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Thursday, April 30, 2020

LOS ANGELES—COVID-19 cases have surged past 20,000 in Los Angeles County, with another 900 cases announced along with more than two dozen additional deaths, increasing the death toll to 948.

On the day testing was ramped up at nursing homes in hopes of slowing spread of the coronavirus, Los Angeles County announced another 29 fatalities Monday, Long Beach announced two and Pasadena reported four. Long Beach and Pasadena both have their own health departments.

Roughly 45% of the fatalities have occurred in institutional settings, primarily skilled nursing homes, according to the county.

The county on Monday instituted a revised testing program at nursing homes, testing all residents and staff regardless of whether they show any symptoms. Testing had previously been reserved only for people showing symptoms of COVID-19, a move that county officials now concede may have fueled the spread of the virus.

"Early on in this pandemic, we were all unaware that COVID-19 could be spread by people who were infected but did not have any symptoms, and this unfortunately has resulted in the spread of the virus even where everybody has been doing their very best to implement infection-control measures with the information that we had at the time," Barbara Ferrer, director of the county Department of Public Health said.

"So I apologize on behalf of all of us for not knowing enough at the start of this epidemic to take additional steps in our congregate living facilities to make sure we were doing everything possible to protect residents and staff."

As of Monday, at least one COVID-19 case has been reported at 312 institutional settings in the county—including nursing homes, skilled nursing facilities, assisted living facilities, shelters, jails and prisons, Ferrer said. There have been 423 deaths in such settings, the vast majority of them at skilled nursing facilities, she said.

The continuing increases in cases and deaths in nursing homes prompted the county's health officer Friday to issue a revised order applicable to all licensed "congregate health care," or long-term care, facilities.

The order bars non-essential visitors to such facilities, allowing only essential workers to enter.

"It suspends all communal dining and activities ... to make sure that there's ample distancing among the residents who reside there," Ferrer said.

"Staff will be required to always wear surgical masks and to use personal protective equipment when it's appropriate. And residents will also need to wear surgical masks or cloth face coverings when they're outside of their personal room."

With 900 new cases reported Monday by the county and six more in Long Beach and 37 more in Pasadena, the total in the county rose to 20,460. Included in that figure are 118 homeless people, 68 of whom were housed in some type of shelter. The county has been dealing with an outbreak at the Union Rescue Mission on Skid Row in downtown Los Angeles, where more than 50 people have tested positive.

Ferrer said there have been 1,968 cases among health care workers in Los Angeles County, an increase of 527 since last week. Eleven health care workers have died in the county—all between March 28 and April 21—with the majority occurring among staff at nursing facilities. Nurses account for 43% of all of the COVID-19 cases among health care workers.

Ferrer again lamented the elevated mortality rate from COVID-19 among certain ethnic groups, most notably the Black community. Of the 942 people who have died from the illness, race/ethnic data was available Monday for 865 of them, with 37% of them Latinx, 28% white, 18% Asian, 14% Black and 1% Native Hawaiian or Pacific Islander.

When compared to the overall population, the numbers show that in the Black community, the mortality rate from the coronavirus is 13.2 for every 100,000 residents. The rate is 9.8 per 100,000 residents among the Latinx community, 7.9 among Asians and 5.7 among white residents.

Ferrer also said communities with high rates of poverty had three times the rate of deaths for COVID-19, at 16.9 deaths per 100,000 people.

"This data is deeply disturbing and it speaks to the need for immediate action in communities with disproportionately high rates of death," Ferrer said.

She said such actions includes increased testing and providing better access to health care resources.

Ferrer said the county is putting online an interactive "dashboard" that includes data about testing, cases and deaths by city/community. She said it is being provided in hopes of giving people "a deeper understanding of how COVID-19 is affecting L.A. County."