On the last day of a very difficult year, San Francisco extended indefinitely its shelter-in-place and travel quarantine orders while Bay Area public health officials made a final desperate plea for people to ring in 2021 at home and skip the exuberant celebrations.
The year-end totals of coronavirus cases and deaths painted a devastating portrait of the United States’ poorly handled battle with the pandemic. Roughly 20 million cases were reported nationwide, representing nearly a quarter of the total cases worldwide and totaling more than any other country. More than 340,000 Americans died of COVID-19 in 2020.
California and the Bay Area fared better than most of the country, even with this latest surge that has put unprecedented pressure on hospitals across the state. California reported about 2.3 million coronavirus cases for the year, and about 25,500 deaths. The Bay Area had about 260,000 cases and 2,500 deaths.
“Like many people, I will be very happy to see this year behind us,” said Dr. Ahmad Kamal, director of health care system preparedness for Santa Clara County, in a news briefing Thursday during which he begged people not to celebrate the end of the year with parties and other gatherings.
“Please, have a very happy new year,” he said. “There will be time to celebrate, there will be time to gather. It’s not now.”
With coronavirus case counts and hospitalizations still climbing across the Bay Area, though at a slower pace than a week or two ago, public health officials said they are not confident that the region is past the worst of the current surge and warned that demand for intensive care could rise dramatically with a post-holiday spike in COVID-19 patients.
The Bay Area region, which the state defines as the usual nine counties plus Santa Cruz and Monterey counties, was at 8.5% ICU availability as of Thursday. Southern California and the San Joaquin Valley remained at 0% ICU availability; the sprawling, population-dense regions have been well over capacity for two weeks.
Public health orders
San Francisco officials said Thursday that the city’s travel quarantine and stay-at-home orders will remain in place for at least two or three more weeks. They will re-evaluate the end dates after the anticipated Christmas and New Year’s Eve coronavirus surges have passed.
San Francisco is in far better shape than most of the state and the Bay Area, with around 30% of ICU beds still available as of Thursday. But the city is not immune to the effects of the pandemic beyond its borders, public health officials said. Extending the local public health orders are a reflection of that.
They extended the travel quarantine order in part to prevent a new, more contagious strain of the coronavirus being imported from other parts of the country into the city. The new strain, first identified in the United Kingdom, was found this week in San Diego County and Colorado and likely is circulating in other places, infectious disease experts said.
Meanwhile, watching hospitals across much of the state struggle to keep up with extraordinary demand for ICU beds has underscored for local authorities how important it is to protect the local hospital capacity, and keep in place a stay-at-home order that appears to be dampening the Bay Area surge.
“Our cases are still at 247 per day, and even though that’s down from where it was a couple of days ago, we still have to wait to see the impact of Christmas holidays and New Year’s weekend,” said Dr. Susan Philip, the acting health officer for San Francisco.
“This is going to be, hopefully, the last time that we are concerned about this level of surge,” she said. “We concurrently have a vaccine that’s rolling out. (But) this winter period is the most concerning and dangerous period.”
San Francisco’s travel quarantine requires people entering the city from outside the greater Bay Area to stay at home for 10 days. The previous order was set to expire on Jan. 4.
The stay-at-home mandate was put in place by San Francisco on Dec. 6 and then ordered by the state Dec. 17, when Bay Area ICU availability dropped below 15%. The state order was to take effect for at least three weeks and could have been lifted as early as Jan. 8, but San Francisco officials said that will not happen.
No other Bay Area counties have said whether they plan to similarly extend local stay-at-home orders.
All of California, except the sparsely populated northern region, is currently under state-mandated stay-at-home orders. The order for greater Sacramento could be lifted as early as Friday, though that region fell under 15% ICU availability on Thursday, after more than week of reporting above that threshold. State officials said the Sacramento order likely would be extended.
Cases and deaths
Coronavirus cases in the Bay Area have leveled off this week, though some of that may be due to reporting lags, with some counties providing sporadic updates over the holidays. Through Wednesday, the Bay Area was reporting on average 3,424 cases a day, down 12% from 3,879 cases a day the previous week.
Statewide, cases keep climbing, though somewhat more slowly than earlier in the month. The state has reported on average 44,280 cases a day this week, up 18% from 37,537 cases a day the previous week. But this week’s average includes a record-crushing 66,726 cases on Monday, which probably included cases that hadn’t been reported on or around Christmas.
Deaths have been fairly stable in the Bay Area this week, so far. But the state reported more than 400 deaths two days this week, both new records for the pandemic. The state toll is being driven by Los Angeles County, where the Public Health Department posted a tweet every 10 minutes all day Thursday to mark a new death from COVID-19.
Hospitals and intensive care
Total hospitalizations for California rose slightly on Wednesday to 20,625, including 2,075 for the Bay Area. The number of COVID-19 patients in intensive care also was relatively flat day over day. About 4,400 people were in the ICU with COVID-19 statewide, including 507 in the Bay Area.
Hospitals across Southern California and the San Joaquin Valley remain under extreme pressure, in some places pushed far past capacity as critical patients were treated in the emergency room, as well as in parking lot tents and converted conference rooms and gift shops.
Some hospitals were running dangerously low on oxygen and sterile water, which is used in nebulizer machines to treat COVID-19 patients with difficulty breathing. Bay Area public health experts said the crush in other parts of the state wasn’t affecting them directly, but it made them wary of what they could face if local outbreaks get further out of hand.
“I’m talking to my Southern California colleagues sometimes on a daily basis, and I do look at their situation, because we want to be prepared for that potential eventuality,” said Dr. Stephen Parodi, an executive vice president of Kaiser Permanente and an infectious disease expert. “We hope it doesn’t get to that. And that’s part of the reason why it’s so important that we beat the drum of the public health measures here.”
Erin Allday is a San Francisco Chronicle staff writer. Email: eallday@sfchronicle.com Twitter: @erinallday
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January 01, 2021 at 12:26AM
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S.F. extends local stay-at-home order and travel quarantine - San Francisco Chronicle
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