News

State to enter more serious regional stay-in-place order in coming days

California sees surge in intensive care unit cases and hospitalizations, more projected in the next few weeks

On Dec. 3, California leaders announced a regional stay-at-home order affecting five areas of the state. The order will go into effect for three weeks when a region's intensive care unit capacity falls below 15%. Courtesy Gavin Newsom's Twitter account.

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.

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"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.

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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.

'If we don't act now, the hospital system will be overwhelmed.'

-Gavin Newsom, California governor

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:

California Gov. Gavin Newsom discusses a new stay-at-home order for five regions of the state at a Dec. 3 press conference. Video courtesy California Governor Gavin Newsom's YouTube channel.

Find comprehensive coverage on the Midpeninsula's response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.

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State to enter more serious regional stay-in-place order in coming days

California sees surge in intensive care unit cases and hospitalizations, more projected in the next few weeks

by / Palo Alto Weekly

Uploaded: Thu, Dec 3, 2020, 3:58 pm

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.

Comments

TimR
Registered user
Downtown North
on Dec 3, 2020 at 4:03 pm
TimR, Downtown North
Registered user
on Dec 3, 2020 at 4:03 pm
15 people like this

What happened to all the "surge capacity" CA created back in March and April? And why aren't hospitals more prepared now? Experts were warning back in August that the holiday season would be bad, and I even told family back then I wouldn't be seeing them for Thanksgiving due to the dire predictions of Dr. Fauci, et al. People like Newsom keep saying they listen to the experts, but they don't. If he did, he would have made sure ICU capacity was able to handle the current uptick in cases. What a failure on his part. Pretty much as bad as Trump at all this. Even in SCC, I noticed on the hospital part of the Dashboard that ICU beds have decreased a little since November. Pathetic.


Anon123456
Registered user
Adobe-Meadow
on Dec 3, 2020 at 4:30 pm
Anon123456, Adobe-Meadow
Registered user
on Dec 3, 2020 at 4:30 pm
8 people like this

New York Times ran an article earlier in the week "Surging Virus Exposes California’s Weak Spot: A Lack of Hospital Beds and Staff"

Web Link

"A dearth of hospital beds has been a worldwide problem throughout the pandemic, but California, with a population of 40 million, has a particularly acute shortage. The wealthiest state in the wealthiest country has 1.8 hospital beds per 1,000 people, a level that exceeds only two states, Washington and Oregon, according to 2018 data compiled by the Kaiser Family Foundation. California has one-third the number of beds per capita as Poland.

Many hospitals in California have maintained lower numbers of beds in part to limit the length of patient stays and lower costs. But that approach is now being tested."


Anonymous
Registered user
Duveneck/St. Francis
on Dec 3, 2020 at 4:49 pm
Anonymous, Duveneck/St. Francis
Registered user
on Dec 3, 2020 at 4:49 pm
13 people like this

Homeless shelters and nursing homes seeing cases in Santa Clara County, per SF Chronicle today (Thursday).
“Thirty-one percent (31%) of the Covid-19 cases are located within five ZIP codes in East San Jose.”
For that, we get reprimanded up here in Palo Alto at the very north of Santa Clara County.
Message included in the article is “the community” must wear masks and remain at home.
Anyone else see what’s wrong with this!?
(I am 100% on board with correct mask-wearing and social distancing, but I don’t agree with destroying all commerce and activity county wide.)


TimR
Registered user
Downtown North
on Dec 3, 2020 at 5:12 pm
TimR, Downtown North
Registered user
on Dec 3, 2020 at 5:12 pm
18 people like this

Anonymous, "Message included in the article is 'the community' must wear masks and remain at home."

And yet, the homeless aren't required to wear masks, at least not in downtown Palo Alto. They are free to hang out downtown and drink, smoke pot, play ping pong, fight, yell at one another, etc, all without masks. But instead of addressing this actual problem, the county punishes people who have very little to do with the problem. They've gone too far this time.


Where was decision made?
Registered user
Old Palo Alto
on Dec 3, 2020 at 6:47 pm
Where was decision made?, Old Palo Alto
Registered user
on Dec 3, 2020 at 6:47 pm
18 people like this

I hope this decision wasn't made by unmasked men and women at the French Laundry while dining and wining and unclear about the distinction between "outdoors" vs. "indoors".


Online Name
Registered user
Embarcadero Oaks/Leland
on Dec 3, 2020 at 7:17 pm
Online Name, Embarcadero Oaks/Leland
Registered user
on Dec 3, 2020 at 7:17 pm
10 people like this

Earlier this week a gentleman was complaining on NextDoor that he couldn't get the PA police to respond to complaints about unmasked shoppers and maybe staff at Grocery Outlet on Alma. They didn't refer him to anyone who might take action.

It reminded me of my time-consuming failed attempts to report PAMF for unmasked workers and other violations. I remember fuming about a note PAMF sent a full MONTH later saying they were NOW requiring most staff to mask up -- like they expected to be congratulated!

My personal care people have better safety practices -- and they're the ones hurting.


chris
Registered user
University South
on Dec 3, 2020 at 7:31 pm
chris, University South
Registered user
on Dec 3, 2020 at 7:31 pm
16 people like this

Tim,

Surge capacity requires doctors and nurses.

[Portion removed] you who are complaining the authorities are acting too drastically will be complaining on Christmas Day that they didn't act soon enough and now you can't get a doctor.

[Portion removed.]


TimR
Registered user
Downtown North
on Dec 3, 2020 at 8:42 pm
TimR, Downtown North
Registered user
on Dec 3, 2020 at 8:42 pm
11 people like this

Chris,
I'm not in denial about anything. It's our leaders who have been in denial for 6 months that this day was coming.

And you're in denial about the fact that the UK, Italy, Spain and France ALL have a higher COVID death rate than the US.* And that's failing more than the US. Try using facts when you want to make an argument next time.

Web Link


Online Name
Registered user
Embarcadero Oaks/Leland
on Dec 4, 2020 at 12:10 am
Online Name, Embarcadero Oaks/Leland
Registered user
on Dec 4, 2020 at 12:10 am
5 people like this

"Surge capacity requires doctors and nurses."

Of course. Also true during normal times.

When I've asked PAMF why the wait time to see specialists has gotten so much longer over the last few years and why it can take up to 9 months to see a preferred specialist or 2+ months for the first available one, they say have trouble recruiting because housing costs are so high, the population growth is creating undue demands, the specialists are now splitting their time with the new branches, etc etc.

When I suggest that just maybe they should stop their incessant ads for more patients, their reactions are always interesting.


Alvin
Registered user
Professorville
on Dec 4, 2020 at 1:52 am
Alvin, Professorville
Registered user
on Dec 4, 2020 at 1:52 am
7 people like this

@Online Name: Have you considered the possibility that those two unmasked customers might have had a medical exemption? There are many people who have trouble breathing while masking but go along anyway to avoid the wrath of the mask gestapo.

For what it's worth, I have not read any compelling evidence that masks prevent infection - assuming that is even a good thing - and arguments can be made that they cause more infections due to false sense of security, constant touching, and the curvature of the masks acts like a jet nozzle (like a hose) on the sides, so the exhaled breath travels farther in aerosolized form.

Did you or anyone else wear face coverings during any of the previous influenza or corona virus seasons? We're coming on 9 months of lockdowns and 8 months of mask mandates in California, with near full compliance, yet we constantly hear that cases are reaching record-levels. If masks, lockdowns and stay-at-home orders work so well, why is this happening and why do we keep doing it?

Do states like Florida, Georgia, and South Dakota (to name a few) and countries like Denmark, Norway, Sweden and Finland - all with no state-wide or country mask mandates - have higher death rates than states with mask mandates? Their businesses and schools are open and life looks more or less normal (pre-2020) in these places.

I don't believe any state or country can do much to stop or control virus spread, but can devastate economies, lives, livelihoods and educations for many years by way of lockdowns, school closures, distancing, and masks.


Lee Forrest
Registered user
Crescent Park
on Dec 4, 2020 at 7:06 am
Lee Forrest, Crescent Park
Registered user
on Dec 4, 2020 at 7:06 am
13 people like this

The enforcement of public health mandates & restrictions is rapidly becoming a constitutional issue...1st Amendment vs statewide protocols that curtail certain provisions explicitly stated in The Bill of Rights.

Liberal perspective = lockdowns....Conservative view = unrestricted gatherings & movement.


bill1940
Registered user
Menlo Park
on Dec 4, 2020 at 3:24 pm
bill1940, Menlo Park
Registered user
on Dec 4, 2020 at 3:24 pm
2 people like this

"1st Amendment vs statewide protocols that curtail certain provisions explicitly stated in The Bill of Rights."

Just what exactly are these 1st amendment rights? To wit:


Amendment 1 - Freedom of Religion, Press, Expression. Ratified 12/15/1791.
Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.

Just where does this amendment state that anyone has the right to walk around, possibly infected with a highly infectious virus, that can be lethal, and is likely to hospitalize those who are infected? Also, none of these rights are absolute.

Thus given the 10th amendment, states have the right to demand that you wear a mask to protect yourself as well as others; to limit assembly in restaurants etc ... .

And yes, masks DO PROTECT both the wearer and those nearby from infection. Since this is not 100% guaranteed, we have the requirement of social distancing of 6 feet. Why 6 feet? Because scientific tests have shown that aerosols released when someone sneezes or coughs and is wearing a mask tend to fall the ground within this range. They can photographs these aerosols as they are released under multiple conditions. This is especially important during winter because the air is dry and the aerosols then to remain in the air because of the lack of humidity.

Also, super-spreaders tend to be asymptomatic, infected people.

Finally, yes, Sweden and the UK both tried to implement herd immunity. It failed and they've backed off. One might note that Taiwan has fewer than 10 deaths associated with SARS-CoV-2 (covid-19); did not shutdown anything; and maintained for the most part business as usual. Why?

They were prepared because the the SARS virus. Everyone wore masks when outside, obeyed quarantines ($3000 fine if violated); socially distanced at work and in restaurants; had temperatures taken before entering an establishment outside of their homes and were quarantined if they had one. There's a lesson in here for those who really care about the safety of others.

Please wear a mask and social distance for all of us.


Annette
Registered user
College Terrace
on Dec 5, 2020 at 1:22 pm
Annette, College Terrace
Registered user
on Dec 5, 2020 at 1:22 pm
4 people like this

@bill1940: thank you for what you wrote.

This new lockdown order needs to be clarified. Given that retail can remain open at 20% capacity, can essential workers continue to report to work at other businesses provided all the requirements of the required Social Protocol are in place and being followed? I think the answer is NO, but that doesn't make a lot of sense.

I've learned a lot from Covid, including that who we elect to office matters tremendously. Leadership is a key quality. Ditto credibility; hypocrites have no business being in elected office. Those we elect make key decisions and appointment people who also make key decisions. Seems to me that, given the circumstances we find ourselves in today, we have not elected the right people for these times. A local exception: Simitian.


Peter Carpenter
Registered user
Menlo Park
on Dec 5, 2020 at 4:28 pm
Peter Carpenter, Menlo Park
Registered user
on Dec 5, 2020 at 4:28 pm
2 people like this

Another outstanding local official with regard to her leadership AND example is Congresswoman Eshoo who was one of the first to encourage her constituents to follow risk reduction behavior and who ends every one of her weekly newsletters with an admonition such as this:

"Every week I say the following to you but it bears repeating: COVID-19 is an overwhelming challenge with many factors contributing to its severity, but the one thing we can control is how we behave. As we approach the December holidays, let’s continue our individual responsibilities for the common good by washing our hands frequently; physically distancing (at least six feet); wearing a mask every time we go out; and avoid gathering with anyone who does not reside with us.

I am humbled and deeply grateful for the trust you’ve placed in me to represent you.

Most gratefully,
Image
Anna G. Eshoo
Member of Congress"

We are very lucky to have her as our Representative!


Lee Forrest
Registered user
Crescent Park
on Dec 5, 2020 at 5:01 pm
Lee Forrest, Crescent Park
Registered user
on Dec 5, 2020 at 5:01 pm
16 people like this

When the Covid-19 vaccine is finally made available to the general public, it will be interesting to see how many people voluntarily step forward to receive the innoculations & given its side-effects, the % of those who return for the booster.

Maybe confidence in the vaccinations will move forward roughly 3-6 months after ALL of the liberal news pundits & politicians promoting the vaccine receive them first & any adverse side effects are fully disclosed to the public...until then, face masks & avoiding direct contact with others may have to suffice.


Peter Carpenter
Registered user
Menlo Park
on Dec 5, 2020 at 5:22 pm
Peter Carpenter, Menlo Park
Registered user
on Dec 5, 2020 at 5:22 pm
2 people like this

"it will be interesting to see how many people voluntarily step forward to receive the innoculations & given its side-effects,"

Here is the current data for the Pfizer and Moderna vaccines:
"Most people will escape “severe” side effects, defined as those that prevent daily activity. Fewer than 2% of recipients of the Pfizer and Moderna vaccines developed severe fevers of 39°C to 40°C. But if the companies win regulatory approvals, they're aiming to supply vaccine to 35 million people worldwide by the end of December. If 2% experienced severe fever, that would be 700,000 people.

Other transient side effects would likely affect even more people. The independent board that conducted the interim analysis of Moderna's huge trial found that severe side effects included fatigue in 9.7% of participants, muscle pain in 8.9%, joint pain in 5.2%, and headache in 4.5%. In the Pfizer/BioNTech vaccine trial, the numbers were lower: Severe side effects included fatigue (3.8%) and headache (2%)."

I would gladly trade any of those side effects for the very high protections from Covid 19 that these vaccines have proven to provide.







[email protected]
Registered user
Mountain View
on Dec 5, 2020 at 6:48 pm
[email protected], Mountain View
Registered user
on Dec 5, 2020 at 6:48 pm
Like this comment

IF the ICU's stay as short as they are, the REGIONAL shutdowns will continue.

The from this website says: (Web Link reads:

"SAHO ICU bed % available as of December 5, 2020 for the 5 regions:

For regions under 15%, the Regional Stay Home Order goes into effect Sunday, December 6, 2020 at 11:59 PM.

The current 7 day average has Santa Clara at 17% seen here (Web Link).

But that is 7 days delayed, obviously the Department of Health knows we are already below 15%, there were 359 available beds on Thursday, and only 344 beds on Friday. 15 NEW patients from Thursday to Friday. 344 available beds where there were 319 used for COVID patients and 1690 beds used for the rest. The total bed count is 344+319+1690= 2343. 344/2343 is 14.68%. Now I understand we are part of a Region, but Santa Clara County is below the 15% threshold NOW

On Sunday November 15 we had 608 available beds. That would have been 25% free ICU beds. Boy are we going in the WRONG direction.


Lee Forrest
Registered user
Crescent Park
on Dec 5, 2020 at 7:19 pm
Lee Forrest, Crescent Park
Registered user
on Dec 5, 2020 at 7:19 pm
18 people like this

>"I would gladly trade any of those side effects for the very high protections from Covid 19 that these vaccines have proven to provide."

Concurring...but 'the proof better be in the pudding' as 'Big Pharma' has been known to embellish as well as cover-up actual efficacies via it's disclaimers & advertisements.


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