Coronavirus updates: California ends 2020 with packed hospitals, 1.8 million vaccine doses

Dec. 29—The final few days of 2020 will be a critical moment in the coronavirus pandemic for California, where COVID-19 infections, hospitalizations and deaths have been skyrocketing for nearly two full months.

This week is sandwiched between two major holidays — Christmas last week and New Year's Day at the end of this one — that health officials have warned for weeks have high probabilities of increasing virus spread, as many are likely to gather in group settings despite pleas to avoid doing so.

The holidays' impact likely won't be visible in the data until about a week into January. But California has not yet even escaped the tidal wave of infections that started in November and has since launched the state, which once fared very well considering its vast size, into its dreadful position as the United States' current epicenter.

More than 570,000 of the state's 2.16 million all-time cases for the 10-month health crisis have been reported in the past two weeks, according to the California Department of Public Health. The statewide total for confirmed patients in hospital beds is creeping toward 20,000, including more than 4,200 in intensive care units.

As the state's death toll heads toward 25,000, officials have recorded an average of more than 230 deaths a day over the past two weeks — nearly 100 higher than the peak moving average during the summer surge.

In glimpses of better news, Gov. Gavin Newsom said in a news conference Monday the most recent statewide data do reflect a "moderate" plateau in COVID-19 hospital admissions; they've actually trended slightly downward outside of Southern California, he said.

CDPH data also show test positivity rate is growing at a much slower pace than it was earlier in December, and may also be on something of a plateau. The 14-day average, now 12.5%, has increased 0.7% over the past 10 days, after it had jumped 3.1% in the previous 10-day stretch.

But concern remains high that a post-Christmas surge will cancel out that progress, plunging California into a steeper surge and a deeper hospital crisis next month.

Hospitals are already heavily impacted.

In Northern California, Kaiser Permanente put at least a one-week pause on elective and non-urgent surgeries, postponing those through Jan. 4.

A spokesperson for Adventist-Rideout hospital in Marysville, the only hospital serving the Yuba-Sutter bicounty region, confirmed to The Sacramento Bee on Tuesday the California National Guard has been assisting in its emergency department "for several weeks" and may continue to assist through next week.

"We continue to request our community to wear a mask when out and avoid gatherings," Adventist-Rideout spokeswoman Monica Arrowsmith added in her emailed response.

In the hardest-hit parts of the state, overwhelmed hospital systems have begun conversations about the possibility of rationing hospital care. The Los Angeles Times reported Monday some Los Angeles County hospitals are so flooded they are putting patients in conference rooms or gift shops.

Where does California's ICU capacity stand?

In Southern California and the San Joaquin Valley, which combine for about 27 million of the state's 40 million residents, ICU availability has been at 0% for well over a week.

The situation has become so severe in those regions that, since Christmas Eve last Thursday, statewide aggregate ICU space has been reported at 0% — even as two of the remaining three geographic regions, Greater Sacramento and Northern California, maintain more than 15% availability.

State Health and Human Services Secretary Dr. Mark Ghaly early this afternoon will give updated data projections for ICU capacity. These projections determine whether the tight, regionally based stay-at-home order that was imposed at the start of December will have to be extended beyond three weeks, leaving restaurants' dining rooms and personal care services like salons shut down.

The three-week window has ended for Southern California and the San Joaquin Valley; both are virtually certain to have the order extended today, given their long streak of 0% availability.

The outlook is less clear for Greater Sacramento, which has fluctuated near but mostly slightly above the 15% cutoff trigger and will reach three weeks within the order on Thursday; and for the Bay Area, which recently fell under 10% availability but won't have its ICU situation reassessed until Jan. 8.

The sparsely populated Northern California region is the only one not to have entered the order, having stayed between about 25% and 30% ICU capacity since the new system was introduced.

What's the latest on vaccine planning, distribution?

The state is slated to receive its second round of Moderna vaccines and third round of Pfizer doses by the end of this week. The state is now expected to end 2020 having received about 1.8 million COVID-19 vaccines, after initially projecting it would receive 2.1 million.

Newsom said more than 260,000 vaccine doses have been administered in California as of Saturday. The early "Phase 1A" doses are dedicated to front-line health care workers who deal directly with COVID-19 patients, as well as skilled nursing facilities.

California is entering a vaccine partnership with Walgreens and CVS, whose pharmacy staffs will administer vaccine doses in high-risk sites like nursing facilities.

"We didn't want to use staff or key supplies and pull it away from our other efforts," Newsom said Monday.

Plans for Phase 1B could be finalized as early as Wednesday, Newsom said, with those shots likely starting to be administered in the next few weeks.

California's vaccine advisory panel met last week to discuss the phases. The committee says Phase 1B should include people who are at high risk of exposure due to working in "selected" critical infrastructure jobs; people ages 75 and older; and people aged 65 through 74 who have medical conditions that place them at higher risk of severe COVID-19.

In that same proposal, Phase 1C — which is farther away from being finalized — would see doses go to more essential workers not included in 1B, those ages 65 through 74 who do not having existing medical conditions and people ages 16 through 64 who do have such a condition.

Newsom also Monday issued a stern warning to medical providers about what will happen if they let a friend or relative cut in line to receive the vaccine.

"I just want to make this crystal clear: If you skip the line or you intend to skip the line, you will be sanctioned, you will lose your license. You will not only lose your license, we will be very aggressive in terms of highlighting the reputational impacts as well."

Gig workers overpaid by federal aid program can file waiver

The new COVID-19 stimulus package passed by Congress and signed by President Donald Trump on Sunday includes a provision meaning many California gig workers and independent contractors won't have to repay portions of overpaid unemployment aid.

The previous relief bill passed in March established a program called Pandemic Unemployment Assistance for self-employed workers and gig workers.

But due to a lack of clear communication regarding whether workers were supposed to report gross or net income, many PUA recipients were overpaid, some of them by thousands of dollars.

The clause in the latest relief bill means many workers won't have to repay California the overpaid aid if they can show they filed their PUA application in good faith — or, as the bill phrases it, if a repayment "would be contrary to equity and good conscience."

Six-county Sacramento area on brink of 100,000 cases

The six-county area of Sacramento, El Dorado, Placer, Sutter, Yolo and Yuba counties entered Tuesday just a few hundred cases shy of 100,000 combined, confirmed COVID-19 cases over the course of the pandemic. At least 1,146 have died.

Sacramento County has reported a total of 63,131 infections since the onset of the pandemic, and 827 residents have died of COVID-19. County health officials on Monday added 3,361 additional cases for a four-day reporting period including Christmas and the weekend, along with 18 newly reported virus deaths.

By date of death occurrence, the county now reports 152 deaths for Dec. 1 through Dec. 22, including 148 in just the first 18 days of the month. December has surpassed the 144 from November to become the second-deadliest month of the pandemic for Sacramento County residents. The current month remains on track to surpass 200, well exceeding the 181 deaths from August.

Virus hospitalizations in Sacramento County have declined in the past few days while the ICU patient total remains elevated. The overall total in hospital beds fell from a record-high 518 reported Wednesday to 452 in Sunday's update, then increased back to 463 Monday.

State data showed 94 ICU patients countywide as of Monday, down from 99 on Sunday, with 95 ICU beds still available. That's the most free ICU beds for the county since Nov. 11.

Placer County health officials have reported a total of 13,055 infections and 125 deaths. The county reported 793 new cases and five new deaths for the four-day period of Christmas through Monday.

State data showed Placer on Monday surpassing 200 hospitalizations for the first time, hitting 201 with 26 in ICU beds. ICU availability fell from 23 beds Sunday to 20 on Monday. Placer on its local dashboard as of Monday reported higher totals of 208 hospitalized and a record-setting 32 in ICUs, but also reported 20 ICU beds still remaining available.

Yolo County has reported a total of 7,810 cases and 109 deaths. Only 18 cases were reported Monday, according to the county's dashboard. The county's last death was reported Thursday.

State data showed Yolo with a record-tying 29 confirmed COVID-19 patients in hospital beds including 13 in ICUs as of Monday.

El Dorado County has reported 5,509 positive test results and 18 deaths. The county reported 414 new cases and five additional deaths Monday for the four-day reporting window that included Christmas.

After suffering just four deaths through the first eight months of the pandemic, El Dorado has had at least 14 residents die of the virus in a little more than three weeks.

Health officials say 28 people are hospitalized with the virus, up three compared to Sunday. Nine are in ICUs, up from five reported on Christmas Eve. State data on Monday showed four ICU beds available in El Dorado County, down from 11 early last week but up from two on Sunday.

In Sutter County, at least 6,290 people have been infected and 49 have died. The county added 253 cases and three deaths in a four-day update. Sutter reported 53 residents hospitalized Monday including 11 in intensive care, up from 51 and seven last Thursday.

Neighboring Yuba County has reported 3,805 infections and 17 dead, with 177 new infections and one fatality reported over the holiday weekend. Twenty-seven Yuba residents were reportedly hospitalized as of Monday, the same count as last Thursday, with five in intensive care.

Not all of those patients are necessarily hospitalized in-county, but the only hospital serving the bi-county region — Adventist-Rideout in Marysville — had a record-high 68 virus patients as of Monday's update from the state, including 14 in the ICU. Only one ICU bed remained available as of that update.

The Bee's Jeong Park and Andrew Sheeler contributed to this story.

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