One day last week proved to be an unusual day at Dr. Nathan Newman’s Santa Monica Urgent Care clinic — in a troubling way.
During the span of the coronavirus pandemic in Los Angeles County, he might have seen three, maybe four, positive cases of the virus in his office in a typical week.
But last week, on one day alone, however, he saw six COVID-19 cases.
“I have never had this many patients in my office testing positive in one day,” he said, taking a moment to catch his breath.
His counterparts across L.A. County are seeing it: Rising numbers. More young people. More concern.
Responding to surging coronavirus numbers in LA and elsewhere around the state, Gov. Gavin Newsom on Sunday ordered bars and nightspots closed in LA and six other counties and recommended closures in eight others, including Riverside and San Bernardino.
In LA County, recent data displays an alarming uptick in cases, hospitalizations and positivity rate across the county.
Not long ago, for instance, 1,350 to 1,450 people might be hospitalized on any given day in the county. On four days last week, the number climbed over 2,000.
The seven-day average of daily new cases — which stood at 1,379 two weeks ago —stood at more than 1,900, officials said in a statement Saturday.
There were also 1,698 people hospitalized with the virus on Saturday, much higher than the daily number seen in recent weeks, which has hovered between 1,350 and 1,450.
In the next few weeks, officials say, those numbers will likely translate into more deaths.
An analysis by Southern California News Group showed that young people under 18 represent the fastest growing number of confirmed positive cases representing a 60% increase over two weeks up to 5,954 cases now representing roughly 7% of all cases.
As of Thursday, people aged 18 to 40 represented the next largest increase in new cases, up 41% from two weeks ago to 34,360 cases, representing 40% of the total.
What doctors are seeing on the ground meshes with what L.A. County public health and state officials have been warning about for weeks. As stay-home restrictions have eased, as people go back to work and get out more, a rise in the number of coronavirus was only a matter of time.
That time is now, LA-area physicians say, and it’s come more acutely than public health experts thought it would.
Local doctors say there’s a confluence of factors going on that’s driving up testing numbers. They are seeing the formula come together as they talk to patients.
Eased stay-home restrictions have employees wanting to get tested as they are out of their homes and among more people. Then, there are people who are increasingly see their family members test positive, so they wanted to get tested. There are those who are just curious. And there are people being treated for pre-existing conditions who find out they are sick with the virus.
In the case of Newman’s office, “All of them were coming in requesting the test — some because they were not feeling well,” he said. “One was just curious. Another had a family member who was sick and wanted to get checked.”
And other themes are emerging.
Those testing positive are trending younger. Physicians share concern about a lack of vigilance for social distancing among the young.
On one hand, it’s understandable, said Dr. Suman Radhakrishna, director of the Infectious Disease department at Dignity Health’s California Hospital Medical Center in Downtown Los Angeles.
There’s the urge to get out and about, months after a March 19 health order that essentially doused the ability to gather.
But in recent days, she’s become increasingly concerned about the toll it might be taking — especially as people defy social distancing orders and guidelines.
“Since we started to open, over the last 10 days or so, it’s again become the same, horrific issue of seeing many many patients coming in with COVID,” she said.
Radhakrishna said she’s seen more people in their 30s, 40s and 50s. Among them, she said some are simply feeling sick, while others have underlying conditions such as hypertension or obesity.
“I hope that being younger, they have a positive basis toward getting better.” she said. “I don’t know whether to call it a second wave. But this is a wave we are seeing in the younger population.”
Radhakrishna’s message was something that public health officials have been sounding for months as they looked to ease stay-home orders.
“Our message should be, if you have to go to work,….then limit it to what is absolutely essential,” she said, urging people to take steps to protect themselves and others.
But it’s a message that physicians and public health officials aren’t sure is fully being heard.
“People have let their guard down,” said Newman, medical director of the clinic in Santa Monica, part of the UrgentMED network of clinics. “As people got back to socializing, they didn’t want to let it go. They want to socialize, and it’s socializing that leads to this.”
Doctors have noted their patients tell them of their experiences, such as birthday parties and family gatherings, that could become spreading events.
Gov. Gavin Newsom said the population of 18-to-34-year-olds was a group showing significant spikes. He urged caution about family gatherings: “You may be putting Uncle John’s life at risk if you do that the way used to do this.”
On Friday, state public health officials acknowledged that recent protests, which saw tens of thousands gather in local public spaces, could be a contributor to the recent spread.
But they also said the picture is unclear because so many are beginning to get out again on a daily basis.
Dr. Jennifer Sudarsky, a physician at the Santa Monica clinic who also leads work at the county’s quarantine center in Pomona, said there are really two types of patients coming in for testing.
“There are the types who are conscientious — they come to get tested because they want to visit their parents, or they’re going to be flying or they want to make sure they are not harboring the virus so they don’t get their family members sick,” she said.
“And then there are the types who are just going out and partying,” she said, “and they are not feeling well and getting tested because they don’t feel good and they are getting tested for STDs, because, they are socially getting out there.
“They are more worried about the STDs then they are about the COVID,” she said. “That was a wake-up call to me.”
Doctors’ concerns came amid sobering local, state and national developments last week.
Texas and Florida reversed course and clamped down on bars again in the nation’s biggest retreat yet, as the number of confirmed coronavirus infections per day in the U.S. surged to an all-time high of 40,000.
The count of new confirmed infections, provided by Johns Hopkins University, eclipsed the previous high of 36,400, set on April 24, during one of the deadliest stretches. Newly reported cases per day have risen on average about 60 percent over the past two weeks, according to an Associated Press analysis.
At a public health briefing on Friday, Dr. Anthony Fauci, the nation’s top infectious-disease expert, urged people to mind their responsibility to others: “A risk for you is not just isolated to you.”
And by Friday, L.A. County’s Public Health Director Barbara Ferrer — with an added not of alarm — was reporting 25 new deaths and 1,809 new cases to add to a toll of 3,267 deaths in L.A. because of the virus since March:
“While we did anticipate increases in cases as sectors reopened, we did not expect the increases to be this steep this quickly. Without immediate actions to slow the spread, we risk having too many people requiring hospital care and possibly overwhelming our healthcare system.
And those hospitalizations, a vital but lagging indicator, was staring doctors and officials in the face.
“This disease does not take a summer vacation,” Newman said.
“Mark my words, we will see with these positive rates going up in the last week or two that in the next week or two, not just in the hospitals,” he added. “You’ll start seeing that tragically in the number of lives lost.”
The Associated Press contributed to this story.
Published at Sun, 28 Jun 2020 06:06:00 +0000