Confirmed cases of coronavirus in California surpassed the 3 million mark on Tuesday at a time of growing optimism that the outbreak may finally be stabilizing, even as officials note some alarming factors that could complicate the projections.
Cases continued to decline across California – including the hard-hit Los Angeles County – after two months of record highs. COVID-19 hospitalizations also declined and began to decrease slightly, giving a desperately needed breathing space for medical facilities still overburdened by COVID-19 patients.
After a slow start, California is starting to increase the distribution of the coronavirus vaccine, which officials see as the best hope of bending the curve and bringing the shaky economy back. Limited supply of the vaccine is likely to mean that many will still have to wait weeks, if not months, to get the vaccines, but there is growing hope that the Biden administration can speed up vaccination efforts.
But despite these positive developments, officials are expressing growing concerns about new and potentially more contagious variants of the coronavirus that have been detected in California and beyond. It is believed that one of the new variants is 50% more transmissible than the conventional variety of coronavirus, which, if generalized, would lead to more infections, hospitalizations and deaths.
It is possible that one of the new mutant variants will become the dominant version of the coronavirus spreading in the state in the coming months – at the same time, many Californians expect to see the economy reopen significantly if conditions continue to improve. Much of the state is in a bid to stay home for six weeks, leaving many small business owners, including restaurants, hairdressers and gyms on the verge of financial ruin.
The Sacramento region had its home stay suspended last week, giving counties the option to allow beauty salons to reopen in limited capacity and open-air restaurants to restart. The continuous improvement of the pandemic elsewhere is likely to put new pressure on government officials to allow the reopening of additional businesses, although the projected available ICU capacity remains critically limited in southern California, the San Joaquin valley and the bay area. .
State officials say requests to stay in a region will be suspended once the available ICU capacity is 15% or more in the next four weeks.
Health experts said they would like to see significant reductions in cases and hospitalizations before they feel confident that California is coming out of the increase. The reductions in daily coronavirus cases in the past few days may have been affected by delays in notification during the three-day Martin Luther King Jr. weekend.
“Cautious optimism may be necessary,” said Dr. Robert Kim-Farley, an epidemiologist and infectious disease specialist at the UCLA Fielding School of Public Health. “However, even if we are flattening at this stage, this is too high a level to be satisfied with just flattening the curve. We have to make substantial decreases in the number of cases, hospitalizations and deaths. “
The 3 million case mark, confirmed through an independent Times survey of county and city health departments, demonstrates how widely the coronavirus has spread throughout the country’s most populous state.
Clearing that limit means that about 1 in 13 Californians tested positive at some point during the pandemic. But the authorities have always believed that the test captures only a certain percentage of those who are infected, because many with the virus have mild symptoms or none at all.
Even so, the growth in the count of documented cases was meteoric. this it took about 10 months for the state to reach 1 million confirmed cases, which happened in mid-November. California went to reached 2 million cumulative infections just before Christmas.
Now, just about four weeks later, the state has added a million more cases to its total.
California has recorded more than 34,400 cumulative coronavirus deaths, and the number of daily deaths is still high. A Times count found 696 deaths reported on Tuesday, the second highest single-day count in the entire pandemic. An average of about 500 Californians recently died of COVID-19 daily. There are so many people dying in Los Angeles County each day that air quality officials have lifted the limits of cremations.
Dr. Tomás Aragón, a state public health officer and director of the California Department of Public Health, called the case number “a serious reminder that COVID-19 is prevalent” across the state. He added: “We all need to do our part by staying at home; wear a mask; avoiding the meeting, especially at home; frequent hand washing and vaccination when eligible and available.
“While we are seeing some encouraging signs as hospitalizations and case rates are decreasing, California remains relentless in its commitment to the battle against COVID-19,” said Aragón. “We cannot become complacent because a vaccine is now available.”
California has also seen a flattening, and even a slight decline, in the number of people who need hospitalization for COVID-19. State hospitalizations peaked about two weeks ago, on January 6, at 21,936; on Monday, there were 20,062 coronavirus positive Californians in state hospitals.
COVID-19 hospitalizations have decreased in 10 of the last 12 days.
The number of people sick enough to need intensive care also dropped from 4,868 on January 10 to 4,693 on Monday. The number of people with COVID-19 in California’s ICUs has dropped in seven of the past eight days.
Although slight, any drop is good news for California hospitals and besieged health professionals, who have had to contend with sharp and sustained increases in the number of patients with COVID-19 since the beginning of November.
“These are the rays of hope that shine,” said Dr. Mark Ghaly, California’s secretary of health and human services.
However, many ICUs across the state remain stressed – mainly in Southern California and the San Joaquin Valley, which have reported 0% availability in their intensive care units for weeks. This forced critically ill patients to wait for ICU beds while they were in the emergency room, which kept sick patients waiting for hours in ambulances outside the doors of the hospital.
Drops in the daily rate of cases, as well as in the percentage of people tested who are infected, hopefully foreshadow a corresponding drop in the number of COVID-19 patients who need to go to the hospital, Ghaly said on Tuesday. Another promising piece of data, he added, is that the state-modeled, or R-effective, transmission rate has now dropped below 1 – meaning that those who test positive are, on average, infecting less than someone else. .
When the R-effective is below 1, the case count will gradually decrease.
“The good news is that … the spread of COVID is not growing in the state, but decreasing – just a little more slowly than we would like,” said Ghaly.
The variant that has attracted the most attention recently has been known as B.1.1.7 – a mutant variant first identified in Britain in September and has since been identified in the counties of Los Angeles, San Diego and San Bernardino. It is not one of the most dominant variants in California, but that could change soon.
But the new mutant variants pose new threats.
The research suggests that B.1.1.7 is about 50% more transmissible than the standard coronavirus variety, and the United States Centers for Disease Control and Prevention warned that the variant may be prevalent in March. A more transmissible virus means that people are even more likely to become infected with the virus if they are exposed to it and are not wearing masks and practicing physical distance.
Scientists think that existing coronavirus vaccines are effective against variant B.1.1.7. But the fact that it is considered more contagious means that the variant, by virtue of potentially infecting more people, would result in an increase in hospitalizations and deaths.
A second, much more common variant in California that started to attract more attention over the weekend is known as the L452R. The L452R variant is relatively old, first described in Denmark in March, but also identified in Alameda County in May. Suddenly, he became more identified in California.
Genetic analysis of virus samples studied in 12 California counties – mainly northern California – found that, while L452R was identified in about 4% of the virus samples studied in late November and early December, L452R suddenly represented 25 % of virus sample studies between mid-December and early January.
“That’s why it’s worrying,” Dr. Charles Chiu, a virologist and professor of laboratory medicine at the University of California, San Francisco, told reporters at a rare press conference on Sunday night, organized by the California Department of Public Health . “It is worrying that it could potentially be more infectious.”
The mutation involves a critical part of the virus that regulates how adherent it is to the part of the human cell it clings to, from which it can inject its genetic material and sequester it to make copies of itself. This raises the question of whether the vaccines that now exist will remain effective and further studies are needed to determine the answer.
Lin reported from San Francisco, Money from Long Beach.