SACRAMENTO, Calif. _ The Los Angeles County Public Health Department on Wednesday confirmed its first coronavirus-related death and six new cases, bringing the county's total to 24.
The woman who died was older than 60 and had underlying health issues, said Dr. Barbara Ferrer, Public Health Department director. The patient was not an L.A. County resident but had been visiting here after extensive travel over the past month, including a long layover in South Korea.
"Shortly after being hospitalized, she unfortunately passed," Ferrer said.
Ferrer said that one of the new cases included the county's second instance of community spread. That individual is hospitalized.
Three individuals are household contacts of an L.A. County resident previously confirmed to have the virus. One of those people is currently hospitalized.
One individual had traveled to France and returned home ill. Another traveled to a religious conference in a different state and was a close contact of someone at the conference who later tested positive for COVID-19.
The county has developed a risk assessment tool that considers how many community transmissions there have been and whether new cases are accelerating, Ferrer said.
"We're trying to use that to drive our judgments about when things need to close," she said. "We will get to a point, unfortunately, here in L.A. County, where we will be asking for events to close. But we're not there yet," Ferrer said.
Ferrer stressed the public's need to be cautious in large gatherings and suggested that people assess, themselves, whether they should venture into a crowded area. Those who are pregnant, elderly or have underlying health issues are especially vulnerable to developing serious effects from the virus.
To date, the county's public health lab has completed 72 tests for COVID-19. That number does not include those performed by commercial labs.
As the outbreak continued its rapid spread across the globe, the World Health Organization, for the first time, referred to the outbreak as a pandemic.
"This is the first pandemic caused by a coronavirus," WHO chief Tedros Adhanom Ghebreyesus said. "We have rung the alarm bell loud and clear."
Coronaviruses typically cause the common cold, but deadly viruses SARS and MERS were also coronaviruses. Tedros emphasized that countries could still take aggressive steps to beat back the spread of the new coronavirus and said he believed united action could effectively combat the spreading illness.
The pandemic classification does not change the WHO's strategy for slowing outbreaks nor should it affect how countries are tackling cases, Tedros said.
Across California, the number of cases continued to grow, including the death Tuesday of a woman at a senior living facility, and officials are saying it's increasingly unlikely they can contain the virus and instead are focusing on slowing its spread.
"The community spread has already occurred," said Peter Beilenson, Sacramento County's health director.
An elderly patient in a Northern California assisted living facility died of the novel coronavirus, sparking fears of an outbreak among other residents there and renewing concerns about statewide availability of testing kits.
Sacramento County health officials announced Tuesday that a patient in her 90s was the county's first fatality from COVID-19, the disease caused by the coronavirus.
The woman was among about 140 patients of the facility in Elk Grove, the same suburb where all public schools were closed this week after two family members with students at multiple sites tested positive for the coronavirus. Tuesday, the district announced that an elementary-school-age student in that family had also tested positive.
Beilenson said Tuesday that all patients in the nursing home would be tested for the virus, but that effort was delayed by a lack of test kits. He said the county has access to only 20 tests per day and is having to ration those between possible cases in the community and medical professionals who may have been exposed.
"It has been very frustrating because we have been stuck now for a couple of weeks with just 20 tests a day," Beilenson said.
Beilenson said other residents of the Elk Grove facility are now subject to special protective measures, including having meals delivered to rooms and not being allowed to congregate in communal areas.
The city of Alameda on Wednesday said a firefighter has tested positive for the virus, and Stanislaus County confirmed its first two positive cases. One of the individuals was a passenger on the Grand Princess cruise to Mexico. The other is likely a case of community transmission, as officials said that the person had not traveled anywhere with a known outbreak or been in contact with someone who previously tested positive.
Seventeen others in Stanislaus County are currently awaiting results, officials said.
Officials have continued to take precautionary measures in an attempt to contain the spread of the illness. San Francisco announced it is banning large group events of 1,000 or more people.
"We know that this order is disruptive, but it is an important step to support public health," said Mayor London Breed, noting that city officials were following advice from state officials.
A growing number of colleges and universities, most recently Cal State Long Beach and Pepperdine University, have suspended in-person classes in favor of online instruction.
Gov. Gavin Newsom said Tuesday that California has 157 confirmed cases of COVID-19 and that thousands of residents may have come into contact with the disease. The United States has surpassed 1,000 coronavirus cases, with most in Washington state, New York and California.
The governor said more than 1,075 Californians have been tested for the coronavirus at 18 labs across the state. The state is monitoring an additional 10,300 individuals who returned to California on international flights and may have been exposed, he said. Many others who have interacted with infected people are being advised to self-monitor and quarantine at home.
The largest outbreak of the illness is in Santa Clara County, where there have been 45 positive cases confirmed. On late Tuesday, officials announced that three Transportation Security Administration agents at Mineta San Jose International Airport tested positive. Two screeners at Los Angeles International Airport also have the coronavirus.
In Los Angeles County, Ferrer said her agency is focused on slowing the spread of COVD-19 but is combining mitigation efforts with containment.
But public health officials in Placer and Yolo counties, which neighbor Sacramento to the northeast and west, have announced a shift from trying to contain the virus to accepting that it is spreading too fast for widespread quarantining measures. Seven people in Placer County have tested positive, including a Rocklin man who died last week. Yolo County has one confirmed case.
Under the new recommendations in Placer and Yolo counties, which are effective through March 31, individuals who have come in contact with a confirmed or suspected case of coronavirus will no longer be required to be quarantined for 14 days. Instead, persons with cold-like symptoms, regardless of whether they have the coronavirus or flu, are asked to self-quarantine and manage their symptoms with over-the-counter drugs.
The counties also said that while they have tests for COVID-19, they will be reserved for those with more serious symptoms,because mild symptoms are treated the same regardless of the diagnosis. The counties urged businesses to allow employees to telecommute where possible and for large events to be postponed or canceled.
Aimee Sisson, Placer County's public health director, said the county will continue to do some tracing of anyone who comes in contact with the virus, but it will screen only for high-risk situations, such as a person who visited a nursing home or came in contact with an immuno-compromised individual.
Widespread quarantine measures can't be sustained, Sisson said, especially for healthcare workers. California already is taxed with a shortage of medical providers, and forcing quarantines on front-line staff is a burden the system can't bear as the virus spreads.
If counties keep quarantining healthcare workers for potential exposure, "we wouldn't have any healthcare workers left," she said.
Sisson said the county does not have the capacity to continue to trace every contact because it lacks the manpower, even with an offer from the state for additional help.
"Even a handful of cases tested our capacity," she said.
