New lockdown possible as state surge accelerates
Worst month: Hospitals braced as cases mount
Parts of California likely face a new stayathome order, perhaps later this week, as coronavirus cases explode across the state and public health experts warn that hospitals could run out of intensive care beds by the end of the year.
In a particularly sober briefing Monday, Gov. Gavin Newsom said that without further public health interventions and if the pandemic continues to surge at its current rate, the state will hit intensive care capacity by mid-December and be over capacity by Christmas
Eve.
The dire forecast came on the final day of California’s worst month yet in the pandemic. And December likely will be even more grim as cases mount during and after the holidays, public health and political leaders said.
“The red flags are flying in terms of the trajectory in our projections of growth,” Newsom said. “If these trends continue, we’re going to have to take much more dramatic, arguably drastic, action.”
California reported more than 21,200 cases on Monday, a new record for the state, though it included a multiday backlog of cases from the long holiday weekend. The Bay Area also reported a new record of more than 2,300 cases, some similarly backlogged.
The state reported, on average, more than 9,900 cases a day for November, nearly triple the rate in October and well over the previous monthly record of 8,700 cases a day in July, according to a Chronicle data analysis. Over the past week, the average swelled to nearly 14,000 cases a day.
Bay Area cases also hit record highs in November, reaching an average of 1,154 a day. The previous high was 1,061 a day in August, at the peak of the summer surge. The region reported only 480 cases a day on average in October.
Public health officials expect another surge in cases in the next week or two, tied to Thanksgiving gatherings and holiday travel. Roughly 10% of people who test positive for the coronavirus end up in the hospital, public health experts say. So the anticipated bump in cases will put further pressure on hospitals that already are feeling strained.
Both California and the Bay Area currently have recordhigh numbers of patients hospitalized with COVID19 — 7,787 and 820, respectively, as of Sunday. Those numbers have roughly tripled over the past month.
And in a news briefing from his home in Sacramento, where Newsom is in quarantine with his family after three of his children were exposed to the virus, the governor provided an unsettling forecast for the state’s hospitals.
Currently about 60% of all beds are occupied, about one in 10 with COVID19 patients, and that will climb to 78% by Dec. 24. That doesn’t seem too concerning. But intensive care beds are in much shorter supply.
About 75% of ICU beds are currently occupied, nearly a quarter of them with COVID19 patients. The state will be at 112% capacity by Dec. 24. The forecast is even darker for some regions: Rural Northern California counties are projected to run out of ICU beds this week or next and the San Joaquin Valley by midDecember. The Bay Area would be over capacity by early January, according to state forecasts.
“The high case numbers that we’ve seen in the last week and 10 days have not even begun to impact hospitals yet,” said Dr. Mark Ghaly, secretary of California Health and Human Services, at the Monday briefing. “Cases today turn into hospitalizations in two weeks, and from there a number of those individuals will need critical care: specialized space, specialized equipment and specialized staff.”
Newsom did not provide details of what a new shelter in place order would look like or which counties it would affect. Ghaly hinted that it likely would impact counties that are experiencing the greatest strain on ICU capacity. More than 99% of the state population is in the most restrictive purple tier— 51 of 58 counties. San Francisco and San Mateo counties were moved there on Saturday, leaving Marin the only Bay Area county in the lessrestrictive red tier.
A new order, Newsom said, would be “more in line with the stayathome order that folks were familiar with at the beginning of this year” in March. He said state officials began talking to county health officers a day or two before Thanksgiving about further restrictions that might best slow down California’s wildly growing surge.
“We are trying to be much more specific, more surgical, and more prescriptive” with new orders, Newsom said, adding that details would be available soon. “This is a dynamic week. An incredibly important week. We will be coming out with some additional information, additional recommendations, in the very, very near future.”
Already some counties have moved ahead of the state blueprint for purple-tier restrictions. A Los Angeles County order put in place Monday forbids most gatherings. Santa Clara County, which reported alarmingly high hospitalization numbers over the past week, issued an aggressive new order on Saturday that severely limits indoor capacity and requires incoming travelers to quarantine for two weeks.
Several Bay Area health officers said they supported the Santa Clara County move and would consider similar orders for their own counties if numbers continue to worsen. In an interview on CNN Monday, Dr. Sara Cody, the Santa Clara County health officer, said that as her local hospital beds are filling, she is appealing for state and even federal restrictions.
The county reported 289 people hospitalized with COVID19 as of Sunday — the most yet in the pandemic, and more than twice as many as just two weeks ago. About a quarter of those patients are in intensive care.
“We are taking local measures to bring the prevalence down, and hoping we get some bold statewide and nationwide action to support us,” Cody said.
After being moved into the purple tier on Saturday, San Francisco and San Mateo counties shut down many indoor operations, including church services, museums and movie theaters. San Mateo County ended indoor dining, the last in the Bay Area to do so. Both counties also fell under a state curfew as of 10 p. m. Monday.
Shannon Bennett, chief of science at the California Academy of Sciences, said she was disappointed that the museum was forced to shut down under the new restrictions, but she understands the reasoning. And she said she supports other, targeted moves to slow down the spread of disease in the community.
The forecasts for the state’s supply of intensive care beds was especially upsetting, she said. “We look great for ICU capacity — right now. But the virus grows exponentially, so it can very quickly surpass capacity,” she said.
Newsom shared a few bright points in his otherwise dreary briefing, including that California will receive 327,000 doses of the first coronavirus vaccine in the next few weeks.
It will be the state’s first tranche of coronavirus vaccines, developed by Pfizer and German firm BioNTech. Pfizer applied for federal authorization earlier this month and is widely expected to receive approval in December.
The first several hundred thousand doses will go to health care workers, but the state’s vaccine committee is still determining which of those workers will be prioritized, Newsom said. There are about 2.4 million health care workers in California.