California May Soon Issue New Stay-at-Home Order If Coronavirus Rates Keep Climbing

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Rachel Thorlund, manager at The Den Cafe, clears an outdoor table following reimposed restrictions on indoor dining in Orange County due to COVID-19 in Santa Ana on Nov. 17, 2020. (Patrick T. Fallon/AFP via Getty Images)

If current trends continue, California may impose another sweeping stay-at-home order across the vast majority of the state, Gov. Gavin Newsom said Monday, due to rapidly rising COVID-19 cases and hospitalization rates.

The potential order would apply to the 51 California counties that are now in the most restrictive, reopening "purple" tier, where transmission is considered widespread, Newsom said. That would place roughly 99% of the state's population under shutdown restrictions similar to those imposed in mid-March, at the beginning of the pandemic, when the state barred nearly all nonessential workers and other residents from leaving their homes except for essential tasks and exercise.

"The red flags are flying in terms of the trajectory in our projections of growth," Newsom, who is currently quarantining at home, said at a virtual news conference. "If these trends continue, we’re going to have to take much more dramatic, arguably drastic, action."

With an average of nearly 15,000 new, daily infections reported over the last week, caseloads are now far outpacing the previous surge during the summer, Newsom said. Roughly 12% of new cases will likely require hospitalization over a two-week period. That could cause a spike in new admissions across the state and quickly strain intensive care units, he said.

"We're not now just looking at case rates; we are now looking in real time at hospitalization numbers and ICU capacity in those regions," Newsom said. Within the next day or two, he said, state health officials will determine whether to mandate a new set of restrictions in purple-tiered counties that is "more in line with the stay-at-home order that folks were familiar with in the beginning of this year."

Referring to the potential order as a "deep purple" measure, Newsom said it could include modifications for some businesses to continue operating under certain conditions, but did not elaborate on what those would be.

"We anticipate, based upon what occurred over the course of the last number of days, that within the next number of weeks, one to two weeks, based upon Thanksgiving activities and all the efforts to educate people against those activities and gatherings, that we will see an increase in cases," he said.

Hospitalizations across the state have increased 89% over the past 14 days and nearly 7,800 coronavirus patients were hospitalized as of Monday, Newsom said.

The biggest concern is intensive care cases, which have increased 67% in the past two weeks, he said. If that continues, it would push ICU beds to 112% of capacity by mid-December.

It's that statistic that is most likely to drive state-mandated stay-at-home orders in 51 of California’s 58 counties that already are seeing the most restrictions on business activities, said Dr. Mark Ghaly, the secretary of California Health and Human Services.

"I'll remind you that the high case numbers that we've seen in the last week and 10 days have not even begun to impact hospitals yet. We know that it takes about two weeks," he said.

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ICU hospitalization rates vary by county and region, he said, and are of greater concern than overall hospital capacity.

"Bottom line is we are looking at intensive care unit capacity as the primary trigger for deeper, more restrictive actions," Ghaly said.

By the second half of December, California "could be pushing the limits in some areas," he said, adding that "we want to act sooner than that so we can get transmission down and we can handle those potential high ICU surges."

As coronavirus cases surge, another six counties — including San Francisco and San Mateo — were moved into the purple tier over the weekend. The state's total number of cases since March has topped 1.2 million, and the death toll from the virus is now more than 19,100.

California, Newsom noted, is currently faring better than most other states in terms of infection rates, ranking 39th lowest, with 34.5 cases per 100,000.

"But that said, the alarming concern — not just for our state, but you're seeing this in other states — is the rate of growth," he said.

Newsom reinforced that these potential new measures were not inevitable, and could be avoided if people step up their vigilance.

"This is in the absence of making better decisions," he said. "If we just sit back and we are bystanders at this moment and we don't subsequently improve upon our existing efforts, this is what we project might occur."

Additionally, Newsom said California expects to receive by mid-December about 327,000 doses of the COVID-19 vaccine produced by drugmaker Pfizer, and said his office would release a detailed distribution plan later this week to determine who gets the first round. That vaccine, which has shown to be 95% effective in preventing new infections, requires two doses, and must be stored at extremely low temperatures — far below the capability of standard freezers.

During the briefing, Newsom also announced a series of new tax relief measures intended to help small businesses, which have been battered particularly hard by COVID-19 restrictions. Those actions include an automatic three-month extension for taxpayers filing less than $1 million in sales tax, as well as interest-free payment agreements to larger companies that have up to $5 million in taxable sales.

"You can hold that money. You can use that money to float any obligations you have," he said.

Newsom said the state was also dipping into reserve accounts to make half a billion dollars of additional funds available to small businesses, cultural institutions and nonprofits, offering individual cash grants of up to $25,000. The program, he said, will serve as "a bridge" over the next month until the Legislature works out a more comprehensive package when it reconvenes in January.

But, he added, "We can't do this alone, even though we are the fifth-largest economy in the world." He implored Congress to quickly approve a new federal relief bill, noting that 248 days have gone by since the first package was offered. Those funds are "drying up," he said.

"We need Congress to act with urgency. Urgency is not January, February, March and April of next year. Urgency is today," Newsom said.