Los Angeles, crushed by COVID-19, now confronts a more contagious variant.

By Lucy Tompkins and Carl Zimmer

Los Angeles County, one of the hardest-hit areas in the United States, may face even more dire weeks ahead.

Hospitals have run out of room in intensive care units, though new cases and hospitalizations appear to be leveling off in recent days. And as the national death toll nears 400,000, deaths continue to climb in Los Angeles County, which recently recorded its worst week ever for COVID-19 fatalities. The county records a coronavirus-related death roughly every seven minutes.

And now that there are variants of the virus that could be more contagious circulating in California, those numbers may rise.

It took nearly 10 months for Los Angeles County, America’s most populous, to hit 400,000 cases, but little more than a month to add another 400,000, from Nov. 30 to Jan. 2, according to a New York Times database. On Saturday, the county became the nation’s first to surpass 1 million recorded coronavirus infections, a number only four states other than California have exceeded: Illinois, New York, Florida and Texas.

And the true rate of infections may be much higher than the one reported: 1 in 3 Los Angeles residents is believed to have been infected with the virus since the beginning of the pandemic, according to the Los Angeles Department of Health.

The virus is surging across California, where daily deaths are averaging 528, an increase of more than 15% from a week ago. Much of the state, including the southern region, remains under a stay-at-home order.

The state is one of many dealing with the arrival of a more contagious viral variant, first discovered in Britain; the first confirmed case in Los Angeles was reported on Saturday. It is believed to be 50% more transmissible than the previous version of the virus.

Officials said they thought the variant, which has caused infections to soar in London and southeast England, has been spreading through Los Angeles for some time. While more contagious, the variant does not appear to cause more severe illness.

Barbara Ferrer, the director of the county’s Public Health Department, called the arrival of the variant “troubling, as our health care system is already severely strained with more than 7,500 people currently hospitalized.”

On Sunday night, the California Department of Public Health reported another variant that had grown more common across the state since December. Known as L452R, it was first detected in Denmark in March and appeared in California in May. In December, researchers at the University of California San Francisco sequenced genomes of coronavirus gathered around the state and found that the variant was present in just 3.8% of their samples. By January, it had jumped to 25.2%.

Charles Chiu, who led the sequencing, cautioned that he and his colleagues worked with a small sample size, so they have not yet proven that this variant is more contagious. “But there are worrisome signs that this variant may be highly transmissible,” he said.

Chiu and his colleagues are now looking more carefully for this variant across the state and are trying to understand how its mutations have altered it. They want to see if the variant can escape from antibodies and perhaps even make vaccines less effective. “These are critical studies that need to be done,” Chui said.

After weeks under a stay-at-home order, the county’s positivity rate is starting to taper. Dr. George Rutherford, a public health researcher at the University of California, San Francisco, said the state and Los Angeles seem to be “in the process of sort of gradually turning a corner here,” he said.

He cautioned against panicking about the more transmissible variant, noting the same cautious behavior will help keep it at bay: stay home, wear a mask, physically distance.

The variant has landed in California during a chaotic vaccination rollout, made more so after Gov. Gavin Newsom’s announcement Wednesday that the state would open up eligibility to anyone 65 or older, effectively abandoning a rollout plan that was meant to ensure that the most vulnerable would be first in line.

Los Angeles County, which opened a mass vaccination center at Dodger Stadium, said it would continue vaccinating only health care workers through at least the end of the month.

With its decentralized public health system, California is a microcosm of the many problems plaguing the national inoculation effort. Experts say the burden has been unduly placed on county public health departments that are left struggling with a deluge of monumental tasks, from testing to contact tracing and now, distributing vaccines. And they’re often doing it with outdated and overwhelmed information systems.

Dr. David Lubarsky, the chief executive of UC Davis Health, said the counties were up against the same problem they faced when trying to ramp up testing: too little manpower.

He suggested that the state should hand more vaccine doses directly to health care providers, who already have the ability to contact vulnerable patients who might be hard for officials to reach.

Jonah Frohlich, a San Francisco-based health care consultant with Manatt Health Strategies, said the counties are doing the best they can, but such an ambitious undertaking should take years, and “there is a real human cost to delaying the rollout of the vaccine.”

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