Stay-at-home orders extended for 2 CA regions; some hospitals prepare for "crisis care"

SACRAMENTO, Calif. - California's Secretary of Health and Human Services Dr. Mark Ghaly says the state's hospital system is nearing a breaking point.

Statewide, 20,390 people are in the hospital with COVID-19, a 36.5% increase over the past two weeks, and 4,308 people in the ICU, a 35.1% increase.

"Stretching many of our hospitals pretty far, but we know that stretch has a limit before it breaks," said Ghaly.

Ghaly says the bulk of the issues and overload are in Southern California, where many hospitals are imlementing parts of what's called "crisis care," when resources are stretched thin. "Hospitals that are running out of staff, having to use rooms they don’t traditionally do, much longer than normal wait times," said Ghaly.  

This can lead to decisions like rationing care and resources, though Ghaly says no hospital has reported to the state that they have moved to such a protocol.  

As predicted, California health officials on Tuesday extended a stay-at-home order for the state’s hardest hit counties amid the coronavirus crisis. Ghaly said the lockdown orders will remain in effect for the southern California and San Joaquin Valley regions until intensive care unit projections are above or equal to 15%.

As of Tuesday, the ICU availability rate in both regions remained at zero-percent."We are essentially projecting that the ICU capacity is not improving in Southern California and the San Joaquin Valley and demand will continue to exceed capacity," said Ghaly. 

This is where current available ICU capacity stands on Tuesday: 

• Northern California: 27.9%
• Greater Sacramento area: 19.1%
• Bay Area: 10.4%
• San Joaquin Valley: 0%
• Southern California: 0%

Though central and Southern California must adhere to the state's strict order for a while longer, Ghaly said it does not mean the order is extended for another three weeks. It will remain in place until ICU capacity in those regions improves. Dr. Ghaly also explained how the state calculates its projections: using ICU capacity, 7-day average case rate, transmission rate and rate of ICU admission. The earliest the Bay Area can exit the order is on January 8. 

Ghaly says most of the state is seeing hospitalizations level out, but worries are building about what is to come from the holidays.

The number of cases the state sees in the next couple weeks will show if people still chose to gather on New Year's Eve. The state could see "a significant surge," warned Ghaly. "A significant need to not only deal with what we’ve seen until now, but even more extreme conditions in the middle and second part of January."

Ghaly said the state’s 14-day positivity rate was 12.6%, which is up from the 10.6% reported on Dec. 15.