A day after California reported a staggering record of more than 62,000 daily cases of coronavirus, the availability of intensive care nationwide fell below 2% on Tuesday for the first time, and public health officials issued urgent requests for people to give up the usual Christmas holidays this week.
With the number of hospitals and ICUs constantly increasing in almost every county, California has expanded its state coverage. The ban on non-essential activities from 22:00 to 5:00 was set to expire on Tuesday, but will remain in place until intensive care capacity is improved everywhere and more restrictive home stay orders will be lifted.
Pressure on hospitals and health care providers to keep up with COVID-19 patients is extreme, public health experts say. Intensive care units were over 100% full on Tuesday for the fifth day in a row in Southern California and the San Joaquin Valley, and the state has opened field hospitals to care for patients who cannot get a bed in traditional facilities.
“We strive to add capacity for COVID patients as we speak,” Greg Adams, executive director of Kaiser Permanente, said during a news briefing on Tuesday.
Kaiser, one of the largest health care providers in the state, reported that 16 of the 36 hospitals exceeded the capacity for intensive care. Four hospitals in Northern California, but none in the Bay Area, were at or near UTI capacity, Kaiser officials said. The entire system accounted for over 100% of its regular patient volume for this time of year, and Adams said more than half of the patients had COVID-19.
“As the number of hospital beds continues to decline, we simply will not be able to keep up if COVID’s growth continues to grow,” Adams said.
The new peak in daily cases has come as Bay Area public health experts say they see indications that local growth may slow slightly, although they have warned that the region is not yet safe. The current growth trajectory may be somewhat less steep, but it is still on trend and may increase again after the holidays.
“I must emphasize that we have a long way to go. Even at this current rate, our situation would be very serious in the next few weeks, “said Dr. Grant Colfax, director of the San Francisco Department of Public Health, in a news briefing on Tuesday. “Holiday gatherings outside your household should be avoided at all costs.”
Cases and deaths
California reported 62,661 cases on Monday, exceeding the previous one-day high by 17%. The Bay Area reported 5,028 cases, which was not recorded, but is the second time the region has exceeded 5,000 cases in one day.
But the growth rate is declining in some parts of the bay. Colfax said that two weeks ago, when the regional order to stay at home and the rise of Thanksgiving waves was implemented, cases in San Francisco increased by about 8% every day. Daily growth has since dropped to about 2 percent, he said.
He said the home residence order, which San Francisco and four other Bay Area counties adopted before a state mandate, likely contributed to the suppression of local transmission. Reproductive value, an indicator of the speed at which the virus spreads, has also dropped, he said – from about 1.45 two weeks ago to 1.24 now.
“We are still in a very dangerous position with the virus,” he said. “But we are beginning to see that our collective efforts make a difference.”
Deaths continue to rise, nationally and locally. California reported 372 deaths on Tuesday, up from last week’s average of about 233 deaths a day.
The Bay Area reported 39 COVID-19 deaths, also an increase from last week’s 24-day average. Alameda County recorded 21 deaths on Tuesday.
Hospitals and intensive care
Nearly 17,900 people have been hospitalized with COVID-19 in California since Monday, more than twice as many as at the beginning of the month three weeks ago. Hospitalizations in the Bay Area nearly doubled, to 1,730 as of Monday.
More than 3,700 people have been on COVID-19 intensive care in California, including 435 in the Bay Area. Statewide availability of intensive care fell to 1.4 percent on Tuesday. But availability remained constant in the Gulf area at 13.4%.
The Northern California region remained the only area not under state control at home, with 29.5% of available UCI beds.
California public health officials released a serious forecast for nationwide hospitalizations on Monday, predicting it could reach 90,000 by the end of January, although many experts say it is unlikely. Hospitals in many parts of the state have already activated growth management plans in patients and anticipate that things will get worse in the coming weeks.
Colfax said Tuesday that models for San Francisco suggest that if the city can increase its reproductive value below 1 next week – which would mean the current outbreak is no longer growing – then growth could peak around December 31 with 220 COVID -19 hospitalized patients. If the reproductive value is 1.24, the models suggest that the peak will not come until March 1, 590 people being hospitalized.
In the near future, Kaiser expects California hospitals could see an increase of 1,400 COVID-19 patients by the end of this week and an increase of 2,000 to 3,000 next month if the situation does not improve.
“What we see now is the effect of Thanksgiving,” said Dr. Stephen Parodi, executive vice president of Kaiser and an expert on infectious diseases. “We understand why people did it, but we really make a bugle – a desperate one – call on Californians not to repeat what happened on Thanksgiving. Our hospital system cannot afford to see another growth, as we saw on Thanksgiving. “
Erin Allday and Catherine Ho are writers on the San Francisco Chronicle staff. Email: [email protected], [email protected] Twitter: @erinallday, @cat_ho