COVID-19 hospitalizations rising faster in California than at any other point in the pandemic

The number of patients with COVID-19 in California’s hospitals is now rising at a faster clip than at any previous time, a surprising development nearly three years into the pandemic.

The spike comes as the highly contagious omicron variant is driving COVID cases nationally to new daily records, and experts worry the wave may just be arriving in the Golden State.

According to a Bay Area News Group analysis, the day-over-day increase in coronavirus hospitalizations in California is steeper than ever, with 451 more people hospitalized Tuesday than the previous day, which was up 346 patients from the day before that. Locally, COVID-19 hospitalizations have spiked most sharply in Contra Costa County — up 76% in the last two weeks. In Orange County to the south, they’ve risen 89%.

“This concerns me,” said infectious disease expert John Swartzberg, clinical professor emeritus at UC Berkeley’s School of Public Health. “I’m going into next week feeling less secure than I was previously.”

Despite the sharp rise, the total number of COVID-19 hospitalizations in California — about 5,200 — is still only about one-fourth of the number during last winter’s surge. But as the omicron surge began late last month, health experts had hoped California might avoid a sharp bump in hospitalizations as the state saw last winter when vaccines weren’t widespread because the new variant appeared to be causing milder illness than delta. That still may be the case, with shorter stays and less severe outcomes. But the growing numbers indicate that the virus is so infectious and spreading to so many people that even if many only experience mild or zero symptoms, plenty of others are getting sick enough to land in the emergency room.

Hospitals, Swartzberg said, will be closely monitoring their available beds, supplies and protective gear and evaluating whether to scale back elective surgeries or visitors.

“We’re going through a really dangerous period over the next at least two weeks, maybe three,” he said.

Across the country, the numbers are alarming. On Tuesday, the Centers for Disease Control and Prevention reported a seven-day average of 277,000 new daily cases. That topped the previous record of more than 250,000 on Jan. 11. But at a White House news conference on Wednesday, Dr. Rochelle P. Walensky, director of the Centers for Disease Control and Prevention, said the rise in hospitalizations and deaths is still lagging behind the record rise in cases.

“This could be due to the fact that hospitalizations tend to lag behind cases by about two weeks,” she said, “but may also be due to early indications that we’ve seen from other countries like South Africa and United Kingdom of milder disease from omicron, especially among the vaccinated and the boosted.”

Either way, Bay Area hospitals are taking action. John Muir Health, which operates medical centers in Concord and Walnut Creek, is canceling many elective surgeries that require an overnight stay and limiting the number of cases added to cardiac catheterization lab schedules until at least Jan. 4, said spokesperson Ben Drew. Emergency surgeries and procedures will continue.

Russell Rodriguez, John Muir’s interim chief medical officer, said the health system has also begun limiting visitors in its emergency department waiting rooms.

At Santa Clara Valley Medical Center, said Chair of the Department of Medicine Clifford Wang, “we’re preparing for a potential surge in hospitalizations.”

Santa Clara County has seen a 13% rise in COVID-19 hospitalizations in the last couple of weeks, a more subdued increase than in most surrounding counties. But the county’s three-hospital medical system has been proactively stocking up on protective gear and making plans to bump up staff if needed.

“We’re better set up for handling surges than in the past,” he said.

Michael Vollmer, an infectious disease specialist and Northern California regional epidemiologist with Kaiser Permanente, said the health care giant has “always anticipated increased hospitalization following big community surges” and is seeing some rise, with more expected.

Kaiser hasn’t had to cancel elective surgeries yet, Vollmer said, but “these are levers hospitals have at their disposal.”

Visitor restrictions are back in effect at many hospitals in the region, including Kaiser in Santa Clara, where on Monday Paul Sossaman visited a coworker who suffered a stroke two weeks ago. The next day, he said, another coworker and the mother of the man, who is not expected to recover, were turned away along with other would-be hospital visitors.

“How can they do such a thing?” Sossaman asked.

One thing that is not clear at most hospitals is how many patients are hospitalized for COVID rather than just with COVID — meaning they came in for another reason but turned up positive during routine testing.

“This will become a central question going forward — though some of the implications are the same,” Bob Wachter, chair of the Department of Medicine at UCSF, said in an email. “I’ve not seen a hospital (including my own) break out these two numbers (for vs. with) but I think we’re going to need to do that. With the prevalence of mild COVID growing astronomically, I suspect that a decent fraction of the growth is, in fact, ‘with.’ “

Rodriguez says John Muir has picked up some incidental cases, including a pregnant woman coming in to deliver and a trauma patient, through standard testing of inpatients. That’s also happening at Santa Clara Valley Medical Center.

“It kind of confirms we’re seeing less severe disease in the hospital compared to delta, but we still want to be on guard,” Wang said.

Regardless of how the cases are discovered, Wachter said, COVID patients “still could contribute to hospitals being overwhelmed since they take more time to care for and require more monitoring — on top of managing the very large staff shortages that we’re all beginning to experience.”

Across the region, health experts are urging people to get vaccinated and boosted to stay out of the hospital.

“The areas that have had more of a burden of hospitalizations,” Vollmer said, “have been areas with lower rates of vaccination.”

“I know everyone is tired,” Wang said. “Hopefully this peak will be much faster.”