Los Angeles County officials are bracing for another coronavirus surge in early January as people who become infected during the holidays return to work and other aspects of normal life. But they recognize they are fighting growing fatigue over stay-at-home restrictions and a feeling from some that the fight is already lost.

It's all but assured that the stay-at-home order that was imposed a month ago will remain in Southern California because hospitals are at the breaking point amid a crush of COVID-19 patients.

Officials say more measures are needed. They have urged every person coming into L.A. County from outside the region to quarantine for 10 days to determine whether they have any symptoms of the coronavirus.

"Mingling with people outside of your immediate household is one of the leading causes for the current surge. All it takes is one unfortunate encounter with an individual with COVID-19 for you to become infected, and sadly, for you to go on and infect many others," said Barbara Ferrer, the county's public health director.

County leaders also urged people to avoid the impulse to simply give up and stop following the rules.

"I understand the futility that so many people are feeling right now — the idea that some people just want to throw their hands up. But we can't think like that," Los Angeles County Supervisor Hilda Solis said. "To be more blunt, each one of us has the power to cause or prevent death and illness among our family members, our coworkers and even strangers."

The current crisis has been fueled by several factors, including Thanksgiving travel and gatherings. Officials know there have also been Christmas travel and gatherings, but it will take several weeks for infections associated with late December events to become apparent.

Ferrer said that "all indicators tell us that our situation may only get worse as we begin 2021. The rate of community transmission remains extraordinarily high. … As cases continue to remain at these alarmingly high levels, hundreds more people are likely to die."

For many people, the virus causes no illness or symptoms. "If you go back to work, you go shopping or you go to any gatherings, at any point over the next 10 days, you could easily pass on this virus to others," Ferrer said. She urged people under quarantine to not leave home, not to accept any visitors and to find others to help buy essential supplies, such as groceries.

"We all need to give our hospitals a fighting chance to handle the flood of COVID-19 patients that are arriving every single day," Ferrer said.

The pace of the fall and winter surge has been breathtaking. On Nov. 1, L.A. County was averaging about 1,300 coronavirus cases a day on a weekly basis; it is now averaging nearly 14,000 cases a day. The daily rate at which coronavirus test results are coming back positive is now 17% in L.A. County, more than quadruple the comparable figure on Nov. 1, when the positivity rate was 4%.

The illness is affecting — and killing — all ages, Solis said. A child died earlier this month of the coronavirus-linked multisystem inflammatory syndrome, known as MIS-C, in Los Angeles County. There have been at least 51 cases of MIS-C in L.A. County, and half of those have been treated in intensive care units. Latino children made up nearly three-quarters of those cases.

Ferrer said that L.A. County has run 29 samples of coronavirus cases and that none has been positive for the potentially more contagious variant of the coronavirus identified in Britain. She said there's a high probability the variant is here, but it doesn't appear to be dominant.

"Whether the variant is here or isn't here, the steps we need to take are exactly the same," she said.

The county could top 10,000 COVID-19 deaths in a matter of days.

Overall, 9,564 L.A. County residents are reported to have died from COVID-19. Health officials said Monday they are sorting through a reporting backlog they expect will add 432 deaths to the toll.

"As bad as it is, the worst is almost certainly yet to come," said Dr. Christina Ghaly, the county's health services director.

There is a real fear that such a "surge on top of a surge" could be too much for overworked hospital staff.

"It is a very, very different and infinitely more dangerous situation to have hospitals experiencing a surge when the staff are exhausted, they're stretched thin and they're already caring for more patients than they can safely handle," Ghaly said.

The state imposed strict limitations on businesses and activities earlier this month in hopes of slowing the spread of the virus.

Though the wave of new coronavirus cases has continued to swell since then, officials noted that the rate of that rise, along with the number of new coronavirus-related hospitalizations, appears to be leveling off in many areas.

"We're seeing now a majority of the state experiencing a plateauing of new hospital admissions ... actually seeing that rate of growth beginning to subside, with one major exception — and that's Southern California," Gov. Gavin Newsom said Monday, as Los Angeles, Riverside and San Bernardino counties continue to report heavy infection numbers.


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