CASES HIT RECORD LEVELS IN STATE’S HOSPITALS
Surge expected to worsen after holiday; some areas impose severe restrictions
More people are hospitalized with COVID-19 in California than at any time since the pandemic began, an ominous development that comes as officials warn of further virus spread after the long holiday weekend.
The rising numbers raise new concerns about hospitals filling up in the coming weeks, which has been predicted as coronavirus cases surge to unprecedented levels across the state.
A wave of new restrictions on personal gatherings and capacity levels at stores takes effect today in Los Angeles County.
The lockdown calls for its 10 million residents to stay home “as much as possible,” prohibiting them from gathering with people outside of their household for public or private occasions, except for faith-based services and protests.
In Northern California, Santa Clara County — home to Silicon Valley — is banning all high school, collegiate and professional sports and imposing a quarantine for those traveling into the region from more than 150 miles away.
But there are concerns that the surge will get worse before it gets better due to Thanksgiving celebrations and Black Friday shopping — which, while less robust than in normal years, is likely to have caused new infections.
“We were prepared for an increase,” said Barbara Ferrer, Los Angeles County’s health director. “None of us really thought the increase would be so big across such a short period of time.”
There were 7,415 COVID-19 pa
tients in California hospitals Saturday, according to the latest numbers released by the state, surpassing the previous high of 7,170, set in July. Only a month earlier, on Oct. 28, there were about 2,400 COVID-19 patients in state hospitals.
The death rate is also rising. Statewide, an average of 75 deaths were reported daily over the seven-day period before Thanksgiving, compared with 40 in midNovember.
San Diego County health officials Sunday reported 1,066 new COVID-19 infections, raising the region’s total to 80,084 cases, with no new deaths, leaving the overall death toll at 997.
Sunday marked the 19th consecutive day that more than 600 new cases were reported.
Of the total number of cases in the county, 4,603 have required hospitalization.
Nine community outbreaks were confirmed Sunday. A community outbreak is defined as three or more COVID-19 cases in a setting and in people of different households over the past 14 days.
The high case count came despite the fact that numbers usually drop on weekends, when some labs don’t report results, and de
spite officials’ predictions that the number would be lower than usual for several days because there was no community testing on Thanksgiving and only limited testing the day after.
State and local officials say that if conditions continue to deteriorate, it may be necessary to issue stricter rules that recall the stay-athome orders imposed in the spring.
“More restrictive measures? I can’t imagine what that would look like at this point,” said Maria Salinas, president and chief executive of the Los Angeles Area Chamber of Commerce.
She said the business community is concerned with the spike in cases, but
many feel the move to shut down outdoor dining was not based on data that proved the virus was spreading among people eating at restaurants.
Health officials have said there’s an elevated risk of spread anywhere people gather with others and eat, drink and linger without wearing masks.
“Here we go again. I am not convinced that shutting down, reopening and shutting down again is effective,” said L.A. County Supervisor Janice Hahn, who, together with Supervisor Kathryn Barger, put forth a proposal that called for the board to allow restaurants to continue to offer outdoor dining. The motion was voted down last week.
“Nothing we have done so far has worked,” Hahn said in a statement. “Our businesses are hurting. Kids aren’t back at school. Our health care system is about to be overwhelmed.”
Other supervisors have said they back the tougher measures recommended by health officials.
“When the case rate reaches a certain point, it takes drastic measures to slow down the spread of this tremendously deadly virus,” Supervisor Hilda Solis said in a statement.
Physicians, epidemiologists and infectious disease experts have been clear: Outdoor restaurant dining is risky, and practices that seemed safe just a few weeks ago are more dangerous now because of the greater levels of virus spreading.
Outdoor dining has likely become even more risky as restaurants have set up plastic sheeting to shield diners from wind — the very breezes that help blow away virus particles exhaled by those infected. Without such drafts, the virus hangs in the air longer, facilitating infection.
“I have yet to see someone eat dinner with their mask on,” said Dr. George Rutherford, epidemiologist and infectious disease expert at UC San Francisco. “Mixing across households — that creates transmission. It’s just the way it is.”
Dr. Robert Kim-Farley, medical epidemiologist and infectious disease expert at the UCLA Fielding School of Public Health, said Sunday that there’s renewed tension between those who wish to save every life possible and those concerned about a devastated economy. But those two goals aren’t mutually exclusive, he said — a recovering economy requires a virus under control.
“The current increasing of restrictions is trying to find a way to break the back of this current surge, to bring us to a level where we are not endangering our hospital system,” said Kim-Farley, a former senior official with the U.S. Centers for Disease Control and Prevention.
California’s surge in coronavirus cases began late last month, and new cases are rising faster than they did during the peak of the crisis in mid-July, officials say. Across California, an average of 13,000 people are testing positive for the virus each day, more than quadruple the late-October average of 3,000.
Southern California as a whole has a particularly high infection rate. Over the seven-day period before Thanksgiving, counties in Southern California reported a daily average of 40 new coronavirus cases per 100,000 residents, the most on record so far and more than twice as many as in the Bay Area, which reported an average of 17 new cases per 100,000 residents.
The case numbers have been climbing so quickly that officials across the state are warning that hospital beds could run short in a matter of weeks unless something is done to dramatically reduce the spread of disease.
Should resources at intensive care units become stretched beyond capacity, the mortality rate will rise. A shortage would affect not only COVID-19 patients but those who need emergency treatment after accidents or for appendicitis, heart attacks or strokes.
Because hospitalizations ref lect cases that were identified two to three weeks earlier, officials are certain they’ll continue to increase for the next two to three weeks, given the rise in case counts.
If so, Ferrer said, “we’re in for a very rough time, because we will have a surge on top of a surge.”
An inf luential model run by the University of Washing ton Institute for Health Metrics and Evaluation says that, without major changes in policies or behavior, California is on track to double its cumulative death toll by the end of the winter, from more than 19,000 to more than 37,000 by March 1.
It’s still possible to change that trajectory, said Anne Rimoin, professor of epidemiology at the UCLA Fielding School of Public Health.
“Every illness, hospitalization and death at this point is avoidable, if we all do our part,” she said.