As Covid Surges, Los Angeles County Public Health Takes a Minimalist Approach

By Lambert Strether of Corrente.

Readers, I was badly triggered by press release on Covid by the County of Los Angeles Health Department, and after I finished banging my head on my desk, I thought I’d post on it. Irritating though the press release was, it’s really isn’t worth putting on my yellow waders for, so first I’ll look at the status of Covid in LA (with special attention to wastewater), then at the many, many actions LA took to successfully bring on another surge (or, as we say, “uptick”), and then finally at the press release, which shows how little we’ve learned, three years into the pandemic.

Covid Status in Los Angeles County

Since this is the land of Freedom, we no longer have any decent case data, let alone contact tracing, so after presenting the case data, I’ll present proxies for actual infection: Hospitalization and deaths, nursing homes (famously lagging indicators), anecdotes, and finally wastewater data.

First, the case data, such as it is. From Deadline, “Los Angeles Covid Cases Rise Nearly 35% In Past Week, Test Positivity Close To Last Summer’s Peak“:

The average of 512 daily cases this week is a nearly 35% increase over last week week. Reported cases do not include home tests, so it’s fairly certain that the actual number of Covid infections is much higher.

Based on the most recent variant sequencing in Los Angeles County as of July 22, XBB.1.5 and EG.5 now account for nearly equal proportions of cases. Combined, they make up 31 percent of the total sequenced cases. XBB.2.3 accounts for the next highest proportion of sequenced cases followed by XBB.1.16.1.

Ninety-eight percent of currently circulating strains in Los Angeles County are descendants of Omicron XBB, including EG.5, which is what the fall vaccine, likely to be released next month, will target. Another variant, BA.2.86, is being closely monitored because it has many mutations that may affect how our body responds to an infection. BA.2.86 has not been detected in recent samples in L.A.

Hospitalization and death, from the Los Angeles Times:


The “Note to Readers” is amusing: “Post-emergency” status, as opposed to “post-pandemic”; the unquestioning acceptance that case counts and positivity numbers are now mysteriously broken; the submissive acceptance of CDC’s hospital-centric “hospitalization and death” metric, which ignores vascular and neurological damage, as well as Long Covid; 

Nursing homes, from the Santa Monica Mirror:

Adding to the concerns, Public Health is now reporting more new outbreaks in skilled nursing facilities, where residents are particularly vulnerable to severe illness and death from COVID-19. For the week ending July 18, Public Health initiated 11 outbreak investigations, similar to the 12 investigations opened the previous week. In comparison, one month ago, only four new outbreaks were reported during the week ending June 20.

Positivity, from the Country of Los Angeles:


Next, anecdotes. From Reddit, r/LosAngeles, the original post:

I took a COVID test 3x and they all came out negative. I’m thinking it’s just a bad cold but a lot of folks I know here in LA have been having similar symptoms

Of the responses, this one stands out:

My whole family has Covid right now. Started off with a runny nose and fever, progressed just like a typical flu so I didn’t even plan on testing until my wife tested positive. I went ahead and tested and was positive too, even though I feel almost totally better. On top of everything else it sucks because my kid’s missing the first week of school.

And this:

Covid seems to be everywhere again. Anecdotally, ‘m hearing people feeling symptoms for a week before it shows up on tests. I’m masking at work – someone’s always out with it and I don’t feel like getting a dose of it right now.

And this:

You have COVID. There’s been a major wave sweeping through LA and there’s a huge percentage of people with this new variant that test negative for up to a week but are still contagious. For the safety of yourself and everyone around you, assume you have it until you recover. Your tests should start coming in positive around day 5 at the latest

Interesting about the delayed positives, though nobody mentions RAT or PCR. (I bet a Reddit aggregation would prove an even more accurate heuristic than “Yankee Candle” reviews, if some clever person could figure out a way to scrape the site.)

Finally, we come to wastewater, where for once we have a multiplicity of sources. First, from Verily, this


(Red is Los the Los Angeles County treatment plant; orange the Los Angeles plant.) Seems to confirm all the sources! Hoo boy. Then I doublechecked the Wastewaterscan tracker (from which Verilly gets its data) and a different picture emerges. Could it be the peak has passed?


Finally, I checked Biobot, which sides with Wastewaterscan:


The origin of the the discrepancy? The first Verily graph is “Raw Data” (see greyed button at middle left). If we use “Normalized” data, Verily, Wastewaterscan, and Biobot all concur:


About normalization: Pepper mild mottle virus (PMMoV, see the greyed out button above) “was recently found to be the most abundant RNA virus in human feces,” and so its used to normalize SARS-CoV-2 data from waste treatment plants nationwide (a matter of some controversy; see here, here, here, and here. I don’t really want to do a deep dive into human fecal matter — I already do election coverage, after all — but it looks like I’m going to have to understand normalization a lot better. After all, we normalize a lot of data (think unemployment, GDP) and in many contexts, “normalize” is a synonym for “game.” Not that I’m foily.

If I had to guess, and guess is all any of us are doing at this point, I’d say Los Angeles County’s Covid surge has not peaked, and that the normalized Covid data is a temporary plateau.

What Los Angeles Did to Bring On a Covid Surge

Now let’s look at the many actions Los Angeles took that — most likely — combined to bring about the current surge.

First, Los Angeles eased Covid “restrictions” (i.e., people were told they should no longer protect others or themselves). From the Los Angeles Times:

The steady unwinding of COVID-19 emergency declarations has ushered in a slate of changes to Los Angeles County’s pandemic guidance, including when to mask, quarantine or isolate, as well as the reporting of new infections and outbreaks.

The most significant — the easing of government-issued masking orders for patients and visitors in healthcare settings — took effect Monday in L.A. County. In other California counties, masking orders for doctors and nurses also have expired.

The tweaks are the latest reflection of a broad new phase of the pandemic, one characterized more by individual risk assessment and targeted intervention than sweeping measures or restrictions.

So, when Deadline’s reading says that “Cases Rise,” that’s like saying the offense make a comeback when the defense left the field.

Second, the Los Angeles Unified School District asked children to come to school even if they were sick:

In a reversal from recent pandemic-era school years, Los Angeles schools Supt. Alberto Carvalho is urging students to come to school sick — at least if they are just a little sick — to combat high rates of absences that officials fault for harming mental health and holding back learning.

If a student has a fever, however, they need to stay home.

For parents and employees, the reversal is a sort of cognitive whiplash for a school system that took pride in having among the strictest school safety protocols in the nation: mask mandates, 10-day illness quarantines, weekly COVID-19 testing — and directives to keep students home at any sign of illness.

County health officials put the current risk from COVID as low based on hospital admissions, although there’s been a recent uptick in hospitalizations and in measures of the virus in wastewater. County health officials warn that the start of school has led to increased COVID outbreaks in recent years and could do so again. The first day of school in L.A. Unified is Monday.

Note the doublethink of “county health officials” relying on a lagging indicator, even though less ladding indicators are flashing yellow! Looks like LAUSD relaxed at exactly the wrong time (which is what always happens; “nobody could have predicted”). But then, we have budgets to worry about:

The change is part of the district’s strategy to boost attendance — which took a deep hit during the pandemic and has not fully recovered — as well as funding.

School districts in California are funded based on average daily attendance, rather than the total number of students who are enrolled — a system Carvalho says is “flawed.”

Hence, minimization:

The guidelines encourage families to use “parental instinct” to determine whether a child is too sick to come to campus, and say children “can wear a mask” when attending with mild symptoms.

Not “must” but “can”?

“I met students who were out 72 days, 40 days, 50 days, 27 days – and when you ask the parents or the students the reasons, one of the reasons that was conveyed to us was that ‘my [child] had the sniffles, and therefore I didn’t think I could send them to school,'” says Carvalho.

“The sniffles.” What if my “parental instincts” are telling me I don’t want my child to be brain-damaged because other parents are reckless?

Third, a ginormous Taylor Swift concert was a potential superspreading event. From Self (!):

And while most of the social media coverage has featured Swifties dancing and belting out bops like “Cruel Summer” and “Lavender Haze,” some attendees of last week’s SoFi Stadium shows in Los Angeles have been posting about a less joyful effect of their concert euphoria: a positive COVID-19 test. And yes, some of these fans claim they took standard safety precautions like wearing a mask and quarantining before and after the concert.

Here we have Reddit anecdotes as well:

3 coworkers, all who went to the concert separately during the weekend, have tested positive for COVID and are out sick this week. Most tested positive on Tuesday.


Superspreader event gonna spread. Also, tens of thousands of infected flew in from elsewhere, so they inevitably flew back home to share it.


Yep i went to the Aug 4th show at Sofi and tested positive on Monday the 7th and have been horribly sick and down for the count since then.

It was worth it to see her but crap I feel bad and I had made it all these years without it.

Interestingly, this thread doesn’t mention waiting a week, while sick, to get a positive. Different strains?

Finally, unmasking in health care settings:

Starting Friday, healthcare workers across Los Angeles County will no longer be required to mask up in hospitals.

The Los Angeles County Department of Public Health announced the county’s mask mandate for employees in health care settings will end – effective Friday, August 11.

The order was put in place in April and was set to be reconsidered later in the year, but LA County Public Health decided to end the policy as early as the end of this week.

And just in time!

County of Los Angeles Public Health Press Release

So, after that Luis Tiant-like windup, the press release. On nursing homes:

Public Health currently strongly recommends[1] masking for staff in skilled nursing facilities and requires it during outbreaks. All residents should have access to clean well-fitting[2] masks with good filtration[3] and these should be worn by anyone suspected positive[4] when not in their rooms[5]. It is also strongly recommended[6] that all residents, staff, and visitors remain up to date with COVID vaccines. Visitors should test before going into a skilled nursing facility and should strongly consider[6] wearing a mask while inside.

[1] Why this pissant weasel-worded deference to people who want to risk infecting helpless elders? Just require masks ffs.

[2] Will there be actual fit-testing?

[3] Is a “Baggy Blue” “good”? Why not just require N95s?

[4] The County of Los Angeles Public Health Department does not, after three years, understand that Covid transmits asympotically. Masks should be required for all, at all times.

[5] The County of Los Angeles Public Health Department does not, after three years, understand that Covid is airborne. It moves like smoke. Like smoke, it does not confine itself within a facility. Masking should be required, for all, at all times, throughout the facility (most definitely including the hallways).

[6] Less deference, more public health, please.

And on schools:

With increased COVID-19 transmission in the community, schools are another place where outbreaks are possible due to large groups of people being indoors together[1] for extended periods of time. And while many children may not experience severe illness associated with a COVID-19 infection, other family members and school staff may be at higher risk.

Parents and guardians are encouraged to keep children home if they are sick, including when they have a fever, bad cough, extreme fatigue, or a sore throat[2]. Those with respiratory symptoms or a known exposure should test for COVID-19; many school districts have already received test kits for free distribution to students and their families. If a child tests positive for COVID-19, it is important to[3] report that to the school as soon as possible so that others can be informed of the exposure. Anyone who tests positive for COVID-19 needs to[4] isolate at home for a minimum of 5 days[5].

[1] Now would be a good time to mention ventilation, HEPA filters, and Corsi-Rosenthal boxes. And masks.

[2] Once again, Covid can spread asymptomically. That is why the entire facility should have layers of protection.

[3] More deference.

[4] Ditto.

[5] No, ten ffs. CDC’s guidance is wrong. Also, it sure is weird that the same logic and standard isn’t applied to nursing home personnel.


Los Angeles County does provide free testing; I’m sure other localities are doing much worse than Los Angeles. But IMNSHO, our entire society should be a  giant non-pharmaceutical intervention, if not for this pandemic, than the next one. Our operational capability is very far from that. Also, celebrities could help by wearing masks in public. Thanks, Taylor, good job.

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About Lambert Strether

Readers, I have had a correspondent characterize my views as realistic cynical. Let me briefly explain them. I believe in universal programs that provide concrete material benefits, especially to the working class. Medicare for All is the prime example, but tuition-free college and a Post Office Bank also fall under this heading. So do a Jobs Guarantee and a Debt Jubilee. Clearly, neither liberal Democrats nor conservative Republicans can deliver on such programs, because the two are different flavors of neoliberalism (“Because markets”). I don’t much care about the “ism” that delivers the benefits, although whichever one does have to put common humanity first, as opposed to markets. Could be a second FDR saving capitalism, democratic socialism leashing and collaring it, or communism razing it. I don’t much care, as long as the benefits are delivered. To me, the key issue — and this is why Medicare for All is always first with me — is the tens of thousands of excess “deaths from despair,” as described by the Case-Deaton study, and other recent studies. That enormous body count makes Medicare for All, at the very least, a moral and strategic imperative. And that level of suffering and organic damage makes the concerns of identity politics — even the worthy fight to help the refugees Bush, Obama, and Clinton’s wars created — bright shiny objects by comparison. Hence my frustration with the news flow — currently in my view the swirling intersection of two, separate Shock Doctrine campaigns, one by the Administration, and the other by out-of-power liberals and their allies in the State and in the press — a news flow that constantly forces me to focus on matters that I regard as of secondary importance to the excess deaths. What kind of political economy is it that halts or even reverses the increases in life expectancy that civilized societies have achieved? I am also very hopeful that the continuing destruction of both party establishments will open the space for voices supporting programs similar to those I have listed; let’s call such voices “the left.” Volatility creates opportunity, especially if the Democrat establishment, which puts markets first and opposes all such programs, isn’t allowed to get back into the saddle. Eyes on the prize! I love the tactical level, and secretly love even the horse race, since I’ve been blogging about it daily for fourteen years, but everything I write has this perspective at the back of it.


  1. antidlc

    Thanks, Lambert.

    What a stupid timeline we live in.

    So much sickness.
    So much disability.
    So much death.

    And it could be prevented.

  2. Robert L. Peters

    Anecdatum, doing my part by hunkering down.
    Of course, I do that almost 24/7/365 anyway except for trips for groceries, and now I have more reasons.
    Glad to avoid Los Angeles any time.

  3. Raymond Sim

    Interesting side note: Right now the American Midwest appears to be the global center of diversity for BA.2.86. Early days of course.

    It’s now documented in the US, UK, Denmark, South Africa, Israel, and Thailand, as well as in a person traveling from Japan, via six separate transmission chains. That the chains seem quite short has it looking like an up-and-comer.


    How many more years of Covid until the cumulative brain damage causes society to disintegrate? Or for some doofus to launch a nuke?

    Covid will never be addressed in America and it’s only a matter of time until we are all so stupid that industrial society can no longer function.

    1. Geo

      Don’t think we needed Covid brain damage to disintegrate our society to that point as we’ve already been well on our way for some time but probably does add more coal to the fire.

  5. JBird4049

    >>>But then, we have budgets to worry about:

    The school district is worried about funding today. Therefore, they are making sure that they will not have funding in the likely near future when all the children and their families get massively and repeatedly sick? This will likely be in the Fall and just before the holidays. Do I have the stupid right?

  6. Bsn

    Lambert, as always, such good work. Regarding this: “And yes, some of these fans claim they took standard safety precautions like wearing a mask and quarantining before and after the concert.” ….. my sweetie is soon to take a long, couple day train ride and then week long conference. The FLCCC suggests taking Ivermectin a couple days in advance of a possible high risk event as well as every couple of days during. ‘Can’t be too cautious. I can imagine (seriously) being in the bathroom cubicle of a train and having the policia bust in to catch him spreading the horse paste on a cracker and getting ready to chase it with some grape juice. Yea baby, USA USA USA!

  7. Rip Van Winkle

    Not so much a drag being old. I first heard the much better version (and video) of Cruel Summer 40 years ago. Also the last season for the great El Tiante!

    Curious about those 2 small counties in eastern Kentucky shutting down the schools, Boss Hogg poor country, populations declining past 75 years. Bet none of them have been to California in their lives.

  8. anon

    We are totally doomed. I just talked with an acquaintance who is a high level public health bureaucrat. I asked him if we knew if people ever actually cleared covid; if there were any long term studies of white cell counts that might tell us if people were continually fighting an infection they never got rid of. He said he knew of no such studies but found the idea in intriguing. FFS this has been the big question from the start. Daniel Brittain Dugger, Daniel Brittain Dugger, Daniel Brittain Dugger. Sometimes there is a big question that is the important question, but these fools haven’t thought to determine if the virus is hanging out in the microglia (or some other area that is somewhat protected from the immune system) until the immune system weakens enough for it to pop out again and lead people to end up with Karposi’s Sarcoma and the like. Maybe some versions of the virus but not others; some are more fusogenic of cells (avoiding antibodies that way) than others; some create burrowing nanotubes.

    I’m not saying Dugger is right; I pray he isn’t, but that is the big question. This health official just sort of assumed that the body was full of microorganisms and that if it were in balance it would keep things under control – indefinitely. But there is another possibility here. And even if the answer is a happy one, we are totally doomed because the people running things are such abject morons.

    1. Terry Flynn


      I asked him if we knew if people ever actually cleared covid; if there were any long term studies of white cell counts that might tell us if people were continually fighting an infection they never got rid of.

      Waiting for immunologist to get back after I finally got GP to refer my bloods results for past several years for examination. I had shown her that there were step changes in some white cell counts in first blood tests taken after each of my putative (and one clinically diagnosed) COVID infections.

      Plus I think there’s a big new outbreak around here (North Nottingham). The main pharmacy has been so understaffed due to illness for 2 weeks now that they’ve drafted in cover from across the country. My latest bout of something has lasted a week so far and is similar to what was my suspected second infection: more “cold-like” in terms of runny nose and sore throat but the worst being chronic fatigue and brain fog. Negative antigen home test for COVID but given 50% sensitivity originally to wild COVID and the natural question as to how good these 2 year old tests are in newest variants I’m not ruling out COVID. Something nasty is definitely severely disrupting all retail (and GP surgery staff) around here.

      1. kareninca

        I’m sorry about your lab results. I hope very much that you feel better and that your body clears this. It is already certain that you are not the only person in this situation concerning lab results – John Hess MD (on twitter) has some cases he is following (I wonder if is possible for you to ask him how yours compares).

        I am taking low dose methylene blue as an antiviral (and for other purposes). This is obviously not medical advice (it is generally very safe, although it can definitely interact badly with other meds like antidepressants and pain killers and medical conditions). I wonder if people should be taking antivirals as they safely can, in order to buy time, while waiting for the medical profession to figure out what is up (if they do; all of the brains seem to have been sucked out of it). Unfortunately antivirals are not medically cost free.

        There are no RATs to be had here in Silicon Valley. From the anecdotes I am seeing on reddit and elsewhere they do seem to still be working. I am seeing people like mrmickme question whether the primers for the PCTs and the wastewater tests are still working, however.

  9. Raymond Sim

    Given that something like 1/3 of our students are ‘chronically absent’ here in California, I’m wondering how there can fail to be some sort of crisis this school year.

    Normally I’d expect the official response to be coercion, but the scale of this problem is so massive …

  10. ChrisRUEcon

    > Note the doublethink of “county health officials” relying on a lagging indicator, even though less ladding indicators are flashing yellow!

    [Emphasis mine]

    Exactly this … hospitalizations and deaths are lagging indicators! These people are criminals. No need to sugarcoat it.

    I recall that the Library of Congress is now indexing this family blog. And while I hate to (ostensibly) be seen as assigning work, I think someone (grins) needs to write the COVID version of “ECONNED” by the time this pandemic is all done and dusted. NC may have to come to prominence in the aftermath of the GFC, but it had grown in importance during the (ongoing) COVID19 pandemic.

  11. stefan

    My girlfriend’s grandson in LA tested positive for COVID yesterday (2nd grader). Two of the school’s three teachers at his grade level are out with COVID. He is being quarantined at home from his twin brother and older sister and parents. His mother is a public school counselor and his father is a high school math teacher.

  12. mrsyk

    “After all, we normalize a lot of data”. Add exit polls to that list and another reason to think “game”. Observational notes, we’ve noticed a strong increase in the number of people we know who have or had Covid in the last month, to the point where it feels like a big surge.

  13. john

    Of course, how anyone could sit and listen to Taylor Swift is beyond me, but to covid on top of it, is peculiarly american….

  14. EnigmaWrappedInBacon

    I live in Los Angeles and my mother is in an assisted living facility that recently went through a Covid outbreak. Of the 22 residents who live on the memory care floor, 9 had Covid; as did at least one of their caregivers. The facility quarantined all residents, including not allowing any guests, for a week. It took more than week until all residents tested negative.

    That was ten days ago. Now no one wears a mask. Not visitors. Not caregivers. Not residents. You can get a blue baggie if you ask for one. They don’t measure ventilation and of course don’t have corsi-rosenthal boxes.

    And if the LA Department of Public Health required testing and masking, this facility would comply. The policy outlined in their press release is reckless AF.

  15. Count Marco

    Any of y’all familiar with the Cochrane Collaborative and it’s twenty years of definitive meta-analysis studies on effectiveness, or lack thereof, of ALL types of masking–from medically fitted N95 down to cloth masks?
    As a longtime reader of this wonderful site, I have always been under the impression that at bottom, it is privileges data-driven analytical tools.
    Asking for a friend.

    1. Yves Smith

      The Cochrane study is crap. This is an unduly polite explanation as to why. It most assuredly is NOT definitive NOR a bona-fide study of mask wearing.

      Lambert was not so kind:

      More generally, masks OBVIOUSLY work. No one could work with hazardous materials like dangerous volatiles if they didn’t. The issue is choosing a mask adequate to the task and making sure it has a good fit. Despite the fact that they look horrible, I find that half face respirators (which do pinch the face a bit) are extremely comfortable to breathe through and unquestionably have a secure fit. I wear them on planes and even sleep in them on planes.

  16. Tim

    In San Diego here. New COVID tests (looks like a litmus rather than the pregancy test looking plastic thingy) just showed up in CVS. Daughter tested as flaming bright positive 48 less than 48 hours after symptoms. She’s in 7th grade, and is one of many that came down with it in a short period of time.

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