(CN) — A swath of California stretching from San Diego to the Sacramento County line will remain under strict health orders as Covid-19 cases continue to rise and hospitals brace for another surge heading into the last days of 2020.
The new stay-at-home order announced Tuesday impacts millions of Californians in the central and southern parts of the state, where hospitals are operating on surge protocols with their intensive care units overwhelmed with sick patients.
Regional stay-at-home orders for the San Joaquin Valley and Southern California regions had been set to expire Dec. 28, but state health officials hit the reset button as demand continues to exceed ICU capacity and the transmission and case rates continue to spike.
Hospitals in the Southern California region remain in crisis, with oxygen in high demand and in low supply in many hospitals and exhausted medical workers working longer shifts according to state health officials.
So far, no hospitals in the state have resorted to crisis care, which involves treating patients in cots or rationing ventilators. But there have been reports of patients treated in hospital conference rooms or in ambulances outside emergency rooms.
“It’s absolutely true, let me be crystal clear, some hospitals in Southern California have put in place some practices that would be part of crisis care,” said state Health and Human Services Secretary Dr. Mark Ghaly. “Whether those are decisions about how ambulances are received into the facility or how stretched staff become to care for patients, looking at the effectiveness of certain treatments for certain patients who are unlikely to survive or do well. That is happening in facilities in Southern California.”
Given that, plus current data on available hospital beds, state health officials extended the two region’s health orders.
Businesses can only serve a fraction of their customers at a time under the regional health order and gatherings, like parties, cannot be held. Church services and protests cannot be held indoors and people must wear masks and practice social distancing.
The San Joaquin Valley region includes Fresno, Kern and 10 other counties, while the Southern California region includes Los Angeles, San Bernardino and nine other counties.
Both will remain under stay-at-home orders for three weeks or until their available ICU beds exceeds 15%.
Currently, both regions stand at 0% ICU capacity, which doesn’t mean that there are no available ICU beds. Instead, it means hospitals are now at surge capacity and unequipped to provide the best care for patients who do not have Covid-19.
The situation remains dire in LA County, where Covid claimed the life of someone every 10 to 15 minutes during the week of Christmas. On Tuesday, the county reported 277 deaths — a daily record.
Roughly 7,000 people in LA hospitals have Covid-19, while the county of 10 million has averaged a daily case count of between 13,000 to 15,000 for the last several days.
Other parts of the state have been weathering the winter spike better.
The Northern California region has not seen the same onslaught of sick patients and is the only part of the state not under a regional health order.
Coincidentally, the state saw a slight dip in the state’s positivity rate, though it has stalled around 12% and remains considerably high according to health officials. The 7-day positivity rate in LA County stands at nearly 17%.
Already beleaguered from the post-Thanksgiving Covid surge, hospital staff across the state are bracing for a post-Christmas surge and New Year’s spike.
“We know that a number of people are going to be newly exposed over the weekend,” said Ghaly. “The urge of many Californians to gather and do so in ways that really are not Covid-safe is going to lead to some transmission.”
Ghaly said he hopes more people will cancel their plans rather than go to a gathering with people from outside their home. But that message has so far been ignored given the current data, with over 20,300 Californians in the hospital and over 4,300 in ICUs across the state.
In the last two weeks, hospitalizations jumped by 36% and admissions to the ICU spiked by 35%.
“This is a tremendous amount of work for these hospital systems,” said Ghaly. “Hospitals are running out of staff, having to use rooms they don’t traditionally use, with much longer than normal wait times in emergency departments.”