The availability of intensive care plummeted across the state and the bay area on Christmas Eve, as hospitals across much of California were overwhelmed to try to keep up with an unprecedented increase in patients with COVID-19.
California technically had 0% availability of intensive care units, although that does not mean that there are no more beds in the state. But with Southern California and the San Joaquin Valley with 0% availability for the seventh consecutive day, the excess of ICUs in these two regions pushed the entire state to capacity on Thursday.
ICU beds remain available in the Bay Area, Greater Sacramento and Northern California regions. Bay Area ICU availability fell to 9.2% from 11.4% the previous day.
The situation in the ICU is dire, public health experts said, with dozens of hospitals across much of the state opening wards and erecting parking tents to care for patients. The state has opened four field hospitals and plans to activate at least one more this week.
And the pressure on hospitals is likely to increase in the coming weeks, if an expected increase in postnatal cases leads to even more people needing intensive care.
“We have hospitalizations that are hurting,” said Dr. Bela Matyas, health officer in Solano County, where 137 COVID-19 patients were hospitalized on Wednesday, including 28 in intensive care, more than at any other time in the hospital. pandemic. “Unfortunately, Thanksgiving Day proved to be what concerned us. And that means that it is more worrying about next week. If people continue to interact with each other, things are not going to get better until all this is over. ”
The entire state saw an increase in cases after Thanksgiving, presumably related to family reunions and friends over the holiday, and this resulted in an increase in hospitalizations. Although public health officials are begging people not to meet for Christmas or any other holiday next week, they anticipate another increase in a week or two.
The advantage is that requests to stay at home appear to decrease cases a little, at least in the Bay Area, infectious disease experts said.
“We are in a better place now. We are not in a good place, but in a better place, ”said Dr. George Rutherford, a specialist in infectious diseases at UCSF. The on-site protection has been “a success so far,” he added, “but it could disappear on Friday”.
Hospitals and intensive care
Nearly 19,000 people were hospitalized with COVID-19 in California on Wednesday, including nearly 4,000 in intensive care. Both numbers are more than double what was reported earlier this month. In the Bay Area, 1,858 patients with COVID-19 were hospitalized on Wednesday and 398 were in the ICU.
California public health officials could not immediately explain on Thursday how the state can have 0% availability of ICU when many regions still have open beds. But public health experts said the likely explanation is that the most affected areas are so far above capacity that they have driven the state’s total to zero.
For example, some hospitals have twice as many patients in intensive care as licensed ICU beds. These patients are being treated in emergency ICU beds, located in converted emergency departments or postoperative rooms, or in COVID-19 wards that have been expanded in a hurry.
Santa Clara County continued to have the highest capacity in the bay area, with about 11% of the ICU beds available on Wednesday. About 42% of all ICU patients had COVID-19, the county said.
“Hospitals are full, ICU beds are few, people are dying,” said Dr. Mark Ghaly, California’s secretary of health and human services, in a statement on Thursday. “The simplest thing we can do, but also the most significant, is to stay at home. We are the first line of defense against this virus and we must act now. “
Cases and deaths
Although cases are still increasing in the bay area, most counties have registered a slight drop in the rate of increase. Experts like Rutherford said this was probably partly due to requests to stay at home that were put in place more than two weeks ago in six counties and a week ago for the rest of the region.
The Bay Area has reported an average of 4,370 cases per day so far this week, which is just slightly higher than the previous week’s daily average of 4,324. This is a welcome change from the weekly increases of 30% to 50% reported in the last month and a half.
Daily cases dropped in some counties, including San Francisco, which reported an average of 233 cases a day this week, compared with just over 300 the week before. The reproductive value and positive test rate, two important markers of the spread of the virus in the community, have also declined in several counties. The reproductive value predicts how many people an infected person will transmit the virus to.
“I have been excited about these numbers for the past few days,” said Dr. John Swartzberg, an infectious disease specialist at UC Berkeley. “Although we are still seeing more cases, we are not growing at the same rate. I am feeling that perhaps it is a sign that we have reached the zenith in the number of cases and we will see a fall soon.
“These are my positive feelings,” he added. “But I think, even if it’s true, we’re still a good 10 days from the Christmas effect.”
The figures across the state are not as hopeful as those in the Bay Area. California reported an average of almost 48,000 cases a day this week, compared with about 42,000 a day the week before.
And the number of deaths, both at the state and regional level, is steadily increasing. The Bay Area reported 35 deaths from COVID-19 on average each day this week, compared with 24 deaths a day last week, an increase of 46%. California recorded 325 deaths a day this week, an increase of 40% over the previous week.
How it is spreading
Public health experts said social gatherings and outbreaks in the workplace continue to drive the spread of disease. That’s why they are still concerned about Christmas, along with Kwanzaa and New Year’s next week.
There was good news for Sonoma County public health officials on Thursday: a New Year’s Eve party planned for 4,000 guests at the Graton Resort and Casino has been canceled by the resort. The casino remained open, despite the order of stay at home, because it is run by a tribal government, which is exempt from California regulations.
Across the country, 1.19 million people traveled through US airports on Wednesday, the highest total number in a day since March, according to federal officials. But traffic at San Francisco International Airport has declined since Thanksgiving, and officials say they have not seen an increase in the number of travelers at Christmas.
Matyas said that in Solano County, he saw recent outbreaks of festive events and in workplaces, including stores and supermarkets, where the virus spreads among employees. What is especially worrying, he said, is the number of people who told investigators in the case that they went to work or a party when they presented the symptoms.
“It’s not all this fear of asymptomatic spread – these are symptomatic people who choose to go to meetings. And I can’t say how many workplaces we saw where people got sick, ”said Matyas.
Among essential workers, he believes that many people are appearing sick because they cannot afford to take time off, feel pressured by employers, or believe that they can avoid infecting others by wearing a mask and staying physically distant.
For social gatherings, he had a harder time finding an explanation. “Unfortunately, some people are simply not taking it seriously,” said Matyas. “And it doesn’t take a lot of people to cause a lot of disease.”
Erin Allday is a writer for the San Francisco Chronicle. Email: [email protected] Twitter: @erinallday