California’s post-Thanksgiving Covid surge offers sobering lesson to Ireland

San Francisco Letter: The formerly cautious state is in a dire situation after people let their guard down

People hug outside Providence St Mary Medical Center amid a surge in Covid-19 patients in southern California on December 18th, in Apple Valley. Photograph: Mario Tama/Getty Images

Winter here in the San Francisco Bay Area is cool, crisp and bright. The sky is a clear, rich blue and the afternoon sun sits low on the horizon. But a dark cloud hangs over us here, as Covid-19 infection rates spiral out of control and intensive care units reach critical capacity, with no sign of any improvement. In fact, it appears that the situation is on track to get significantly worse.

Last Wednesday, the San Francisco Bay Area entered a regional stay-at-home order triggered by ICU capacity dropping to a meagre 12.9 per cent. In the state of California as a whole, four out of five regions have been forced into a lockdown due to similarly dwindling ICU capacity. The situation in southern California, which includes LA, and in the central San Joaquin Valley region, which includes vast swathes of farming territory, is even worse, with both regions already at zero per cent ICU capacity.

Dr Sara Cody, the public health director of Santa Clara county in the heart of Silicon Valley, fought back tears when she spoke last week about the unprecedented surge. "Unfortunately, I mostly have very, very difficult news to share . . . We have very dark days ahead," she said. "Our pandemic locally is out of control . . . Our healthcare system is quite stretched. Not to the breaking point, but steadily marching toward that point."

Body bags

California governor Gavin Newsom noted grimly that the state had just ordered 5,000 additional body bags and had 60 53ft refrigerated storage units on standby to deal with the anticipated mass death toll. "That should be sobering," he said. "I don't want to scare folks, but this is a deadly disease and we need to be mindful of where we are. We are not at the finish line yet."


The Covid-19 situation here in the Bay Area and across the entire state of California is the worst yet in the nine-month pandemic. Over the past week there has been an average of 41,725 new cases per day in California, and last Wednesday there were a record 398 deaths in a single day. Current Covid-19 figures have far outstipped the initial outbreak in March and April, and have even eclipsed a summer surge that came after July 4th celebrations.

This winter outbreak in the Bay Area was sudden and dramatic, and took many people by surprise: in mid-October, the Covid-19 numbers for the 11-county Bay Area region hovered around a manageable seven-day average of 484 new cases a day. This region has a population of 8.5 million, almost twice that of the Republic of Ireland, which by comparison is currently tracking at a weekly average of 431 daily cases.

Around that time in October, Bay Area restrictions on indoor dining had recently been lifted, gyms and cinemas had opened with limited capacity, hair salons and beauty parlours were allowed to operate indoors, and some schools had reopened for in-person learning. But then, the now-familiar story played out: a mixture of pandemic fatigue and complacency set in, and with the loosening restrictions people started resuming activities, socialising, dining out and travelling.

There was an initial surge about two weeks after Halloween, as Covid-19 numbers in the Bay Area crept up. Then as Thanksgiving approached on November 26th, the Covid-19 figures looked increasingly dire, and local health officials pleaded with people to cancel plans to celebrate the occasion with extended family or other households, to limit all social interactions and to avoid travel. But it was too little, too late.

The surge following Thanksgiving has been dramatic and deeply concerning: the San Francisco Bay Area has jumped from a weekly average of 484 cases per day in mid-October to an average of 4,891 daily cases by mid-December, and there is no sign of the numbers abating. Indeed, they keep increasing.

Burnt out

Doctors and nurses, already exhausted and burnt out after nine months of being overworked in understaffed hospitals, are now facing their most challenging period yet as ICUs fill up across the state and hospitals risk being overwhelmed. "We are getting crushed," said Brad Spellberg, chief medical officer at Los Angeles County-University of Southern California Medical Center. "I'm not going to sugar-coat this."

Early on in the pandemic, California was praised for its rapid and effective response, which quickly brought the rate of infections under control. It has consistently been one of the most cautious states in the US in its response to Covid-19, with the strictest restrictions and widespread mask-wearing. But despite this we have not been spared the unrelenting rampage of the disease.

This Christmas, it wouldn’t take much for Ireland to find itself in a similar situation. Whatever plans you have made to meet family or friends, rethink them.

An easing of restrictions and relatively low case numbers can lull people into a false sense of security. The people of California are suffering the consequences of exactly this.