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Newsom, California Health Officer Issue Emergency Orders To Prepare Hospitals & ICUs For Increasing Delta Surge

On Monday, California Governor Gavin Newsom’s office announced that one of his staffers, who was fully vaccinated, had contracted Covid-19. According to multiple reports, the staffer had not been near the governor or any of the aides who have worked closely with Newsom’s of late.

The breakthrough case in Newsom’s orbit comes on the same afternoon that the state’s Health Officer, Dr. Tomás J. Aragón, issued a new health officer order meant to ensure rapidly filling hospitals and ICUs flexibility.

“California is currently experiencing the fastest increase in Covid-19 cases during the entire pandemic with 23.8 new cases per 100,000 people per day, with case rates increasing eleven-fold within two months,” wrote Aragón. “Hospitalizations have increased over 700% in the past two months and are projected to continue to increase.”

If that wording sounds familiar, it’s because Aragón issued a similar warning last week, when the state was experiencing 22.7 new cases per 100,000 people per day, with case rates increasing tenfold since early June.

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In response to this weeks rise, Aragón’s order requires hospitals statewide to accept transfer patients from facilities with limited ICU capacity when clinically appropriate. The order will take effect August 18, 2021

“We are continuing to see an increase in cases and hospitalizations due to the Delta variant of Covid-19 and are taking action to ensure the state’s health care delivery system is prepared and can respond should the situation worsen,” said Dr. Aragón. “Today’s action will make sure all patients in California continue to receive appropriate care.”

The last time the state took such drastic action was during the deadly winter surge of the virus.

Today, California reported 7,166 Covid hospitalizations and will likely surpass 7,200 hospitalizations in the days ahead, which was the highest number experienced during last year’s summer surge of cases. However, the state’s Covid hospitalizations this summer are still far below the overall peak of nearly 22,000 experienced during the January 2021 surge. One concern is, however, that the state could see another winter surge this year.

Last year’s cases began rising on or about September 14 as people began to spend more time indoors in the fall. While this year’s record heat across much of California would argue against such a trend, if people were to begin gathering indoors once again about that date, the state would likely start any surge from a much higher baseline. It’s a situation health experts warned about last fall: That a summer surge, while not overwhelming in itself, could set the region up for a much higher winter surge.

Last year, summer case numbers peaked on July 16 at 11,658. Today’s case numbers are nearly identical, at 11,437. The 7-day average of cases per 100,000 — considered a good measure of viral spread — is nearly identical as well: 25.8 per 100,000 at the peak of the summer wave vs. 25.6 per 100,000 today. The problem is, today’s case number is likely artificially low due to data delays from over the weekend. The state reported 14,099 new daily cases on Friday. That’s 20% higher than last summer’s peak.

What’s more, the 2020 summer peak came on July 16. This summer’s wave of infections, should it break tomorrow, would have also peaked a month later, meaning infections would have a month less to drop before a similar winter surge would set it. Also, as noted above, the number of hospitalizations are already higher than those of summer 2020. Being a lagging indicator, hospitalizations don’t drop as soon as cases do. They continue to rise for at least two weeks more as infections run their course and send more seeking in patient treatment. That time lag could create a nightmare situation for California going into winter 2021 with kids back in school, some adults still unvaccinated and the delta variant at large.

Officials said in a statement, “The state has learned from previous surges in cases and hospitalizations that preparing early through statewide coordination is the best course of action. While the state works to further increase the number of eligible Californians vaccinated, we must take steps to protect the unvaccinated who are more at risk of severe illness, hospitalization and death from Covid-19. Today’s action will ensure the state’s health care delivery system is prepared and can respond appropriately.”

Newsom today issued his own Executive Order that extends the state’s ability to waive licensing and certification requirements for out-of-state medical personnel supporting the state’s response through the end of the year. The order also grants regulatory flexibility to respond to the ongoing pandemic including, in Newsom’s words, “to hire retired teachers (as) is necessary to assist public schools in providing continuity of educational services for students in the face of rising case rates.” Given the outbreaks already seen in the first week of school at Ventura County and Oakland schools last week, that may be prescient as well as prudent.

Also on Monday, Dr. Aragón indicated that state health officials are supporting the recent federal recommendation of an additional vaccine dose for individuals whose immune systems are compromised.

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