Coronavirus updates: 525,000 cases in 2 weeks for California; ICU availability at 2.5%
Amid a flurry of related developments — from Congress agreeing on a second stimulus deal, to a second vaccine earning approval, to Gov. Gavin Newsom quarantining for the second time — California finds itself in an increasingly untenable coronavirus situation.
Winter officially arrived Monday, and it figures to be the darkest season in living memory for many, many Californians.
Nearly one-quarter of all licensed hospital beds across the state are occupied by patients positive for COVID-19. Intensive care units, which handle the most critically ill, had 2.5% availability statewide as of Monday, according to the California Department of Public Health.
And tens of thousands more Californians are testing positive for the coronavirus every day, meaning there’s no relief in sight for a few more weeks at the absolute minimum.
It’s already by far the worst surge of the 10-month pandemic. But new infections, hospitalizations, ICU patients and the rate of death are still growing at unrelenting paces, promising to deepen both the health crisis and the economic hit taken as businesses endure another round of widespread closures. Things will almost certainly get worse before they get better.
California’s COVID numbers: 525,000 cases in past 2 weeks
The state for the first several months of the pandemic fared among the best in the U.S. as far as COVID-19 metrics, a feat that had been especially impressive considering its vast size and population of roughly 40 million.
Not anymore. Entering Monday, California has reported the second-most new cases per 100,000 residents over the past week among all 50 states, behind only Tennessee, according to data compiled by Johns Hopkins University.
California has, remarkably, recorded more than 525,000 lab-confirmed COVID-19 cases in the past two weeks, including more than 90,000 this past weekend, according to CDPH. Daily increases of more than 40,000 cases have suddenly become the norm, after the state had been averaging about one-tenth that number as recently as early November.
The 525,000 infection figure represents 28% of the cumulative total for the entire health crisis, which is now on the edge of 1.9 million. It also nearly quadruples the worst 14-day stretch from summer, while testing capacity has only increased a bit more than double since then.
For the past two weeks, 12% of diagnostic tests for the virus have returned positive; for the past seven days, the statewide rate is 13.3%. The percentage is up from a record low of 2.5% in mid-October, climbing quickly and steadily over the past two months.
More than 17,000 are hospitalized across California with confirmed cases of COVID-19, including over 3,600 in ICU beds, according to state data updated Monday. Between virus patients and others requiring high-level care, a little over 1,400 ICU beds were vacant. (The ICU percentage doesn’t just reflect unoccupied beds but also other considerations including staffing availability.)
The hospitalized total has doubled since the start of December, when it was reported at about 8,500. The ICU patient load has increased 80% this month, up from just over 2,000.
Statewide, new fatalities from the coronavirus are coming faster than ever, and the COVID-19 death toll has also accelerated extremely quickly.
The two-week rolling average on Monday reached 196 deaths per day, 38% higher than the summer’s peak of 142. California entered December averaging fewer than 70 daily deaths over the prior two weeks. In early November, the rate had been as low as 40.
COVID-19 metrics correlate along a chain beginning with infections and ending in deaths: Elevated new cases lead to increased concurrent hospital totals, which lead to crowded ICUs, which result in higher fatality rates.
To date, more than 1.89 million Californians have tested positive and at least 22,676 have died of COVID-19, according to CDPH.
Where does regional ICU capacity stand?
The state on Sunday said Southern California, home to 20 million, and San Joaquin Valley, where 7 million reside, each remain at 0% ICU availability, as they have for most of the past week.
The 13-county Greater Sacramento region improved to 16.2% and the 11-county Bay Area increased to 13.7% on Monday. Each had reported capacities of about 12% on Sunday.
Those four regions, home to over 98% of California’s population, are all subject to the regional stay-at-home order, which prohibits both indoor and outdoor restaurant dining among other restrictions. The order is activated across the entirety of a region once that region crosses below 15% ICU availability. The state will assess the ICU situation in each region after three weeks to determine whether those tighter protocols can be lifted.
Only the 11-county North State region, home to about 685,000, has not yet fallen below that mark and entered the tighter restrictions; it was at 28.7% Monday, up from 24% on Sunday.
What does 0% ICU availability mean?
With Southern California and the San Joaquin Valley recently running out of available ICU beds, there are early reports of what that actually looks like in the state.
Hospitals are still accepting patients. But some critically ill ones who would normally be given an ICU bed are now being treated in parts of hospitals that are being transitioned for intensive care, such as emergency rooms or postoperative surgical beds, according to numerous media reports from across the state.
Nurses are having to treat a higher number of patients at the same time, necessarily reducing the quality of care received.
In Fresno and nearby Central California counties, ambulances may soon deny rides for less-sick patients if they’re determined not to urgently require emergency care, The Fresno Bee reported.
One of California’s largest hospitals, Los Angeles County USC Medical Center, is under such intense strain that some patients must wait hours to receive care, NPR and the Los Angeles Times each reported in recent days.
The latter publication also reported that if the crisis worsens, Los Angeles County — home to 10 million people — may have to ration hospital care. That’s a dire, last-resort strategy: It would mean establishing a triage system, compromising availability of care in an effort to keep as many people alive as possible.
Late last week, the Washington Post published a haunting seven-minute video showing the situation at St. Mary Medical Center in the San Bernardino County town of Apple Valley, giving a relatively rare glimpse inside an overwhelmed hospital.
“Covid patients are treated in parking lots, hallways and lobbies of a California hospital that, like the nation, is struggling to keep pace with the pandemic,” the Post’s description for that video reads.
The governor’s office earlier this month announced a pilot “Home O2” program, instituted in the Southern California counties of Riverside, Imperial and San Bernardino, that’d see as many as 200 patients sent home with “oxygen and paramedic support,” another move intended to free up hospital space.
Newsom began a Monday afternoon news conference on California’s COVID-19 situation by saying that ICUs are hitting “breaking points” across much of the state.
What about California’s 11 overflow hospital sites?
Overflow sites are being activated across the state, with patients now being treated in five of 11 established surge centers.
The five sites have 105 patients in beds, and the 11 in total have a combined 1,544 beds in “warm” status, ready to be activated on short notice.
That includes the Sleep Train Arena practice gym, where the state said 16 patients were being treated as of Sunday’s update. During the spring, the Sleep Train alternate care facility never treated more than 10 patients in any one day.
The surge sites contain “low-acuity” beds, not ICU, Office of Emergency Services officials have confirmed for weeks. But treating patients at these locations frees up space and staffing at regular hospitals that can be used for ICU patients.
Newsom back in quarantine
California’s governor is quarantining for the second time in as many months, this time following exposure to a staff member who tested positive for COVID-19.
Newsom reportedly tested negative Sunday, along with other staff members who had contact with the infected staffer.
The governor will quarantine for 10 days. State guidelines on quarantining were recently revised, shortening the recommended period from 14 days to 10.
Moderna’s vaccine clears multiple approvals
The U.S. Food and Drug Administration last Friday granted Moderna’s COVID-19 vaccine emergency use authorization for adults, and a coalition of Western states after its own independent review agreed over the weekend that Moderna’s vaccine is safe and efficient.
It’s the second coronavirus vaccine cleared for use in the U.S. and California, following approval of the Pfizer-BioNTech vaccine one week earlier.
California is expecting more than 670,000 doses from Moderna and another 233,000 doses of Pfizer’s vaccine in about the next week. The latter total is less than was initially expected.
Both vaccines use similar technology, with clinical trials showing them each as about 95% effective. Both require two doses taken a few weeks apart.
Because supply is limited, the vaccine will first be administered in California to front-line health care workers and in nursing facilities. Subsequent phases will include health workers who deal less directly with COVID-19 patients, along with elderly residents.
It is expected to take a few more months until the vaccine is widely available to all who want it across all age groups.
Because of this, measures like mask use and social distancing will remain paramount even as a vaccine is deployed to the above-listed vulnerable groups, hopefully slashing death numbers and reducing hospital burden.
$900 billion stimulus bill passes. What’s in it?
Congressional leaders on Sunday announced a $900 billion stimulus agreement in response to the coronavirus crisis. It is expected to be approved Monday by Congress and President Donald Trump, and reportedly includes $600 direct payments for most qualified taxpayers.
The bill includes an extension of unemployment benefits, affecting about 1 million Californians whose benefits had been set to expire at the end of this week.
It also extends a federal eviction moratorium that had been set to expire at the end of 2020, while providing $25 billion in nationwide rental assistance.
Most notably absent from the stimulus package is aid for local and state governments. In California, state and local governments received roughly $15 billion from the spring’s CARES Act stimulus.
Over 1,000 dead in six-county Sacramento area
The six-county Sacramento area made up of Sacramento, El Dorado, Placer, Sutter, Yolo and Yuba counties has combined for nearly 89,000 confirmed coronavirus cases, of which at least 1,048 people have died.
Sacramento County has reported a total of 57,082 infections since the onset of the pandemic and 774 resident deaths from COVID-19. The local health office in a Monday update including the weekend added 3,079 cases and 33 newly reported fatalities.
Sacramento County hospitals shot to a record-setting 493 patients with confirmed COVID-19 as of Monday’s update, up 16 from the previous day, while the ICU total fell from 110 to 97. Available ICU beds rose from 63 on Sunday to 71 Monday.
By date of death occurrence, the county now reports at least 101 virus fatalities have come in the first 17 days of December. That preliminary figure puts the month well on track to surpass August’s 181 to become the deadliest month of the pandemic. November’s death toll has swelled to 142, as cause of death determinations are confirmed well into December.
The two deadliest days of the health crisis, locally, have come in the past two weeks: 15 infected residents died Dec. 7 and 14 on Dec. 10, county data show.
Yolo County has reported a total of 7,100 infections and 104 deaths, adding 80 cases to the tally in Monday’s update.
As of Monday, Yolo had 26 virus patients hospitalized including 12 in ICUs. The ICU patient total remained the same as Sunday, but available beds increased from two to six.
Placer County health officials have reported a total of 11,541 infections and 104 deaths. The county on Monday reported 765 cases and one fatality for the three-day window including the weekend, following Friday’s reporting of 222 cases and five deaths.
State data showed 181 hospitalized COVID-19 patients in Placer hospitals, down from 189 on Sunday. The county had 29 in ICU beds both Sunday and Monday, a record. Placer County has 27 ICU beds available, an increase of five compared to Sunday.
The county on its own dashboard reported 172 hospitalized patients as of Monday, with 27 in ICU beds, but with the same figure of 27 available ICU beds as reported by the state. State and local numbers typically vary slightly.
El Dorado County has reported 4,412 positive test results and eight deaths. Nearly 800 of those cases were confirmed last week.
Health officials say 21 people are hospitalized with the virus in El Dorado, the same total as Sunday, but with the ICU total decreasing from eight on Sunday to six on Monday. State data shows six ICU beds now available in El Dorado County.
In Sutter County, 5,449 people have been infected and 43 have died. Of those, 83 were confirmed infected Thursday and three were reported dead. On Friday, 88 more were infected and one death was reported. County health officials reported a daily record for infections with 204 new cases on Dec. 8. The bi-county health office reported 51 Sutter residents were hospitalized with the virus as of Friday.
Neighboring Yuba County has reported 3,260 infections and 15 dead, with 81 new infections on Thursday and 47 infections plus one death reported Friday. Twenty Yuba residents were in the hospital with COVID-19 as of Friday.
Not all of those Yuba-Sutter residents were hospitalized in-county. Adventist-Rideout, the lone hospital serving the bi-county region, as of Monday’s state data update was treating 58 virus patients, including 10 in ICUs, with zero ICU beds left available.
This story was originally published December 21, 2020 at 10:12 AM.
