Signs of plateau in hospital admissions

As hospitals brace for a postholiday spike in coronavirus patients, there was a possible sign of good news amid the worst month of the pandemic: The number of people in Bay Area hospitals with COVID19 may be flattening — at least for the time being.

Over the past four days, the number of COVID19 patients in Bay Area intensive care units stayed relatively level at around 475, while the number of people in the hospital with the respiratory disease held at roughly 1,830, with some daytoday fluctuations.

The data offered a rare break from a sustained surge that caused the number of Bay Area patients sick with COVID19 to more than double in December. But health experts said the region is still far from turning the corner, and the hardest weeks of the pandemic are most likely ahead.

“I’ve been looking at the numbers

and saying, ‘ Maybe it’s telling us something,’ said John Swartzberg, an infectious disease expert at UC Berkeley. “But I would be really cautious about making too much out of a few days of numbers.” UCSF Department of Medicine Chair Bob Wachter tweeted last week that there was “perhaps ( a) hint of a plateau?” as he looked at San Francisco’s hospitalizations. The number of COVID19 patients in the city was 164 as of Friday, down from a record 171 on Thursday.

On Friday, California reported the highest number of COVID19 patients in the hospital and intensive care units statewide since the beginning of the pandemic: nearly 18,950 and 4,050, respectively. However, the number of hospitalizations recorded Friday rose by only six statewide — a welcome contrast to the tripledigit increases on most other December days.

Short staffing around the holidays may have caused incomplete reporting, leading to artificially low hospitalization counts, Swartzberg said. And even if the Bay Area trend is real and hospital admissions are leveling, it could reverse in the coming weeks following Christmas and New Year celebrations.

“I think we’re going to remain in a really dark period for about three to four more weeks,” Swartzberg said.

Much of California saw a bump in coronavirus cases after Thanksgiving, which was probably connected to gatherings with family and friends. Though public health officials pleaded with people not to get together for Christmas, they expect another spike in cases in the coming weeks.

The state could experience

“a surge on top of a surge on top of a surge unless we are careful and mindful,” Gov. Gavin Newsom said in a briefing Wednesday.

The available capacity at intensive care units in the Bay Area rose to 11.3% Saturday, up from 9.8% on Friday. Regions of California with capacity under 15% are required to follow additional restrictions, including closing indoor and outdoor dining, barring private gatherings and limiting the number of people in retail stores.

Capacity at intensive care units in Southern California and the San Joaquin Valley was zero percent Saturday, continuing a prolonged and severe strain on the regions’ hospitals. The dire figure does not yet mean people will be turned away for care, but it has forced hospitals to construct parking lot tents and surge wards to care for patients.

Los Angeles County, which has become a national hot spot of the pandemic, saw an increase in the number of COVID19 patients in the hospital and intensive care units every day over the past two weeks.

The crisis has forced patients in Los Angeles to wait as long as eight hours in ambulances before being allowed into the emergency room, according to the Los Angeles Times, and some hospitals are running low on supplies of oxygen.

“The reality is you never want to get so sick you have to be hospitalized with COVID19, but if you had to pick a time to get COVID19 and be hospitalized, now would be the worst,” Swartzberg said, noting that overcrowded facilities can lead to overstretched staff and diminished quality of care.

Experts are hopeful the regional stayhome orders that went into effect this month will dull another postholiday surge in cases and hospitalizations. Yet some worry that without strict enforcement, the impact will be lessened.

“If you have these restrictions and zero consequences, the restrictions are kind of worthless,” said Nadine Whisnant, a longtime resident of Orinda who said many in her community are not complying with the stayhome order. “Unless people follow the rules, this isn’t going to end until we all get the vaccine.”