LOS ANGELES — Gov. Gavin Newsom on Monday warned that California is again on the brink of a wider coronavirus stay-at-home order as public health officials work desperately to shore up a state hospital system that is contending with record numbers of COVID-19 patients.
Should the recent trends continue, officials warn, there's a chance that the viciously resurgent pandemic could overwhelm aspects of the state health care system.
Of particular concern is the state's intensive care capacity. Currently, about 75% of the state's 7,733 ICU beds are occupied — with 1,812 of them filled by coronavirus patients.
Unless things change, the state could exhaust its existing ICU capacity by mid-December, according to projections Newsom presented.
"If these trends continue, we're going to have to take much more dramatic — arguably drastic — actions," he said during a briefing.
Those include "the potential for a stay-at-home order" for areas in the strictest purple tier of California's coronavirus reopening road map, he said. Of the state's 58 counties, 51 are in the purple tier.
Officials have watched with growing alarm as a recent record-setting flood of new coronavirus cases has started to wash over the state's hospital system.
There were 7,787 coronavirus patients hospitalized statewide as of Sunday, according to the latest available data. That's the highest number recorded during the pandemic and an increase of roughly 89% from two weeks ago.
Even more sobering is that the current figures largely don't include the recent deluge of infections — as COVID-19 hospitalizations reflect cases that were identified two to three weeks earlier, according to Dr. Mark Ghaly, California's health and human services secretary.
Everything, Ghaly said Monday, "is on the table in terms of considering how we effectively guide the state through this," though he said California is "working with our local partners to make sure what we do is both impactful and as time-limited as possible."
The stakes for hospitals, like with intensive care units, are high. Newsom said about 59% of California's hospital beds are currently occupied by patients needing care for all sorts of reasons — but that could rise to 78% by Christmas Eve.
Newsom emphasized that the alarming numbers would come to pass if "we just sit back and we are bystanders at this moment and we don't subsequently improve upon our existing efforts."
"We intend to bend this proverbial curve and impact these statistics favorably," he said.
The specter of additional state-level restrictions comes as some counties are already taking additional steps aimed at tamping down transmission of the coronavirus.
Los Angeles County's strictest rules in months went into effect Monday, while Santa Clara County has ordered a mandatory 14-day quarantine for virtually anyone coming into the county from more than 150 miles away — with some exceptions, such as for people traveling for medical treatment.
Officials in both counties have warned that unless they can halt the alarming coronavirus surge, which is unprecedented in its scope and scale, hospitals could run out of beds in weeks.
"We have come to a place where our cases and our hospitalizations are so high that we must do something to settle things down," Dr. Sara Cody, the health officer for Santa Clara County, said Saturday. "We are now at a critical inflection point."
In L.A. County, officials have rolled out what they refer to as a "targeted safer-at-home order" — which closes public playgrounds; places new capacity limits on retail stores, outdoor museums, galleries, zoos and aquariums; and prohibits all gatherings among people from different households, except for outdoor religious services and political demonstrations.
Those limitations are on top of other restrictions that went into effect last week, including a controversial renewed ban on outdoor dining.
"We were prepared for an increase," said Barbara Ferrer, L.A. County's public health director. "None of us really thought the increase would be so big across such a short period of time."
Santa Clara County has restricted hotels to essential travel only or to people needing medical isolation or quarantine and further capped capacity at retail establishments.
Authorities also suspended contact sports for professional teams, forcing the San Francisco 49ers to look elsewhere to play their home games scheduled for December.
"This pandemic is like a high-speed train, and our projections tell us that we are on target to derail by around the third week of December if we don't apply brakes, right now, with all our collective might," Cody said. "We urge everyone to stay home to the greatest extent that you can. Please stay home. Do not go out unless it is for essential reasons or essential purposes."
While acknowledging that the rules present further challenges to businesses already reeling from months of coronavirus-related limitations, officials have said the restrictions, combined with residents' adherence to the practices that can help keep them and their loved ones safe, will help turn back the tide of new infections.
"It is our collective responsibility, first and foremost, to prevent the unnecessary loss of more lives," L.A. County Supervisor Mark Ridley-Thomas said. "We know people are fatigued and frustrated, but this is the time to sober up to what could be a grim reality if we don't all do our part."
As of Monday morning, there had been more than 1.2 million confirmed coronavirus cases in California. But even that immense total belies the severity of the current spike.
Before mid-November, the state had surpassed 10,000 daily new coronavirus infections on 10 occasions throughout the course of the pandemic. California has crested that threshold 13 times since Nov. 12, according to data compiled by the Los Angeles Times.
Over the last week, California has averaged 13,937 cases per day, a nearly 75% increase from two weeks ago.
That flood of new cases is starting to wash over hospitals.
California posted a record number of people hospitalized with COVID-19 — 7,415 — on Saturday, according to the latest available data. That figure surpassed the previous record of 7,170 that was set in July.
Just a month ago, 2,525 COVID-19 patients were hospitalized statewide.
The sustained and significant surge threatens to stress health care systems beyond their capacity. L.A. County health officials have sounded the alarm that they are on pace to see a shortage of beds — especially in intensive care units — over the next two to four weeks if these trends continue.
"I don't want to minimize the gravity of the situation or the need for people really to take very seriously their behavior and what they're doing that might be contributing to the increased transmission," Dr. Christina Ghaly, the county's director of health services, said last week.
Santa Clara County recorded its seventh consecutive day of record COVID-19 hospitalizations Saturday, with 263, according to state data. That's 34% more than its previous all-time peak, 196, which was recorded at the end of July.
Health officials and experts have maintained that they expect the exponential jumps in infections and hospitalizations to eventually lead to an increase in deaths.
Already, more than 19,100 Californians have died from COVID-19.
The state has averaged roughly 61 daily deaths over the last week. Should that pace hold, California would record its 20,000th coronavirus-linked fatality by mid-December.
The new wave of cases is also affecting nursing homes. According to the Times' coronavirus nursing home tracker, average daily deaths have roughly doubled in recent weeks, and average daily cases have tripled.
Because COVID-19 hospitalizations reflect cases that were identified two to three weeks earlier, officials expect those figures will continue to increase in the coming weeks, given the continued crush of cases.
Santa Clara Valley Medical Center, the county's flagship hospital, is so overwhelmed by COVID-19 patients that doctors and nurses are working extra shifts to care for them, said Dr. Clifford Wang, chairman of the Department of Medicine.
"We're heading into probably one of the ... toughest periods of the pandemic," Wang said. "We're getting hit both with COVID and non-COVID cases. This is one of the busiest times of the year."
