Los Angeles County Post Surge Response Plan - Los Angeles County Department of Public Health Wednesday, March 02, 2022
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Los Angeles County Post Surge Response Plan Los Angeles County Department of Public Health Wednesday, March 02, 2022
TABLE OF CONTENTS
Metrics to Assess Risk and Assign Appropriate Prevention Measures............................... 3
CDC Community Levels ................................................................................................... 3
TABLE 1: CDC COVID-19 Community Levels ................................................................. 3
Community Prevention Strategies (Aligned with Community Levels) ............................ 4
TABLE 2: Community Prevention Strategies ................................................................ 4
LAC Early Alert Signals and Levels of Concern ................................................................ 6
TABLE 3: LAC Early Alert Signals ................................................................................... 6
Priority Sector Mitigation Measures ............................................................................... 7
TABLE 4: Priority Sector Response ............................................................................... 7
LAC Post Surge Preparedness Plan................................................................................ 14
Outbreak Management Preparedness Post-Surge........................................................... 14
Vaccination Preparedness Post-Surge ............................................................................. 14
Testing Preparedness Post-Surge..................................................................................... 15
Therapeutic Distribution Preparedness ........................................................................... 15
Surveillance Preparedness ............................................................................................... 15
Los Angeles County Post Surge Response Plan (Revised 3/2/2022)
Page 1 of 15As we enter this post surge phase with COVID-19, Los Angeles County (LAC) will utilize both the Centers
for Disease Control and Prevention (CDC) community monitoring measures and California SMARTER plan
to guide the realignment of our local public health response. While we welcome our recovery from the
dangerous Omicron variant surge, we recognize that post-surge does not imply that the pandemic is over
or that there will not be additional unpredictable waves of surges that will require different monitoring
metrics and approaches to meet changing mitigation needs.
The role of LAC Department of Public Health (DPH) post-surge continues to be ensuring an equitable
distribution of the resources and opportunities needed to prevent COVID-19 transmission and protect
residents and workers from devastating consequences associated with COVID-19 illness. As we have
seen over the past two years, the pandemic has illuminated stark inequities in the burden of disease by
race/ethnicity and geography, with Black and Brown individuals and those living in under-resourced
communities experiencing higher case, hospitalization, and death rates. These disparities did not happen
by chance and reflect decades of disinvestment, marginalization, and racism.
The solutions to eliminating the gaps in health outcomes require transforming systems, policies, and
practices. Engaging in this work calls for a long-term commitment to centering equity work at all levels,
including mitigation efforts post-surge. Calls to ‘returning to normal’ and minimizing public health
response activities can have an unintended consequence of exacerbating inequitable outcomes since
the existing health care and social services systems are not yet organized to provide those most
vulnerable and marginalized with the necessary resources to mitigate the impact of the virus.
To ensure an equity focused response, LAC DPH will organize post-surge actions to:
• Protect the most vulnerable, including those at risk of experiencing elevated rates of illness and
death from COVID-19
• Protect hospitals and health system functioning
• Prevent unconstrained spread and significant illness
• Prepare for future potential challenges presented by the evolving conditions of the virus
Los Angeles County Post Surge Response Plan (Revised 3/2/2022)
Page 2 of 15Metrics to Assess Risk and Assign Appropriate Prevention Measures
CDC Community Levels
Los Angeles County (LAC) will use the Centers for Disease Control and Prevention’s (CDC) COVID-19
Community Level Matrix (Table 1) to assess the level of risk across the county and adopt corresponding
prevention strategies as described in Table 2. LA County will move to a lower or higher community level
after qualifying for the new level for 7 consecutive days.
TABLE 1: CDC COVID-19 Community Levels
LA County’s
New Cases
Level of Risk Current Values
(per 100,000 Low Medium High New Cases:
population in Indicators
216.5/100,000
the last 7 days)
(as of 2/24/2022)
New COVID-19
admissions per
100,000 populationCommunity Prevention Strategies (Aligned with Community Levels)
The community prevention strategies below reflect CDC, state, and county mitigation efforts in four
areas: masking, testing, vaccination verification, and ventilation. Federal and state requirements are
embedded in Table 2 below and will be changed if and when these requirements change.
TABLE 2: Community Prevention Strategies
Strategies Low Medium High
Masking • Required in all indoor • Required in all indoor • Required in all indoor
Indoors spaces at K-12 schools spaces at K-12 schools spaces at schools, public,
until 3/12/22 until 3/12/22 and business settings
• Required at all • Required at all healthcare • Required at all healthcare
healthcare settings, settings, correctional and settings, correctional and
correctional and detention facilities, public detention facilities, public
detention facilities, transit, transportation transit, transportation
public transit, hubs, congregate care hubs, congregate care
transportation hubs, facilities, and homeless facilities, and homeless and
congregate care and emergency shelters emergency shelters
facilities, and homeless • Required for those that • Required for those that exit
and emergency shelters exit isolation or isolation or quarantine
• Required for those that quarantine early by testing early by testing through
exit isolation or through day 10 of day 10 of isolation or
quarantine early by isolation or quarantine quarantine period
testing through day 10 of period • Required for employers
isolation or quarantine • Required for employers to required to offer well-
period offer well-fitting medical fitting medical masks or
• Required for employers masks or respirators to respirators to employees
to offer well-fitting employees working working indoors in close
medical masks or indoors in close contact contact with other workers
respirators to employees with other workers and/or and/or customers
working indoors in close customers
contact with other • Strongly recommended
workers and/or for all individuals,
customers regardless of vaccination
• Strongly recommended status, in indoor spaces
for all individuals, • Recommended for those
regardless of vaccination at elevated risk of severe
status, in indoor spaces illness
• Recommended for those • Recommended for those
at elevated risk of severe gathering with individuals
illness at elevated risk
• Recommended for those • Employers required to
gathering with offer medical grade masks
and respirators to
Los Angeles County Post Surge Response Plan (Revised 3/2/2022)
Page 4 of 15Strategies Low Medium High
individuals at elevated employees working
risk indoors in close contact
with other workers and/or
customers
Testing • Required to exit isolation • Required to exit isolation • Required to exit isolation
or quarantine between or quarantine between or quarantine between
days 6-10 days 6-10 days 6-10
• Recommended for those • Testing for those exposed • Testing for those exposed
exposed or symptomatic or symptomatic or before or symptomatic or before
gathering with those at gathering with those at
elevated risk elevated risk
• Implement screening • Implement screening
testing, as appropriate, in testing, as appropriate, in
workplaces, schools and workplaces, schools and
high-risk congregate high-risk congregate
settings settings
Vaccination • Required for indoor • Required for indoor mega • Required for indoor mega
Verification mega events events events
• Required for healthcare • Required for healthcare • Required for healthcare
in Higher workers, employees at workers, employees at workers, employees at
Risk healthcare facilities, and healthcare facilities, and healthcare facilities, and
Settings employees at high-risk employees at high-risk employees at high-risk
congregate care settings congregate care settings congregate care settings
• Required for visitors at • Required for visitors at
healthcare facilities, healthcare facilities,
including congregate care including congregate care
sites; a negative test result sites; a negative test result
may be substituted for may be substituted for
those not fully vaccinated those not fully vaccinated
• Recommended at outdoor • Recommended at outdoor
mega events, and indoor mega events, and indoor
portions of bars, lounges, portions of bars, lounges,
nightclubs, distilleries, nightclubs, distilleries,
wineries, and breweries; a wineries, and breweries; a
negative test result may negative test result may
be substituted for those be substituted for those
not fully vaccinated not fully vaccinated
Ventilation • Ensure and maintain • Ensure and maintain • Ensure and maintain
improved ventilation improved ventilation improved ventilation
throughout indoor throughout indoor spaces throughout indoor spaces
spaces
Los Angeles County Post Surge Response Plan (Revised 3/2/2022)
Page 5 of 15LAC Early Alert Signals and Levels of Concern
Public Health will monitor the following signals to provide early indication of concerning trends that can
result in future high rates of transmission and/or increased illness severity. The signals below include
three community-wide measures (variants of concern, Emergency Department COVID-19 visits,
cumulative case rate in high poverty communities) and four (4) sector specific measures (outbreaks at
Skilled Nursing Facilities [SNFs], outbreaks at Kindergarten through 12th Grade schools, outbreaks at
settings assisting persons experiencing homelessness [PEH], clusters at worksites). Alerts in two (2) or
more sectors that reach the threshold for moderate or high concern will trigger an in-depth review of
contributing factors and the possibility of modifications to community prevention strategies. Sector
specific alerts that reach the threshold for moderate or high concern will result in action steps outlined
in Table 4: Mitigation Measures for Priority Sectors.
TABLE 3: LAC Early Alert Signals
Indicator LA County
Low Medium High
Thresholds Current Values
Percent of specimens
sequenced that are identified Less than 5% 5%-10% of More than 10%
as a new variant of concern of sequenced sequenced of sequenced N/A
(based on the World Health specimens specimens specimens
Organization’s designation)
7-day average of the percent
Less than 5% Between 5% and
of Emergency Department More than 10% 4.9%
of ED 10% of ED
(ED) encounters classified as of ED encounters (2/21/22-2/27/22)
encounters encounters
coronavirus-related
7-day cumulative crude case Case rate is
Case rate is 100- Case rate is >200 82 per 100,000
rate for the lowest income 20 new
3
skilled nursing facilities over outbreaks in outbreaks in past outbreaks in past
(2/23/22-3/1/22)
the past 7 days past 7 days 7 days 7 days
Number of new outbreaks in ≤3 new 4-9 new ≥10 new
7
TK-12 schools over the past 7 outbreaks in outbreaks in past outbreaks in past
(2/23/22-3/1/22)
days past 7 days 7 days 7 days
Number of new outbreaks in ≤10 new 11-20 new >20 new
6
PEH settings over the past 7 outbreaks in outbreaks in past outbreaks in past
(2/23/22-3/1/22)
days past 7 days 7 days 7 days
< 100 worksite 100-300 worksite > 300 worksite
Number of worksite cluster 64
cluster reports cluster reports in cluster reports in
reports in the past 7 days (2/21/22-2/27/22)
in past 7 days past 7 days past 7 days
Los Angeles County Post Surge Response Plan (Revised 3/2/2022)
Page 6 of 15Priority Sector Mitigation Measures
During post-surge, detailed below are both general mitigation measures and additional measures that vary depending on the threshold for
concern for each priority sector.
TABLE 4: Priority Sector Response
Sector General Mitigation Measures Low Concern Moderate Concern High Concern
SNFs • Increase vaccination and booster • Test all symptomatic • Test all symptomatic • Test all symptomatic staff
coverage for those eligible staff and residents. staff and residents. and residents.
(required for SNF employees). • Conduct contact • Conduct contact • Conduct contact tracing
• Require masking at all healthcare tracing and assure tracing and assure and assure proper
settings. Require respirators for all proper isolation of proper isolation of isolation of cases and
staff when in direct contact with cases and quarantining cases and quarantining quarantining of close
residents/patients. of close contacts of close contacts contacts based on the
• Ensure adequate testing capacity to based on the county based on the county county HOO.
meet routine and response testing HOO. HOO. • Test contacts within
requirements as defined by the • Test contacts within • Test contacts within facility required at day 2
state’s All Facility Letters (AFLs) and facility required at day facility required at day and 7 after exposure.
county HOOs. 2 and 7 after 2 and 7 after • Implement universal
• Ensure access to therapeutics. exposure. exposure. masking of all staff and
• Optimize indoor ventilation where • Require masking at all • Require masking at all residents. Require N95
possible. healthcare settings. healthcare settings. respirators for all staff
• Continue aggressive management • Conduct weekly • Conduct weekly during the entire time
of outbreaks and expanded screening testing of screening testing of while in the facility.
infection control measures. unvaccinated staff and unvaccinated staff and • Conduct twice weekly
• Continue to provide consultation, residents required. residents required. screening testing of all
education and information on Report all cases among • Require unvaccinated staff and weekly testing
optimal infection control practices. staff and residents to DPH. visitors be tested (PCR of residents required,
• Prioritize DPH assistance with or Antigen) within 48 regardless of vaccination
outbreaks. hours prior to indoor status.
visitation.
Los Angeles County Post Surge Response Plan (Revised 3/2/2022)
Page 7 of 15Sector General Mitigation Measures Low Concern Moderate Concern High Concern
• Limit communal dining • Require all visitors be
and activities to fixed tested (PCR or Antigen)
cohorts. within 48 hours prior to
• Report all cases indoor visitation.
among staff and • Pause communal dining
residents to DPH. and group activities.
• Report all cases among
staff and residents to
DPH.
K-12 and • Masking required in all indoor • Strongly recommend • Strongly recommend • Implement universal
Early spaces at ECE and TK-12 schools masking indoors for masking indoors for masking indoors for staff
Childhood until 3/12/22. staff and students. staff and students. and students with
Education • Ensure adequate testing capacity at • Improve ventilation. • Improve ventilation. medical grade masks for
(ECE) K-12 schools and ECE settings. • Monitor for • Monitor for staff.
• Continue offering group contact symptoms. symptoms. • Improve ventilation.
tracing option to schools as an • Conduct response • Recommend weekly • Monitor for symptoms.
alternative to individual contact testing (symptoms testing of • Require weekly testing of
tracing in TK-12 schools. and/or exposure). unvaccinated. unvaccinated in TK -12
• Recommend that all eligible staff • Promote proper • Conduct response schools
and students receive their isolation of cases. testing (symptoms • Strongly recommend
vaccines/booster dose; vaccination • Consider surveillance and/or exposure). weekly testing for
requirements are determined by testing in a TK-12 • Promote proper unvaccinated in ECE
the state or school districts. school/district sample isolation of cases. settings
• Prioritize DPH assistance with to monitor for trends, Recommend test to • Conduct response testing
outbreaks. During an outbreak: only if staffing and test return for shortened (symptoms and/or
o Require weekly testing of all capacity allows (e.g., isolation period. exposure).
students and staff at any 10%+ of school • Implement group • Promote proper isolation
school site that experiences population with tracing + once weekly of cases. Require test to
an outbreak(s) involving cadences of weekly, testing of return for shortened
15% of students and staff biweekly, monthly unvaccinated in the isolation period.
Los Angeles County Post Surge Response Plan (Revised 3/2/2022)
Page 8 of 15Sector General Mitigation Measures Low Concern Moderate Concern High Concern
over a 14-day period on based on school group in TK -12 • Implement group tracing
campus, provided that need/capacity). schools + once weekly testing of
adequate testing resources • Report all outbreaks • Report all outbreaks all in the group regardless
are available. among staff and among staff and of vaccination status in
o Strongly recommend students to DPH. students to DPH. TK -12 schools
weekly testing of all • Report all outbreaks
students and staff at any among staff and students
ECE site that experiences an to DPH.
outbreak(s) involving 15% • Require weekly testing
of students and staff over a for asymptomatic
14-day period on campus, unvaccinated/not fully
provided that adequate vaccinated close contacts
testing resources are of infected individuals
available. remaining in school.
o Quarantine and isolation
periods may be extended
for additional days to help
control transmission risk.
This could include
eliminating any modified
quarantine option.
• Prioritize DPH assistance with
outbreak management.
• Strongly encourage school-based
vaccine clinics to enroll as COVID-
19 providers.
PEH • Recommend that all eligible staff • Require staff at • Require staff at • Require staff at
and PEH receive their vaccine and shelters/interim shelters/interim shelters/interim housing
booster dose. housing to wear housing to wear to wear surgical masks or
respirators.
Los Angeles County Post Surge Response Plan (Revised 3/2/2022)
Page 9 of 15Sector General Mitigation Measures Low Concern Moderate Concern High Concern
• Ensure capacity for routine surgical masks or surgical masks or • Require all guests at
screening testing of PEH at shelters. respirators. respirators. shelters/interim housing
• Ensure access to therapeutics. • Require all guests at • Require all guests at to wear masks and offer
• Improve indoor ventilation where shelters/interim shelters/interim high quality masks to all
possible. housing to wear masks housing to wear masks guests.
• Continue aggressive management and offer high quality and offer high quality • Test all symptomatic
of outbreaks and expanded masks to all guests. masks to all guests. persons for COVID-19
infection control measures. • Offer point of care or • Offer point of care or regardless of vaccination
• Continue to provide consultation, other screening other screening status.
education, and information on testing to PEH clients testing to PEH clients • Conduct weekly
optimal infection control practices. and staff at shelters. and staff at shelters. screening testing of all
• Prioritize DPH assistance with Test all symptomatic • Test all symptomatic shelter staff and
outbreak management. persons for COVID-19 persons for COVID-19 residents, regardless of
regardless of regardless of vaccination status.
vaccination status. vaccination status. • Conduct contact tracing
• Conduct weekly • Conduct weekly and assure proper
testing of all shelter screening testing of all isolation of cases and
staff and residents shelter staff and quarantining of close
who are not residents who are not contacts based on the
vaccinated required up to date with county HOO.
(per county HOO). vaccinations. • Report all cases among
• Conduct weekly • Conduct contact staff and residents to
screening testing 10% tracing and assure DPH.
unvaccinated PEH, as proper isolation of
capacity allows. cases and quarantining
• Conduct contact of close contacts
tracing and assure based on the county
proper isolation of HOO.
cases and quarantining
of close contacts
Los Angeles County Post Surge Response Plan (Revised 3/2/2022)
Page 10 of 15Sector General Mitigation Measures Low Concern Moderate Concern High Concern
based on the county • Report all cases
HOO. among staff and
• Report all cases residents to DPH.
among staff and
residents to DPH.
Worksites • Ensure information regarding • Employers required to • Encourage masking for • Implement universal
vaccinations, testing and offer well-fitting workers with elevated indoor masking at
therapeutics to employees medical masks and risk. worksites.
• Encourage worker vaccination. respirators to • Employers required to • Employers required to
• Investigate workplace outbreaks; employees working offer well-fitting offer well-fitting medical
require employers to implement indoors in close medical masks and masks and respirators to
safety measures that limit contact with other respirators to employees working
transmission. workers and/or employees working indoors in close contact
• Continue to provide consultation, customers indoors in close with other workers
education and information on • Require symptomatic contact with other and/or customers
optimal infection control practices. workers to isolate and workers and/or • Require symptomatic
test. customers workers to isolate and
• Encourage contacts to • Require symptomatic test.
test and quarantine as workers to isolate and • Encourage contacts to
needed. test. test and quarantine as
• Optimize ventilation at • Encourage contacts to needed.
worksites. test and quarantine as • Optimize ventilation at
• Require employers to needed. worksites.
report if 3 or more • Optimize ventilation at • Increase risk messaging
COVID-19 cases are worksites. to high-risk worksites
known or reported at • Increase risk such as manufacturing
a worksite within a 14- messaging to high-risk and warehousing.
day period. worksites such as • Encourage remote work
manufacturing and where possible.
warehousing.
Los Angeles County Post Surge Response Plan (Revised 3/2/2022)
Page 11 of 15Sector General Mitigation Measures Low Concern Moderate Concern High Concern
• Encourage remote • Implement physical
work where possible. distancing in communal
• Encourage physical areas such as
distancing in breakrooms, cafeterias.
communal areas. • Require employers to
• Require employers to report if 3 or more
report if 3 or more COVID-19 cases are
COVID-19 cases are known or reported at a
known or reported at worksite within a 14-day
a worksite within a 14- period.
day period.
Highly- • Increase vaccination and booster • Continue investment • Prioritize community • Continue to prioritize
Impacted coverage. in community-based and workplace community and
Communities • Ensure access to vaccinations, organizations (CBOs) outreach and workplace outreach and
testing and therapeutics in and faith-based vaccination efforts in vaccination efforts in
communities hardest-hit by COVID- organizations (FBOs) communities showing communities showing
19. working in increased rates of increased rates of
communities hardest transmission. transmission and/or
hit to provide resource • Begin to assess illness severity.
linkages, conduct quarantine and • Promote enhanced and
COVID-19 outreach isolation (QI) housing targeted outreach by
and education, and capacity if rates of CBOs and other partners
facilitate access to transmission and/or to support growing
vaccination illness severity demand for education
opportunities. continue to increase. resources.
• Continue Public Health • Expand PH Council • Explore increased QI
Councils program to outreach in essential housing capacity, if
provide critical low-wage worker necessary.
support to low-wage industries • Support targeted PPE and
essential works; disproportionately screening testing access
Los Angeles County Post Surge Response Plan (Revised 3/2/2022)
Page 12 of 15Sector General Mitigation Measures Low Concern Moderate Concern High Concern
consider broader impacted by in priority sectors and
efforts to support outbreaks. communities.
other essential, low- • Support access to PPE • Amplify CBO/FBO
wage worker and screening testing messaging for
industries not in priority sectors and communities of concern;
previously included in communities. convene CBO/FBO
the pilot program. • Tailor CBO/FBO partners to discuss
messaging for strategies and resources
communities of to mitigate the spread of
concerns. COVID-19.
Hospitals • Masking is required for everyone in • Require respirators for • Require respirators for • Require respirators for all
and Health a healthcare facility regardless of all staff when in direct all staff when in direct staff when in direct
Systems vaccination status. contact with contact with contact with
• Increase booster coverage for residents/patients. residents/patients. residents/patients.
those eligible (required for all • Test all symptomatic • Test all symptomatic • Test all symptomatic staff
health care personnel). staff and patients. staff and patients. and patients.
• Continue option for modified • Conduct contact • Conduct contact • Conduct contact tracing
isolation and quarantine tracing and assure tracing and assure and assure proper
requirements only where needed proper isolation of proper isolation of isolation of cases.
to accommodate severe staffing cases. cases. • Assure vaccination
shortages. • Assure vaccination • Assure vaccination requirements for all
• Coordinate with MHOAC to requirements for all requirements for all applicable staff are
safeguard regional capacity for applicable staff are applicable staff are adhered to.
essential pre-hospital (EMS) and adhered to. adhered to. • Report all cases among
hospital services and ensure surge • Report all cases • Report all cases staff and patients to DPH.
capacity. among staff and among staff and
• Continue to provide consultation, patients to DPH. patients to DPH.
education and information on
optimal infection control practices.
Los Angeles County Post Surge Response Plan (Revised 3/2/2022)
Page 13 of 15LAC Post Surge Preparedness Plan
The lessons we have learned from navigating more than 2 years of the pandemic will inform
preparedness activities for LA County. The five focus areas identified below include: preparedness for
outbreak management, vaccine distribution/information dissemination, testing, therapeutic
distribution, and surveillance.
Outbreak Management Preparedness Post-Surge
Worksites are required to report clusters of three (3) or more cases within 14 days to DPH as part of a
broader strategy to ensure workplace safety and protect employees when there is spread of an
infectious agent. Post-surge worksite outbreak management strategies will include the following:
• Contact will be made with all worksites reporting an outbreak to provide information about employer
responsibilities and recommendations/requirements for mitigation of additional spread.
• Sites experiencing outbreaks may be required by DPH to implement mitigation measures, such as
indoor masking, routine testing, distancing, and other infection control measures, to limit the spread
of COVID-19 among workers at a worksite.
Vaccination Preparedness Post-Surge
Vaccinations provide the most powerful personal and community protection from COVID-19. Increasing
coverage by ensuring access and addressing concerns regarding vaccine efficacy and safety remain
priority activities. The following actions are essential components of the preparedness plan:
• Increase vaccination and booster coverage among those at elevated risk for severe illness and those
working/living with those at elevated risk.
• Maintain a network of at least 300 mobile teams per week that can provide access to vaccines in low-
coverage communities and at schools.
• Maintain an extensive fixed vaccination clinic network to provide access across the entire county.
• Increase numbers of medical providers offering vaccines to their patients through their routine
services. Emphasize pediatricians incorporating COVID-19 vaccination into routine vaccination
practice.
• Increase participation of health plans in ensuring homebound residents have access to vaccinations
and boosters.
• Maintain homebound services to provide vaccinations and booster to those at elevated risk for
severe illness.
• Increase the number of residents trained as community ambassadors, parent ambassadors, and
student ambassadors.
• Increase funding for CBOs and FBOs to support dissemination of vaccination information and
promote access to vaccine clinics.
• Transition at least 3 Public Health vaccination sites to provide multiple COVID-19 services including
vaccination, testing, resources and mental health services.
Los Angeles County Post Surge Response Plan (Revised 3/2/2022)
Page 14 of 15Testing Preparedness Post-Surge
• Testing may continue to be required by businesses, local or state HOOs, Cal/OSHA or state AFLs in
high-risk settings (e.g., SNFs, shelters, correctional facilities, health care facilities, schools), for entry
into Mega Events for those not fully vaccinated, and for outbreak management.
• Access to free and accessible testing for those with symptoms, exposures, exiting isolation or
quarantine, or complying with travel and return to work/school requirements, is important. While
there are requirements that health plans provide reimbursement to their members for testing, not
everyone is insured and there is neither sufficient supply of tests nor ability for all members to
purchase tests. Community testing sites that provide free and accessible testing to residents will
remain essential over the upcoming months.
• Distribution of antigen test kits continues to be needed in high-risk settings and communities with
high case rates, where testing remains an essential strategy for protecting workers and community
members/residents.
Therapeutic Distribution Preparedness
Although currently there is extraordinary scarcity in the supply of effective therapeutics, there is a need
to ensure that those with less access to health care can receive appropriate therapeutics. This includes
the following:
• Ensure a vast network of providers with information, supply of therapeutics, and prescribing ability
across the county, with emphasis on deep penetration in hard hit and low-resourced communities.
• Ensure a vast network of distribution sites (including pharmacies and community clinics) that can
distribute oral medications with no barriers with deep penetration in hard hit and low-resourced
communities.
• Provide a call center where residents can get more information about therapeutics and how to access
therapeutics; provide culturally and linguistically appropriate information and information on
accessing free medications.
• Consider using telehealth platforms at public health clinics or other community clinics to augment
sites that can prescribe and distribute oral therapeutics in low-resourced communities.
Surveillance Preparedness
To maintain an early alert system that can track the presence of emerging variants of concern, the
following is required:
• Capacity to sequence 15% -25% of positive specimens.
• Ability to expand wastewater surveillance to all areas of the county.
• Expanded capacity to use sentinel sites to provide data on illness patterns.
Los Angeles County Post Surge Response Plan (Revised 3/2/2022)
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