Coronavirus updates: Sacramento exits regional stay-at-home order; latest on vaccines
Coronavirus deaths continue to pour in at a record clip in California, but recent signs of plateau in hospital totals have spurred some cautious optimism amid the state’s winter surge.
California’s COVID-19 death toll officially passed 30,000 on Tuesday with the confirmation of 548 fatalities and added 589 more on Wednesday to surpass 31,000, pushing the average to 439 deaths a day over the past two weeks, according to the California Department of Public Health.
That’s more than triple the peak from the summer surge, when the 14-day average maxed out at 142.
Concurrent totals for patients hospitalized and in intensive care units with confirmed virus cases have increased substantially since the surge took hold more than two months ago. Since Nov. 1, the hospitalized total has grown from 2,537 to 21,654, and the ICU total from 708 to 4,829, with the latest numbers updated Wednesday.
But both growth curves have been flattening in about the past week, CDPH data show.
The situation remains better in some parts of the state than others. Gov. Gavin Newsom on Tuesday announced that the 13-county Greater Sacramento has exited the state’s strict, regional stay-at-home order due to a projected increase in ICU availability.
The change means that in those 13 counties, restaurants may very soon reopen outdoor dining areas, and personal care services like barbershops will be able to get back to business, pending amendments to county-level health orders.
Those counties return to the color-coded tier system, in which a vast majority of the state remains in “purple” restrictions. For Greater Sacramento, that includes 11 of the 13 — all but Alpine and Sierra counties, which each have fewer than 4,000 residents.
Health leaders still urge caution.
“Although the Purple Tier 1 is less restrictive, we still have widespread transmission of COVID-19 in Sacramento County,” county health officer Dr. Olivia Kasirye said in a statement. “We need to continue to stay at home as much as possible, comply with the cautious reopening of business sectors and maintain social distancing, limit gatherings with non-household members and always wear a mask in public spaces.”
To date, more than 2.78 million Californians have tested positive for COVID-19 and at least 31,102 have died of the disease, CDPH reported Tuesday. The state has confirmed 563,000 positive cases in the past two weeks for an average of 40,200 a day, with 13.3% of diagnostic tests returning positive.
Why was the Greater Sacramento stay-at-home order lifted?
The state’s announcement on Tuesday that Greater Sacramento has exited the regional restrictions was something of a surprise development, given recent numbers near the capital, but one welcomed by some business owners who’d been in limbo for more than a month.
County officials and elected leaders in Butte, Sacramento and Yuba also eagerly shared the news a few hours before Newsom and CDPH confirmed and announced it.
“We’re seeing stabilization in ICUs and positivity rates,” Newsom said in a social media post at 4:30 p.m. Tuesday. “Greater Sacramento is coming out of the regional stay-at-home and going back to purple tier effective today.”
The governor noted the stabilization even as Placer and Sacramento counties, the two most populous and with by far the most hospital beds in the region, hit record highs for COVID-19 patients earlier this week. Sacramento had 120 in ICUs with 83 beds remaining available Tuesday; and Placer reported 32 patients Monday and 30 on Tuesday, with just four ICU beds remaining available each day.
So, what data led to the order being lifted?
First, a refresher. Newsom introduced the regional stay-at-home order — the tightest set of restrictions imposed since the governor’s original order last March — in early December in response to the ongoing surge in infections and hospitalizations.
The regional order broke California into five geographic areas with counties grouped by existing mutual aid infrastructures. The order triggers for a region once the region’s aggregate ICU availability drops below 15%, at which point all counties in the region are subject to the order for a minimum of three weeks.
After the initial three-week window, the state will lift a region from the stay-at-home order when CDPH data projections show ICU availability at or above 15% four weeks into the future.
Greater Sacramento first entered the order Dec. 11, so its three-week window stretched through New Year’s Day. For most of those 21 days, CDPH reported the region’s ICU availability hovering around 15%, mostly slightly above it. More recently it has dipped below 7% on some weekend days, and on Tuesday it was reported at 9.4%.
Even with the current capacity level well below the 15% threshold, Greater Sacramento has exited the order based on the four-week projections, which predict the situation in early February.
The region is the first to emerge from the order, and CDPH as of Wednesday morning has not posted any specific projection figures linked to Tuesday’s decision.
However, Sacramento County Supervisors Sue Frost and Phil Serna in public social media posts Tuesday each said the county was told projections showed regional ICU availability at 19.1% in four weeks.
The projections are mathematical and take into account a number of different factors including current ICU space, recent infection rates and more, Newsom has said previously.
Those factors may also include totals for COVID-19 patients who are hospitalized but not in ICUs. This metric can be a solid indicator of how ICU totals will trend roughly a week into the future, as some of those non-ICU patients will be admitted as their status declines. And decline in non-ICU virus patient totals help free up staff, hospital resources and physical space that can be converted for ICU surge purposes.
While both Sacramento and Placer counties have seen modest incline in ICU patients, state data show Sacramento’s overall hospitalized total has essentially been on a plateau for three weeks; Placer has been on a modest decline for about two weeks.
What about the other four regions?
The ICU situation remains dire in the San Joaquin Valley and Southern California, with CDPH having reported 0% availability in both vast regions for nearly four full weeks and some health systems already rationing care and resources like oxygen. The Bay Area recently dropped below 1% ICU availability, but rebounded in Tuesday’s update to 4.7%.
The sparsely populated, 11-county Northern California region, the only one to have avoided the order so far, cratered to 17.6% after weeks of ranging mostly between 25% and 30%. If that figure drops below 15 percent in today’s update, Northern California will enter the regional order tomorrow.
Vaccine update: Progress still slow as efforts scale up
State health leaders last week stated a goal of administering 1 million Phase “1A” vaccines to front-line health workers and long-term care residents in the following 10 days.
But according to a CDPH data tracker, the state is only on pace to reach a little more than half that goal, administering roughly 330,000 in the first six of 10 days.
Vaccine rollout has been slow. The state reports that as of Monday, it has distributed a cumulative total of 2.47 million vaccine doses to local health offices and hospital systems statewide.
CDPH reported Tuesday that health networks have administered only about 817,000 of those shots, or about one-third of the distributed total.
The Centers for Disease Control and Prevention on its own data tracker says close to 3.3 million doses have been distributed to California, with 816,000 “initiating vaccinations” (first doses) administered. That’s a little less than 25%, which a vaccine tracker maintained by Bloomberg shows as ranking fourth-worst among the 50 states.
While California is at the bottom of the pack, about half of all U.S. states have distributed fewer than 40% of the doses they’ve received, the Bloomberg tracker shows.
Both the Pfizer and Moderna vaccine products are two-dose regimens, designed to be taken a few weeks apart.
Until very recently, federal guidelines have instructed states to hold second doses in reserve, in order to ensure all who receive a first dose get their second on time.
Following announcement that the incoming Biden administration would do the same, the Trump administration this week reversed course and said it would release all available second doses.
In the event that there are large-scale manufacturing or distribution issues involving either Pfizer or Moderna’s vaccine, administering shots without a second dose in reserve presents some risk, though the precise nature of that risk isn’t clear because those who got the shots during clinical trials received the intended two-dose regimens.
The announcement earlier this week that multiple major stadium and fairgrounds venues across California will be used as large vaccination centers has potential to be a game-changer, with the Los Angeles Times recently reporting that transitioning Dodger Stadium’s large testing site into a vaccine site will triple its daily inoculations. The transition began Monday, when the test center closed.
Six-county Sacramento area hits 120,000 all-time cases
The six counties that make up the bulk of the 13-county Greater Sacramento region — Sacramento, El Dorado, Placer, Sutter, Yolo and Yuba counties — have reported more than 120,000 combined positive cases and recorded at least 1,472 virus deaths as of Wednesday morning.
Sacramento County has confirmed 76,220 cases since the onset of the pandemic, and at least 1,044 of those residents have died of COVID-19. The county reported 984 new cases and increased the death toll by 13 in a Wednesday update, following 1,135 cases and 16 deaths in Tuesday’s update.
By date of death occurrence, December marked by far Sacramento County’s deadliest month of the pandemic. County health officials now report at least 336 deaths for the month — an average of more than 11 a day. The total is still growing as death confirmations are made official, mostly from the second half of the month, but it has already exceeded the previous worst month, August, by 155 deaths.
Additionally, at least 31 county residents died through the first nine days January, the county said.
Virus hospitalizations in Sacramento County have fluctuated some but have held relatively stable, while ICU cases continue to climb. The overall patient total was 492 as of Wednesday, the same as Tuesday, while the ICU total fell from a record-high 120 to 115, state data show. However, the available ICU bed total dropped by a dozen, from 83 to 71.
Placer County health officials have confirmed a total of 16,135 infections and 160 deaths, on Tuesday reporting 157 new cases and removing one death as a data correction. The removal followed two deaths reported Monday and a record-high 17 last Friday.
State data show Placer’s hospitalized total declining from a peak of 216 near the end of 2020. Placer’s own local dashboard on Tuesday showed 155 in hospitals, down 12 from the previous day, with ICU cases declining from 33 to 26; state data on Wednesday showed the same number in ICUs, but 171 hospitalized. CDPH also reported Placer’s available ICU bed total rising from four to nine.
Yolo County has reported a total of 9,445 cases and 130 deaths, adding 140 cases and three new fatalities in Tuesday’s update following 13 cases and no deaths Monday.
State data on Tuesday showed Yolo with 30 virus patients in hospital beds, up from 26 on Tuesday but below the 32 reported Monday, and with the ICU tally holding at nine. The state reports 18 ICU beds available in Yolo County, down one compared to Tuesday. Yolo’s local dashboard in recent updates has shown lower available bed counts than the state.
El Dorado County has reported 7,222 positive test results and 38 deaths, updated Tuesday with 181 new cases and five new deaths.
Following just four deaths from March through mid-November, at least 34 El Dorado residents died of COVID-19 between Nov. 25 and New Year’s Day, county officials report.
State health officials reported a record-high 46 virus patients in El Dorado on Tuesday, dropping slightly to 42 on Wednesday. The total in ICUs held steady at nine, though the number of available ICU beds dropped one, from seven to six.
In Sutter County, at least 7,316 people have contracted the virus and 74 have died. Sutter on Monday added 229 cases and three deaths since last Friday’s update, followed by one more death and 70 new cases Tuesday.
Sutter County on Monday and Tuesday reported 43 residents hospitalized with COVID-19, down from a record-high 58 on Jan. 6. Ten were in intensive care, a decrease by two since then.
Neighboring Yuba County has reported 4,638 infections and 26 dead, with one new fatality and 155 additional cases reported Monday for the weekend followed by 42 new cases and no deaths Tuesday.
Yuba said on Monday it had 28 residents hospitalized with the virus, down seven from a record high of 35 set Friday. Six are in ICUs, same as last Friday.
Not all patients are necessarily hospitalized in-county, but the only hospital serving the Yuba-Sutter bi-county region — Adventist-Rideout in Marysville — had 55 hospitalized virus patients as of Wednesday’s state data update, an increase of one compared to Tuesday, with the ICU total also increasing from 14 to 15. Only one ICU bed remains available, down from two on Tuesday.
This story was originally published January 13, 2021 at 8:19 AM.
