In summary

Which California counties have the highest rates of coronavirus hospitalization? CalMatters is following confirmed and suspected cases. Some are a surprise.

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After a brief respite from a moderate COVID-19 summer surge — driven partially by the BA.4 and BA.5 variants of the virus — transmission is once again on the upswing in California. On Oct. 21, cases began climbing, nearly doubling within three weeks to a seven-day average of 11.6 cases per 100,000 people. Those continually climbing numbers, however, likely underrepresent the amount of virus circulating in the population with official testing rates dropping below 200 tests per 100,000 people, a number not seen since the early months of the pandemic when testing was sparse. (At-home, rapid test results are not reported to health departments and not included in state numbers.) 

Hospitalizations exceeded 2,400 the week of Thanksgiving and are expected to continue climbing. However, experts say widespread immunity from vaccination and prior COVID-19 infections, as well as better treatments, are expected to temper hospitalization rates, which remain far below any previous surge seen during the pandemic. Less than half as many people were hospitalized from COVID-19 heading into this holiday season compared to the beginning of last winter’s omicron surge. Nearly 75% of eligible people have gotten a COVID-19 vaccine, but only 16% have received the new bivalent booster that accounts for variants. 

As colder weather and holiday gatherings drive people indoors, however, California’s hospitals are battling a “triple-demic” of flu, respiratory syncytial virus, and COVID-19. The COVID-19 state of emergency, which gives hospitals staffing flexibility to confront overwhelming numbers of patients, is set to end Feb. 28, 2023.

— Kristen Hwang

CalMatters investigative and data-driven reporting is supported by the Inasmuch Foundation, previously known as the Ethics and Excellence in Journalism Foundation.

More on the coronavirus in California:

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California’s response to coronavirus, explained

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Timeline: California reacts to coronavirus

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John Osborn D'Agostino

John Osborn D’Agostino is an award-winning data journalist, web developer and game designer. Previously, he's worked with The Hechinger Report, EdSource, the East Bay Express, Berkeleyside, and the North...

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Lo Bénichou is a visual journalist at CalMatters. Prior to joining the team, they worked at Mapbox and at a number of media organizations like WIRED, Youth Radio, KQED, NPR. At Mapbox, they supported...