Public Health: Respiratory diseases on the rise amid early flu season

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County staff to communicate with residents about potential health risks for children 

The Los Angeles County Board of Supervisors voted Tuesday to address health concerns as the county’s Department of Public Health presented some concerning data on rising rates of flu and coronavirus. 

“During the past week, an average of just under 980 cases were reported per day, an increase from the seven-day average of about 940 cases reported per day last week,” said Muntu Davis, public health officer. “We are no longer seeing the steady decline in cases we’ve been reporting since July.” 

Hospitalizations and deaths as indicators for identifying transmission rate of COVID-19 in the county are lagging, Davis added.  

Though, he noted in the past week there was an average of 59 admissions per day — a slight decrease from the 66 admissions from the previous week — and an average of 10 to 12 deaths reported per day last week, too. 

“Using the CDC [Centers for Disease Control] community levels framework, L.A. County remains in the low community level,” Davis said. “Given the plateauing of cases noted earlier, it will be critical to keep an eye on our weekly case rate, which increased slightly this past week to 67 cases per 100,000 people.” 

Public Health officials indicated early-alert signals used to monitor and identify potential changes in COVID-19 transmission met the threshold for medium concern. Officials noted these metrics are of slight concern, and the data suggests there is no longer a consistent decline of COVID-19 transmission.  

“This reminds us that we ought to prepare for the possibility of another winter surge,” Davis said. “We want to be realistic since every COVID surge brings additional risk.” 

“However, we are also optimistic because we have powerful tools including therapeutics and the new bivalent vaccine boosters,” he added. 

According to the U.S. Food and Drug Administration, the bivalent vaccine was authorized as a single-dose booster, which provides broad protection against COVID-19 including the original virus strain and a component of the omicron variant.  

Davis said more people may be vulnerable this fall and winter to COVID-19. L.A. County residents should consider getting boosted, which will likely help keep residents out of the hospital and keep the county’s health care system from getting overwhelmed, he added.  

He also noted the county has been tracking data on flu and other respiratory diseases, neither of which require mandatory reporting of cases. 

“Instead of tracking individual cases, we monitor trends in the percentage of specimen testing positive for flu, or other respiratory viruses such as RSV [respiratory syncytial virus] at clinical laboratories serving hospitals and health care networks across L.A. County,” Davis said.  

Typically, Public Health begins monitoring trends in October through September of the following year.  

In the 2018-19 flu season, it started late in December and peaked around late February. Davis said that flu season lasted longer, increasing gradually and abating later. 

The 2019-20 flu season was different as residents tested positive in November and it rose sharply in January. However, the season ended abruptly, dropping to nearly zero by early April — as more people became infected with COVID-19. 

The 2020-21 flu season was extremely low, as it was essentially skipped due to isolation and other COVID precautions, he added.  

“The 2021-22 flu season… was also very unusual. You can see that the flu season began in December right around the same time as the new variant, Omicron, of COVID was surging here for the first time,” Davis said.  

Protections in place to stop Omicron also prevented the flu from spreading in the county. This season, flu started spreading in early-October, he said.   

“This is the earliest start of the flu season we’ve experienced in the past five years,” Davis said. “We don’t know what this means for the trajectory of flu this year.” 

This year’s flu season could peak quickly and die or be a prolonged season, according to Davis. He encouraged residents to get vaccinated against the flu, given the unusually high transmission rate. 

According to Public Health, most recent data — nearly 26% — shows children ages 0 to 4 are increasingly showing symptoms related to an influenza-like illness, and about 21% of 5- to 11-year-olds are being brough to emergency departments with the same characteristics.  

Medical professionals are also reporting an increase in respiratory syncytial virus, a common respiratory virus that usually causes mild cold symptoms. Though most people recover in one to two weeks, RSV can be more serious in older adults and very young children.  

RSV can cause inflammation in the bronchioles or the small airways in the lungs, Davis said. According to the CDC, this respiratory disease is the most common cause of pneumonia and bronchitis in children under 1 in the U.S. 

“This is unusually high, underscoring the need for preventive measures to protect children,” Davis added. “As we see high levels of flu and RSV activity, especially in children, we’re also keeping watch on the pediatric hospital capacity.” 

Public Health has communicated with hospitals in the county about these potential challenges as the county prepares for fall.  

The county Board of Supervisors received and filed Public Health’s report. The supervisors also unanimously voted to instruct the director of Public Health to work with the superintendent of schools of the county’s Office of Education, community service providers and other partners to communicate about the risks of RSV. 

In 60 days, county staff will report back to the board with a status update. The county will also create messages about the importance of vaccination against COVID and the flu.  

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