Tag Archives: San Francisco Bay Area

Virus surges: ICU beds filling up in hard-hit spots; Bay Area shutdown likely mid-December

Newsom to impose new stay-at-home orders in California’s hardest-hit areas

[see map below]
A masked Los Gatos woman who declined to share her name waits to see a doctor after being admitted to the Emergency Department at Good Samaritan Hospital in San Jose, Calif. Friday, July 31, 2020 where doctors are currently treating twelve COVID-19 patients in various states of severity. Photo: Jessica Christian / The Chronicle
San Francisco Chronicle, Alexei Koseff, Peter Fimrite, Dec. 3, 2020

SACRAMENTO — Vast swaths of California will fall under new shutdown orders in the coming weeks after Gov. Gavin Newsom announced additional restrictions Thursday to try to slow the coronavirus surge in areas where intensive care unit capacity is dwindling.

Newsom said he was “pulling the emergency brake” to help California through a third surge of the pandemic, one he hoped would be a final ordeal before a coronavirus vaccine becomes widely available after the winter months.

“The bottom line is if we don’t act now, our hospital system will be overwhelmed. If we don’t act now, we’ll continue to see a death rate climb, more lives lost,” Newsom said during a news briefing. But, he added, “There is light at the end of this tunnel. We are not in a permanent state.”

The orders, which do not immediately impact the Bay Area, will close personal care services such as hair and nail salons, playgrounds, bars and wineries, movie theaters, museums and zoos in places where fewer than 15% of intensive care unit beds are available across an entire region. ICU capacity will be tracked in five regions: Bay Area, rural Northern California, Greater Sacramento, San Joaquin Valley and Southern California, stretching from San Luis Obispo to the Mexican border.

Retailers, grocery stores and other businesses in those regions that are allowed to remain open will have to operate at 20% capacity, and restaurants will be able to offer only takeout or delivery. No outdoor or indoor dining will be allowed. Schools that have received a waiver to reopen can continue to offer in-person classes.

The orders will remain in effect for at least three weeks after the state imposes them and can be lifted only if the available ICU capacity in the region is projected to rise above 15% again within four weeks after that. At that point, counties in the region will return to one of the state’s current color tiers, with associated restrictions, based on their individual case rates.

Dr. Grant Colfax, director of the San Francisco Department of Public Health, said Thursday that the city is considering issuing orders similar to the new state edict even before the city hits the 15% ICU mark. Alameda County public health officials Thursday indicated they may follow that same path, issuing stronger restrictions before the state takes action.

“Everything is on the table at this point,” Colfax said. “It is likely that we will take additional steps consistent with the governor’s orders soon.”

As of Thursday, the Bay Area region had 25.3% of its ICU beds available, the state said.

Whether San Francisco or other Bay Area counties move faster than the state prescribes depends on the trajectory of hospitalizations and case rates across the region, Colfax said. At the current rate, the city will run out of ICU beds on Dec. 26, Colfax said.

“And that’s without accounting for what we expect from Thanksgiving,” he said. “We are doing relatively well compared to the rest of the state, but the virus is spreading like wildfire across the state, and if we run out of beds, whether it’s San Francisco or Santa Clara (County), there is not going to be capacity to put people in beds outside the region.”

The state is also reinstating a ban on all nonessential travel statewide, a move intended to reduce mixing between households and discourage family gatherings ahead of the holidays. It includes an exemption for outdoor exercise.

“Today’s message is not about how do we mix safely,” said Mark Ghaly, secretary of California’s Health and Human Services Agency. “It’s about how we reduce our mixing altogether — staying at home unless it is absolutely essential.”

Newsom said the Bay Area will probably fall below the ICU threshold for new shutdowns by mid-December. The state defined Bay Area in this matter as San Francisco, Alameda, Contra Costa, San Mateo, Santa Clara, Sonoma, Marin, Napa, Solano, Santa Cruz and Monterey counties.

Other parts of the state are expected to come under the stay-at-home order even sooner.

The moves come as California struggles with a dramatic rise in COVID-19 cases and hospitalizations, which has already forced Bay Area counties to crack down on community activities. Much of the state and every Bay Area county except Marin have instituted curfews prohibiting nonessential activity between 10 p.m. and 5 a.m.

As of Thursday afternoon, the nine-county Bay Area had recorded 158,554 cases and 1,996 deaths since the pandemic began. The numbers have exploded over the past month.

The region averaged nearly 1,600 new cases per day for the week that ended Nov. 29, an increase of more than 33% over the previous week, according to a Chronicle data analysis. The Bay Area set an ignominious record in November, averaging 1,158 new cases a day, an average that increased to 1,500 a day over the last two weeks of the month. That’s compared to 480 new cases a day in October. The previous high for a month was 1,061 per day in August.

On Monday, following the Thanksgiving holiday, the Bay Area reported 2,500 cases, by far the most in a single day since the start of the health crisis.

Peter Chin-Hong, a professor of medicine and infectious diseases at UCSF, said Newsom’s order was not as drastic as it could have been. He said the governor could issue blanket restrictions but suspects he limited the order to preserve the economy.

Still, he said, the fact that there are hospitals in California with less than 15% capacity in their intensive care units is disturbing.

“For me it illustrates very loudly that this third surge in California is very different than the other two,” Chin-Hong said. “There is no room for complacency. I’m scared. Now everybody is hurting, so there is no give in the system.”

The surge is happening in every Bay Area county, but Chin-Hong said Santa Clara County is likely to be the hardest hit by the regulations, at least right away.

With nearly 2,000 COVID-19 patients in hospitals, only 44 ICU beds are available countywide, officials said. Dr. Sara Cody, the county health officer, said the county is in danger of running out of beds if the current trend continues.

One indication of Santa Clara County’s trouble is the fast-spreading outbreaks at long-term care facilities.

Dr. George Han, the county’s deputy public health officer, said Thursday that 151 people recently tested positive at the Amberwood Gardens skilled nursing center. Sixty have tested positive since Nov. 23, including four staffers, at San Jose’s Boccardo Reception Center. Fourteen tested positive there Wednesday.

Han said the infected residents and those with exposure were put up in hotels. It was the county’s first large-scale outbreak at a homeless shelter, but it wasn’t the only one. Seven people have tested positive since Nov. 18 at South Hall, a shelter in San Jose.

“We have seen an increase recently in all these settings,” said Han, who attributed the increase to a rise in cases throughout the community. “It is more dangerous right now in our community than at any other point in the pandemic.”

In an attempt to quell the spread, Santa Clara County issued a travel directive Monday requiring a 14-day quarantine for people who travel into the county from a distance greater than 150 miles.

The disease is rampant in San Francisco, which reported 209 new infections on Thursday, a count not seen since the summer surge in July. It brought the total cases in the city to 16,001 since the start of the pandemic. The number of people hospitalized with COVID-19 in San Francisco has increased 45% in the past week, and cases have more than quadrupled over a month.

The daily average of new cases in California climbed above 15,000 in the past week, Newsom said, and the number of deaths is rising again, as well. The state saw back-to-back days of more than 100 deaths this week, including 113 on Wednesday, the governor said. A month ago, the daily total was 14 deaths.

Newsom said that without further public health interventions, the state could run out of capacity in intensive care units by Christmas Eve if the surge continues at its current rate. About three-quarters of ICU beds are full, nearly 25% with COVID-19 patients.

Restaurant owners were relieved that Newsom did not shut down outdoor dining statewide at once, an option the governor could have considered.

“I was prepared for the worst, but I’m relieved that the governor made some concessions for restaurants to allow us to try to stay afloat,” said Rocco Biale, the owner of Rocco’s Ristorante Pizzeria in Walnut Creek. “It’s a break for the restaurant industry. Let’s see how long it can last.”

Los Angeles County and the city of Los Angeles adopted their own modified stay-at-home orders this week, largely prohibiting people from gathering outside their immediate households but allowing retail businesses, parks, beaches, golf courses and tennis courts to remain open.

Republican leaders immediately slammed the new order as excessively harsh and questioned the scientific rationale behind the move.

“Gov. Newsom continues to disrupt life as we know it without releasing the full data behind his decisions or showing the impact his actions are having on our lives,” state Senate Republican Leader Shannon Grove of Bakersfield said in a statement. “The governor owes the state leadership that is committed to transparency and accountability.”

Recognizing that frustration has mounted across the state with his quickly changing restrictions, Newsom practically begged Californians to take the latest order seriously.

“This is the time, if there was any doubt, to put aside your doubt,” he said, “to put aside your skepticism, to put aside your cynicism, to put aside your ideology, to put aside any consideration except this: Lives are in the balance. Lives will be lost, unless we do more than we’ve ever done.”

San Francisco Chronicle staff writers Erin Allday and Michael Williams contributed to this report.

Stay-at-home order coming soon in San Francisco Bay Area

Bay Area projected to reach threshold in “mid-late December”

twitter.com/KQED – Governor Newsom announced the details of a sweeping new stay-at-home-order that will come into effect for three weeks in certain California regions when their intensive care unit capacities drop below 15%.  The Bay Area is projected to reach that point in “mid-late December.”


Newsom to impose new stay-at-home orders in California’s hardest-hit areas

San Francisco Chronicle, by Alexei Koseff and Peter Fimrite, Dec. 3, 2020 2:32 p.m.
Two respiratory therapists (no names given) wheel a CPAP machine with a modified viral filter through the emergency department at Seton Medical Center in Daly City, Calif. Friday, May 1, 2020. As ER and ICU doctors gain a better understanding of previously unknown COVID-19 complications, such as blood clots, they are changing the way they care for patients. Doctors are now giving many patients blood thinners in light of emerging evidence that many are developing small and large blood clots that cause strokes. They're also finding that CPAP machines often work better to help patients breathe than ventilators, which were once thought to be a standard course of treatment for patients struggling to breathe.
Two respiratory therapists (no names given) wheel a CPAP machine with a modified viral filter through the emergency department at Seton Medical Center in Daly City, Calif. Friday, May 1, 2020.  Photo: Jessica Christian / The Chronicle

SACRAMENTO — Vast swaths of California will fall under new shutdown orders in the coming weeks after Gov. Gavin Newsom announced additional restrictions Thursday to try to slow the surging number of coronavirus cases in areas where intensive care unit capacity is dwindling.

Newsom said he was “pulling the emergency brake” to help California through a third surge of the pandemic this winter, one he hoped would be a final ordeal before a coronavirus vaccine becomes widely available.

“The bottom line is if we don’t act now, our hospital system will be overwhelmed. If we don’t act now, we’ll continue to see a death rate climb, more lives lost,” Newsom said during a news briefing. But, he added, “There is light at the end of this tunnel. We are not in a permanent state.”

The regional orders will close personal care services such as hair and nail salons, playgrounds, bars and wineries, movie theaters, museums and zoos in places where ICU capacity has dropped below 15%.

Retailers, grocery stores and other businesses in those regions that are allowed to remain open will have to operate at 20% capacity, and restaurants will be able to offer only takeout or delivery. No outdoor or indoor dining will be allowed. Schools that have received a waiver to reopen can continue to offer in-person classes.

Troubling trend in Bay Area pandemic – more young people infected, ill

[Solano County’s COVID age group data doesn’t mesh with age group data given in this report.  But I can report that 10% of Solano cases are youth under 18, significantly higher than in April.  And although the 18-49 age group is 41% of the County population, it represents over 61% of total cases, by far the highest percentage of all age groups.  More Solano data here.  – R.S.]

Troubling trend in pandemic: More young people infected, ill

San Francisco Chronicle, By Catherine Ho, August 10, 2020

A young crowd attends the Juneteenth celebration at Lake Merritt in Oakland. Young people make up thefastest-growing demographic contracting the coronavirus in many regions.
A young crowd attends the Juneteenth celebration at Lake Merritt in Oakland. Young people make up the fastest-growing demographic contracting the coronavirus in many regions. Photo: Nina Riggio / Special to The Chronicle

As the coronavirus enters its eighth month, a troubling trend has emerged in the Bay Area and around the nation: More young people are getting sick, in numbers so large that in some regions they now make up the largest and fastest-growing demographic contracting the virus.

It marks a dramatic shift from the narrative that dominated the early weeks of the pandemic, when health experts emphasized that older adults, in part due to the higher likelihood of chronic health conditions, were most at risk of falling ill.

“We are seeing increased rates of infection among young adults,” Santa Clara County public health officer Dr. Sara Cody said at a July county board of supervisors meeting. “It’s where the epidemic is spreading the most quickly. … This is disproportionately accelerating among young adults.”

In six Bay Area counties, people in their 30s or younger make up the largest proportion of cases. In San Francisco, for instance, 18-to-40-year-olds represent 48% of all cases; in Santa Clara County, 20-39­year-olds represent 39% of all cases. Anecdotally, the region’s medical clinics are reporting a major uptick in younger people coming in with COVID-19 symptoms like shortness of breath, fever and cough.

Statewide, the number of cases among people ages 18 to 34 shot up 1358% between May 1 and Aug. 1, from 12,373 to 180,354 — representing an increase from 24% of all cases to 35% of all cases, according to the California Department of Public Health. During the same period, the number of cases among people 65 and older grew more slowly, 387%, from 11,547 to 56,206 — representing a drop from 22% of all cases to 11% of all cases.

At the Stanford coronavirus outpatient clinic, the proportion of patients under age 40 has more than doubled since April, from about 25% to 55%, said Dr. Maja Artandi, the clinic’s medical director.

In the South Bay, Kaiser is seeing more patients under age 30 getting hospitalized with COVID-19, which was unusual during the first surge in March. And more patients in their 20s are also seeking medical care for the virus from their primary care doctors.

“It’s worrisome,” said Dr. Charu Ramaprasad, an infectious disease physician in Kaiser’s San Jose Medical Center, who has been leading much of the health system’s coronavirus response.

Health officials and physicians have not pinpointed exactly why younger adults appear to be driving the latest surge in infections. But many believe it is likely because young people have been going out more — either for jobs that require them to interact with the public frequently, or in social settings — and are being more lax about social distancing and wearing masks.

And younger people may experience less severe symptoms, which may lead them to think it’s OK to gather with friends if they have just a minor cough or a scratchy throat, said Dr. Aisha Mays, medical director of the Dream Youth Clinic at Roots Community Health Center in Oakland.

“We have seen our young folks have a false sense of security that make them more susceptible to contracting COVID,” Mays said. “In the beginning, we were really concerned about our elderly population because they are so much more susceptible to the negative effects of COVID, including death. At the same time, it might have sent an unintended message to our young people that they were more immune to contracting COVID.

“We know that’s not true. We know young people can still contract COVID as easily as anyone else.”

People in their 20s and 30s are less likely to be hospitalized or die from the coronavirus than people in their 60s and 70s. Eight out of 10 coronavirus-related deaths in the United States have been among adults 65 or older, according to the U.S. Centers for Disease Control and Prevention. And hospitalization rates for people between 18 to 29 years old are 56 per 100,000, compared to 281 per 100,000 for people between 65 and 74 years old.

Still, many young people have symptoms severe enough to send them to the emergency room or intensive care. And even if they have mild symptoms, they still risk exposing older family members or friends who may get much sicker from the virus.

One of them is Tyler Lopez, 27, who in June began experiencing fatigue and chest congestion and lost his sense of smell. Lopez tested positive for the coronavirus, quarantined for 10 days and felt like he had recovered — but was soon hit with a second and much more severe wave of symptoms.

His heart rate repeatedly shot up to above 120, at times going as high as 140, even when he was sitting or lying down, and he had a fever and chest pain so bad it felt like the inside of his chest was inflamed, he said.

Lopez, who lives in Riverside, was admitted to a hospital twice. Doctors ran tests and concluded the COVID-19 infection likely caused inflammation in the tissue surrounding the heart, and that he could’ve gone into cardiac arrest if the medication he received at the hospital had not reduced the inflammation fast enough, he said.

“It’s just crazy what COVID can do,” said Lopez, who was released from the hospital last week and is recovering at home. He plans to go back to his doctor next week to see if he can get cleared to return to work — nearly two months after he first noticed symptoms. “The past couple months, it totally changed my life.”

Before he got sick, Lopez said, he did not take the virus seriously and continued going to the gym and meeting up with friends.

“I was like, ‘It’s not that big of a deal, whatever, if I get it, I get it,’ ” he said. “I was just living life without taking that extra precaution.”

He now wishes he had been more careful.

“It jacked me up,” he said. “I wouldn’t wish this on my worst enemy.”

Local health officials recently launched initiatives to urge people in their teens and 20s to practice social distancing, wear masks and limit activities to the outdoors like biking or hiking. Contra Costa County beginning Aug. 10 will start training hundreds of youth ambassadors to help get the message out to their peers.

A regional effort led by seven Bay Area public health departments, Crushing the Curve, has a similar aim.

Brandi House, 19, will participate in both programs as a youth leader. She said many of her acquaintances and coworkers have been going to parties during the pandemic, not believing the virus is serious or that they will get sick. She hopes to help dispel such attitudes.

“The message I’d like to put out for young people is to know this is real,” said House, of Richmond. “I know a lot of people not believing COVID is real. I know people that are still going to parties and stuff. I’m like, ‘Why are you going to parties during this time?’

“There’s a lot of people that have been getting sick and passing from it. That’s one message I want to get out.”

SF Chronicle report on contact tracing in Bay Area – “Solano County did not respond”

Bay Area’s contact tracers struggle amid coronavirus surge

San Francisco Chronicle, by Carolyn Said, July 20, 2020
In a photo taken with a telephoto lens, beachgoers gather at Robert W. Crown Memorial Beach on Tuesday, May 26, 2020, in Alameda, Calif. Most people maintained at least fifteen feet between groups.
In a photo taken with a telephoto lens, beachgoers gather at Robert W. Crown Memorial Beach on Tuesday, May 26, 2020, in Alameda, Calif.  Most people maintained at least fifteen feet between groups. Photo: Noah Berger / Special to The Chronicle

Contact tracing — finding and notifying everyone who has had close contact with a person infected with the coronavirus — is key to stemming the pandemic. Once people learn they’ve spent time near someone who had the virus, they can get tested themselves and quarantine so they don’t infect others.

Bay Area county health departments ramped up in April and May to handle the laborious process, most of it armchair detective work by phone and email, not the high-tech surveillance some in Silicon Valley originally envisioned. But the recent surge in cases has made the task much harder, because there are more people to contact and because it takes longer to be tested and then get the results.

Alameda, Contra Costa, Marin, San Francisco, San Mateo and Santa Clara counties all fall short of their goal of doing case investigations for 90% of the people who test positive, and then reaching out to 90% of the folks those people had close contact with while they were infectious.

Napa, Sonoma and  Solano  counties did not respond to requests for information.

When it comes to reaching contacts of the people who tested positive, the counties range from 70% to 80%, except for Contra Costa, which reaches only 26% of those who had contact with infected people, and Marin, which reached only 46% (its numbers are older). Still, those numbers are far better than those in New York and some other states.

“Obviously we want as many as possible because that’s where you get the most bang for your buck,” said Dr. George Rutherford, an infectious diseases expert at UCSF who spearheaded San Francisco’s contact-tracing program. But modeling shows that even reaching 43% of infected people’s contacts provides some disease suppression. “I think the spread would be worse without” contact tracing, even though it hasn’t reached its potential, he said.

Contra Costa County could not say why it is so far below the Bay Area norm, especially since it is closer than Alameda and San Mateo counties to meeting its contact tracing staff goal.

“We’ve been grappling with it,” said Erika Jenssen, deputy director of Contra Costa Health Services. “To do effective contact tracing, we need timely lab results for tests, adequate staffing and to partner with the community.”

She pointed to delayed test results as a major obstacle. While the median turnaround time in the county is four days, many results come in as late as 10 days after testing — by which time a person may not longer be infectious.

And it’s not just results that take a while: In parts of the Bay Area, some people must wait a week or more for a testing slot to open up.

The case investigations — interviews with newly diagnosed people — shed light on how the virus has spread since shelter-in-place orders were eased.

“We are seeing more people who were at some kind of gathering; that’s a common source of exposure,” Jenssen said. Contra Costa County investigators found that 18% of those who tested positive had attended large gatherings in the previous 15 days, while 17% had been to in-person workplaces. About 20% had visited restaurants, supermarkets and other stores.

Signs encourage wearing a mask at Lake Merritt in Oakland in June.
Signs encourage wearing a mask at Lake Merritt in Oakland in June. Photo: Carlos Avila Gonzalez / The Chronicle
Even counties that have maintained fairly high contact tracing numbers say they struggle with the surge.