How Bad Could California’s Winter Coronavirus Surge Get?

After falling since late summer, coronavirus cases in the state have begun to tick up.


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Sleep Train Arena was converted into a 400-bed emergency field hospital to help deal with the surge of coronavirus cases last year in Sacramento.Credit…Rich Pedroncelli/Associated Press

As you probably remember, the winter coronavirus surge in California last year was nothing short of catastrophic.

Emergency rooms were so full that ambulances often had nowhere to drop off patients desperate for treatment. Hospitals needed refrigerated trucks to manage the overflow of bodies in their morgues. In less than three months, California’s death toll from Covid-19 more than doubled.

So, with our second pandemic winter nearly upon us, will disaster strike again?

Coronavirus cases in California have been ticking up since late October. The state is preparing for the possibility of a winter surge — what Gov. Gavin Newsom last week called his “biggest anxiety.”

But unlike last year, 76 percent of Californians have gotten at least one dose of a coronavirus vaccine. That means that while the holiday season may again lead to more transmission of the virus, the consequences will be less ruinous, experts say.

“I don’t think we’ll have the same huge peak we had last winter, but I do think we will see another peak,” Dr. Timothy Brewer, an infectious-disease expert at the University of California, Los Angeles, told me. “And the big difference will be because of the large number of people vaccinated.”

Why numbers will keep climbing

Getting your Covid-19 shots remains the best way to protect against serious illness. And as of last week, all Californians can now receive booster doses to enhance immunity.

But the fact remains that some 9.5 million Californians are totally unvaccinated against the coronavirus. And that’s where things get tricky.

Even in a place like San Francisco, which has one of the highest vaccination rates in the state, tens of thousands of people — roughly a quarter of the city’s population — aren’t fully vaccinated, according to a New York Times vaccination tracker. And some residents who have gotten their shots may have had their immunity wane in recent months.

“From an individual perspective, I feel really safe,” said Dr. Kirsten Bibbins-Domingo, an epidemiologist at the University of California, San Francisco, who added that she and her family had gotten their boosters. “But I don’t feel like the city where I live, the state where I live, will be out of the woods. That I don’t feel confident about.”

Bibbins-Domingo and others worry that hospitals could still be overloaded, mostly by unvaccinated individuals, as the virus takes off this winter. Unvaccinated Californians are nearly 10 times more likely to be hospitalized with Covid-19 as those who are fully immunized.

The next few months concern epidemiologists because the coronavirus appears to follow a seasonal pattern — similar to how the flu proliferates in the winter — that causes a peak in California in the summer and a bigger one around the end of the year.

Plus, the arrival of chillier weather pushes people to socialize indoors, where it’s easier for the virus to spread. And during the Thanksgiving and winter holidays, families and friends from multiple households tend to congregate, further increasing the chances of coronavirus transmission.

These conditions could mean that regions with large numbers of unvaccinated people, such as the Central Valley and far Northern California, could see disastrous overflows in their hospitals, experts say. (Already, these regions have the highest level of transmission in the state.)


Thanksgiving last year in Los Angeles.Credit…Isadora Kosofsky for The New York Times

Adjusting to living with the coronavirus

Still, even if California logs as many new coronavirus cases as it did last winter (which seems unlikely), the death toll won’t approach the same heights because so many people have protection conferred by the vaccines.

In recent days, some experts have been calling for California to focus on hospitalizations instead of case numbers, since most people who become infected won’t also become seriously ill.

Brewer, the U.C.L.A. physician, recommended that vaccinated Californians think about holiday precautions differently than they did last year, when officials asked everyone to stay home.

He instead suggested figuring out what Covid-19 precautions can make your gatherings safer. The most important thing, he said, is to make sure that everyone you spend time with is vaccinated. Then perhaps consider avoiding parties with hundreds of people.

“I think what people need to realize is that this virus is not going away,” Brewer told me. “So going into the holidays, people need to recognize that the coronavirus will be out there. There will be transmission. There will be cases, and the question just is: What is your comfort level in terms of trying to go on with your life?”

For more:

Check your community’s vaccination rates.

What we know so far about waning vaccine effectiveness.

Los Angeles has a new vaccination mandate for businesses.


A Glock-style ghost gun at the San Francisco district attorney’s office. Homemade firearms now account for a significant portion of shootings in California. Credit…Kelsey McClellan for The New York Times

If you read one story, make it this

The proliferation of untraceable firearms known as “ghost guns” has reached epidemic proportions in California.


Nurses and workers staged an informational picket outside the Kaiser Permanente San Francisco Medical Center last week.Credit…Justin Sullivan/Getty Images

The rest of the news

Strike averted: The health care provider Kaiser Permanente reached a tentative agreement with a coalition of unions that has averted a strike that had been planned for today.

Record gas prices: The cost of a gallon of fuel hit $4.67 on Sunday, the highest price ever for the state, CNN reports.

Supply chain crisis: Congestion at U.S. ports and a shortage of truck drivers have left farmers struggling to export their crops.

Stimulus checks: California started issuing another round of Golden State Stimulus II checks on Friday, KTLA reports.

Britney Spears: After nearly 14 years, a judge has ruled to end the conservatorship controlling the artist’s life and finances.

Experts say it’s unusual to end a conservatorship without a mental health screening.


High school football: Two Los Angeles County high schools, St. John Bosco and Santa Ana Mater Dei, are making high school football look increasingly like the Division I college game.


Kern River protest: About 30 people walked the length of the Kern River bed to protest the river’s lack of water, The Bakersfield Californian reports.

Astroworld memorial: Family and friends of Axel Acosta held a memorial service for Acosta, 21, who was killed at the Astroworld Festival in Houston, ABC 13 reports.


Weather warning: Strong winds and possible rain are expected in Lassen, Plumas and Sierra Counties starting Monday.

U.C. Davis hazing: A report from the University of California, Davis, said that the school’s baseball team hazed new players, The Associated Press reports.

What you get

Homeowners are trying to build disaster-proof houses.


Credit…Ryan Liebe for The New York Times

What we’re eating

The ultimate pumpkin pie.

Where we’re traveling

Today’s travel tip comes Lori Silver, who recommends Paso Robles:

“It used to be a place to pass through, but it’s become a wonderful place to stay. The wine tasting rooms have come to town, and that has changed the entire town. New restaurants have come in. Try the Alchemist’s Garden for best cocktails and small bites. Go see a light installation a mile out of town called Sensorio.

We loved the art gallery of locally made high quality art and crafts. In April and October, the main plaza turns into an art event. The stores are charming. We come from Carmel to visit!”

Tell us about your favorite places to visit in California. Email your suggestions to We’ll be sharing more in upcoming editions of the newsletter.


Credit…Christian Arevalo

And before you go, some good news

In the summer of 2012, Audrey Han and Dong Frank Han had to sit next to each other at an internship in New York because the seats were assigned alphabetically.

The two hadn’t known each other before and, despite sharing a last name, aren’t related. They exchanged phone numbers at the end of the summer, but never bothered to call.

Five years later, the two had separately moved to San Francisco and saw each other on a dating app.

“Wow, she was gorgeous,” he recalled.

“He was even more handsome than I remembered,” she said.

The rest, as they say, is history. The couple married last month in front of 100 of their family and friends.

Read their love story in The Times.

Thanks for reading. I’ll be back tomorrow. — Soumya

P.S. Here’s today’s Mini Crossword, and a clue: Canyon reverberation (4 letters).

Mariel Wamsley contributed to California Today. You can reach the team at

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