New Orleans Health Department director, Dr. Jennifer Avegno, announced last Tuesday, the reinstatement of the mask mandate for Orleans parish, which went into effect at 6am the following day, “until further notice.”

Presumably, under the direction of Mayor Latoya Cantrell, Avegno said “given that there continues to be substantial transmission of COVID, and the continued risk of overwhelming hospitals and disrupting schools, the city of New Orleans is reinstating the indoor mask mandate at all indoor spaces, including schools […] and will remain in place until further notice.”

The latest mask mandate comes five weeks into the latest surge spurred by the omicron variant, and after the city has already gone through end of year holiday gatherings, New Year’s Eve and the Sugar Bowl, which sees a large influx of out of towners. During this time, Orleans parish has actually seen a reduction in both the number of COVID-related deaths, and in the case fatality rate (CFR) of the virus.

Isn’t death what is most feared?  And isn’t death what is trying to be avoided and averted in the fight against COVID-19? And shouldn’t the number of deaths and rate of death be the ultimate indicator of success and failure in fighting the virus—or for the implementation of mitigation measures and public health policy?  

And is the fear of “overwhelming” hospitals, and pediatric cases a genuine concern given the science?

Science Says Kids Risk Near Zero

As we have previously reported, the risk for children is practically zero.  As of last Friday, there have been 170,787 COVID-positive cases in Louisiana in the 0–17-year-old age group, and 18 deaths. This equals a case fatality rate (CFR) of 0.011%; or survival rate of 99.99989%.  It will be difficult for any mitigation measure, or vaccine to improve this statistic. 

As a point of comparison, drowning deaths are arguably more preventable than an airborne virus, but in 2020 alone, there were 24 drowning deaths for children 0-14 years-old.  That’s just in one year, and in a smaller dataset. It does not include those minors between the age of 15-17 years-old as the 18 COVID deaths do, which also spans a longer time period of almost two years. 

There is no science which supports any of the measures put in place to prevent virus spread among children because healthy kids, with no underlying conditions, are at virtually no risk.

Cases and Deaths Before, During Omicron

An examination of the cases and deaths in Orleans parish during the five weeks from the start of the latest surge from omicron around December 6th; up to just before the start of the latest mask mandate on January 9th, shows there were 18,510 cases, and 8 deaths, which equals a CFR of 0.043%. Those are the numbers. 

Keep in mind, this was after people traveled and families gathered for Thanksgiving celebrations. From a data collection standpoint, hospitalizations and death lag behind cases, but even with the increase in cases and hospitalizations, there was not an increase in COVID deaths in Orleans parish.   

When the same data is extracted from the five weeks before the omicron surge during the weeks between November 1st – December 5th, there were 847 cases, and 14 deaths, which is a CFR of 1.65%. 

Simple math reveals there were actually six less COVID-related deaths during the first five weeks of the omicron variant surge, compared to the five weeks before the start of the latest surge.

While cases did increase by over twenty-fold when comparing the two five-week periods, deaths actually declined by 43%, which proves omicron is less virulent.  That is the science.

An interesting, but unfortunate side note, according to the Lexis-Nexis community crime map, during the first five weeks of the omicron variant surge, there were fifteen homicides in Orleans parish, which means you had a greater risk of death walking the streets of New Orleans, than dying a COVID-related death.

No Scientific Support

So, why is Orleans parish requiring indoor masking again when the science does not support it?

During last Tuesday’s press conference, Dr. Avegno, recited other major cities with mask and vaccine mandates but said New Orleans has a unique risk “because of the large gatherings that loom on the calendar” adding, “even if our cases begin to decline in the next week or two, and I believe that that’s likely, […] hospitalizations and death will lag, likely, through at least, next month.”

Avegno is referring to Mardi Gras and all of its balls, extravaganzas and parties which come with the season, and is the reason for the reinstatement of the mask mandate.  But if cases are “likely” to decline, as Avegno stated—what’s the concern?

“Hospitalizations and death will lag, likely, through at least, next month,” according to Avegno.  What she seems to be saying is that even though cases will “likely” decline during the upcoming weeks, she believes there will be a spike in hospitalizations and death because of Carnival gatherings.

This notion though, is not supported by any publicly available data or science.  

Testing positive for COVID, and becoming a “case” does not mean you are symptomatic, or will end up hospitalized or dead.  To this point, the overall case fatality rate for the state, regardless of vaccination status, has fallen from 1.91% on Monday, December 6th at the start of the latest surge, down to 1.65% as of Sunday, January 9th. Those are numbers.

Furthermore, there is an apparent inverse relationship between, cases, hospitalizations and death thus far with the latest surge.  In other words, cases have gone up, but deaths have gone down; and if deaths continue to decline or remain flat, then why would hospitalizations increase, like they curiously have lately, when hospital stays are often the precursor to death?  This raises the question of who is in the hospital for what?

Lack of Detail in Data

An issue with the available data is the lack of detail in the publicly available information published by the Orleans parish COVID dashboard, and the Louisiana Department of Health (LDH) where the above numbers are derived.

Detailed data, would provide clarity, transparency and texture to the information, which is crucially important when it comes to cases, hospitalizations and deaths.

Health department leaders keep reminding us of how concerned they are of hospitals being overwhelmed. As of this writing though, there are no separate datasets listing those who are in the hospital because of COVID, and those in the hospital for a routine or preventative procedure, who happens to test positive with COVID while being admitted into the hospital for a non-COVID treatment or procedure.

The difference is obvious, and so are the potential ramifications. If a significant number of hospitalizations are with COVID, as opposed to in the hospital because of COVID, that would mean overwhelmed hospitals are not full due to COVID-19 illness. 

The latest numbers from last Friday prove this out. According to the LDH, on Friday January 14th, only 21.2% of all beds in use were occupied by COVID-positive patients; this, while we don’t know if these patients are in the hospital because of COVID, or with COVID. 

We reached out to the LDH, for clarification on hospitalizations, asking if those admissions include patients in the hospital because of COVID, and those with COVID.

In an email response to the LIJ from Kevin Litten, a “communication strategist” with the Bureau of Media and Communications (BMAC), “any hospital patient who is COVID positive upon admission is counted as a COVID hospitalization.”  This suggests there is no distinction between those admitted because of COVID, and those who happened to test positive with COVID during the admission process.  

Likewise, as of the publishing of this story, there are no publicly available data separating the number of asymptomatic (no symptoms) and symptomatic (with symptoms) COVID-positive cases. 

This is an important distinction because despite the claims, asymptomatic spread is virtually non-existent and this is supported by data published in a December 2020 BMJ article, where “a city-wide prevalence study of almost 10 million people in Wuhan found no evidence of asymptomatic transmission.” Further support of no asymptomatic spread came from the WHO in June of 2020 which states Covid-19 asymptomatic transmission is “very rare.” That’s the science.

Similarly, there is no differentiation within the data between those who died with COVID, versus those who died because of COVID.  

These distinctions matter greatly. If we had this information, it would give a clearer and more accurate picture of the actual risks and dangers associated with COVID, and perhaps reduce the amount of stress, fear and anxiety felt by some in the community.  

But it’s apparent, the simple reliance on cases, hospitalizations and deaths to guide decision-making without any distinction between symptoms/no symptoms, “with” COVID/“because” of COVID clouds the picture, ignores science and data, and leads to ineffective public health policy.