SAN DIEGO (CNS) - As expected, a regional stay-at-home order in effect across Southern California due to surging COVID-19 hospitalizations was formally extended Tuesday, continuing a ban on all gatherings of people from different households and in-person dining and setting strict capacity limits at many businesses.
The state's regional order, which covers an 11-county Southern California area, took effect at 11:59 p.m. Dec. 6 and was set to expire Monday. But with the region's intensive-care unit capacity at hospitals still officially listed at 0%, Gov. Gavin Newsom said Monday the order was all but certain to be extended. The state's Health and Human Services Secretary, Dr. Mark Ghaly, made it official Tuesday, saying incoming COVID-19 patients are expected to continue exceeding ICU capacity in the region over the next four weeks.
The order was not extended for any specific timeframe. Ghaly said the four-week projections are evaluated daily, and the region can emerge from the stay-at-home order whenever the projection indicates a region's ICU capacity will rise above 15%.
The four-week projections are based on four factors: current ICU capacity, the region's seven-day average daily new case rate, the transmission rate and the rate of ICU admissions.
With the Southern California region's current ICU capacity is still listed at 0% -- and health officials anticipating case numbers and hospitalizations to rise throughout January based on gatherings that likely occurred for Christmas and will again for New Year's Eve despite warnings -- the region is expected to remain under the order for weeks to come.
"We should expect that the hospitals that are under duress, that are in crisis already, will continue to see a high number of patients knocking on the door asking for care. Ambulances that still need to find a place to drop off a patient so they can get back in the field to support other patients who need care," Ghaly said. "... All of those trends tell me and give me continued concern that we need to continue to work to prepare for (the) next holiday surge of cases into the early part of next year, and that likely ... in the middle of January we will see a significant higher number of cases than we have today of individuals with COVID who need hospital-level care."
In anticipation of the state's action, Los Angeles County on Sunday night extended its local stay-at-home order, which essentially mirrors the state's restrictions.
The state also extended the stay-at-home order for the San Joaquin Valley. Four of the five regions carved out by the state are under stay-at-home orders, covering 98% of the state's population. Only far northern California is not under a stay-at-home order.
The Southern California region covers Los Angeles, Orange, Riverside, San Diego, Imperial, Inyo, Mono, San Bernardino, San Luis Obispo, Santa Barbara and Ventura counties. Most broadly, the order bars gatherings of people from different households.
Under the order, the following businesses/recreational facilities were forced to close:
-- indoor recreational facilities
-- hair salons and barbershops
-- personal care services
-- museums, zoos, and aquariums
-- movie theaters
-- bars, breweries and distilleries
-- family entertainment centers
-- cardrooms and satellite wagering
-- limited services
-- live audience sports
-- amusement parks
Schools with waivers can remain open, along with "critical infrastructure" and retail stores, which will be limited to 20% of capacity. Restaurants are restricted to takeout and delivery service only. Hotels are allowed to open "for critical infrastructure support only," while churches would be restricted to outdoor only services. Entertainment production -- including professional sports -- can continue without live audiences.
The order was triggered in each area when the region's ICU bed availability dropped below 15%. In some counties, the official ICU bed availability is 0%. That percentage does not mean that there aren't any ICU beds available, since the state adjusts the number based on the ratio of COVID- 19 patients being housed in the units.
Newsom noted Monday that COVID-19 hospital admissions have begun to plateau across much of the state -- except in Southern California, with Los Angeles, Riverside and San Bernardino counties continuing to be the hardest hit.
Los Angeles County has rapidly become the epicenter of the pandemic in the state, with the state reporting more than 7,400 COVID-19 patients in L.A. County hospitals as of Tuesday, including nearly 1,500 in intensive-care unit beds. Newsom said 96% of Los Angeles County hospitals diverted ambulances to other facilities at some point over the weekend due to overcrowding in emergency rooms -- up from a normal average of 33% of hospitals going on diversion.
According to Newsom, county hospitals on average spent 16 hours on diversion over the weekend, unable to find space for emergency patients.
Ghaly said hospitals are doing the best they can under trying circumstances, and while some Southern California medical centers have begun taking steps that might be considered part of "crisis care," none have fully entered that mode and been forced to make decisions such as rationing equipment like ventilators.
Ghaly again preached compliance with health orders such as staying at home as much as possible, wearing a face covering and practicing social distancing.
"Much of what we're dealing with is avoidable," he said. "Much of what we're seeing can be stopped if we collectively make decisions to stop it."
Newsom on Monday had harsh words for counties and county officials who continue to "thumb your nose" at health orders. He singled out Riverside County, where Sheriff Chad Bianco has publicly criticized Newsom and said his agency would not be "blackmailed" into becoming an enforcement arm of state health officials.
Newsom has said repeatedly that counties that don't adhere to health restrictions would lose state funding.
"We're in the midst of a pandemic," Newsom said. "I don't know what more evidence you need, particularly, as highlighted, Riverside County is experiencing what they're experiencing in ICUs and hospitals and lives lost. I mean, what more evidence do you need that trying to enforce good behavior will actually save lives? It's a noble and right thing to do.
"To dismiss as many have in the past and some of the same folks ... some still holding onto this as a hoax or face coverings don't matter. ... They're not helping. They're not advancing that cause, and so we will be assertive as we have been, we will be aggressive, as we have been."
Bianco, in a video message posted online earlier this month, called state health mandates "flat-out ridiculous," while calling Newsom's stances hypocritical in light of his criticism of the federal government for withholding funds from states, and following Newsom's well-publicized attendance at a dinner party in spite of his own regulations against such gatherings.
Bianco told residents in his message to wear a mask and practice social distancing, but said, "While the governor's office and the state has threatened action against violators, the Riverside County Sheriff's Department will not be blackmailed, bullied or used as muscle against Riverside County residents in the enforcement of the governor's orders."