California buckles down to beat back COVID

Respiratory isolation tent being prepared outside Palomar Health emergency rooms in March 2020 as COVD-19 began to run wild./Palomar Health Foundation

COVID-19 is running roughshod over San Diego County and California, and state officials are about to clamp down like Junior Seau dropping an opposing running back.

On Thursday, Dec. 3, San Diego County health officials reported 1,504 new COVID-19 cases and five additional deaths. Thursday’s data raise the county’s totals to 86,142 cases and 1,040 deaths

Rising hospitalization rates throughout the state prompted Gov. Gavin Newsom to issue a conditional stay-at-home order. Newsom said the new round of regional stay-at-home orders would take effect as intensive-care beds filled up. Millions of people across Southern and Central California are likely to see outdoor dining shuttered, playgrounds roped off and hair salons closed within days if the available intensive-care capacity in their areas dips below a 15 percent threshold.

The new restrictions will last for at least three weeks, strictly limit store capacity and allow restaurants to serve only takeout or delivery. The governor also said people should temporarily call off all nonessential travel.

“If we don’t act now our hospital system will be overwhelmed,” Mr. Newsom said. “If we don’t act now we’ll continue to see our death rate climb.”

More than 2,750 Americans died of the coronavirus on Thursday, and another 100,000 were in hospitals. Case counts continue to skyrocket.

Although no region met that under-15 percent intensive care criteria capacity threshold as of Thursday, Newsom said the Southern California region could meet it in a matter of days.

The order takes effect Saturday and, once triggered, regions would have 24 hours to implement the rules, which stay in effect at least three weeks. The rules don’t apply to public schools with in-person learning.

“The bottom line is if we don’t act now our hospital system will be overwhelmed,” Newsom said during an online news conference from his home, where he has quarantined with his family for the past two weeks after his children were exposed to the virus. “This is the most challenging moment since the beginning of this pandemic.

Unlike the state’s four-tiered coronavirus monitoring system, which grades every county individually, the new stay-at-home order will apply more broadly to five “regions” in the state: Southern California, the Bay Area, the greater Sacramento area, Northern California and the San Joaquin Valley.

San Diego County has an ICU occupancy rate of 77%. Of 696 ICU beds ready for use, 534 are occupied — 212 by COVID-19 patients, or nearly 40%, according to City News Service.

Counties will be grouped by regional hospital networks and the stay-at-home order will go into effect when the region’s intensive care unit capacity drops below 15%.

Essential businesses can remain open at 20% capacity.

Healthcare workers and nurses from Palomar Health in May 2020 protest against layoffs during the outbreak of the coronavirus disease in Escondido./File

The regions are: Northern California, Greater Sacramento, Bay Area, San Joaquin Valley and Southern California.

The Southern California region, which includes San Diego, is expected to drop below 15% ICU capacity early December, Newsom said.

Sectors that will be temporarily closed for three weeks when a region is placed into the stay-at-home order include:

— Bars

— Wineries

— Personal Services

— Hair Salons / Barbershops

Sectors that will remain open when a region is placed into the Stay-At-Home Order include:

— Schools that have received a waiver

— Critical infrastructure

— Retail (20% capacity to reduce exposure)

— Restaurant (take-out and delivery)

We’re seeing about three times the number that we saw just a couple of months ago,” said Dr. Omar Khawaja, the Chief Medical Officer for Palomar Health. “About 25 percent of the positive patients are ending up in the ICU; that’s less than we saw during the first spike.”

Khawaja said he expects more hospitalizations in the coming weeks as COVID-19 cases related to Thanksgiving gatherings start to show up.

In Escondido, Palomar Medical Center has had room to handle more COVID-19 patients from other hospitals for several months now. A federal medical station is set up inside the hospital with 202 beds that haven’t been used yet.

Khawaja said they’re now ready to take on patients from other hospitals across the county that become overwhelmed, but the set-up is not meant for ICU patients.

“It could be beds that we would be offload some of the less sick patients from other systems into there so they can handle the sicker patients; we don’t have a solid plan for it yet,” he said. “I don’t think it’ll be activated in the next week; it may be three or four weeks out, so we’re planning for that now.”

As he did repeatedly earlier this year, Mr. Newsom emphasized that California would withhold funding from counties that refused to enforce the new stay-at-home order. “We didn’t want to be punitive but we wanted to be firm,” he said. That approach, however, has drawn criticism in the past, as it resulted in piecemeal compliance with restrictions.

The new rules are the Newsom administration’s latest attempt to control a virus that is spreading at rates that astonished health experts. In the last month, the state has pulled the “emergency brake” by imposing restrictions in 52 of the state’s 58 counties, including asking people not to leave the state and implementing an overnight curfew.

The curfew from 10 p.m. to 5 a.m. had little impact, Dr. Mark Ghaly, the state’s top public health officer, acknowledged Thursday. He said data shows people have not curtailed trips outside their homes during the period that is only supposed to be for essential trips.

“We of course had hoped and wanted to see more from that already, but we haven’t,” he said.

As California’s reopening led to a summer surge of the virus, some counties openly resisted putting into place prevention measures, prompting the governor to establish an enforcement task force just before the Fourth of July.

Through November the task force levied more than $2 million in fines to businesses and carried out 4,366 enforcement actions, including 179 citations and three revocations of business licenses. The other actions were mainly warnings.

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