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New Orleans Moves To Modified Phase 1 As COVID-19 Hospitalizations, Positivity Rate Soar

A streetcar passes through Lee Circle, RTA has reduced their service because of COVID-19. New Orleans, Louisiana. April 7, 2020.
A streetcar passes through Lee Circle, RTA has reduced their service because of COVID-19. New Orleans, Louisiana. April 7, 2020.

New Orleans will move back to a modified version of Phase 1 at 6 a.m. Friday in response to the soaring rate of positive COVID-19 tests and hospitalizations.

For three weeks, indoor service at restaurants will be reduced to 25 percent capacity. Gatherings are to be limited to households. That means that even when dining or drinking outside, guests at those tables should all be from the saavme household. Tables can have no more than six guests. Indoor sporting events will be reduced to 4 percent capacity. Bars can continue with outdoor service at 25 percent capacity.

“These actions that I’m putting forth are necessary and they are mandatory,” Mayor LaToya Cantrell said at a press conference on Wednesday.

Cantrell called the current rate of infections and hospitalizations in New Orleans “critical.”

“Every metric we are tracking indicates a major community outbreak in New Orleans,” said Dr. Jennifer Avegno, the city’s health director and an emergency healthcare provider. “I saw more people admitted with COVID [recently] than since I have in March and April.”

Avegno said that the majority of patients are getting sick from attending small gatherings of people from different households.

New Orleans’ COVID-19 test positivity rate nearly doubled in one week. The rate between Dec. 17 and Dec. 23 was 5.5 percent, already high enough for the city to ban indoor bar service under Modified Phase 2 guidelines. The rate for the week of Dec. 24 to Dec. 30 was 10.4 percent, an 89 percent increase, according to the Louisiana Department of Health. The seven-day average number of new cases per day is now 224.

Susan Hassig, associate professor of epidemiology at the Tulane University School of Public Health, said in an interview she is frustrated by a lack of willingness from the American public to wear masks, socially distance, avoid large gatherings, and to aggressively wash their hands — actions that have proven to prevent the spread of the virus. She referenced the more than 3,000 COVID-19-related deaths-per-day in the United States.

“That's like 10 or 12 airplanes crashing every day with a full passenger load,” Hassig said. “And I think that these numbers that we've been dealing with for a really long time now are getting numbing, and people are just desensitized to the criticality of the situation. … People have got to get on the program in terms of masking and distancing and avoiding gatherings.”

Beginning in November, city and state officials began warning Louisiana residents that hospitals would become overwhelmed with COVID-19 patients if the curve could not be flattened and urged people to refrain from gathering in groups outside of their households during the holiday season.

In the beginning of November there were roughly 600 people hospitalized with COVID-19. That number has been rapidly increasing. Hospitalizations have gone from roughly 1,500 patients on Dec. 27 to 1,993 patients on Jan. 6.

“That's a very short period of time to have added that many more people,” Hassig said. “We are now almost as high in terms of hospitalizations as we were at the highest peak of the first surge in March, April. And that was not a good place to be. And unfortunately, the case data doesn't suggest that we're likely to start going down anytime soon.”

Avegno said the increase in hospitalizations is probably due to gatherings from just before the Christmas and New Year’s holidays. Hospitalizations from New Year’s Eve gatherings will likely begin two weeks from now.

Hassig said that the current number of hospitalizations in Louisiana is “challenging, but manageable.” State and city health officials continue to say that, while hospital beds are available, the supply of staff to attend to patients is quickly diminishing.

Hassig explained that the stay-at-home order and restrictions on hospitality businesses were put in place last spring to aggressively lower the spread of the virus. She does not anticipate another stay-at-home order.

“From an epidemiologic perspective, I think that's what we probably need to do. But I don't think it's politically viable,” Hassig said.

On Wednesday, Gov. John Bel Edward indicated that he would likely not be adding extra statewide restrictions beyond the current modified Phase 2 guidelines that are in place until January 16.

Hassig said a stay-at-home order might not be necessary if other orders, like shutting down indoor dining and closing bars and breweries, were made.

Hassig expressed concern for the high rate of infection. In New Orleans the rate of infection has increased to 1.2, meaning that each person infected with COVID-19 is spreading the virus to more than one person. Once the transmission rate reaches 1 or higher it can multiply quickly.

A more transmissible mutation of COVID-19 has been detected in Colorado, California, Florida and New York. Scientists are looking for the new strand in Louisiana, but it has not been detected yet. Avegno said that residents should expect that the strain will arrive in Louisiana.

“I suspect it's already here,” Hassig said, “The problem with increased transmissibility, is that it means there will likely be more people infected in environments where people aren't doing the things to stop the variant we already have present … which means more infections, more hospitalizations, and everything else that comes with that.”

Avegno said that at this point either strain could be what’s driving up hospitalizations.

“Whether it's the original strain or this new strain, either one of those is threatening to overwhelm us,” Avegno said.

The test percent positivity rates in nearby Jefferson and St. Tammany Parishes are 16.4 and 17.5 respectively. The health department has listed the entire state at the highest risk level. Claiborne Parish appears to have the highest percent positivity rate at 25 percent, but that rate is increasing slower than it is in Orleans. With the current rate of infection, it is possible that New Orleans’ percent positivity rate could double once more in the next week.

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