As California lifts restrictions, a top health official worries about Covid-19 variants and the slow vaccine supply

The stay-at-home order in California has ended, but a top Los Angeles health official worries that another spike could be on the horizon as Covid-19 variants spread and the supply of vaccines struggles to meet the demand.

State officials in California, a recent epicenter of the pandemic in the US, lifted the regional stay at home order for all five regions on Monday in light of expectations that the ICU bed capacity would meet a key threshold in four weeks.

Trends are moving in a positive direction as well in Los Angeles County, which has more than halved its number of daily positive cases since reaching a peak earlier in January, said the county’s public health director Barbara Ferrer.

But she warned that coronavirus variants pose an increasing threat.

“They will become dominant and will make it easier for people to become infected and lead to a surge,” Ferrer said, while urging residents to remain vigilant.

“This would not be the time to think just because we are reopening that things are looking rosy,” she said noting that asymptomatic spread is a problem. “We do need to move through the next few weeks with caution. At many other points where we’ve been reopening our sectors, we in fact have seen a bump up in our cases,” Ferrer said.

Lifting the order means a return to the four-tiered reopening system, and Los Angeles County will lift restrictions on outdoor dining and a local overnight curfew for non-essential workers on Friday, Ferrer said. But those reopenings will require safety modifications, and Ferrer said she plans to meet with restaurant workers and unions Wednesday to discuss the changes.

Some elected officials have questioned the timing of lifting restrictions in the state, but California Health and Human Services Secretary Dr. Mark Ghaly said Tuesday that he believes it was lifted “at the right time.”

“This was not a regional stay-at-home order based on community transmission rates only, it was really focused on what we would see in the hospitals a few weeks out,” Dr. Ghaly explained.

Limited vaccines and a slow rollout

Another cause for concern is the limited supply of vaccines, Ferrer said.

Los Angeles County receives over 168,000 doses of the vaccine weekly, but that is chipping away too slowly at the number of people — more than 2 million people — who are currently eligible to be vaccinated, she said.

“Patience is going to be required because we just don’t have enough doses,” she said. “We’re really constrained with supply right now. This is an issue at the federal level, the administration has promised to both be more transparent but also to quickly beef up production, so that we’ll be able to get more supply here in the county.”

The unpredictability of doses each week makes it difficult to open vaccine appointments beyond a week at a time, said Ferrer. The next two weeks will be “rocky,” she said.

Supply is limited throughout the state, but the California Department of Public Health announced Tuesday that a new system will be introduced to respond to criticism over slow and inefficient rollout of doses.

Starting next month, all Californians in Phase 1B Tier 1 will be able to make an appointment to receive the vaccine under a statewide standardized system. These people include health care workers, residents over 65 years old, education and childcare, emergency services and food and agriculture workers.

Instead of counties and hospitals running their own vaccination delivery systems, the state will now use a third-party administrator that will allocate vaccines directly to providers to maximize distribution efficiency, they said.

“We have learned that to accelerate pace we need to dial up the scale of our efforts to ensure vaccine supply goes into arms as quickly as it arrives in the state,” Gov. Gavin Newsom said in a statement.