California Leads U.S. in COVID Deaths, But Experts Say It's Looking Better

California had the highest COVID-19 death toll in the nation with 70,132 by midday Monday, according to data from John Hopkins University, the Associated Press reported.

The data showed California surpassing Texas by about 3,000 and Florida by 13,000, although its per capita fatality rate of 177 per 100,000 people ranks in the bottom third for the U.S.

"There's very little if anything ever to compare that to," Dr. Mark Ghaly, California's health secretary, said of the level of deaths. "Take a moment of silence and reflection on what that's meant for Californians. Families that have lost more than one family member, key breadwinners, people who couldn't protect themselves."

California is in a better situation heading into the colder months this year. Even if there is a new surge, "the level of life-altering behaviors may be different this time around than we saw last winter," Ghaly said.

"I think this winter is going to be a lot better than last winter, especially in California," said Dr. Monica Gandhi, an infectious disease expert at the University of California, San Francisco.

Marm Kilpatrick, an infectious disease expert at the University of California, Santa Cruz, projects that the current level of immunity is still too low to avert another surge, particularly because people are tired of safety precautions.

For more reporting by the Associated Press, see below.

California was the first to impose a statewide stay-at-home order, in March of 2020, and that aggressive action by Governor Gavin Newsom was credited by many with sparing the state from the kind of surge that devastated New York City early in the pandemic.

But later Newsom faced criticism that he was too slow to remove restrictions on businesses and activities. He ultimately faced a recall election last month and voters overwhelmingly chose to keep him in office.

Even as cases fell, Newsom recently announced the nation's first plan to require all eligible schoolchildren to be vaccinated. The state also requires masks in school.

But the state's local governments have been imposing and lifting requirements on their own, creating a confusing patchwork of regulations.

In Los Angeles County, a vaccine requirement just took effect for customers at indoor bars, wineries and a small group of other businesses. But in the city of Los Angeles, a far more aggressive vaccine mandate that applies to virtually all indoor businesses is set to take effect next month. No counties around Los Angeles County have such mandates.

In Northern California, San Francisco and several nearby counties announced plans to begin easing masking requirements as conditions improve. On Friday, Newsom called that "an encouraging sign," while also offering caution about moving too quickly.

"This time last year we were experiencing not dissimilar optimism, only to experience that winter surge," he said.

California has the lowest per capita rate of new coronavirus cases in the country. It is one of only two states that the U.S. Centers for Disease Control and Prevention rates as having a "substantial" rate of transmission, which is a step below the "high" rate that all other states have.

California recorded 67 cases per 100,000 people in the last week; the nation's average is 195. And the state's positivity rate in the last seven days was 2.5 percent while the country averaged 6.1 percent.

The rate at which each infected person spreads the disease, known as the R-effective, has been dropping steadily in California since mid-July and now is at 0.78 statewide. Anything below 1 means the number of infected persons will decrease.

Statewide, hospitalizations crested at nearly 22,200 and ICU admissions at almost 5,000 in January. There are now about 4,100 hospitalizations 2,100 intensive care cases, down from 8,220 and 1,200, respectively, a month ago.

Gandhi thinks California is nearing levels where it could lift most precautions and accept living with a virus that won't go away but one that isn't likely to kill or seriously injure most vaccinated people. She said California seems unlikely to lift restrictions until children 5-11 are widely vaccinated and there are improvements in the rest of the nation.

Meantime, the upcoming flu season will present its own challenges as health care providers test patients to sort out common symptoms from the coronavirus.

Ghaly said the state has been preparing for a crush of testing. Dr. Lee Riley, chairman of the Division of Infectious Disease and Vaccinology at the University of California, Berkeley, School of Public Health, expects problems.

"We're probably going to overwhelm the testing service," Riley said. Moreover, he said the flu can make even vaccinated people more susceptible to lung damage and other severe symptoms.