Coronavirus outbreaks are in high demand in Gulf hospitals, and some counties fear they may exceed capacity over the next two to three weeks, especially if they see a further jump in cases after Thanksgiving, public health officials said Friday.
The dreadful warnings came when San Francisco officials said they expected the city to land in the state’s most restrictive purple layer early next week, perhaps Sunday. This would put the city under the new police regime and force almost all indoor activities to be closed.
New weekly coronavirus cases have tripled more than three times in the past month, said Dr. Grant Colfax, director of the San Francisco Department of Public Health, in a news briefing. Models suggest that if the current jump continues unabated, “we could probably have hundreds of people in the hospital by the end of December or the beginning of January.”
Santa Clara County Health Officer Dr. Sarah Cody said the county reported 407 cases on Friday, more than ever during the pandemic, and hospitalizations have increased by 50 percent in the past week. If this growth rate continues, the county will exceed hospital capacity in about three weeks, she said.
“Cancel your vacation plans,” Cody told a news conference. “The choices each of us makes over the next two weeks can mean the difference between enough hospital capacity to care for all of us and not enough.”
Daily coronavirus cases in California and the Gulf region have doubled in the past month, and the state has reported 10,000 cases a day four times this week, peaks not seen since the height of the summer tide. California reported a record 13,422 cases on Thursday.
However, this wave is much more disturbing than the summer tide. The growth rate is already steeper, and only Thanksgiving can lead to an even more drastic increase in cases over the next few weeks. Public health officials are increasingly urging people to stay home during the holiday and not get together.
The recent curfew aims to try to limit some of this activity. Public health officials say full locking in the form of a new on-site shelter is still an option.
“We have fallen into a wave that has the potential to overwhelm our local health system … and force us to take shelter on the spot,” Colfax said.
After San Francisco retired to the purple floor, internal operations such as museums, movie theaters, gyms and places of worship would cease within 24 hours. Curfew, which requires minor activities to stop between 22:00 and 5:00, will take effect two days after the transition to purple.
The new restrictions will also include a ban on indoor social gatherings, which are currently allowed for a maximum of three households. Assuming the new restrictions land before Thursday, it will force Thanksgiving rallies – which the city is strongly discouraged anyway – out.
As of Friday, 41 of California’s 58 counties, representing nearly 95% of the state’s population, were in purple. Gov. Gavin Newsum issued a one-month evening order for all purple counties on Thursday and takes effect at 10 p.m. on Saturday. Currently, six of the nine counties in the bay are in purple.
Public health officials hope the curfew, along with other efforts to discourage people from gathering or interacting with those outside the home, will help slow the number of new infections and prevent hospital congestion, something that the bay area managed to do through previous pandemic waves. Even when hospitalizations peaked at about 800 in the Gulf region in July, there was still enough capacity.
But just as cases are exploding at an unprecedented rate, hospitalizations are also increasing. And the number of hospitals usually lags behind by 10 to 14 days after the cases, so the new infections that are now being reported are not yet straining the healthcare system.
As of Thursday, 511 people had been hospitalized with COVID-19 in the Gulf region and 4,755 in the state. Both numbers have increased by about 40% over the previous week. The number of intensive care units increased by about 35%, with 139 patients in the Gulf region and 1,240 across the country on Thursday.
In addition to the expected increase in patients with COVID-19, hospitals are now fuller than in the spring and summer, health care providers said. Hospitals are trying to catch up with patients who delayed care earlier in the pandemic and this time did not stop elective procedures or advised people to postpone routine appointments.
“We are definitely concerned that hospitals are starting from a place of greater use and adding to that with COVID-19,” said Dr. Ahmad Kamal, director of health preparedness for Santa Clara County.
Dr Yvonne Maldonado, an infectious disease expert at Stanford, said the medical center was not “almost overexploited” at the moment. But she is worried about the increase in the number of patients not only with COVID-19, but also with the flu and other seasonal respiratory viruses. And like Kamal, she noted that the hospital already has a smaller capacity than earlier in the year.
“A lot of us are starting to eliminate our surge plans that we pulled out back in March, and we’re starting to reconsider our chances of starting to see insurmountable cases,” Maldonado said.
Gulf public health officials are not alone in California concerned about the demand for hospitals. This week, Los Angeles County officials announced hospital-based thresholds that would cause new restrictions on public health. About 1,400 people were hospitalized in Los Angeles on Thursday. If hospitalizations exceed 1,750, the county will close the outdoor table. If they exceed 2,000, the county will issue a new shelter order.
First-line health care providers said they were anxiously watching hospitals fill up in other parts of the country and wondered if that was their fate. The Gulf region has avoided doubling its number of hospitals in earlier waves – they hope the region can do it again. But now the stakes are higher, said Dr. Jahan Fahimi, an emergency physician at UCSF.
Ten countries currently report extremely high hospitalizations, meaning that people with COVID-19 make up more than 15% of all patients, according to federal reports. Dozens of counties across the country had to open outpatient sites to relocate less critical patients and make room for the most needy in intensive care.
Healthcare providers in some places are told to keep working even after the tests are positive for the virus.
“If other states and other places are somehow a barometer of what we’re preparing for, it looks worse than the first and second time,” Fahimi said. “The caveat is that the Gulf region, and San Francisco in particular, has done very well with these other places. I hope we do well after all. But that doesn’t mean it will be great. “
Erin Olday is a staff writer for the San Francisco Chronicle. Email: firstname.lastname@example.org Twitter: @erinallday