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Coming as no surprise to all and given the low availability of intensive care unit (ICU) beds, the Regional Stay-at-Home Order for the Southern California region, which includes San Diego County, has been extended until further notice. The state announced the extension of the order on Dec. 29, after the region’s ICU availability remained at 0.0%, well below the 15% capacity intended to have for it to be lifted. The San Joaquin Valley region’s stay-at-home order has also been extended.

The order covers 11 counties in the Southern California area, and took effect at 11:59 p.m. Dec. 6, and was initially set to expire on Dec. 28. But as the ICU capacity continued to decline, and effectively listed at 0%, the order was extended for the “foreseeable future,” Dr. Mark Ghaly, Secretary of the California Health and Human Service said.

The state was still compiling hospital and case data, and completing hospital-demand projections for the next four weeks, but Governor Gavin Newsom alluded that the region’s order would remain due to the low capacity of ICU beds.

“It is clear and understandable that it’s likely those stay-at-home orders will be extended,” Governor Newsom said.

However, a 0.0% ICU availability does not necessarily mean there are no ICU beds available. It indicates that hospitals in that region are operating at surge capacities and their ability to treat other ill people – patients with heart attacks, strokes, other traumas, etc. – is limited.

Moving forward, the state will make four-week projections using the following regional indicators:

Current ICU capacity

Current seven-day average case rate

Current transmission rate

Current rate of ICU admission

If the four-week projection is at or above 15% of ICU availability, the region may be released from the order. If it’s below, it will remain under the order.

This also does not mean the region will be under the order for four weeks. It could be shorter if the above indicators improve prior to that time frame and the 15% threshold is met. The projection will be calculated by the state daily.

The number of COVID-19 cases in California continues to rise, topping two million and counting with 2.44 million.

Under the order, the following businesses/recreational facilities were forced to close:

Indoor recreational facilities;

Hair salons and barbershops;

Personal care services;

Museums, zoos, and aquariums;

Movie theaters;

Wineries;

Bars, breweries and distilleries;

Family entertainment centers;

Cardrooms and satellite wagering;

Limited services;

Live audience sports; and

Amusement parks.

Schools with waivers can remain open, along with “critical infrastructure’’ and retail stores, which will be limited to 20% of capacity. Restaurants are restricted to takeout and delivery service only. Hotels are allowed to open “for critical infrastructure support only,’’ while churches would be restricted to outdoor only services. Entertainment production – including professional sports – would be allowed to continue without live audiences.

Governor Newsom unveiled a new plan on Dec. 30 to allow for schools to reopen for in-person learning as early as February and March. He proposed an additional $2 billion in funding to support schools’ spring reopening, with a focus on bringing young elementary students back first, as well as students with disabilities those in foster care, and those who are homeless.

In order to reopen schools for in-person learning, counties must have fewer than 28 COVID-19 cases per 100,000 residents. According to the most recent data released by the California Department of Public Health, only nine large counties have a seven-day average of new cases below that threshold: Alameda, Humboldt, Marin, Napa, San Francisco, San Luis Obispo, San Mateo, Santa Cruz and Sonoma.

Other parts of the new plan include:

• Increased testing: California will work toward testing all school staff and students, with the frequency of testing depending on the county’s reopening tier.

• PPE: All staff will be required to wear surgical masks and all students will be required to wear masks in the classroom.

• Contact tracing: State contact tracers will monitor schools and help coordinate with local health departments.

• Vaccinations: School staff will be prioritized as part of Phase 1B of vaccination distribution.