COVID-19 Response Plan

Los Angeles County (LAC) will continue to use the Centers for Disease Control and Prevention’s (CDC) COVID-19 hospital admission levels (table below) to guide assessment of risk across the county and inform the adoption of prevention strategies as described in the Community Safety Protection Measures and Prevention Strategies table. LAC will implement strategies for a higher hospital admission level when the hospital admission rate is at or above the threshold for a higher level for at least fourteen (14) consecutive days. Strategies will revert to a lower hospital admission level when the hospital admission rate has fallen below the threshold for the higher level for at least 7 consecutive days or the hospital admission rate has been declining consistently for the prior fourteen (14) days.

Public Health will monitor the following signals to provide early indication of concerning trends that can result in future high rates of transmission and/or increased illness severity. The signals in the table below include four (4) community-wide measures (variants of concern, Emergency Department COVID-19 visits, cumulative case rate in high poverty communities, SARS-CoV-2 wastewater concentration) and four (4) sector specific measures (outbreaks at Skilled Nursing Facilities [SNFs], outbreaks at Transitional Kindergarten (TK) through 12th grade schools, outbreaks at settings assisting persons experiencing homelessness [PEH], clusters at worksites). An alert in any measure that reaches the threshold for medium or high concern will trigger an in-depth review of contributing factors and the possibility of modifications to community prevention strategies.

Much of the COVID-19 Response Plan depends on our ability to focus resources on response actions and preparedness activities. Response actions include addressing increasing levels of community risk and early alert signals that may be sector specific. Preparedness activities are focused on strategies that consistently allow the county to respond to changing conditions.

Note: Starting May 25, 2023, the dashboard will be updated once per month on the third Thursday of the month.

The lessons we have learned from navigating more than three years of the pandemic will inform preparedness activities for LA County. The five focus areas identified below include: preparedness for outbreak management, vaccine distribution/information dissemination, testing, therapeutic distribution, and surveillance.

Outbreak Management Preparedness

Outbreak notification letters which include recommended and required mitigation measures will be sent to all sites experiencing an outbreak. Sites may be required by DPH to implement mitigation measures, such as indoor masking, routine testing, and other infection control measures, to limit the spread of COVID-19 among residents, employees, and students. See, County Health Officer Order for applicable COVID-19 case reporting requirements.

Vaccination Preparedness

Vaccinations provide the most powerful personal and community protection from COVID-19. Increasing coverage by ensuring access and addressing concerns regarding vaccine efficacy and safety remain priority activities. The following actions are essential components of the preparedness plan:

• Increase up-to-date vaccination coverage among those at elevated risk for severe illness and those working/living with those at elevated risk.
• Provide focused support for Skilled Nursing Facilities with technical assistance, education, and incentives to increase the proportion of patients and staff who are up to date on vaccinations.
• Maintain a network of at least 200 mobile sites per week that can provide access to vaccines in low-coverage communities and at schools.
• Maintain an extensive community-located clinic and pharmacy vaccination network to ensure access across the entire county.
• Increase numbers of medical providers offering vaccines to their patients through their routine services. Emphasize pediatricians incorporating COVID-19 vaccination into routine vaccination practice.
• Increase participation of health plans in ensuring homebound residents have access to vaccinations and boosters.
• Maintain homebound services to provide vaccinations to those at elevated risk for severe illness.
• Increase the number of residents trained as community ambassadors, parent ambassadors, and student ambassadors.
• Increase funding for CBOs and FBOs to support dissemination of vaccination information and promote access to vaccine clinics.
• Provide expanded services in at least 2 Public Health vaccination sites to provide multiple COVID-19 resources including vaccination, testing, therapeutics, and mental health services.

Testing Preparedness

• Testing may continue to be required by businesses, local or state HOOs, Cal/OSHA or state AFLs in high-risk settings (e.g., SNFs, shelters, correctional facilities, health care facilities, schools), and for outbreak management.
• Access to free and accessible testing for those with symptoms, exposures, exiting isolation or quarantine, or complying with travel and return to work/school requirements, is important. While there are requirements that health plans provide reimbursement to their members for testing, not everyone is insured and there is neither sufficient supply of tests nor ability for all members to purchase tests. Community testing sites that provide free and accessible testing to residents will remain essential over the upcoming months.
• Distribution of antigen test kits continues to be needed in high-risk settings and communities with high case rates, where testing remains an essential strategy for protecting workers and community members/residents.

Therapeutic Distribution Preparedness

The supply of effective therapeutics is currently widely available but there remains a need to ensure that those with less access to health care can receive appropriate therapeutics. This includes the following:

• Ensure a vast network of providers with information, supply of therapeutics, and prescribing ability across the county, with emphasis on deep penetration in hard hit and low-resourced communities.
• Ensure a vast network of distribution sites (including pharmacies and community clinics) that can distribute oral medications with no barriers with deep penetration in hard-hit and less-resourced communities.
• Provide a call center where residents can get more information about therapeutics and how to access therapeutics; provide culturally and linguistically appropriate information and information on accessing free medications.
• Provide a telehealth platform that provides services free of charge for those who are uninsured, underinsured or have difficulty accessing therapeutics through their own providers. This resource would augment sites that can prescribe and distribute oral therapeutics in low-resourced communities.

Surveillance Preparedness

To maintain an early alert system that can track the presence of emerging variants of concern, the following is required:

• Capacity to sequence at least 300 positive specimens over a 2-week period.
• Ability to expand wastewater surveillance to all areas of the county.
• Expanded sentinel surveillance capacity to detect changing patterns in community rates of respiratory illness that might indicate the emergence of a new variant.