COVID wave pushes California to brink of 2 million cases

Using tongs, a man grasps a coronavirus test from a woman at a walk-up testing site.

Published Dec. 22, 2020 Updated Dec. 23, 2020 12:25 AM PT

It took almost 10 months for California to record its millionth confirmed coronavirus case.

Now, just six weeks after crossing that milestone, the state is on the cusp of surpassing 2 million.

The staggering rate of growth demonstrates how widely the coronavirus is circulating statewide and underscores the reality that activities and behaviors thought to be relatively safe just weeks ago now carry a higher risk of infection than ever before.

“Without sustained efforts to stop the surge, we can expect that this tragic trajectory will continue,” Los Angeles County Public Health Director Barbara Ferrer said this week.

There are now 1.96 million confirmed coronavirus cases in California, according to data compiled by the Los Angeles Times.

That includes 62,661 new cases reported Monday — by far the most confirmed in a single day since the pandemic began. Nearly 35,000 more were reported Tuesday.

California averaged more than 45,000 new coronavirus cases a day over the past week — more than seven times the comparable figure from six weeks ago.

At that rate, the state will cross the 2-million mark as soon as Wednesday.

Experts say it’s more important than ever to take steps to prevent infection by wearing masks in public, regularly washing your hands and staying home as much as possible.

Experts and officials also warn against traveling and gathering with those you don’t live with over the holidays. The failure of many to follow those restrictions for Thanksgiving, they say, fueled the record infection numbers.

“We are really making a clarion and desperate call to Californians to not repeat what happened at Thanksgiving,” said Dr. Stephen Parodi, associate executive director of the Permanente Medical Group. “And our hospital systems cannot afford to see another increase like we saw with Thanksgiving.”

The ramifications of the exponential climb in confirmed cases reach far beyond a spreadsheet or newspaper headline. Every newly announced batch foreshadows the inevitability of more people falling seriously ill, and some dying, from COVID-19.

“We are anticipating a substantial increase in the hospital surge,” Gov. Gavin Newsom said Monday.

Already, the number of COVID-19 fatalities, like cases and hospitalizations, has reached unprecedented levels. California averaged 258 deaths per day over the last week, a record and roughly double the number seen two weeks ago.

More than 23,000 Californians have died from COVID-19 since the pandemic began, a milestone crossed Tuesday.

On Tuesday, 375 deaths were reported statewide, according to a county-by-county tally conducted by The Times, marking the second worst death toll in a single day, just shy of the record recorded Dec. 16, when 394 deaths were recorded.

Los Angeles County on Tuesday tallied 96 new deaths, the third highest single-day count, pushing its cumulative death total past 9,000 for the first time. L.A. County is now averaging 85 deaths a day over the past week, a record.

Fresno County reported 89 deaths Tuesday; previously, the largest number of fatalities it reported in a single day was 28, which happened on Dec. 11. Fresno County is now reporting nearly 2,000 new coronavirus cases a day over the past week, nearly seven times worse than the comparable number from Thanksgiving.

Fresno County is now averaging 13 deaths a day from COVID-19 over the past seven days; the comparable number from Thanksgiving was two deaths a day.

On Monday, the most recent day for which complete data are available, there were record-high numbers statewide of COVID-19 hospitalizations — 17,843 — and patients in intensive care — 3,755.

Those numbers have ballooned by 69% and 55%, respectively, over the last two weeks.

Officials say they expect those statistics to climb further as some of those who were recently infected fall ill and start showing up in emergency rooms.

“We believe that 12% of today’s cases will be hospitalized 12 days from now, and then 12% of those hospitalized patients will be admitted to the ICU for critical-care needs,” Dr. Mark Ghaly, California’s Health and Human Services secretary, said Monday. “Looking at the cases day-over-day and the trajectory we are on, we are worried that certain regions do exceed their existing capacity — and even may go beyond the existing surge capacity that they currently have planned.”

Of particular concern are the state’s ICUs, which provide specialized care to those who are critically ill or injured.

The torrent of COVID-19 patients has stretched some of those units to their limits. As of Tuesday, ICU availability remained at 0% in Southern California and the San Joaquin Valley, according to state figures.

That doesn’t mean there are no unoccupied beds, as the state uses a weighted formula to ensure that some remain open for non-COVID patients. But officials and experts warn that an overcrowded ICU can overburden doctors and nurses, imperiling the quality of care for everyone who needs it.

“It is true that some counties, or some regions, may begin to exceed their existing stated hospital capacity — not just ICU capacity — by the end of the month and early in January,” Ghaly said. “We don’t see that across the entire state quite at that time, but we’re watching it very closely.”

Statewide, 1.4% of ICU beds were available Tuesday.

In the face of the ongoing surge, state officials and representatives from three large healthcare systems — Kaiser Permanente, Sutter Health and Dignity Health — issued a joint call Tuesday for Californians to do their part to stave off coronavirus transmission by not “sharing their air.”

While healthcare workers are a vital last line of defense for those in need of medical attention, officials said it’s incumbent upon all Californians to be the first line and protect themselves from becoming infected.

“We are tired. We are going home and fearful for what we might bring home to our family,” Dr. Vanessa Walker, medical director of the Sutter Health Valley Area electronic ICU, said during a press conference. “We are struggling every day to deal with the same fatigue that you have — not being able to go out and enjoy the things that we used to. ... We’re asking you to please do your part and continue to avoid gathering indoors, avoid sharing your air.”

In L.A. County, home to 10 million people, a point-in-time survey found that there were 30 available ICU beds as of 9 a.m. Sunday. A similar tally last week found 69.

“Today, we’re over 100% of our usual patient volume, and of that volume, 52% of our inpatients are patients diagnosed with COVID,” Greg Adams, chairman and chief executive of Kaiser Permanente, said Tuesday. “Sixteen of our 36 hospitals are already above 100% occupancy in our ICUs. We’re struggling to add capacity for COVID patients as we speak.”

Already, hospitals are having to step up measures to ensure that the sickest patients get the highest level of care possible. That includes moving some patients who would typically be in the ICU to other areas of the hospital, such as a recovery area, or keeping them in the emergency room for longer than normal.

The overriding concern, though, is not physical space but having enough trained healthcare professionals. Unlike in localized disasters, such as an earthquake or hurricane, the latest surge of COVID-19 is hammering the entire country — meaning resources are stretched thin nationwide, and healthcare staff are overworked and exhausted.

Officials fear a time may come when there are simply too many critically ill patients for the limited numbers of ICU doctors and nurses available. In other areas where hospitals have become overwhelmed, such as New York City and northern Italy, the death tolls have been severe.

Dr. Thomas McGinn, executive vice president of physician enterprise with Dignity Health, said he worked in New York earlier in the pandemic and “saw patients, firsthand, suffering. I saw the families suffering. I saw the healthcare teams exhausted, working around the clock.

“I know it’s been a long road for everybody. It’s been nine months; we’ve all been wearing masks; we’re tired of doing this,” he said Tuesday. “But this is the time, right now, that we need to be most conscious of this. If you want to celebrate next year with your family and your friends and your loved ones, now is the time to be disciplined. Now is the time to stick with it.”

San Francisco Mayor London Breed said Tuesday that local coronavirus cases have begun to level off, as residents have been moving around less in the past two weeks. She urged residents to continue staying home as much as possible, warning that failing to heed that call could have dire consequences.

“Nothing scares me more than if we get to a point where we have to turn someone away from the hospital,” she said. “I don’t even want to look someone in the eye and and say that their mom or dad died because we didn’t have space in our hospital for them.”

While healthcare systems are doing all they can to manage the influx of patients, officials say they’re worried they won’t be able to keep pace if the numbers continue rising as they have.

That’s why recent images of “people out and about, lots of people in parks ... busy shopping centers and retail centers” are tremendously troubling, according to L.A. County Health Services Director Dr. Christina Ghaly.

“If you’re still out there shopping for your loved ones for this holiday season, or you’re planning a holiday get-together, then you are missing the gravity of the situation that is affecting hospitals across Los Angeles County and California and this nation,” she said. “People are very sick in the hospital. They are dying there. And our hospitals may not have the equipment or the capacity or the resources to take care of you in the way that you need or expect.”

Times staff writers Susanne Rust, Sean Greene, Sandhya Kambhampati and Jennifer Lu contributed to this report.