Covid deaths at highest level since April as Biden pledges to ‘fight like hell’

For all its size and economic might, California has long had one of America’s lowest number of hospital beds relative to its population. Now state officials warn that this shortfall, combined with acute staffing shortages, may prove catastrophic.

In the spring, California had some of the earliest outbreaks and was the first state to issue a stay-at-home order. By summer, many Californians thought the worst was behind them, only to see an explosion of cases at the end of June. The number of cases dropped, then plateaued, before skyrocketing again this fall.

On Sunday, California became the first state to record more than 100,000 cases in a week. The state government estimates that about 12 percent of its confirmed cases end up in a hospital.

Complicating the situation for hospitals is the fact that cases are now exploding in nearly all parts of the country, meaning that healthcare workers cannot be brought from other states as an emergency stopgap like they were in the spring, when the pandemic was mostly concentrated in a few coastal states, experts say.

The shortage of nursing staff will make handling the surge of virus cases “extraordinarily difficult for us in California,” said Carmela Coyle, the head of the California Hospital Association, which represents 400 hospitals across the state.

“This pandemic is a story of shortage,” Ms. Coyle said. “It’s what has made this pandemic unique and different from other disasters.”