Expected coronavirus peak in California drops sharply from previous estimates
As experts are cautioning people nationwide to be particularly careful in the next few weeks in the fight against the novel coronavirus, there are indications that California’s swift action to curtail it is working.
Peak day for California is estimated to be April 14, according to widely cited projections from the Institute for Health Metrics and Evaluation, a global health research center at the University of Washington. On that day, the state is expected to have 4,869 people hospitalized with the virus. That is a dramatic drop from two weeks ago: On March 27, the same center predicted the state’s peak to hit April 24, with a total of more than 15,000 people hospitalized.
Experts say the next few weeks are critical.
“This is the moment to not be going to the grocery store, not going to the pharmacy, but doing everything you can to keep your family and your friends safe,” Dr. Deborah Birx, who is coordinating the White House’s response to the pandemic, said Saturday.
“The next two weeks are extraordinarily important.”
Surgeon General Jerome Adams warned on Sunday that the coming week would be America’s “Pearl Harbor moment, our 9/11 moment” in the coronavirus pandemic.
More than 1.2 million cases of the COVID-19 virus have been confirmed worldwide with more than 65,000 deaths as of Sunday, according to Johns Hopkins University. The United States has more than 312,000 confirmed cases and more than 8,500 deaths.
While early efforts in California may help the state avoid the kind of devastating scenes playing out elsewhere, officials and experts caution any early gains can be wiped out if safety measures are eased.
If you live in an urban area where local health officials initiated early social-distancing orders, the peak of new cases could hit later this month. If you live in a rural area, the coronavirus spread will take longer and stretch limited hospital resources thin.
Here is a look at current estimates of surge moments for California as well as Sacramento-area counties, other major areas of the state and some “hot spots” outside of California.
(These are fast-changing numbers. The Bee will attempt to update the numbers and dates in this article every few days in the coming weeks.)
COVID-19 in California
State health officials say they believe the peak moment is more likely to be May than April. Gov. Gavin Newsom on Friday declined to answer questions about how the state’s modeling differs from others.
Gov. Gavin Newsom and health officials say the state’s dramatic stay-at-home order nearly three weeks ago may have bought the state’s hospitals a bit more time to prepare, and will mean lower numbers of more serious patients for hospitals to deal with.
The University of Washington institute forecasts 5,068 Californians will die in the next three months before fatalities largely stop by the last week of June.
That death number is notable: California comprises 12 percent of the U.S. population. That number of deaths is less than 6 percent of the institute’s estimate of 93,500 deaths nationally. The Trump administration has warned the death toll could be between 100,000 and 240,000.
But to hold the death number down in California, not only will people have to continue staying home as the peak arrives, they also will have to stay home for a month after the peak hits.
“In California, by the end of June, early July, we will have controlled this,” said Dr. Ali Mokdad, a professor of health metrics science at the Washington institute. “But our concern is: What is next? We haven’t seen this virus before. We don’t have antibodies. Another surge later is possible if we don’t control it now.”
Put another way: “Instead of becoming a peak, it can become a roller coaster ride,” said Dr. John Swartzberg, a professor emeritus at UC Berkeley School of Public Health.
Stanislaus and San Joaquin County cases
As of Monday morning, Stanislaus County had recorded 71 cases of COVID-19, with 1,620 people testing negative for the virus. So far, there are no deaths related to the virus in Stanislaus County.
Neighboring San Joaquin County, which has recorded 206 cases and 11 deaths from the virus to date, has released a projection of peak daily cases there, expected to reach 299 on May 30. Health officials note that the projected peak has dropped significantly, and moved by several weeks, due to mitigation efforts such as social distancing and staying at home. Without these efforts, officials said, their modeling shows daily hospital admissions peaking at 768 patients on April 30.
Stanislaus County officials said Monday they are working on similar projections locally and hope to have them available to the public by midweek.
Sacramento County cases
County health officials, studying computer models, said the heaviest load for seriously ill patients will come at the end of April. But modeling for California as a whole now suggests Sacramento’s peak will come sooner than that.
Sacramento County public health director Peter Beilenson said it appears the county has enough hospital beds to handle what could be up to 600 cases at a time, but said hospitals report they do not have as many ventilators as they may need.
He is “cautiously optimistic” that Sacramento residents are slowing the disease spread through social distancing.
Though 16 people have died in Sacramento County and 442 are known to be infected, Beilenson said Sacramento should escape what New York, Seattle, Los Angeles and some other cities face.
“Our stay at home order came on the early side. Unlike L.A., we don’t have places like Disneyland, Universal Studios, the beaches. We have basketball arenas and movie theaters, but those were shut down early. And our density is much less than San Francisco and hugely less than New York.”
“If we keep up social distancing, ramp that up, the models say we are not going to hit (hospital) capacity,” he said.
Placer County peak
County health director Aimee Sisson said projections have been so varied that it’s hard to know when the peak will hit. It could come anywhere between May and August, she said
“Those models leave a lot to be desired,” she said. The data suffers from a lack of pervasive virus testing in the county. As of Sunday, 103 people had tested positive for coronavirus in the county and three had died.
She said she fears the county’s three main hospitals — Kaiser Roseville, Sutter Roseville, Sutter Auburn Faith — could be hit beyond capacity, given they also handle patients from Sacramento County and nearby foothill counties.
As of last weekend, there were 467 combined intensive care and surgical beds in the three hospitals. Only 38 of them were occupied by patients who had tested positive for the virus or who have virus-like symptoms. The county has 142 ventilators at the three, and of those, 92 percent were not in use.
“We are OK right now,” Sisson said. “If we have a real healthcare surge, though, we are going to have shortages.”
Bay Area coronavirus curve
Public health experts in the Bay Area have been hesitant to say when they expect a surge to come. But two weeks after Bay Area counties issued some of the first orders to shelter in place in the state, hospitals have been reporting fewer cases than previously expected.
There was “reasonably good evidence of some flattening of the curve,” Dr. Bob Wachter, a professor and chair of the University of California, San Francisco’s department of medicine, told the New York Times last week.
Still, as of the end of last week, Bay Area counties had topped 3,000 cases, and mounting.
Los Angeles
For weeks, local officials have been juggling questions about whether Los Angeles will become the next New York, where coronavirus cases have overwhelmed the hospital system.
“A week or two from now, we will have images like we’re seeing in New York here in Los Angeles.” Mayor Eric Garcetti said last week, according to the Los Angeles Times.
Dr. Barbara Ferrer, Los Angeles County public health director, has said her office plans to release a report this week that includes modeling for when the peak date might arrive.
“The truth of the matter is none of us really know,” she told reporters Monday. “We’re all making the best guess that we can using the different modeling techniques that are available.”
The Navy’s Mercy medical ship has arrived in the port of Los Angeles to treat up to 1,000 non-COVID-19 patients, beginning Monday. That ship will treat only non COVID-19 patients, freeing up space in onshore county hospitals for virus patients. The Los Angeles Convention Center is also set to be converted into a field hospital, and the county is rapidly increasing the number of overall beds available.
Stay-at-home orders in Los Angeles are set to expire April 19, but Garcetti told Vanity Fair “My gut has been that it’s going to be at least two months.”
New York epicenter
New York and New Jersey are the epicenters of the virus in the United States.
According to Johns Hopkins University, nearly one half of the 312,000-plus cases in the country were in those two states, focused on the dense New York-Newark metropolitan area, where hospitals already are overwhelmed.
Last week, New York Gov. Andrew Cuomo said he thought the peak could be three weeks out. He’s since said it will come much sooner.
The Washington institute projection is for a peak in New York this week on April 8.
Post-surge worries
Newsom is among many who worry what people will do when the news media announces the peak is over.
Already, he said, he is hearing of people suffering from “cabin fever” who want to get out. An upset friend reported to Newsom on Saturday that her son intended to go to a party.
“Give me his cell phone number,” Newsom said he told her, so he could disabuse the teen.
The crisis will not be over, though, in the first, second or even third week after new case numbers begin to drop. Experts say they fear if businesses open too soon, infections will spike again.
“If you really shut things down now and the number of cases goes down, it’s not like you’re past the danger point,” said Dr. Joshua Sharfstein, a vice dean at Johns Hopkins Bloomberg School of Public Health.
“Anyone who thinks you’re going to be flipping the switch in May and going back to the way things were is incorrect.”
Sacramento Bee staff reporter Sophia Bollag and Modesto Bee staff writer Erin Tracy contributed to this report.
This story was originally published April 6, 2020 at 2:17 PM with the headline "Expected coronavirus peak in California drops sharply from previous estimates."