The latest and deadliest coronavirus boom has blown up in California, leaving no country untouched in the massive and diverse state, from dense, busy subways to vast suburbs to vast rural and agricultural lands.
Yet different parts of the state felt the impact very differently.
The main tension of the latest boom is the availability of intensive care units. Government officials, fearing an increase in Thanksgiving would overwhelm hospitals in some cases, have set an ICU availability threshold of 15% to trigger regional shutdown orders. The restrictions apply to four of five regions, which make up more than 98% of the state’s residents.
In Northern California, the only region not living at home, nearly one-third of ICU beds are still available. Greater Sacramento is at 17.4%, and the Bay Area region was last reported at 7.5%.
Both the San Joaquin Valley and Southern California regions are at 0%.
These and other data comparisons highlight the differences between the provinces and metro areas in the state, especially between the northern and southern parts of the state.
THE BAY ENVIRONMENT
The Bay Area as a whole performs better than some of the most populous areas in and around Los Angeles. The Bay Area’s number of new daily cases per 100,000 inhabitants has fluctuated between the 40s and the mid-50s over the past few weeks.
“This may reflect the high masking compliance, high ventilation in our area due to the location and general distance compliance in the Bay compared to other regions,” said Monica Gandhi, an infectious disease specialist at UCSF.
She added that a “general confidence of public health officials in the Bay Area, leading to greater compliance with home measures”, may also explain why the boom here is not as severe compared to Southern California.
Case rates differ quite a bit in individual provinces in the Bay Area. The counties of San Francisco and Marin have recent daily falls, while Solano, Santa Clara and Napa are about twice as high. But it is still falling below the state’s daily business rate, which was in the high 90s and low 100s this past week.
Solano County still leads the Bay Area with the highest daily incidence. The province’s health official attributed the boom to Thanksgiving and other weekend gatherings and activities, and individuals who continue to gather or go to work with others, even though they know the risk or symptoms.
Santa Clara County also recently recorded high daily dropout rates – mostly in the mid-60s per 100,000 people. Dr. Ahmad Kamal, director of the province’s health preparedness, said Santa Clara had 28 ICU beds, or 8.5% availability, as of Wednesday. He said that pandemic fatigue is the most important factor, and that color communities in the southern and eastern part of the country bear the heaviest.
Kamal said the province five days after Christmas had not yet seen a resurgence comparable to that which took place after Thanksgiving, and he hoped residents canceled plans and took extra precautions during the holiday.
“We have great concern with New Year’s Eve, which has traditionally been a common time to get together, especially among young people who feel they have a low risk or are not as susceptible to the virus,” he said.
Kamal said any further increase would lead us a little over the edge to the point of Southern California, where patients are treated in gift shops and corridors in the hospital.
“We stumble on the threshold and wait with bated breath waiting for New Year’s Eve,” he said. “We are not quite there yet, but we are very close.”
GREATER SACRAMENTO REGION
Sacramento County cases have recently been close to the Bay Area average, dropping from the low 60s to the mid-50s per 100,000 population. In a board of supervisors on Wednesday, dr. Olivia Kasirye, public health official, said the country had an average of 800 cases and ten additional deaths a day before Christmas, and after the holidays it was 664 cases and six deaths a day.
“It looks like we’re starting to move in the right direction, but it’s still too early to know,” she said. “We have not seen the impact of Christmas and the journey our residents have made during that time, so we are still very careful about the direction the numbers go.”
While the availability of ICUs in Sacramento County is currently higher than the 15% closure threshold in the state, the health official said the shelter may not be lifted any time soon if there is a holiday increase, and patients in other overwhelming areas may need to be moved. to hospitals in the Sacramento region. Earlier this month, the province began treating some COVID-19 patients at an alternative care facility set up in Sleep Train Arena.
SOUTH CALIFORNIA
Southern California has been overwhelmed by the latest boom, with cases so rampant that it has pushed the state’s rate to number 1 in the country.
Robert Kim-Farley, a professor at the UCLA Fielding School of Public Health, attributes the rise to pandemic fatigue. Provinces in Southern California are also starting from a higher baseline, and many have never reached the very low levels that the provinces in the Bay Area saw in October.
“With such high levels of the disease, the chances are much greater to go to the store and come in contact with the virus,” he said. “It’s going to be a snowball effect.”
The composition of the workforce in Southern California also made the region vulnerable. Provinces of San Bernardino and Los Angeles in particular have a large number of people working essential jobs in the manufacturing sector. Many are Latino and live in densely populated areas with lower incomes where the virus can spread more easily.
According to state data, San Bernardino County has the highest seven-day average rate in the state at 165.5 per 100,000, the highest positive test rate at 23% and the highest positivity rate among underprivileged communities at 26.8%.
Los Angeles County also has, according to statistics, one of the highest cases with 132.7 per 100,000, with a positive test score of 16.5% and a positive rate of 23.4% for the health equality test. Hospitals in the state of Los Angeles were overloaded, and some ambulances placed their patients in gift shops and conference rooms. Officials fear if it gets much worse, hospitals may have to start rationing.
Los Angeles County has by far the largest population in California, with more than 10 million inhabitants, and is racially and economically diverse. Experts say the city was vulnerable to a pandemic from the beginning. According to the CDC, the province has a high social vulnerability, indicating how a natural disaster or disease outbreak could affect the health of a community. The neighboring counties of San Bernardino and Riverside have even higher scores.
Kim-Farley said that occasional mixed messages from provincial leaders have led to residents’ confusion, including from the divided council of supervisors, some of whom want to reopen the economy, and others who want strong measures from the Department of Public Health continue.
“People are not united around a common vision and common message, and that confuses people,” Kim-Farley said. “It was a problem at many levels of government.”
In neighboring Orange County, the case averaged 104 per 100,000 people last week. Hospitalizations increased by 225% compared to a month ago. While home ordering has expanded in the Southern California region, meaning restaurants are closed for personal dining, some Orange County restaurant owners have defied the restrictions by using the hashtag #OpenSafe.
On Tuesday, Riverside County recorded 73 deaths, a state high.
The California National Guard deployed medical corps members to support an understaffed provincial hospital, and overflowing patients waiting to open beds were placed in the facility’s cafeteria.
Kim-Farley said the provinces of Southern California are experiencing their “New York moment.” At the start of the pandemic, the case in New York skyrocketed and hospitals were overwhelmed.
“I think we are going to see another increase in the next few weeks due to the strengthening that is taking place during the holidays,” he said. “There’s a light at the end of the tunnel with vaccines, but the tunnel looks uglier and uglier to get through.”
Todd Trumbull designed the graphics in this article.
Kellie Hwang is a staff writer for the San Francisco Chronicle. Email: [email protected]