Earlier this week, California once again became the most Covid-infected state in the nation, retaking the ignominious title back from Texas.
As the the number of COVID-19 cases, hospitalizations and coronavirus-related ICU patients has risen over the past weeks in the state, health officials across the board have warned that those numbers are important because, statistically over the course of the pandemic, they all lead to one thing: an increase in deaths. On Thursday, those warnings became undeniable fact as the California saw the highest number of COVID-related deaths ever. That, as the nation at large on Wednesday suffered its highest daily number of coronavirus deaths ever, at 3,124.
California has, in recent months, managed to staunch jumps in cases before they resulted in deaths overtopping the grim record of 219 lives lost on July 31st. But the dam seems to have been broken by the now tsunami-like surge of daily new cases.
In mid-July, the number of daily cases that led to that awful death count reached near 13,000. Now, in early December, the daily new cases number is well over double that at 29,677. Given that deaths lag cases by about four weeks, it’s clear the record number of 220 deaths reported on Thursday is just the beginning.
In fact, four weeks ago, the case count stood at about 8,000. What that means is, while deaths are at an all time high, they are likely to go much, much higher in the next few weeks. To what extent, is at this point unclear, but for months Los Angeles County Director of Health and Human Services Dr. Christina Ghaly has laid out the following equation, which has proven reliable: Ghaly has that about 12% of all coronavirus cases end up in the hospital. “Half of those end up in ICU,” she said in November. “Two-thirds of those are on a ventilator. Half of those will die, based on previous experience.”
Doing the math, that means 3,561 of the 29,677 infections reported on Thursday will end up in a hospital. Of those, 1,780 will require ICU care. Some 1,175 of those ICU patients will require a ventilator. That means 587 people will die as a result of Thursday’s single-day new numbers.
So in early January, California can expect to be seeing over 500 residents die each day from the virus. Even a week of such numbers is 3,500-4,000 Californians lost. That’s assuming the ICUs are not overwhelmed in January, which is not a given if the state is then seeing 1,700 new ICU patients each day.
Governor Gavin Newsom said in mid-November that there were 7,662 ICU beds in the system. There are likely a bit more by now. Two days of 1,700 new ICU patients would probably overwhelm the system, which late Wednesday had only 9.9% of its beds available. And that’s not counting all the other maladies that create demand for ICU care in the winter.
The state may be able to surge some new units and move patients around, but it is greatly limited by available appropriately-trained medical personal. Newsom announced the arrival of some 800-plus specially trained staff this week, but it is unlikely the state will see more given the demand across the country and the fact that such expertise cannot be surged in a few weeks.
What’s more, California is currently seeing record numbers of healthcare workers falling ill, which further constrains the ICU bed count. ICUs in some counties, such as three in the San Joaquin Valley, have already overtopped capacity.
The above calculations do not take into account any ameliorating impact of Newsom’s current Regional Stay-at-Home Order. But the state has already seen numbers at or very near 30,000 in the past few days and the state’s test positivity rate has been skyrocketing. That data indicates case numbers will ascend even higher in the near term. So daily death counts close to 600 are pretty much locked in for early January.
The remaining questions are: How big will the surge from gatherings during the December holidays be on top of the current Thanksgiving-fed surge; how hard will flu season impact already stressed acute care facilities; and, if the state ICU system is overwhelmed, how many more Californians will die as as result?
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