Screenshot from Gov. Gavin Newsom's press conference announcing a new regional stay-at-home order on Dec. 3, 2020
(Office of California Governor)
COVID 2021

Can new stay-at-home order, tied to ICU beds, curb state’s COVID-19 surge?

Gov. Gavin Newsom announced Thursday the strictest measure in months for a regional stay-at-home order tied to ICU hospital bed capacity in the face of a statewide coronavirus surge.

“The effects of Thanksgiving have not yet been felt. Dr. Fauci said it best — he said we should anticipate a surge on top of the surge. These are pre-Thanksgiving numbers,” Newsom said Thursday.

This new order will be based on the ICU capacity of five different regions in the state — with Santa Cruz County falling in the Bay Area region. Though no region has met the threshold, the governor is warning parts of California could cross the new threshold for mandating people stay within their households as much as possible when a region’s ICU capacity drops below 15%.

A graphic map of California divided into five regions.
(State of California)

ICU actual capacity as of December 3, 2020 for the 5 regions:

Northern California18.60%
Bay Area25.30%
Greater Sacramento22.20%
San Joaquin19.70%
Southern California20.60%

Counties included in the Bay Area region are Alameda, Contra Costa, Marin, Monterey, Napa, San Francisco, San Mateo, Santa Clara, Santa Cruz, Solano, and Sonoma counties.

The Bay Area region currently has a total ICU capacity of 25.3%. But if current trends continue, it could fall below the 15% capacity threshold by mid- to late-December, Newsom said. And individual counties could implement their own stricter rules whenever they like — as neighboring Santa Clara County has done.

Santa Cruz County currently has 18 out of 37 ICU beds occupied and half of those patients have COVID-19. This puts the county’s ICU capacity at roughly 49% Thursday.

The new regional stay-at-home order is different from the first order that came in the early days of the pandemic. Here...

But because capacity is assessed regionally, and not by county, “our numbers have very little to do with the expanded stay-at-home order, given our relatively small size in the overall Bay Area,” said county spokesperson Jason Hoppin.

Under the order, people would have to stay home as much as possible, although they can still go out for essential things like groceries, exercise and doctors appointments. K-12 schools that have reopened can remain open, and retail stores can operate indoors at 20% capacity. Bars that serve food and restaurants would have to curtail outdoor drinking and dining but would remain open for takeout and delivery.

“We are at a tipping point in our fight against the virus and we need to take decisive action now to prevent California’s hospital system from being overwhelmed in the coming weeks,” Newsom said in a statement.

If a region dips under the 15% ICU capacity, the regional order will be triggered within 48 hours, according to the Governor’s office. Once triggered, the stay-at-home order will be applied for three weeks. After that, any reopening of closed services and activities will be based on four-week projections of a region’s ICU capacity — suggesting the broad new restrictions could easily last through the end of the year in some communities.

Over the last few days, Newsom said the 14-day coronavirus positivity testing rate had gone up from 5.2% to over 7%. Hospitalizations had increased by 86% and hospitalizations in ICUs around the state had increased by 67%, he said.

According to figures released Thursday, the U.S. logged more than 3,100 COVID-19 deaths in a single day Wednesday — more than 20% higher than the previous record set last spring — while the number of Americans hospitalized with the coronavirus eclipsed 100,000 for the first time and new cases are topping 200,000 a day, the Associated Press reported.

Data compiled by Lookout content partner, the LA Times, shows the state has averaged nearly 15,000 cases a day over the last week, triple the rate in the last month. COVID-19 hospitalizations have also tripled over the same period. And an average of 67 Californians were dying daily from COVID-19 over the last week, a 60% jump from mid-November.

Santa Cruz County has reached an official death toll of 37, at least 25 of them related to outbreaks in skilled nursing or residential care facilities. Most of the fatalities (35/37) were in patients over 65, and most (28/37) had at least one underlying condition.

Unlike the shutdown Newsom issued in the spring, most outdoor activities including beach access and hiking will not be affected. But similar to other state government rules, it allows local leaders to impose public health rules that are more strict.

Some epidemiologists say state officials may have no choice but to impose a stricter shutdown order to avoid one of the worst public health catastrophes in the state’s modern history, with California’s death toll of nearly 20,000 plausibly doubling by the end of winter.

The initial coronavirus wave “has now become a viral tsunami,” said Dr. Robert Kim-Farley, a medical epidemiologist and infectious disease expert at the UCLA Fielding School of Public Health. “The virus is now everywhere, and so, therefore, the restriction of activities needs to also be applied everywhere to be able to return to where we were — on a decreasing trend.”

If triggered, the businesses that will remain open under a regional stay-at-home order are:

  • Schools that are already open
  • Critical infrastructure
  • Retail (20% capacity to reduce exposure)
  • Restaurants (take-out and delivery)

Those that will be temporarily closed:

  • Bars
  • Wineries
  • Personal services
  • Hair Salons/ barbershops

Contributing: LA Times, CalMatters

If you missed the press conference, you can watch it below: