In an attempt to prevent a crisis in hospitals and intensive care units in the coming weeks due to ballooning cases of COVID-19, California Gov. Gavin Newsom on Thursday announced a regional stay-at-home order for most areas of the state, including in Santa Clara and San Mateo counties.
The state's regional stay-at-home order, which could begin in days or weeks depending on the region, affects areas where the overall intensive care unit capacity in hospitals is below 15%. The state is projecting five regions that will be below that level by mid- to late December. The first could reach that level in the next day or two, he said.
Currently, hospital beds statewide are at 86% of capacity and ICU beds are at 67% of capacity, he said. The Greater Sacramento, Northern California, San Joaquin Valley and Southern California regions are projected to drop below the 15% capacity ICU-bed threshold in early December; the Bay Area is projected to reach that level by mid- to late December, Newsom said.
Santa Clara County's COVID-19 dashboard states that the seven-day rolling average of ICU beds with COVID-19 patients is only 23% as of Thursday. The overall occupancy of ICU beds, when including all patients, is 84% in the nonsouthern part of the county and is even more limited in the southern end of the county, including in Morgan Hill, Gilroy and east San Jose. There were fewer than a dozen beds across all five hospitals serving the south county community, Dr. Jennifer Tong, assistant chief medical officer for Santa Clara Valley Medical Center, said during a press conference on Wednesday.
The order temporarily closes bars, wineries, personal services, hair salons and barbershops. Schools already with waivers and critical infrastructure such as grocery stores and pharmacies will remain open. Retail will be limited to 20% of capacity to reduce exposure, and restaurants will be restricted to takeout and deliveries. Once triggered, the order would be in place for at least three weeks, he said. The order also limits all nonessential travel.
"If we don't act now, the hospital system will be overwhelmed," Newsom said, adding that "this is not a permanent state" but that the nation is in the final surge in the pandemic. With vaccines, the state is a few months away from seeing some control over the virus, he said.
But in the meantime, California residents must prevent as many deaths as possible and help keep hospitals and their essential workers from being overwhelmed. The number of COVID-19 deaths, for example, has increased eight-fold in the last 30 days, from 14 deaths on Nov. 2 to 113 on Dec. 2, he noted.
Dr. Mark Ghaly, the state's health and human services secretary, said that after three weeks the state will reassess the situation in each region and could either extend the order or allow counties within an individual region to return to one of the four tiers established by the state's Blueprint for a Safer Economy — yellow, orange, red or purple — for gradually reopening the economy.
"We will look at transmission rates and project four weeks after that," he said. "About 12% of cases identified today will be hospitalized two weeks from now; 1.5 weeks after that, many of the cases go into the ICU."
State officials are also taking additional steps to ensure there are enough hospital beds. For the last 72 hours, they have been discussing with hospitals ways to proactively suspend elective surgeries to free up beds. The state also has 11 facilities in the "warm status" with 1,503 additional beds to meet the surge. One facility, at the San Mateo County Convention Center, has the capacity for 250 beds.
Newsom urged people to comply with the regional order and to exercise patience. He estimated the next month or two would be significantly challenging.
"This is the light at the end of the tunnel. This is not a marathon any longer; this is a sprint," he said.
The state expects to receive the first 327,000 vaccine doses from pharmaceutical company Pfizer Inc. by as early as Dec. 12 to 15. Since two doses must be administered about a month apart, that means only 163,500 people would actually be vaccinated, he noted. The state is also expecting to receive doses from Moderna Inc. and details are currently being worked out, he said. Pfizer has halved its expected rollout of 100 million doses worldwide by year end, however, due to supply chain issues, according to the Wall Street Journal. The company expects it will ship 1.3 billion doses worldwide in 2021. It is awaiting emergency-use authorization from the U.S. Food and Drug Administration.
Under a phased system, the first group of vaccines under Phase 1A would be distributed in three tiers:
• Tier 1: Acute care, psychiatric and correctional facility hospitals; skilled nursing and assisted living facilities and similar settings for older or medically vulnerable patients; paramedics, EMTs and other emergency medical workers; and dialysis centers.
• Tier 2: Intermediate care facilities; home health care and in-home supportive services; community health workers; public health field staff; primary care clinics and federally qualified health centers; rural health centers; correctional facility clinics; and urgent care centers.
• Tier 3: Specialty clinics; laboratory workers; dental/oral health clinics; pharmacy staff not working in higher tiers.
Information will be updated on the state's website, covid19.ca.gov.
Watch Newsom's full news conference here:
Find comprehensive coverage on the Midpeninsula's response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.