LOS ANGELES — California has begun placing equipment and contracting temporary health workers in preparation for another possible wave of winter coronavirus cases, Governor Gavin Newsom said Wednesday.
The country’s most populous state is still doing relatively well with the rest of the US in terms of cases and hospitalizations. But Newsom warned Californians must prepare for another severe pandemic winter, even as the state is one of the nation’s leaders with about 74% of eligible people on at least one dose of the vaccine.
While statewide hospitalizations have fallen by about half since a summer peak in late August, they have begun to rise in some areas, most notably the Central Valley and parts of Southern California, including Los Angeles and San Bernardino counties.
“We’ve seen some signs of concern,” Newsom said.
California had the lowest number of cases earlier this fall but now ranks 16th, he said, while the test positive rate is 2.3% after falling below 1% in June.
Newsom has signed an executive order through March 31 that allows out-of-state medical workers to treat patients in California and allows emergency medical technicians and others to administer vaccines and provide other related services. It also keeps flexibility for healthcare facilities, for example by using parking lots for vaccination sites.
Aside from the upward trend in certain parts of the state, state health officials said they were generally concerned that colder weather would keep people indoors. There will be more holiday mix-up at a time when the vaccine and natural immunity acquired months ago start to wane unless more people get booster shots.
“We’ve learned in the past two years that COVID-19 benefits when we’re on our guard,” Newsom’s health department said in a statement.
The state’s own models still predict an overall decline in hospital admissions and intensive care cases over the next month. And the statewide R-effective measuring infection rates also continues to fall and now stands at 0.85. Anything below 1 means that the number of infected people will decrease.
The concern is that even those who are vaccinated could be more vulnerable to the extremely contagious delta variant unless many more people get booster shots, which are currently lagging, said Dr. Kirsten Bibbins-Domingo, a professor of epidemiology at the University of California, San Francisco.
In addition, California is so large and geographically and demographically diverse that conditions are “wildly variable,” also affecting state modeling at a time when many have grown tired of precautions like masking and isolating, she said.
“There are plenty of local models showing rising hospitalization rates that we’re already starting to see in local settings,” Bibbins-Domingo said. “It’s kind of a race, and it kind of depends on whether declining immunity wins or we get boosters in people.”
Newsom used a visit to a COVID-19 vaccination and flu clinic in Los Angeles to encourage residents, including newly eligible children ages 5 to 11, to get vaccinated. He also pushed for booster shots for those who qualify.
Newsom, who was boosted on Oct. 27, said the experience of Europe and other US states has shown that the coronavirus has a seasonal aspect that can lead to an increase in infections.
He used apocalyptic memories of last year’s winter wave, when officials bought body bags and brought mobile morgues to Southern California, as the number of infections increased tenfold in eight weeks and overwhelmed many hospitals.
“Thousands of people lost their lives, thousands of people were provided with livelihoods, close to death,” he said. That is why state officials are “doing everything in our power to prepare”.
Brian Ferguson, a spokesman for the governor’s emergency services, said the state’s preparations since the start of the pandemic have “put the state in a much better place to withstand every wave that happens this winter.”
The state “has all of the expanded capacity of the mobile field hospitals and supply caches acquired during the pandemic, as well as the contracts to bring in nurses and medical staff that were previously put in place,” Ferguson said.
Stephanie Roberson, director of government relations for the California Nurses Association, said the Health and Human Services Agency has been “working super closely with the hospitals to make sure they get staffed.”
That includes extending a waiver for out-of-state staff and waivers for nurses to work as teams. Roberson expects the state to start spending money on hiring temporary workers soon, as it did before when hospitals were stretched to breaking point last winter.
The California Hospital Association is in regular contact and working with state health officials as the number of cases increases in parts of the state, spokeswoman Jan Emerson-Shea said.
Staff shortages in hospitals are already a concern in some areas, Bibbins-Domingo said.
“The challenge is that the areas that have been least vaccinated are also the areas least resistant to a wave, which are often our rural areas” and denser, poorer urban areas, she said. “It makes sense to factor that in to some degree, just because we’re more likely to see it in those areas that can withstand it least.”