Strict business and activity limitations will remain in effect throughout Southern California for the foreseeable future as COVID-19 patients continue to flood the region’s healthcare system.
While not unexpected, the extension of the regional order to stay home on Tuesday to southern California and the San Joaquin Valley underscores the state’s precarious pandemic position.
On Monday, California again registered the highest number of new coronavirus infections in a single day, at 66,811. While that count includes an accumulation from the long Christmas weekend, during which many counties have not released reports, officials said they expect that in the coming weeks there will be another outbreak of new infections from meetings and travel during the winter holidays.
Any significant increase in coronavirus cases, experts warn, will invariably trigger a corresponding increase in the number of people who need to be hospitalized two to three weeks later. Hospitals across the state already serve more than 20,000 patients with positive coronavirus, the highest number since the pandemic began.
“If we want to overcome this, meetings must stop and strict precautions must be followed by companies that have been allowed to remain open,” said Los Angeles County supervisor Hilda Solis in a statement on Tuesday. “This is a terrible situation – one that we have avoided so far and, frankly, one that we know was preventable because we avoided it before.”
The regions defined by the state of Southern California and the San Joaquin Valley are under the last home stay request since December 6.
These regions cover 23 counties that are home to most of California’s population: Imperial, Inyo, Los Angeles, Mono, Orange, Riverside, San Bernardino, San Diego, San Luis Obispo, Santa Barbara, Ventura, Calaveras, Fresno, Kern, Reis , Madera, Mariposa, Merced, San Benito, San Joaquin, Stanislaus, Tulare and Tuolumne.
Officials said the most recent round of restrictions – which include reduced capacity in retail stores; the closing of some businesses, including hairdressers, manicures, card games, museums, zoos and aquariums; and the ban on most meetings, hotel stays for tourism and dinner at open-air restaurants – aim to shield hospitals from a torrent of patients with COVID-19.
Orders are put into effect when bed availability in a region’s intensive care unit drops to less than 15%, as has already happened in four of the state’s five defined regions: Southern California, San Joaquin Valley, Bay Area and Greater Sacrament.
Only northern California is not subject to additional rules.
Once implemented, the restrictions have a mandatory useful life of three weeks. They can be removed after that, depending on the expected conditions of the hospital in a region in the near future.
Southern California and the San Joaquin Valley reached a three-week low on Monday. However, both regions languished with 0% availability in their ICUs for more than a week.
Despite the surprising percentage, this does not mean that there are no unoccupied ICU beds; the state uses a weighted formula to ensure that some remain open to patients who do not have COVID-19.
“Whether or not we can increase our ICU capacity to an appropriate level depends on the behavior of Los Angeles County residents – and residents of all of Southern California,” said Solis on Tuesday. “COVID-19 cases are not limited to the boundaries of a county.”
However, even as hospitals staggered with the overload of COVID-19 and prepared for more cases, a small ray of hope dawned on Monday, indicating that the order to stay at home is starting to have an effect.
Viewed more broadly, the average daily number of cases reported over a one-week period fell slightly from its peak, which reached about 45,000 per day in the seven-day period that ended on December 22. As of Monday night, the average daily number of new coronavirus cases was around 38,000.
The improvement is nothing to be overly cheerful, however. Monday’s daily average is even worse than the comparable figure two weeks ago. It will probably take a few weeks for this reduction in new cases of coronavirus to result in a slight reduction in new hospitalizations – a short delay before authorities and experts expect it to be another outbreak of new infections from meetings and travel during winter holidays .
And California hospitals are clearly in crisis. Across the state, 20,390 coronavirus-positive patients were hospitalized on Monday, and 4,308 of them were in the ICU. Both numbers are record-breaking and represent increases of 43% and 40%, respectively, compared to two weeks ago.
In LA County, hospitals are so overcrowded that some have had to convert conference rooms and gift shops into patient care areas. Others report such a high oxygen demand by patients with COVID-19 who are having trouble maintaining air pressure in the pipes or a shortage of supply.
But state officials still found reason to argue that requests to stay at home are working and that some residents are taking requests more seriously than before.
Without orders, state officials and some experts say California would be in an even more precarious position.
“That would have been much, much worse had we not introduced some of these interventions,” said Governor Gavin Newsom on Monday.
Dr. Mark Ghaly, California’s secretary of health and human services, said the plateau on average new coronavirus cases appears to be real and may offer a short break. However, officials said they expect hospitals to be hit by a wave of infected patients in mid-January, underscoring the importance of even a small drop in infections now.
“We are pleased to see a small plateau,” said Ghaly. Without this flattening, “the impact that we anticipate coming from Christmas [and] The New Year would be even worse. “
That is all the more reason, said Ghaly, to show that many new coronavirus infections, hospitalizations and deaths can be easily prevented if people stay at home and renounce meetings away from home during the New Year.
“These will be the things that will help us keep that slight drop down or … just a flattening of upward trends that help us anticipate a slightly reduced impact on our hospitals,” said Ghaly.
The average daily number of new coronavirus cases has also started to decline in LA County, generally hovering around 14,000 a day for the past 12 days.
County officials warn, however, that for hospitals to become safer, the number of cases needs to stabilize at a significantly lower point.
A count of 14,000 to 15,000 cases per day “is too high for any comfort,” said LA County Public Health Director Barbara Ferrer last week. “We would have to level at a much lower rate to protect our hospitals.”
On Monday, Ferrer said it was clear from what happened after Thanksgiving that “living with people outside your home is one of the main causes of the current rise.”
“One unfortunate encounter with an individual with COVID-19 is enough for you to be infected and, unfortunately, to continue infecting many others,” said Ferrer. She asked people who traveled for Christmas or other winter holidays to be quarantined for at least 10 days to see if they develop signs of illness.
The number of people hospitalized with COVID-19 in California remains the highest ever. Sunday was the 30th consecutive day that COVID-19 hospitalizations in the state reached a new record, with 19,766, almost eight times the number on November 1.
The number of people in the state’s ICUs with COVID-19 is also a record – 4,228 on Sunday, almost six times more than on November 1.
Across California in the past week, an average of 231 people died every day from COVID-19. California is on track this week to mark its 25,000th death from COVID-19. As of Monday night, 24,545 deaths were reported across the state.