The stay-at-home-order for Stanislaus County residents will continue for the foreseeable future as hospitals continue to struggle with mounting COVID-19 cases.

California Secretary of Health and Human Services Dr. Mark Ghaly announced on Tuesday that the stay-at-home orders would continue for the San Joaquin Valley and Southern California because the two regions have an ICU capacity of 0%.

Ghaly also outlined guidelines for hospitals in hard hit areas, like the San Joaquin Valley, that could soon be forced into crisis care operations, which could include rationing treatment when staffing and resources are in short supply. When medical professionals have to make such decisions, the state guidelines do not allow for them to be based on age, gender, race, ability to pay or previous medical conditions, according to Kim McCoy Wade, director of the California Department of Aging. The decisions must be made solely on the "likelihood of surviving in the near term."

The stay-at-home-order is triggered when a region's ICU capacity falls below 15%. For the San Joaquin Valley and Southern California, the rate is reported at zero percent, though the rate is not actually zero but rather calculated based on the proportion of ICU patients who have COVID-19 to ensure hospitals have enough beds to treat all critical patients, according to the Associated Press.

The ICU capacity projections are based on four factors: current estimated regional ICU capacity available, measure of current community transmission, current regional case rates and the proportion of ICU cases being admitted. Decreasing community transmission and increasing the health system capacity can help a region’s projected ICU capacity so they can exit the order.

Stanislaus County Health Services Agency spokesperson Kamlesh Kaur said two patients from Stanislaus County have been sent to the state's alternative care site at Sleep Train Arena in Sacramento.

"Once a hospital has met capacity, they are able to send patients to the arena or request for state assistance," Kaur said. "None of our hospitals have requested state assistance yet. Each hospital has their own surge plan and when they decide to activate it, we can assist them according to their needs."

As of Tuesday, Stanislaus County has recorded 33,899 COVID-19 cases, with 3,938 presumed active. There have been 596 residents who have died from COVID-19. Within the county, 335 people are currently hospitalized with the virus and of those, 74 are in intensive care units.

The death rate in Stanislaus County continues to be highest among individuals 65 years and older. The three age breakdowns of 65-74, 75-84, and 85 and older combine to account for 80% of the county's deaths. Those 55-64 years account for 12% of the deaths; 45-54 are 6%; 25-44 are 3%; and those 24 years and under account for less than six deaths, according to the Stanislaus County Health Services Agency.

Conversely, the three age breakdowns of 15-24, 25-34 and 35-44 account for the largest percentage of COVID-19 cases, making up 53.3% of the county's total cases. Those 14 and under account for 7.6%; 45-54 at 15.1%; 65-74 at 6.5%; 75-84 at 3.5% and 85 years and over at 2%.

Stanislaus County's current daily case rate is at 69.8/100,000 residents, Kaur said. In the past 14 days the vast majority of cases have been traced to gatherings. Friends and family gatherings account for 63.55% of the current cases, according to the SCHSA. Other transmissions come from schools (7.74%), religious services (6.83%), miscellaneous sites including gyms, restaurants, and personal services (15.49%), .23% were from rallies or demonstrations and 6.15% declined to tell.