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Halloween instructions during a pandemic.

Again citing mounting evidence of residents ignoring health orders to gather in public places or hold private get-togethers, Los Angeles County's public health director warned today of an already worsening COVID-19 situation becoming even more dire during the upcoming holiday season without rapid behavioral changes.

Barbara Ferrer said surveys of residents and patients who have become infected with the coronavirus show steady increases in interactions with people outside their own households. She said an ongoing USC study found that for the week ending Oct. 20, 57% of survey respondents reported being in close contact with someone they don't live with in the previous seven days.

The study also found that roughly one-third of respondents that week reported visiting another person's home in the previous seven days, while one-third said they had visitors at their own home. About 10% said they had attended a gathering of 10 or more people in the past week.

"I know this sounds like a small number, but if 10% of L.A. residents attend gatherings, this translates to 1 million people gathering with others not in their household," Ferrer said. "And if we assume that 2% of people can be infected, we could possibly have 20,000 people capable of infecting others who are milling about at these gatherings each week."

She said the USC data, combined with information collected during contact-tracing interviews with virus patients, shows "there's ample evidence that gatherings are increasing and are one of the drivers of the increases in cases in L.A. County."

And with Thanksgiving just weeks away, Ferrer said concern is mounting that the holidays could make things worse.

"With our case numbers already on the rise, we are concerned about the upcoming months," Ferrer said. "Holiday gatherings and cooler weather, when people are more likely to gather indoors, are perfect conditions for spreading COVID-19."

Ferrer announced another 1,406 coronavirus cases on Monday -- a day that is typically marked by relatively low daily case numbers due to reporting lags from the weekend. She noted that the county has reported almost 3,000 new cases over the last two days, a time of week when numbers are always lower than the rest of the week.

"So if that trend holds true, then we're going to see higher numbers for the rest of this week," she said. "And that would in fact not only create a lot of concern for us but also mean that it is unlikely that in the next two weeks we make any movement in L.A. County to'' the next tier of the state's economic-reopening roadmap.

The county is still in the most restrictive "purple" tier of the matrix, and will need to lower daily case numbers to about 700 to have a chance to move on.

"If we do nothing or continue on the path we're currently on as a country, the cases will continue to rise," Ferrer said. "... I have faith that we're going to get back to slowing the spread, and we have to get back to slowing the spread right now."

She added: "We'd have to stop with the gatherings. ... We're pretty convinced at this point that these smaller gatherings where people feel pretty safe because they're with friends and extended family are in fact fueling a lot of the increase, because they're just not as safe as we'd like to believe they are."

Ferrer said the county does not want to be forced into a position of forcing the re-closure of businesses that have been allowed to reopen during the pandemic, but it will take a commitment of residents to adhere to protocols.

And while young people have been cited as representing the bulk of newer virus cases in the county, Ferrer said that demographic isn't solely to blame for such gatherings.

"I don't agree at all that all the young people aren't taking this seriously, aren't feeling like they have an obligation to help slow the spread, because I know lots and lots of young people that are doing the right thing," she said. "... There are a group of people, and some are young people and some are not-so-young people, that continue to defy what I think are common-sense orders."

The 1,406 new cases reported by the county, along with 10 more announced by Long Beach health officials, pushed the county's cumulative total since the start of the pandemic to 310,605.

The county also reported two new deaths, giving the county an overall death toll of 7,076.

There were 777 people hospitalized with COVID-19 as of Monday, down from 799 on Sunday.

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