Stay-at-home orders were extended Tuesday for two large parts of California as hospitals have been severely strained by surging Covid-19 cases, health officials said.
"We certainly know that Southern California hospitals are in crisis, and some have begun to implement parts of crisis care," Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, said in a video briefing.
No facility has notified the state that it is fully in crisis care yet, but some in Southern California have made decisions that would be a part of that, he said, including decisions about how to accept ambulances and staffing.
A hospital in Los Angeles turned its chapel into an overflow unit. Ghaly said that wait times have been much longer than normal in some emergency departments and that hospitals are using post- and pre-operation beds to care for Covid-19 and other patients, among other steps.
Gov. Gavin Newsom warned Monday that travel during the last holiday week made it all but inevitable that the state would have a "surge on top of a surge."
Full coverage of the coronavirus outbreak
Most of the state is under regional stay-at-home orders that have required some businesses, like bars, wineries and hair salons, to close and have reduced capacity in others — the requirements kick in once a region's intensive care capacity falls below 15 percent.
Southern California and the San Joaquin Valley remained at zero percent ICU availability Tuesday, which means not that there are no beds but that hospitals have had to go to surge capacity. The orders were extended into 2021 and will remain in place until projections show that the ICU threshold is reached.
Los Angeles County health officials reported 227 more Covid-19 deaths Tuesday and said hospitalizations passed 7,000 for the first time in the pandemic.
"Suffering followed by more suffering continues as too many residents and businesses behave as if we are not living in the most dangerous time of the most devastating pandemic," Dr. Barbara Ferrer, the county health director, said in a statement.
She pleaded with residents to cancel New Year's parties, saying, "We are each other's keepers."
More than 31,200 cases were reported statewide Tuesday, and the positivity rate is averaging around 12 percent, according to the state health department. It is higher in Los Angeles County, at more than 16 percent.
Download the NBC News app for full coverage of the coronavirus outbreak
California has had more than 2.1 million people with Covid-19, and 24,500 have died, the state health department said.
Northern California is the only region not under a regional stay-at-home order. Newsom said Monday that among the biggest areas of concern are Southern California and the Los Angeles area.
Newsom said 96 percent of Los Angeles County hospitals were "under diversion" Saturday, meaning they can't accept ambulances and must divert them elsewhere. Even in the pandemic, the number was 33 percent before the current surge in cases, he said.