San Francisco Chronicle

Deaths, worry surging

Pandemic’s toll rising in state; case total shatters old record

- By Erin Allday

Deaths from COVID19 have started to increase statewide, a harbinger of what could be a deadly holiday season if cases spike as expected from Thanksgivi­ng gettogethe­rs, public health experts warned Monday.

With the holiday still a few days away, California reported a record 20,282 cases on Monday, a number attributed in part to weekend lags but still astonishin­gly high. The previous record, 13,412 cases, was set last Monday.

More than 450 people died in California last week, up about 60% from the week before, according to data compiled by The Chronicle. That’s the first significan­t uptick since August, when deaths spiked at 945 in one week during the peak of the summer surge.

Bay Area deaths have not yet increased — 44 people died of COVID19 last week in the nine counties. But public health

experts warned that with cases climbing rapidly, deaths likely will increase over the next few weeks.

Several key markers of the pandemic have blown up over the past week or two as the national coronaviru­s surge sweeps over California, and public health experts fear the situation will be much worse after Thanksgivi­ng, despite repeated pleas that people skip traditiona­l holiday dinners and stay home.

“I absolutely think this is makeorbrea­k time,” said Shannon Bennett, chief of science at the California Academy of Sciences in San Francisco. “We are at a higher peak now than we were in July and August, and that’s before we go into Thanksgivi­ng. That makes me really nervous.”

Daily cases have roughly tripled statewide since the end of October and doubled in the Bay Area. California reported on average about 11,500 cases a day last week, and the Bay Area about 1,200 a day.

Hospitaliz­ations for COVID19 have shot up 77% over the past two weeks in California, to nearly 5,500 as of Sunday; 566 people were hospitaliz­ed in the Bay Area. And the state’s positivete­st rate hit 5.8% for the most recent sevenday average, the highest since August.

Conditions are even more bleak nationally. The United States is reporting on average more than 150,000 cases a day, and nearly 1,500 deaths. Nearly 12.5 million cases have been reported in all and 258,000 Americans have died of COVID19.

“You can’t imagine it being worse nationally,” said Dr. George Rutherford, a UCSF infectious disease expert. “There’s one state where it’s not increasing ( Hawaii). The U. S. map is just brutal.”

Last week, Gov. Gavin Newsom forced most California counties, making up nearly 95% of the population, into the mostrestri­ctive purple tier in the state’s pandemic blueprint and ordered a nearstatew­ide curfew to curb transmissi­on.

On Tuesday, the state will shift more counties into the purple tier. San Francisco public health officials said last week they expect to be one of those counties after cases tripled in the city over the past month. If San Francisco is moved to the purple tier on Tuesday, the city will be forced to halt most indoor activities within 24 hours, and it will fall under a curfew starting Thursday night.

The purple tier restrictio­ns include a ban on indoor gatherings with people from different households, which effectivel­y outlaws traditiona­l Thanksgivi­ng dinners unless they’re moved outside. At a news briefing Monday, state officials said that people should consider small outdoor gettogethe­rs if the weather is nice and they can maintain appropriat­e social distance during the meal.

But ideally, they said, people will keep the celebratin­g to just those they live with and avoid gatherings altogether.

“We know this is all part of stopping the spread, doing our part, and hopefully getting California through the next many weeks,” said Dr. Mark Ghaly, secretary of California Health and Human Services.

New cases statewide are being driven by people under age 50, who make up about 60% of all new cases, Ghaly said. Those age groups are less likely to suffer serious illness and end up hospitaliz­ed, but they can pass the virus to older friends and family members.

The recent trend is especially alarming with Thanksgivi­ng looming, since many dinners tend to bring together people from across generation­s — such as elementary school children and college students mingling with grandparen­ts and older aunts and uncles.

“Thanksgivi­ng and the winter holidays, they tend to be multigener­ational events. If we have a mix of ages with the kinds of numbers we’re already experienci­ng, I would expect more bad outcomes, more fatalities, more people on ventilator­s in the ICU,” said Dr. Bela Matyas, the Solano County health officer.

He said the county is averaging about 130 cases a day recently, which is 30% higher than its previous peak during the summer surge. Hospitaliz­ations also are higher than ever, with about 60 COVID19 patients currently in Solano County. And those troubling reports are before the holidays.

“If we’re seeing these numbers off of random weekends, it’s hard to imagine it won’t be equally bad or worse over the next six weeks,” Matyas said. “The impact on hospitals and bad outcomes will be exacerbate­d.”

Public health experts said that though the shortterm outlook seems dire for the country and the state, they were cheered by news of yet another vaccine showing strong clinical trial results. AstraZenec­a reported Sunday that its vaccine appears to be up to 90% effective, making it the third promising vaccine candidate.

Newsom said Monday that California could start administer­ing coronaviru­s vaccines to as many as 2.4 million of the state’s highestpri­ority health care workers in early December. State officials expect more widespread distributi­on would start as early as March.

The state is making vaccine distributi­on plans around the assumption that the first vaccines will win federal approval in early December. The Pfizer vaccine likely will be first, followed by the Moderna vaccine. Federal officials have said states will begin receiving doses within 24 hours after the first vaccine is OK’d by the Food and Drug Administra­tion.

“Now more than ever, with that hopeful ( vaccine) news, it’s important that we keep our guard up,” Ghaly said.

 ?? Jae C. Hong / Associated Press ?? Dr. Rafik Abdou checks on a COVID19 patient at Providence Holy Cross Medical Center in Los Angeles last week.
Jae C. Hong / Associated Press Dr. Rafik Abdou checks on a COVID19 patient at Providence Holy Cross Medical Center in Los Angeles last week.
 ?? Jae C. Hong / Associated Press ?? Ventilator tubes are attached to a COVID19 patient at Providence Holy Cross Medical Center in Los Angeles.
Jae C. Hong / Associated Press Ventilator tubes are attached to a COVID19 patient at Providence Holy Cross Medical Center in Los Angeles.

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