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L.A. County coronavirus weekly death rate 70% higher than in Bay Area: Why so much worse?

Some shoppers wear masks, while others do not, at an outdoor market.
Some shoppers wear masks, while others do not, at a very congested market on Santee Alley on July 14.
(Irfan Khan / Los Angeles Times)
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With Los Angeles County set to decide in the coming days whether to impose a new mask mandate, one factor of note is a rise in coronavirus deaths.

L.A. County’s weekly COVID-19 death rate is significantly higher than that of the San Francisco Bay Area. On a per-capita basis, L.A. County was recording 96 deaths a week for every 10 million residents, while the Bay Area was recording 56 deaths a week for every 10 million residents.

In other words, L.A. County’s latest weekly COVID-19 death rate is more than 70% higher than the rate in the Bay Area.

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The two regions’ death rates had been closer to each other through parts of June. But something changed in July, and there was a dramatic rise in L.A. County’s death rate not matched by that in the Bay Area.

There are various reasons that could explain why L.A. County has a higher death rate. The nation’s most populous county, L.A. County is structurally at higher risk from COVID-19 waves due to a higher rate of poverty and overcrowded housing. Additionally, vaccination and booster rates are generally higher in the Bay Area, and anecdotally, some have observed that voluntary masking seems more common in the Bay Area than in L.A. County.

Unless the hospitalization rate drops significantly next week, a new mask order will go into effect July 29.

Since the start of the pandemic, L.A. County has been among the hardest-hit counties in California. Of the state’s 15 most populous counties, L.A. County has one of the worst cumulative COVID-19 death rates — about 3,200 dead for every million residents. (San Bernardino County has an even worse rate, of about 3,700 dead for every million residents.)

By contrast, the Bay Area’s cumulative death rate is far lower than that of L.A. County. The Bay Area’s cumulative death rate is roughly 1,200 dead for every million residents.

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L.A. County could impose a new universal indoor mask mandate for public settings as soon as Friday, although Public Health Director Barbara Ferrer has raised the possibility of postponing such a decision should pandemic conditions significantly improve in the coming days. The Bay Area is not currently publicly considering a mask mandate.

When Ferrer was asked at a news briefing last week why her agency’s approach to a possible mask mandate differed from that of other counties in the state, she pointed to factors that have left L.A. County particularly vulnerable, including its size and population of 10 million, 2 million of whom remain unvaccinated.

The order, which could go into effect as soon as July 29, has raised concerns among business groups and sparked questions about its necessity.

The county is also home to many older residents generally at higher risk of severe health outcomes from COVID-19, as well as nursing homes and industrial work settings where transmission can be particularly problematic.

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Data also continue to show that COVID-19 is taking a disproportionate toll on Black and Latino residents as well as people living in poorer areas of L.A. County.

“Getting transmission levels down low benefits everybody, but it particularly reduces risks for those most vulnerable,” Ferrer said.

In L.A. County, hospitalization rates have grown much faster in recent weeks for older residents.

“When people pass along misinformation that the current COVID surge is not affecting or hurting anyone, these are the people they are dismissing: our elders,” Ferrer said.

Weekly coronavirus cases are showing early signs of a decrease in Los Angeles County, but it’s too soon to say whether it’s a blip or the beginning of a sustained trend.

As of Monday afternoon, L.A. County was averaging about 6,100 coronavirus cases a day over the previous week, down 11% from the prior week’s average of nearly 6,900 cases a day. On a per-capita basis, the latest rate is 425 cases a week for every 100,000 residents. A case rate of 100 or more is considered high.

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This is the largest week-over-week decline in cases in a month. But the future remains uncertain. A similar decline in mid-June ended up being temporary, only to be followed by more weeks of even steeper increases in cases.

The coming days will probably be critical in determining whether L.A. County implements a mask mandate starting Friday.

Ferrer said last week that if a steep decline in cases emerges this week, her agency is likely to pause the implementation of a universal mask order for indoor public settings.

Officials also are closely watching to see whether the rate of new weekly coronavirus-positive hospital admissions improves.

A key metric that would determine whether L.A. County remains headed toward a mask mandate is whether there are 10 or more new weekly coronavirus-positive hospital admissions for every 100,000 residents. L.A. County on Thursday reported the rate was 11.4.

Citing new data available through Saturday, the U.S. Centers for Disease Control and Prevention said that rate had fallen to exactly 10.

Throughout this late spring and summer pandemic wave, most public health officials in Bay Area counties have not publicly suggested the need for a renewed local mask mandate. The lone exception, Alameda County, rescinded its own mask mandate three weeks after implementing it on June 3. Because the other highly populated Bay Area counties did not join with Alameda County’s decision, its mask mandate attracted significantly less attention in the Bay Area.

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Weekly coronavirus cases, while showing signs of flattening in L.A. County, remain elevated as a decision on reimposing an indoor mask mandate looms.

Since the beginning of May, L.A. County’s COVID-19 death rate over a 12-week period has grown to far exceed that of the Bay Area.

From May 1 through Friday, L.A. County has recorded 664 COVID-19 deaths, and the Bay Area, 389 deaths. On a per capita basis, that means — over this 12-week period — L.A. County has recorded 658 deaths for every 10 million residents, while the Bay Area has reported 464 deaths for every 10 million residents.

In other words, if L.A. County had the Bay Area’s death rate, L.A. County would have recorded nearly 30% fewer deaths — about 200 fewer fatalities — over the last 12 weeks.

And if the Bay Area had L.A. County’s death rate, the Bay Area would’ve had more than 40% more deaths — about an additional 160 fatalities — over the same time period.

The calculations for the Bay Area include nine counties adjacent to the San Francisco Bay and also Santa Cruz and Monterey counties, which matches the state Department of Public Health’s definition for the region.

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