With coronavirus cases surging statewide and hospital beds expected to fill rapidly, Gov. Gavin Newsom said Monday a more sweeping stay-at-home order could soon be imposed in the vast majority of California in hopes of preventing the health care system from being overrun.

Newsom said nine more of the state’s 58 counties have been moved into the most restrictive “purple” tier of the state’s COVID-19 monitoring system, meaning 51 counties are now in that tier. And those counties would be the ones likely subjected to a stay-at-home order reminiscent of the restrictions that were imposed at the onset of the pandemic, he said. All of Southern California is in the “purple” tier.

“The red flags are flying in terms of the trajectory in our projections of (case and hospitalization) growth,” Newsom said. “… If these trends continue we’re going to have to take much more dramatic, arguably drastic action, including taking a look at those purple tier counties.”

He said those actions include “the potential for a stay-at-home order for those regions in purple.”

The action follows what Newsom called an 89% increase in hospitalizations statewide over the past 14 days, and projections that the number of hospitalizations could double or triple within a month, based on the surging case numbers over the past two weeks. The state projects that 78% of hospital beds will be filled by Christmas Eve, and all currently available intensive care unit beds will be occupied by mid-December.

“We’re now looking in real time at hospitalization numbers and ICU capacity in those regions,” he said. “We are assessing this in real time over the next day or two to make determinations of deep purple moves in those purple tier status (counties) that is more equivalent, more in line with the stay-at-home order that folks were familiar with at the beginning of this year, with modifications in terms of the work that we are currently doing.”

Newsom noted that all hospitals have the ability to increase bed capacity, and the state has 11 surge facilities planned statewide that can add nearly 1,900 beds. But providing staffing for all of those beds could be an issue, he said.

Dr. Mark Ghaly, the state’s Health and Human Services Secretary, noted that since hospital numbers tend to rise about two weeks later than cases are confirmed, the impact of the infection surge over the past two weeks has not even begun to impact the already elevated hospitalization numbers.

Ghaly said everything is on the table in terms of confronting the surge, including the possible stay-at-home order.

“Everything is on the table in considering how we effectively guide the state through this, and working with our local partners to make sure what we do is both impactful and as time-limited as possible,” Ghaly said. “We know this is hard for all Californians, and (we are) making sure that we choose something that will make a difference but that we can track that difference and give people some confidence that we will only do it as long as we need to to bring the hospitals into a situation that they can handle the incoming patient numbers and provide high-quality care in a way that protects our health care workforce as well.”

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