At the current rate, that means 2,640 hospitalizations from each day’s new case total. “We know that we can expect in the upcoming weeks alarming increases in hospitalizations and deaths,” said Barbara Ferrer, health director for Los Angeles County, the state’s largest with 10 million residents. For some, “the respiratory infection becomes unbearable — they have difficulty breathing and it’s very frightening,” said California Hospital Association president and CEO Carmela Coyle.

What starts with a spike in emergency room visits can cascade into jammed hospital beds and ultimately intensive care units. California’s hospitalizations already are at record levels, and the state has seen a roughly 70% increase in ICU admissions in just two weeks, leaving just 1,700 of the state’s 7,800 ICU beds available. “That fragile but important system may be overwhelmed,” Dr. Mark Ghaly, the state’s top public health officer, said Tuesday. “And the goal of saving lives becomes threatened when that system isn’t as robust and as strong as it can be.” Several hospitals in Los Angeles County and others in San Diego, Imperial and Fresno counties are among those close to running out of intensive care beds that are needed for the sickest patients.

In response, California has requested nearly 600 health care workers to help in ICUs through a contracting agency and the federal government. It’s starting a two-day program to train registered nurses to care for ICU patients and setting up links for doctors to consult remotely on ICU patients. Some hospitals are postponing elective surgeries to free up staff and beds. “Without some major change in our overall behavior … we will see hospitals continue to feel that pressure and get overwhelmed,” Ghaly warned. With that tragic scene in mind, Gov. Gavin Newsom recently imposed an overnight curfew, a ban on nonessential travel, and issued stay-home orders in regions where open ICU beds have dipped below 15%. Similar concerns about patient overload and staffing shortages faded during the initial months of the pandemic, leaving most of the state’s auxiliary surge hospitals barely used.

But now capacity is dwindling even before the impact of infections spread by those who ignored entreaties to stay home for Thanksgiving. County health officials point to a spike in health care workers themselves becoming infected and a dearth of traveling nurses who are busy in other states dealing with their own unprecedented spikes. When specially trained critical care nurses become overwhelmed, hospitals will likely first draft post-surgery nurses to fill the void. And if they too are swamped, hospitals will shift to a team approach, where a critical care nurse oversees others with less training who can still perform many duties.

That would require waiving strict nurse-to-patient ratios that are uniquely written into law in California, something the California Nurses Association argues would inevitably endanger patients’ care. Riverside University Health System Medical Center, for instance, has opened an ICU in a former storage room, chief executive Jennifer Cruikshank told Riverside County supervisors on Tuesday. An ICU nurse who typically cares for two patients is now taking care of three, she said, and doctors and housekeepers are taking extra shifts. In another attempt to help, the state is activating the first two of 11 alternative care sites that have a total capacity of 1,862 beds. A site in hard-hit Imperial County, on the border with Mexico, already has 19 of its 25 available beds in use, though it can expand to handle 115 patients. The second site is at the former home of the Sacramento Kings professional basketball team.

The goal is to have the first 20 beds ready by Wednesday in a practice gymnasium, then prepare another 224 beds in the main arena — some in luxury suites where well-heeled fans once watched games. It’s still unclear what patients will be placed there, Office of Emergency Services spokesman Brian Ferguson said. Last spring the state spent $12 million initially setting up the arena and hiring roughly 250 medical workers who were told to expect 30 to 60 patients within days. But only nine arrived over the next 10 weeks, leaving doctors frustrated before the site was put back into mothballs. It will be staffed this time with California Medical Assistance Teams, which usually respond to disasters like wildfires, and members of Newsom’s California Health Corps — paid volunteers who are often recently retired medical professionals.

The state also is seeking workers from contract medical providers and the federal government. Newsom wants more volunteers after his corps dwindled to fewer than 900 members, less than 1% of the 93,000 who originally signed up. Only 10 corps members were recently assisting at hospitals and nursing homes. But program spokesman Rodger Butler said some have previously assisted in intensive care units and Newsom on Monday said the program “has been incredibly effective, particularly in our skilled nursing facilities,” with members helping at more than 100 facilities statewide. Coyle said the corps isn’t a major help for hospitals “because the patients we are caring for are among the most acutely ill and very few of the Health Corps volunteers were trained at that highest level.”

Fresno County has been pleading for state help to staff three area hospitals for several weeks, but was sent just one or two workers for each amid the nationwide shortage, county Emergency Medical Services Director Daniel Lynch said. “We’re fulfilling what we can, but it is getting harder,” Ghaly said. Fresno officials urged the state to open 123 alternative care beds ready for use at Porterville Development Center in Tulare County, but Lynch said they were told the state’s priority is the Sacramento arena. Now county officials are considering putting overflow beds in the Fresno Convention Center.

Ferguson defended the state’s approach of having “flexible” alternative care sites that could serve residents displaced from nursing homes or skilled nursing facilities, or absorb some of hospitals’ less serious patients. “This is kind of what the next stage of this looks like, if things go back to really bad,” Ferguson said.

Associated Press writers Brian Melley contributed from Los Angeles, Amy Taxin from Orange County and Daisy Nguyen from Oakland.

-DON THOMPSON Associated Press

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WASHINGTON (AP) — As states frantically prepare to begin months of vaccinations that could end the pandemic, a new poll finds only about half of Americans are ready to roll up their sleeves when their turn comes.

The survey from The Associated Press-NORC Center for Public Affairs Research shows about a quarter of U.S. adults aren’t sure if they want to get vaccinated against the coronavirus. Roughly another quarter say they won’t.

Many on the fence have safety concerns and want to watch how the initial rollout fares — skepticism that could hinder the campaign against the scourge that has killed nearly 290,000 Americans. Experts estimate at least 70% of the U.S. population needs to be vaccinated to achieve herd immunity, or the point at which enough people are protected that the virus can be held in check.

“Trepidation is a good word. I have a little bit of trepidation towards it,” said Kevin Buck, a 53-year-old former Marine from Eureka, California.

Buck said he and his family will probably get vaccinated eventually, if initial shots go well.

“It seems like a little rushed, but I know there was absolutely a reason to rush it,” he said of the vaccine, which was developed with remarkable speed, less than a year after the virus was identified. “I think a lot of people are not sure what to believe, and I’m one of them.”

Amid a frightening surge in COVID-19 that promises a bleak winter across the country, the challenge for health authorities is to figure out what it will take to make people trust the shots that Dr. Anthony Fauci, the top U.S. infectious-disease expert, calls the light at the end of the tunnel.

“If Dr. Fauci says it’s good, I will do it,” said Mary Lang, 71, of Fremont, California. She added: “Hopefully if enough of us get the vaccine, we can make this virus go away.”

Early data suggests the two U.S. frontrunners — one vaccine made by Pfizer and BioNTech and another by Moderna and the National Institutes of Health — offer strong protection. The Food and Drug Administration is poring over study results to be sure the shots are safe before deciding in the coming days whether to allow mass vaccinations, as Britain began doing with Pfizer’s shots on Tuesday.

Despite the hopeful news, feelings haven’t changed much from an AP-NORC poll in May, before it was clear a vaccine would pan out.

In the survey of 1,117 American adults conducted Dec. 3-7, about 3 in 10 said they are very or extremely confident that the first available vaccines will have been properly tested for safety and effectiveness. About an equal number said they are not confident. The rest fell somewhere in the middle.

Experts have stressed that no corners were cut during development of the vaccine, attributing the speedy work to billions in government funding and more than a decade of behind-the-scenes research.

Among those who don’t want to get vaccinated, about 3 in 10 said they aren’t concerned about getting seriously ill from the coronavirus, and around a quarter said the outbreak isn’t as serious as some people say.

About 7 in 10 of those who said they won’t get vaccinated are concerned about side effects. Pfizer and Moderna say testing has uncovered no serious ones so far. As with many vaccines, recipients may experience fever, fatigue or sore arms from the injection, signs the immune system is revving up.

But other risks might not crop up until vaccines are more widely used. British health authorities are examining two possible allergic reactions on the first day the country began mass vaccinations with the Pfizer shot.

Among Americans who won’t get vaccinated, the poll found 43% are concerned the vaccine itself could infect them — something that’s scientifically impossible, since the shots don’t contain any virus.

Protecting their family, their community and their own health are chief drivers for people who want the vaccine. Roughly three-quarters said life won’t go back to normal until enough of the country is vaccinated.

“Even if it helps a little bit, I’d take it,” said Ralph Martinez, 67, who manages a grocery store in Dallas. “I honestly think they wouldn’t put something out there that would hurt us.”

Over the summer, about a third of Martinez’s employees were out with COVID-19. He wears a mask daily but worries about the constant public contact and is concerned that his 87-year-old mother is similarly exposed running her business.

COVID-19 has killed or hospitalized Black, Hispanic and Native Americans at far higher rates than white Americans. Yet 53% of white Americans said they will get vaccinated, compared with 24% of Black Americans and 34% of Hispanics like Martinez.

Because of insufficient sample size, the survey could not analyze results among Native Americans or other racial and ethnic groups that make up a smaller proportion of the U.S. population.

Horace Carpenter of Davenport, Florida, knows that as a Black man at age 86, he is vulnerable. “I’d like to see it come out first,” he said of the vaccine. But he said he, too, plans to follow Fauci’s advice.

Given the nation’s long history of racial health care disparities and research abuses against Black people, Carpenter isn’t surprised that minority communities are more hesitant about the new vaccines.

“There is such racial inequality in our society,” he said. “There’s bound to be some hiccups.”

Health experts say it is not surprising that people have doubts because it will take time for the vaccines’ study results to become widely known.

“Sometimes you have to ask people more than once,” said John Grabenstein of the Immunization Action Coalition, a retired Army colonel who directed the Defense Department’s immunization program. He said many eventually will decide it’s “far, far better to take this vaccine than run the risk of coronavirus infection.”

Adding to the challenge are political divisions that have hamstrung public health efforts to curtail the outbreak. The poll found 6 in 10 Democrats said they will get vaccinated compared with 4 in 10 Republicans; about a third of Republicans said they won’t.

Only about 1 in 5 Americans are very or extremely confident that vaccines will be safely and quickly distributed, or fairly distributed, though majorities are at least somewhat confident.

Nancy Nolan, 64, teaches English as a second language at a New Jersey community college and has seen the difficulty her students face in getting coronavirus testing and care. “I don’t think it’ll be fairly distributed,” she said. “I hope I’m wrong.”

She raised concerns, too, over the speed with which the vaccine was developed: “If I rush, I could have a car accident, I could make a mistake.”

Health workers and nursing home residents are set to be first in line for the scarce initial doses. Plans call for other essential workers and people over 65 or at increased risk because of other health problems to follow, before enough vaccine arrives for everyone, probably in the spring.

The poll found majorities of Americans agree with that priority list. And 59% think vaccinating teachers should be a high priority, too. Most also agree with higher priority for hard-hit communities of color and people in crowded living conditions such as homeless shelters and college dorms.

“Once those individuals are cared for, I wouldn’t hesitate to get the vaccine if it was available for me,” said Richard Martinez, 35, a psychologist in Austin, Texas, who nonetheless understands some of the public skepticism.

“I think it’d be naïve to think that resources wouldn’t get someone to the front of the line,” he said.

___

AP journalists Marion Renault, Federica Narancio and Kathy Young contributed to this report.

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As the Covid-19 quarantine continues to keep everyone apart, the valley community is gathering together to help keep the Historic Hemet Theatre from becoming a victim of the pandemic. Just a couple of months ago, it looked like 2020 was going to be a spectacular year for the popular concert venue:

The first three concerts of the year, featuring tributes to Elton John, Karen Carpenter and Tina Turner, were sell outs; Final touches were coming together on a stunning lobby renovation; Architects and the City of Hemet were tweaking the plans for the next phase of construction; and volunteers were brainstorming ideas for a dozen special events to celebrate the 100th birthday of the theatre in 2021.

Since then, the box office has been locked up tight and nine concerts have been postponed. It is likely that several more will be postponed before state and local officials allow the facility to reopen.

Even after movie theaters open, HHT will remain silent until all the social distancing restrictions are removed. With top bands and low ticket prices, HHT events cannot even pay the band with only 25% of seats filled.

Meanwhile, in order to help meet its financial obligations during the shutdown, HHT has launched a fundraiser on Facebook and social media. Donations from Facebook, the HHT website and checks through the mail are arriving every day.

In just the first week, over $3600 was raised from patrons and supporters helping to keep the Foundation going through the virus emergency. Meanwhile, patrons holding tickets are waiting for the box office to reopen and they can exchange their tickets for an upcoming show. Once a reopening is scheduled, tickets will be available for the remainder of the year.

To join the campaign to help keep HHT alive, visit the theatre’s website, www.HistoricHemetTheatre.com, or Facebook page, www.facebook.com/HistoricHemetTheatre.

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RIVERSIDE (CNS) – Riverside County has had its largest single-day increase in the number of coronavirus cases — 210 — and the county’s top health official says that, with a total 1,961 documented infections, the process of relaxing austerity measures imposed on the public will not happen immediately.

“There is a modest slowing because of social distancing,” Public Health Officer Dr. Cameron Kaiser said during a briefing at the County Administrative Center in Riverside Wednesday. “We have been underwater for a long time. It’s bad. But it will be worse if we come up too soon and then have to go back under.”

Kaiser said the doubling rate — a 100% increase in COVID-19 cases every five days — appears to be settling down, but there “are more cases to find, and we’re still testing.”

Metrics point to the doubling rate as a primary indicator that there has been no moderation in infectious spread. In order for the doubling rate to materialize this week, the county would have to have recorded record a total of 2,700 coronavirus cases by the end of Wednesday.

“Whatever we do in the short term is about finding cases and containing them,” the doctor said. “Don’t expect a lot of change. Even if I tear up every single emergency health order that I’ve signed to date, the governor’s order still applies. There might a relaxation (in mandates) by region, or statewide, and some mandates may be looser, while others will not be.”

“This is a gradual, step-by-step process. There will be long-standing changes in the way we do business to keep COVID-19 contained in the county,” he said.

The virus-related death toll was unchanged at 50, a day after officials reported nine more fatalities — the largest single-day jump in deaths.

Officials this week began sharing specific data on the COVID-19-linked deaths, showing that 41 have been men. More than half of the county’s deaths — 28 — were people between the ages of 65 and 84, the data indicated.

There are now 376 patient recoveries, officials said. Recovered patients are defined as those who have completed their period of isolation and are no longer symptomatic, according to county spokeswoman Brooke Federico.

Kaiser said more than 29,000 residents have been tested for the virus, and with four screening locations countywide, there’s capacity to test 2,200 people daily.

“Many of you in the small-business community are losing tremendous amounts of money while we’re keeping the community safe,” Dr. Michael Mesisca of Riverside University Health System said Friday. “We hope to see some progress, but our modeling is still playing out,” he said. “We hear of other places where the positive (infection) rates are coming down, such as New York.

We hope to see that here.”

The fourth county-run testing site opened Tuesday at the Perris Fairgrounds. The location will be staffed Tuesdays to Saturdays, 9:30 a.m. to 3 p.m. The other sites are at the county Fairgrounds in Indio, The Diamond in Lake Elsinore and Harvest Christian Fellowship in Riverside. Appointments to visit any of the sites must be made in advance at 800-945-6171.

Workers are still needed at the second federal field hospital to open in the county, this one inside the shuttered Sears store at Arlington and Streeter avenues in Riverside.

National Guard personnel are working with a U.S. Department of Health & Human Services team to prepare the 125-bed facility for opening in the next several weeks. It will be reserved for sub-acute patients, according to Emergency Management Department Director Bruce Barton.

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