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California counts the dead by the hour as its I.C.U.s fill up.

Just two weeks ago, Gov. Gavin Newsom warned Californians that the state’s intensive care beds might be full before Christmas.

Now, it appears that this dire projection is being borne out.

How bad is the coronavirus surge in California?

In Los Angeles County, officials say, an average of two people are dying every hour. And one in every 80 people there is thought to be infected.

“Our hospitals are under siege, and our models show no end in sight,” Dr. Christina Ghaly, the director of health services in Los Angeles County, said on Thursday.

Statewide, California reported 3 percent availability of I.C.U. beds on Thursday.

But the problem is most severe in the southern part of the state. Within the month, Dr. Ghaly said, the number of patients requiring I.C.U. care in Los Angeles County “could easily exceed” the 2,500 licensed adult beds by 1,000 or more.

California continues to shatter records. On Thursday, the state reported more than 45,000 new cases and over 260 deaths. That made it the second-worst day in terms of daily reported cases and the third-worst for a single-day death toll.

And it is hardly alone. More than a third of Americans live in areas where hospitals are running critically short of intensive care beds, federal data show. A recent New York Times analysis found that 10 percent of Americans — across a large swath of the Midwest, South and Southwest — live in areas where I.C.U.’s are either completely full or have under 5 percent of beds available.

The total number of confirmed infections in the United States since the pandemic began passed 17.2 million on Thursday, just five days after eclipsing the 16-million mark. There have been at least 310,900 deaths. On Thursday alone, there were at least 238,100 new cases and at least 3,290 new deaths reported.

In California, the authorities have ordered an extra 5,000 body bags, activated an aid network for morgues and coroner’s offices, and stationed 60 refrigerated storage units in counties around the state to handle remains. Health officials in Orange County said they would roll out three field hospitals.

Hospitals are particularly overwhelmed in San Joaquin Valley, where many low-wage essential workers live without good access to health care even in the best of times.

Even the Bay Area, which for a time managed to stave off the worst of the surge, has not been spared. I.C.U. capacity there has dropped below 15 percent, leading to a new regional stay-at-home order.

The ever-climbing numbers are all the more demoralizing for Californians, because they have endured some of the most stringent pandemic restrictions in the country. But health officials said that now more than ever, they need to keep hunkering down.

”It’s going to be a wild ride probably for another four, five or six weeks,” said Dr. Nancy Gin, Kaiser Permanente’s medical director for Southern California. She urged Californians to stay home and not give in to temptation to travel as the holidays near.

The arrival of vaccinations has buoyed people’s spirits, but many health care workers are exhausted.

“It’s really hard to put all of it into words,” said Helen Cordova, an I.C.U. nurse who was the first person in California to receive a vaccine shot. “This is a very real disease — those images of inside of hospitals, that’s very accurate.”


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