Reopening Los Angeles

The Los Angeles County Department of Public Health provides a web page for Metrics to Guide Reopening LA County. Criteria include:

• Deaths: 7-day average number of deaths has not increased over the past 14 days
• Hospitalizations and Hospital Capacity: the 3-day average number of hospitalized patients has not increased over the past 14 days
• Supply of Personal Protective Equipment in Hospitals: at least 60% of hospitals have 15+ days of available PPE
• Testing: an average of at least 15,000 tests (equal to 1.5 tests per 1,000 residents) have been done each day over the past 7 days
• Contact Tracing: at least 90% of COVID-19 cases have had follow-up investigation initiated within 1 day of assignment

Currently all criteria are met, with the exception of the PPE criterion where we’ve fallen short on the metric for having 15+ days of available gowns for at least 60% of hospitals (currently at 54%). But generally it looks like we’re in good shape. These criteria differ in some aspects from the White House Opening up America Again guidelines which include 3 gating criteria:

• Symptoms: Downward trajectory of influenza-like illnesses (ILI) reported within a 14-day period AND Downward trajectory of covid-like syndromic cases reported within a 14-day period
• Cases: Downward trajectory of documented cases within a 14-day period OR Downward trajectory of positive tests as a percent of total tests within a 14-day period (flat or increasing volume of tests)
• Hospitals: Treat all patients without crisis care AND Robust testing program in place for at-risk healthcare workers, including emerging antibody testing

I think there are pros and cons for each set of criteria. The White House criteria are overall very sensible from a medical perspective but can be difficult to measure given our gaps in understanding of actual symptoms and prevalence of COVID-19. The Los Angeles Department of Public Health criteria are measurable (again, with some limitations), and it would be nice if they added a criterion for “declining daily cases” similar to the White House criteria. The data for cumulative and daily cases are actually available at the Los Angeles County Department of Public Health COVID-19 Dashboard, and here is the figure provided today:



Data for cumulative and daily cases and deaths are also available for download in the “Counts by Date Table” section. The following caveats are also provided: Recent dates are incomplete due to due to lags in reporting. Cases reported by Episode Date which is the earliest existing value of: Date of Onset, Date of Diagnosis, Date of Death, Date Received, Specimen Collection Date. Deaths reported by Date of Death or Date Received if Date of Death is missing. Number of daily cases will not match the number of newly reported Los Angeles County cases as episode date reflects date of underlying illness rather than date of report.

In any case, by most metrics it is appears that we are on the path to safely re-opening Los Angeles, and I hope that is true for all other cities in the United States.