The stay-at-home orders in place for Southern California and the San Joaquin Valley were theoretically eligible to expire on Monday, but in a grim post-Christmas reality check, Gov. Gavin Newsom said that it was “self-evident” that the restrictions must be extended.
“Things, unfortunately, will get worse before they get better,” the governor said in a news conference on Monday.
[Track coronavirus cases, as well as hospitalizations and deaths, by county in California.]
Hospitals — already overwhelmed across much of the state — must prepare for what experts have projected to be a “surge on top of a surge, arguably on top of another surge,” stemming from the holidays, Mr. Newsom said.
And the state has sent a team to Los Angeles County to help address an influx of patients, which led to people being turned away from emergency rooms at alarming rates over the weekend.
“Routine E.R. care is being slowed,” Mr. Newsom said. “The impact of this pandemic is being felt on the entire hospital system, and could impact each and every one of us — God forbid.”
California has in recent weeks become the epicenter of the pandemic, with more than two million confirmed virus cases, and 24,331 deaths, according to a New York Times database.
Intensive care units have been at or near capacity for weeks in Southern California and the Central Valley. Doctors and nurses have been forced to treat patients in lobbies and hallways. Tents have been erected to serve as waiting rooms, and in some cases, as field hospitals.
And even if most health care providers hadn’t formally begun rationing care, experts have said that full hospitals will probably result in fewer people seeking care they need, which is most likely already causing more deaths.
[See how full intensive care units are at hospitals near you.]
The current tidal wave of infections in the state, the nation’s most populous, started rising before Thanksgiving. As case numbers continued to skyrocket early this month, state leaders announced a plan for regional stay-at-home orders tied to intensive care unit capacity.
The restrictions, officials said at the time, could expire in three weeks, as long as intensive care units were projected to have 15 percent of their capacity available. The idea that trends would reverse — or at least level off — within that time felt optimistic, but theoretically possible.
With distribution of a coronavirus vaccine beginning in the U.S., here are answers to some questions you may be wondering about:
- If I live in the U.S., when can I get the vaccine? While the exact order of vaccine recipients may vary by state, most will likely put medical workers and residents of long-term care facilities first. If you want to understand how this decision is getting made, this article will help.
- When can I return to normal life after being vaccinated? Life will return to normal only when society as a whole gains enough protection against the coronavirus. Once countries authorize a vaccine, they’ll only be able to vaccinate a few percent of their citizens at most in the first couple months. The unvaccinated majority will still remain vulnerable to getting infected. A growing number of coronavirus vaccines are showing robust protection against becoming sick. But it’s also possible for people to spread the virus without even knowing they’re infected because they experience only mild symptoms or none at all. Scientists don’t yet know if the vaccines also block the transmission of the coronavirus. So for the time being, even vaccinated people will need to wear masks, avoid indoor crowds, and so on. Once enough people get vaccinated, it will become very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we as a society achieve that goal, life might start approaching something like normal by the fall 2021.
- If I’ve been vaccinated, do I still need to wear a mask? Yes, but not forever. Here’s why. The coronavirus vaccines are injected deep into the muscles and stimulate the immune system to produce antibodies. This appears to be enough protection to keep the vaccinated person from getting ill. But what’s not clear is whether it’s possible for the virus to bloom in the nose — and be sneezed or breathed out to infect others — even as antibodies elsewhere in the body have mobilized to prevent the vaccinated person from getting sick. The vaccine clinical trials were designed to determine whether vaccinated people are protected from illness — not to find out whether they could still spread the coronavirus. Based on studies of flu vaccine and even patients infected with Covid-19, researchers have reason to be hopeful that vaccinated people won’t spread the virus, but more research is needed. In the meantime, everyone — even vaccinated people — will need to think of themselves as possible silent spreaders and keep wearing a mask. Read more here.
- Will it hurt? What are the side effects? The Pfizer and BioNTech vaccine is delivered as a shot in the arm, like other typical vaccines. The injection into your arm won’t feel different than any other vaccine, but the rate of short-lived side effects does appear higher than a flu shot. Tens of thousands of people have already received the vaccines, and none of them have reported any serious health problems. The side effects, which can resemble the symptoms of Covid-19, last about a day and appear more likely after the second dose. Early reports from vaccine trials suggest some people might need to take a day off from work because they feel lousy after receiving the second dose. In the Pfizer study, about half developed fatigue. Other side effects occurred in at least 25 to 33 percent of patients, sometimes more, including headaches, chills and muscle pain. While these experiences aren’t pleasant, they are a good sign that your own immune system is mounting a potent response to the vaccine that will provide long-lasting immunity.
- Will mRNA vaccines change my genes? No. The vaccines from Moderna and Pfizer use a genetic molecule to prime the immune system. That molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse to a cell, allowing the molecule to slip in. The cell uses the mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any moment, each of our cells may contain hundreds of thousands of mRNA molecules, which they produce in order to make proteins of their own. Once those proteins are made, our cells then shred the mRNA with special enzymes. The mRNA molecules our cells make can only survive a matter of minutes. The mRNA in vaccines is engineered to withstand the cell’s enzymes a bit longer, so that the cells can make extra virus proteins and prompt a stronger immune response. But the mRNA can only last for a few days at most before they are destroyed.
But capacity in the Southern California region, which includes Los Angeles, Orange and San Diego Counties, dropped below the 15 percent threshold to trigger the restrictions almost immediately. So did capacity in the San Joaquin Valley, which has been particularly hard hit throughout the pandemic.
Now, some 98 percent of Californians are living under the restrictions, which prohibit gatherings of people from different households and require restaurants to serve only takeout.
Mr. Newsom said the state would most likely make the extension of the orders official today.
Here are a few more things to know:
The governor has said California hoped to have gotten a little more than two million vaccine doses by the end of the year. But by the end of the week, the state expects to have received only 1.76 million doses. Still, Mr. Newsom said the effort had been monumental.
Starting on Monday, nursing home residents were set to begin getting Pfizer vaccine doses administered by CVS and Walgreens through a federal partnership, Mr. Newsom announced. Los Angeles County has opted out, though, as The Wall Street Journal recently reported.
Mr. Newsom said that the plan for the next phase of the vaccine distribution was likely to be finalized in coming days. After health care workers and care home residents, the expected guidelines would prioritize people who are 75 and older, as well as education and child care workers, emergency services workers, and grocery store employees and other workers in the food supply chain.
As cases in Los Angeles reach crisis levels, public health officials are requiring anyone who has traveled outside Los Angeles County and recently returned to quarantine for 10 days.
It rained in Southern California
On Sunday night, Southern California got its first real storm in months. Lightning flashed. Thunder clapped. Angelenos (like me) were wrested from deep slumber by the sound of pouring rain. A lot of people felt compelled to tweet about it.
Although the weather prompted warnings about debris flows, light flooding and bad driving, the news was generally met with glee. Rain, of course, dampens fire risk and helps spur plant growth in places that have burned.
Tuesday was set to be sunny.
California Today goes live at 6:30 a.m. Pacific time weekdays. Tell us what you want to see: CAtoday@nytimes.com. Were you forwarded this email? Sign up for California Today here and read every edition online here.
Jill Cowan grew up in Orange County, graduated from U.C. Berkeley and has reported all over the state, including the Bay Area, Bakersfield and Los Angeles — but she always wants to see more. Follow along here or on Twitter.
California Today is edited by Julie Bloom, who grew up in Los Angeles and graduated from U.C. Berkeley.