The winter surge that filled emergency rooms and hospital beds with COVID-19 patients in late December  through January and into early February is over.

As Southern California enters the post-omicron surge phase, once-jammed hospitals are seeing fewer than half the number of infected patients, while incidents of infection in each county have dropped by as much as 90%.

With hospitalization rates the most important metric cited by experts, Los Angeles County, for example, has had more than seven consecutive days of below 2,500 hospitalizations. By meeting that target, the county has lifted the masking requirement for outdoor settings at schools and large events.

“We’ve met that milestone. And we are reaching the end of our devastating winter surge,” said Dr. Barbara Ferrer, director of public health for LA County, on Thursday, Feb. 17.

Likewise, cases in the most populated county in Southern California have fallen 93% since the omicron variant’s high water mark on Jan. 7, she said.

While LA and other counties report sharp drops in confirmed cases, indicating a slowing of community transmission, the numbers of cases are still elevated. LA County predicts it will sustain “moderate transmission” rates (50 cases per 100,00 residents) for seven consecutive days by mid-to-late March, and at that time the county health department could lift indoor mask requirements, Ferrer explained.

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Doctors and hospital CEOs said the omicron variant came on strong and quickly drove up caseloads, but it behaved like a tornado, rapidly infecting mostly unvaccinated and other vulnerable populations at the height of the viral storm but exiting the region almost as quickly.

“It was super high but relatively fast. It didn’t drag on like the delta (variant) surge” that lasted for months last summer, said Dr. Kimberly Shriner of Huntington Memorial Hospital in Pasadena.

The good news can be heard from all corners of the medical establishment in Southern California:

• LA County has seen a 65% drop in COVID-19 patients in hospitals during the past 30 days, county health reported on Thursday, Feb. 17.

• In Orange County, the number of COVID-19 patients in a hospital bed has dropped by about 66% since the middle of January, said Dr. Regina Chinsio-Kwong, deputy health officer for the Orange County Health Care Agency, said Friday, Feb. 18. “Overall, the decrease in hospitalization is reassuring,” she added.

• In Riverside County, hospitalized COVID-19 patients fell by 54% from Jan. 24 to Feb. 14, explained Jose Arballo Jr., spokesperson for Riverside County’s public health department. “That indicates to us the impact of the omicron surge has dropped,” he said.

• In San Bernardino County, hospitalized patients fell 52% from Jan. 31 to Feb. 15, according to data from the California Department of Public Health. The drop-off accelerated in the past two weeks, data shows.

At Arrowhead Regional Medical Center in Colton, a major San Bernardino County facility, the number of COVID-19 patients fell from 91 in early January to 24 patients on Friday, Feb. 18, said Andrew Goldfrach, chief operating officer. The drop has translated into a 6% average daily decline in the past 30 days, he said.

“We saw a very sharp decrease in caseload. Our numbers followed the trend,” Goldfrach said. Likewise, the number of occupied ICU beds dropped from the high teens in mid-January to four on Friday, he said.

Kaiser Permanente’s 15 hospitals in Southern California experienced a 30% decline in COVID-19 patients from Feb. 1 to Feb. 16, as compared to Jan. 1 to Jan. 16, wrote Dr. Nancy Gin, regional medical director of quality for Kaiser Permanente Southern California, in an emailed response.

“Our numbers in our hospitals, including ICU and those on ventilators, continue to decline,” with ICU volume at 56% and ventilator volume at 69% as compared to peak days during the omicron surge, Gin added. “We anticipate the numbers in February will continue to decline for the remainder of the month.”

Lagging statistic: Deaths

So what keeps hospital CEOs and doctors up at night?

For LA County, death rates are still high but they have begun to come down. They dropped slightly to 65 new deaths in a seven-day average reported on Wednesday, Feb. 16, from an average of 73 reported on Feb. 9. The county reached a grim milestone last week by going above 30,000 people dying from COVID-19 since the pandemic began.

Riverside County is seeing its new deaths average out about the same, from 15 on Jan. 27 to 14 new deaths on average on Thursday, Feb. 17.

San Bernardino County had 5.6 new deaths on average on Thursday, Feb. 17, up from 3.1 on Feb. 9.

Orange County had 24 new deaths on average on Feb. 10, dropping to 20 on Friday, Feb. 18.

Unvaccinated children at risk

A particularly worrisome aspect of the omicron surge was the increase in children getting sick. Elementary schools accounted for the bulk of K-12 student cases in LA County, the county health department reported.

From Jan. 10 to Jan. 16, LA County reported 21,000 cases of COVID-19 among elementary school students, 11,000 high schoolers and 9,200 middle schoolers. By Feb. 13, cases dropped to 1,650 elementary, 810 high school and 648 middle school.

Unvaccinated children — who are two to three times more likely to become infected when compared to those fully vaccinated — accounted for the spike in school-age cases, Ferrer said. Only 26% of 5- to 11-year-olds are fully vaccinated in LA County.

“We still have a lot of children who have not been vaccinated who could be vaccinated,” said Shriner in Pasadena. “It is the responsibility of adults who are vaccinated to protect them.”

Orange County hospitals went from 69 pediatric hospitalizations on Jan. 13, including 17 in ICU, to 19 overall on Friday, Feb. 18, including four in ICU, said Chinsio-Kwong.

Still, during the winter surge, California had the least amount of school disruptions (closures, all-virtual learning, delayed openings) than any state in the union, Ferrer said.

What’s next?

Gov. Gavin Newsom and state health officials earlier this week said California must learn to “live with” COVID-19, announcing the state’s response to the virus is shifting from crisis mode to long-term management.

There are concerns about the virus mutating again, however. A second variation of omicron, known in medical circles at BA.2, has shown up in less than 1% of all recent cases in LA County. Ferrer said the BA.2 variant spreads more easily but it does not lead to more serious illness.

“It is not spreading here in the United States,” she added.

Shriner predicts there could be a fourth shot — either a booster or a generalized coronavirus vaccination — coming down the pike in late summer or fall.

She hopes more anti-viral medications will be available by then as well.

Goldfrach in San Bernardino County is concerned about the after effects of the Super Bowl in Inglewood and the at-home or sports-bar celebrations among fans.

“Any time people gather in large settings always concerns me,” he said. “It’s another opportunity to create a potential for spread.”

Where to find vaccines

For COVID-19 vaccine information:

San Bernardino County: sbcovid19.com/vaccine

Riverside County: www.rivcoph.org/COVID-19-Vaccine

Los Angeles County: www.VaccinateLACounty.com

Orange County: occovid19.ochealthinfo.com

Staff writer Nikie Johnson contributed to this story.

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