California has again recorded its most coronavirus cases in a single day amid a sustained and alarming wave in infections that threatens to swamp hospitals statewide.
The number of newly confirmed infections reported Monday, 21,848, surpasses the previous high of 20,654 set a week ago, according to data compiled by The Times. The latest figure was partially inflated by reporting lags stemming from the Thanksgiving holiday.
By Monday night, California was averaging about 14,000 coronavirus cases a day over a seven-day period — a level not seen at any point in the entire pandemic.
The new record marks a distressing end to a month that saw the resurgent pandemic roar to never-before-seen heights in California. About 298,000 of the state’s more than 1.2 million coronavirus cases were diagnosed in November alone, the most of any single month.
California’s recent numbers, though unprecedented, remain lower than many other states when adjusted for population. Over the last seven days, California has averaged 37.1 new cases per day per 100,000 residents — tied for the 15th-lowest mark among all states, according to data from the Centers for Disease Control and Prevention.
While some of the state’s exponential growth stems from ramped-up testing, officials say the rate of tests coming back positive has also increased — demonstrating that the coronavirus is becoming more widespread.
The statewide 14-day positivity rate has risen to 6.5%, a marked increase over where it was roughly two weeks prior, 4.7%.
“That rate of growth on the cases, as well as positivity rate, is of concern,” Gov. Gavin Newsom said during a briefing Monday.
Policymakers and public health officials worry how the skyrocketing infection numbers will eventually affect California’s hospitals.
State health officials have estimated that 12% of those who have tested positive for the virus are hospitalized two to three weeks later — meaning that the recent high case counts would push even more people into the professional healthcare system.
That’s a particularly harrowing possibility, given that the number of COVID-19 patients in California’s hospitals is already growing at an unprecedented rate.
The average net increase in people hospitalized in California with COVID-19 is now about 333 patients a day over the last week, according to a Times analysis. The acceleration is twice as bad as the summertime surge, which saw the average net increase in hospitalizations top out at 173 patients a day over a weeklong period in late June.
Officials are keeping an especially close watch on California’s intensive care unit capacity. According to numbers Newsom presented Monday, about 75% of the state’s 7,733 ICU beds are occupied — with 1,812 of them filled by coronavirus patients.
Given the way things are trending, the state could exhaust its existing ICU capacity by mid-December, Newsom said.
The rural counties of Northern California could exceed ICU capacity by early December, Southern California and the San Joaquin Valley by mid-December, the Sacramento area by late December and the Bay Area by early January.
Providing ICU-level care usually entails “specialized space, specialized equipment and specialized staff” — meaning that, while hospitals can expand their capacities, their ability to do so is not infinite, according to Dr. Mark Ghaly, California’s health and human services secretary.
The “bottom line is we are looking at intensive care unit capacity as the primary trigger for deeper, more restrictive actions,” he said Monday, as “when that capacity goes away or even when it gets stretched so far that staffing is stretched, that we have to have set up space that isn’t typically used for intensive care units, we know that the quality of care … sometimes takes a dip, and we see outcomes we don’t want to see” because resources are spread too thin.
Overall, there were 8,240 coronavirus patients hospitalized statewide as of Monday, according to the latest available data. That’s more than triple the hospitalization rate on Nov. 2, when there were 2,602.
It’s also the highest number recorded during the pandemic and the third consecutive day the record for COVID-19 hospitalizations has been broken.
The overall figure tells only part of the story, though. Given California’s immense and geographically dispersed population, the coronavirus stresses different parts of the state’s healthcare system in different ways.
“Some counties in California don’t themselves have a hospital, certainly don’t have many ICU beds, so they depend on regional networks of hospitals, different systems coming…