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California exceeds 1 million coronavirus cases; the second state to do so after Texas

Staff and wire reports

California became the second state to surpass 1 million coronavirus cases on Thursday, according to data from Johns Hopkins University.

The nation’s most populous state has now reported 1,000,631 coronavirus cases and more than 18,000 deaths as the calendar inches closer to flu season amid the holidays — two factors that health officials worry could stress the California health care system.

It is the second state to hit the grim milestone after Texas, the second-most populous in the U.S., became the first Wednesday. Its border city of El Paso is adding mobile morgues in anticipation of virus deaths overwhelming hospitals for weeks.

California is home to about 40 million residents, roughly 10 million more than Texas. The true number of infections for all states is likely much higher because many infected don't feel sick and have not been tested.

Only 10 countries have surpassed 1 million cases as of Thursday, according to Johns Hopkins. 

While the infection rate in California remains much lower than the U.S. as a whole, coronavirus is engulfing the country from coast to coast. Health officials fear the trend will accelerate in the Golden State as relatives gather for the holidays and spend more time inside during winter months. They're expected to release more rigid holiday guidelines in the coming weeks.

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Already, Gov. Gavin Newsom has said that "Uncle Joe with a heart condition shouldn’t be coming over to see the kids for the holidays."

The U.S. Centers for Disease Control and Prevention advises holiday celebrations occur only between members of the same household this year, instead of inviting other family members or friends over for a group meal.

As countries across the globe experience second surges, officials are also saying holiday travel should be avoided this year. New lockdowns in England and Wales mean international travel is only permitted for business or education. In England, people traveling home for the holidays could face fines. 

Travel restrictions are meant to lessen spread of the virus as cases have spiked in recent weeks in France, Spain, England, Germany and Italy, among other countries.

The U.S. has recorded over 240,000 deaths and about 10.3 million confirmed infections, with new cases soaring to all-time highs of well over 120,000 per day over the past week. Health experts have blamed the increase in part on the onset of cold weather and growing frustration with mask-wearing and other precautions.

In New York, Gov. Andrew Cuomo said all restaurants, bars and gyms statewide will have to close at 10 p.m. starting Friday, a major retreat in a corner of the U.S. that had seemingly brought the virus largely under control months ago. He also barred private gatherings of more than 10 people.

Between the cold weather, lax behaviors and the holidays, December and January will be the worst months the U.S. has seen so far in the COVID-19 pandemic, public health experts said. 

Coronavirus spreading in all parts of state

More areas of California are imposing restrictions on businesses to try to curb a resurgence of the virus that has hospitalizations rising as they did in June when the state mandated masks, officials said this week.

Three of the largest counties are among 11 statewide with sufficiently high numbers of infections to trigger state-mandated limits on business operations. In contrast, San Francisco, which has the lowest virus case rates among California's major cities, voluntarily imposed new restrictions, including a ban on indoor dining. 

San Diego, Sacramento and Contra Costa counties all moved backward this week in the state's four-tiered system for reopening, which is based on case and infection rates.

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“We are certainly seeing, almost all across the state, an upward trajectory," Dr. Mark Ghaly, California's secretary of health and human services, said on Tuesday.

Thirty-eight of California’s 58 counties were in the most restrictive tier when the state launched the new system at the end of August. That number fell to 10 as case rates declined statewide into October but now is at 12, including four of the five largest counties — Los Angeles, San Diego, Riverside and San Bernardino. 

The state's average number of daily cases, hospitalizations and intensive care cases began rising in mid-October. The rate of infections climbed from a seven-day average of 2.9% two weeks ago to 4.2% this week.

"We hadn’t seen test positivities above 4 since the end of August, early September,” Ghaly said.

How did California get here?

California imposed the nation's first statewide stay-home order in March. Cases plateaued in early spring, then began sharply rising in June after much of the state's economy was reopened. 

Shutdowns were ordered and cases peaked mid-summer, then began a sharp decline until last month. Hospitalizations have risen more then 25% in the past two weeks to more than 3,000, similar to where those numbers were when the June spike occurred but far below the high of more than 7,000 in July. 

Residents of San Diego County, California’s second-most populous with 3.3 million people and an over-achiever among large counties for much of the pandemic, “got lulled into complacency,” Supervisor Nathan Fletcher said. “Unfortunately, COVID-19 doesn’t get complacent, it doesn’t get fatigued, it doesn’t get tired.”

But it's not just major population centers that are seeing increases. Rural Modoc, Siskiyou and Trinity counties in far Northern California moved one step back this week from the least restrictive tier of the state's reopening plan.

The new restrictions bring increased dilemmas for restaurants, houses of worship and other businesses and institutions that must keep activities outside just as California’s wet, windy and cooler winter arrives. Schools may have to continue remote instruction instead of renewing in-person classes.

What's the path forward?

While a coalition of Southern California counties are trying to push the state to relax restrictions, San Francisco County is doing the opposite—  despite seeing much fewer cases than its southern neighbors. 

San Francisco, which has from the start taken an aggressive approach to combatting the virus, will halt indoor dining starting Saturday, including at food courts, restaurants and bars that serve food. High schools that have not yet reopened indoors will not be able to do so and gyms and movie theaters will have to cut back capacity.

San Francisco County currently is reporting five new COVID-19 cases per day per 100,000 people and a positivity rate of 1.1%.

“Making a decision to support opening a business, and then asking that business to close, it is heartbreaking," Mayor London Breed said. "It is very, very unfortunate, but it is necessary."

These tough decisions before a surge happens are necessary, health officials have said, because a rise in cases has the potential to overwhelm hospitals again.

“(Thinking about increasing hospitals) will become more important as people move indoors during the winter, as people have more flu and respiratory symptoms, and we see more people mingling,” Newsom said. “The numbers are sobering, but the total capacity we built out is greater than even a few weeks ago, a few months ago.”

Desert Sun editor Kristin Scharkey and reporter Nicole Hayden, Associated Press and USA Today contributed to this report.