Lake County, CA -With the rapidly increasing number of COVID cases in the region and statewide, Governor Newsom has issued new "Stay at Home Orders" that will take effect when the ICU bed availability in the region goes below 15%. These orders are not in effect in Lake County at this point, but the projections are that they will begin sometime in the next few weeks.
In Lake County, we have now experienced over 1000 confirmed COVID cases since the beginning of the pandemic, and 21 people have died. The number of cases is rising dramatically, as are the number of people hospitalized with COVID-related symptoms. Given the way hospitals work in rural areas, our two hospitals operate as a part of a larger regional network. So, when looking at hospital capacity, it is important to evaluate the bed availability in the larger region. As of yesterday, we currently have 13 people in the hospital with a positive COVID status, 11 of them are in out-of-county facilities.
Since the trigger for these new restrictions is ICU bed availability, the state is evaluating regional bed capacity on a daily basis. The thinking is that the number of ICU beds is limited, and when they start getting filled up, there can be problems in getting necessary care, and the number of deaths can rise. The best way to try to prevent this is to add more restrictions that can limit interaction with people outside of your household, so we have less virus transmission. Increased transmission leads to increased cases; approximately 12% of the cases end up in the hospital within a few weeks. Some of these people will end up in the ICU, and a week or two later, we tend to see an increase in deaths. The state’s strategy here is to try to add the restrictions a few weeks before these tragic outcomes. So, 85% of the ICU beds being filled is the state’s trigger to bring on the strongest intervention in time to try to prevent this severe situation.
The current projections are that the Northern California region (including Mendocino, Lake, and going north) will likely cross this 85% ICU threshold within the next few weeks. As of yesterday, 78% of ICU beds were filled in Lake County, and 76% in the Northern California region. The state and our local team will be checking daily, and when they flip the switch, we will have 24 hours to comply.
The new restrictions will be similar to what we had to do back in the spring, with some improvements.
Non-essential gatherings are not permitted.
People should stay at home except for necessary activities.
Gatherings for worship and political expression are permitted outdoors.
Restaurants, food pick-up and delivery only.
Schools may continue as they are in the purple tier.
Retail establishments can operate at 20% capacity with metering at the door. The "essential" and "non-essential" distinction is not being applied to stores.
Outdoor recreation can continue, with precautions.
Lodging not permitted for recreational travel. People travelling out of area should self-quarantine for 14 days upon return.
The next few months will be tough, but we should begin to start going back to a more normal life in spring and summer. Now is the really important time to take the strongest precautions against the virus, even before the “stay at home order” goes into effect. Stay home whenever possible, cancel travel plans, go out only when necessary. Continue exercising and going outside (indoor gyms and exercise classes are not currently permitted)—and we do not anticipate a closing of the lake-- but do so safely, wearing masks and keeping distant from people not from your household. Protect the vulnerable people in your home. Get the vaccine when it is available. We will be through this in a few months, so please take care of your family and friends by being very cautious in the coming months.
Gary Pace, MD, MPH