While 2020 may be over, Santa Clara County health officials warned on Wednesday that January may be the COVID-19 pandemic's worst month yet.
"January is by far the most challenging month we have," said Dr. Ahmad Kamal, the county's director of health care preparedness. "As awful as it is, it could get worse. And there's no other way to say that."
This is not only because hospital capacity is stretched thin. There are currently zero ICU beds available, which is impacting the county's 911 system too.
"Our health care system is inundated with patients. This also includes our 911 system and how it's impacting us," said Daniel Franklin, the county's EMS duty chief. "We have less beds available to transition people from ambulances to the emergency room."
"What this means is we have less experienced ambulances available in our system because they're currently waiting at hospitals," Franklin continued.
Some patients have had to wait more than an hour in ambulances to get a bed inside the hospital.
"The wait times are anywhere between an additional 30 minutes to a case that took eight hours to offload one patient," Franklin said. "It fluctuates based on time of day and what hospitals are experiencing."
Offload times have steadily climbed since July and most local hospitals reached record highs in December.
San Jose's Valley Medical Center and Regional Medical Center off-load times tripled since July, averaging about an hour and a half wait, according to county data.
The strain on hospitals and emergency responders has grown in tandem with the rise in COVID-19 cases. As of Wednesday, the county had tallied 77,366 total COVID-19 cases and 799 deaths.
By next week, the number is expected to significantly increase again because of the holiday season, County Counsel James Williams said.
"We don't expect cases to show up on the dashboards for at least 10 days to two weeks from when an event occurs," Williams said. "That's because it takes time of course for someone to test positive. So if you put all those pieces together, we are not going to get a full picture of what may have happened around the holidays and New Year's until sometime next week."
He also warned that the state's regional stay-at-home order, poised to expire on Friday, will likely be extended "because the hospitalization situation has not improved," Williams said.
An extension of the order means personal care services such as barbershops, nail salons and gyms; bars and wineries; movie theaters; and other nonessential indoor activities will remain closed. Restaurants will be limited to takeout or delivery, and retail businesses can operate at 20% capacity.
Currently, health officials say they are still dealing with the aftermath of Thanksgiving gatherings and subsequent surges. Another holiday surge could potentially make other resources unavailable, too.
"Right now, we haven't been in a situation where there are two people gasping for breath and there's just one ventilator. We could get there," Kamal said.
Already, hospitals have been forced to "get creative" with where they keep patients, said Jeff Chien, Valley Medical Center's director of emergency services.
"We are getting very creative with places to see patients and patients are struggling. Some folks look like they are drowning while they are sitting in bed in front of us," Chien said. "The ER is full. Folks are waiting for beds."
The only way to mediate post-holiday surges, Chien said, is to continue to follow health order directives: stay home, wear a mask and socially distance.
"I'm begging everyone to help us out because we're not the front line," Chien said. "We're the last line."