U.S. case tally hits new high

20 million mark reached in surge

LOS ANGELES — The number of confirmed U.S. coronavirus cases surpassed 20 million on Friday, nearly twice as many as the No. 2 country, India, and nearly one-quarter of the more than 83 million cases globally, according to data from Johns Hopkins University.

In the past week, Ca l i fornia reported nearly 20% of the country’s new infections, the most by far of any state and a proportion that outstrips its share of the U.S. population.

For months, California did many of the right things to avoid a catastrophic surge from the pandemic. But by the time Gov. Gavin Newsom said Dec. 15 that 5,000 body bags were being distributed, it was clear that the nation’s most populous state had entered a new phase of the covid-19 crisis.

Now infections have been racing out of control for weeks, and California remains at or near the top of the list of states with the most new cases per capita. It has routinely set new

marks for infections and deaths, and began the new year reporting a record 585 deaths in a single day.

Experts say a variety of factors combined to wipe out the past efforts, which for much of the year held the virus to manageable levels. Cramped housing, travel and Thanksgiving gatherings contributed to the spread, along with a public fatigued by regulations that closed many schools and businesses and encouraged — or required — an isolated lifestyle.

Another factor could be a more contagious variant of the virus detected in Southern California, although it’s not clear yet how widespread that may be.

California’s woes have helped fuel the year-end U.S. infection spike and added urgency to the attempts to beat back the scourge that has killed more than 340,000 Americans. Even with vaccines becoming available, cases are almost certain to continue growing, and yet another surge is expected in the weeks after Christmas and New Year’s.

In California, the southern half of the state has seen the worst effects, from the agricultural San Joaquin Valley to the Mexico border. Hospitals are swamped with patients, and intensive-care units have no more beds for covid-19 patients. Makeshift wards are being set up in tents, arenas, classrooms and conference rooms. Some hospitals are having difficulty keeping up with the demand for oxygen.

Hospitalizations statewide have gone up more than eightfold in two months and nearly tenfold in Los Angeles County. On Thursday, the total number of California deaths surpassed 25,000, joining only New York and Texas at that milestone.

“Most heartbreaking is that if we had done a better job of reducing transmission of the virus, many of these deaths would not have happened,” said Barbara Ferrer, the county’s public health director, who has pleaded with people not to get together and worsen the spread.

Crowded houses and apartments are often cited as a source of spread, particularly in Los Angeles, which has some of the densest neighborhoods in the U.S. Households in and around Los Angeles often have several generations — or several families — living under one roof. Those tend to be lower-income areas where residents work essential jobs that can expose them to the virus at work or while commuting.

The socioeconomic situation in Los Angeles County is “like the kindling,” said Paula Cannon, a professor of microbiology and immunology at the University of Southern California. “And now we got to the stage where there was enough covid out in the community that it lit the fire.”

Home to a quarter of the state’s 40 million residents, Los Angeles County has had 40% of the state’s deaths and a third of its 2.3 million cases. The virus has hit Hispanic and Black communities harder.

Cannon said there’s a moral imperative for people who can follow stay-home orders to help prevent spread that is harder to contain in other areas.

“What you can’t do is say to people, ‘Can you stop living in a house with eight other people, five of whom are working essential worker jobs?’” she said. “This is the structure that we can’t change in LA. This is, I think, contributing to why our levels have suddenly got scarily high and looks like they’re going to keep going up and keep staying that way.”

In March, during the early days of the pandemic, Newsom was hailed for issuing the nation’s first state stayhome order.

The Democrat eased business restrictions in May, and when a broader restart led to another surge, imposed more rules. In early December, with cases out of control, he issued a looser stay-home order. He also closed businesses such as barbershops and salons, halted restaurant dining and limited capacity in retail stores. The latest restrictions apply everywhere except in rural Northern California.

But Dr. Lee Riley, an infectious-diseases professor at the University of California at Berkeley, said that while the state managed to flatten the curve of rising cases, it never effectively bent the curve downward to the point infections would die out.

When cases rose in June and July, California was never able to do enough contact tracing to isolate infected people and those they may have exposed before they spread the disease — often unwittingly — to others, he said. And public-health directives were never adequately enforced.

“What California did was to maybe delay the peak,” Riley said. Infections “really just never got low enough. And we started lifting the restrictions, and that just allowed the transmissions to just continue to increase. We never really saw a real decline.”

California’s health secretary, Dr. Mark Ghaly, said if state and local leaders had not made difficult decisions early on that saved lives, the current surge might not be the worst the state has seen.

He acknowledged the exhaustion many people feel after enduring months of disruptions to their lives. Public-health officials, he said, need to find a way to reach people who have given up or not followed rules on social distancing and masks.

Across California, local officials have reminded people that the fate of the virus lies in their behavior and asked for one more round of shared sacrifice. They reminded people that activities that were safe earlier this year are now risky as the virus becomes more widespread.

“You can practice safety and low-risk behavior from March to October. But all that is erased. Nothing matters except what you are doing to fight the virus right now,” said Corinne McDaniels-Davidson, director of the Institute for Public Health at San Diego State University. “This pandemic is an ultra-marathon. In our culture, we are used to sprints.”

3 MILLION VACCINATIONS

Meanwhile, the number of vaccinations across the United States crossed 3 million Thursday, only about one-seventh of the doses that federal officials had promised to deliver to Americans’ arms by the end of the year. Although authorities insist that lags in reporting mean the official tally is an undercount, the immunization campaign has nevertheless been marred by logistical delays as the nation experiences the most powerful surge of the pandemic so far.

Sen. Mitt Romney of Utah on Friday positioned himself as a prominent Republican critic of the Trump administration’s handling of vaccinations. “That comprehensive vaccination plans have not been developed at the federal level and sent to the states as models is as incomprehensible as it is inexcusable,” he said in a statement.

Among other ideas, Romney proposed enlisting active and retired health care workers not currently delivering care — such as veterinarians, combat medics and medical students — to administer vaccinations. Within each category of people used to prioritize inoculations, he suggested scheduling vaccinations according to birthdays.

“Public health professionals will easily point out the errors in this plan — so they should develop better alternatives based on experience, modeling and trial,” Romney added.

Also Friday, Texas hit a new high for patients hospitalized with covid-19 for the fifth consecutive day, in a continued surge after holiday gatherings and travel.

Texas reported 12,481 covid-19 patients in state hospitals on New Year’s Day, an increase of more than 1,750 from a week ago. Intensive-care units in several parts of Texas were full or nearly full, according to the Texas Department of State Health Services.

The grim count has continued to climb as some Texans gathered to celebrate the new year, despite warnings from health officials that congregation is likely to further spread the virus.

On Thursday evening, a state judge upheld a ban on late- night dine- in services at Austin- area restaurants and bars, siding with local officials over Texas Attorney General Ken Paxton. But some bars in the state capital remained open past the curfew and people inside carried on seemingly unbothered by the restrictions, according to the Austin American-Statesman.

Paxton said Friday that he intends to ask the Texas Supreme Court to stay the lower court’s decision to allow the prohibition on late-night service through Sunday.

State health officials on Friday reported 12,369 new, confirmed cases of the virus and another 3,658 probable cases. They also counted 334 newly reported fatalities, raising the state’s death toll to 27,771.

The actual number of cases is believed to be far higher because many people haven’t been tested and some who get sick don’t show symptoms.

Separately, at a vaccination clinic in West Virginia, more than 40 people were accidentally given an antibody treatment for the virus, instead of Moderna’s vaccine. The West Virginia National Guard, which is assisting with inoculations, said those people were at no risk of harm.

Also Thursday, Florida became the third state to identify a case of the coronavirus variant first detected in the United Kingdom, a reminder that the pandemic remains a formidable foe.

The latest instance of the variant was found in a man in his 20s with no recent travel history, health officials said. The more transmissible version of the virus also has been reported in California and Colorado, and experts expect it to be identified in additional states.