Over the last few weeks, COVID-19 cases and hospitalizations have been steadily increasing in Los Angeles County.
Public health experts told ABC News that newer subvariants circulating plus low booster uptake has led to a surge and it may be time to mask up again.
Average daily infections currently sit at 3,028, a 129% increase from the 1,322 average cases recorded one month ago, according to an ABC News analysis of data from the county's Department of Public Health.
What's more, hospitalizations currently sit at 1,304, a jump from the 580 hospitalizations reported one month ago, the analysis found.
'In a winter surge'
"What we're seeing here in Los Angeles is what we'll describe as a winter surge," Dr. Armando Dorian, CEO of USC Verdugo Hills Hospital and an emergency medicine physician, told ABC News. "We were at a point where we had zero COVID patients in the hospital and over the last couple of weeks, there's been a steady increase in the number of inpatients with COVID as either the diagnosis or part of their diagnosis."
Dorian said the surge, both at his hospital and in the county is at whole, is not like previous surges that have occurred during the winter, which overwhelmed hospitals, but that the numbers are not insignificant.
Daily COVID-19 Cases in Los Angeles County
LA County Department of Public Health
"Currently, we're sitting just under I think around 18% of the patients in the hospital are COVID-positive," he said.
Dr. Soniya Gandhi, associate chief medical officer at Cedars-Sinai, told ABC News it's a similar situation at her hospital.
However, this surge is different compared to previous surges because hospitals are also dealing with flu and RSV cases, in what's been described as a "tripledemic."
"We're seeing now the other circulating viruses like flu and RSV, which we hadn't experienced in prior surges," Gandhi said. "So, we are starting to see a lot of COVID in the community. We're starting and have been seeing a lot of flu as well in the community. Our flu positivity rate was as high as 30% last week, which is incredibly high compared to [past] years.
However, in some good news, RSV cases appear to have peaked in early November and are now on the decline in California, CDC data shows.
New variants and low booster update
Experts said there are a few reasons for the rising number of COVID-19 cases in the community, one of them being new variants.
"We have newer subvariants, namely BQ.1 and BQ.1.1 that are cousins of the prior omicron variant," Gandhi said. "They're more infectious, and they're increasingly prevalent in the community."
Data from the CDC shows that in Region 9, where Los Angeles is located, the two variants make up 67.8% of all new infections.
Additionally, more people are gathering in crowded indoor spaces due to the colder weather and the holiday season, which increases the risk of spread.
However, another factor is that vaccination and booster rates are lower than what doctors would like to see. Department of Public Health data shows only 13% of those aged 5 and older have received an updated booster dose.
"The true reason to get the booster or vaccinated is so that you potentially keep yourself from getting really ill from it and avoiding hospitalization," Dorian said. "We do see a percentage of people that potentially could have definitely prevented themselves from getting admitted to the hospital, or even getting significantly ill because they did not get boosted or vaccinated."
Los Angeles County appears in the midst of another full-blown coronavirus surge, with cases rising by 75% over the last week.
Irfan Khan/Los Angeles Times via Getty Images
Are mask mandates coming back?
Meanwhile, the potential return of an indoor mask mandate hangs over the county.
Last week, Public Health Director Dr. Barbara Ferrer said during a press conference a mask mandate would not be implemented even as the county entered the "high" COVID-19 community transmission category, as defined by the Centers for Disease Control and Prevention.
This was a reversal from a previous policy that moving into the high category would trigger a mandate. Instead, Ferrer said the mandate would be reinstated if certain hospital metrics were met such as 10% of county hospital beds filled with COVID patients.
Experts said right now the county is trending in the direction of a mask mandate.
"I think if we continue to trend in the direction, where we seem to be going, I think based on the previously outlined criteria, a mask mandate could certainly return and probably would need to be seriously considered," Gandhi said. "That being said, I don't think individuals should wait for a mask mandate to practice common sense."
Dorian agreed, saying that implementing a mask mandate would be polarizing and that people should consider their own risk level and the level of those around them when considering masking.
"Do we really need somebody to tell us when to put a mask on is the question," Dorian said. "I think if you're not feeling well, or you're potentially immunocompromised, or you're going into a space where there's a lot of people, you should just mask."
He continued, "So, I think just continuously educating the community on why we're asking and why there's an increase and making sure we protect the vulnerable."
