Update: When experts predict new coronavirus cases will peak in California, Sacramento
Updated April 11
It’s the moment we are all waiting for. And worrying about. When will the growing wave of coronavirus infections peak in the Sacramento region and California?
Experts say the next few weeks are critical: The magnitude of the virus’ sweep is about to come into focus.
“This is the moment to not be going to the grocery store, not going to the pharmacy, but doing everything you can to keep your family and your friends safe,” Dr. Deborah Birx, who is coordinating the White House’s response to the pandemic, said on Saturday, April 4.
“The next two weeks are extraordinarily important.”
Surgeon General Jerome Adams warned the following day that the coming week would be America’s “Pearl Harbor moment, our 9/11 moment” in the coronavirus pandemic.
In the five days following Adams’ warning, the United States saw a jump from 312,000 confirmed cases to 504,000 cases, and the death total more than doubled, from 8,500 to 18,860.
Internationally that week, the virus spread to 500,000 more people, bringing the total to 1.7 million confirmed cases of the COVID-19 virus as of April 11, according to Johns Hopkins University. That included 105,000 deaths internationally, an increase of 40,000 deaths in less than one week.
While early efforts in California may help the state avoid the kind of devastating scenes playing out elsewhere, officials and experts caution any early gains can be wiped out if safety measures are eased.
If you live in an urban area where local health officials initiated early social-distancing orders, the peak of new cases could hit later this month. If you live in a rural area, the coronavirus spread will take longer and stretch limited hospital resources thin.
Here is a look at current estimates of surge moments for California as well as Sacramento-area counties, other major areas of the state and some “hot spots” outside of California.
COVID-19 in California
Peak day for California as a whole is estimated to be April 13, according to widely cited projections from the Institute for Health Metrics and Evaluation, a global health research center at the University of Washington.
That date has moved forward over the past two weeks from an earlier projection of late April.
However, state health officials say they believe the peak moment is more likely to be mid-May. Gov. Gavin Newsom has declined to answer questions about how the state’s modeling differs from others, but said the state’s current case-growth pace suggests a peak moment later than April.
Newsom and health officials say the state’s dramatic stay-at-home order nearly three weeks ago may have bought the state’s hospitals a bit more time to prepare, and will mean lower numbers of more serious patients for hospitals to deal with.
The University of Washington institute has dramatically dropped its forecast of deaths in California, from a projected 5,068 on April 6 to a forecast on April 11 of 1,616 deaths before fatalities largely stop. The institute initially projected deaths in California to drop off to near zero by the last week of June. The institute had moved that projection, as of April 11, to a cessation of deaths in early May.
Similarly, the institute’s estimate as of April 11 of 61,545 deaths nationally is substantially lower than the projection one week prior of of 93,500.
The Trump administration warned at the beginning of April the death toll could be between 100,000 and 240,000. One week into April, though, Dr. Anthony Fauci of the White House coronavirus task force said the number could be around 60,000, based on evolving data. As of April 11, more than 20,000 had died in the United States.
To hold the death number down in California, not only will people have to continue staying home as the peak arrives, they also will have to stay home for a month after the peak hits.
“In California, by the end of June, early July, we will have controlled this,” said Dr. Ali Mokdad, a professor of health metrics science at the Washington institute said in late March. “But our concern is: What is next? We haven’t seen this virus before. We don’t have antibodies. Another surge later is possible if we don’t control it now.”
Put another way: “Instead of becoming a peak, it can become a roller coaster ride,” said Dr. John Swartzberg, a professor emeritus at UC Berkeley School of Public Health.
Sacramento County cases
County health officials, studying computer models, said the heaviest load for seriously ill patients will come at the end of April. But modeling for California as a whole now suggests Sacramento’s peak will come sooner than that.
Sacramento County public health director Peter Beilenson said it appears the county has enough hospital beds to handle what could be up to 600 cases at a time, but said hospitals report they do not have as many ventilators as they may need.
He is “cautiously optimistic” that Sacramento residents are slowing the disease spread through social distancing.
Although 24 people have died in Sacramento County and 653 were known to be infected as of April 10, Beilenson said Sacramento should escape what New York, Seattle, Los Angeles and some other cities face.
“Our stay at home order came on the early side. Unlike L.A., we don’t have places like Disneyland, Universal Studios, the beaches. We have basketball arenas and movie theaters, but those were shut down early. And our density is much less than San Francisco and hugely less than New York.”
“If we keep up social distancing, ramp that up, the models say we are not going to hit (hospital) capacity,” he said.
Placer County peak
County health director Aimee Sisson said projections have been so varied that it’s hard to know when the peak will hit. It could come anywhere between May and August, she said
“Those models leave a lot to be desired,” she said. The data suffers from a lack of pervasive virus testing in the county. As of Sunday, 103 people had tested positive for coronavirus in the county and three had died.
She said she fears the county’s three main hospitals — Kaiser Roseville, Sutter Roseville, Sutter Auburn Faith — could be hit beyond capacity, given they also handle patients from Sacramento County and nearby foothill counties.
As of late March, there were 467 combined intensive care and surgical beds in the three hospitals. Only 38 of them were occupied by patients who had tested positive for the virus or who have virus-like symptoms. The county has 142 ventilators at the three, and of those, 92 percent were not in use.
“We are OK right now,” Sisson said. “If we have a real healthcare surge, though, we are going to have shortages.”
Yolo County infections
Like in Placer, limited testing in Yolo County has hampered the county’s ability to better determine when and how long a surge may last, according to the county public health officer Ron Chapman.
The number of cases in Yolo County — 37, with one death — “reflect just the tip of the iceberg,” he told supervisors. Seventeen had been hospitalized as of Saturday.
Woodland Memorial Hospital and Sutter Davis Hospital have about 150 hospital beds, including 14 beds for intensive care, according to state records.
The county is not forecasting when the peak caseload might happen.
“April is going to be very telling” regarding when a surge in Yolo County will come, and how bad it will be, Chapman told supervisors.
El Dorado County
In more rural parts of the state like El Dorado County where there are fewer hospital resources, some public health experts worry that residents reluctant to follow public health orders might lead to a delayed surge in coronavirus cases. That, coupled with a higher elderly population, could spell trouble.
About one in five residents in El Dorado County are 65 and older, a higher rate than the state average. And the county never issued a stay at home order to residents — despite Newsom’s order earlier this month, the county continues to call its local rules a “directive,” which do not carry the force of law.
As of Sunday, El Dorado County had 22 coronavirus cases and no deaths.
The county is “refining our modeling” and does not have an estimated date for when the peak might hit, county spokeswoman Carla Hass said in an email. “There is nothing formal to share yet.”
Marshall Medical Center in Placerville, a 125-bed hospital with 20 ICU beds, “is adequately prepared with supplies and staff and are actively planning for the inevitable patient surge,” said the hospital’s CEO Siri Nelson in a statement.
There are 80 total beds available today, said spokeswoman Brittany Garcia, and none of the beds are occupied with positive COVID-19 cases, though there are eight pending results, she said. The hospital has 22 ventilators, two of which are currently in use.
Bay Area coronavirus curve
Public health experts in the Bay Area have been hesitant to say when they expect a surge to come. But two weeks after Bay Area counties issued some of the first orders to shelter in place in the state, hospitals have been reporting fewer cases than previously expected.
There was “reasonably good evidence of some flattening of the curve,” Dr. Bob Wachter, a professor and chair of the University of California, San Francisco’s department of medicine, told the New York Times last week.
Still, as of the end of last week, Bay Area counties had topped 3,000 cases, and mounting.
Los Angeles
For weeks, local officials have been juggling questions about whether Los Angeles will become the next New York, where coronavirus cases have overwhelmed the hospital system.
“A week or two from now, we will have images like we’re seeing in New York here in Los Angeles.” Mayor Eric Garcetti said in early April, according to the Los Angeles Times.
Dr. Barbara Ferrer, Los Angeles County public health director, has said her office plans to release a report this week that includes modeling for when the peak date might arrive.
“The truth of the matter is none of us really know,” she told reporters Monday. “We’re all making the best guess that we can using the different modeling techniques that are available.”
The Navy’s Mercy medical ship has arrived in the port of Los Angeles to treat up to 1,000 non-COVID-19 patients, beginning Monday. That ship will treat only non COVID-19 patients, freeing up space in onshore county hospitals for virus patients. The Los Angeles Convention Center is also set to be converted into a field hospital, and the county is rapidly increasing the number of overall beds available.
Stay-at-home orders in Los Angeles are set to expire April 19, but Garcetti told Vanity Fair “My gut has been that it’s going to be at least two months.”
New York epicenter
New York and New Jersey are the epicenters of the virus in the United States.
According to Johns Hopkins University, nearly one half of the 312,000-plus cases in the country were in those two states, focused on the dense New York-Newark metropolitan area, where hospitals already are overwhelmed.
Last week, New York Gov. Andrew Cuomo said he thought the peak could be three weeks out. He’s since said it will come much sooner.
The Washington institute projection for peak “healthcare resource use” in New York was April 8.
Post-surge worries
Newsom is among many who worry what people will do when the news media announces the peak is over.
Already, he said, he is hearing of people suffering from “cabin fever” who want to get out. An upset friend reported to Newsom on Saturday that her son intended to go to a party.
“Give me his cell phone number,” Newsom said he told her, so he could disabuse the teen.
The crisis will not be over, though, in the first, second or even third week after new case numbers begin to drop. Experts say they fear if businesses open too soon, infections will spike again.
“If you really shut things down now and the number of cases goes down, it’s not like you’re past the danger point,” said Dr. Joshua Sharfstein, a vice dean at Johns Hopkins Bloomberg School of Public Health.
“Anyone who thinks you’re going to be flipping the switch in May and going back to the way things were is incorrect.”
The Bee Capitol Bureau’s Sophia Bollag contributed to this report.
Statistics in this report, such as infection and death totals, have been updated since initial publication date of April 5. In key instances, for comparison purposes, the report also notes the original statistics published.
This story was originally published April 6, 2020 at 5:00 AM.