Los Angeles County health and elected officials have again highlighted disparities in COVID-19 deaths among black residents and warned that a recent uptick in transmission rates could result in a lack of sufficient ICU beds in coming weeks if it continues.
Supervisor Hilda Solis began the coronavirus news briefing by saying that "unabated and unaccountable police violence" amounts to a second health crisis.
"We've seen another public health crisis highlighted. According to the (American) Public Health Association, addressing law enforcement violence should be a public health priority," Solis said. "The root cause of health inequities, especially during the pandemic, is systemic racism and discrimination."
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The Los Angeles County Department of Public Health on Friday announced 36 more deaths due to COVID-19, although one of those fatalities was actually reported Thursday afternoon by Long Beach, which has its own health department. Long Beach announced an additional two deaths Friday afternoon.
The new deaths -- which included 12 at skilled nursing facilities -- increased the countywide total to 2,567.
The county also announced another 1,445 newly confirmed cases of the virus, while Long Beach added another 23, for a total of 61,068 total cases as of Friday.
"It's important that we continue to expand our access to testing," Ferrer said. "As long as we are testing a lot of people ... we should expect to see our case numbers go up."
Ferrer said the higher numbers of cases aren't necessarily bad news, because they allow health care workers to trace contacts and advise those who might otherwise spread the infection to self-isolate. Only about 4.5% of those getting tested are testing positive, she said.
The percentage of people dying who had underlying health conditions remained high, at 94%, leading Ferrer to caution vulnerable residents to continue to stay home even as more businesses begin to open and to call a doctor at the first sign of symptoms.
The data available on race and ethnicity continued to reveal much higher rates of deaths among black residents and those living in poverty.
While Latino residents represent 41% of total COVID-19 deaths countywide, it is more telling to look at those deaths in context of the overall population. Based on that analysis, the death rate for Latino residents is 29 per 100,000 people, as compared with 31 per 100,000 people for black residents -- both much higher than the 15 per 100,000 white residents.
Asians die at a rate of 21 per 100,000, while the numbers for Native Hawaiians and Pacific Islanders with COVID-19 are dying at a rate of 30 per 100,000 people.
Poverty also pays a significant role.
"We see that people who live in areas with high rates of poverty have almost four times the rate of death for COVID-19," Ferrer said.
Based on a model that considers how many people would have died if all people of all races and ethnicities were dying at the same rate as those with the lowest rate, public health officials calculated "excess deaths."
"It paints a very disturbing picture," Ferrer said. "If the death rate for all groups were the same as it is for white residents, who have the lowest death rate, we would have 754 fewer deaths."
Of those hypothetical "excess deaths," 480 represent Latino residents, 143 black lives could have been saved and 125 of disproportionate deaths represent Asian residents.
"These results are absolutely devastating and represent real people whose lives have been lost," Ferrer said. "They also starkly show how inequities have a life and death consequence."
She said the county is working hard to increase resources for these under-resourced communities, including expanding testing sites to 73 facilities across the county.
"The very real impact of the injustices plays out every day with the news I share with you and amplifies why racism is a public health issue," Ferrer said. "The disproportionately higher number of deaths from COVID-19 among black and brown people is an indication of the impact of racism and discrimination on health and well-being."
"It starts at the beginning of life when black babies are three to four more times likely to die before they reach their first birthday and at the very end of life when black residents die, on average, six to 10 years younger than all others," Ferrer continued. "We must look at the root at the structures, systems and practices in our society to understand the root cause of these inequities."
As largely peaceful protests against police brutality continued across the Southland, Ferrer again urged people participating in large gatherings of any kind to take steps to avoid infecting others and quarantine themselves if they believe they've been exposed.
Anyone who has been in close contact with people not wearing face coverings for at least 15 minutes should isolate themselves for 14 days, she said.
"Please remember that this virus has a long incubation period and it will be important for you to remain away from others for as much as possible for the next 14 days," Ferrer said. "If you do get tested right away after you think you've had an exposure, you're likely to test negative because your viral load will be too low to be detected."
She urged residents who have potentially been exposed and are living with people who are elderly or have underlying health conditions to wear face coverings at home and maintain a six-foot distance. Those people were also urged to "avoid preparing food for others, sharing utensils, bedding and towels, and increase cleaning and disinfecting of common surfaces."
Protests, largely peaceful now, aren't the only concern. Cases of coronavirus could also surge as more businesses reopen countywide, including in- restaurant dining and hair salons and barbershops.
Dr. Christina Ghaly, director of the Department of Health Services, said the rate of transmission of COVID-19 has ticked up slightly.
"While we don't know precisely yet how reopening and the recovery activities will affect transmission of COVID-19, (the rate) does seem to be greater than (one-to-one) and slightly uptrending," Ghaly said.
In the next one to two weeks, if that trend holds, there should be enough general hospital capacity, but perhaps not enough ICU beds, she said.
"The number of ICU beds may become inadequate in two to four weeks based on the currently available number of beds," she said. "DHS ... is watching this availability of ICU beds very closely."
Ghaly said the rate of testing being done among residents of color is now proportionate based on the expansion of testing sites. She also announced that the county would be shifting from an oral test to a nasal swab. While the earlier test is effective, she said the new procedure should result in fewer false negatives.
She urged everyone to continue to follow guidance about wearing masks or face coverings in public, frequently washing hands and maintaining social distancing.
"There are ways to maintain (good public health) practices even as we reenter society and get people back to work," Ghaly said. "Please continue to do everything you can to follow these core public health practices. Your actions, my actions have an impact not just on our own health but the health of all of those around us ... We are all in this together."