The county also announced that it expects nursing home visitors to test within 24 hours of visiting a facility or submit to a rapid test onsite. Although testing is not required, it is highly encouraged.
“We’re at a different place now compared to early in the pandemic, when we didn’t have [testing] available,” she said. “We do feel based on evidence, the risk is lower and there is a lot of consideration for quality of life for residents.”
Nie said the No. 1 thing providers can do to protect staff and residents is to encourage everyone to stay up to date with COVID-19 vaccines and boosters. She pointed to two recent studies released last week by the CDC showing early data on the bivalent booster and its effectiveness at preventing severe outcomes such as hospitalizations and deaths.
LA County, she added, is starting to transition much of its guidance to align with recent CDC changes, moving toward a “new normal” that has fewer restrictions because of the vaccines.
“There is a lot of vaccine/booster fatigue. People are wondering, ‘How frequently are we going to have this?’ It’s hard to predict the future,” she said. “Our goal is to get back to some kind of a new normal, where we’re not always so careful in having to restrict activities for fear or to prevent everyone from getting COVID. The vaccine is the best way to do that.”
